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Saleem A, Zeeshan B, Dissanayake G, Zergaw M, Elgendy M, Billey A. Anti-Smith Antibodies as a Predictive Factor for Developing Lupus Nephritis in Systemic Lupus Erythematosus Patients: A Systematic Review. Cureus 2024; 16:e66270. [PMID: 39238683 PMCID: PMC11376143 DOI: 10.7759/cureus.66270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 08/06/2024] [Indexed: 09/07/2024] Open
Abstract
Lupus nephritis (LN) is the most frequent and lethal complication of systemic lupus erythematosus (SLE), often presenting with subtle or no initial symptoms. Therefore, it is crucial to identify SLE patients who are at risk of developing LN to ensure they receive timely intervention. Significant scientific efforts have been made to identify various genes and antibodies that could increase the risk of LN. Our objective is to review the role of anti-Smith antibodies in this disease and evaluate their potential as a predictive marker for LN. This review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We searched for different study types from 2019 onwards as per our inclusion and exclusion criteria, to look for the significance of anti-Smith antibodies. The following databases were used: PubMed, PMC, Google Scholar, Science Direct, and Scopus. Twenty-two studies were checked for eligibility, of which 17 studies passed, based on the commonly used quality assessment tool for each of the corresponding studies. The study results indicated that anti-Smith antibodies are highly specific for SLE and are part of its classification criteria. In addition, we observed that positive titers correlate with disease activity. The presence of anti-Smith antibodies is influenced by ethnicity being most common among Black patients. However, the data regarding their effectiveness as a predictive marker for LN is not fully established. A more sensitive investigation and larger cohorts on diverse ethnic populations could provide a definitive answer regarding the role of anti-Smith antibodies in LN, highlighting the need for additional research.
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Affiliation(s)
- Asra Saleem
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Bushra Zeeshan
- Dermatology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Gayanthi Dissanayake
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Meaza Zergaw
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohamed Elgendy
- Orthopaedics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Alvin Billey
- Laboratory Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Guo Q, Qiao P, Wang J, Zhao L, Guo Z, Li X, Fan X, Yu C, Zhang L. Investigating the value of urinary biomarkers in relation to lupus nephritis histopathology: present insights and future prospects. Front Pharmacol 2024; 15:1421657. [PMID: 39104393 PMCID: PMC11298450 DOI: 10.3389/fphar.2024.1421657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 07/02/2024] [Indexed: 08/07/2024] Open
Abstract
Lupus nephritis (LN), a leading cause of death in Systemic Lupus Erythematosus (SLE) patients, presents significant diagnostic and prognostic challenges. Although renal pathology offers critical insights regarding the diagnosis, classification, and therapy for LN, its clinical utility is constrained by the invasive nature and limited reproducibility of renal biopsies. Moreover, the continuous monitoring of renal pathological changes through repeated biopsies is impractical. Consequently, there is a growing interest in exploring urine as a non-invasive, easily accessible, and dynamic "liquid biopsy" alternative to guide clinical management. This paper examines novel urinary biomarkers from a renal pathology perspective, encompassing cellular components, cytokines, adhesion molecules, auto-antibodies, soluble leukocyte markers, light chain fragments, proteins, small-molecule peptides, metabolomics, urinary exosomes, and ribonucleic acids. We also discuss the application of combined models comprising multiple biomarkers in assessing lupus activity. These innovative biomarkers and models offer insights into LN disease activity, acute and chronic renal indices, fibrosis, thrombotic microangiopathy, podocyte injury, and other pathological changes, potentially improving the diagnosis, management, and prognosis of LN. These urinary biomarkers or combined models may serve as viable alternatives to traditional renal pathology, potentially revolutionizing the method for future LN diagnosis and observation.
