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Conference Paper: Clinico-pathological Associations with Serum Thrombomodulin Level in Patients with Lupus Nephritis
Title | Clinico-pathological Associations with Serum Thrombomodulin Level in Patients with Lupus Nephritis |
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Authors | |
Issue Date | 2020 |
Publisher | American Society of Nephrology. The Journal's web site is located at http://www.jasn.org |
Citation | American Society of Nephrology (ASN) Kidney Week 2020: Reimagined, Digital Meeting, 22-25 October 2020. In Journal of the American Society of Nephrology, 2020, v. 31 n. Suppl., p. 553, abstract no. PO1769 How to Cite? |
Abstract | BACKGROUND: Conventional serological markers do not always correlate with clinical activity or histolopathology in lupus nephritis (LN). There is evidence of endothelial activation and injury in LN pathogenesis. Thrombomodulin (TM), a component of endothelial glycocalyx, is shed into the circulation in endothelial cell injury. We investigated clinico-pathological associations of circulating TM level.
METHODS: TM level was measured by ELISA in sera collected serially every 3-4 months over >2 years (n=482) from 31 patients with biopsy-proven Class III/IV LN. Patients with non-renal SLE or non-lupus kidney diseases (CKD) and healthy subjects were included as Controls.
RESULTS: Patients with active LN had the highest serum TM level, compared with LN patients in remission, patients with active non-renal SLE, CKD patients, or healthy subjects (P<0.01, for all). Serum TM level correlated with anti-dsDNA antibody titre, proteinuria, serum creatinine, SLEDAI-2K and renal SLEDAI-2K score; and inversely correlated with eGFR and C3 (P<0.05, for all). 8 patients had blood samples collected before disease flare, and 6 showed increased TM level (3.65±2.16 months before clinical flare). All episodes of LN flare were accompanied by elevated TM level, which decreased after treatment. A temporal relationship was noted between TM level and anti-dsDNA titre and C3 levels, proteinuria, SLEDAI-2K and renal SLEDAI-2K scores. TM level also correlated with renal interstitial inflammation score (r=0.54, P=0.0081). ROC analysis showed that serum TM level distinguished active LN from healthy subjects (sensitivity 100.00%, specificity 100.00%), from LN in remission (sensitivity 89.66%, specificity 68.97%), from active non-renal SLE (sensitivity 90.91%, specificity 100.00%), and from CKD (sensitivity 89.66%, specificity 56.52%) (P<0.001, for all).
CONCLUSION: Determination of serum TM level may facilitate early diagnosis of active LN, and may be useful in monitoring the response to treatment. |
Description | Session: Glomerular Diseases: Lupus and Membranous - 1202 Glomerular Diseases: Immunology and Inflammation - Abstract no. PO1769 |
Persistent Identifier | http://hdl.handle.net/10722/300968 |
ISSN | 2023 Impact Factor: 10.3 2023 SCImago Journal Rankings: 3.409 |
DC Field | Value | Language |
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dc.contributor.author | Chan, DTM | - |
dc.contributor.author | Yu, KYC | - |
dc.contributor.author | Yap, YHD | - |
dc.contributor.author | Yung, SSY | - |
dc.date.accessioned | 2021-07-06T03:12:44Z | - |
dc.date.available | 2021-07-06T03:12:44Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | American Society of Nephrology (ASN) Kidney Week 2020: Reimagined, Digital Meeting, 22-25 October 2020. In Journal of the American Society of Nephrology, 2020, v. 31 n. Suppl., p. 553, abstract no. PO1769 | - |
dc.identifier.issn | 1046-6673 | - |
dc.identifier.uri | http://hdl.handle.net/10722/300968 | - |
dc.description | Session: Glomerular Diseases: Lupus and Membranous - 1202 Glomerular Diseases: Immunology and Inflammation - Abstract no. PO1769 | - |
dc.description.abstract | BACKGROUND: Conventional serological markers do not always correlate with clinical activity or histolopathology in lupus nephritis (LN). There is evidence of endothelial activation and injury in LN pathogenesis. Thrombomodulin (TM), a component of endothelial glycocalyx, is shed into the circulation in endothelial cell injury. We investigated clinico-pathological associations of circulating TM level. METHODS: TM level was measured by ELISA in sera collected serially every 3-4 months over >2 years (n=482) from 31 patients with biopsy-proven Class III/IV LN. Patients with non-renal SLE or non-lupus kidney diseases (CKD) and healthy subjects were included as Controls. RESULTS: Patients with active LN had the highest serum TM level, compared with LN patients in remission, patients with active non-renal SLE, CKD patients, or healthy subjects (P<0.01, for all). Serum TM level correlated with anti-dsDNA antibody titre, proteinuria, serum creatinine, SLEDAI-2K and renal SLEDAI-2K score; and inversely correlated with eGFR and C3 (P<0.05, for all). 8 patients had blood samples collected before disease flare, and 6 showed increased TM level (3.65±2.16 months before clinical flare). All episodes of LN flare were accompanied by elevated TM level, which decreased after treatment. A temporal relationship was noted between TM level and anti-dsDNA titre and C3 levels, proteinuria, SLEDAI-2K and renal SLEDAI-2K scores. TM level also correlated with renal interstitial inflammation score (r=0.54, P=0.0081). ROC analysis showed that serum TM level distinguished active LN from healthy subjects (sensitivity 100.00%, specificity 100.00%), from LN in remission (sensitivity 89.66%, specificity 68.97%), from active non-renal SLE (sensitivity 90.91%, specificity 100.00%), and from CKD (sensitivity 89.66%, specificity 56.52%) (P<0.001, for all). CONCLUSION: Determination of serum TM level may facilitate early diagnosis of active LN, and may be useful in monitoring the response to treatment. | - |
dc.language | eng | - |
dc.publisher | American Society of Nephrology. The Journal's web site is located at http://www.jasn.org | - |
dc.relation.ispartof | Journal of the American Society of Nephrology | - |
dc.relation.ispartof | American Society of Nephrology (ASN) Kidney Week 2020 | - |
dc.title | Clinico-pathological Associations with Serum Thrombomodulin Level in Patients with Lupus Nephritis | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Chan, DTM: dtmchan@hku.hk | - |
dc.identifier.email | Yap, YHD: desmondy@hku.hk | - |
dc.identifier.email | Yung, SSY: ssyyung@hku.hk | - |
dc.identifier.authority | Chan, DTM=rp00394 | - |
dc.identifier.authority | Yap, YHD=rp01607 | - |
dc.identifier.authority | Yung, SSY=rp00455 | - |
dc.description.nature | abstract | - |
dc.identifier.hkuros | 323300 | - |
dc.identifier.volume | 31 | - |
dc.identifier.issue | Suppl. | - |
dc.identifier.spage | 553, abstract no. PO1769 | - |
dc.identifier.epage | 553, abstract no. PO1769 | - |
dc.publisher.place | United States | - |