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Zhang CX, Cai L, Shao K, Wu J, Zhou W, Cao LF, Chen TX. Serum IP-10 is useful for identifying renal and overall disease activity in pediatric systemic lupus erythematosus. Pediatr Nephrol 2018; 33:837-845. [PMID: 29264699 DOI: 10.1007/s00467-017-3867-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 12/05/2017] [Accepted: 12/06/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Traditional serological biomarkers often fail to assess systemic lupus erythematosus (SLE) disease activity and discriminate lupus nephritis (LN). The aim of this study was to identify novel markers for evaluating renal and overall disease activity in Chinese patients with pediatric systemic lupus erythematosus (pSLE). METHODS The study included 46 patients with pSLE (35 girls, 11 boys; average age 13.3 ± 2.6 years) and 31 matched healthy controls (22 girls, 9 boys; average age 12.3 ± 2.4 years). The SLE Disease Activity Index (SLEDAI) and renal SLEDAI were used to assess disease activity. Nine different soluble mediators in plasma, including tumor necrosis factor alpha (TNF-α), platelet-derived growth factor-BB (PDGF-BB), interferon (IFN) gamma inducible protein 10 (IP-10), interleukin (IL)-1β, IFN-γ, IL-17A, IL-2, Fas and Fas ligand, were measured by Luminex assay and compared between patients with active and inactive pSLE as well as between patients with pSLE with active and inactive renal disease. Receiver operating characteristic curve analysis was used to measure the discrimination accuracy. RESULTS Of the 46 patients with pSLE, 30 (65.2%) had LN. These patients had significantly elevated levels of serum TNF-α, PDGF-BB, IP-10 and Fas. The serum levels of IP-10 were also significantly higher in patients with active pSLE. We found that IP-10 was also more sensitive and specific than conventional laboratory parameters, including anti-double-stranded DNA and complement components C3 and C4, for distinguishing active lupus from quiescent lupus. The serum level of IP-10 was also significantly increased in children with pSLE with active renal disease relative to those with inactive renal disease. There was also a positive correlation between serum IP-10 levels and renal SLEDAI scores as well as with 24 h urine protein. CONCLUSIONS Serum IP-10 is useful for identifying renal and overall disease activity in children with pSLE.
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Affiliation(s)
- Chen-Xing Zhang
- Department of Allergy and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University, 1678, Dongfang Road, Shanghai, China.,Division of Immunology, Institute of Pediatric Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Cai
- Department of Allergy and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University, 1678, Dongfang Road, Shanghai, China.,Division of Immunology, Institute of Pediatric Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Kang Shao
- Department of Laboratory Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Wu
- Division of Immunology, Institute of Pediatric Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Zhou
- Department of Nephrology and Rheumatology, Shanghai Children's Medical Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lan-Fang Cao
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Tong-Xin Chen
- Department of Allergy and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University, 1678, Dongfang Road, Shanghai, China. .,Division of Immunology, Institute of Pediatric Translational Medicine, Shanghai Jiao Tong University, Shanghai, China. .,Department of Nephrology and Rheumatology, Shanghai Children's Medical Center, Shanghai Jiao Tong University, Shanghai, China.
