Plasma chemokine CXC motif-ligand 16 as a predictor of renal prognosis in immunoglobulin A nephropathy
Plasma chemokine CXC motif-ligand 16 as a predictor of renal prognosis in immunoglobulin A nephropathy
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血浆趋化因子 CXC 基序配体 16 作为免疫球蛋白 A 肾病肾脏预后的预测因子
DOI：
10.21037/atm.2020.02.05
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发表时间：
2020
影响因子：
--
通讯作者：
Xu Gang
中科院分区：
文献类型：
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作者：
Luo Ran;Yang Yi;Cheng Yi-Chun;Chang Dan;Liu Ting-Ting;Li Yue-Qiang;Dai Wei;Zuo Mei-Ying;Xu Yu-Lin;Zhang Chun-Xiu;Ge Shu-Wang;Xu Gang
研究背景：很少有非侵入性生物标志物被发现可以改善IgA肾病（IgAN）患者的风险分层。CXCL16已被证明在炎症性疾病中作为化学引诱剂、粘附和纤维化因子发挥关键作用。本研究评估了CXCL16血浆作为IgAN患者潜在生物标志物的潜力。方法对2012 - 2014年入选的230例肾活检IgAN患者进行血浆CXCL16检测。患者随访41.3个月，以肾小球滤过率降低50%或终末期肾病为终点。结果在多因素分析中，IgAN患者血浆CXCL16水平与尿酸、肾小球滤过率和小管萎缩/间质纤维化评分密切相关。此外，IgAN患者肾活检中CD4+ T细胞、CD8+ T细胞和CD20+ B细胞计数与血浆CXCL16水平显著相关，而CD68+巨噬细胞计数与血浆CXCL16水平无显著相关。最后，我们得出结论，与血浆CXCL16水平较低的患者相比，血浆CXCL16水平较高的患者肾脏预后不良的风险增加。CXCL16基因多态性与血浆CXCL16水平及预后等临床参数无相关性。结论血浆CXCL16水平与临床参数相关；病理损害;肾组织CD4+ T细胞、CD8+ T细胞、CD20+ B细胞浸润；IgAN患者的肾脏预后。血浆CXCL16可能是中国IgAN患者的潜在预后预测因子。
Background There are few non-invasive biomarkers that have been identified to improve the risk stratification of patients with IgA nephropathy (IgAN). CXCL16 has been shown to play a key role as a chemoattractant, adhesion, and fibrosis factor in inflammatory disease. This study evaluated the potential for CXCL16 plasma as a potential biomarker in patients with IgAN. Methods Plasma CXCL16 was measured in 230 patients with renal biopsied IgAN enrolled from 2012 to 2014. The patients were followed for 41.3 months, with a 50% reduction in estimated glomerular filtration rate or end-stage renal disease as endpoints. Results The plasma CXCL16 levels in IgAN patients were strongly correlated with the uric acid, estimated glomerular filtration rate and tubular atrophy/interstitial fibrosis score in multivariate analysis. Furthermore, counts of CD4+ T cells, CD8+ T cells, and CD20+ B cells in renal biopsies of IgAN patients were significantly correlated with the plasma CXCL16 levels, but not CD68+ macrophage. Lastly, we concluded that patients with higher levels of plasma CXCL16 had an increased risk of poor renal outcome compared to those with lower levels. There was no association between the polymorphisms and clinical parameters of CXCL16, including the levels and prognosis of plasma CXCL16. Conclusions Plasma CXCL16 levels were associated with clinical parameters; pathological damage; CD4+ T cell, CD8+ T cell, and CD20+ B cell infiltration in renal tissue; and renal outcome in IgAN patients. Plasma CXCL16 might be a potential prognosis predictor in Chinese IgAN patients.