April 6, 2017
Granular capillary loop staining for thrombospondin type-1 domain-containing 7A (THSD7A). Our understanding of the pathogenesis of membranous glomerulopathy was transformed with the discovery that most cases of ‘idiopathic’ MN are due to autoantibodies directed against the phospholipase A2 receptor (PLA2R) protein.1 More recently, thrombospondin type-1 domain-containing 7A (THSD7A) protein was described as a second antigenic target of autoantibodies in this disease.2 Recent reports have implicated malignancy as the underlying etiology in some cases of THSD7A-associated MN.3-5
1. Beck LH, Bonegio RG, Lambeau G, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med 2009; 361: 11-21.
2. Tomas NM, Beck LHJ, Meyer-Schwesinger C, et al. Thrombospondin type-1 domain-containing 7A in idiopathic membranous nephropathy. N Engl J Med 2014; 371: 2277-2287.
3. Stahl PR, Hoxha E, Wiech T, et al. THSD7A expression in human cancer. Genes, chromosomes & cancer 2017; 56: 314-327.
4. Hoxha E, Wiech T, Stahl PR, et al. A Mechanism for Cancer-Associated Membranous Nephropathy. N Engl J Med 2016; 374: 1995-1996.
5. Hoxha E, Beck LH, Jr., Wiech T, et al. An Indirect Immunofluorescence Method Facilitates Detection of Thrombospondin Type 1 Domain-Containing 7A-Specific Antibodies in Membranous Nephropathy. J Am Soc Nephrol 2017; 28: 520-531.