尿髓样IgA Fc α受体(CD89)和转谷氨酰胺酶-2作为活动性IgA肾病和henoch-Schönlein紫癜性肾炎的新生物标志物

Rafael N. Moresco , Marijn M. Speeckaert , Slawomir C. Zmonarski , Magdalena Krajewska , Ewa Komuda-Leszek , Agnieszka Perkowska-Ptasinska , Loreto Gesualdo , Maria T. Rocchetti , Sigurd E. Delanghe , Raymond Vanholder , Wim Van Biesen , Joris R. Delanghe
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Therefore, urinary CD89 and TG2 could be potential biomarkers to identify active IgAN/HSPN.</p></div><div><h3>Methods</h3><p>In this multicenter study, 160 patients with IgAN or HSPN were enrolled. Urinary concentrations of CD89 and TG2, as well as some other biochemical parameters, were measured.</p></div><div><h3>Results</h3><p>Urinary CD89 and TG2 were lower in patients with active IgAN/HSPN compared to IgAN/HSPN patients in complete remission (<em>P</em> <!-->&lt;<!--> <!-->0.001). The CD89xTG2 formula had a high ability to discriminate active <strong>from inactive</strong> IgAN/HSPN in both situations<strong>: CD89xTG2/proteinuria ratio</strong> (AUC: 0.84, <em>P</em> <!-->&lt;<!--> <!-->0.001, sensitivity: 76%, specificity: 74%) <strong>and CD89xTG2/urinary creatinine ratio</strong> (AUC: 0.82, <em>P</em> <!-->&lt;<!--> <!-->0.001, sensitivity: 75%, specificity: 74%). 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引用次数: 26

摘要

diga肾病(IgAN)和Henoch-Schönlein紫癜性肾炎(HSPN)是具有共同中心致病机制的肾小球疾病。两种情况下均可观察到含有IgA1、髓系IgA Fcα受体(Fcα ri /CD89)和转谷氨酰胺酶-2 (TG2)的免疫复合物的形成。因此,尿CD89和TG2可能是鉴定活性IgAN/HSPN的潜在生物标志物。方法本研究纳入160例IgAN或HSPN患者。检测尿CD89、TG2浓度及其他生化指标。结果IgAN/HSPN活跃患者的CD89和TG2水平低于IgAN/HSPN完全缓解患者(P <0.001)。CD89xTG2配方在两种情况下都具有高度的区分活性和非活性IgAN/HSPN的能力:CD89xTG2/蛋白尿比(AUC: 0.84, P <0.001,敏感性:76%,特异性:74%)和CD89xTG2/尿肌酐比值(AUC: 0.82, P <0.001,敏感性:75%,特异性:74%)。尿CD89与TG2相关性显著(r = 0.711, P <0.001)、蛋白尿和尿CD89 (r = - 0.585, P <0.001),蛋白尿和尿TG2 (r = - 0.620, P <0.001)。结论尿样中CD89和TG2的检测可用于IgAN/HSPN活动性的鉴别。
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Urinary myeloid IgA Fc alpha receptor (CD89) and transglutaminase-2 as new biomarkers for active IgA nephropathy and henoch-Schönlein purpura nephritis

Background

IgA nephropathy (IgAN) and Henoch-Schönlein purpura nephritis (HSPN) are glomerular diseases that share a common and central pathogenic mechanism. The formation of immune complexes containing IgA1, myeloid IgA Fc alpha receptor (FcαRI/CD89) and transglutaminase-2 (TG2) is observed in both conditions. Therefore, urinary CD89 and TG2 could be potential biomarkers to identify active IgAN/HSPN.

Methods

In this multicenter study, 160 patients with IgAN or HSPN were enrolled. Urinary concentrations of CD89 and TG2, as well as some other biochemical parameters, were measured.

Results

Urinary CD89 and TG2 were lower in patients with active IgAN/HSPN compared to IgAN/HSPN patients in complete remission (P < 0.001). The CD89xTG2 formula had a high ability to discriminate active from inactive IgAN/HSPN in both situations: CD89xTG2/proteinuria ratio (AUC: 0.84, P < 0.001, sensitivity: 76%, specificity: 74%) and CD89xTG2/urinary creatinine ratio (AUC: 0.82, P < 0.001, sensitivity: 75%, specificity: 74%). Significant correlations between urinary CD89 and TG2 (r = 0.711, P < 0.001), proteinuria and urinary CD89 (r =  0.585, P < 0.001), and proteinuria and urinary TG2 (r =  0.620, P < 0.001) were observed.

Conclusions

Determination of CD89 and TG2 in urine samples can be useful to identify patients with active IgAN/HSPN.

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