Research parameters

Anti-PLA2R and anti-THSD7A antibodies are present in 75 % to 85 % of patients with primary membranous nephropathy (pMN). The underlying antigens or antibodies in the remaining 15 % to 25 % of pMN patients remained unclear for a long time. In recent years, however, various studies have identified further candidate antigens that appear to be associated with pMN. One promising serological parameter are anti-NELL1 antibodies.

The identification of anti-NELL1 has expanded the spectrum of known target antigens in pMN. In a study by Sethi et al., anti-NELL1 antibodies were detected in the renal glomeruli of 16% of patients with pMN.¹ In particular, those patients who were negative for both anti-PLA2R and anti-THSD7A antibodies were anti-NELL1 positive. A study by Caza et al. also showed that 71% of patients with NELL1-associated pMN had anti-NELL1 antibodies in their serum.²  

NELL1-associated pMN tends to have similar clinical features to other forms of pMN, but may be associated with certain clinical contexts such as malignancies (particularly solid tumours).²  

The discovery of anti-NELL1 antibodies has broadened the spectrum of antigens involved in pMN. The antibodies appear promising for improving diagnostics, risk stratification and monitoring of disease activity. However, further research is needed to fully explain their pathogenic role and define their potential significance as markers of pMN.  

Euroimmun offers two products for the detection of anti-NELL1 antibodies. Both products are approved for research use only and not for use as in vitro diagnostic medical devices in routine clinical practice.

* for research use only, not for in vitro diagnostic use in the sense of EU directive 98/79/EC.

¹Sethi et al. Kidney Int 97(1):163-174 (2020) 

²Caza et al. Kidney Int 99(4):967-976 (2021)