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Affiliation(s)
- Qianyu Guo
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Department of Rheumatology, Shanxi Bethune Hospital, Taiyuan, China
| | - Pengyan Qiao
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Department of Rheumatology, Shanxi Bethune Hospital, Taiyuan, China
| | - Juanjuan Wang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Stem Cell Translational Laboratory, Shanxi Bethune Hospital, Taiyuan, China
| | - Li Zhao
- School of Pharmacy, Shanxi Medical University, Taiyuan, China
| | - Zhiying Guo
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Department of Rheumatology, Shanxi Bethune Hospital, Taiyuan, China
| | - Xiaochen Li
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Department of Rheumatology, Shanxi Bethune Hospital, Taiyuan, China
| | - Xiuying Fan
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Office of Drug Clinical Trial Institution, Taiyuan, China
| | - Chong Yu
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Department of Rheumatology, Shanxi Bethune Hospital, Taiyuan, China
| | - Liyun Zhang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Department of Rheumatology, Shanxi Bethune Hospital, Taiyuan, China
- Stem Cell Translational Laboratory, Shanxi Bethune Hospital, Taiyuan, China
- Office of Drug Clinical Trial Institution, Taiyuan, China
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Zhang J, Tian J, Wang X, Shen H. Serum Uric Acid Combined with Homocysteine as a Predictive Biomarker of Lupus Nephritis. Horm Metab Res 2024; 56:455-462. [PMID: 38710215 DOI: 10.1055/a-2294-6749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Serum uric acid (UA) and homocysteine (Hcy) are potential biomarkers of systemic lupus erythematosus (SLE). In this study, the expressions of UA and Hcy in SLE patients and the predictive value of these two parameters for lupus nephritis (LN) were studied. A total of 476 SLE patients were recruited to this case-control study, of which 176 SLE patients diagnosed with LN and 300 without LN. Serum UA and Hcy levels were analyzed. Multivariate logistic regression analysis was used to evaluate the relationship between serum UA and Hcy and LN. The receiver operating characteristic (ROC) curves were used to predict the role of combination of serum UA and Hcy in LN. We found that serum UA and Hcy levels in SLE patients with LN were significantly higher than those in controls (p<0.05). Multivariate logistic regressions showed that serum UA (OR+=+1.003, 95+% CI: 1.001-1.006, p+=+0.003), apolipoprotein B (Apo B) (OR+=+21.361, 95+% CI: 2.312-195.373, p+=+0.007) and Hcy (OR+=+1.042, 95+% CI: 1.011-1.080, p+=+0.014) were independent markers of LN. Combined serum UA and Hcy revealed a better result (AUC+=+0.718, 95+% CI: 0.670-0.676, p<0.001) in prediction of LN compared to that of the serum UA (AUC+=+0.710) and Hcy (AUC+=+0.657) independently. In conclusion, serum UA and Hcy could be predictive biomarkers of LN, and joint detection of serum UA and Hcy might be useful in the clinical setting.
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Affiliation(s)
- Juan Zhang
- Department of Rheumatology, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Jingjing Tian
- Department of Rheumatology, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xiaoyuan Wang
- Department of Rheumatology, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Haili Shen
- Department of Rheumatology, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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Chen F, Shi B, Liu W, Gong J, Gao J, Sun Y, Yang P. Circulating exosomal microRNAs as biomarkers of lupus nephritis. Front Immunol 2023; 14:1326836. [PMID: 38223506 PMCID: PMC10785001 DOI: 10.3389/fimmu.2023.1326836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/08/2023] [Indexed: 01/16/2024] Open
Abstract
Objective Disruption in the delicate symphony of genes, microRNA (miRNA), or protein expression can result in the dysregulation of the immune system, leading to the devastating consequences such as lupus nephritis (LN). The capacity of exosomes to transport miRNAs between cells and modify the phenotype of recipient cells implies their involvement in persistent kidney inflammation. This study unveils identifying two previously undiscovered exosomal miRNAs in the serum of LN patients, offering potential solutions to the current challenges in LN diagnosis and management. Methods Initially, we used a reagent-based kit to isolate serum exosomes from patients with Systemic lupus erythematosus (SLE) and used Trizol method for total RNA extraction. Subsequently, we employed small RNA sequencing to screen for differential expression profiles of exosomal small RNAs. The RT-qPCR method was used to individually validate samples in both the screening and validation cohorts, enabling the identification of candidate small RNAs; specific to LN. We assessed the diagnostic potency using receiver operating characteristic (ROC) curve, and explored the biological roles of miRNAs using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. Results Compared to SLE patients without LN, SLE patients accompanied by LN exhibited significantly spiked levels of exosomal hsa-miR-4796-5p and hsa-miR-7974. The duo of miRNAs, hsa-miR-4796-5p and hsa-miR-7974, exhibited promising potential as biomarkers for diagnosing LN, with an AUC exceeding 0.8. Correlation analysis revealed a strong positive association between these miRNAs and proteinuria, as well as the SLE Disease Activity Index (SLEDAI) score. Moreover, the levels of two miRNAs in LN patients were significantly elevated in comparison to other autoimmune nephritis conditions, such as immunoglobulin A nephropathy (IgAN) and diabetic nephropathy (DN). Furthermore, the bioinformatics analysis indicated that this miRNAs duo can play a pivotal role in the regulation of immune processes by modulating signal pathways, such as the mTOR and PI3K-Akt signaling pathway. Conclusion This study provides a new ground that serum exosomal miRNAs can effectively identify and predict LN in SLE patients.
