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Serum IP-10 is useful for identifying renal and overall disease activity in pediatric systemic lupus erythematosus

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Abstract

Background

Traditional serological biomarkers often fail to assess systemic lupus erythematosus (SLE) disease activity and discriminate lupus nephritis (LN). The aim of this study was to identify novel markers for evaluating renal and overall disease activity in Chinese patients with pediatric systemic lupus erythematosus (pSLE).

Methods

The study included 46 patients with pSLE (35 girls, 11 boys; average age 13.3 ± 2.6 years) and 31 matched healthy controls (22 girls, 9 boys; average age 12.3 ± 2.4 years). The SLE Disease Activity Index (SLEDAI) and renal SLEDAI were used to assess disease activity. Nine different soluble mediators in plasma, including tumor necrosis factor alpha (TNF-α), platelet-derived growth factor-BB (PDGF-BB), interferon (IFN) gamma inducible protein 10 (IP-10), interleukin (IL)-1β, IFN-γ, IL-17A, IL-2, Fas and Fas ligand, were measured by Luminex assay and compared between patients with active and inactive pSLE as well as between patients with pSLE with active and inactive renal disease. Receiver operating characteristic curve analysis was used to measure the discrimination accuracy.

Results

Of the 46 patients with pSLE, 30 (65.2%) had LN. These patients had significantly elevated levels of serum TNF-α, PDGF-BB, IP-10 and Fas. The serum levels of IP-10 were also significantly higher in patients with active pSLE. We found that IP-10 was also more sensitive and specific than conventional laboratory parameters, including anti-double-stranded DNA and complement components C3 and C4, for distinguishing active lupus from quiescent lupus. The serum level of IP-10 was also significantly increased in children with pSLE with active renal disease relative to those with inactive renal disease. There was also a positive correlation between serum IP-10 levels and renal SLEDAI scores as well as with 24 h urine protein.

Conclusions

Serum IP-10 is useful for identifying renal and overall disease activity in children with pSLE.

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Acknowledgements

This study was funded by the National Natural Science Foundation of China (81273314, 81571605) and Shanghai Municipal Education Commission (14ZZ105). We also would like to thank the patients and their families who participated in the study for their time and effort.

Author information

Authors and Affiliations

  1. Department of Allergy and Immunology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University, 1678, Dongfang Road, Shanghai, China

    Chen-xing Zhang, Li Cai & Tong-xin Chen

  2. Division of Immunology, Institute of Pediatric Translational Medicine, Shanghai Jiao Tong University, Shanghai, China

    Chen-xing Zhang, Li Cai, Jing Wu & Tong-xin Chen

  3. Department of Laboratory Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China

    Kang Shao

  4. Department of Nephrology and Rheumatology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University, Shanghai, China

    Wei Zhou & Tong-xin Chen

  5. Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China

    Lan-fang Cao

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  1. Chen-xing Zhang
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  2. Li Cai
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  3. Kang Shao
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Contributions

All authors were involved in drafting the article or revising it critically for important intellectual content and all authors approved the final version to be published. Tong-xin Chen, Lan-fang Cao and Wei Zhou were responsible for study conception and design. Chen-xing Zhang and Li Cai were responsible for the experiment as well as the analysis and interpretation of data. Kang Shao and Jing Wu were responsible for the acquisition of data. Tong-xin Chen reviewed the final version of the manuscript.

Corresponding author

Correspondence to Tong-xin Chen.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of Shanghai Children’s Medical Center and all participants signed a consent form in order to participate.

Conflicts of interest

The authors declare that they have no competing interests and all authors read and approved the final manuscript and the final version to be published.

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Zhang, Cx., Cai, L., Shao, K. et al. Serum IP-10 is useful for identifying renal and overall disease activity in pediatric systemic lupus erythematosus. Pediatr Nephrol 33, 837–845 (2018). https://doi.org/10.1007/s00467-017-3867-1

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  • DOI: https://doi.org/10.1007/s00467-017-3867-1

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