The predictive value of serum LXA4, MK and CXCL16 for renal damage in children with allergic purpura
Serum LXA4, MK and CXCL16 for renal damage in allergic purpura
Abstract
Objective To explore the predictive value of the combined application of serum intermediate factor (MK), lipoxin A4(LXA4), and CXC chemokine ligand 16(CXCL16) for renal damage in children with henoch-Schonlein purpura (HSP).
Methods 117 children with HSP who were admitted to our hospital between January 2021 and December 2024 were selected for the HSP group. After treatment, they were followed up for 6 months, and the occurrence of renal damage was statistically analyzed. The control group consisted of an additional 59 voluntarily enrolled youngsters who received health examinations throughout the same time frame. The levels of serum MK, LXA4, and CXCL16 in the two groups of research patients were determined using an enzyme-linked immunosorbent assay, and clinical data from children with HSP were gathered. The factors that contribute to renal damage in children with HSP were investigated using both univariate and multivariate logistic regression. Serum MK, LXA4, and CXCL16 levels were analyzed for their predictive value of renal impairment in children with HSP using a receiver operating characteristic (ROC) curve.
Results Compared with the control group, the levels of serum MK, LXA4 and CXCL16 in the HSP group were all increased (P<0.05). During the 6-month follow-up, among the 117 children with HSP, 35 cases developed renal damage (renal damage group), with an incidence rate of 29.91%(35/117), and the remaining 82 cases were in the non-renal damage group. The proportions of children with a diagnosis time of ≥7 days, respiratory tract infections, and serum levels of MK, LXA4, and CXCL16 in the renal damage group were all higher than those in the non-renal damage group (P<0.05). However, the percentages of children with joint pain/arthritis, gastrointestinal bleeding, and EBV infection did not change statistically significantly between the two groups in terms of gender, age, or body weight (P>0.05). According to multivariate logistic regression analysis, a diagnosis time of at least seven days, respiratory tract infection, and elevated levels of serum MK, LXA4, and CXCL16 were all independent risk factors for renal damage in children with HSP (P<0.05). The results of ROC curve analysis showed that the area under the curve for the combined prediction of serum MK, LXA4, and CXCL16 levels for renal damage in children with HSP was larger than that predicted by MK, LXA4, and CXCL16 alone (P<0.05).
Conclusion The elevated levels of serum MK, LXA4 and CXCL16 in children with HSP are closely related to renal damage. The combined prediction of serum MK, LXA4 and CXCL16 levels in children with HSP has a relatively high value.
References
2.Min S, Chen X, Wang D, Lin X, Jiang G. Risk Factors for Renal Involvement in Childhood Henoch-Schonlein Purpura (IgA Vasculitis). J Coll Physicians Surg Pak. 2024 Oct;34(10):1258-1261. doi: 10.29271/jcpsp.2024.10.1258. PMID: 39410700.
3.Wang Z, Li M, Gao H, Deng F. [Correlation between streptococcal infection and renal damage in children with Henoch-Schönlein purpura nephritis]. Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Apr 18;57(2):284-290. Chinese. doi: 10.19723/j.issn.1671-167X.2025.02.010. PMID: 40219558; PMCID: PMC11992448.
4.Hassas Yeganeh M, Sinaei R, Yaraghi A, Rahmani K, Javadi Parvaneh V, Shiari R, Hosseinzadeh H. Correlation between antiphospholipid antibodies and renal involvement in children with Henoch-Schönlein purpura: A cross-sectional study. Caspian J Intern Med. 2024 Spring;15(2):287-293. doi: 10.22088/cjim.15.2.287. PMID: 38807720; PMCID: PMC11129061.
5.Liu Y, Wu Q, Huang Z, Zhou D, Cai C, Luo W, Feng P. TLR4 Inhibitor TAK-242 Protected Henoch-Schonlein Purpura Nephritis in Rats by Regulating Inflammatory Response and Immune Competence via NF- κB/NLRP3 Signalling. Clin Exp Pharmacol Physiol. 2025 Jan;52(1):e70008. doi: 10.1111/1440-1681.70008. PMID: 39564921.
