Thrombotic microangiopathy mediates poor prognosis among lupus nephritis via complement lectin and alternative pathway activation

Zhang, Binshan; Xing, Guolan

doi:10.3389/fimmu.2022.1081942

Cited by 8 publications

(3 citation statements)

References 58 publications

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“…They demonstrated the roles of thrombomodulin, MCP/CD46, complement Factor H, complement Factor I, and complement Factor B in the development of TMA [ 38 ]. The prevalent “whole house” pattern (positive staining for IgG, IgM, IgA, C3, c1q) in LN and TMA monitored by Binsan Zhang et al using immunofluorescence suggests that the pathogenesis of LN and TMA is influenced by LP and AP [ 39 ]. Establishing early warning signs for the identification of complement deficiency can help identify LN and TMA and improve outcomes.…”

Section: Discussionmentioning

confidence: 99%

Research trends and frontiers in lupus nephritis: a bibliometric analysis from 2012 to 2022

Wang

et al. 2023

Int Urol Nephrol

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Objectives Lupus nephritis is a prevalent renal manifestation of systemic lupus erythematosus (SLE) and represents a significant cause of morbidity and mortality associated with the disease. This study endeavors to undertake a meticulous bibliometric analysis of LN publications to comprehend the research hotspots and future directions. Methods The literature on LN was acquired from the Web of Science Core Collection (WoSCC). Co-occurrence and cooperative relationship analysis of authors, institutions, countries, journals, references and keywords in the publication was performed through CiteSpace, VOSviewer and a bibliometric online analysis platform. The knowledge graphs were created, and clustering and emergence analyses were performed. Results According to the search strategy, a total of 2077 publications related to lupus nephritis (LN) have been identified, with China being the largest contributor globally. The Ohio State University emerged as the most prolific institution. Lupus is the most cited and published journal. Jan J Weening and Brad Rovin were the most prolific and cocited authors. The current research focus revolved around the “nirp3 inflammasome,” “biomarker,” and “voclosporin”. “international society,” “thrombotic microangiopathy (TMA),” and “pathway” were identified to be future research hotpots by keyword burst analysis. Conclusions This bibliometric analysis summarizes for the first time the progress of LN research (2012–2022), and qualitatively and quantitatively evaluates the bibliometric information of LN research. There has been a steady increase in the scientific literature on LN over the past 11 years, with an average growth rate of 7.27%. In this field, researchers are primarily based in China and the United States. The pathogenic mechanisms, management strategies and prognostic outcomes of LN are acknowledged as prospective research hotspots. Bibliometrically, the research status and trends of LN publications may greatly assist and be a significant reference for future research in the area.

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Section: Discussionmentioning

confidence: 99%

Research trends and frontiers in lupus nephritis: a bibliometric analysis from 2012 to 2022

Wang

et al. 2023

Int Urol Nephrol

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“…[61] было установлено, что больные с таким сочетанием независимо от этиологии ТМА имели более высокую протеинурию и креатинемию, а при гистологическом исследовании биоптатов почекбольшие значения индексов активности и склероза, более выраженную эндокапиллярную гиперклеточность, тубулярную атрофию и интерстициальный фиброз. Очевидно, что подобные клинико-морфологические проявления служат неблагоприятными факторами почечного прогноза ВН при любых ТМА, что было продемонстрировано в целом ряде исследований [57,60,61,74,77,78]. Пациенты с ТМА и ВН опережают больных без ТМА в темпах достижения терминальной почечной недостаточности.…”

