Reliability of Histologic Scoring for Lupus Nephritis: A Community-based Evaluation

Wernick, Richard; Smith, David L.; Houghton, Donald C.; Phillips, David S.; Booth, James L.; Runckel, Douglas N.; Johnson, D. S.; Brown, Kevin K.; Gaboury, Cynthia L.

doi:10.7326/0003-4819-119-8-199310150-00006

Cited by 62 publications

(52 citation statements)

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“…The interpretation and classification of pathologic changes on renal biopsy can be unreliable (113,114), and it was recommended that kidney biopsy tissues be interpreted by a minimum of 2 renal pathologists who are blinded to the clinical history as well as to each other's assessments. If the 2 interpretations differ, then a consensus reading is recommended.…”

Section: Resultsmentioning

confidence: 99%

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

Liang

Schur

Fortin

et al. 2006

Arthritis & Rheumatism

229

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Section: Resultsmentioning

confidence: 99%

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

Liang

Schur

Fortin

et al. 2006

Arthritis & Rheumatism

229

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“…The formalin-fixed tissue was sectioned and treated with H&E, periodic acid-Schiff, and Masson stains. The degree of glomerular damage was assessed, using the National Institutes of Health activity score system (23), by an assessor who was blinded with regard to the source of the sample. Briefly, each sample was assessed on the basis of cellular proliferation, leukocyte infiltration, cellular crescents, and wire loop formation.…”

Section: Assessment Of Autoimmune Disease In (Nzb ϫ Nzw)f 1 Micementioning

confidence: 99%

A Mimic of p21WAF1/CIP1 Ameliorates Murine Lupus

Goulvestre

Chéreau

Nicco

et al. 2005

The Journal of Immunology

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Systemic lupus erythematosus (SLE) is a progressive autoimmune disease characterized by the production of high levels of affinity-matured IgG autoantibodies to dsDNA and, possibly, visceral involvement. Pathogenic autoantibodies result from the activation and proliferation of autoreactive T and B lymphocytes stimulated by epitopes borne by nucleosomal histones. To inhibit the proliferation of autoreactive cells and abrogate the development of SLE, a novel tool, cell cycle inhibiting peptide therapy, was used. Thus, a peptidyl mimic of p21WAF1/CIP1 that inhibits the interaction between cyclin-dependent kinase 4 and type D cyclins abrogated the in vitro proliferative response of T cells to histones and T-independent and T-dependent proliferative responses of B cells. The WAF1/CIP1 mimic also abrogated the in vitro production of total and anti-dsDNA IgG Abs by B cells. Similarly, the p21WAF1/CIP1 construct inhibited the ex vivo T and B cell proliferative responses to histones and decreased the numbers of activated/memory B and T spleen cells. The alterations in the balance of spleen cell subsets resulted from proapoptotic effects of the p21WAF1/CIP1 construct on activated splenocytes. Finally, in vivo, four i.v. injections of the p21WAF1/CIP1 mimic were sufficient to inhibit the progression of the lupus-like syndrome in (NZB × NZW)F1 mice. The levels of anti-dsDNA IgG autoantibodies and the incidence and severity of renal involvement were lower in treated mice than in nontreated mice. Those observations open new avenues for the treatment of SLE and prompt us to evaluate the potential interest of peptidic therapy in human SLE.

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“…[15][16][17][18][19] Moreover, they do not show good reproducibility. 20,21 There are some lesions for which the A or C status is debatable (e.g., the membranoproliferative pattern, of which it is stated that this pattern ". .…”

Section: Activity and Chronicitymentioning

confidence: 99%

The Revisited Classification of GN in SLE at 10 Years

Wilhelmus

Alpers

Cook

et al. 2015

Journal of the American Society of Nephrology

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Over 10 years have passed since the latest revision of the histopathologic classification of lupus nephritis. This revision was a significant improvement compared with the previous version, mainly because of clearer and more concise definitions and the elimination of mixed subclasses. Despite these improvements, there are still some difficulties in the classification for lupus nephritis, many of which are in the definitions provided. In this review, we focus on the difficulties surrounding the evaluation of classes III and IV lesions, particularly the definitions of endocapillary and extracapillary proliferation, the use of the terms endocapillary proliferation and hypercellularity, the clinical relevance of segmental and global subdivision in class IV, and the value of distinguishing lesions that indicate activity and chronicity. Vascular and tubulointerstitial lesions are also discussed. Furthermore, we give an overview of the history of the classification to provide background on the origin and development of the definitions in lupus nephritis. The issues raised in this review as well as the suggestions for improvements may assist with a revision of the lupus nephritis classification in the near future.

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Reliability of Histologic Scoring for Lupus Nephritis: A Community-based Evaluation

Abstract: In a nonreferral setting, the NIH-modified scoring system for lupus nephritis is only moderately reproducible and, if used to prognosticate renal outcome, may result in erroneous predictions of risk for renal failure and response to therapy.

Cited by 62 publications

References 0 publications

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

A Mimic of p21WAF1/CIP1 Ameliorates Murine Lupus

The Revisited Classification of GN in SLE at 10 Years

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