Department of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Front Immunol. 2023 May 23;14:1179986. doi: 10.3389/fimmu.2023.1179986. eCollection 2023.
This study aimed to access whether serum human epididymis protein 4 (HE4) level could identify lupus nephritis (LN) pathological classes in adults and children.
The serum HE4 levels of 190 healthy subjects and 182 patients with systemic lupus erythematosus (SLE) (61 adult-onset LN [aLN], 39 childhood-onset LN [cLN], and 82 SLE without LN) were determined using Architect HE4 kits and an Abbott ARCHITECT i2000SR Immunoassay Analyzer.
Serum HE4 level was significantly higher in the aLN patients (median, 85.5 pmol/L) than in the patients with cLN (44 pmol/L, < 0.001) or SLE without LN (37 pmol/L, < 0.001), or the healthy controls (30 pmol/L, < 0.001). Multivariate analysis showed that serum HE4 level was independently associated with aLN. Stratified by LN class, serum HE4 level was significantly higher in the patients with proliferative LN (PLN) than in those with non-PLN, and this difference was found only in aLN (median, 98.3 49.3 pmol/L, = 0.021) but not in cLN. Stratified by activity (A) and chronicity (C) indices, the aLN patients with class IV (A/C) possessed significantly higher serum HE4 levels than those with class IV (A) (median, 195.5 60.8 pmol/L, = 0.006), and this difference was not seen in the class III aLN or cLN patients.
Serum HE4 level is elevated in patients with class IV (A/C) aLN. The role of HE4 in the pathogenesis of chronic lesions of class IV aLN needs further investigation.
本研究旨在评估血清人附睾蛋白 4（HE4）水平能否用于确定成人和儿童狼疮肾炎（LN）的病理类型。
采用Architect HE4 试剂盒和 Abbott ARCHITECT i2000SR 免疫分析仪，检测 190 例健康对照者和 182 例系统性红斑狼疮（SLE）患者（61 例成人起病 LN [aLN]，39 例儿童起病 LN [cLN]，82 例 SLE 无 LN）的血清 HE4 水平。
aLN 患者的血清 HE4 水平（中位数，85.5 pmol/L）明显高于 cLN 患者（44 pmol/L，<0.001）或 SLE 无 LN 患者（37 pmol/L，<0.001）或健康对照者（30 pmol/L，<0.001）。多变量分析显示，血清 HE4 水平与 aLN 独立相关。按 LN 类型分层，增殖性 LN（PLN）患者的血清 HE4 水平明显高于非 PLN 患者，且仅在 aLN 中观察到这种差异（中位数，98.3 49.3 pmol/L，=0.021），而在 cLN 中则没有。按活动（A）和慢性（C）指数分层，IV 级（A/C）aLN 患者的血清 HE4 水平明显高于 IV 级（A）患者（中位数，195.5 60.8 pmol/L，=0.006），而 III 级 aLN 或 cLN 患者则无此差异。
血清 HE4 水平在 IV 级（A/C）aLN 患者中升高。HE4 在 IV 级 aLN 慢性病变发病机制中的作用需要进一步研究。
