Serum Axl predicts histology-based response to induction therapy and long-term renal outcome in lupus nephritis

Autor: Guillaume Cosson, Madiha Fathima, Ioannis Parodis, Iva Gunnarsson, Huihua Ding, Chandra Mohan, Caroline Grönwall, Agneta Zickert
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
Nephrology
Physiology
Biopsy
Lupus nephritis
Urine
Kidney
Severity of Illness Index
Biochemistry
Gastroenterology
chemistry.chemical_compound
0302 clinical medicine
Medicine and Health Sciences
Lupus Erythematosus
Systemic
Longitudinal Studies
Nephritis
Multidisciplinary
medicine.diagnostic_test
Area under the curve
Drugs
Induction Chemotherapy
Middle Aged
Prognosis
Lupus Nephritis
Body Fluids
3. Good health
Treatment Outcome
Renal pathology
Creatinine
Disease Progression
Medicine
Female
Renal biopsy
Drug Monitoring
Anatomy
Immunosuppressive Agents
Research Article
medicine.drug
Adult
medicine.medical_specialty
Histology
Cyclophosphamide
Science
Immunology
Surgical and Invasive Medical Procedures
Systemic Lupus Erythematosus
Autoimmune Diseases
Young Adult
03 medical and health sciences
Rheumatology
Proto-Oncogene Proteins
Internal medicine
medicine
Humans
Retrospective Studies
Pharmacology
030203 arthritis & rheumatology
Lupus Erythematosus
business.industry
Receptor Protein-Tyrosine Kinases
Biology and Life Sciences
medicine.disease
Axl Receptor Tyrosine Kinase
030104 developmental biology
chemistry
Case-Control Studies
Clinical Immunology
Clinical Medicine
business
Biomarkers
Zdroj: PLoS ONE, Vol 14, Iss 2, p e0212068 (2019)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0212068
Popis: Axl is a receptor tyrosine kinase with important functions in immune regulation. We investigated serum levels of soluble (s)Axl in lupus nephritis (LN) in association with renal disease activity, tissue damage and treatment response. We surveyed 52 patients with International Society of Nephrology/Renal Pathology Society (ISN/RPS) class III/IV LN and 20 healthy controls. Renal biopsies were performed at the time of active LN and post-treatment. Patients were classified as clinical responders (CRs) or clinical non-responders based on the American College of Rheumatology (ACR) criteria. Improvement by ≥50% in renal activity index scores defined histological responders (HRs). sAxl levels were elevated in patients compared to controls (median: 18.9 ng/mL), both at baseline (median: 45.7; P5 times higher probability of histology-based response (odds ratio, OR: 5.5; 95% confidence interval, CI: 1.2–25.1). High post-treatment sAxl levels were associated with worsening in chronicity index scores (P = 0.025); low levels predicted favourable renal outcome (creatinine ≤88.4 μmol/L) 10 years after the baseline renal biopsy (area under the curve: 0.71; 95% CI: 0.54–0.89). In conclusion, sAxl may prove useful as a marker of renal activity, histological response to immunosuppression, and renal damage progression in LN. Persistently high sAxl levels after completion of treatment may be indicative of a need for treatment intensification.
Databáze: OpenAIRE
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