Setyawan Yuswanto, Susianti Hani, Samsu Nur, Fitri Loeki Enggar
Doctoral Program in Medical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
Division of Nephrology and Hypertension, Department of Internal Medicine Dr. Ramelan Naval Hospital, Surabaya, Indonesia.
Lupus Sci Med. 2025 Apr 7;12(1):e001445. doi: 10.1136/lupus-2024-001445.
Lupus nephritis (LN) is a major cause of morbidity and mortality in patients with SLE, a complex autoimmune disease characterised by loss of tolerance to self-nuclear antigens. Toll-like receptor 4 (TLR4), the first line of defence in the innate immune system, has been linked to the pathogenesis of autoimmune diseases and LN by activating nuclear factor-κB (NF-κB) or interferon regulatory transcription factor 3 (IRF3). Local expression of those biomarkers in pristane-induced lupus mice is still unknown. Therefore, this study aimed to prove the role of TLR4, NF-κB and IRF3 in pristane-induced lupus mice.
The study subjects were female Balb/c pristane-induced lupus mice model, 8-12 weeks of age, n=30, divided into two groups, nephritis (LN group) and non-nephritis (SLE group). The control group were age-matched healthy female Balb/c mice, n=11. All mice were euthanised at weeks 16. Kidney tissue was taken for histopathology examination and TLR4, NF-κB, IRF3 immunofluorescence assay. The diagnosis of LN was based on proteinuria and histopathology examination according to the ISN/RPS 2004 classification of LN. Statistical analysis was performed using IBM SPSS Statistics V.25. P value <0.05 was considered statistically significant.
There were significant differences in the expressions of TLR4, NF-κB and IRF3 among the LN, SLE and healthy control groups (p=0.000), with the highest expression found in the LN group for all markers. The linear regression between TLR4 and NF-κB resulted in p value=0.000; R=0.817; β=0.904. Linear regression between TLR4 and IRF3 showed p value=0.000; R=0.896; β=0.947, which means TLR4 had an 81.7% effect on NF-κB and 89.6% on IRF3 expression.
TLR4, NF-κB and IRF3 expression were increased in lupus, with the highest expression found in the LN group, suggesting that these biomarkers may be responsible for the development of nephritis in SLE, with TLR4 likely playing a dominant role in this pathway. Increased expression of these biomarkers in lupus without nephritis may indicate progression towards nephritis, which still needs to be proven with further research.
狼疮性肾炎(LN)是系统性红斑狼疮(SLE)患者发病和死亡的主要原因,SLE是一种复杂的自身免疫性疾病,其特征是对自身核抗原失去耐受性。Toll样受体4(TLR4)是固有免疫系统的第一道防线,通过激活核因子κB(NF-κB)或干扰素调节转录因子3(IRF3)与自身免疫性疾病和LN的发病机制相关。这些生物标志物在 pristane诱导的狼疮小鼠中的局部表达仍不清楚。因此,本研究旨在证实TLR4、NF-κB和IRF3在pristane诱导的狼疮小鼠中的作用。
研究对象为8至12周龄的雌性Balb/c pristane诱导的狼疮小鼠模型,n = 30,分为两组,肾炎组(LN组)和非肾炎组(SLE组)。对照组为年龄匹配的健康雌性Balb/c小鼠,n = 11。所有小鼠在第16周时安乐死。取肾脏组织进行组织病理学检查以及TLR4、NF-κB、IRF3免疫荧光测定。LN的诊断基于蛋白尿和根据ISN/RPS 2004 LN分类的组织病理学检查。使用IBM SPSS Statistics V.25进行统计分析。P值<0.05被认为具有统计学意义。
TLR4、NF-κB和IRF3在LN组、SLE组和健康对照组中的表达存在显著差异(p = 0.000),所有标志物在LN组中的表达最高。TLR4与NF-κB之间的线性回归结果为p值 = 0.000;R = 0.817;β = 0.904。TLR4与IRF3之间的线性回归显示p值 = 0.000;R = 0.896;β = 0.947,这意味着TLR4对NF-κB表达的影响为81.7%,对IRF3表达的影响为89.6%。
狼疮中TLR4、NF-κB和IRF3的表达增加,在LN组中表达最高,表明这些生物标志物可能与SLE中肾炎的发生有关,其中TLR4可能在该途径中起主导作用。这些生物标志物在无肾炎的狼疮中的表达增加可能表明向肾炎的进展,这仍需要进一步研究证实。