{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:59:51Z","timestamp":1790315991790,"version":"4.1.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the predictive value of anti-phospholipase A2 receptor (PLA2R) antibody levels and clinical risk factors for relapse in patients with primary membranous nephropathy (pMN) who achieved remission after immunosuppressive therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a single-center, retrospective, cohort study. Patients with biopsy-proven pMN from Jining No.1 People\u2019s Hospital, who had a follow-up period of at least 12 months, were enrolled. Three landmark time points were evaluated: baseline and 3 and 6 months after treatment initiation. Multivariable Cox regression, receiver operating characteristic curve analysis, and Kaplan\u2013Meier survival analysis were performed. Cox model discrimination and fit were assessed using Harrell\u2019s C-index and the Akaike information criterion (AIC), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 154 patients with PLA2R-associated pMN were included in the study. Among the 96 patients (62.34%) who achieved remission (either partial or complete) within 12 months, 17 (17.71%) experienced a relapse; the median time from treatment initiation to relapse was 23 months. The baseline anti-PLA2R antibody level in the relapse group was significantly higher than that in the non-relapse group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). In the 3-month landmark model, anti-PLA2R antibody seropositivity at 3 months (\u2265 14 RU\/mL) was independently associated with a higher subsequent risk of relapse (HR 9.44, 95% CI 2.69-33.21; p &amp;lt; 0.001), whereas a greater increase in serum albumin from baseline to 3 months was associated with a lower relapse risk (HR 0.85, 95% CI 0.74-0.98; p = 0.03). The 3-month landmark model demonstrated better model fit and discrimination than the 6-month landmark model, with a lower AIC (123.41 vs. 138.84) and a higher C-index (0.83 vs. 0.66).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this exploratory study, anti-PLA2R antibody seropositivity and a blunted increase in serum albumin after 3 months of treatment were identified as potential risk factors for relapse among patients with pMN who achieved remission. Larger-scale studies are warranted for further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1780071","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:31:46Z","timestamp":1790314306000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti-PLA2R antibody levels and clinical risk factors for predicting relapse in primary membranous nephropathy"],"prefix":"10.3389","volume":"17","author":[{"given":"Hongju","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Nephrology, Jining No.1 People\u2019s Hospital","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Jining No.1 People\u2019s Hospital","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijing","family":"Wang","sequence":"additional","affiliation":[{"name":"Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(15)60731-0","article-title":"Pathophysiological advances in membranous nephropathy: time for a shift in patient's care","volume":"385","author":"Ronco","year":"2015","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa0810457","article-title":"M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy","volume":"361","author":"Beck","year":"2009","journal-title":"N Engl J 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