1. M-Type Phospholipase A2 Receptor as Target Antigen in Idiopathic Membranous Nephropathy
Laurence H. Beck, Jr., M.D., Ph.D., Ramon G.B. Bonegio, M.D., Gerard Lambeau, Ph.D., David M. Beck, B.A.,
N Engl J Med 2009;361:11-21.
R3 So-Hee, Park/prof . Chun-gyoo,Ihm

2. Idiopathic membranous nephropathy
A common cause of the nephrotic syndrome in adults
An organ-specific autoimmune disease.
Target antigen has been elusive
Megalin
To identify the target antigen in idiopathic membranous nephropathy
Circulating antibodies from adults
Western blotting
Mass spectrometry

3. Methods Serum and Kidney-Tissue Sample Serum samples
Membranous nephropathy with other glomerular or autoimmune disorders
Normal controls
Idiopathic membranous nephropathy
Renal biopsy in patients lacked features suggestive of secondary membranous nephropathy

4. Western Blotting
Mass Spectrometry Analysis and Data
Interpretation
Immunoprecipitation
Immunohistologic Analysis

5. Results Identification of a Target Protein in Glomerular Extracts
37 patients with idiopathic membranous nephropathy.
A 185-kD protein band : 26 patients (70%)
Not react with this antigen
30 normal controls
15 patients with proteinuric conditions other than membranous nephropathy
7 patients with other autoimmune disorders
8 patients with secondary membranous disorders

13. Conclusion Circulating auto antibodies against PLA2R
Normal glomerular podocytes
Glomerular immune
The specificity of these findings for idiopathic membranous nephropathy
Implications for the diagnosis and treatment of the disease.