Journal article
Soluble urokinase plasminogen activator receptor (suPAR) levels predict damage accrual in patients with recent-onset systemic lupus erythematosus
Journal of autoimmunity, v 106, 102340
01 Jan 2020
PMID: 31629628
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: The soluble urokinase plasminogen activator receptor (suPAR) has potential as a prognosis and severity biomarker in several inflammatory and infectious diseases. In a previous cross-sectional study, suPAR levels were shown to reflect damage accrual in cases of systemic lupus erythematosus (SLE). Herein, we evaluated suPAR as a predictor of future organ damage in recent-onset SLE.
Methods: Included were 344 patients from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort who met the 1997 American College of Rheumatology classification criteria with 5-years of follow-up data available. Baseline sera from patients and age- and sex-matched controls were assayed for suPAR. Organ damage was assessed annually using the SLICC/ACR damage index (SDI).
Results: The levels of suPAR were higher in patients who accrued damage, particularly those with SDI >= 2 at 5 years (N = 32, 46.8% increase, p = 0.004), as compared to patients without damage. Logistic regression analysis revealed a significant impact of suPAR on SDI outcome (SDI >= 2; OR = 1.14; 95% CI 1.03-1.26), also after adjustment for confounding factors. In an optimized logistic regression to predict damage, suPAR persisted as a predictor, together with baseline disease activity (SLEDAI-2K), age, and non-Caucasian ethnicity (model AUC = 0.77). Dissecting SDI into organ systems revealed higher suPAR levels in patients who developed musculoskeletal damage (SDI >= 1; p = 0.007).
Conclusion: Prognostic biomarkers identify patients who are at risk of acquiring early damage and therefore need careful observation and targeted treatment strategies. Overall, suPAR constitutes an interesting biomarker for patient stratification and for identifying SLE patients who are at risk of acquiring organ damage during the first 5 years of disease.
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Details
- Title
- Soluble urokinase plasminogen activator receptor (suPAR) levels predict damage accrual in patients with recent-onset systemic lupus erythematosus
- Creators
- Helena Enocsson - Linköping UniversityLina Wirestam - Linköping UniversityCharlotte Dahle - Linköping UniversityLeonid Padyukov - Karolinska University HospitalAndreas Jonsen - Lund UniversityMurray B. Urowitz - Toronto Western HospitalDafna D. Gladman - Toronto Western HospitalJuanita Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránSang-Cheol Bae - Hanyang UniversityPaul R. Fortin - Université LavalJorge Sanchez-Guerrero - Toronto Western HospitalAnn E. Clarke - University of CalgarySasha Bernatsky - McGill University Health CentreCaroline Gordon - University of BirminghamJohn G. Hanly - Queen Elizabeth II Health Sciences CentreDaniel J. Wallace - Cedars-Sinai Medical CenterDavid A. Isenberg - University College LondonAnisur Rahman - University College LondonJoan T. Merrill - Oklahoma Medical Research FoundationEllen Ginzler - SUNY Downstate Health Sciences UniversityGraciela S. Alarcon - University of Alabama at BirminghamW. Winn Chatham - University of Alabama at BirminghamMichelle Petri - Johns Hopkins MedicineMunther Khamashta - St Thomas' HospitalCynthia Aranow - Feinstein Institute for Medical ResearchMeggan Mackay - Feinstein Institute for Medical ResearchMary Anne Dooley - University of North Carolina at Chapel HillSusan Manzi - Allegheny Health NetworkRosalind Ramsey-Goldman - Northwestern UniversityOla Nived - Lund UniversityKristjan Steinsson - Reykjavík UniversityAsad A. Zoma - Hairmyres HospitalGuillermo Ruiz-Irastorza - BioCruces Health research InstituteS. Sam Lim - Emory UniversityKenneth C. Kalunian - University of California, San DiegoMurat Inanc - Istanbul UniversityRonald F. van Vollenhoven - Amsterdam University Medical CentersManuel Ramos-Casals - Consorci Institut D'Investigacions Biomediques August Pi I SunyerDiane L. Kamen - Medical University of South CarolinaSoren Jacobsen - Copenhagen Univ Hosp, Rigshosp, Ctr Rheumatol & Spine Dis, Copenhagen Lupus & Vasculitis Clin, Copenhagen, DenmarkChristine A. Peschken - University of ManitobaAnca Askanase - Columbia University Irving Medical CenterThomas Stoll - Spitäler SchaffhausenIan N. Bruce - NIHR Manchester Biomedical Research CentreJonas Wettero - Linköping UniversityChristopher Sjowall - Linköping University
- Publication Details
- Journal of autoimmunity, v 106, 102340
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- NIHR/Welcome Trust Manchester Clinical Research Facility 8UL1TR000150 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA King Gustaf V and Queen Victoria's Freemasons Foundation Versus Arthritis Lupus UK Swedish Rheumatism Association NIHR Manchester Biomedical Research Centre; National Institutes of Health Research (NIHR) Region Ostergotland (ALF Grants) King Gustaf V's 80-year Anniversary Foundation NRF-2017M3A9B4050335 / National Research Foundation of Korea
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000508747000012
- Scopus ID
- 2-s2.0-85073722485
- Other Identifier
- 991021934010904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Immunology