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肾脏病与透析肾移植杂志 ›› 2025, Vol. 34 ›› Issue (3): 204-211.DOI: 10.3969 / j.issn.1006⁃298X.2025.03.002

• 论著 • 上一篇    下一篇

狼疮肾炎患者疾病活动新型生物标志物的发现及验证

  

  • 出版日期:2025-06-28 发布日期:2025-06-26

Discovery and validation of novel biomarkers reflecting disease activity in lupus nephritis patients

  • Online:2025-06-28 Published:2025-06-26

摘要: 目的:寻找狼疮肾炎(LN)患者循环中反映疾病活动的新型生物标志物。   方法:用 Olink 蛋白组学检测健康对照(CON1,n= 10)、活动组(ALN1,n= 9)和非活动组(ILN1,n = 9)的LN 患者以及前瞻性队列血浆中92 个炎症分子和92 个免疫分子。  在更大样本量的 LN 患者(n = 99) 和随访队列(n = 50) 中用 ELISA 验证筛选出的分子。  结果:与 CON1 组和ILN1 组相比,ALN1 组有17 个差异分子且区别ALN1 和ILN1 的曲线下面积(AUC) >0.8。  前瞻性队列显示其中有11 个分子随治疗缓解而降低,筛选11 个分子后得到2 个未在系统性红斑狼疮中报道的分子白血病抑制因子受体(LIFR)和嗜乳脂蛋白亚家族3 成员A2(BTN3A2)。  在更多样本和队列中验证这两个分子,它们在活动性LN 患者中明显高于非活动患者。  LIFR、BTN3A2 与SLE 疾病活动指数(SLE⁃DAI)评分呈正相关,r 分别为0.557 和0.468。  随访队列结果显示循环中2 个分子的水平随疾病缓解显著下降,而未缓解者并无改变。  结论:本研究发现循环 LIFR 和 BTN3A2 可作为反映LN 患者疾病活动的新型生物标志物。

关键词: 狼疮肾炎, 疾病活动, 生物标志物

Abstract:  Objective:Assessing whether lupus  nephritis  ( LN)  is  active  or  not  is  crucial  for  developing  tailored treatment plans and improving patients' prognosis. The objective of this study was to identify novel markers in the circulation of LN patients that can reflect  disease  activity. Methodology:Olink proteomics  was  employed to  detect 92 inflammatory molecules and 92 immune response molecules in the plasma of three cohorts: healthy controls ( CON1, n = 10), active LN patients ( ALN1, n = 9)  and  inactive  LN  patients  ( ILN1,  n = 9).  Additionally,  prospective  cohort  was  included  in  the analysis. The molecules identified through screening were subsequently validated using ELISA in a larger sample size of LN patients ( n = 99)  and in a follow⁃up cohort ( n = 50).    Results:Compared with the CON1 group and the ILN1 group, the ALN1 group  had  17  differential  molecules,  and  the  area  under  the  curve  ( AUC)  distinguishing  ALN1  from  ILN1  was greater than 0.8. A cohort study showed that 11 of these molecules decreased with treatment remission. After screening the 11 molecules, LIFR and BTN3A2 were finally identified as meeting the criteria.  In a larger sample and cohort, these two molecules were validated to be significantly higher in active LN patients than in inactive patients. Both LIFR and BTN3A2 were positively  correlated  with  the  SLE⁃DAI  score,  with  correlation  coefficients  of  0.557  and  0.468,  respectively.  The cohort  results  showed  that  the  levels  of  these  two  molecules  in  circulation  significantly  decreased  with  disease  remissionwhile no changes were observed in those who did not achieve remission.    Conclusion:In this study, wecirculating LIFR and BTN3A2 serve as novel biomarkers that mirror LN isease activity.

Key words: lupus nephritis, disease activity, biomarker