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Affiliation(s)
- Fei Chen
- Department of Clinical Laboratory, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Bo Shi
- Department of Clinical Laboratory, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Wenjing Liu
- Department of Clinical Laboratory, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jianmin Gong
- College of Life Sciences, Yangtze University, Jingzhou, China
| | - Jia Gao
- Department of Orthopedics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yifan Sun
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, China
| | - Ping Yang
- Department of Clinical Laboratory, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
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Moriano C, Bellido-Pastrana D, San Román Gutiérrez C, Rodríguez E. Evolution of diagnosis and treatment for lupus nephritis in Spain. Nefrologia 2023; 43:668-675. [PMID: 38246809 DOI: 10.1016/j.nefroe.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/28/2022] [Indexed: 01/23/2024] Open
Abstract
Lupus nephritis (LN) is a serious manifestation of systemic lupus erythematosus that can lead to end-stage renal disease. Many clinical and prognostic data on which our therapeutic decisions are based come from international cohorts, which have important ethnic and prognostic differences. To identify clinical and prognostic data from patients with LN in Spain, we undertook a bibliographic search of NL-related papers by Spanish authors and published in national and international journals between 2005 and 2022. According to the selected references, renal biopsy is not only essential for LN diagnosis but its repetition can be useful for the follow-up. Regarding LN treatment, standard strategy consists of an induction phase and a maintenance phase. However, as new drugs have been released, a new paradigm of treatment in a single, continuing and personalized phase has been proposed.
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Affiliation(s)
- Clara Moriano
- Servicio de Reumatología, Hospital Universitario de León, León, Spain
| | - David Bellido-Pastrana
- Servicio de Medicina Interna, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | - Eva Rodríguez
- Servicio de Nefrología, Hospital del Mar, Barcelona, Spain.
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Renaudineau Y, Brooks W, Belliere J. Lupus Nephritis Risk Factors and Biomarkers: An Update. Int J Mol Sci 2023; 24:14526. [PMID: 37833974 PMCID: PMC10572905 DOI: 10.3390/ijms241914526] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Lupus nephritis (LN) represents the most severe organ manifestation of systemic lupus erythematosus (SLE) in terms of morbidity and mortality. To reduce these risks, tremendous efforts have been made in the last decade to characterize the different steps of the disease and to develop biomarkers in order to better (i) unravel the pre-SLE stage (e.g., anti-nuclear antibodies and interferon signature); (ii) more timely initiation of therapy by improving early and accurate LN diagnosis (e.g., pathologic classification was revised); (iii) monitor disease activity and therapeutic response (e.g., recommendation to re-biopsy, new urinary biomarkers); (iv) prevent disease flares (e.g., serologic and urinary biomarkers); (v) mitigate the deterioration in the renal function; and (vi) reduce side effects with new therapeutic guidelines and novel therapies. However, progress is poor in terms of improvement with early death attributed to active SLE or infections, while later deaths are related to the chronicity of the disease and the use of toxic therapies. Consequently, an individualized treat-to-target strategy is mandatory, and for that, there is an unmet need to develop a set of accurate biomarkers to be used as the standard of care and adapted to each stage of the disease.
