Journal of Translational Autoimmunity最新文献

{"title":"Prognostic value of β1 adrenergic receptor autoantibodies for microvascular obstruction in patients with STEMI with Post-PCI: A prospective cohort study","authors":"Ning Cao ,&nbsp;Wenxi Dang ,&nbsp;Yanguo Xin ,&nbsp;Jiayu Li ,&nbsp;Shaohua Guo ,&nbsp;Qitian Li ,&nbsp;Hui Chen ,&nbsp;Shun Li","doi":"10.1016/j.jtauto.2024.100261","DOIUrl":"10.1016/j.jtauto.2024.100261","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Coronary microvascular obstruction (MVO) frequently occurs in patients with ST-segment elevation myocardial infarction (STEMI) following percutaneous coronary intervention (PCI), leading to poor prognosis. β₁ adrenergic receptor autoantibodies (β₁-AA) are present in various cardiovascular diseases and correlate with cardiac damage and dysfunction. However, whether β₁-AA is associated with the occurrence of MVO in patients with STEMI after PCI remains unclear.</div></div><div><h3>Aims</h3><div>To investigate the prognostic relationship between β₁-AA and the occurrence of MVO in patients with STEMI with post-PCI.</div></div><div><h3>Methods</h3><div>This prospective study included 403 patients with STEMI who underwent primary PCI. The patients were divided into MVO+ and MVO- groups. Serum β₁-AA levels were measured prior to primary PCI. The primary outcome was MVO, assessed through cardiac magnetic resonance imaging at 5–7 days after PCI.</div></div><div><h3>Results</h3><div>A total of 127 MVO+ and 276 MVO– patients were identified. Patients with MVO + exhibited higher β₁-AA optical density (OD) compared to MVO- patients. β₁-AA OD, pNT-proBNP, pCK-MB and pTNI were positively associated with MVO following PCI. Notably, the assocition between β₁-AA levels and MVO risk strengthened with increasing pNT-proBNP levels. The combination of β₁-AA, pNT-proBNP and pTNI yielded the most efficient MVO prediction with an area under the ROC curve of 0.87 (95 % CI: 0.83–0.90).</div></div><div><h3>Conclusions</h3><div>β₁-AA is significantly associated with the occurrence of MVO in STEMI patients following primary PCI. The combination of β₁-AA with pNT-proBNP and pTNI improves predictive accuracy, providing a more robust and effective strategy for assessing MVO risk.</div></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"9 ","pages":"Article 100261"},"PeriodicalIF":4.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay between epidermal barrier distribution, microbiota composition, and immune infiltrate defines and stratifies psoriasis patients and is associated with disease severity","authors":"Elizabeth M. Ortega Rocha ,&nbsp;Paul Hernández-Herrera ,&nbsp;Sofia V. de los Santos- Carmona ,&nbsp;Saraí G De León-Rodríguez ,&nbsp;Ángel Juárez-Flores ,&nbsp;Vadim Pérez-Koldenkova ,&nbsp;Octavio Castro-Escamilla ,&nbsp;Samira Muñoz-Cruz ,&nbsp;Alicia Lemini-López ,&nbsp;Laura C. Bonifaz","doi":"10.1016/j.jtauto.2024.100257","DOIUrl":"10.1016/j.jtauto.2024.100257","url":null,"abstract":"<div><div>Psoriasis is a chronic inflammatory autoimmune skin disease characterized by keratinocyte hyperproliferation, primarily driven by the IL-23/IL-17 axis. In addition to immune response, various skin components, including the epidermal barrier and the skin microbiota, have been individually implicated in the disease pathogenesis. Here, we aimed to investigate the interplay between epidermal tight junctions, Staphylococcus aureus enterotoxin B (SEB), and CD4 T cell-mediated immune responses. By immunofluorescence analyses of skin biopsies, we observed that claudin-1 distribution was significantly altered in psoriatic patients, which correlated with the localization of <em>Staphylococcus aureus</em> and SEB across skin layers and with disease severity. Furthermore, functional CD4 TCRvβ17 cells were associated with SEB presence in patients skin and positively correlated with psoriasis severity. Notably, in patients with SEB detected in the dermis, CD4 TCRvβ17 IL-17 cells were linked to barrier abnormalities.