Journal of Peking University(Health Sciences) >
Characteristics of serum autoantibodies in patients with lupus nephritis and tubulointerstitial damage
Received date: 2022-08-16
Online published: 2022-12-19
Supported by
the Science and Technology Program for Basic Research in Shenzhen(JCYJ20190809095811254);Project of Shenzhen Municipal Health Commission(SZXJ2017046)
Objective: To observe the tubulointerstitial damage (TID) in lupus nephritis (LN) and investigate the relationship between autoantibodies and TID in lupus nephritis. Methods: This cross-sectional study was conducted in a comprehensive tertiary hospital in Peking University Shenzhen Hospital. From March 2012 to July 2021, LN patients who performed renal biopsy were enrolled in the study. Clinical, laboratory and pathology data were collected. We classified the patients into none-or-mild group and moderate-to-severe groups according to the severity of interstitial fibrosis (IF) /tubular atrophy (TA) or tubulointerstitial inflammation (TII). The t test, U test and Chi-square test were used for statistical analysis as appropriate. Results: A total of 226 patients were included, of who 190 (84%) were female with a median age of 32 (26, 39) years. 89% (201/226) of the patients who pathologically proved to be proliferative LN by renal biopsy. The frequency of moderate-to-severe TII and moderate-to-severe IF/TA was 30% (67/226) and 34% (76/226) respectively. For autoantibodies, the patients with moderate-to-severe TII had a lower rate of positive serum anti-ribonucleoprotein (anti-RNP) antibodies than the patients with none-or-mild TII (34% vs. 51%), and moderate-to-severe IF/TA had a lower rate of positive anti-ribosomal P protein (anti-P) antibodies than patients with none-or-mild IF/TA (19% vs. 33%). For other clinical indicators, the patients with moderate-to-severe TII and moderate-to-severe IF/TA were more often combined with proliferative LN, hypertension and anemia than the patients with none-or-mild TII and none-or-mild IF/TA, respectively. The patients with moderate-to-severe TII had higher serum creatinine values and lower glomerular filtration rates than the patients with none-or-mild TII. The patients with moderate-to-severe IF/TA had higher serum creatinine values, and lower glomerular filtration rates than the patients with none-or-mild IF/TA. Conclusion: In patients with LN in Southern China, anti-RNP antibodies and anti-P antibodies may be potential protective factors for TII and IF/TA, respectively. More studies are needed to identify the risk factors of lupus patients with TID and investigate the correlation between autoantibodies and TID, which are critical for developing better preventive and therapeutic strategies to improve the survival rate of LN.
Lu ZHANG , Cheng CHEN , Mei-ting WENG , Ai-ping ZHENG , Mei-ling SU , Qing-wen WANG , Yue-ming CAI . Characteristics of serum autoantibodies in patients with lupus nephritis and tubulointerstitial damage[J]. Journal of Peking University(Health Sciences), 2022 , 54(6) : 1094 -1098 . DOI: 10.19723/j.issn.1671-167X.2022.06.006
| 1 | Kiriakidou M , Ching CL . Systemic lupus erythematosus[J]. Ann Intern Med, 2020, 172 (11): ITC81- ITC96. |
| 2 | Fanouriakis A , Kostopoulou M , Cheema K , et al. 2019 Update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis[J]. Ann Rheum Dis, 2020, 79 (6): 713- 723. |
| 3 | Rijnink E , Teng Y , Wilhelmus S , et al. Clinical and histopathologic characteristics associated with renal outcomes in lupus nephritis[J]. Clin J Am Soc Nephrol, 2017, 12 (5): 734- 743. |
| 4 | Broder A , Mowrey WB , Khan HN , et al. Tubulointerstitial da-mage predicts end stage renal disease in lupus nephritis with preserved to moderately impaired renal function: A retrospective cohort study[J]. Semin Arthritis Rheum, 2018, 47 (4): 545- 551. |
