Clinical significance of the determination of antibodies to thrombospondin type 1 containing domain 7A (THSD7A) in membranous nephropathy

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Abstract

Background. Membranous nephropathy (MN) is an immunocomplex glomerular disease, which is the most common cause of nephrotic syndrome in adults. Numerous studies have established that autoantibodies against the target podocyte autoantigens, including the thrombospondin type 1 domain containing 7A (THSD7A), play a leading role in the development of idiopathic MN.

Aim. To evaluate the prevalence of anti-THSD7A autoantibodies (anti-THSD7A AB) in a group of Russian patients with MN.

Materials and methods. Serum titers of anti-THSD7A AB were tested in 61 patients with biopsy-proven MN and 12 healthy controls.

Results. The prevalence of anti-THSD7A AB was not differing significantly in patients with MN and in the control group (110.9 [71.63; 210.62] and 159.25 [125.64; 231.97] pg/ml, respectively; p=0.111). When comparing subgroups of anti-PLA2R-negative patients and patients who did not receive immunosuppressive therapy with the control group, there were also no statistically significant differences in the Anti-THSD7A AB levels (p>0.05). In the MN group, 1 (1.6%) patient was anti-THSD7A-positive: a 60-year-old man with anti-PLA2R-negative MN and the presence of hormonally inactive adenomas of both adrenal glands and colon polyps (villous adenoma with focal moderate dysplasia, tubulo-villous and tubular adenoma with focal moderate severe dysplasia).

Conclusion. THSD7-associated MN is a rare variant of MN and is usually detected in PLA2R-negative patients. Screening for malignancies in THSD7A-positive MN patients is proposed.

About the authors

Patimat A. Kakhsurueva

Sechenov First Moscow State Medical University (Sechenov University)

Email: kamyshova_e_s@staff.sechenov.ru
ORCID iD: 0009-0002-6138-870X

аспирант каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Elena S. Kamyshova

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: kamyshova_e_s@staff.sechenov.ru
ORCID iD: 0000-0002-1823-0125

канд. мед. наук, доц. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Irina N. Bobkova

Sechenov First Moscow State Medical University (Sechenov University)

Email: kamyshova_e_s@staff.sechenov.ru
ORCID iD: 0000-0002-8007-5680

д-р мед. наук, проф. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Ekaterina V. Stavrovskaya

Sechenov First Moscow State Medical University (Sechenov University)

Email: kamyshova_e_s@staff.sechenov.ru
ORCID iD: 0000-0001-6381-2186

канд. мед. наук, доц. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Tatiana E. Rudenko

Sechenov First Moscow State Medical University (Sechenov University)

Email: kamyshova_e_s@staff.sechenov.ru
ORCID iD: 0000-0002-1296-4494

канд. мед. наук, доц. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Elena Y. Andreeva

Sechenov First Moscow State Medical University (Sechenov University)

Email: kamyshova_e_s@staff.sechenov.ru

канд. мед. наук, врач-нефролог клиники ревматологии, нефрологии и профпатологии им. Е.М. Тареева Университетской клинической больницы №3

Russian Federation, Moscow

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2. Fig. 1. Antibody levels to THSD7A in general and control groups.

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