</div><div>Unsupervised analysis stratified psoriasis patients into three groups based on SEB presence and location, supporting the previous findings. The patient group with SEB in the dermis exhibited improved responses to biological therapy, including reductions in PASI score, claudin-1 fragmentation, <em>S. aureus</em> and SEB presence, and CD4 TCRvβ17 cell percentages. Our findings emphasize the complex interplay between epidermal barrier distribution, SEB localization, and functional CD4 TCRvβ17 cells in psoriatic skin, highlighting their potential in patient stratification in association with the severity of the disease.</div></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"9 ","pages":"Article 100257"},"PeriodicalIF":4.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The autoimmune tautology revisited","authors":"Juan-Manuel Anaya,&nbsp;Santiago Beltrán","doi":"10.1016/j.jtauto.2023.100204","DOIUrl":"10.1016/j.jtauto.2023.100204","url":null,"abstract":"","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"7 ","pages":"Article 100204"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589909023000175/pdfft?md5=aef034a48774c20b443cb7b347a4a934&pid=1-s2.0-S2589909023000175-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47516650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 and thyroid diseases","authors":"Małgorzata Staruszkiewicz ,&nbsp;Anna Pituch-Noworolska ,&nbsp;Szymon Skoczen","doi":"10.1016/j.jtauto.2023.100214","DOIUrl":"https://doi.org/10.1016/j.jtauto.2023.100214","url":null,"abstract":"<div><p>SARS-CoV-2 virus responsible for acute respiratory disease affected other organs leading to co-existence symptoms or complications. Thyroid gland was one of them due to expression of angiotensin-converting enzyme 2 (ACE2), the protein facilitating viral binding to the host cells. Moreover, thyroid gland, important for regulation of hormonal network, is extremely sensitive to any changes in homeostasis and metabolism. It was shown, that COVID-19 was associated with induction of thyroid disease or increasing existing functional disturbances or autoimmune process. Thyroid diseases are mainly based on immunological pathomechanism although the relation between immune system and thyroid function is bidirectional e.g. thyroid hormones modulate specific immune responses, including cell-mediated immunity, NK cell activity, the production of antiviral interferon (IFN) and proliferation of T- and B-lymphocytes. The effects of COVID-19 and mRNA vaccine on thyroid function and diseases are discussed.</p></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"7 ","pages":"Article 100214"},"PeriodicalIF":3.9,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49858292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of generative artificial intelligence models in differential diagnoses of familial Mediterranean fever and deficiency of Interleukin-1 receptor antagonist","authors":"Joshua Pillai ,&nbsp;Kathryn Pillai","doi":"10.1016/j.jtauto.2023.100213","DOIUrl":"https://doi.org/10.1016/j.jtauto.2023.100213","url":null,"abstract":"<div><p>With the increasing development of artificial intelligence, large language models (LLMs) have been utilized to solve problems in natural language processing tasks. More recently, LLMs have shown unique potential in numerous applications within medicine but have been particularly investigated for their ability in clinical reasoning. Although the diagnostic accuracy of LLMs in forming differential diagnoses has been reviewed in general internal medicine applications, much is unknown in autoinflammatory disorders. From the nature of autoinflammatory diseases, forming a differential diagnosis is challenging due to the overlapping symptoms between disorders and even more difficult without genetic screening. In this work, the diagnostic accuracy of the Generative Pre-Trained Transformer Model-4 (GPT-4), GPT-3.5, and Large Language Model Meta AI (LLaMa) were evaluated in clinical vignettes of Deficiency of Interleukin-1 Receptor Antagonist (DIRA) and Familial Mediterranean Fever (FMF). We then compared these models to a control group including one internal medicine physician. It was found that GPT-4 did not significantly differ in correctly identifying DIRA and FMF patients compared to the internist. However, the physician maintained a significantly higher accuracy than GPT-3.5 and LLaMa 2 for either disease. Overall, we explore and discuss the unique potential of LLMs in diagnostics for autoimmune diseases.