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Virchows Archiv

, Volume 467, Issue 1, pp 87–94 | Cite as

Reappraisal of PLA2R1 in membranous nephropathy: immunostaining method influence and association with IgG4-dominant phenotype

  • Shigeo HaraEmail author
  • Shunsuke Goto
  • Nozomu Kamiura
  • Akihiro Yoshimoto
  • Takayuki Naito
  • Naoko Imagawa
  • Yukihiro Imai
  • Motoko Yanagita
  • Shinichi Nishi
  • Tomoo Itoh
Original Article

Abstract

The M-type phospholipase A2 receptor (PLA2R1) was identified recently as a specific target antigen in idiopathic membranous nephropathy. However, the influence of different sample preparation techniques on the immunostaining of PLA2R1 is unclear. Previous studies have identified IgG4 as the dominant subclass of PLA2R1 antibodies. However, it remains unclear whether the IgG subclass profiles of the glomerular immune complexes of PLA2R1-positive and -negative idiopathic membranous nephropathy cases are similar. To address these questions, we conducted the present study of 58 idiopathic membranous nephropathy cases. The PLA2R1 positivity rate for the paraffin-embedded sections was 61 %, whereas that for the frozen sections was 65 %. Nonspecific background staining was observed in the frozen sections. Discrepancies between different sample preparations occurred in three cases (6 %); two cases were PLA2R1-positive in paraffin sections and PLA2R1-negative in frozen sections and one case was PLA2R1-negative in paraffin sections and PLA2R1-positive in frozen sections. Regarding the IgG subclass profile, 89 % of the PLA2R1-positive cases demonstrated the IgG4-dominant/codominant phenotype versus 31 % of the PLA2R1-negative cases (p < 0.001). Clinical characteristics and pathological findings did not significantly differ between PLA2R1-positive and -negative cases. In summary, the PLA2R1 immunofluorescence results were not affected by the different sample preparation techniques, although paraffin-embedded sections were preferred for the histological detection of PLA2R1 because of the nonspecific background staining observed in frozen sections. The observed lower frequency of the non-IgG4-dominant/codominant phenotype in PLA2R1-negative idiopathic membranous nephropathy cases may suggest that there are heterogeneous subgroups of this disease.

Keywords

PLA2R1 IgG subclass Membranous nephropathy Immunofluorescence study 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Shigeo Hara
    • 1
    • 6
    Email author
  • Shunsuke Goto
    • 2
  • Nozomu Kamiura
    • 3
  • Akihiro Yoshimoto
    • 3
  • Takayuki Naito
    • 4
  • Naoko Imagawa
    • 5
  • Yukihiro Imai
    • 6
  • Motoko Yanagita
    • 7
  • Shinichi Nishi
    • 2
  • Tomoo Itoh
    • 1
  1. 1.Department of Diagnostic PathologyKobe University Graduate School of MedicineKobeJapan
  2. 2.Division of Nephrology and Kidney CenterKobe University Graduate School of MedicineKobeJapan
  3. 3.Department of NephrologyKobe City Medical Center General HospitalKobeJapan
  4. 4.Nephrology and Dialysis DivisionHiroshima Prefectural HospitalHiroshimaJapan
  5. 5.Department of Diagnostic Pathology and Kobe Advanced Tissue Staining CenterKobe University HospitalKobeJapan
  6. 6.Department of PathologyKobe City Medical Center General HospitalKobeJapan
  7. 7.Department of Nephrology, Graduate School of MedicineKyoto UniversityKyotoJapan

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