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2016 ; 95
(40
): e5037
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Serum IL-18 as biomarker in predicting long-term renal outcome among
pediatric-onset systemic lupus erythematosus patients
#MMPMID27749566
Wu CY
; Yang HY
; Yao TC
; Liu SH
; Huang JL
Medicine (Baltimore)
2016[Oct]; 95
(40
): e5037
PMID27749566
show ga
An urge of biomarker identification is needed to better monitor lupus nephritis
(LN) disease activity, guide clinical treatment, and predict patient's long-term
outcome. With the proinflammatory effect and its association with inflammasomes,
the significance of interleukin-18 (IL-18) among pediatric-onset systemic lupus
erythematous (pSLE) patient, especially, its importance in predicting long-term
renal outcome was investigated.In a pSLE cohort of 96 patients with an average
follow-up period of 10.39?±?3.31 years, clinical data and laboratory workups
including serum IL-18 were collected at time of disease onset and 6 months after
treatment despite their initial renal status. Through Cox regression analysis,
the parameters at baseline and at 6 months posttreatment were carefully
analyzed.Average age of all cases was 12.74?±?3.01 years old and 65 of them
underwent renal biopsy at the time of diagnosis. Nine subjects (9.38%) progressed
to end-stage renal disease (ESRD) and 2 cases (2.08%) died during follow-up.
Through multivariate analysis, serum IL-18 level 6 months posttreatment was found
to be the most unfavorable factor associating poor clinical outcome despite
patient's initial renal status. In addition, the presentation of serum IL-18 in
its correlation with SLE global disease activity as well as the presence and
severity of LN were all significant (P?0.001, P?=?0.03, and P?=?0.02,
respectively). The histological classification of LN, however, was not associated
with the level of IL-18 among the pSLE patients (P?=?0.64).The role of serum
IL-18 as biomarker representing global disease activity and status of renal
flares among pSLE population was shown for the first time. Additionally, we have
identified IL-18 at 6 months posttreatment a novel marker for long-term renal
outcome prediction.