Yamaka Kosuke, Aomura Daiki, Harada Makoto, Nakajima Takero, Nimura Takayuki, Hashimoto Koji, Tanaka Naoki, Kamijo Yuji
Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan.
Center for Medical Education and Clinical Training, Shinshu University School of Medicine, Matsumoto, Japan.
Front Immunol. 2025 Jun 16;16:1571147. doi: 10.3389/fimmu.2025.1571147. eCollection 2025.
Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus, often leading to end-stage kidney disease. Serum sulfatide levels are linked to severe kidney vasculitis. This study aimed to assess serum sulfatide levels as a marker for classifying and evaluating disease activity in LN.
We conducted a retrospective study of patients admitted to our hospital between 2003 and 2022. Serum sulfatide levels were compared between LN patients and controls as well as across LN classes based on the International Society of Nephrology/Renal Pathology Society classification. We also analyzed the association between sulfatide levels and active lesions, the Activity Index, and its components.
Serum sulfatide levels were significantly lower in LN patients than in controls (6.90 ± 2.22 vs. 8.34 ± 1.68, = 0.007). Levels across LN classes were as follows: 9.41 nmol/mL in Class I, 8.21 ± 1.68 nmol/mL in Class II, 7.33 ± 2.25 nmol/mL in Class III, 6.14 ± 1.63 nmol/mL in Class IV, and 7.89 ± 2.12 nmol/mL in Class V, with Class IV having the lowest levels. Serum sulfatides were significantly lower in patients with active lesions (6.38 ± 1.81 vs. 8.23 ± 2.55, = 0.006) and negatively correlated with the Activity Index (r = -0.51, < 0.001) and pathological components such as endocapillary hypercellularity, neutrophils/karyorrhexis, and interstitial inflammation ( < 0.001).
Serum sulfatide levels were significantly lower in LN patients than in controls and strongly correlated with active lesions and the Activity Index. These findings suggest sulfatide levels as a useful marker for assessing LN disease activity.
狼疮性肾炎（LN）是系统性红斑狼疮的一种严重并发症，常导致终末期肾病。血清硫苷脂水平与严重的肾血管炎有关。本研究旨在评估血清硫苷脂水平作为LN疾病分类和评估疾病活动度的标志物。
我们对2003年至2022年期间我院收治的患者进行了一项回顾性研究。比较了LN患者与对照组之间以及根据国际肾脏病学会/肾脏病理学会分类的不同LN类别患者的血清硫苷脂水平。我们还分析了硫苷脂水平与活动性病变、活动指数及其组成部分之间的关联。
LN患者的血清硫苷脂水平显著低于对照组（6.90±2.22对8.34±1.68，P=0.007）。不同LN类别的水平如下：I类为9.41 nmol/mL，II类为8.21±1.68 nmol/mL，III类为7.33±2.25 nmol/mL，IV类为6.14±1.63 nmol/mL，V类为7.89±2.12 nmol/mL，其中IV类水平最低。有活动性病变的患者血清硫苷脂水平显著降低（6.38±1.81对8.23±2.55，P=0.006），且与活动指数呈负相关（r=-0.51，P<0.001），与诸如毛细血管内细胞增多、中性粒细胞/核碎裂和间质炎症等病理成分也呈负相关（P<0.001）。
LN患者的血清硫苷脂水平显著低于对照组，且与活动性病变和活动指数密切相关。这些发现表明硫苷脂水平是评估LN疾病活动度的有用标志物。