</p></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"7 ","pages":"Article 100213"},"PeriodicalIF":3.9,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49858293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of autoantibodies targeting interferon type 1 in COVID-19 severity: A systematic review and meta-analysis","authors":"Abolfazl Akbari ,&nbsp;Alireza Hadizadeh ,&nbsp;Mahdi Amiri ,&nbsp;Neshat Najaf Najafi ,&nbsp;Zahra Shahriari ,&nbsp;Tannaz Jamialahmadi ,&nbsp;Amirhossein Sahebkar","doi":"10.1016/j.jtauto.2023.100219","DOIUrl":"10.1016/j.jtauto.2023.100219","url":null,"abstract":"<div><h3>Introduction</h3><p>Impairment of the type I interferon (IFN–I) signaling pathway is associated with increased severity of COVID-19 disease. Here we have undertaken a systematic review and meta = analysis on the association between the severity of COVID-19 and IFN-1 autoantibodies (AAbs; aIFN-1, aIFN-α, aIFN-ω, and aIFN-β).</p></div><div><h3>Methods</h3><p>Four databases, including Medline [PubMed], Embase, Web of Science, and Scopus, were systematically searched to find papers on the role of aIFN-1 and its subtype AAbs in the severity of COVID-19 infection. Data on the prevalence of aIFN-1, aIFN-α, aIFN-ω, and aIFN-β were pooled using random- or fixed-effects models. Subgroup analysis was performed based on disease severity. Odds ratios (OR) for COVID-19 disease outcome, including length of hospital stay, ICU admission and death, were calculated in relation to positive or negative plasma IFN-1 AAbs.</p></div><div><h3>Results</h3><p>A total of 33 studies with 13023 patients were included. The overall prevalence of circulating aIFN-1, aIFN-α, and aIFN-ω AAbs was 17.8 % [13.8, 22.8], 7.2 % [4.7, 10.9], and 4.4 % [2.1, 8.6], respectively, and the overall prevalence of neutralizing aIFN-1, aIFN-α, aIFN-ω, and aIFN-β AAbs was 7.1 % [4.9, 10.1], 7.5 % [5.9, 9.5], 8.0 % [5.7, 11.1] and 1.2 % [0.4, 3.5], respectively. Circulating aIFN-α (OR = 4.537 [2.247, 9.158]), neutralizing aIFN-α (O = 17.482 [8.899, 34.342]), and neutralizing aIFN-ω (OR = 12.529 [7.397, 21.222]) were significantly more frequent in critical/severe patients than in moderate/mild patients (p &lt; 0.001 for all). Anti–IFN–1 was more common in male subjects (OR = 2.248 [1.366, 3.699], p = 0.001) and two COVID-19 outcomes including ICU admission (OR = 2.485 [1.409, 4.385], p = 0.002) and death (OR = 2.593 [1.199, 5.604], p = 0.015) occurred more frequently in patients with positive anti–IFN–1.</p><p>Conclusion: aIFN-1 and its subtypes AAbs are associated with severe and critical COVID-19 disease and may be a predictive marker for a poor prognosis, particularly in men.</p></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"7 ","pages":"Article 100219"},"PeriodicalIF":3.9,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel web-based online nomogram to predict advanced liver fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome","authors":"Zhiyi Zhang ,&nbsp;Jian Wang ,&nbsp;Yun Chen ,&nbsp;Yiguang Li ,&nbsp;Li Zhu ,&nbsp;Huali Wang ,&nbsp;Yilin Liu ,&nbsp;Jiacheng Liu ,&nbsp;Shengxia Yin ,&nbsp;Xin Tong ,&nbsp;Xiaomin Yan ,&nbsp;Yuxin Chen ,&nbsp;Chuanwu Zhu ,&nbsp;Jie Li ,&nbsp;Yuanwang Qiu ,&nbsp;Chao Wu ,&nbsp;Rui Huang","doi":"10.1016/j.jtauto.2023.100215","DOIUrl":"https://doi.org/10.1016/j.jtauto.2023.100215","url":null,"abstract":"<div><h3>Background</h3><p>Patients with autoimmune hepatitis-primary biliary cholangitis (AIH-PBC) overlap syndrome have a worse prognosis compared to AIH or PBC alone and accurately predicting the severity and dynamically monitoring the progression of disease are therefore essential. We aimed to develop a nomogram-based model to predict advanced liver fibrosis in patients with AIH-PBC overlap syndrome.</p></div><div><h3>Methods</h3><p>A total of 121 patients with AIH-PBC overlap syndrome were retrospectively included and randomly assigned to a development set and a validation set. Backward stepwise regression's best model with the lowest AIC was employed to create a nomogram. Diagnose accuracy was evaluated using the area under the receiver operator characteristic curve (AUROC), calibration analysis, and decision curve analysis (DCA) and was compared with aspartate aminotransferase-to-platelet ratio (APRI) and fibrosis index based on four factors-4 (FIB-4) score.