Clinical impact of urinary CD11b and CD163 on the renal outcomes of anti-neutrophil cytoplasmic antibody-associated glomerulonephritis

Yuki Yokoe, Naotake Tsuboi, Takahiro Imaizumi, Akimitsu Kitagawa, Munetoshi Karasawa, Takaya Ozeki, Nobuhide Endo, Yuriko Sawa, Sawako Kato, Takayuki Katsuno, Shoichi Maruyama, Kunihiro Yamagata, Joichi Usui, Michio Nagata, Kenei Sada, Hitoshi Sugiyama, Koichi Amano, Yoshihiro Arimura, Tatsuya Atsumi, Yukio YuzawaHiroaki Dobashi, Yoshinari Takasaki, Masayoshi Harigai, Hitoshi Hasegawa, Hirofumi Makino, Seiichi Matsuo

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: The detection of leukocyte-derived CD11b (α subunit of integrin Mac-1) and CD163 (scavenger receptor) in urine may reflect renal inflammation in antineutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN). The objective of this study was to evaluate the clinical significance of urinary CD11b (U-CD11b) and CD163 (U-CD163) in ANCA-GN. Methods: U-CD11b and U-CD163 were examined using enzyme-linked immunosorbent assay in ANCA-GN urine samples from our institutional cohort (n = 88) and a nationwide cohort (n = 138), and their association with renal histology was subsequently analyzed. Logistic regression analyses were performed on a nationwide ANCA cohort to determine the associations of the two urinary molecules with renal remission failure at 6 months or with yearly estimated glomerular filtration rate (eGFR) slope over a 24-month observation period. Results: U-CD11b and U-CD163 were significantly associated with cellular crescent formation and leukocyte accumulation in glomerular crescents. With regard to interstitial inflammation, both levels of U-CD11b and U-CD163 at diagnosis remarkably increased in ANCA-GN compared with the levels observed in nonglomerular kidney disorders including nephrosclerosis, immunoglobulin G4-related disease and tubulointerstitial nephritis; however, the presence of U-CD11b alone was significantly correlated with tubulointerstitial leukocyte infiltrates. Although neither U-CD11b nor U-CD163 at diagnosis was associated with remission failure at 6 months, multivariate analysis demonstrated that the baseline U-CD11b levels were significantly associated with the increase in eGFR following immunosuppressive therapy. Conclusions: Although both U-CD11b and U-CD163 reflect renal leukocyte accumulation, U-CD11b at diagnosis provides additional clinical value by predicting the recovery rate after the treatment of ANCA-GN.

Original languageEnglish
Pages (from-to)1452-1463
Number of pages12
JournalNephrology Dialysis Transplantation
Volume36
Issue number8
DOIs
Publication statusPublished - Aug 1 2021

Keywords

  • Anti-neutrophil cytoplasmic antibody
  • Biomarkers
  • Inflammation
  • Macrophages
  • Neutrophils

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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