Insight into the Interplay of Gd-IgA1, HMGB1, RAGE and PCDH1 in IgA Vasculitis (IgAV)
Abstract
:1. Introduction
2. Results
2.1. Baseline Characteristics of IgAV Patients
2.2. Laboratory Parameters
2.3. Serum and Urine Gd-IgA1, HMGB1, RAGE and PCDH1 in Patients with IgAV and Controls
2.4. Serum and Urine Gd-IgA1, HMGB1, RAGE and PCDH1 in Patients with IgAV without Nephritis and with Nephritis
2.5. ROC Analysis
2.6. Logistic Regression Analysis
2.7. Correlation of Gd-IgA1, HMGB1, RAGE and PCDH1 with Clinical Characteristics and Disease Activity
2.8. Correlation of Gd-IgA1, HMGB1, RAGE and PCDH1 with Laboratory Parameters in IgAV Patients at the Onset of the Disease and after Six-Month Follow-Up
3. Discussion
4. Materials and Methods
4.1. Participants and Study Design
4.2. Clinical Assessment
4.3. Disease Activity Assessment
4.4. Laboratory Analysis
4.5. Analysis of Gd-IgA1, HMGB1, RAGE and PCDH1
4.6. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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N = 86 | % of the Cohort | |
---|---|---|
Demographic data | ||
mean age (years) | 6.4 (4.5–7.8) | |
female | 43 | 57% |
male | 37 | 43% |
Clinical features | ||
skin changes | 86 | 100% |
joint involvement | 76 | 88.4% |
gastrointestinal involvement | 39 | 45.3% |
nephritis | 26 | 30.2% |
scrotal involvement | 6 | 16.2% # |
Treatment | ||
NSAIDs | 75 | 87.2% |
Glucocorticoids | 36 | 41.8% |
ACE inhibitors | 15 | 17.4% |
immunosuppressants | 11 | 12.8% |
PVAS | 4 (2–6) | |
outcome of nephritis | ||
A | 18 | 69.3% ## |
B | 8 | 30.7% ## |
C | 0 | 0% |
D | 0 | 0% |
Parameter | IgAV Group | Control Group | p * | p ** | p *** | |
---|---|---|---|---|---|---|
Onset | Follow Up | |||||
ESR (mm/h) | 18 (8–30) | 9 (6–14) | 7 (4.75–11) | <0.001 | 0.012 | <0.001 |
CRP (mg/L) | 6.8 (2.1–18.3) | 1 (0.6–1.7) | 1 (1–1) | <0.001 | 0.406 | <0.001 |
leukocytes (109/L) | 10.1 (8.2–12.8) | 7.24 (6.1–8.03) | 6.15 (5.0–7.0) | <0.001 | <0.001 | <0.001 |
neutrophils | 5.5 (4.2–8.1) | 3.15 (2.41–4.04) | 2.7 (2.1–3.7) | <0.001 | 0.889 | <0.001 |
erythrocytes (1012/L) | 4.62 ± 0.42 | 4.75 ± 0.35 | 4.75 ± 0.38 | 0.063 | 0.078 | 0.04 |
hemoglobin (g/L) | 124.3 ± 11.3 | 127.2 ± 8.9 | 130.8 ± 11.1 | <0.001 | 0.015 | 0.068 |
platelets (109/L) | 355.3 ± 82.1 | 334.1 ± 68.5 | 291.8 ± 71.6 | <0.001 | <0.001 | 0.072 |
creatinine (µmol/L) | 35 (28–40.25) | 36 (31.5–42) | 44 (36.25–50.75) | <0.001 | <0.001 | 0.197 |
urea (mmol/L) | 4.5 ± 1.15 | 4.12 ± 1.01 | 4.4 ± 1.08 | 0.647 | 0.462 | 0.005 |
fibrinogen (g/L) | 3.5 (2.8–4.2) | 2.7 (2.4–3.1) | 2.4 (2.2–2.8) | <0.001 | 0.118 | <0.001 |
D-dimer (µg/L) | 2.9 (1.1–7.3) | 0.27 (0.19–0.36) | 0.2 (0.19–0.33) | <0.001 | 0.865 | <0.001 |
PT | 1.01 ± 0.15 | 1.03 ± 0.16 | 0.99 ± 0.13 | 0.653 | 0.153 | 0.624 |
aPTT (s) | 25.4 ± 3.8 | 27.4 ± 2.8 | 25.65 ± 2.09 | 0.703 | 0.425 | <0.001 |