| 5 | Yu F , Wu LH , Tan Y , et al. Tubulointerstitial lesions of patients with lupus nephritis classified by the 2003 International Society of Nephrology and Renal Pathology Society system[J]. Kidney Int, 2010, 77 (9): 820- 829. |
| 6 | Olsen NJ , Karp DR . Autoantibodies and SLE: The threshold for disease[J]. Nat Rev Rheumatol, 2014, 10 (3): 181- 186. |
| 7 | Londo?o Jimenez A , Mowrey WB , Putterman C , et al. Brief report: Tubulointerstitial damage in lupus nephritis: A comparison of the factors associated with tubulointerstitial inflammation and renal scarring[J]. Arthritis Rheumatol, 2018, 70 (11): 1801- 1806. |
| 8 | Hong R , Xu D , Hsieh E , et al. Factors associated with renal involvement in primary Sj?gren's syndrome: A meta-analysis[J]. Front Med (Lausanne), 2020, 7, 614482. |
| 9 | Pan HF , Fang XH , Wu GC , et al. Anti-neutrophil cytoplasmic antibodies in new-onset systemic lupus erythematosus and lupus nephritis[J]. Inflammation, 2008, 31 (4): 260- 265. |
| 10 | Shi ZR , Cao CX , Tan GZ , et al. The association of serum anti-ribosomal P antibody with clinical and serological disorders in systemic lupus erythematosus: A systematic review and meta-analysis[J]. Lupus, 2015, 24 (6): 588- 596. |
| 11 | Hochberg MC . Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus[J]. Arthritis Rheum, 1997, 40 (9): 1725. |
| 12 | Petri M , Orbai A , Alarcón G , et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus[J]. Arthritis Rheum, 2012, 64 (8): 2677- 2686. |
| 13 | Weening J , D'Agati V , Schwartz M , et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited[J]. J Am Soc Nephrol, 2004, 15 (2): 241- 250. |
| 14 | Gomes MF , Mardones C , Xipell M , et al. The extent of tubulo-interstitial inflammation is an independent predictor of renal survi-val in lupus nephritis[J]. J Nephrol, 2021, 34 (6): 1897- 1905. |
| 15 | Leatherwood C , Speyer CB , Feldman CH , et al. Clinical characteristics and renal prognosis associated with interstitial fibrosis and tubular atrophy (IFTA) and vascular injury in lupus nephritis biopsies[J]. Semin Arthritis Rheum, 2019, 49 (3): 396- 404. |
| 16 | Wilson PC , Kashgarian M , Moeckel G . Interstitial inflammation and interstitial fibrosis and tubular atrophy predict renal survival in lupus nephritis[J]. Clin Kidney J, 2018, 11 (2): 207- 218. |
| 17 | Austin HA , Muenz LR , Joyce KM , et al. Diffuse proliferative lupus nephritis: identification of specific pathologic features affecting renal outcome[J]. Kidney Int, 1984, 25 (4): 689- 695. |
| 18 | Migliorini P , Baldini C , Rocchi V , et al. Anti-Sm and anti-RNP antibodies[J]. Autoimmunity, 2005, 38 (1): 47- 54. |
| 19 | Carpintero M , Martinez L , Fernandez I , et al. Diagnosis and risk stratification in patients with anti-RNP autoimmunity[J]. Lupus, 2015, 24 (10): 1057- 1066. |
| 20 | Bastian H , Roseman J , Mcgwin G , et al. Systemic lupus erythematosus in three ethnic groups. Ⅻ. Risk factors for lupus nephritis after diagnosis[J]. Lupus, 2002, 11 (3): 152- 160. |
| 21 | Choi M , Fitzpatrick R , Buhler K , et al. A review and meta-analysis of anti-ribosomal P autoantibodies in systemic lupus erythematosus[J]. Autoimmun Rev, 2020, 19 (3): 102463. |
| 22 | Kang J , Park D , Choi S , et al. Protective role of anti-ribosomal P antibody in patients with lupus nephritis[J]. Int J Rheum Dis, 2019, 22 (5): 913- 920. |
| 23 | Tzioufas A , Tzortzakis N , Panou-pomonis E , et al. The clinical relevance of antibodies to ribosomal-P common epitope in two targeted systemic lupus erythematosus populations: A large cohort of consecutive patients and patients with active central nervous system disease[J]. Ann Rheum Dis, 2000, 59 (2): 99- 104. |
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