ArticleFrontiers in immunology2022
Thrombotic microangiopathy mediates poor prognosis among lupus nephritis
Article in Frontiers in immunology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Complement-amplified thrombotic microangiopathy in systemic lupus erythematosus and lupus nephritis: a systematic review of 78 reported patients.Frontiers in immunology · 2026Pooled it
- Kidney Biopsy and Prognosis in Lupus Nephritis: Histological Predictors of Renal Outcome-A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Article
- Advances in the lectin pathway in systemic lupus erythematosus: from clinical correlations and mechanisms to targeted interventions.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026Review
- Complement-Mediated Kidney Diseases: Role of Alternative Pathway in Glomerular Inflammation.Kidney international reports · 2026Review
- Renal thrombotic microangiopathy impairs renal function recovery in lupus nephritis.Clinical kidney journal · 2025Article
- Significant glomerular IgM deposition predicts poorer kidney outcomes in lupus nephritis compared with other forms of immune complex deposits.Lupus science & medicine · 2025Article
- Urine proteins reveal distinct coagulation and complement cascades underlying acute versus chronic lupus nephritis.The Journal of clinical investigation · 2025Article
- Clinical characteristics and treatment response of patients with SLE complicated with thrombotic thrombocytopenic purpura.Lupus science & medicine · 2025Article
- Systematic Review of the Outcomes and Prognostic Factors of Patients With Systemic Lupus Erythematosus-Associated Thrombotic Microangiopathy.Kidney international reports · 2025Article
- Early administration of caplacizumab combined with plasma exchange for thrombotic microangiopathy due to malignant hypertension: a case report.CEN case reports · 2025Article
- Lupus Nephritis from Pathogenesis to New Therapies: An Update.International journal of molecular sciences · 2024Review
- Early-onset lupus nephritis.Clinical kidney journal · 2024Review
- Research trends and frontiers in lupus nephritis: a bibliometric analysis from 2012 to 2022.International urology and nephrology · 2024Article
- Role of complement factor D in cardiovascular and metabolic diseases.Frontiers in immunology · 2024Review
- Microvascular C5b-9 deposition in non-lesional skin in patients with SLE and its correlation with active lupus nephritis: a prospective observational study.Lupus science & medicine · 2023Observational
- Complement-Mediated Hemolytic Uremic Syndrome Due to MCP/CD46 Mutation: A Case Report.Journal of investigative medicine high impact case reportsArticle
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: The pathogenesis of thrombotic microangiopathy (TMA) in lupus nephritis (LN) remains complicated. This study aimed to detect the deposition of complement lectin pathway (LP) and alternative pathway (AP) components in renal tissues, then evaluate the clinicopathological characteristics and risk factors for renal survival between patients with or without TMA in LN cohorts. Methods: We included 79 patients with biopsy-proven LN-associated TMA and matched the same number of LN patients without TMA as the control group. The deposition of mannose binding lectin (MBL), MBL-associated serine proteases 1/3 (MASP1/3), complement factor B (CFB), complement factor D (CFD), C4d, and von Willebrand factor (VWF) in renal tissue was assessed by immunohistochemistry and immunofluorescence. Besides, co-localization of C5b-9 and CD34 was detected by confocal microscopy. Results: In our retrospective cohort, the incidence of acute kidney injury (30% vs. 14%, p = 0.013), acute hemodialysis (35% vs. 5%, p < 0.001), and interstitial fibrosis (43% vs. 13%, p < 0.001) is higher in the TMA, compared with the control group. Despite aggressive steroids pulse, plasma exchange, and immunosuppressive therapy among TMA group, they still had significantly inferior 3-year renal survival rates (68% vs. 89%, p = 0.002) than those in the non-TMA group. COX regression analysis identified that TMA (HR 4.807, 95% CI [2.052, 11.263], p < 0.001) is a risk factor in LN. MBL, MASP1/3, CFB, CFD, C4d, and VWF deposited along the glomerulus among LN, while TMA had stronger staining intensity and deposition. The co-localized expression of CD34 and C5b-9 in the endothelial cells was also observed in the renal tissues. Conclusions: TMA is an independent risk factor for renal survival in LN patients. Moreover, LP and AP activation are involved in the pathogenesis of LN-associated TMA.
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