ObjectiveTo systematically review the diagnostic value of anti-C1q antibodies for lupus nephritis (LN) in Chinese population. MethodsWe electronically searched databases including PubMed, EMbase, CNKI, The Cochrane Library, VIP and WanFang Data for diagnostic accuracy studies of anti-C1q antibodies for LN in Chinese population from inception to 1st March, 2015. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies by QUADAS tool. Then, meta-analysis was performed by Meta-DiSc 1.4 software and Stata 11.0 software. ResultsA total of 11 studies involving 1 084 systemic lupus erythematosus (SLE) patients were included. Among them, 474 patients were LN. The results of meta-analysis showed that:the pooled sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio of anti-C1q in the diagnosis of LN were 0.67 (95%CI 0.63 to 0.71), 0.69 (95%CI 0.65 to 0.74), 5.09 (95%CI 3.29 to 7.85), 2.18 (95%CI 1.75 to 2.72), and 0.48 (95%CI 0.39 to 0.60), respectively. The area under the curve (AUC) of SROC was 0.749 6 and the Q index value was 0.693 1. The average missed diagnosis rate was 33.0% and the misdiagnosis rate was 31.0%. ConclusionCurrent evidence indicates that anti-C1q antibodies may have some value in the diagnosis of LN. Because of the high missed diagnosis rate and the misdiagnosis rate, it could not be used to diagnose LN alone, and it only could be used as an adjuvant diagnostic indicator for LN. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective A series of bioinformatics methods were used to identify ferroptosis related biomarkers in lupus nephritis (LN). Methods We retrieved sequencing data of GSE112943 from the GEO (Gene Expression Omnibus) database and screened LN differentially expressed genes. We searched for ferroptosis-related gene (FRG) through FerrDb database, and screened LN-FRG. We conducted enrichment analysis on the LN-FRGs using David online bioinformatics database and screened the core LN-FRG using cytoHubba. We used external data sets to verify the core LN-FRGs, constructed competing endogenous RNA networks, and conducted molecular docking analysis. Results A total of 37 LN-FRGs were selected through screening. These genes are mainly enriched in inflammation, immune regulation and ferroptosis related signaling pathways. Through the cytoHubba and external dataset validation, the key core LN-FRG of ATF3 (activating transcription factor 3) was ultimately identified, and its expression was significantly increased in LN (P<0.05). Molecular docking analysis showed that ATF3 was closely bound to SLC7A11 and NRF2, and may participate in the occurrence and development of LN through the microRNA-27-ATF3 regulation axis. Conclusion The pivotal gene ATF3 may participate in the inflammation and immune injury of LN through ferroptosis.
Objective To assess the efficacy and safety of mycophenolate mofetil (MMF) versus cyclophosphamide (CTX) in the induction treatment for lupus nephritis (LN). Methods Such databases as MEDLINE, EMBASE, SCIE, The Cochrane Library, the Cochrane Controlled Trials Register, CBM, and CNKI were searched from their establishment date to August of 2010 to retrieve the randomized controlled trials (RCTs) about MMF versus CTX for LN. The methodology quality of included studies was evaluated. The efficacy indexes i.e. the clinical total remission (TR), complete remission (CR), partial remission (PR), pathological activity index, the chronicity index and complete induction therapy rate (CIR), and the safety indexes i.e. the rate of patient intolerance-to-drug, the incidence of infection, leukopenia and diarrhea, were abstracted. Finally the Meta-analyses were conducted by using Cochrane Collaboration’s RevMan 4.2. Results Eight RCTs involving 773 patients met the inclusive criteria. The results of meta-analyses showed that the total remission rate (OR=1.49, 95%CI 1.10 to 2.02) and complete remission rate (OR=1.67, 95%CI 1.08 to 2.57) were significantly higher in the MMF group than the CTX group. There was no significant difference in the rate of partial remission, the complete induction rate, the rate of patient intolerance-to-drug, the incidence of infection and leukopenia. However, the incidence of diarrhea was higher in the MMF group (OR=2.99, 95%CI 1.87 to 4.78). The results of meta-analyses for type IV LN were the same. Conclusion MMF is superior to CTX in the induction therapy to Lupus Nephritis (type III, IV, V), but the incidence of diarrhea is higher.