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Abstract: SA-PO834

Plasma TET2 as Potential Noninvasive Biomarker for Type IV Lupus Nephritis

Session Information

Category: Glomerular Diseases

  • 1401 Glomerular Diseases: From Inflammation to Fibrosis

Authors

  • Zhou, Hua, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
  • Kopp, Jeffrey B., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States
  • Liu, Jiayue, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
  • Yang, Hongyu, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
  • Jiao, Congcong, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
  • Luan, Junjun, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
Background

Therapeutic regimen of lupus nephritis (LN) should be based on the pathological classification by renal biopsy. The class IV is the most common type and has the worst prognosis in LN patients. However, some patients are contraindicated to renal biopsy. A non-invasive biomarker that can mirror to renal classification will help clinical decision-making. Ten-eleven translocation methylcytosine dioxygenase 2 (TET2) has been reported to involve in the pathogenesis of systemic lupus erythematosus and kidney diseases. We aim to verify whether plasma TET2 can reflect renal classification in LN patients.

Methods

Plasma samples were collected from 49 patients diagnosed as LN approved by renal biopsy in our department from January 2019 to January 2023 and 27 age-and -sex matched healthy volunteers (NC). Class IV (n=14) and class III + V/IV +V/ V (n=31) were included in LN patients. Plasma levels of TET2 were analyzed by enzyme-linked immunosorbent assay. Student's t test or one-way ANOVA test and receiver operating characteristic curve (ROC) were used for the data analysis.

Results

Plasma TET2 levels were increased in LN patients compared to NC. Plasma TET2 differentiated LN from NC with a high diagnostic accuracy with area under the curve (AUC=0.77, p<0.001, n=76).The sensitivity for diagnosing LN was 65.30%, and the specificity was 85.20%. Further more, plasma TET2 levels in class IV were decreased compared to that in class III+V/IV+V/V inside LN patients. Plasma TET2 also differentiated class IV from class III+V/IV+V/V (AUC=0.73, p<0.001, n=45) with the sensitivity 78.6%, and the specificity 71%. Serum albumin (sAlb) differentiated class IV from the other classes with 0.684 of AUC (p=0.047). With combination of blood TET2 and sAlb, AUC was increased to 0.83 (p<0.001) to differentiate class IV from class III+V/IV+V/V. The sensitivity was 85.7%, and the specificity was 80.6% with TET2 cutoff as 350 pg/ml.

Conclusion

Plasma TET2 level differentiated LN class IV from class III+V/IV+V/V. Combination with sAlb increased the differentiation efficiency. A panel of blood TET2 and sAlb might help on diagnosing LN class IV for those patients with contraindication of renal biopsy and benefiting to therapeutic decision. This study needs to be validated in large cohort of LN patients.

Funding

  • Government Support – Non-U.S.