</p></div><div><h3>Results</h3><p>The median age of patients was 53.0 years (IQR: 46.0–63.0), and female patients accounted for 95.0 %. Platelets, globulin, total bilirubin, and prothrombin time were associated with advanced fibrosis (≥S3) and used to construct an AIH-PBC overlap syndrome fibrosis (APOSF)-nomogram (available online at <span>https://ndth-zzy.shinyapps.io/APOSF-nomogram/</span><svg><path></path></svg>). The AUROCs of APOSF-nomogram were 0.845 (95 % CI: 0.754–0.936) and 0.843 (95 % CI: 0.705–0.982) in development set and validation set respectively, which was significantly better than APRI and FIB-4. Calibration revealed that the estimated risk fits well with biopsy-proven observation. DCA outperformed APRI and FIB4 in terms of net benefit, demonstrating clinical utility.</p></div><div><h3>Conclusion</h3><p>This novel non-invasive web-based online APOSF-nomogram provided a convenient tool for identifying advanced fibrosis in patients with AIH-PBC overlap syndrome. Further prospective, multicenter studies with large sample size are necessary to validate the applicability of APOSF-nomogram.</p></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"7 ","pages":"Article 100215"},"PeriodicalIF":3.9,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49858262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"suPAR and WT1 modify the adhesion of podocytes and are related to proteinuria in class IV lupus nephritis","authors":"Juan-José Bollain-y-Goytia ,&nbsp;Felipe-de-Jesús Torres-Del-muro ,&nbsp;Sara-Paola Hernández-Martínez ,&nbsp;Esperanza Avalos-Díaz ,&nbsp;Rafael Herrera-Esparza","doi":"10.1016/j.jtauto.2023.100216","DOIUrl":"10.1016/j.jtauto.2023.100216","url":null,"abstract":"<div><h3>Introduction</h3><p>Lupus nephritis (LN) affects up to 60 % of the patients with Systemic Lupus Erythematosus (SLE) and renal damage progression is associated with proteinuria, caused in part by the integrity of the glomerular basement membrane (GBM) and by podocyte injury. The soluble urokinase plasminogen activator receptor (suPAR) and Wilms Tumor 1 (WT1) have been related to podocyte effacement and consequently with proteinuria which raises questions about its pathogenic role in LN.</p></div><div><h3>Objective</h3><p>Define whether suPAR levels and WT1 expression influence in podocyte anchorage destabilization in LN class IV.</p></div><div><h3>Materials and methods</h3><p>This is a cross-sectional study of cases and controls. We studied patients with SLE without renal involvement (n = 12), SLE and LN class IV with proteinuria ≤0.5 g/24 h (n = 12), LN class IV with proteinuria ≥0.5 g/24 h (n = 12) and compared them with renal tissue control (CR) (n = 12) and control sera (CS) (n = 12). The CR was integrated by cadaveric samples without SLE or renal involvement and the CS was integrated by healthy participants. The expression and cellular localization of WT1, urokinase-type plasminogen activator receptor (uPAR), ac-α-tubulin, vimentin, and β3-integrin was assessed by immunohistochemistry (IHC). The concentration of suPAR in serum was analyzed by enzyme-linked immunosorbent assay (ELISA).</p></div><div><h3>Results</h3><p>In patients with LN, the activation of anchoring proteins was increased, such as podocyte β3-integrin, as well as the acetylation of alpha-acetyl-tubulin and uPAR, in contrast to the decrease in vimentin; interestingly, the cellular localization of WT1 was cytoplasmic and the number of podocytes per glomerulus decreased. The concentrations of suPAR was increased in patients with LN.</p></div><div><h3>Conclusion</h3><p>The destabilization of podocyte anchorage modulated by β3-integrin activation, and tubulin acetylation, associated with decreased WT1 cytoplasmic expression, and increased suPAR levels could be involved in kidney damage in patients with LN class IV.