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Affiliation(s)
- Yves Renaudineau
- Department of Immunology, Referral Medical Biology Laboratory, University Hospital of Toulouse, Institut National de la Santé Et de la Recherche Médicale (INSERM) U1291, Centre National de la Recherche Scientifique (CNRS) U5051, 31400 Toulouse, France
| | - Wesley Brooks
- Department of Chemistry, University of South Florida, Tampa, FL 33620, USA;
| | - Julie Belliere
- Department of Nephrology and Organ Transplantation, Referral Centre for Rare Kidney Diseases, University Hospital of Toulouse, INSERM U1297, 31400 Toulouse, France;
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Tsai CY, Li KJ, Shen CY, Lu CH, Lee HT, Wu TH, Ng YY, Tsao YP, Hsieh SC, Yu CL. Decipher the Immunopathological Mechanisms and Set Up Potential Therapeutic Strategies for Patients with Lupus Nephritis. Int J Mol Sci 2023; 24:10066. [PMID: 37373215 PMCID: PMC10298725 DOI: 10.3390/ijms241210066] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Lupus nephritis (LN) is one of the most severe complications in patients with systemic lupus erythematosus (SLE). Traditionally, LN is regarded as an immune complex (IC) deposition disease led by dsDNA-anti-dsDNA-complement interactions in the subendothelial and/or subepithelial basement membrane of glomeruli to cause inflammation. The activated complements in the IC act as chemoattractants to chemically attract both innate and adaptive immune cells to the kidney tissues, causing inflammatory reactions. However, recent investigations have unveiled that not only the infiltrating immune-related cells, but resident kidney cells, including glomerular mesangial cells, podocytes, macrophage-like cells, tubular epithelial cells and endothelial cells, may also actively participate in the inflammatory and immunological reactions in the kidney. Furthermore, the adaptive immune cells that are infiltrated are genetically restricted to autoimmune predilection. The autoantibodies commonly found in SLE, including anti-dsDNA, are cross-reacting with not only a broad spectrum of chromatin substances, but also extracellular matrix components, including α-actinin, annexin II, laminin, collagen III and IV, and heparan sulfate proteoglycan. Besides, the glycosylation on the Fab portion of IgG anti-dsDNA antibodies can also affect the pathogenic properties of the autoantibodies in that α-2,6-sialylation alleviates, whereas fucosylation aggravates their nephritogenic activity. Some of the coexisting autoantibodies, including anti-cardiolipin, anti-C1q, anti-ribosomal P autoantibodies, may also enhance the pathogenic role of anti-dsDNA antibodies. In clinical practice, the identification of useful biomarkers for diagnosing, monitoring, and following up on LN is quite important for its treatments. The development of a more specific therapeutic strategy to target the pathogenic factors of LN is also critical. We will discuss these issues in detail in the present article.
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Affiliation(s)
- Chang-Youh Tsai
- Division of Immunology & Rheumatology, Department of Medicine, Fu Jen Catholic University Hospital & College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan
| | - Ko-Jen Li
- Division of Rheumatology, Immunology & Allergy, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 106319, Taiwan; (K.-J.L.); (C.-Y.S.); (C.-H.L.); (S.-C.H.)
| | - Chieh-Yu Shen
- Division of Rheumatology, Immunology & Allergy, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 106319, Taiwan; (K.-J.L.); (C.-Y.S.); (C.-H.L.); (S.-C.H.)
| | - Cheng-Hsun Lu
- Division of Rheumatology, Immunology & Allergy, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 106319, Taiwan; (K.-J.L.); (C.-Y.S.); (C.-H.L.); (S.-C.H.)
| | - Hui-Ting Lee
- MacKay Memorial Hospital & MacKay Medical College, New Taipei City 25245, Taiwan;
| | - Tsai-Hung Wu
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital and Faculty of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan;
| | - Yee-Yung Ng
- Department of Medicine, Fu Jen Catholic University Hospital & College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan;
| | - Yen-Po Tsao
- Division of Holistic and Multidisciplinary Medicine, Department of Medicine, Taipei Veterans General Hospital and Faculty of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan;
| | - Song-Chou Hsieh
- Division of Rheumatology, Immunology & Allergy, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 106319, Taiwan; (K.-J.L.); (C.-Y.S.); (C.-H.L.); (S.-C.H.)
| | - Chia-Li Yu
- Division of Rheumatology, Immunology & Allergy, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 106319, Taiwan; (K.-J.L.); (C.-Y.S.); (C.-H.L.); (S.-C.H.)
