Lupus & antiphospholipid syndrome
Serum Soluble Mediator Signatures of Lupus Nephritis: Histologic Features and Response to Treatment
Authors' conclusion
Serum soluble mediators, particularly syndecan-1 and VCAM-1, reflect LN histologic activity, and early decreases predict treatment response, supporting their potential use as noninvasive longitudinal biomarkers.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) undergoing clinically indicated kidney biopsies (UPCR ≥ 0.5), Accelerating Medicines Partnership (AMP) RA and SLE Network268 SLE patients
- Participants
- 160 / 96 / 22
- Exposure
- Proliferative lupus nephritis (LN) vs nonproliferative LN; serum mediator changes vs 12-month treatment response
- Proliferative LNn = 160
- Nonproliferative LNn = 96reference
- Healthy controlsn = 22
- Outcome
- Serum mediator predictors of proliferative LN (class III/IV ± V) and of 12-month treatment response (complete/partial vs no response)
Methodological detailsmulticentre, biomarker study, bootstrapped least absolute shrinkage and selection operator (LASSO) regression, logistic regression, molecular clustering, 66 immune mediators quantified by xMAP multiplex assays; TACE by ELISA; 7 mediators with >95% values below detection limits excluded
- Multicentre
- Biomarker study
- Bootstrapped LASSO regression
- Logistic regression
- Molecular clustering
- 66 immune mediators quantified by xMAP multiplex assays; TACE by ELISA; 7 mediators with >95% values below detection limits excluded
Main finding
As reported in the abstract
Prediction of proliferative LN by 20 LASSO-selected baseline mediators · biopsy
AUC of 20-mediator model for proliferative LN
0.82
95% CI 0.81–0.91
Observational data: associations, not effects.
Further findings
Prediction of 12-month treatment response in proliferative LN · 3-month changes; 12-month response
- Model with syndecan-1 and VCAM-1 reductions and UPCR decline
- 0.90 (95% CI, 0.82-0.98)
- 3-month reductions in syndecan-1 and VCAM-1 predicted 12-month treatment response
Molecular clustering of mediator profiles
- Distinct LN subgroups with unique soluble mediator signatures and clinical features not captured by histology alone
- 4
Original publication
Serum Soluble Mediator Signatures of Lupus Nephritis: Histologic Features and Response to Treatment. Arthritis Care Res (Hoboken). Published 3 December 2025. doi:10.
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