Test in Focus
In this episode of “A Test in Focus,” Sanjeev Sethi, M.D., Ph.D., explains Mayo Clinic Laboratories’ new immunohistochemistry assay for the detection of NELL-1 antigen, a biomarker for membranous nephropathy (MN). Identified by Dr. Sethi in 2019, NELL-1 antigen triggers the production of NELL-1 antibodies, which are present in approximately 10% to 15% of MN patients and may be associated with an underlying cancer.
“While many cases of NELL-1 are primary and there’s no disease association, there are multiple studies now that show a subset of NELL-1 positive patients have an underlying malignancy,” Dr. Sethi says. “So if a physician gets a diagnosis of NELL-1 membranous nephropathy, they need to be extra vigilant in screening for hidden malignancies, because it is possible that you treat the malignancy and then the membranous goes away as well.”
Dr. Sethi notes that establishing disease etiology through NELL-1 antigen detection not only enables accurate diagnosis, but elevates treatment outcomes by providing a disease expression on which to base follow-up care.
Listen to learn more about how NELL-1 antigen testing enhances MN diagnosis by equipping providers with specific information on disease manifestation.
Note: Podcasts will not playback on Internet Explorer. Please use an alternative web browser, or listen from your mobile device on a preferred listening app.
NELL1 | Neural Epidermal Growth Factor-Like 1 Protein Immunostain, Technical Component Only (coming soon)
Identification of neural epidermal growth factor-like 1 protein (NELL1) primary membranous nephropathy
- Supplies: Immunostain Technical Only Envelope (T693)
- Specimen Type: Tissue
- Container/Tube: Immunostain Technical Only Envelope
- Preferred: 2 unstained positively charged glass slide (25- x 75- x 1-mm) per test ordered; sections 4-microns thick.
- Acceptable: Formalin-fixed, paraffin-embedded (FFPE) tissue block
- Day(s) and time(s) test performed: Monday through Friday
- Analytic time: 1 to 3 days
The latest from Test in Focus
John Mills, Ph.D., explains Mayo Clinic Laboratories’ approach to MAG antibody testing. The ELISA-based assay uses higher reference ranges and human MAG antigen to detect MAG antibodies, which are associated with a rare, hard-to-treat condition known as DADS neuropathy.
Pua Hopson, D.O., discusses Mayo Clinic Labs’ new disaccharidase activity panel, which measures levels of five digestive enzymes to identify deficiencies that cause carbohydrate maldigestion and can lead to chronic conditions like celiac disease or inflammatory bowel disease. Performed on tissue sample biopsies during upper endoscopy, the activity panel is the gold standard test for detecting disaccharidase deficiencies.
Divyanshu (Div) Dubey, M.B.B.S., explains how Mayo Clinic Labs’ new Kelch-11 antibody test — the first in the world — can confirm diagnosis, guide treatment, and improve outcomes in patients affected by testicular cancer-associated paraneoplastic encephalitis.