In our study, 2 patients had eosinophilia. study was authorized by the Institutional Committee on Human being Research of our institution (authorization No. 4506). The subjects were 22 IgG4-dominating, primary MN individuals. The individuals underwent kidney biopsy without an apparent secondary cause. We performed immunofluorescence (IF) staining for determining PLA2R and THSD7A levels using freezing biopsy samples. Thereafter, we tried to search for potential concomitant living of malignancy by computed tomography, dietary fiber gastroscopy, and colonoscopy. If staining results exposed that 3 of 22 individuals (13.6%) were negative for both PLA2R and THSD7A, nobody was positive for both, leaving 19 individuals (14 with PLA2R, 5 with THSD7A). We compared the baseline and medical characteristics of PLA2R-MN and THSD7A-MN (Table 1). Male individuals accounted for less in those with THSD7A-MN (THSD7A group) than in those with PLA2R-MN (PLA2R group), although this difference did not reach statistical significance (20 vs. 57.1%, Value /th /thead Age, years, [median (IQR)]61 (50, 64)70 (54, 72)0.63Male, n, (%)1 (20.0)8 (57.1)0.15Serum creatine, mg/dl, [median (IQR)]0.77 (0.56, 1.00)0.83 (0.71, 0.88)0.83Serum IgG, mg/dl, [median (IQR)]540 (271, 623)654 (593, 1033)0.02Serum total protein, g/dl, [median (IQR)]4.6 MGC4268 (3.6, 4.7)5.5 (4.8, 6.3)0.08Urine protein, g/gcre, [median (IQR)]7900 (5327, 8778)2647 (1114, 4980)0.049Allergy disease, n, (%)3 (60.0)1 (7.1)0.01Malignancy, n, (%)2 (40.0)1 (7.1)0.08 Open in a separate window Table 2 summarizes the characteristics of five THSD7A-MN cases. Three of five individuals were positive for THSD7A antibody as determined by ELISA (EUROIMMUN, Lbeck, Germany). Of these three individuals, two individuals had not received immunosuppressive therapy, primarily oral glucocorticoid and are in total remission. In three individuals who received immunosuppressive therapy, only one with severe asthma and eosinophilia did not experience total remission in spite of receiving many immunosuppressive providers (oral glucocorticoid, cyclosporine and mizoribine). Table 2. Characteristics of THSD7A individuals with membranous nephropathy. thead th align=”remaining” rowspan=”1″ colspan=”1″ Case /th th align=”center” rowspan=”1″ colspan=”1″ Age /th th align=”center” rowspan=”1″ colspan=”1″ Sex /th th align=”center” rowspan=”1″ colspan=”1″ Urinary protein (g/gCr) /th th align=”center” rowspan=”1″ colspan=”1″ Serum THSD7A |antibody (ELISA) /th th align=”center” rowspan=”1″ colspan=”1″ Co-morbidity /th th align=”center” rowspan=”1″ colspan=”1″ Treatment /th th align=”center” rowspan=”1″ colspan=”1″ Prognosis /th /thead 150Male12.7Not performedAsthma br / EosinophiliaPredonisolone br / Cyclosporine br / MizoribinePartial remission230Female3.2positiveEosinophiliaPredonisoloneComplete remission361Female5.3positiveThymoma br / AsthmaNo immunosuppresiveComplete remission488Female8.8Not performedGastric malignancy br / Rheumatoid arthritisPredonisoloneComplete remission564Female9.1positiveNoNo immunosuppresiveComplete remission Open in a separate window In our single-center cohort study, we described and compared the characteristics of PLA2R-MN and THSD7A-MN. In our study, THSD7A-MN accounted more for main MN compared to earlier report [2]. As reported previously [3], we found malignancy (gastric malignancy and thymoma) in two from five individuals (40%) in THSD7A-MN group. We also found Omeprazole allergic disease is definitely more prevalent in THSD7A-MN group than PTA2R-MN group. Hoxha et?al. [3] reported that from 25?MN individuals with serum THSD7A antibodies, as many as 7 (28%) had a malignant tumor. THSD7A manifestation was reportedly high in colorectal and breast tumor cells [4]. Therefore, aggressive tumor screening is advised for PLA2R-negative MN individuals, particularly those positive for THSD7A. Tumor cells from THSD7A-MN individuals was not necessarily positive for THSD7A [5]. PLA2R-MN offers been recently reported to be associated with malignancy [5]. However, whether main MN (PLA2R-MN and THSD7A-MN) and malignancy exist just coincidentally or are pathogenetically connected is still unclear. Only a few studies have reported the relationship between MN and sensitive disease before THSD7A-MN was reported. In another Japanese study, 4 of 14 individuals (28.6%) had allergic disease (1 case: eosinophilic pneumonitis) as similar to our study [2]. In our study, 2 individuals had eosinophilia. In one case, both eosinophilia and proteinuria were refractory for immunosuppressive therapy [6]. In contrast, another case showed good response to glucocorticoid treatment, leading to no recurrence of eosinophilia [7]. Matsumoto et?al. [8] reported the eosinophils of individuals with angiolymphoid Omeprazole hyperplasia with eosinophilia indicated vascular endothelial growth factor-A, which upregulated THSD7A manifestation, especially under Th2-susceptible conditions in cultured human being umbilical Omeprazole vein endothelial cells. In fact, a significant increase in IgG4 level in the presence of IL-4 (TH2 cytokine) was observed in idiopathic MN [9]. For any clinical program and basic study, we consider that THSD7A-MN is definitely associated with eosinophilia. However, the reason Omeprazole behind THSD7A manifestation in podocytes and not in endothelial cells in THSD7A-MN is definitely unclear. Therefore, further investigation is required to understand the mechanism of THSD7A-MN development. Limitation of this study is definitely small sample size, particularly THSD7A-MN. In conclusion, in our cohort study of main MN with THSD7A-MN or PLA2R-MN, we found that THSD7A-MN may be associated with sensitive disease, especially eosinophilia as well as malignancy. Disclosure statement The authors declare that they have no relevant monetary interests..