Lupus & antiphospholipid syndrome
CD163+ macrophage infiltration reflects disease activity and early treatment response in lupus nephritis
Authors' conclusion
CD163+ macrophage infiltration at baseline is associated with active disease and early treatment response in LN, independent of received treatment. While LN class guides treatment choice, CD163+ macrophage infiltration may offer additional prognostic value regarding early therapeutic response. These findings support further investigation of CD163+ macrophages as a biomarker not only providing prognostic information but also helping guide treatment choices beyond the current LN classification system.
Study context
- Population
- Biopsy-proven lupus nephritis (LN) patients (2002–2018)biopsy-proven LN patients, mean follow-up of 77 months
- Participants
- 58 participants
- Outcome
- CD163+ macrophage infiltration (glomerular and tubulointerstitial) and clinical and histological activity
- Follow-up
- Baseline
Methodological detailscorrelation matrices and linear mixed models
- Correlation matrices and linear mixed models
Main finding
As reported in the abstract
- Significantly associated with lower baseline eGFR, lower complement levels, more leukocyturia/erythrocyturia and higher activity index scores
Observational data: associations, not effects.
Further findings
Improvement of eGFR and proteinuria · first 6 months of treatment post-diagnosis
- Significantly greater improvement in patients with high CD163+ infiltration
Repeat biopsy
- Low CD163+ infiltration associated with increased likelihood of requiring a repeat biopsy
- High glomerular C5aR1+ infiltration linked to repeat biopsy
Long-term outcomes (renal flares, dialysis, transplantation)
- None of the macrophage markers were associated with long-term outcomes
Associations stratified by LN class
- These associations were not observed when stratifying by LN class
Other macrophage markers and disease activity
- CD68+ macrophages showed a similar trend
- CD206+ and C5aR1+ macrophages were not associated with markers of disease activity
Original publication
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