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The clinical significance of plasma CFHR 1-5 in lupus nephropathy
Xiaofang Hu1, Hengdao Liu2, Jie Du1
1Department of Pharmacy, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders (Xiangya), Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Insights
Elevated levels of complement factor H-related proteins 3 and 5 (CFHR3 and CFHR5) are linked to lupus nephritis severity. Higher CFHR3 and CFHR5 indicate worse disease activity and poorer prognosis in lupus nephritis patients.
Area of Science:
- Immunology
- Nephrology
- Complement System Biology
Background:
- Lupus nephritis is characterized by complement factor H deficiency, leading to C3 consumption and C3b deposition.
- The role of complement factor H-related proteins (CFHRs 1-5) in lupus nephritis pathogenesis is not well understood.
- Investigating CFHRs may reveal new insights into lupus nephritis development and progression.
Purpose of the Study:
- To compare circulating levels of CFHR1-5 in lupus nephritis patients versus healthy individuals.
- To explore the association between CFHR1-5 expression and lupus nephritis disease activity and progression.
- To evaluate the prognostic value of CFHR3 and CFHR5 in lupus nephritis.
Main Methods:
- Plasma levels of CFHR1-5 were measured in 152 lupus nephritis patients and 20 healthy controls.
- Correlations were assessed between CFHR levels, disease activity (SLEDAI), proteinuria, creatinine, C3, and eGFR.
- Receiver operating characteristic (ROC) curve analysis was used to determine predictive values for disease activity and endpoints.
Main Results:
- Plasma CFHR3 and CFHR5 levels were significantly higher in lupus nephritis patients compared to controls.
- CFHR3 and CFHR5 concentrations positively correlated with SLEDAI, proteinuria, creatinine, and anti-dsDNA levels.
- CFHR3 and CFHR5 levels negatively correlated with C3 levels and eGFR, and were predictive of disease activity and outcomes.
Conclusions:
- Elevated plasma CFHR3 and CFHR5 are associated with increased disease activity and severity in lupus nephritis.
- CFHR3 and CFHR5 demonstrate prognostic value, with high levels indicating a worse prognosis and shorter progression-free survival.
- CFHR3 and CFHR5 may serve as potential biomarkers for monitoring lupus nephritis activity and predicting disease progression.
Abstract:
A deficiency of complement factor H may lead to excessive consumption of C3 and an increase in C3b deposition, which are important pathological characteristics of lupus nephritis. Complement factor H-related proteins (CFHRs), comprising CFHR1 to CFHR5 (CFHR1-5), are members of the wider factor H/CFHR family. Their role in lupus nephritis remains unclear. In this study, we compared circulating levels of CFHR1-5 in 152 patients diagnosed with lupus nephritis and 20 unrelated healthy individuals to explore the relationship between the expression of CFHR1-5 and development of the disease. We found that plasma levels of CFHR3 and CFHR5 were higher in patients with lupus nephritis than in healthy individuals; also, CFHR3 and CFHR5 concentrations increased with increasing systemic lupus erythematosus disease activity index (SLEDAI) values (P < 0.05). Pearson's and Spearman's correlation test results confirmed that plasma CFHR3 and CFHR5 levels in lupus nephritis patients were positively correlated with proteinuria and levels of creatinine (Cr) and anti-dsDNA (correlation coefficients = 0.491-0.717, P < 0.05), while they were negatively correlated with plasma C3 levels and eGFR [correlation coefficients = -(0.706-0.788), P < 0.05]. Receiver operating characteristic (ROC) curve analysis results confirmed that plasma CFHR3 and CFHR5 levels were predictive of SLEDAI values and disease end points (area under the curve = 0.664-0.884, P < 0.05), with patients with both high CFHR3 and high CFHR5 exhibiting the shortest progression-free survival. Thus, both CFHR3 and CFHR5 are of prognostic value in lupus nephritis status.
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