Study on the clinical and pathological features of PLA2R-related membranous nephropathy in Japan

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K09257
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Kidney internal medicine
• Research Institution: Nagoya University
• Principal Investigator: Akiyama Shin'ichi 名古屋大学, 医学系研究科, 特任講師 (20500010)
• Co-Investigator(Kenkyū-buntansha): 丸山 彰一 名古屋大学, 医学系研究科, 教授 (10362253)
• Research Collaborator: Yokoyama Hitoshi ; Matsusaka Taiji
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: PLA2R / 膜性腎症 / ネフローゼ症候群 / 臨床

Outline of Final Research Achievements

We studied on the clinical reality and pathophysiology of PLA2R-associated membranous nephropathy, a new concept of primary membranous nephropathy, in Japanese patients. We optimized the method of measuring PLA2R antibody according to the clinical situation of Japanese patients. The PLA2R antibody measurement at the time of renal biopsy was shown not only useful for differentiation of PLA2R-related membranous nephropathy but also useful for predicting prognosis. PLA2R antibody-positive patients who have a history of smoking have been shown to delay complete remission. Patients with a PLA2R antibody concentration of 50 RU/ml or more at the time of renal biopsy were shown to have a significantly worse renal prognosis.

Free Research Field

腎臓内科学

Academic Significance and Societal Importance of the Research Achievements

一次性膜性腎症は、成人ネフローゼ症候群の主要疾患のひとつであり、本邦では予後は必ずしも良好ではなく、診療には高度な専門的技術が必要であった。本研究の成果は、PLA2R関連膜性腎症の鑑別と予後推定に極めて有用な手段とエビデンスを提供し、診療技術のアップデートを促すものである。