Clinical comparisons between previously diagnosed SLE and newly diagnosed SLE by kidney biopsy

Tonsawan, Pantipa; Sawanyawisuth, Kittisak

doi:10.1186/s13317-020-00140-2

Cited by 3 publications

(1 citation statement)

References 19 publications

(20 reference statements)

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“…Lupus nephritis (LN) is a severe clinical manifestation of SLE [8], and a significant proportion of patients with new onset SLE have LN as the initial presentation [9,10]. According to glomerular pathological features, LN is classified by the International Society of Nephrology/Renal Pathology Society (ISN/RPS) as follows: class I and II are defined as lesions involving only the mesangium; class III is focal glomerulonephritis that affects < 50% of total number of glomeruli; class IV is diffuse glomerulonephritis that involves ≥50% of total number of glomeruli; class V is membranous lupus nephritis; and class VI is characterized by advanced sclerosing lesions [11,12].…”

Section: Introductionmentioning

confidence: 99%

Endocapillary hypercellularity levels are associated with early complete remission in children with class IV lupus nephritis as the initial presentation of SLE

Han

Zhang

et al. 2022

BMC Nephrol

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Background Endocapillary hypercellularity (ECHC) is commonly seen in class IV lupus nephritis (LN), the most common and severe LN in children. Factors influencing early complete remission (CR) in pediatric class IV LN have been poorly described. We investigated the relationship between ECHC levels and early CR in pediatric class IV LN. Methods Patients with newly, simultaneously diagnosed systemic lupus erythematosus (SLE) and class IV LN by renal biopsy from 2012 to 2021 were studied. In this retrospective study, two pathologists who were blind to clinical information reviewed all pathological data retrospectively and classified glomerular lesions according to the revised criteria of the International Society of Nephrology and the Renal Pathology Society (ISN/RPS). The demographics, baseline clinical characteristics, laboratory parameters, renal histopathological findings, treatment regimen and CR at 6 months after immunosuppressive therapy were analyzed. ECHC was categorized as: > 50% (group A), 25–50% (group B) and < 25% (group C). CR was defined as absence of clinical symptoms, 24-hour urinary protein < 0.15 g, and normal levels of serum creatinine and albumin. Results Sixty-four patients were identified: 23, 15 and 26 in groups A, B and C, respectively. Group A had significantly higher levels of D-dimer, urine protein, and SLE disease activity index (SLEDAI) than groups B and C. Group C had a markedly higher estimated glomerular filtration rate (eGFR) than groups A and B. A substantially greater proportion of patients in group A had glomerular microthrombi and basement membrane thickening than in groups B and C. At 6 months post treatment, CR was achieved in 19 (82.6%), 5 (33.3%) and 11 (42.3%) in groups A, B and C, respectively (p < 0.05, group A vs groups B and C). Multiple logistic regression analysis revealed that ECHC and urine protein levels were significantly associated with CR. Conclusion ECHC and urine protein levels may be valuable biomarkers for predicting early CR in pediatric class IV LN.

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Section: Introductionmentioning

confidence: 99%

Endocapillary hypercellularity levels are associated with early complete remission in children with class IV lupus nephritis as the initial presentation of SLE

Han

Zhang

et al. 2022

BMC Nephrol

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Effect of belimumab on kidney-related outcomes in patients with lupus nephritis: post hoc subgroup analyses of the phase 3 BLISS-LN trial