6.Hu L, Li L, Che H, Zhao B, Xiao LI, Liu P, Yi W, Liu S. Huanglian Decoction treats Henoch-Schonlein purpura nephritis by inhibiting NF-κB/NLRP3 signaling pathway and reducing renal IgA deposition. An Acad Bras Cienc. 2024 Apr 8;96(1):e20220970. doi: 10.1590/0001-3765202420220970. PMID: 38597498.
7.Jiang J, Liao K, Guo H, Chen XY. Varicella-associated disseminated intravascular coagulation secondary to Henoch-Schönlein purpura with renal and gastrointestinal system involvement in a child: A case report. Medicine (Baltimore). 2023 Nov 17;102(46):e36203. doi: 10.1097/MD.0000000000036203. PMID: 37986286; PMCID: PMC10659683.
8.Jiang YJ, Song DY, Li JL. [Predictive Value of Complete Blood Count and Inflammation Marker on Risk of Recurrence in Children with Henoch-Schönlein Purpura]. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Jun;31(3):837-842. Chinese. doi: 10.19746/j.cnki.issn.1009-2137.2023.03.032. PMID: 37356948.
9.Sun Y, Yang X, Xi L, Feng Z, Ren X. Correlation between the course of kidney injury and clinicopathology and prognosis of children with Henoch-Schönlein purpura nephritis. Int Urol Nephrol. 2025 May;57(5):1625-1631. doi: 10.1007/s11255-024-04336-7. Epub 2024 Dec 26. PMID: 39724485.
10.Pan M, Li M, Li N, Mao J. Predicting renal damage in children with IgA vasculitis by machine learning. Pediatr Nephrol. 2024 Oct;39(10):2997-3004. doi: 10.1007/s00467-024-06432-3. Epub 2024 Jun 25. PMID: 38916780.
11.Czarniak P, Zurowska A. Treatment strategies to prevent renal damage in hypertensive children. Curr Hypertens Rep. 2014 Apr;16(4):423. doi: 10.1007/s11906-014-0423-2. PMID: 24522942; PMCID: PMC3960483.
12.Li M, Amaerjiang N, Li Z, Xiao H, Zunong J, Gao L, Vermund SH, Hu Y. Insufficient Fruit and Vegetable Intake and Low Potassium Intake Aggravate Early Renal Damage in Children: A Longitudinal Study. Nutrients. 2022 Mar 14;14(6):1228. doi: 10.3390/nu14061228. PMID: 35334885; PMCID: PMC8951514.
13.Wu L, Zheng Y, Liu J, Luo R, Wu D, Xu P, Wu D, Li X. Comprehensive evaluation of the efficacy and safety of LPV/r drugs in the treatment of SARS and MERS to provide potential treatment options for COVID-19. Aging (Albany NY). 2021 Apr 20;13(8):10833-10852. doi: 10.18632/aging.202860. Epub 2021 Apr 20. PMID: 33879634; PMCID: PMC8109137.
14.Bush NC, Keays M, Adams C, Mizener K, Pritzker K, Smith W, Traylor J, Villanueva C, Snodgrass WT. Renal damage detected by DMSA, despite normal renal ultrasound, in children with febrile UTI. J Pediatr Urol. 2015 Jun;11(3):126.e1-7. doi: 10.1016/j.jpurol.2015.01.011. Epub 2015 Mar 21. PMID: 25842992.
15.Tombesi M, Ferrari CM, Bertolotti JJ. Renal damage in refluxing and non-refluxing siblings of index children with vesicoureteral reflux. Pediatr Nephrol. 2005 Aug;20(8):1201-2. doi: 10.1007/s00467-005-1886-9. Epub 2005 Jun 23. PMID: 15973530.
16.Wang Z, Li M, Gao H, Deng F. [Correlation between streptococcal infection and renal damage in children with Henoch-Schönlein purpura nephritis]. Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Apr 18;57(2):284-290. Chinese. doi: 10.19723/j.issn.1671-167X.2025.02.010. PMID: 40219558; PMCID: PMC11992448.