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Lin W, Lin Z, Lin X, Peng Z, Liang X, Wei S. Integrated analysis and clinical correlation analysis of hub genes, immune infiltration, and potential therapeutic agents related to lupus nephritis. Lupus 2023; 32:633-643. [PMID: 36912500 DOI: 10.1177/09612033231161587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND Lupus nephritis (LN) is the most common complication of systemic lupus erythematosus (SLE). This study aimed to explore biomarkers, mechanisms, and potential novel agents regarding LN through bioinformatic analysis. METHOD Four expression profiles were downloaded from the Gene Expression Omnibus (GEO) database and differentially expressed genes (DEGs) were acquired. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGGs) pathway enrichment analyses of DEGs were performed using the R software. The protein-protein interaction (PPI) network was developed using the STRING database. Additionally, five algorithms were used to screen out the hub genes. Expression of the hub genes were validated using Nephroseq v5. CIBERSORT was used to evaluate the infiltration of immune cells. Finally, The Drug-Gene Interaction Database was used to predict potential targeted drugs. RESULT FOS and IGF1 were identified as hub genes, with excellent specificity and sensitivity diagnosis of LN. FOS was also related to renal injury. LN patients had lower activated and resting dendritic cells (DCs) and higher M1 macrophages and activated NK cells than healthy control (HC). FOS had a positive correlation with activated mast cells and a negative correlation with resting mast cells. IGF1 had a positive correlation with activated DCs and a negative correlation with monocytes. The targeted drugs were dusigitumab and xentuzumab target for IGF1. CONCLUSION We analyzed the transcriptomic signature of LN along with the landscape of the immune cell. FOS and IGF1 are promising biomarkers for diagnosing and evaluating the progression of LN. The drug-gene interaction analyses provide a list of candidate drugs for the precise treatment of LN.
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Affiliation(s)
- Weiyi Lin
- Zhujiang Hospital, The Second School of Clinical Medicine, 70570Southern Medical University, Guangzhou, The People's Republic of China
| | - Zien Lin
- Zhujiang Hospital, The Second School of Clinical Medicine, 70570Southern Medical University, Guangzhou, The People's Republic of China
| | - Xiaobing Lin
- Zhujiang Hospital, The Second School of Clinical Medicine, 70570Southern Medical University, Guangzhou, The People's Republic of China
| | - Zhishen Peng
- Zhujiang Hospital, The Second School of Clinical Medicine, 70570Southern Medical University, Guangzhou, The People's Republic of China
| | - Xiaofeng Liang
- Zhujiang Hospital, The Second School of Clinical Medicine, 70570Southern Medical University, Guangzhou, The People's Republic of China
| | - Shanshan Wei
- Department of Dermatology, Zhujiang Hospital, 70570Southern Medical University, Guangzhou, The People's Republic of China
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Zhao J, Jiang J, Wang Y, Liu D, Li T, Zhang M. Significance of urine complement proteins in monitoring lupus activity. PeerJ 2022; 10:e14383. [PMID: 36420131 PMCID: PMC9677877 DOI: 10.7717/peerj.14383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/21/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives Complement activation is a critical feature in the development of systemic lupus erythematosus (SLE). Whether there are changes of complement components in the urine of SLE has not been reported. The aim of the study was to evaluate the complement-related proteins in the urine of SLE, verify differentially expressed proteins(DEPs) in the active phase of SLE, further explore their clinical application value. Methods First, we used bioinformatics and functional enrichment to screen and identify the urine protein profile of SLE patients. Then, analyzed and verified the proteins related to the complement pathway by western-blot and Parallel Reaction Monitoring (PRM) technology. Further evaluated the relationship between urinary DEPs related to complement pathway and disease activity. Results A total of 14 complement pathway-related proteins were screened for differences in expression between the active group and the stable group, eight of these DEPs were up-regulated and six were down-regulated. These DEPs may play a key role in SLE disease activity. We used PRM technology to verify the eight up-regulated proteins, and found that four of these complement proteins, namely C9, C8A, C4B, and C8G, were significantly increased in active group. Furthermore, these four DEPs were highly correlated with disease activity. In the urine of SLE patients, AUCs of 0.750, 0.840, 0.757 and 0.736 were achieved with C9, C8A, C4B, and C8G, respectively. Conclusions Complement-related DEPs in urine have a certain correlation with SLE disease activity. Urine C9, C8A, C4B and C8G present promising non-invasive biomarkers for monitoring lupus activity.