Anders

Furie

Malvar³

et al. 2023

Nephrology Dialysis Transplantation

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Background Data on belimumab efficacy in patients with lupus nephritis (LN) according to diagnosis duration or induction therapy are limited. Post hoc analyses of the Phase 3, randomized, double-blind BLISS-LN study were performed to assess belimumab efficacy on kidney-related outcomes in newly diagnosed and relapsed LN subgroups, and according to use of glucocorticoid pulses at induction. Methods BLISS-LN (GSK BEL114054; NCT01639339) randomized 448 patients with active LN to monthly intravenous belimumab 10 mg/kg or placebo plus standard therapy. Post hoc analyses assessed Primary Efficacy Renal Response (PERR) and Complete Renal Response (CRR) at Week 104, time to kidney-related event or death, and time to first LN flare from Week 24 in newly diagnosed and relapsed patients, and patients with/without glucocorticoid pulses at induction. Results A greater proportion of patients achieved PERR with belimumab versus placebo in the newly diagnosed (69/148 [46.6%] vs 55/148 [37.2%]; odds ratio, OR [95% confidence interval, CI] 1.36 [0.85, 2.20]) and relapsed (27/75 [36.0%] vs 17/75 [22.7%]; 2.31 [1.07, 5.01]) subgroups. Similarly for CRR (newly diagnosed: 50/148 [33.8%] vs 36/148 [24.3%]; OR 1.49 [95% CI 0.88, 2.51] and relapsed: 17/75 [22.7%] vs 8/75 [10.7%]; 3.11 [1.16, 8.31]). Probability of kidney-related event or death, or LN flare, was lower with belimumab versus placebo in both subgroups. Belimumab was associated with improved kidney outcomes versus placebo with or without glucocorticoid pulses at induction. Conclusions Data suggest consistent benefits of belimumab on kidney outcomes for newly diagnosed and relapsed patients, and irrespective of glucocorticoid pulses at induction.

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LncRNA XIST/miR-381-3P/STAT1 axis as a potential biomarker for lupus nephritis

Chen,

Li,

Shang

et al. 2024

Lupus

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Objective We aim to investigate the potential roles of key genes in the development of lupus nephritis (LN), screen key biomarkers, and construct the lncRNA XIST/miR-381-3P/STAT1 axis by using bioinformatic prediction combined with clinical validation, thereby providing new targets and insights for clinical research. Methods Gene expression microarrays GSE157293 and GSE112943 were downloaded from the GEO database to obtain differentially expressed genes (DEGs), followed by enrichment analyses on these DEGs, which were enriched and analyzed to construct a protein-protein interaction (PPI) network to screen core genes. The lncRNA-miRNA-mRNA regulatory network was predicted and constructed based on the miRNA database. 37 female patients with systemic lupus erythematosus (SLE) were recruited to validate the bioinformatics results by exploring the diagnostic value of the target ceRNA axis in LN by dual luciferase and real-time fluorescence quantitative PCR (RT-qPCR) and receiver operating characteristic (ROC). Results The data represented that a total of 133 differential genes were screened in the GSE157293 dataset and 2869 differential genes in the GSE112943 dataset, yielding a total of 26 differentially co-expressed genes. Six core genes (STAT1, OAS2, OAS3, IFI44, DDX60, and IFI44L) were screened. Biological functional analysis identified key relevant pathways in LN. ROC curve analysis suggested that lncRNA XIST, miR-381-3P, and STAT1 could be used as potential molecular markers to assist in the diagnosis of LN. Conclusion STAT1 is a key gene in the development of LN. In conclusion, lncRNA XIST, miR-381-3P, and STAT1 can be used as new molecular markers to assist in the diagnosis of LN, and the lncRNA XIST/miR-381-3P/STAT1 axis may be a potential therapeutic target for LN.

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Clinical comparisons between previously diagnosed SLE and newly diagnosed SLE by kidney biopsy

Cited by 3 publications

References 19 publications

Endocapillary hypercellularity levels are associated with early complete remission in children with class IV lupus nephritis as the initial presentation of SLE

Endocapillary hypercellularity levels are associated with early complete remission in children with class IV lupus nephritis as the initial presentation of SLE

Effect of belimumab on kidney-related outcomes in patients with lupus nephritis: post hoc subgroup analyses of the phase 3 BLISS-LN trial

LncRNA XIST/miR-381-3P/STAT1 axis as a potential biomarker for lupus nephritis

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