Urinary soluble CD163 is useful as “liquid biopsy” marker in lupus nephritis at both diagnosis and follow-up to predict impending flares

IF 4.7 Q2 IMMUNOLOGY Journal of Translational Autoimmunity Pub Date : 2024-06-20 DOI:10.1016/j.jtauto.2024.100244
Yves Renaudineau , Dominique Chauveau , Stanislas Faguer , Antoine Huart , David Ribes , Gregory Pugnet , Laurent Sailler , Thibaut Jamme , Emmanuel Treiner , Françoise Fortenfant , Chloé Bost , Caroline Carlé , Julie Belliere
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Abstract

Lupus nephritis (LN) diagnosis and follow-up requires noninvasive biomarkers. Therefore, the added value of coupling the urinary soluble (s)CD163/creatinuria ratio with serological markers was evaluated in a real-world clinical practice. To this end, a monocentric and retrospective study was conducted in 139 SLE patients with biopsy-proven nephritis having an active LN (LN-A, n = 63 with a positive SLEDAI-renal score) or inactive (n = 76), as well as 98 non-renal SLE patients. The urinary sCD163/creatinuria ratio outperformed serological markers for predicting LN-A (AUC>0.972; p < 10−4 with a 100 % specificity threshold fixed at 320 ng/mmol), and for monitoring renal activity allowing prediction of impending flares and remissions in follow-up (AUC = 0.789, p < 10−4). LN-A patients with an elevated spot proteinuria/creatinuria ratio (p = 8 × 10−6) and sCD163/creatinuria ratio (p = 10−3) were at risk for developing end-stage kidney disease but sCD163/creatinuria ratio cannot substitute kidney biopsy to discriminate LN-A from other glomerulonephritis. Among serological markers (n = 14), anti-dsDNA and anti-C1q antibodies (Abs) (AUC>0.750 versus non-LN patients, and AUC>0.640 versus LN-IR patients) best predicted LN-A, and higher levels were retrieved in class III/IV proliferative LN-A. In multivariate logistic regression analysis, the urinary sCD163/creatinuria ratio remained the only statistically significant biomarker to predict LN-A (p < 0.001). In conclusion, and as compared to classical serological markers, the urinary sCD163/creatinuria ratio provides an additional parameter for monitoring LN patients.

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尿液可溶性 CD163 可作为狼疮肾炎的 "液体活检 "标记物,在诊断和随访时预测即将复发的病情
狼疮性肾炎(LN)的诊断和随访需要无创生物标志物。因此,我们在实际临床实践中评估了尿可溶性(s)CD163/肌酐尿比值与血清学标志物相结合的附加值。为此,我们对 139 名经活检证实患有活动性 LN(LN-A,n = 63,SLEDAI-肾脏评分为阳性)或非活动性(n = 76)肾炎的系统性红斑狼疮患者,以及 98 名非肾脏病系统性红斑狼疮患者进行了单中心回顾性研究。在预测LN-A(AUC>0.972; p <10-4,100%特异性阈值固定为320纳克/毫摩尔)和监测肾脏活动方面,尿液sCD163/肌酐尿量比值优于血清学标记物(AUC = 0.789, p <10-4)。斑点蛋白尿/肌酐尿比值升高(p = 8 × 10-6)和 sCD163/肌酐尿比值升高(p = 10-3)的 LN-A 患者有发展为终末期肾病的风险,但 sCD163/肌酐尿比值不能替代肾活检来区分 LN-A 和其他肾小球肾炎。在血清学标记物(n = 14)中,抗dsDNA和抗C1q抗体(Abs)(与非LN患者相比,AUC>0.750;与LN-IR患者相比,AUC>0.640)最能预测LN-A,在III/IV级增生性LN-A中,Abs水平更高。在多变量逻辑回归分析中,尿 sCD163/肌酐尿比值仍是预测 LN-A 的唯一具有统计学意义的生物标志物(p <0.001)。总之,与传统的血清学标志物相比,尿液中的 sCD163/肌酐比值为监测 LN 患者提供了一个额外的参数。
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来源期刊
Journal of Translational Autoimmunity
Journal of Translational Autoimmunity Medicine-Immunology and Allergy
CiteScore
7.80
自引率
2.60%
发文量
33
审稿时长
55 days
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