Natural killer cells as biomarkers for disease activity, lupus nephritis, and time to remission in treatment-naïve childhood-onset systemic lupus erythematosus: a cohort study
Authors' conclusion
Absolute NK cell count independently stratifies patients with cSLE by disease activity, clinical diagnosis of lupus nephritis, and time to first remission.
Study context
- Population
- Treatment-naïve, infection-free patients with childhood-onset SLE (cSLE) diagnosed 2015–2025
- Participants
- 96 participants
- Exposure
- Association of natural killer (NK) cell levels with disease activity, organ involvement and time to first remission
- Outcome
- Clinical relevance of NK cell levels: higher disease activity (SLEDAI > 9 vs ≤ 9), organ involvement (LN) and time to first remission
Methodological detailslogistic regression, Cox regression, linear mixed-effects model
- Logistic regression
- Cox regression
- Linear mixed-effects model
Main finding
As reported in the abstract
Independent factors associated with higher disease activity (SLEDAI > 9)
Absolute NK cell count, OR (95% CI 0.969-0.995), P = 0.007
0.982
Anti-dsDNA positivity, OR (95% CI 1.257-20.757), P = 0.023
5.107
Neuropsychiatric involvement, OR (95% CI 6.79-163.32), P < 0.001
33.306
Observational data: associations, not effects.
Further findings
Independent factors for LN
- Anti-dsDNA positivity, OR (95% CI 2.302-31.791), P = 0.001
- 8.555
- Absolute NK cell count, OR (95% CI 0.982-1.000), P = 0.041
- 0.991
Time to first remission (multivariate Cox regression, forward likelihood ratio)
- Higher absolute NK cell count, shorter time to first remission, HR (95% CI 1.001-1.009), P = 0.015
- 1.005
- Hypocomplementemia, longer time to first remission, HR (95% CI 0.244-0.912), P = 0.026
- 0.472
- Optimal cut-off, cells/µL
- 126
Original publication
Natural killer cells as biomarkers for disease activity, lupus nephritis, and time to remission in treatment-naïve childhood-onset systemic lupus erythematosus: a cohort study. Pediatr Rheumatol Online J. Published 9 March 2026. doi:10.
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