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Erschienen in: Wiener klinische Wochenschrift 5-6/2022

17.01.2022 | original article

Identification of novel classes for patients with lupus nephritis using two-step cluster model

verfasst von: Dr. Ting Huang, Dr. Shasha Xie, Dr. Liqing Ding, Prof. Xiaofeng Zeng, Prof. Hui Luo

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 5-6/2022

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Summary

Objective

To identify and reclassify the patients in the lupus nephritis (LN) cohort, and to further analyze the prominent clinical features and clinical significance of each cluster.

Methods

In this retrospective cross-sectional study, we used a two-step clustering method to classify 635 patients with LN into different clusters, then we observed the main differences and analyzed relevant clinical significance between the clusters.

Results

Cluster 1 (20.5%) presented with the highest disease severity, patients in this group had the disease for a longer duration and higher systemic lupus erythematosus disease activity index (SLEDAI) score, with multiple positive auto-antibodies and lower complement level. Patients of cluster 2 (20.8%) had lower levels of IgG, IgA and IgM, with renal function being relatively worse in this cluster than in clusters 1 and 3. Cluster 3 was the largest group (58.7%), and the patients in this group showed mild disease severity.

Conclusion

This study reclassified LN patients in a large cohort into three clusters. Our classification might be helpful to implement targeted therapy at various stages of systemic lupus erythematosus.
Literatur
1.
Zurück zum Zitat Yu F, Haas M, Glassock R, et al. Redefining lupus nephritis: clinical implications of pathophysiologic subtypes. Nat Rev Nephrol. 2017;13(8):483–95. CrossRef Yu F, Haas M, Glassock R, et al. Redefining lupus nephritis: clinical implications of pathophysiologic subtypes. Nat Rev Nephrol. 2017;13(8):483–95. CrossRef
2.
Zurück zum Zitat Meacock R, Dale N, Harrison MJ. The humanistic and economic burden of systemic lupus erythematosus : a systematic review. PharmacoEconomics. 2013;31(1):49–61. CrossRef Meacock R, Dale N, Harrison MJ. The humanistic and economic burden of systemic lupus erythematosus : a systematic review. PharmacoEconomics. 2013;31(1):49–61. CrossRef
3.
Zurück zum Zitat Gladman D, Goldsmith CH, Urowitz MB, et al. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index for Systemic Lupus Erythematosus International Comparison. J Rheumatol. 2000;27(2):373–6. PubMed Gladman D, Goldsmith CH, Urowitz MB, et al. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index for Systemic Lupus Erythematosus International Comparison. J Rheumatol. 2000;27(2):373–6. PubMed
4.
Zurück zum Zitat Sada KE, Makino H. Usefulness of ISN/RPS classification of lupus nephritis. J Korean Med Sci. 2009;24(Suppl):S7–S10. CrossRef Sada KE, Makino H. Usefulness of ISN/RPS classification of lupus nephritis. J Korean Med Sci. 2009;24(Suppl):S7–S10. CrossRef
5.
Zurück zum Zitat Markowitz GS, D’Agati VD. The ISN/RPS 2003 classification of lupus nephritis: an assessment at 3 years. Kidney Int. 2007;71(6):491–5. CrossRef Markowitz GS, D’Agati VD. The ISN/RPS 2003 classification of lupus nephritis: an assessment at 3 years. Kidney Int. 2007;71(6):491–5. CrossRef
6.
Zurück zum Zitat Bertsias GK, Tektonidou M, Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis. 2012;71(11):1771–82. CrossRef Bertsias GK, Tektonidou M, Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis. 2012;71(11):1771–82. CrossRef
7.
Zurück zum Zitat Gladman D, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29(2):288–91. PubMed Gladman D, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29(2):288–91. PubMed
8.
Zurück zum Zitat Lam GK, Petri M. Assessment of systemic lupus erythematosus. Clin Exp Rheumatol. 2005;23(5 Suppl 39):S120–S32. PubMed Lam GK, Petri M. Assessment of systemic lupus erythematosus. Clin Exp Rheumatol. 2005;23(5 Suppl 39):S120–S32. PubMed
9.
Zurück zum Zitat Yap D, Chan TM. B cell abnormalities in systemic lupus erythematosus and lupus nephritis-role in pathogenesis and effect of immunosuppressive treatments. Int J Mol Sci. 2019;20(24):6231. CrossRef Yap D, Chan TM. B cell abnormalities in systemic lupus erythematosus and lupus nephritis-role in pathogenesis and effect of immunosuppressive treatments. Int J Mol Sci. 2019;20(24):6231. CrossRef
10.
