尿 CD163 是儿童发病狼疮性肾炎活动期的肾脏疾病标志物。
Urinary CD163 is a marker of active kidney disease in childhood-onset lupus nephritis.
机构信息
Department of Biomedical Engineering, University of Houston.
Department of Pathology, Texas Children's Hospital.
出版信息
Rheumatology (Oxford). 2023 Mar 1;62(3):1335-1342. doi: 10.1093/rheumatology/keac465.
OBJECTIVE
The objective of this study was to evaluate the utility of urine CD163 for detecting disease activity in childhood-onset SLE (cSLE) patients.
METHODS
Sixty consecutive pediatric patients fulfilling four or more ACR criteria for SLE and 20 healthy controls were recruited for testing of urinary CD163 using ELISA. SLE disease activity was assessed using the SLEDAI-2K.
RESULTS
Urine CD163 was significantly higher in patients with active LN than inactive SLE patients and healthy controls, with receiver operating characteristics area under the curve values ranging from 0.93 to 0.96. LN was ascertained by kidney biopsy. Levels of CD163 significantly correlated with the SLEDAI, renal SLEDAI, urinary protein excretion and C3 complement levels. Urine CD163 was also associated with high renal pathology activity index and chronicity index, correlating strongly with interstitial inflammation and interstitial fibrosis based on the examination of concurrent kidney biopsies.
CONCLUSION
Urine CD163 emerges as a promising marker for identifying cSLE patients with active kidney disease. Longitudinal studies are warranted to validate the clinical utility of urine CD163 in tracking kidney disease activity in children with lupus.
目的
本研究旨在评估尿液 CD163 在检测儿童发病系统性红斑狼疮（cSLE）患者疾病活动度中的作用。
方法
本研究纳入了 60 例符合 4 项或更多 ACR 标准的儿童 SLE 患者和 20 名健康对照者，采用 ELISA 法检测尿液 CD163。采用 SLEDAI-2K 评估 SLE 疾病活动度。
结果
与无活动 SLE 患者和健康对照组相比，活动性狼疮肾炎（LN）患者的尿液 CD163 显著升高，ROC 曲线下面积为 0.93 至 0.96。LN 通过肾活检确定。CD163 水平与 SLEDAI、肾脏 SLEDAI、尿蛋白排泄和 C3 补体水平显著相关。尿液 CD163 还与高肾脏病理活动指数和慢性指数相关，与同时进行的肾活检中间质炎症和间质纤维化的检查结果具有强烈相关性。
结论
尿液 CD163 可能成为一种有前途的标志物，用于识别有活动性肾脏疾病的 cSLE 患者。需要进行纵向研究来验证尿液 CD163 在监测狼疮儿童肾脏疾病活动度方面的临床应用价值。
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