1117 Neutrophil extracellular traps as a biomarker to predict outcomes in lupus nephritis

Whittall-García, Laura; Naderinavi, Farnoosh; Gladman, Dafna D.; Urowitz, Murray B.; Touma, Zahi; Konvalinka, Anna; Wither, Joan E.

doi:10.1136/lupus-2022-lupus21century.82

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“… *2003 International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification system. 52 †National Institutes of Health activity and chronicity index in lupus nephritis. 53 eGFR, estimated glomerular filtration rate; LN, lupus nephritis; SLE, systemic lupus erythematosus.…”

Section: Resultsmentioning

confidence: 99%

“… 52 †National Institutes of Health activity and chronicity index in lupus nephritis. 53 eGFR, estimated glomerular filtration rate; LN, lupus nephritis; SLE, systemic lupus erythematosus. …”

Section: Resultsmentioning

confidence: 99%

“… *2003 International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification system. 52 …”

Section: Resultsmentioning

confidence: 99%

“…Data are presented as median (IQR) or n (%). *2003 International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification system 52. †National Institutes of Health activity and chronicity index in lupus nephritis 53.…”

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confidence: 99%

“…*2003 International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification system 52. †National Institutes of Health activity and chronicity index in lupus nephritis 53. eGFR, estimated glomerular filtration rate; LN, lupus nephritis; SLE, systemic lupus erythematosus.The levels of NET remnants at the time of the LN flare predicted the response to treatment The levels of both complexes were higher in patients who failed to achieve a CR at 12 and 24 months after the LN flare (online supplemental table 1).…”

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confidence: 99%

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Circulating neutrophil extracellular trap remnants as a biomarker to predict outcomes in lupus nephritis

Whittall-Garcia,

Naderinabi,

Gladman

et al. 2024

Lupus Sci Med

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ObjectiveTo determine if the serum levels of neutrophil extracellular trap (NET) remnants (Elastase-DNA and HMGB1-DNA complexes) at the time of a lupus nephritis (LN) flare predict renal outcomes in the following 24 months.MethodsThis was a retrospective study performed in prospectively followed cohorts. The study included two cohorts: an exploratory cohort to assess the association between NET remnant levels and the presence of active LN, and a separate LN cohort to determine the utility of NET remnants to predict renal outcomes over the subsequent 24 months.ResultsNinety-two individuals were included in the exploratory cohort (49 active systemic lupus erythematosus (SLE), 23 inactive SLE and 20 healthy controls (HC)). NET remnants were significantly higher in patients with SLE patients compared with HC (p<0.0001 for both complexes) and those with active LN (36%) had significantly higher levels of NET remnants compared with active SLE without LN (Elastase-DNA: p=0.03; HMGB1-DNA: p=0.02). The LN cohort included 109 active LN patients. Patients with proliferative LN had significantly higher levels of NET remnants than non-proliferative LN (Elastase-DNA: p<0.0001; HMGB1-DNA: p=0.0003). Patients with higher baseline levels of NET remnants had higher odds of not achieving complete remission (Elastase-DNA: OR 2.34, p=0.007; HMGB1-DNA: OR 2.61, p=0.009) and of progressing to severe renal impairment (Elastase-DNA: OR 2.84, p=0.006; HMGB1-DNA: OR 2.04, p=0.02) at 24 months after the flare.ConclusionsElastase-DNA and HMGB1-DNA complexes predict renal outcomes, suggesting they could be used to identify patients requiring more aggressive therapy at flare onset.

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