Značaj biomarkera inflamacije u predikciji aktivnosti lupus nefritisa

Biomarkeri u predikciji aktivnosti lupus nefritisa

  • Dr sc. med. Violeta Rabrenović Violeta RabrenovićVioleta S Rabrenović" violettarab@gmail.com
  • Milica Petrovic Klinika ya nefrologiju , Vojnomedicinska Akademija Beograd
  • Milorad Rabrenovic Centar za hiperbaricnu medicinu, Vojnomedicinska akademija ,Beograd
  • Dejan Pilcevic Klinika za nefrologiju , Vojnomedicinska Akademija , Beograd
  • Nemanja Rancic Centre for Clinical Pharmacology, Military Medical Academy ,Faculty of Medicine, Military Medical Academy, University of Defense, Belgrade,
DOI: https://doi.org/10.5937/jomb0-43457
Ključne reči: lupus nefritis, aktivnost, NLR, PLR SII, SIRI

Sažetak


Uvod/Cilj: Lupus nefritis (LN) je jedna od najozbiljnijih manifestacija sistemskog eritemskog  lupusa (SLE). Sve je više studija u kojima se ispituju uloge različitih biomarkera koji bi olakšali dijagnostiku, praćenje aktivnosti LN, pojavu relapsa kao i pravo vreme za uvođenje terapije održavanja. Naš cilj je bio da ispitamo važnost određivanja neutrofilno/limfocitnog odnosa (NLR), trombocitno/limfocitnog odnosa (PLR), sistemskog imunsko inflamatornog indeksa (SII) i indeksa sistemskog inflamatornog odgovora (SIRI) u LN, upoređujući njihov značaj sa drugim standardnim parametri aktivne bolesti.

Materijal i metode: Kliničkim ispitivanjem obuhvaćena je grupa od 89 pacijenata, od kojih 66 sa LN (34 sa aktivnom i 32 sa LN u remisiji) i 23 bolesnika u kontrolnoj grupi - bez autoimunske bolesti. Ispitivani parametri bili su: CRP, CBC, kreatinin, albumin, GFR, C3, C4, ANA, anti ds DNK At,  u urinu: analiza sedimenta, proteinurija  i Up/cre. Određivali smo i izvedene markere: NLR, PLR, SIRI, SII i njihovu korelaciju sa drugim parametrima aktivne bolesti.

Rezultati: Poređenjem grupe sa aktivnom LN sa LN u remisiji i kontrolne grupe, dobijena je statistički značajna razlika za CRP (p=0,004), a za RBV i hemoglobin, albumin, C3, ANA i anti ds DNK At (p< 0,001) i za parametre urina, SLEDAI/r, proteinuriju 24č. i odnos Up/cre. Upoređujući markere: NLR, PLR, SIRI, SII između grupa, uočava se značajna razlika za sve odabrane parametre, za NLR je bila najizraženija (p<0,001). U aktivnom LN, NLR je korelirao sa CRP, kreatininom i GFR, ANA i proteinurijom 24h, PLR sa kreatininom, ANA, proteinurijom 24h, a SIRI i SII sa CRP, kreatininom i ANA. NLR je bio parametar sa najvećim značajem u korelaciji sa: C3, SLEDAI/r i proteinurijom (p=0,000), ANA (p=0,001), anti ds DNK Ab (p= 0,004) i Up/cre (p= 0,018) .

Zaključak:  Rezultati našeg ispitivanja su  ukazali da su NLR, PLR, SIRI, SII povišeni u grupi pacijenata sa aktivnom LN, te da korelacije NLR i PLR sa drugim parametrima aktivnosti mogu biti značajne za procenu aktivnosti LN.

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Objavljeno
2023/08/09
Broj časopisa
Vol. 43 Br. 1 (2024): Vol. 43 No. 1 (2024): Journal of Medical Biochemistry
Rubrika
Original paper

Sva prava zadržana (c) 2023 Violeta Rabrenović, Milica Petrovic, Milorad Rabrenovic, Dejan Pilcevic , Nemanja Rancic

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