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血液可溶性 CD89-IgA 复合物可能是预测儿童免疫球蛋白 A 血管炎多器官受累(尤其是肾脏受累)的潜在生物标志物。

Blood soluble CD89-IgA complex may be a potential biomarker for predicting multi-organ involvement, especially renal involvement in children with immunoglobulin A vasculitis.

机构信息

Pediatrics Department, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China.

Qingdao University, Qingdao, Shandong 266000, China.

出版信息

Int Immunopharmacol. 2024 Dec 5;142(Pt A):113063. doi: 10.1016/j.intimp.2024.113063. Epub 2024 Sep 5.

DOI:10.1016/j.intimp.2024.113063
PMID:39241523
Abstract

BACKGROUND

Immunoglobulin A vasculitis (IgAV) is a kind of systemic vasculitis mediated by IgA immune complexes (IgA-ICs). Soluble CD89-IgA complex (sCD89-IgA) as a type of IgA-IC associated with renal involvement in IgAV, the ability of blood sCD89-IgA as a biomarker to predict renal or multi-organ involvement in children with IgAV is not evident, and this study mainly focused on this.

METHODS

The clinical characteristics and blood samples of 57 pediatric patients with IgAV were collected. ELISA was used to detect plasma IgA-ICs and sCD89-IgA levels. Serum IgA levels were detected by Nephelometry method. Statistical analysis was conducted to analyze the relationship between sex, age, serum IgA levels, plasma IgA-ICs levels, plasma sCD89-IgA levels and the involvement of multiple organs (except skin) including kidneys in these patients.

RESULTS

Compared to patients with simple skin involvement, patients with multi-organ involvement, especially kidneys, had higher levels of plasma IgA-ICs and sCD89-IgA, and the statistical difference was significant. In addition, a high level of plasma sCD89-IgA was a high-risk factor for patients to develop multi-organ or renal involvement in addition to the skin. ROC curve analysis showed that the AUC was 0.861 (Sensitivity: 83 %, Specificity: 88 %, p < 0.0001) when plasma sCD89-IgA predicted multi-organ involvement, and AUC 0.926 (Sensitivity: 94 %, Specificity: 88 %, p < 0.0001) for predicting renal involvement.

CONCLUSIONS

The results suggested that plasma sCD89-IgA may be a potential biomarker for predicting multi-organ involvement (in addition to skin), especially renal involvement in IgAV pediatric patients.

摘要

背景

免疫球蛋白 A 血管炎(IgAV)是一种由 IgA 免疫复合物(IgA-ICs)介导的系统性血管炎。可溶性 CD89-IgA 复合物(sCD89-IgA)作为与 IgAV 肾脏受累相关的 IgA-IC 之一,其血液 sCD89-IgA 作为预测 IgAV 患儿肾脏或多器官受累的生物标志物的能力尚不明显,本研究主要集中于此。

方法

收集 57 例儿童 IgAV 患者的临床特征和血液样本。采用 ELISA 法检测血浆 IgA-ICs 和 sCD89-IgA 水平。采用散射比浊法检测血清 IgA 水平。统计分析分析性别、年龄、血清 IgA 水平、血浆 IgA-ICs 水平、血浆 sCD89-IgA 水平与肾脏等多器官(皮肤除外)受累的关系。

结果

与单纯皮肤受累患者相比,多器官受累,尤其是肾脏受累患者的血浆 IgA-ICs 和 sCD89-IgA 水平更高,差异有统计学意义。此外,高水平的血浆 sCD89-IgA 是患者除皮肤外发生多器官或肾脏受累的高危因素。ROC 曲线分析显示,血浆 sCD89-IgA 预测多器官受累的 AUC 为 0.861(灵敏度:83%,特异性:88%,p<0.0001),预测肾脏受累的 AUC 为 0.926(灵敏度:94%,特异性:88%,p<0.0001)。

结论

结果表明,血浆 sCD89-IgA 可能是预测 IgAV 患儿多器官受累(皮肤除外),尤其是肾脏受累的潜在生物标志物。

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