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Affiliation(s)
- Jin Zhao
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jun Jiang
- Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Yuhua Wang
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Dan Liu
- Peking University Ninth School of Clinical Medicine, Beijing, China
| | - Tao Li
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Man Zhang
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China,Peking University Ninth School of Clinical Medicine, Beijing, China,Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing, China
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The Bladder Microbiome, Metabolome, Cytokines, and Phenotypes in Patients with Systemic Lupus Erythematosus. Microbiol Spectr 2022; 10:e0021222. [PMID: 35913213 PMCID: PMC9620774 DOI: 10.1128/spectrum.00212-22] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Emerging studies reveal unique bacterial communities in the human bladder, with alteration of composition associated to disease states. Systemic lupus erythematosus (SLE) is a complex autoimmune disease that is characterized by frequent impairment of the kidney. Here, we explored the bladder microbiome, metabolome, and cytokine profiles in SLE patients, as well as correlations between microbiome and metabolome, cytokines, and disease profiles. We recruited a group of 50 SLE patients and 50 individually matched asymptomatic controls. We used transurethral catheterization to collect urine samples, 16S rRNA gene sequencing to profile bladder microbiomes, and liquid chromatography-tandem mass spectrometry to perform untargeted metabolomic profiling. Compared to controls, SLE patients possessed unique bladder microbial communities and increased alpha diversity. These differences were accompanied by differences in urinary metabolomes, cytokines, and patients’ disease profiles. The SLE-enriched genera, including Bacteroides, were positively correlated with several SLE-enriched metabolites, including olopatadine. The SLE-depleted genera, such as Pseudomonas, were negatively correlated to SLE-depleted cytokines, including interleukin-8. Alteration of the bladder microbiome was associated with disease profile. For example, the genera Megamonas and Phocaeicola were negatively correlated with serum complement component 3, and Streptococcus was positively correlated with IgG. Our present study reveals associations between the bladder microbiome and the urinary metabolome, cytokines, and disease phenotypes. Our results could help identify biomarkers for SLE. IMPORTANCE Contrary to dogma, the human urinary bladder possesses its own unique bacterial community with alteration of composition associated with disease states. Systemic lupus erythematosus (SLE) is a complex autoimmune disease often characterized by kidney impairment. Here, we explored the bladder microbiome, metabolome, and cytokine profiles in SLE patients, as well as correlations between the microbiome and metabolome, cytokines, and disease profiles. Compared to controls, SLE patients possessed a unique bladder microbial community and elevated alpha diversity. These differences were accompanied by differences in bladder metabolomes, cytokines, and patients’ disease profiles. SLE-enriched genera were positively correlated with several SLE-enriched metabolites. SLE-depleted genera were negatively correlated to SLE-depleted cytokines. Alteration of the bladder microbiome was associated with disease profile. Thus, our study reveals associations between the bladder microbiome and the bladder metabolome, cytokines, and disease phenotypes. These results could help identify biomarkers for SLE.
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Intertwined pathways of complement activation command the pathogenesis of lupus nephritis. Transl Res 2022; 245:18-29. [PMID: 35296451 PMCID: PMC9167748 DOI: 10.1016/j.trsl.2022.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/26/2022]
Abstract
The complement system is involved in the origin of autoimmunity and systemic lupus erythematosus. Both genetic deficiency of complement components and excessive activation are involved in primary and secondary renal diseases, including lupus nephritis. Among the pathways, the classical pathway has long been accepted as the main pathway of complement activation in systemic lupus erythematosus. However, more recent studies have shown the contribution of factors B and D which implies the involvement of the alternative pathway. While there is evidence on the role of the lectin pathway in systemic lupus erythematosus, it is yet to be demonstrated whether this pathway is protective or harmful in lupus nephritis. Complement is being explored for the development of disease biomarkers and therapeutic targeting. In the current review we discuss the involvement of complement in lupus nephritis.
