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Urinary tissue factor (uTF), tissue factor pathway inhibitor (TFPI) and plasmin as novel biomarkers in early diagnosis of lupus nephritis

医学 内科学 狼疮性肾炎 组织因子 胃肠病学 泌尿系统 痹症科 组织因子途径抑制剂 门诊部 纤溶酶 疾病 凝结 生物化学 化学
作者
Ayat Salah
出处
期刊:Egyptian Journal of Immunology [Egyptian Association of Immunologists]
卷期号:31 (01): 143-154
标识
DOI:10.55133/eji.310115
摘要

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease, with multi systematic affection. Lupus nephritis (LN) is the most frequent cause of renal damage in SLE patients with variable presentations that may progress to end stage renal failure. Coagulation disorders are frequently reported in SLE and LN with higher mortality rates. Renal biopsy is an invasive process, and the existing indicators for LN diagnosis and activity are unreliable. New urinary biomarkers with significant validity, safety, and accuracy are the current focus of most studies. Our study sought to assess the value of urinary tissue factor (uTF), tissue factor pathway inhibitor (TFPI), and plasmin as biomarkers for the early identification and detection of LN and its activity. This was a cross-sectional study, included 100 subjects (80 SLE patients, and 20 healthy controls), they were recruited from the Internal Medicine department, Rheumatology and Nephrology units and outpatient’s clinics at Assiut University hospital between the period of 2020 and 2022. All patients underwent full history taking, clinical evaluation, and activity scoring calculation and laboratory investigations. The results showed that the best diagnostic accuracy of LN was observed with TFPI (90% accuracy, sensitivity 80% and specificity 95% with p<0.001 at cutoff point of >193.2 ng/ml), followed by uTF (75.4% overall accuracy at cut off point of >12.6 ng/ml, sensitivity 90% and specificity 68% with p< 0.001) and plasmin (70.3% accuracy at cut off point of >30.5 ng/ml, sensitivity 55% and specificity 78% with p< 0.001). Urinary TFPI was the best predictor of LN occurrence with odd ratio of 4.34, (p< 0.001). In conclusion urinary TFPI could be used as a diagnostic marker for LN with high accuracy and an early predictor of LN.

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