A new chemiluminescence immunoassay for phospholipase A2 receptor 1 autoantibodies allows early identification of autoantibody recurrence in patients with membranous nephropathy
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A new chemiluminescence immunoassay for phospholipase A2 receptor 1 autoantibodies allows early identification of autoantibody recurrence in patients with membranous nephropathy. / Hoxha, Elion; Stahl, Rolf; Reinhard, Linda; Kühnl ; Schlumberger ; Dähnrich .
In: KIDNEY INT REP, Vol. 6, No. 4, 04.2021, p. 928-935.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - A new chemiluminescence immunoassay for phospholipase A2 receptor 1 autoantibodies allows early identification of autoantibody recurrence in patients with membranous nephropathy
AU - Hoxha, Elion
AU - Stahl, Rolf
AU - Reinhard, Linda
AU - Kühnl ,
AU - Schlumberger ,
AU - Dähnrich ,
PY - 2021/4
Y1 - 2021/4
N2 - BackgroundCirculating autoantibodies against the M-type phospholipase A2 receptor 1 (PLA2R1) are important biomarkers in membranous nephropathy (MN), supporting the diagnosis and the clinical monitoring of patients. Standardized recombinant cell-based indirect immunofluorescence assay (RC-IFA) and enzyme-linked immunosorbent assay (ELISA) are widely established for the detection of anti-PLA2R1 autoantibodies (PLA2R1-ab). The RC-IFA provides higher sensitivity than the ELISA, but lacks exact graduated quantification of antibody levels. In this study, we evaluated the diagnostic performance of a novel PLA2R1-ab immunoassay based on chemiluminescence (ChLIA) by comparing it to RC-IFA and ELISA in samples from patients with MN with different diagnostic scenarios.MethodsSerum samples from patients with biopsy-proven MN and disease controls were analyzed for PLA2R1-ab by ChLIA, ELISA, and RC-IFA.ResultsThe ChLIA demonstrated almost perfect agreement with RC-IFA for the identification of patients with PLA2R1-associated MN, while additionally allowing fine-graduated quantification of PLA2R1-ab levels. In patients with a relapse of MN, the ChLIA allowed an earlier detection of PLA2R1-ab recurrence by at least 3 months in 63% of cases compared with the ELISA.ConclusionsThe PLA2R1-ab ChLIA had the same excellent diagnostic performance as the RC-IFA and outperformed the ELISA in the diagnosis of MN and the early identification of relapses. It thus presents a favorable tool for accurate PLA2R1-ab assessment in routine diagnostic settings, while enabling fast processing and fully automated random-access implementation.
AB - BackgroundCirculating autoantibodies against the M-type phospholipase A2 receptor 1 (PLA2R1) are important biomarkers in membranous nephropathy (MN), supporting the diagnosis and the clinical monitoring of patients. Standardized recombinant cell-based indirect immunofluorescence assay (RC-IFA) and enzyme-linked immunosorbent assay (ELISA) are widely established for the detection of anti-PLA2R1 autoantibodies (PLA2R1-ab). The RC-IFA provides higher sensitivity than the ELISA, but lacks exact graduated quantification of antibody levels. In this study, we evaluated the diagnostic performance of a novel PLA2R1-ab immunoassay based on chemiluminescence (ChLIA) by comparing it to RC-IFA and ELISA in samples from patients with MN with different diagnostic scenarios.MethodsSerum samples from patients with biopsy-proven MN and disease controls were analyzed for PLA2R1-ab by ChLIA, ELISA, and RC-IFA.ResultsThe ChLIA demonstrated almost perfect agreement with RC-IFA for the identification of patients with PLA2R1-associated MN, while additionally allowing fine-graduated quantification of PLA2R1-ab levels. In patients with a relapse of MN, the ChLIA allowed an earlier detection of PLA2R1-ab recurrence by at least 3 months in 63% of cases compared with the ELISA.ConclusionsThe PLA2R1-ab ChLIA had the same excellent diagnostic performance as the RC-IFA and outperformed the ELISA in the diagnosis of MN and the early identification of relapses. It thus presents a favorable tool for accurate PLA2R1-ab assessment in routine diagnostic settings, while enabling fast processing and fully automated random-access implementation.
U2 - 10.1016/j.ekir.2020.12.034
DO - 10.1016/j.ekir.2020.12.034
M3 - SCORING: Journal article
VL - 6
SP - 928
EP - 935
JO - KIDNEY INT REP
JF - KIDNEY INT REP
SN - 2468-0249
IS - 4
ER -