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González MA, Barrera-Chacón R, Peña FJ, Fernández-Cotrina J, Robles NR, Pérez-Merino EM, Martín-Cano FE, Duque FJ. Urinary proteome of dogs with renal disease secondary to leishmaniosis. Res Vet Sci 2022; 149:108-118. [PMID: 35777279 DOI: 10.1016/j.rvsc.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 10/17/2022]
Abstract
Canine leishmaniosis is frequently associated with the development of renal disease. Its pathogenesis is complex and not fully understood. For this reason, this study aimed to describe the urinary proteome, and identify possible new biomarkers in dogs with kidney disease secondary to leishmaniosis. Urine samples were collected from 20 dogs, 5 from healthy dogs, and 15 from stages Leishvet III and IV. Urine samples were analyzed by UHPLC-MS/MS. The data are available via ProteomeXchange with identifier PXD029165. A total of 951 proteins were obtained. After bioinformatic analysis, 93 urinary proteins were altered in the study group. Enrichment analysis performed on these proteins showed an overrepresentation of the complement activation pathway, among others. Finally, 12 discriminant variables were found in dogs with renal disease secondary to leishmaniosis, highlighting C4a anaphylatoxin, apolipoprotein A-I, haptoglobin, leucine-rich alpha-2-glycoprotein 1, and beta-2-microglobulin. This study is the first to describe the urinary proteomics of dogs with renal disease caused by leishmaniosis, and it provides new possible biomarkers for the diagnosis and monitoring of this disease.
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Affiliation(s)
- Mario A González
- Animal Medicine Department, University of Extremadura, 10003 Cáceres, Spain.
| | | | - Fernando J Peña
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, 10003 Cáceres, Spain
| | - Javier Fernández-Cotrina
- LeishmanCeres Laboratory (GLP Compliance Certified), Parasitology Unit, Veterinary Teaching Hospital, University of Extremadura, 10003 Cáceres, Spain
| | - Nicolás R Robles
- Nephrology Service, Badajoz University Hospital, University of Extremadura, 06080 Badajoz, Spain
| | - Eva M Pérez-Merino
- Animal Medicine Department, University of Extremadura, 10003 Cáceres, Spain
| | - Francisco E Martín-Cano
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, 10003 Cáceres, Spain
| | - Francisco J Duque
- Animal Medicine Department, University of Extremadura, 10003 Cáceres, Spain
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Kang Y, Zuo Y, He M, Duo L, Chen X, Tang W. Clinical predictive model to estimate probability of remission in patients with lupus nephritis. Int Immunopharmacol 2022; 110:108966. [PMID: 35764016 DOI: 10.1016/j.intimp.2022.108966] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Lupus nephritis (LN) is a major organ complication and cause of morbidity and mortality in patients with systemic lupus erythematosus. This study aims to provide the clinician with a quantitative tool for the prediction of the individual remission probability of LN and obtain new insights for improved clinical management in LN treatment. METHODS A total of 301 patients with renal biopsy-proven LN were recruited and randomly divided into model construction and validation group. The least absolute shrinkage and selection operator regression analysis was conducted to select significant variables, and a multivariate Cox regression predictive model was established. The performance of the model was verified and tested with 1000-bootstrap validation in the validation group. Finally, the nomogram was constructed, and the performance was evaluated. The predictive accuracy and efficiency were verified through receiver operation characteristic and calibration curves. RESULTS A total of 210 and 91 patients who all received renal biopsy were included in the training and validation group, respectively. A final prognostic model was established, which included the course of LN, gender, 24h-proteinuria, creatinine, triglycerides, FIB, Complement C3, anti-dsDNA antibody, tubular atrophy and classification of kidney biopsy. Moreover, an easy-to-use nomogram was built based on the predictive model. The areas under the curve (AUC) of the 1, 2, 5-year prediction were 77.12, 77.98 and 87.01 in the training group, respectively. In the validation group, the AUC of the 1, 2, 5-year prediction were 81.42, 87.20 and 92.81 respectively, which indicated good performance in predicting the remission probability of LN. CONCLUSION This novel model was constructed to predict the remission probability of patients with LN for the first time. This model displayed good predictive performance and was easy to use for clinical practice.
