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Abstract: FR-PO605

Clinico-Pathological Associations of Serum CD44 Level in Patients With Lupus Nephritis

Session Information

Category: Glomerular Diseases

  • 1302 Glomerular Diseases: Immunology and Inflammation

Authors

  • Gao, Yawen, Department of Medicine, School of Clinical Medicine, the University of Hong Kong, Hong Kong SAR, Hong Kong
  • Yung, Susan, Department of Medicine, School of Clinical Medicine, the University of Hong Kong, Hong Kong SAR, Hong Kong
  • Chan, Tak Mao Daniel, Department of Medicine, School of Clinical Medicine, the University of Hong Kong, Hong Kong SAR, Hong Kong
Background

Conventional serological markers do not always correlate with clinical activity in lupus nephritis (LN). CD44 is a transmembrane glycoprotein that is widely expressed in immune and non-immune cells, and has been implicated in tissue inflammation and fibrosis. CD44 also serves as a cell receptor for hyaluronan (HA), a glycosaminoglycan that contributes to inflammatory and fibrotic processes. We previously reported that serum HA level correlated with clinical and serological parameters in LN. This study investigated clinico-pathological associations of circulating CD44 level.

Methods

Serial serum samples from patients with biopsy-proven Class III/IV LN were collected at intervals of 3-4 months over 3 years. Sera from sex- and age-matched patients with non-renal SLE or non-lupus chronic kidney disease (CKD) or healthy subjects were included as Controls. Serum CD44 was measured by ELISA.

Results

Six hundred and sixty-two sera from 41 LN patients (31 female and 10 male, age 38.78±12.02 years) were included. Serum CD44 level was significantly higher in active LN compared to remission, non-renal SLE, CKD, or healthy subjects (P<0.0001, for all). Serum CD44 level correlated with SLEDAI-2K and renal SLEDAI-2K scores, anti-dsDNA antibody titre, proteinuria, and serum HA level, and inversely correlated with eGFR and C3 level (P<0.0001, for all). All episodes of LN flare were accompanied by increased serum CD44 level, which decreased after treatment with immunosuppression. A temporal relationship was observed between CD44 level and SLEDAI-2K and renal SLEDAI-2K scores, anti-dsDNA antibody titre, C3 level, and proteinuria. ROC analysis showed that serum CD44 level distinguished active LN from healthy subjects (sensitivity 98.31%, specificity 100.00%), from LN in remission (sensitivity 86.44%, specificity 98.31%), from non-renal SLE (sensitivity 98.31%, specificity 98.00%), and from non-lupus CKD (sensitivity 98.31%, specificity 100.00%) (P<0.0001, for all).

Conclusion

Active LN is associated with increased serum CD44 level. Further studies are warranted to investigate whether CD44 may serve as a biomarker in the diagnosis and monitoring of LN activity.

Funding

  • Government Support – Non-U.S.