Section: тромботическая микроангиопатияunclassified

Lupus nephritis – modern aspects of diagnosis and therapy. Part I

Solovyev,

Kozlovskaya,

Aseeva

et al. 2024

Naučno-praktičeskaâ revmatologiâ

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Lupus nephritis (LN) is considered to be one of the most frequent severe manifestations of systemic lupus erythematosus (SLE), its various colonic manifestations occur in at least 50% of SLE patients, both at the onset and at various stages of the disease, and develop LN is considered one of the most important predictors of mortality in SLE. The structure of nephritis is dominated by diffuse proliferative LN with clinical and morphological signs of progression and the rapid development of terminal renal failure. SLE is diagnosed based on the 2019 EULAR/ACR (European Alliance of Associations for Rheumatology/American College of Rheumatology) diagnostic classification criteria. To confirm the diagnosis, evaluate the prognosis, and choose the tactics of treating the dis-ease, all patients in the absence of contraindications require a kidney biopsy. In addition to LN, the spectrum of SLE-associated renal lesions includes vascular pathology represented by thrombotic microangiopathy, lupus vasculopathy or vasculitis, tubulointerstitial injury, and lupus podocytopathy.

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“…23 26 In a retrospective study of 79 patients with LN-associated TMA on renal biopsy and 79 without TMA-associated LN, TMA-associated LN was associated with a higher incidence of acute haemodialysis (35% vs 5%; p<0.002), higher IFTA (43% vs 13%, p<0.001) and inferior 3-year renal survival rates (68% vs 89%, p=0.002). 27 Case series report that refractory TMA associated LN is highly responsive to treatment with the complement inhibitor eculizumab, with one study showing renal recovery in 80% of patients. 23 26 In unpublished data at our institution, we found seven of nine (77%) patients with TMHA who were subsequently treated with either eculizumab or ravulizumab, also had a non-lesional skin biopsy positive for significant microvascular C5b-9 deposition.…”

Section: Lupus Nephritismentioning

confidence: 99%

Microvascular C5b-9 deposition in non-lesional skin in patients with SLE and its correlation with active lupus nephritis: a prospective observational study

Anderson,

Magro,

Belmont

2023

Lupus Sci Med

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ObjectiveTissue damage in lupus nephritis (LN) is mediated by activation of the classical complement pathway. Complement-mediated upregulation of endothelial cell adhesion molecules is seen in dermal blood vessels of non-lesional skin of patients with active lupus. In diseases with systemic complement activation, extensive microvascular C5b-9 deposition is seen in non-lesional skin. In this study, we assess the presence of systemic complement pathway activation as determined by non-lesional skin microvascular C5b-9 deposition in patients with LN.MethodsEight patients with active LN and eight patients without active LN underwent non-lesional skin biopsies. Using a diaminobenzidine technique, specimens were evaluated for microvascular C5b-9 consistent with systemic complement pathway activation.ResultsFive of eight patients with active LN and one of eight patients without active LN demonstrated positive C5b-9 staining in non-lesional skin (p=0.04). Positive non-lesional C5b-9 staining has greater specificity, 87.5%, for active LN than pyuria, low complements, elevated double-stranded DNA (dsDNA) and proteinuria. Urine protein creatinine ratio was significantly higher in patients with positive non-lesional C5b-9 deposition (5.18 vs 1.20; p=0.04). C5b-9 deposition was not associated with a higher NIH Activity Index, interstitial fibrosis, dsDNA or lower complements.ConclusionThis is the first study to demonstrate evidence in non-lesional skin of microvascular C5b-9 indicative of systemic complement pathway activation in LN. C5b-9 deposition is statistically more common and demonstrated greater specificity than most historical biomarkers for active LN. The findings support a potential role for microvascular C5b-9 assessment in non-lesional skin as a biomarker for LN activity.

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Thrombotic microangiopathy mediates poor prognosis among lupus nephritis via complement lectin and alternative pathway activation

Cited by 8 publications

References 58 publications

Research trends and frontiers in lupus nephritis: a bibliometric analysis from 2012 to 2022

Research trends and frontiers in lupus nephritis: a bibliometric analysis from 2012 to 2022

Lupus nephritis – modern aspects of diagnosis and therapy. Part I

Microvascular C5b-9 deposition in non-lesional skin in patients with SLE and its correlation with active lupus nephritis: a prospective observational study

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