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Affiliation(s)
- Yingxi Kang
- Department of Nephrology, West China Hospital, Sichuan University, No. 37, Guoxue alley, Chengdu, Sichuan Zipcode:610000, China
| | - Yongdi Zuo
- Department of Nephrology, West China Hospital, Sichuan University, No. 37, Guoxue alley, Chengdu, Sichuan Zipcode:610000, China
| | - Manrong He
- Department of Nephrology, West China Hospital, Sichuan University, No. 37, Guoxue alley, Chengdu, Sichuan Zipcode:610000, China
| | - Lijin Duo
- Department of Nephrology, West China Hospital, Sichuan University, No. 37, Guoxue alley, Chengdu, Sichuan Zipcode:610000, China
| | - Xiaolei Chen
- Department of Nephrology, West China Hospital, Sichuan University, No. 37, Guoxue alley, Chengdu, Sichuan Zipcode:610000, China.
| | - Wanxin Tang
- Department of Nephrology, West China Hospital, Sichuan University, No. 37, Guoxue alley, Chengdu, Sichuan Zipcode:610000, China.
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Alarcón-Riquelme ME. Transcriptome Studies in Lupus Nephritis. Arch Immunol Ther Exp (Warsz) 2022; 70:15. [PMID: 35469108 DOI: 10.1007/s00005-022-00651-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/09/2022] [Indexed: 11/28/2022]
Abstract
The present review is aimed at describing the main works that have used gene expression to analyze tissue kidney samples of lupus nephritis patients. Most studies used the gene expression arrays, which enormously advanced our knowledge on the possible mechanisms behind lupus nephritis. However, using bulk gene expression platforms, either as arrays, or as sequencing of RNA is not enough to go into detail of the cells and their molecular patterns and single cell mechanisms of disease. More recently, the first single cell RNA Sequencing study was published and this will also be discussed in the context of lupus nephritis. Single cell RNA sequencing allows to retrieve the genes expressed in each cell in the tissue of interest or in blood. In this context, the results of such studies give us a first glimpse of how a lupus nephritis kidney looks like, but much is still to be done to understand the changes that occur with treatment or with the different pathological subtypes of lupus nephritis and their cellular content.
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Affiliation(s)
- Marta E Alarcón-Riquelme
- GENYO. Center for Genomics and Oncological Research. Pfizer / University of Granada / Andalusian Regional Government, Av de la Ilustración 114, 18016, Granada, Spain. .,Institute for Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
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Zheng C, Xie L, Qin H, Liu X, Chen X, Lv F, Wang L, Zhu X, Xu J. The Role of Extracellular Vesicles in Systemic Lupus Erythematosus. Front Cell Dev Biol 2022; 10:835566. [PMID: 35309937 PMCID: PMC8924487 DOI: 10.3389/fcell.2022.835566] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/07/2022] [Indexed: 12/19/2022] Open
Abstract
Extracellular Vesicles (EVs) are small vesicles that can be actively secreted by most cell types into the extracellular environment. Evidence indicates that EVs can carry microRNAs (miRNAs), long non-coding RNAs (lncRNAs), tRNA-derived small RNAs (tsRNAs), proteins, and lipids to target cells or tissue organizations. Latest studies show that EVs play a vital role in the immune modulation and may contribute to the pathogenesis of autoimmune diseases. Systemic lupus erythematosus (SLE) is a common autoimmune disease characterized by abnormal T cell activation and sustained production of autoantibodies against self-antigens, resulting in inflammation and damage to multiple systems. Pathogenic mechanisms of SLE, however, are still not well understood. In this review, we summarize the latest research advances on the functions and mechanisms of EVs, and its role in the pathogenesis, diagnosis, and treatment of SLE.
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Affiliation(s)
| | - Lin Xie
- *Correspondence: Lin Xie, ; Xiaohua Zhu, ; Jinhua Xu,
| | | | | | | | | | | | - Xiaohua Zhu
- *Correspondence: Lin Xie, ; Xiaohua Zhu, ; Jinhua Xu,
| | - Jinhua Xu
- *Correspondence: Lin Xie, ; Xiaohua Zhu, ; Jinhua Xu,
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