Nassif Mary Atef
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Cent Eur J Immunol. 2021;46(3):351-359. doi: 10.5114/ceji.2021.109151. Epub 2021 Oct 7.
Lupus nephritis (LN) is considered a serious manifestation of systemic lupus erythematosus (SLE). Therefore, a reliable non-invasive biomarker is a priority for monitoring renal involvement instead of the kidney biopsy. Interleukin 35 (IL-35) has an immunosuppressive and anti-inflammatory role in many autoimmune diseases. However, its role in LN still needs to be elucidated.
To evaluate urine and serum levels of IL-35 in SLE patients with LN and without nephritis identifying their potential as biomarkers of renal involvement.
Urine and serum levels of IL-35 were measured in 42 SLE patients, divided into 22 with LN and 20 without LN, and 20 matched healthy controls using enzyme-linked immunosorbent assay (ELISA). SLE disease activity was assessed for patients by the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K).
Levels of serum and urine IL-35 were significantly higher (p < 0.001) in the LN group compared with those without LN and with controls. In LN patients, a strong correlation (p < 0.001) was observed between serum and urine IL-35 levels with SLEDAI-2K score (r = 0.677 and 0.806 respectively). Furthermore, proteinuria had a strong and significant correlation (p ˂ 0.001) with serum and urinary IL-35 levels in the patients with LN. Serum IL-35 had 90.9% sensitivity and 85% specificity while urine IL-35 had 95.5% sensitivity and 75% specificity to differentiate LN from healthy individuals.
Urine and serum IL-35 may aid in assessment of renal involvement in SLE patients, serving as potential biomarkers of LN.
狼疮性肾炎（LN）被认为是系统性红斑狼疮（SLE）的一种严重表现。因此，一种可靠的非侵入性生物标志物是监测肾脏受累情况而非肾活检的首要任务。白细胞介素35（IL-35）在许多自身免疫性疾病中具有免疫抑制和抗炎作用。然而，其在LN中的作用仍有待阐明。
评估有LN和无肾炎的SLE患者尿液和血清中IL-35水平，确定其作为肾脏受累生物标志物的潜力。
采用酶联免疫吸附测定（ELISA）法检测42例SLE患者（分为22例LN患者和20例无LN患者）及20例匹配的健康对照者尿液和血清中的IL-35水平。通过系统性红斑狼疮疾病活动指数2000（SLEDAI-2K）评估患者的SLE疾病活动度。
与无LN患者及健康对照相比，LN组血清和尿液IL-35水平显著更高（p<0.001）。在LN患者中，血清和尿液IL-35水平与SLEDAI-2K评分之间存在强相关性（p<0.001）（分别为r = 0.677和0.806）。此外，LN患者蛋白尿与血清和尿液IL-35水平之间存在强且显著的相关性（p˂0.001）。血清IL-35区分LN与健康个体的敏感性为90.9%，特异性为85%；尿液IL-35的敏感性为95.5%，特异性为75%。
尿液和血清IL-35可能有助于评估SLE患者的肾脏受累情况，作为LN的潜在生物标志物。