17.Yang Y, Wang C, Li X, Chai Q, Fei Y, Xia R, Xu R, Yang L, Liu J. Chinese herbal medicine for Henoch-Schönlein purpura in children without renal damage: a systematic review of randomized controlled trials. Complement Ther Med. 2015 Oct;23(5):741-50. doi: 10.1016/j.ctim.2015.07.010. Epub 2015 Jul 31. PMID: 26365455.
18.Wu L, Zhong Y, Wu D, Xu P, Ruan X, Yan J, Liu J, Li X. Immunomodulatory Factor TIM3 of Cytolytic Active Genes Affected the Survival and Prognosis of Lung Adenocarcinoma Patients by Multi-Omics Analysis. Biomedicines. 2022 Sep 10;10(9):2248. doi: 10.3390/biomedicines10092248. PMID: 36140350; PMCID: PMC9496572.
19.Cao T, Zhu Y, Zhu Y. Construction of Prediction Model of Renal Damage in Children with Henoch-Schönlein Purpura Based on Machine Learning. Comput Math Methods Med. 2022 May 23;2022:6991218. doi: 10.1155/2022/6991218. PMID: 35651924; PMCID: PMC9150995.
20.Safaeian B, Nickavar A, Zaeri H, Lahootian L, Behnampour N. Utility of Urine N-acetyl-β-D-glucosaminidase for Prediction of Renal Damage in Obese Children. Saudi J Kidney Dis Transpl. 2021 May-Jun;32(3):699-702. doi: 10.4103/1319-2442.336764. PMID: 35102911.
21.Cunningham RJ 3rd. Urinary tract infection in infants and children. Preventing recurrence and renal damage. Postgrad Med. 1984 May;75(6):59-64. doi: 10.1080/00325481.1984.11716307. PMID: 6718284.
22.Trachtenberg F, Barregard L, McKinlay S. The influence of urinary flow rate in children on excretion of markers used for assessment of renal damage: albumin, gamma-glutamyl transpeptidase, N-acetyl-beta-D -glucosaminidase, and alpha1-microglobulin. Pediatr Nephrol. 2008 Mar;23(3):445-56. doi: 10.1007/s00467-007-0568-1. Epub 2007 Aug 18. PMID: 17704953.
23.Wu L, Liu Q, Ruan X, Luan X, Zhong Y, Liu J, Yan J, Li X. Multiple Omics Analysis of the Role of RBM10 Gene Instability in Immune Regulation and Drug Sensitivity in Patients with Lung Adenocarcinoma (LUAD). Biomedicines. 2023 Jun 29;11(7):1861. doi: 10.3390/biomedicines11071861. PMID: 37509501; PMCID: PMC10377220.
24.Traxer O, Lottmann H, Archambaud F, Helal B, Mercier-Pageyral B. La lithotritie extracorporelle chez l'enfant. Etude de son efficacité et évaluation de ses conséquences parenchymateuses par la scintigraphie au DMSA-Tc 99m: une série de 39 enfants [Extracorporeal lithotripsy in children. Study of its efficacy and evaluation of renal parenchymal damage by DMSA-Tc 99m scintigraphy: a series of 39 children]. Arch Pediatr. 1999 Mar;6(3):251-8. French. doi: 10.1016/s0929-693x(99)80260-7. PMID: 10191889.
25.Trachtenberg F, Barregard L. Effect of storage time at -20°C on markers used for assessment of renal damage in children: albumin, γ-glutamyl transpeptidase, N-acetyl-β-D-glucosaminidase and α1-microglobulin. Scand J Urol Nephrol. 2010 Nov;44(5):331-6. doi: 10.3109/00365599.2010.492785. Epub 2010 Jun 21. PMID: 20560801; PMCID: PMC2951491.