</p></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"7 ","pages":"Article 100216"},"PeriodicalIF":3.9,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-adenylate kinase 5 encephalitis: Clinical characteristics, diagnosis, and management of this rare entity","authors":"Er-Chuang Li ,&nbsp;Qi-Lun Lai ,&nbsp;Meng-Ting Cai ,&nbsp;Gao-Li Fang ,&nbsp;Chun-Hong Shen ,&nbsp;Mei-Ping Ding ,&nbsp;Yin-Xi Zhang","doi":"10.1016/j.jtauto.2023.100218","DOIUrl":"10.1016/j.jtauto.2023.100218","url":null,"abstract":"<div><p>The spectrum and understanding of antibody-positive autoimmune encephalitis (AE) have expanded over the past few decades. In 2007, a rare subtype of AE known as anti-adenylate kinase 5 (AK5) encephalitis, was first reported. This disease is more common in elderly males, with limbic encephalitis as the core phenotype (characterized by subacute anterograde amnesia, sometimes with psychiatric symptoms, and rarely with seizures). Brain magnetic resonance imaging typically demonstrated initial temporal lobe T2/fluid-attenuated inversion recovery hyperintensities, and subsequent atrophy. No concomitant tumors have been found yet. AK5 antibody, targeting the intracellular antigen, is a biomarker for a non-paraneoplastic T-cell autoimmunity response, and can be detected in serum and cerebrospinal fluid using tissue-based and cell-based assays. Cytotoxic T-cell-mediating neuronal injury and loss play a pivotal role in the immunopathogenesis of anti-AK5 encephalitis. Patients mostly show poor response to immunotherapy and thus a poor prognosis in the long run. Herein, we review the literature and provide updated knowledge of this less-known entity, focusing on clinical characteristics, paraclinical findings, diagnosis process, and therapeutic approaches.</p></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"7 ","pages":"Article 100218"},"PeriodicalIF":3.9,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c7/38/main.PMC10582738.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are serum C3 levels or kidney C3 deposits useful markers for predicting outcomes in patients with ANCA-associated vasculitis?","authors":"Alexis Cassard ,&nbsp;Clément Kounde ,&nbsp;Laurence Bouillet ,&nbsp;Tiphaine Goulenok ,&nbsp;David Ribes ,&nbsp;Rafik Mesbah ,&nbsp;Vincent Langlois ,&nbsp;Audrey Delas ,&nbsp;Françoise Fortenfant ,&nbsp;Sébastien Humbert ,&nbsp;Céline Lebas ,&nbsp;Julie Belliere ,&nbsp;Philippe Kerschen ,&nbsp;Dominique Chauveau ,&nbsp;Magali Colombat ,&nbsp;Stanislas Faguer","doi":"10.1016/j.jtauto.2023.100217","DOIUrl":"https://doi.org/10.1016/j.jtauto.2023.100217","url":null,"abstract":"<div><h3>Introduction</h3><p>Complement activation emerged as a key actor of anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV). Whether serum levels of C3 (sC3) or C3 kidney deposition may help to refine the prognosis of AAV remains elusive.</p></div><div><h3>Methods</h3><p>Retrospective multicentric study that included 154 patients with a first flare of AAV and sC3 (n = 143) or C3 kidney staining (n = 95) available at diagnosis. Clinical presentations, kidney pathology, and survival of patients with normal or low sC3 were compared using univariate analyses, Kaplan-Maier curves with log-rank comparison, or multivariate Cox’ model, as appropriate.</p></div><div><h3>Results</h3><p>20 patients (14 %) had low sC3. sC3 (as bivariate low/normal or as a continuous variable) was associated with 5-year mortality but not with kidney survival. C3 kidney deposition (C3+) was identified in 23 patients who were characterized by more frequent chronic hypertension and lower eGFR at presentation (p = 0.04). C3+ correlated with IgG, IgM, C1q deposition (p = 0.07, p &lt; 0.0001 and p = 0.003, respectively). Chronicity and activity scores were similar in C3+ and C3- patients. Among C3+ patients, those with C3 deposition ≥2+ had lower eGFR at presentation (p = 0.006) and were more frequently classified as sclerotic using the Berden classification (p = 0.04) and as ‘high risk’ using the Brix score (p = 0.03). However, eGFR improvement following induction regimen was similar between C3+ and C3- patients, and kidney survival at 5 years was similar.</p></div><div><h3>Conclusions</h3><p>Correlation of sC3 with mortality confirms mechanistic links between complement pathways and AAV, but the lack of clear predictive sC3 cut-off and the similar kidney outcome irrespective of C3 deposition precludes their use as biomarkers of AAV outcomes and response to treatment.</p></div>","PeriodicalId":36425,"journal":{"name":"Journal of Translational Autoimmunity","volume":"7 ","pages":"Article 100217"},"PeriodicalIF":3.9,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49858261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}