Evidence map›Paper›PMID 41314813›Full record

ArticleLupus science & medicine2025

Inflammation in areas of fibrosis precedes loss of kidney function in lupus nephritis.

Silvia Malvica, Paride Fenaroli, Chen-Yu Lee, Sarah Louis, Alessandra Ida Celia, Serena Bagnasco, Xiaoping Yang, Daniel Salvetti, Jeffrey Hodgin, H Michael Belmont and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Lupus science & medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. CD8Frontiers in immunology · 2026
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Silvia Malvica *Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Paride Fenaroli *Nephrology and Dialysis Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Chen-Yu Lee *Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA.
Sarah LouisDivision of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA.
Alessandra Ida CeliaUniversity of Rome La Sapienza, Rome, Italy.
Serena BagnascoDepartment of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Xiaoping YangDepartment of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Daniel SalvettiDepartment of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Jeffrey HodginDepartment of Pathology, University of Michigan, Ann Arbor, Michigan, USA.
H Michael BelmontRheumatology, NYU Grossman School of Medicine, New York City, New York, USA.
Peter IzmirlyRheumatology, NYU Grossman School of Medicine, New York City, New York, USA.
Jill P BuyonRheumatology, NYU Grossman School of Medicine, New York City, New York, USA.ORCID http://orcid.org/0000-0002-3852-7129
Laurence MagderUniversity of Maryland Medical Center, Baltimore, Maryland, USA.
Michelle A PetriDivision of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA.ORCID http://orcid.org/0000-0003-1441-5373
Accelerating Medicines Partnership: RA/SLE Network
Avi Rosenberg *Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA.
Andrea Fava *Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA afava1@jh.edu.ORCID http://orcid.org/0000-0001-6738-4836

Funding

PEARL: Pathway Exploration and Analysis in Renal LupusUH2AR067688 · NIAMS · FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH · PI DIAMOND, BETTY, WOFSY, DAVID · 2014 to 2020
$9.0M
Tissue Acquisition Research GroupUM2AR067678 · NIAMS · STANFORD UNIVERSITY · PI HOLERS, VERNON MICHAEL, UTZ, PAUL JOSEPH · 2014 to 2020
$8.2M
Multi-Ethnic Translational Research Optimization (METRO) Lupus ConsortiumUH2AR067689 · NIAMS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BUYON, JILL P, PUTTERMAN, CHAIM · 2014 to 2020
$6.3M
Evolving Adaptive and Effector Mechanisms from Pre-RA Through Established DiseaseUH2AR067681 · NIAMS · UNIVERSITY OF COLORADO DENVER · PI HOLERS, VERNON MICHAEL · 2014 to 2020
$5.5M
Molecular and Cellular Dissection of Early Rheumatoid ArthritisUH2AR067694 · NIAMS · FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH · PI BRENNER, MICHAEL B., GREGERSEN, PETER K. · 2014 to 2020
$5.4M
RA-SLE Molecular Deconstruction Leadership CenterUH2AR067677 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI BRENNER, MICHAEL B., RAYCHAUDHURI, SOUMYA · 2014 to 2020
$4.3M
Cellular Dynamics at the Synovium-Bone interface in RAUH2AR067690 · NIAMS · UNIVERSITY OF ROCHESTER · PI ANOLIK, JENNIFER HOWITT · 2014 to 2020
$3.0M
Clinical applications of urine proteomics to lupus nephritisR01DK134625 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI Andrea Fava · 2023 to 2026
$2.8M
Stanford Technology Accelerating Medicines Partnership CenterUH2AR067676 · NIAMS · STANFORD UNIVERSITY · PI ROBINSON, WILLIAM H, UTZ, PAUL JOSEPH · 2014 to 2020
$2.6M
Accelerating Medicines Partnership in RA and Lupus: Network Sites (UH2/UH3)UH2AR067679 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI PETRI, MICHELLE A · 2014 to 2020
$2.1M
Molecular Pathways in Treatment Response and Flare in RAUH2AR067691 · NIAMS · HOSPITAL FOR SPECIAL SURGERY · PI BYKERK, VIVIAN P, IVASHKIV, LIONEL B · 2014 to 2020
$2.0M
UPITT Rheumatoid Arthritis Combined Center (UPITT RACC)UH2AR067685 · NIAMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MCGEACHY, MANDY J, MORELAND, LARRY W · 2014 to 2019
$1.2M
NIAMS NIH HHS UH2 AR067676NIAMS NIH HHS UH2 AR067677NIAMS NIH HHS UH2 AR067679NIAMS NIH HHS UH2 AR067681NIAMS NIH HHS UH2 AR067685NIAMS NIH HHS UH2 AR067688NIAMS NIH HHS UH2 AR067689NIAMS NIH HHS UH2 AR067690NIAMS NIH HHS UH2 AR067691NIAMS NIH HHS UH2 AR067694NIAMS NIH HHS UM2 AR067678NIDDK NIH HHS R01 DK134625
6 · The paper itself

Abstract

backgroundInterstitial fibrosis in lupus nephritis (LN) is often infiltrated by immune cells but typically regarded as non-specific 'scar reaction'. This study aimed to investigate the relationship between inflammatory fibrosis and kidney disease progression in LN.

methodsInterstitial fibrosis and tubular atrophy (IFTA) were scored in 124 LN kidney biopsies. Inflammation in areas of IFTA (i-IFTA) was graded 0-3 according to the Banff Classification of Allograft Pathology. Significant glomerular filtration rate (GFR) loss was defined as a decline of >15 mL/min at 3 years from biopsy. Immune cell phenotype was defined by serial immunohistochemistry (13-plex).

resultsIFTA was observed in 88/124 (71%) biopsies, and i-IFTA was identified in 76/88 (86%) cases. The distribution of i-IFTA grades was heterogeneous across all IFTA grades. In patients with moderate-to-severe IFTA (>25%), the degree of i-IFTA was associated with a higher risk of significant GFR loss: 0/1 (0%), 0/3 (%), 3/4 (75%) and 7/9 (78%) for i-IFTA grades 0, 1, 2 and 3, respectively (p=0.015). Multiplexed histology revealed that i-IFTA was mostly composed of CD163+ macrophages and CD4 T cells, followed by CD8 T cells and granulocytes.

conclusionI-IFTA is frequently observed in LN and is dominated by macrophages and T cells. For patients with baseline IFTA >25%, the degree of i-IFTA emerged as a predictor of GFR loss. These data support the routine scoring of i-IFTA in LN due to its prognostic implications and nominate i-IFTA as a potential therapeutic target.

Indexed as

InflammationKidneyLupus NephritisAdultAtrophyBiopsyDisease ProgressionFemaleFibrosisGlomerular Filtration RateHumansKidney TubulesMaleMiddle AgedYoung AdultInflammationLupus NephritisRisk Factors

Identifiers

PMID41314813
PMCPMC12666189

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.