Urinary myeloid IgA Fc alpha receptor (CD89) and transglutaminase-2 as new biomarkers for active IgA nephropathy and henoch-Schönlein purpura nephritis

尿髓样 IgA Fc α 受体 (CD89) 和转谷氨酰胺酶 2 作为活动性 IgA 肾病和过敏性紫癜肾炎的新生物标志物

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作者:Rafael N Moresco, Marijn M Speeckaert, Slawomir C Zmonarski, Magdalena Krajewska, Ewa Komuda-Leszek, Agnieszka Perkowska-Ptasinska, Loreto Gesualdo, Maria T Rocchetti, Sigurd E Delanghe, Raymond Vanholder, Wim Van Biesen, Joris R Delanghe

Background

IgA nephropathy (IgAN) and Henoch-Schönlein purpura nephritis (HSPN) are glomerular diseases that share a common and central pathogenic mechanism. The formation of immune complexes containing IgA1, myeloid IgA Fc alpha receptor (FcαRI/CD89) and transglutaminase-2 (TG2) is observed in both conditions. Therefore, urinary CD89 and TG2 could be potential biomarkers to identify active IgAN/HSPN.

Conclusions

Determination of CD89 and TG2 in urine samples can be useful to identify patients with active IgAN/HSPN.

Methods

In this multicenter study, 160 patients with IgAN or HSPN were enrolled. Urinary concentrations of CD89 and TG2, as well as some other biochemical parameters, were measured.

Results

Urinary CD89 and TG2 were lower in patients with active IgAN/HSPN compared to IgAN/HSPN patients in complete remission (P < 0.001). The CD89xTG2 formula had a high ability to discriminate active from inactive IgAN/HSPN in both situations: CD89xTG2/proteinuria ratio (AUC: 0.84, P < 0.001, sensitivity: 76%, specificity: 74%) and CD89xTG2/urinary creatinine ratio (AUC: 0.82, P < 0.001, sensitivity: 75%, specificity: 74%). Significant correlations between urinary CD89 and TG2 (r = 0.711, P < 0.001), proteinuria and urinary CD89 (r = - 0.585, P < 0.001), and proteinuria and urinary TG2 (r = - 0.620, P < 0.001) were observed. Conclusions: Determination of CD89 and TG2 in urine samples can be useful to identify patients with active IgAN/HSPN.

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