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Zhao T, Lin FA, Chen H. Analysis of risk factors for the progression and prognosis of connective tissue disease-associated interstitial lung disease. Arch Rheumatol 2023; 38:274-281. [PMID: 37680526 PMCID: PMC10481697 DOI: 10.46497/archrheumatol.2023.9602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/29/2022] [Indexed: 09/09/2023] Open
Abstract
Objectives This study aimed to investigate the risk factors of lung progression in patients with connective tissue disease-associated interstitial lung disease (ILD). Patients and methods A total of 91 ILD patients (28 males, 63 females; mean age: 54.9±11.3 years; range, 30 to 77 years) were included in the prospective follow-up study conducted throughout 2020. They were divided into progressors (n=27) and nonprogressors (n=64) according to whether the pulmonary disease progressed during a six-month follow-up period. The clinical data of the two groups were analyzed, and a logistic regression model was constructed to analyze the risk factors of the progression of ILD in all patients. Results Univariate analysis revealed significant differences (p<0.05) between the two groups in smoking history, serum ferritin, FVC% (the percentage of forced vital capacity), DLCO% (the percentage of diffusion capacity for carbon monoxide), and computed tomography involvement range. Further application of a logistic regression model revealed that increased serum ferritin level was an independent risk factor for ILD progression (odds ratio=1.002, 95% confidence interval: 1.000-1.003, p=0.004). The optimal critical value of serum ferritin was 303.25 ng/mL, the sensitivity and specificity were 81.5% and 54.7%, respectively, and the area under the curve was 0.747. Conclusion The level of serum ferritin may be an independent predictor for ILD progression.
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Affiliation(s)
- Ting Zhao
- Department of Rheumatology and Immunology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Fu-an Lin
- Department of Rheumatology and Immunology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Hongpu Chen
- Department of Rheumatology and Immunology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
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Jiang Y, Li X, Zhou W, Jin M, Li S, Lao Y, Zhu H, Wang J. Clinical significance of serum ferritin in patients with systemic sclerosis. J Clin Lab Anal 2022; 36:e24597. [PMID: 35808930 PMCID: PMC9396164 DOI: 10.1002/jcla.24597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/12/2022] [Accepted: 06/28/2022] [Indexed: 12/01/2022] Open
Abstract
Objective The purpose of this study was to explore the clinical significance of serum ferritin (SF) in patients with systemic sclerosis (SSc). Methods The levels of SF were measured in 115 patients with SSc and 117 healthy controls (HCs). Clinical characteristics and laboratory indexes between the high ferritin SSc group and the normal ferritin SSc group were analyzed. Results The level of SF in SSc patients was significantly higher than that in HCs (319.78 [179, 554.33] ng/ml vs. 99 [49.03, 164.29] ng/ml, p < 0.01). Compared with the normal ferritin SSc group, the high ferritin SSc group was more likely to develop skin diffuse cutaneous SSc, fingertip arthralgia, and cardiac involvement. In addition, the levels of glutamine transaminase (GGT), alanine aminotransferase (ALT), creatine kinase (CK), creatine kinase isoenzyme‐MB (CK‐MB), lactate dehydrogenase (LD), immunoglobulin G (IgG), immunoglobulin A (IgA), C‐reactive protein (CRP), erythrocyte sedimentation rate (ESR), and the positive rate of anti‐Scl70 antibody in the high ferritin SSc group were significantly higher (each p < 0.05). SF was positively correlated with GGT, ALT, CK, CK‐MB, LD, IgA, CRP, and ESR (each p < 0.05). Multiple linear regression analysis showed that cardiac involvement, ALT, and ESR were independent influencing factors of SF in SSc. Conclusion Our study shows that the level of SF in patients with SSc is increased, and the elevated SF is related to abnormal liver function, myocardial involvement, inflammatory status, and production of autoantibodies in SSc. Cardiac involvement, ALT, and ESR are independent factors affecting SF in SSc.
