Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.
Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan.
J Microbiol Immunol Infect. 2020 Oct;53(5):797-802. doi: 10.1016/j.jmii.2018.12.003. Epub 2018 Dec 19.
This clinical study investigates the role of 5-methoxytryptophan (5-MTP) in pediatric systemic lupus erythematosus (SLE), with a particular interest in lupus nephritis (LN).
One hundred ten children with SLE were enrolled in the cohort study. Among the patients, seventy-seven (70%) had active LN and thirty-three (30%) were not present with LN during their first visit to the clinic. The diagnoses of LN were biopsy-proven. Serum samples were collected before and after administration of immunosuppressive medications to evaluate 5-MTP levels and regular laboratory data. Data were analyzed longitudinally.
Before any treatment started, patients with active LN had significantly higher 5-MTP levels as compared to patients with no LN (1.021 ± 0.709 vs. 0.719 ± 0.606, P = 0.0456). Also, in patient with active LN, 5-MTP level was significant decreased after treatment, compared with the levels before treatment (1.021 ± 0.709 vs. 0.802 ± 0.597, P = 0.0484). Patients who reached complete remission also had significantly higher initial serum 5-MTP levels than that in patients with no remission (1.244 ± 0.784 vs. 0.846 ± 0.556, P = 0.0488). There was an overall reduction in 5-MTP levels after six months of immunosuppressive treatment, regardless of the disease outcome. Subgroup analysis further revealed a significantly higher 5-MTP level during the active stage of LN (1.127 ± 0.149 vs. 0.742 ± 0.092, P = 0.0384).
We demonstrated that serum 5-MTP level is positively correlated to the disease activity, prognosis, and remission status of pediatric LN in vivo.
本临床研究探讨了 5-甲氧基色氨酸（5-MTP）在儿科系统性红斑狼疮（SLE）中的作用，特别是在狼疮性肾炎（LN）方面。
本队列研究纳入了 110 名 SLE 患儿。其中 77 名（70%）患儿患有活动性 LN，33 名（30%）患儿在首次就诊时无 LN。LN 的诊断通过活检证实。采集患者在接受免疫抑制治疗前后的血清样本，以评估 5-MTP 水平和常规实验室数据。对数据进行纵向分析。
在开始任何治疗之前，与无 LN 的患者相比，患有活动性 LN 的患者的 5-MTP 水平明显更高（1.021±0.709 与 0.719±0.606，P=0.0456）。此外，在活动性 LN 患者中，治疗后 5-MTP 水平与治疗前相比显著降低（1.021±0.709 与 0.802±0.597，P=0.0484）。达到完全缓解的患者的初始血清 5-MTP 水平也明显高于未缓解的患者（1.244±0.784 与 0.846±0.556，P=0.0488）。无论疾病结局如何，经过六个月的免疫抑制治疗后，5-MTP 水平总体呈下降趋势。亚组分析进一步显示，在 LN 的活动期，5-MTP 水平显著升高（1.127±0.149 与 0.742±0.092，P=0.0384）。
我们的研究表明，血清 5-MTP 水平与儿科 LN 的疾病活动度、预后和缓解状态呈正相关。
