Lupus & antiphospholipid syndrome
Circulating neutrophil extracellular trap remnants as a biomarker to predict outcomes in lupus nephritis
Authors' conclusion
Elastase-DNA and HMGB1-DNA complexes predict renal outcomes
Study context
- Population
- Patients with active lupus nephritis (LN) flare (LN cohort) and an exploratory cohort of active systemic lupus erythematosus (SLE), inactive SLE and healthy controlsLN cohort
- Participants
- 109 patients
- Exposure
- Higher vs lower baseline serum neutrophil extracellular trap (NET) remnant levels at LN flare
- Active SLEn = 49
- Inactive SLEn = 23
- Healthy controls (HC)n = 20reference
- Outcome
- Renal outcomes (not achieving complete remission; progression to severe renal impairment) predicted by NET remnant levels at LN flare
- Follow-up
- 24 months
Methodological detailsprospectively followed cohorts, exploratory cohort and separate LN cohort
- Prospectively followed cohorts
- Exploratory cohort and separate LN cohort
Main finding
As reported in the abstract
Not achieving complete remission at 24 months after flare, by higher baseline NET remnant levels (LN cohort)
OR for not achieving complete remission
2.34
P = 0.007
Higher baseline Elastase-DNA
OR for not achieving complete remission
2.61
P = 0.009
Higher baseline HMGB1-DNA
Observational data: associations, not effects.
Further findings
Progression to severe renal impairment, per higher baseline NET remnants · 24 months after the flare
| OR | P value | |
|---|---|---|
| Higher baseline Elastase-DNA | 2.84 | P = 0.006 |
| Higher baseline HMGB1-DNA | 2.04 | P = 0.02 |
| Outcome | P value |
|---|---|
| NET remnants, SLE vs HC (exploratory cohort)Significantly higher in SLE | P < 0.0001 for both complexes |
| NET remnants, active LN vs active SLE without LN (exploratory cohort)Active LN vs Active SLE without LN · significantly higher in active LN (36%) | Elastase-DNA: p=0.03 |
| NET remnants, active LN vs active SLE without LN (exploratory cohort)Active LN vs Active SLE without LN | HMGB1-DNA: p=0.02 |
| NET remnants, proliferative vs non-proliferative LN (LN cohort)Proliferative LN vs Non-proliferative LN · significantly higher in proliferative LN | Elastase-DNA: p<0.0001 |
| NET remnants, proliferative vs non-proliferative LN (LN cohort)Proliferative LN vs Non-proliferative LN | HMGB1-DNA: p=0.0003 |
Original publication
Circulating neutrophil extracellular trap remnants as a biomarker to predict outcomes in lupus nephritis. Lupus Sci Med. Published 4 January 2024. doi:10.
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