ferritin (ng/mL) | 58.45 (34.6–86.1) | 24.85 (16.2–41.7) | - | - | - | <0.001 |
uACR (mg/mmol) | 5.1 (1.3–14) | 3.7 (1–12) | 0.85 (0.6–1.3) | <0.001 | <0.001 | 0.154 |
24-h proteinuria (g/dU) | 0.07 (0.05–0.15) | 0.07 (0.05–0.14) | - | - | - | 0.625 |
E/mm3 (urine spot test) (%) | 22 (25.6%) | 13 (15.5%) | - | - | - | 0.103 |
proteinuria (urine spot test) (%) | 14 (16.3%) | 8 (9.5%) | - | - | - | 0.189 |
eGFR (mL/min/1.73 m2) | 139.2 ± 29.7 | 148.2 ± 29.4 | - | - | - | 0.111 |
total proteins (g/L) | 68.5 (65–72) | 72 (67–74) | 72 (69.5–74) | <0.001 | 0.289 | <0.001 |
serum albumin (g/L) | 39.44 ± 5.13 | 43.95 ± 4.84 | 45.16 ± 3.05 | <0.001 | 0.298 | <0.001 |
IgA (g/L) | 1.7 (1.25–2.42) | 1.49 (1–1.9) | 1.24 (0.98–1.56) | <0.001 | 0.472 | <0.001 |
IgG (g/L) | 10.92 ± 2.92 | 10.1 ± 2.16 | 10.68 ± 2.09 | 0.612 | 0.392 | <0.001 |
IgM (g/L) | 0.94 (0.7–1.2) | 1.03 (0.76–1.26) | 1.1 (0.8–1.3) | 0.164 | 0.968 | <0.001 |
C3 (g/L) | 1.32 ± 0.24 | 1.22 ± 0.21 | - | - | - | |
C4 (g/L) | 0.27 (0.21–0.33) | 0.23 (0.17–0.26) | - | - | - | <0.001 |
CH50 (%) | 91 (79–109) | 81 (76–97) | - | - | - | |
positive FOBT (%) | 24 (27.9%) | 1 (1.2%) | - | - | - | <0.001 |
fecal calprotectin (µg/g) | 37 (20–83) | 28 (20–34) |
Parameter | IgAV Group | Control Group (N = 70) | p * | p ** | p *** | ||
---|---|---|---|---|---|---|---|
Onset (N = 86) | Follow-Up (N = 83) | ||||||
Gd-IgA1 (µg/mL) | serum | 52.4 (25.3–96.1) | 49.9 (22.1–87.8) | 54.1 (19.4–90.3) | 0.299 | 0.668 | 0.231 |
urine | 10.8 (6.3–21.2) | 11.7 (5.9–18.9) | 5.4 (3.2–9.3) | <0.001 | <0.001 | 0.944 | |
HMGB1 (pg/mL) | serum | 5573 (2274–13,829) | 3477 (1308–6445) | 1088 (574.3–2942) | <0.001 | <0.001 | <0.001 |
urine | 178.4 (96.7–596.9) | 173.1 (94.2–380.2) | 57.1 (36.9–168) | <0.001 | <0.001 | 0.755 | |
RAGE (pg/mL) | serum | 309.9 (166.6–432.1) | 302.4 (163.2–388) | 201.3 (112.7–319.6) | 0.005 | 0.014 | 0.012 |
urine | 12.2 (7.3–21.2) | 10.1 (5.9–18.7) | 5.9 (4.1–10.4) | <0.001 | <0.001 | 0.077 | |
PCDH1 (ng/mL) | serum | 44.5 (28.2–61.5) | 46.9 (31.8–59.6) | 18.8 (1.2–45.4) | <0.001 | <0.001 | 0.746 |
urine | 174.6 (72.8–327.5) | 226.4 (102.1–414.9) | 71.1 (2.1–138.1) | <0.001 | <0.001 | 0.109 |
Parameter | IgAV Group | IgAVN Group | p * | p ** | |||
---|---|---|---|---|---|---|---|
Onset (N = 60) | Follow-Up (N = 58) | Onset (N = 26) | Follow-Up (N = 25) | ||||
Gd-IgA1 (µg/mL) | serum | 55.7 (23.5–96.9) | 51.09 (21.52–88.75) | 50 (31.2–91.6) | 40.24 (27.93–90.1) | 0.783 | 0.863 |
urine | 10.8 (6.3–18.9) | 12.04 (6.86–19.36) | 10.8 (6.4–25.7) | 11.17 (4.26–19.98) | 0.657 | 0.618 | |
HMGB1 (pg/mL) | serum | 5477.5 (2266.6–14,531.6) | 3245 (1367–5552) | 6303.9 (2349–11,042.9) | 3519 (1241–9295) | 0.966 | 0.832 |
urine | 143.1 (88.9–568.3) | 133.2 (85.9–318.6) | 340.9 (134.7–644.1) | 270.9 (146.7–542.7) | 0.083 | 0.049 | |
