Mangoud Amal M, Abd Elbary Eman H, Francis Magdy R, Zanaty Mohamed A, Morsy Ayman T A
Department of Pathology, Faculty of Medicine, Zagazig University, Egypt.
J Egypt Soc Parasitol. 2010 Aug;40(2):321-35.
Lupus nephritis includes a wide range of parenchymal injuries and severity. Better predictors to outcome are needed for patients newly diagnosed with lupus nephritis, so that an appropriate management strategy may be selected. This study aimed to determine whether the ratio of hepatocyte growth factor (HGF) to transforming growth factor beta 1 (TGF beta1) in lupus nephritis could be a prognostic factor for response to therapy with cyclophosphamide and steroids at six months. Also, to determine whether a simple automated system for objective scoring of biopsies of lupus nephritis could be a prognostic factor for response to therapy with cyclophosphamide and steroids at 6 months. Consequently, renal biopsy findings and clinical parameters of thirty parasites-free patients with new onset lupus nephritis were recorded. Histopathologic, clinical, immune-histochemical and morphometric data at baseline served to define the predictive value for outcome after 6 months of therapy. The results showed a significant positive relationship between response to therapy and HGF IS (P= 0.007), HGF ES (P= 0.026), HGF IS/ TGFbeta1 IS ratio (P= 0.022) and HGF ES/ TGFbeta1 ES ratio (P= 0.001). A significant inverse relationship was proved between response to therapy and TGFbeta1 IS (P= 0.025) as well as TGFbeta1 ES (P= 0.017). Also, a significant inverse relationship was present between response to therapy and nuclear index, tubular index and matrix index (P = 0.03, 0.03 and 0.029 respectively).
狼疮性肾炎包括广泛的实质损伤和严重程度。新诊断为狼疮性肾炎的患者需要更好的预后预测指标，以便选择合适的治疗策略。本研究旨在确定狼疮性肾炎中肝细胞生长因子（HGF）与转化生长因子β1（TGFβ1）的比值是否可作为六个月时环磷酰胺和类固醇治疗反应的预后因素。此外，确定一种简单的自动系统用于狼疮性肾炎活检的客观评分是否可作为六个月时环磷酰胺和类固醇治疗反应的预后因素。因此，记录了30例新发无寄生虫狼疮性肾炎患者的肾活检结果和临床参数。基线时的组织病理学、临床、免疫组织化学和形态计量学数据用于确定治疗6个月后预后的预测价值。结果显示治疗反应与HGF IS（P = 0.007）、HGF ES（P = 0.026）、HGF IS/TGFβ1 IS比值（P = 0.022）和HGF ES/TGFβ1 ES比值（P = 0.001）之间存在显著正相关。治疗反应与TGFβ1 IS（P = 0.025）以及TGFβ1 ES（P = 0.017）之间存在显著负相关。此外，治疗反应与核指数、肾小管指数和基质指数之间也存在显著负相关（分别为P = 0.03、0.03和0.029）。
