A biomarker emerging from European research has potential to select out those patients who don't need immunosuppressive treatment for an autoimmune kidney disorder, and therefore could avoid exposure to unnecessary side effects.
Around half of people with idiopathic membranous nephropathy will develop kidney failure, and this can be treated with immunosuppressants, but these powerful and life-saving drugs can also cause serious side effects, and will not benefit all patients. As Julia Hofstra of the Radboud University Nijmegen Medical Center in the Netherlands explains: "It is unclear who should be treated, when treatment should be started, and how long treatment should be continued."
As the disease develops, antibodies start to form against the phospholipase A2 receptor (antiPLA2R antibodies) and damage the kidneys. By screening the blood of 117 people with idiopathic membranous nephropathy, the researchers found that increasing levels of these antibodies linked directly with worsening disease, and patients with higher levels were less likely to recover spontaneously from the condition.
"The data provide hope that in the near future, antiPLA2R antibodies can be detected with a simple assay and measuring the antibody levels may improve optimal treatment in patients with idiopathic membranous nephropathy," says Dr. Hofstra.