RAGE (pg/mL) | serum | 294.1 (145.3–434.2) | 275.9 (140.8–369) | 314.1 (251.7–425.2) | 331.3 (236.4–416.6) | 0.492 | 0.073 |
urine | 12.2 (8.2–17.6) | 8.6 (5.9–19.1) | 13.8 (6.9–29.1) | 11.99 (6.04–18.52) | 0.540 | 0.697 | |
PCDH1 (ng/mL) | serum | 46.5 (32.4–62.4) | 49.74 (38.35–59.07) | 41.0 (2.6–59) | 41.27 (10.8–65.1) | 0.309 | 0.206 |
urine | 174.4 (86.3–302.7) | 209.1 (103–409.5) | 186.4 (6.2–364.1) | 257.1 (77.6–459.2) | 0.733 | 0.699 |
Parameter | AUC | 95% CI | p * | Youden Index | Cut-Off Value | Sensitivity | Specificity | |
---|---|---|---|---|---|---|---|---|
Gd-IgA1 (µg/mL) | serum | 0.549 | 0.467–0.628 | 0.3041 | 0.1575 | >31.716 | 68.60 | 47.14 |
urine | 0.736 | 0.659–0.803 | <0.0001 | 0.4130 | >6.383 | 75.58 | 65.71 | |
HMGB1 (pg/mL) | serum | 0.784 | 0.711–0.846 | <0.0001 | 0.5030 | >3926.95 | 67.44 | 82.86 |
urine | 0.782 | 0.709–0.844 | <0.0001 | 0.4944 | >81.481 | 83.72 | 65.71 | |
RAGE (pg/mL) | serum | 0.631 | 0.550–0.707 | 0.0037 | 0.2508 | >329.02 | 46.51 | 78.57 |
urine | 0.720 | 0.642–0.789 | <0.0001 | 0.4146 | >9.254 | 68.60 | 72.86 | |
PCDH1 (ng/mL) | serum | 0.705 | 0.625–0.776 | <0.0001 | 0.3496 | >29.03 | 75.58 | 59.38 |
urine | 0.728 | 0.650–0.798 | <0.0001 | 0.3590 | >158.18 | 54.65 | 81.25 |
Parameter | SE | Z-Value | OR | 95% CI | p * | |
---|---|---|---|---|---|---|
Gd-IgA1 (µg/mL) | serum | 0.107 | 0.555 | 1.001 | 0.997–1.006 | 0.579 |
urine | 0.341 | 1.159 | 1.029 | 0.981–1.087 | 0.246 | |
HMGB1 (pg/mL) | serum | 0.036 | 3.923 | 1.000 | 1.0001–1.0003 | <0.001 |
urine | 0.083 | −0.122 | 0.999 | 0.999–1.001 | 0.903 | |
RAGE (pg/mL) | serum | 0.074 | 2.712 | 1.004 | 1.001–1.007 | 0.007 |
urine | 0.224 | 1.968 | 1.033 | 1.002–1.070 | 0.049 | |
PCDH1 (ng/mL) | serum | 0.487 | 1.849 | 1.018 | 0.999–1.038 | 0.064 |
urine | 0.098 | 0.495 | 1.001 | 0.997–1.005 | 0.621 |
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Held, M.; Kozmar, A.; Sestan, M.; Turudic, D.; Kifer, N.; Srsen, S.; Gagro, A.; Frkovic, M.; Jelusic, M. Insight into the Interplay of Gd-IgA1, HMGB1, RAGE and PCDH1 in IgA Vasculitis (IgAV). Int. J. Mol. Sci. 2024, 25, 4383. https://doi.org/10.3390/ijms25084383
Held M, Kozmar A, Sestan M, Turudic D, Kifer N, Srsen S, Gagro A, Frkovic M, Jelusic M. Insight into the Interplay of Gd-IgA1, HMGB1, RAGE and PCDH1 in IgA Vasculitis (IgAV). International Journal of Molecular Sciences. 2024; 25(8):4383. https://doi.org/10.3390/ijms25084383
Chicago/Turabian StyleHeld, Martina, Ana Kozmar, Mario Sestan, Daniel Turudic, Nastasia Kifer, Sasa Srsen, Alenka Gagro, Marijan Frkovic, and Marija Jelusic. 2024. "Insight into the Interplay of Gd-IgA1, HMGB1, RAGE and PCDH1 in IgA Vasculitis (IgAV)" International Journal of Molecular Sciences 25, no. 8: 4383. https://doi.org/10.3390/ijms25084383