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sIL7R concentrations in the serum reflect disease activity in the lupus kidney.

Lauwerys BR, Husson SN, Maudoux AL, Badot V, Houssiau FA - Lupus Sci Med (2014)

Bottom Line: These patients had significantly higher serum double-stranded DNA (dsDNA) Ab and urinary protein to creatinine (UPC) ratio.Administration of immunosuppressive therapy resulted in a significant decrease in serum sIL7R concentrations.Serum sIL7R is a sensitive and specific marker of renal disease activity in SLE.

View Article: PubMed Central - PubMed

Affiliation: Pôle de pathologies rhumatismales , Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain , Brussels , Belgium ; Service de Rhumatologie , Cliniques Universitaires Saint-Luc , Brussels , Belgium.

ABSTRACT

Objectives: Evaluation of disease activity in systemic lupus erythematosus (SLE) nephritis is a challenge, and repeated renal biopsies are usually needed in order to confirm a suspicion of flare. In a previous cross-sectional study, we reported that serum soluble form of the interleukin-7 receptor (sIL7R) levels is strongly associated with nephritis in SLE patients. In the present study, we wanted to confirm the association between changes in serum sIL7R concentrations and renal disease activity in a large longitudinal cohort of SLE nephritis patients.

Methods: Sera were harvested longitudinally in 105 SLE nephritis patients. Serum sIL7R cut-off value for the detection of SLE nephritis activity was determined as the mean sIL7R concentration in non-nephritis SLE patients + 2 SDs using data collected in our previous study. Patients with glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) (n=17) were excluded from the study due to persistently elevated serum sIL7R values.

Results: Serum sIL7R concentrations above the renal cut-off value were observed in 25 (out of 88) patients with a normal GFR. These patients had significantly higher serum double-stranded DNA (dsDNA) Ab and urinary protein to creatinine (UPC) ratio. Strikingly, 12 of them developed a renal British Isles Lupus Assessment Group index (BILAG) A within the next 3 months, while this was only the case in four out of the 63 other patients (p<0.0001). The test had 75.0% sensitivity and 81.9% specificity for the detection of a renal BILAG A. Combination of serum sIL7R with any of the classical tests (anti-dsDNA Ab titres, UPC ratio, serum C3) resulted in an increased specificity for the detection of a renal flare. Administration of immunosuppressive therapy resulted in a significant decrease in serum sIL7R concentrations.

Conclusions: Serum sIL7R is a sensitive and specific marker of renal disease activity in SLE. Elevated serum sIL7R values in SLE patients are associated with or predict the occurrence of an SLE nephritis flare.

No MeSH data available.


Related in: MedlinePlus

Serum soluble form of the interleukin-7 receptor (sIL7R) longitudinal measurements in 88 patients with SLE nephritis. sIL7R serum concentrations are depicted in patients who will (A) (n=16) versus will not (B) (n=72) present a renal BILAG A during the time of the study. The time interval between two measurements is represented as an arbitrary unit, and varies between 2 and 14 (median 5) months. The dashed line represents the renal cut-off value for sIL7R serum concentrations (1042 pmol/mL).
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LUPUS2014000036F2: Serum soluble form of the interleukin-7 receptor (sIL7R) longitudinal measurements in 88 patients with SLE nephritis. sIL7R serum concentrations are depicted in patients who will (A) (n=16) versus will not (B) (n=72) present a renal BILAG A during the time of the study. The time interval between two measurements is represented as an arbitrary unit, and varies between 2 and 14 (median 5) months. The dashed line represents the renal cut-off value for sIL7R serum concentrations (1042 pmol/mL).

Mentions: Serum sIL7R values correlated with SLEDAI scores (Pearson r=0.48, p<0.0001). Strikingly, 12 out of the 25 patients with serum sIL7R levels above the renal cut-off developed a renal BILAG A (seven International Society of Nephrology/Renal Pathology Society class IV(G), two class IV(S) and three class III kidney biopsies) at the time of or within the next 3 months following the abnormal measurement, while this was only the case in four (one class IV(G), two class IV(S), one had no biopsy) out of the 63 other patients (p<0.0001 by Fisher's exact test) (figure 2).


sIL7R concentrations in the serum reflect disease activity in the lupus kidney.

