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Results

IgG 4 was the most common isotype for all antibodies; IgG 1 and IgG 3 were nearly negligible. IgG 4 levels were positive in a significant proportion of MN patients (AR, 34%; SOD2, 28%; αENO, 43%). Antibody titers were higher in MN than in healthy and pathologic controls (P< 0.005). Anti-NEP IgG 4 did not differ from normal controls (P= 0.12). Anti-PLA2r IgG 4 was detected in 60% of patients and correlated with anti-AR, anti-SOD2, and anti-αENO IgG 4 (P< 0.001). In MN patients negative for the whole antibody panel (20%), 1-year proteinuria was lower compared with patients with at least one antibody positivity (P< 0.05).

Conclusions

Our data suggest that IgG 4 is the prevalent isotype for antibodies against cytoplasmic antigens of podocytes (AR, SOD2, αENO). Their levels were higher than in other proteinuric glomerulonephritides and in normal controls and were correlated with anti-PLA2r. Only baseline …