Lan Lan, Han Fei, Lang Xiabing, Chen Jianghua
Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, P.R. China.
PLoS One. 2016 Jul 26;11(7):e0159964. doi: 10.1371/journal.pone.0159964. eCollection 2016.
Early diagnosis is important for the outcome of lupus nephritis (LN). However, the pathological type of lupus nephritis closely related to the clinical manifestations; therefore, the treatment of lupus nephritis depends on the different pathological types.
To assess the level of monocyte chemotactic protein (MCP-1), fractalkine (Fkn), and receptor for advanced glycation end product (RAGE) in different pathological types of lupus nephritis and to explore the value of these biomarkers for predicting the prognosis of lupus nephritis.
Patients included in this study were assessed using renal biopsy. Class III and class IV were defined as the proliferative group, class V as non-proliferative group, and class V+III and class V+IV as the mixed group. During the follow-up, 40 of 178 enrolled patients had a poor response to the standard immunosuppressant therapy. The level of markers in the different response groups was tested.
The levels of urine and serum MCP-1, urine and serum fractalkine, and serum RAGE were higher in the proliferative group, and lower in the non-proliferative group, and this difference was significant. The levels of urine and serum MCP-1 and serum RAGE were lower in the poor response group, and these differences were also significant. The relationship between urine MCP-1 and urine and serum fractalkine with the systemic lupus erythematosus disease activity index was evaluated.
The concentration of cytokines MCP-1, fractalkine, and RAGE may be correlated with different pathology type of lupus nephtitis. Urine and serum MCP-1 and serum RAGE may help in predicting the prognosis prior to standard immunosuppressant therapy.
早期诊断对狼疮性肾炎(LN)的预后很重要。然而,狼疮性肾炎的病理类型与临床表现密切相关;因此,狼疮性肾炎的治疗取决于不同的病理类型。
评估不同病理类型狼疮性肾炎中单核细胞趋化蛋白(MCP-1)、fractalkine(Fkn)和晚期糖基化终末产物受体(RAGE)的水平,并探讨这些生物标志物对预测狼疮性肾炎预后的价值。
本研究纳入的患者接受肾活检评估。Ⅲ类和Ⅳ类定义为增殖组,Ⅴ类为非增殖组,Ⅴ+Ⅲ类和Ⅴ+Ⅳ类为混合组。在随访期间,178例入组患者中有40例对标准免疫抑制治疗反应不佳。检测不同反应组中标志物的水平。
增殖组的尿和血清MCP-1、尿和血清fractalkine以及血清RAGE水平较高,非增殖组较低,且差异有统计学意义。反应不佳组的尿和血清MCP-1以及血清RAGE水平较低,这些差异也有统计学意义。评估了尿MCP-1以及尿和血清fractalkine与系统性红斑狼疮疾病活动指数之间的关系。
细胞因子MCP-1、fractalkine和RAGE的浓度可能与狼疮性肾炎的不同病理类型相关。尿和血清MCP-1以及血清RAGE可能有助于在标准免疫抑制治疗前预测预后。