26.Wu L, Zheng Y, Ruan X, Wu D, Xu P, Liu J, Wu D, Li X. Long-chain noncoding ribonucleic acids affect the survival and prognosis of patients with esophageal adenocarcinoma through the autophagy pathway: construction of a prognostic model. Anticancer Drugs. 2022 Jan 1;33(1):e590-e603. doi: 10.1097/CAD.0000000000001189. PMID: 34338240; PMCID: PMC8670349.
27.He Y, Guo WL, Zhang MC. Development of a machine learning model for predicting renal damage in children with closed spinal dysraphism. BMC Pediatr. 2025 Aug 1;25(1):584. doi: 10.1186/s12887-025-05936-7. PMID: 40751187; PMCID: PMC12315280.
28.Lottmann HB, Archambaud F, Hellal B, Pageyral BM, Cendron M. 99mTechnetium-dimercapto-succinic acid renal scan in the evaluation of potential long-term renal parenchymal damage associated with extracorporeal shock wave lithotripsy in children. J Urol. 1998 Feb;159(2):521-4. doi: 10.1016/s0022-5347(01)63975-2. PMID: 9649283.
29.Wu L, Zhong Y, Yu X, Wu D, Xu P, Lv L, Ruan X, Liu Q, Feng Y, Liu J, Li X. Selective poly adenylation predicts the efficacy of immunotherapy in patients with lung adenocarcinoma by multiple omics research. Anticancer Drugs. 2022 Oct 1;33(9):943-959. doi: 10.1097/CAD.0000000000001319. Epub 2022 Aug 9. PMID: 35946526; PMCID: PMC9481295.
30.Bailey RR. Vesico-ureteric reflux, urinary-tract infection, and renal damage in children. Lancet. 1995 Sep 30;346(8979):900. PMID: 7564685.
31.Buonomo C, Treves ST, Jones B, Summerville D, Bauer S, Retik A. Silent renal damage in symptom-free siblings of children with vesicoureteral reflux: assessment with technetium Tc 99m dimercaptosuccinic acid scintigraphy. J Pediatr. 1993 May;122(5 Pt 1):721-3. doi: 10.1016/s0022-3476(06)80012-0. PMID: 8388446.
32.Wu L, Li H, Liu Y, Fan Z, Xu J, Li N, Qian X, Lin Z, Li X, Yan J. Research progress of 3D-bioprinted functional pancreas and in vitro tumor models. International Journal of Bioprinting. 2024, 10(1), 1256. doi: 10.36922/ijb.1256.
33.Felix A, Assad Z, Bidet P, Caseris M, Dumaine C, Faye A, Melki I, Kaguelidou F, Valtuille Z, Ouldali N, Meinzer U. Common Seasonal Pathogens and Epidemiology of Henoch-Schönlein Purpura Among Children. JAMA Netw Open. 2024 Apr 1;7(4):e245362. doi: 10.1001/jamanetworkopen.2024.5362. PMID: 38578638; PMCID: PMC10998156.
34.Bista S, Adhikari Y, Karmacharya S, Joshi S, Pandey S, Adhikari N. Henoch-Schönlein purpura with antecedent allergic diseases in a 4-year-old child: a case report. Ann Med Surg (Lond). 2023 May 8;85(6):3066-3069. doi: 10.1097/MS9.0000000000000782. PMID: 37363590; PMCID: PMC10289484.
35.Chen J, Chen P, Song Y, Wei J, Wu S, Wu F, Xu Z. The relationship between the severity and complications of Henöch-Schönlein purpura in children and dietary inflammatory index: a retrospective cohort study. PeerJ. 2024 Sep 24;12:e18175. doi: 10.7717/peerj.18175. PMID: 39346080; PMCID: PMC11430262.
36.Liang M, Deng Z, Wu W, Dong Q, Fan J. Study on the correlation between intestinal flora and cytokines in children with Henoch-Schönlein purpura. Cytokine. 2025 Jul;191:156959. doi: 10.1016/j.cyto.2025.156959. Epub 2025 May 14. PMID: 40373421.
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