Clinicopathological Characteristics And The Related Biomarkers Of Patients With Lupus Nephritis

Background Lupus nephritis(LN) is one of the systemic autoimmune diseases. It is common to occur in women of reproductive age. The clinical manifestation of LN is complex and varied with multisystem damaged, and the kidney is the most vulnerable organ to get involved. It will cause chronic renal failure. LN has ethnic and regional differences, and it is the most common disease in the African-American and Asian population. Recently, though great improvement has been achieved in the diagnosis and treatment of LN, the morbidity and the mortality is still high. The kidney biopsy as a invasive manipulation is the gold standard to diagnose LN, and there are not any noninvasive biomarkers associated with the diagnosis and detection disease activity of LN. Therefore, we need to study the clinicopathological characteristics, the rate of kidney biopsy, the prognosis and the biomarkers of LN.Objective To analyze the clinicopathological characteristics and the prognosis of patients with LN in central China and study the potential biomarkers of LN.Methods1. A total of 244 patients diagnosed with LN from 2011.01.01-2015.10.31 at the Tongji Hospital affiliated to Huazhong University of Science and Technology were admitted and their clinical and pathological data were analyzed.2. The plasma expressive levels of mi R-21, mi R-126 and mi R-148 a in 44 patients with lupus nephritis(LN) and 24 healthy controls were studied.Result 1. Of the 244 patients with LN in central China, 30(12.3%) were male and 214(87.7%) were female. The mean age was 33.1(range 14-67) years old. And 50.6% patients were from 20-30 years old. There was significant difference in gender(P<0.05). The trend of newly diagnosed with LN was increasing, but the rate of the biopsy presented a falling tendency. LN with multisystem damaged and it presented complicated and diverse clinical manifestations. Symptoms such as fever, erythema, alopecia, fatigue, ulcer, photosensitization, arthritis and myositis, edema and gross hematuria were common to see. In addition, the digestive system, the respiratory system, and the nervous system were also involved. LN patients had severe kidney damage(hematuria, proteinuria, edema, and renal injury). The percent of severe disease activity(SLEDAI score >12) was more than 68.5%. The renal histopathological classification of LN is predominant with type ?(13.5%), type ?(36.5%), and type?(26.9%). Immune complex deposits, widespread wire loops and mesangiocapillary proliferation were typical characters. The presence of tubulointerstitial fibrosis, tubular atrophy and vascular fibrinoid necrosis was 74.5%, 88.7% and 27.9%, respectively.2. Plasma levels of mi R-21, mi R-148 a, and mi R-126 in LN patients were significantly increased, and plasma mi R-21 levels are associated with C3 and C4 levels and the SLEDAI.Conclusions 1. Lupus nephritis(LN) is one of the systemic autoimmune diseases common occur in women of reproductive age. The trend of newly diagnosed with LN was increasing, but the rate of the biopsy presented a falling tendency. The histopathological manifested with multiple immune complex deposits.2. The circulating mi R-21 may be a potential non-invasive biomarker in LN patients, but more related studies are still needed.