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Retinal Drusen Are More Common and Larger in Systemic Lupus Erythematosus With Renal Impairment
INTRODUCTION: Complement has been implicated in systemic lupus erythematosus (SLE) pathogenesis on the basis of the associations with inherited complement defects and genome-wide association study risk alleles, glomerular deposits, reduced serum levels, and occasional reports of retinal drusen. This...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039474/ https://www.ncbi.nlm.nih.gov/pubmed/35497809 http://dx.doi.org/10.1016/j.ekir.2022.01.1063 |
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author | Ham, Ye Ji Nicklason, Eleanor Wightman, Tony Akom, Sarah Sandhu, Kieran Harraka, Philip Colville, Deb Catran, Andrew Barit, David Langsford, David Pianta, Tim Foote, Andrew Buchanan, Russell Mack, Heather Savige, Judy |
author_facet | Ham, Ye Ji Nicklason, Eleanor Wightman, Tony Akom, Sarah Sandhu, Kieran Harraka, Philip Colville, Deb Catran, Andrew Barit, David Langsford, David Pianta, Tim Foote, Andrew Buchanan, Russell Mack, Heather Savige, Judy |
author_sort | Ham, Ye Ji |
collection | PubMed |
description | INTRODUCTION: Complement has been implicated in systemic lupus erythematosus (SLE) pathogenesis on the basis of the associations with inherited complement defects and genome-wide association study risk alleles, glomerular deposits, reduced serum levels, and occasional reports of retinal drusen. This study examined drusen in SLE and their clinical significance. METHODS: This cross-sectional observational study compared individuals with SLE recruited from renal and rheumatology clinics with hospital controls. Participants were reviewed for clinical features and underwent imaging with a nonmydriatic retinal camera. Deidentified images were examined by 2 trained graders for drusen number and size using a grid overlay. RESULTS: The cohort with SLE (n = 65) comprised 55 women (85%) and 10 men (15%) with a median age of 47 years (interquartile range 35–59), where 23 (35%) were of southern European or Asian ancestry, and 32 (49%) had biopsy-proven lupus nephritis. Individuals with SLE had higher mean drusen numbers than controls (27 ± 60, 3 ± 9, respectively, P = 0.001), more drusen counts ≥10 (31, 48% and 3, 5%, respectively, P < 0.001), and more medium-large drusen (14, 22% and 3, 5%, respectively, P < 0.001). In SLE, mean drusen counts were higher, and drusen were larger, with an estimated glomerular filtration rate (eGFR) <90 ml/min per 1.73 m(2) (P = 0.02, P = 0.02, respectively) or class IV nephritis (P = 0.03, P = 0.02). CONCLUSION: Drusen composition resembles that of glomerular immune deposits. CFH controls complement activation in the extracellular matrix and CFH risk variants are shared by drusen in macular degeneration and by SLE. CFH represents a possible treatment target for SLE especially with renal impairment. |
format | Online Article Text |
id | pubmed-9039474 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-90394742022-04-27 Retinal Drusen Are More Common and Larger in Systemic Lupus Erythematosus With Renal Impairment Ham, Ye Ji Nicklason, Eleanor Wightman, Tony Akom, Sarah Sandhu, Kieran Harraka, Philip Colville, Deb Catran, Andrew Barit, David Langsford, David Pianta, Tim Foote, Andrew Buchanan, Russell Mack, Heather Savige, Judy Kidney Int Rep Clinical Research INTRODUCTION: Complement has been implicated in systemic lupus erythematosus (SLE) pathogenesis on the basis of the associations with inherited complement defects and genome-wide association study risk alleles, glomerular deposits, reduced serum levels, and occasional reports of retinal drusen. This study examined drusen in SLE and their clinical significance. METHODS: This cross-sectional observational study compared individuals with SLE recruited from renal and rheumatology clinics with hospital controls. Participants were reviewed for clinical features and underwent imaging with a nonmydriatic retinal camera. Deidentified images were examined by 2 trained graders for drusen number and size using a grid overlay. RESULTS: The cohort with SLE (n = 65) comprised 55 women (85%) and 10 men (15%) with a median age of 47 years (interquartile range 35–59), where 23 (35%) were of southern European or Asian ancestry, and 32 (49%) had biopsy-proven lupus nephritis. Individuals with SLE had higher mean drusen numbers than controls (27 ± 60, 3 ± 9, respectively, P = 0.001), more drusen counts ≥10 (31, 48% and 3, 5%, respectively, P < 0.001), and more medium-large drusen (14, 22% and 3, 5%, respectively, P < 0.001). In SLE, mean drusen counts were higher, and drusen were larger, with an estimated glomerular filtration rate (eGFR) <90 ml/min per 1.73 m(2) (P = 0.02, P = 0.02, respectively) or class IV nephritis (P = 0.03, P = 0.02). CONCLUSION: Drusen composition resembles that of glomerular immune deposits. CFH controls complement activation in the extracellular matrix and CFH risk variants are shared by drusen in macular degeneration and by SLE. CFH represents a possible treatment target for SLE especially with renal impairment. Elsevier 2022-02-02 /pmc/articles/PMC9039474/ /pubmed/35497809 http://dx.doi.org/10.1016/j.ekir.2022.01.1063 Text en © 2022 International Society of Nephrology. Published by Elsevier Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Clinical Research Ham, Ye Ji Nicklason, Eleanor Wightman, Tony Akom, Sarah Sandhu, Kieran Harraka, Philip Colville, Deb Catran, Andrew Barit, David Langsford, David Pianta, Tim Foote, Andrew Buchanan, Russell Mack, Heather Savige, Judy Retinal Drusen Are More Common and Larger in Systemic Lupus Erythematosus With Renal Impairment |
title | Retinal Drusen Are More Common and Larger in Systemic Lupus Erythematosus With Renal Impairment |
title_full | Retinal Drusen Are More Common and Larger in Systemic Lupus Erythematosus With Renal Impairment |
title_fullStr | Retinal Drusen Are More Common and Larger in Systemic Lupus Erythematosus With Renal Impairment |
title_full_unstemmed | Retinal Drusen Are More Common and Larger in Systemic Lupus Erythematosus With Renal Impairment |
title_short | Retinal Drusen Are More Common and Larger in Systemic Lupus Erythematosus With Renal Impairment |
title_sort | retinal drusen are more common and larger in systemic lupus erythematosus with renal impairment |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039474/ https://www.ncbi.nlm.nih.gov/pubmed/35497809 http://dx.doi.org/10.1016/j.ekir.2022.01.1063 |
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