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Affiliation(s)
- Yanting Jiang
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xi Li
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wei Zhou
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Min Jin
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Sihui Li
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yuehong Lao
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Haiqing Zhu
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jian Wang
- Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Soliman SA, Haque A, Vanarsa K, Zhang T, Ismail F, Lee KH, Pedroza C, Greenbaum LA, Mason S, Hicks MJ, Wenderfer SE, Mohan C. Urine ALCAM, PF4 and VCAM-1 Surpass Conventional Metrics in Identifying Nephritis Disease Activity in Childhood-Onset Systemic Lupus Erythematosus. Front Immunol 2022; 13:885307. [PMID: 35720325 PMCID: PMC9204340 DOI: 10.3389/fimmu.2022.885307] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/28/2022] [Indexed: 12/20/2022] Open
Abstract
Objectives Serial kidney biopsy for repeat evaluation and monitoring of lupus nephritis (LN) in childhood-onset Systemic Lupus Erythematosus (cSLE) remains challenging, thus non-invasive biomarkers are needed. Here, we evaluate the performance of ten urine protein markers of diverse nature including cytokines, chemokines, and adhesion molecules in distinguishing disease activity in cSLE. Methods Eighty-four pediatric patients meeting ≥4 ACR criteria for SLE were prospectively enrolled for urine assay of 10 protein markers normalized to urine creatinine, namely ALCAM, cystatin-C, hemopexin, KIM-1, MCP-1, NGAL, PF-4, Timp-1, TWEAK, and VCAM-1 by ELISA. Samples from active renal (LN) and active non-renal SLE patients were obtained prior to onset/escalation of immunosuppression. SLE disease activity was evaluated using SLEDAI-2000. 59 patients had clinically-active SLE (SLEDAI score ≥4 or having a flare), of whom 29 patients (34.5%) were classified as active renal, and 30 patients (35.7%) were active non-renal. Twenty-five healthy subjects were recruited as controls. Results Urine concentrations of ALCAM, KIM-1, PF4 and VCAM-1 were significantly increased in active LN patients versus active non-renal SLE, inactive SLE and healthy controls. Five urine proteins differed significantly between 2 (hemopexin, NGAL, MCP1) or 3 (Cystatin-C, TWEAK) groups only, with the highest levels detected in active LN patients. Urine ALCAM, VCAM-1, PF4 and hemopexin correlated best with total SLEDAI as well as renal-SLEDAI scores (p < 0.05). Urine ALCAM, VCAM-1 and hemopexin outperformed conventional laboratory measures (anti-dsDNA, complement C3 and C4) in identifying concurrent SLE disease activity among patients (AUCs 0.75, 0.81, 0.81 respectively), while urine ALCAM, VCAM-1 and PF4 were the best discriminators of renal disease activity in cSLE (AUCs 0.83, 0.88, 0.78 respectively), surpassing conventional biomarkers, including proteinuria. Unsupervised Bayesian network analysis based on conditional probabilities re-affirmed urine ALCAM as being most predictive of active LN in cSLE patients. Conclusion Urinary ALCAM, PF4, and VCAM-1 are potential biomarkers for predicting kidney disease activity in cSLE and hold potential as surrogate markers of nephritis flares in these patients.
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Affiliation(s)
- Samar A Soliman
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt.,Department of Biomedical Engineering, University of Houston, Houston TX, United States
| | - Anam Haque
- Department of Biomedical Engineering, University of Houston, Houston TX, United States
| | - Kamala Vanarsa
- Department of Biomedical Engineering, University of Houston, Houston TX, United States
| | - Ting Zhang
- Department of Biomedical Engineering, University of Houston, Houston TX, United States
| | - Faten Ismail
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Kyung Hyun Lee
- Center for Clinical Research and Evidence-Based Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Claudia Pedroza
- Center for Clinical Research and Evidence-Based Medicine, University of Texas Health Science Center at Houston, Houston, TX, United States
| | | | - Sherene Mason
- Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford, CT, United States
| | - M John Hicks
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States
| | - Scott E Wenderfer
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States
| | - Chandra Mohan
- Department of Biomedical Engineering, University of Houston, Houston TX, United States
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