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Ho RC, Ong H, Thiaghu C, Lu Y, Ho CS, Zhang MW. Genetic Variants That Are Associated with Neuropsychiatric Systemic Lupus Erythematosus. J Rheumatol 2016; 43:541-51. [PMID: 26773105 DOI: 10.3899/jrheum.150884] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVE While genetic risks have been implicated in systemic lupus erythematosus (SLE), the involvement of various genotypes in neuropsychiatric SLE (NPSLE) remains uncertain. The present metaanalysis aimed to combine data from different studies and evaluate the association between each genotype and the risk of developing NPSLE. METHODS Studies were searched and retrieved from online databases (PubMed, EMBASE, BIOSIS, and ScienceDirect). Case-control studies were chosen if they reported genotype frequencies of the γ Fc region (FCγR) receptors II-A, III-A, and III-B; tumor necrosis factor-α (TNF-α); mannan-binding lectin (MBL); integrin alpha M (ITGAM); interleukin (IL) 1, IL-1β, and IL-6; IL-10 promoter; and vitamin D genes. The OR were used to assess the strength of this association between patients with NPSLE and SLE. RESULTS A total of 33 studies were considered in this metaanalysis. The results suggest that these genotypes demonstrated a significant association with NPSLE: the homozygous FCγR IIIa 158 FF genotype (OR 1.89, p = 0.03 for FF vs VV + FV), heterozygous FCγR IIIb NA1/2 genotype (OR 2.14, p = 0.03 for NA1/2 vs NA1/1; OR 1.81, p = 0.04 for NA1/2 vs NA1/1 + NA2/2), and homozygous ITGAM rs1143679 HH genotype (OR 3.39, p = 0.04 for HH vs RH; OR 3.11, p = 0.048 for HH vs RR + RH). Polymorphisms of the TNF-α, MBL2, IL-1, IL-1β, IL-6, IL-10 promoter, and vitamin D receptor genes did not show a statistically significant association with the risk of developing NPSLE (p > 0.05). CONCLUSION This metaanalysis indicates that polymorphisms in the pathways of immune complex clearance, such as the FcγRIIIa, FcγRIIIb, and ITGAM genotypes, are potential susceptibility genes for NPSLE.
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Affiliation(s)
- Roger C Ho
- From the Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Institute of Mental Health, Singapore; Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.R.C. Ho, FRCPC, Assistant Professor, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; H. Ong, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; C. Thiaghu, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Y. Lu, PhD, Assistant Professor, Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine; C.S. Ho, MRCPsych, Specialist Registrar, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; M.W. Zhang, MRCPsych, Specialist Registrar, Institute of Mental Health
| | - Huiyi Ong
- From the Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Institute of Mental Health, Singapore; Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.R.C. Ho, FRCPC, Assistant Professor, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; H. Ong, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; C. Thiaghu, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Y. Lu, PhD, Assistant Professor, Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine; C.S. Ho, MRCPsych, Specialist Registrar, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; M.W. Zhang, MRCPsych, Specialist Registrar, Institute of Mental Health
| | - Chandra Thiaghu
- From the Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Institute of Mental Health, Singapore; Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.R.C. Ho, FRCPC, Assistant Professor, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; H. Ong, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; C. Thiaghu, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Y. Lu, PhD, Assistant Professor, Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine; C.S. Ho, MRCPsych, Specialist Registrar, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; M.W. Zhang, MRCPsych, Specialist Registrar, Institute of Mental Health
| | - Yanxia Lu
- From the Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Institute of Mental Health, Singapore; Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.R.C. Ho, FRCPC, Assistant Professor, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; H. Ong, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; C. Thiaghu, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Y. Lu, PhD, Assistant Professor, Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine; C.S. Ho, MRCPsych, Specialist Registrar, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; M.W. Zhang, MRCPsych, Specialist Registrar, Institute of Mental Health.
| | - Cyrus S Ho
- From the Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Institute of Mental Health, Singapore; Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.R.C. Ho, FRCPC, Assistant Professor, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; H. Ong, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; C. Thiaghu, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Y. Lu, PhD, Assistant Professor, Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine; C.S. Ho, MRCPsych, Specialist Registrar, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; M.W. Zhang, MRCPsych, Specialist Registrar, Institute of Mental Health
| | - Melvyn W Zhang
- From the Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Institute of Mental Health, Singapore; Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.R.C. Ho, FRCPC, Assistant Professor, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; H. Ong, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; C. Thiaghu, MBBS, Medical Officer, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Y. Lu, PhD, Assistant Professor, Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine; C.S. Ho, MRCPsych, Specialist Registrar, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; M.W. Zhang, MRCPsych, Specialist Registrar, Institute of Mental Health
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