血清和尿液半乳糖凝集素-9 和 C-X-C 基序趋化因子配体 10。
Serum and urinary galectin-9 and C-X-C motif chemokine ligand 10.
机构信息
Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
出版信息
Lupus. 2022 Apr;31(4):482-487. doi: 10.1177/09612033221082907. Epub 2022 Mar 4.
BACKGROUND
Systemic lupus erythematosus (SLE) is characterized by a type I interferon (IFN) signature, and traditional methods for its measurement like gene expression analysis are cumbersome for routine use. Thus, we aimed to study galectin-9 as a biomarker and compared it with a validated marker, C-X-C motifchemokine ligand 10(CXCL-10).
METHODS
Ninety-seven patients with SLE (26 years; 89 females) were included and stratified based on renal involvement and activity into - active (SLEDAI > 4) renal (35), active non-renal (32) and inactive renal subgroups (30) along with 20 healthy controls (HC, 25 years; 15 females). The median disease duration was 24 months (6-48), and SLEDAI 2K was 9 (2-15). Serum and urine galectin-9 and CXCL-10 levels were measured by ELISA. Urine levels were normalized with spot urine creatinine values. Follow-up serum and urine galectin-9 levels were measured for those in the active renal group at 6 months.
RESULTS
Patients with SLE had higher serum galectin-9 (5.6 vs 1.7 μg/mL, = .0001) but not urine galectin-9 (0.52 vs 0.32 μg, = .7) levels as compared to HC. Serum galectin-9 but not urine galectin-9 was higher in patients with active as compared to inactive lupus (12.9 - active renal, 16.7 - active non-renal vs 3.57 μg/mL, = .04 and .005). Serum CXCL-10 (0.16 vs 0.05, = .01) and urine CXCL-10 (0 vs 0, = .01) were both significantly higher in the SLE group as compared with HC. Serum but not urine CXCL-10 was higher in the active as compared to inactive lupus (0.2 - active renal, 0.3 - active non-renal vs 0.08 μg/mL, = .9 and .02). Serum galectin-9 showed a modest correlation with CXCL-10 0.4 (0.2-0.6), whereas none was found between their urine levels.Serum galectin-9 and CXCL-10 showed a moderate positive correlation with SLEDAI 2K. Serum galectin-9 showed a greater AUC than CXCL-10 (0.77 vs 0.67) in differentiating active from inactive SLE, and both tested together had the best AUC of 0.82. However, urinary levels had no association with SLEDAI 2K or renal SLEDAI. In a subset of patients with active renal disease, serum galectin-9 but not urine levels declined significantly after 6 months.
CONCLUSION
Serum galectin-9 is a good marker of lupus activity; however, it does not differentiate between active renal and active non-renal disease. It performs slightly better than CXCL-10. Urinary galectin-9 does not reflect renal activity
背景
系统性红斑狼疮（SLE）的特征是存在 I 型干扰素（IFN）特征，而传统的基因表达分析等测量方法对于常规使用来说过于繁琐。因此，我们旨在研究半乳糖凝集素-9（galectin-9）作为生物标志物，并将其与经过验证的标志物 C-X-C 基序趋化因子配体 10（CXCL-10）进行比较。
方法
纳入 97 例 SLE 患者（26 岁；89 名女性），根据肾脏受累和活动情况分为活跃性（SLEDAI > 4）肾脏（35 例）、活跃性非肾脏（32 例）和非活跃性肾脏亚组（30 例），以及 20 名健康对照者（HC，25 岁；15 名女性）。中位疾病持续时间为 24 个月（6-48），SLEDAI 2K 为 9（2-15）。通过 ELISA 测定血清和尿液 galectin-9 和 CXCL-10 水平。尿液水平以尿肌酐值进行标准化。对于活跃性肾脏组的患者，在 6 个月时测量随访血清和尿液 galectin-9 水平。
结果
与 HC 相比，SLE 患者的血清 galectin-9 水平更高（5.6 比 1.7 μg/mL， =.0001），但尿液 galectin-9 水平无差异（0.52 比 0.32 μg， =.7）。与非活跃性狼疮相比，活跃性狼疮患者的血清 galectin-9 水平更高（12.9-活跃性肾脏，16.7-活跃性非肾脏与 3.57 μg/mL， =.04 和.005），而尿液 galectin-9 水平无差异。与 HC 相比，SLE 组的血清 CXCL-10（0.16 比 0.05， =.01）和尿液 CXCL-10（0 比 0， =.01）水平均显著升高。与非活跃性狼疮相比，活跃性狼疮患者的血清 CXCL-10 水平更高（0.2-活跃性肾脏，0.3-活跃性非肾脏与 0.08 μg/mL， =.9 和.02）。血清 galectin-9 与 CXCL-10 呈中度正相关（0.4[0.2-0.6]），而尿液水平无相关性。血清 galectin-9 和 CXCL-10 与 SLEDAI 2K 呈中度正相关。血清 galectin-9 在区分活跃性与非活跃性 SLE 方面的 AUC 大于 CXCL-10（0.77 比 0.67），两者联合的 AUC 最佳，为 0.82。然而，尿液水平与 SLEDAI 2K 或肾脏 SLEDAI 均无关联。在一组活跃性肾脏疾病患者中，血清 galectin-9 水平在 6 个月后明显下降，但尿液水平无变化。
结论
血清 galectin-9 是狼疮活动的良好标志物，但不能区分活跃性肾脏疾病与活跃性非肾脏疾病。它的性能略优于 CXCL-10。尿液 galectin-9 不能反映肾脏活动情况。
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