Zurück zum Zitat Devarapu SK, Lorenz G, Kulkarni OP, et al. Cellular and molecular mechanisms of autoimmunity and lupus nephritis. Int Rev Cell Mol Biol. 2017;332:43–154. CrossRef Devarapu SK, Lorenz G, Kulkarni OP, et al. Cellular and molecular mechanisms of autoimmunity and lupus nephritis. Int Rev Cell Mol Biol. 2017;332:43–154. CrossRef
11.
Zurück zum Zitat Yap DY, Lai KN. Pathogenesis of renal disease in systemic lupus erythematosus—the role of autoantibodies and lymphocytes subset abnormalities. Int J Mol Sci. 2015;16(4):7917–31. CrossRef Yap DY, Lai KN. Pathogenesis of renal disease in systemic lupus erythematosus—the role of autoantibodies and lymphocytes subset abnormalities. Int J Mol Sci. 2015;16(4):7917–31. CrossRef
12.
Zurück zum Zitat Bagavant H, Fu SM. Pathogenesis of kidney disease in systemic lupus erythematosus. Curr Opin Rheumatol. 2009;21(5):489–94. CrossRef Bagavant H, Fu SM. Pathogenesis of kidney disease in systemic lupus erythematosus. Curr Opin Rheumatol. 2009;21(5):489–94. CrossRef
13.
Zurück zum Zitat Flechsig A, Rose T, Barkhudarova F, et al. What is the clinical significance of anti-Sm antibodies in systemic lupus erythematosus? A comparison with anti-dsDNA antibodies and C3. Clin Exp Rheumatol. 2017;35(4):598–606. PubMed Flechsig A, Rose T, Barkhudarova F, et al. What is the clinical significance of anti-Sm antibodies in systemic lupus erythematosus? A comparison with anti-dsDNA antibodies and C3. Clin Exp Rheumatol. 2017;35(4):598–606. PubMed
14.
Zurück zum Zitat Choe JY, Lee S, Kwak SG, et al. Anti-Sm antibody, damage index, and corticosteroid use are associated with cardiac involvement in systemic lupus erythematosus: data from a prospective registry study. J Korean Med Sci. 2020;35(21):e139. CrossRef Choe JY, Lee S, Kwak SG, et al. Anti-Sm antibody, damage index, and corticosteroid use are associated with cardiac involvement in systemic lupus erythematosus: data from a prospective registry study. J Korean Med Sci. 2020;35(21):e139. CrossRef
15.
Zurück zum Zitat Ahn SS, Jung SM, Yoo J, et al. Anti-Smith antibody is associated with disease activity in patients with new-onset systemic lupus erythematosus. Rheumatol Int. 2019;39(11):1937–44. CrossRef Ahn SS, Jung SM, Yoo J, et al. Anti-Smith antibody is associated with disease activity in patients with new-onset systemic lupus erythematosus. Rheumatol Int. 2019;39(11):1937–44. CrossRef
16.
Zurück zum Zitat Novak GV, Marques M, Balbi V, et al. Anti-RO/SSA and anti-La/SSB antibodies: association with mild lupus manifestations in 645 childhood-onset systemic lupus erythematosus. Autoimmun Rev. 2017;16(2):132–5. CrossRef Novak GV, Marques M, Balbi V, et al. Anti-RO/SSA and anti-La/SSB antibodies: association with mild lupus manifestations in 645 childhood-onset systemic lupus erythematosus. Autoimmun Rev. 2017;16(2):132–5. CrossRef
17.
Zurück zum Zitat Higuera-Ortiz V, Mora-Arias T, Castillo-Martinez D, et al. Anti-Ro/SSA antibodies are associated with severe mitral valve regurgitation in patients with systemic lupus erythematosus. Mod Rheumatol. 2017;27(3):476–80. CrossRef Higuera-Ortiz V, Mora-Arias T, Castillo-Martinez D, et al. Anti-Ro/SSA antibodies are associated with severe mitral valve regurgitation in patients with systemic lupus erythematosus. Mod Rheumatol. 2017;27(3):476–80. CrossRef
18.
Zurück zum Zitat ter Borg EJ, Groen H, Horst G, et al. Clinical associations of antiribonucleoprotein antibodies in patients with systemic lupus erythematosus. Semin Arthritis Rheum. 1990;20(3):164–73. CrossRef ter Borg EJ, Groen H, Horst G, et al. Clinical associations of antiribonucleoprotein antibodies in patients with systemic lupus erythematosus. Semin Arthritis Rheum. 1990;20(3):164–73. CrossRef
19.
Zurück zum Zitat Bastian HM, Roseman JM, McGwin GJ, et al. Systemic lupus erythematosus in three ethnic groups. XII. Risk factors for lupus nephritis after diagnosis. Lupus. 2002;11(3):152–60. CrossRef Bastian HM, Roseman JM, McGwin GJ, et al. Systemic lupus erythematosus in three ethnic groups. XII. Risk factors for lupus nephritis after diagnosis. Lupus. 2002;11(3):152–60. CrossRef
Metadaten
Titel
Identification of novel classes for patients with lupus nephritis using two-step cluster model
verfasst von
Dr. Ting Huang
Dr. Shasha Xie
Dr. Liqing Ding
Prof. Xiaofeng Zeng
Prof. Hui Luo
Publikationsdatum
17.01.2022
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 5-6/2022
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-021-02001-y