Lauwerys BR, Husson SN, Maudoux AL, Badot V, Houssiau FA - Lupus Sci Med (2014)

Serum soluble form of the interleukin-7 receptor (sIL7R) longitudinal measurements in 88 patients with SLE nephritis. sIL7R serum concentrations are depicted in patients who will (A) (n=16) versus will not (B) (n=72) present a renal BILAG A during the time of the study. The time interval between two measurements is represented as an arbitrary unit, and varies between 2 and 14 (median 5) months. The dashed line represents the renal cut-off value for sIL7R serum concentrations (1042 pmol/mL).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4225729&req=5

LUPUS2014000036F2: Serum soluble form of the interleukin-7 receptor (sIL7R) longitudinal measurements in 88 patients with SLE nephritis. sIL7R serum concentrations are depicted in patients who will (A) (n=16) versus will not (B) (n=72) present a renal BILAG A during the time of the study. The time interval between two measurements is represented as an arbitrary unit, and varies between 2 and 14 (median 5) months. The dashed line represents the renal cut-off value for sIL7R serum concentrations (1042 pmol/mL).
Mentions: Serum sIL7R values correlated with SLEDAI scores (Pearson r=0.48, p<0.0001). Strikingly, 12 out of the 25 patients with serum sIL7R levels above the renal cut-off developed a renal BILAG A (seven International Society of Nephrology/Renal Pathology Society class IV(G), two class IV(S) and three class III kidney biopsies) at the time of or within the next 3 months following the abnormal measurement, while this was only the case in four (one class IV(G), two class IV(S), one had no biopsy) out of the 63 other patients (p<0.0001 by Fisher's exact test) (figure 2).

Bottom Line: These patients had significantly higher serum double-stranded DNA (dsDNA) Ab and urinary protein to creatinine (UPC) ratio.Administration of immunosuppressive therapy resulted in a significant decrease in serum sIL7R concentrations.Serum sIL7R is a sensitive and specific marker of renal disease activity in SLE.

View Article: PubMed Central - PubMed

Affiliation: Pôle de pathologies rhumatismales , Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain , Brussels , Belgium ; Service de Rhumatologie , Cliniques Universitaires Saint-Luc , Brussels , Belgium.

ABSTRACT

Objectives: Evaluation of disease activity in systemic lupus erythematosus (SLE) nephritis is a challenge, and repeated renal biopsies are usually needed in order to confirm a suspicion of flare. In a previous cross-sectional study, we reported that serum soluble form of the interleukin-7 receptor (sIL7R) levels is strongly associated with nephritis in SLE patients. In the present study, we wanted to confirm the association between changes in serum sIL7R concentrations and renal disease activity in a large longitudinal cohort of SLE nephritis patients.

Methods: Sera were harvested longitudinally in 105 SLE nephritis patients. Serum sIL7R cut-off value for the detection of SLE nephritis activity was determined as the mean sIL7R concentration in non-nephritis SLE patients + 2 SDs using data collected in our previous study. Patients with glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) (n=17) were excluded from the study due to persistently elevated serum sIL7R values.

Results: Serum sIL7R concentrations above the renal cut-off value were observed in 25 (out of 88) patients with a normal GFR. These patients had significantly higher serum double-stranded DNA (dsDNA) Ab and urinary protein to creatinine (UPC) ratio. Strikingly, 12 of them developed a renal British Isles Lupus Assessment Group index (BILAG) A within the next 3 months, while this was only the case in four out of the 63 other patients (p<0.0001). The test had 75.0% sensitivity and 81.9% specificity for the detection of a renal BILAG A. Combination of serum sIL7R with any of the classical tests (anti-dsDNA Ab titres, UPC ratio, serum C3) resulted in an increased specificity for the detection of a renal flare. Administration of immunosuppressive therapy resulted in a significant decrease in serum sIL7R concentrations.

Conclusions: Serum sIL7R is a sensitive and specific marker of renal disease activity in SLE. Elevated serum sIL7R values in SLE patients are associated with or predict the occurrence of an SLE nephritis flare.

No MeSH data available.


Related in: MedlinePlus