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Correlation of Glomerular MBL Deposition with the Clinicopathology and Prognosis of Idiopathic Membranous Nephropathy: A PLA2R Subgroup Analysis

Year: 2026

Type: article

Abstract: Background and Objective: This study investigates the correlation between mannose-binding lectin(MBL)and autoantibody IgG4 against the phospholipase A2 receptor (PLA2R) in idiopathic membranous nephropathy(IMN), as well as the role of MBL in the pathogenesis, clinicopathology, and prognosis of IMN. Methods: Thirty-nine patients with IMN from our hospital between 2021 and 2022 were divided into positive and negative groups based on glomerular MBL immunofluorescence results and anti-PLA2R antibody status. Clinical, pathological, and follow-up data were analyzed. Results: Among the 39 patients, the positive rates of glomerular MBL deposition, IgG4 deposition, and serum anti-PLA2R antibodies were 79.5%, 100%, and 66.7%, respectively. There were no significant differences in clinical and pathological features between MBL-positive and-negative groups, but renal tissue IgG4 expression differed (p<0.05). No significant differences in MBL deposition were found among IMN patients grouped by serum PLA2R antibody levels. Renal tissue C1q expression was low (15.38%). Univariate and multivariate Cox regression analyses showed that lower body weight and C3 negativity were independent promoting factors for patient improved prognosis (P<0.05). Kaplan-Meier survival analysis indicated that there were no significant differences in complete remission, partial remission, and relapse between MBL deposition positive and negative patients (P>0.05). Conclusion: Glomerular MBL deposition correlates with renal tissue IgG4 deposition (p=0.03), suggesting participation in IMN pathogenesis via lectin-pathway complement activation. However, no significant difference in MBL deposition was found between patients grouped by serum anti-PLA2R antibody status, nevertheless, its presence or absence exerts no significant impact on clinical presentation, pathology, or prognosis. In the exploratory Cox regression analysis, negative glomerular C3a deposition was associated with a higher likelihood of remission, though this requires validation in larger cohorts.

Source: International Journal of General Medicine

DOI: 10.2147/ijgm.s631116