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Dickkopf Homolog 3 (DKK3) as a Prognostic Marker in Lupus Nephritis: A Prospective Monocentric Experience

Background: The gold standard for diagnosis of lupus nephritis (LN) is still represented by renal biopsy, and serological prognostic biomarkers are still lacking. Dickkopf homolog-3 (DKK3) has been suggested as a marker of tissue fibrosis in different conditions; however, its role in autoimmune dise...

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Autores principales: Sciascia, Savino, Barinotti, Alice, Radin, Massimo, Cecchi, Irene, Menegatti, Elisa, Terzolo, Edoardo, Rossi, Daniela, Baldovino, Simone, Fenoglio, Roberta, Roccatello, Dario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181809/
https://www.ncbi.nlm.nih.gov/pubmed/35683365
http://dx.doi.org/10.3390/jcm11112977
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author Sciascia, Savino
Barinotti, Alice
Radin, Massimo
Cecchi, Irene
Menegatti, Elisa
Terzolo, Edoardo
Rossi, Daniela
Baldovino, Simone
Fenoglio, Roberta
Roccatello, Dario
author_facet Sciascia, Savino
Barinotti, Alice
Radin, Massimo
Cecchi, Irene
Menegatti, Elisa
Terzolo, Edoardo
Rossi, Daniela
Baldovino, Simone
Fenoglio, Roberta
Roccatello, Dario
author_sort Sciascia, Savino
collection PubMed
description Background: The gold standard for diagnosis of lupus nephritis (LN) is still represented by renal biopsy, and serological prognostic biomarkers are still lacking. Dickkopf homolog-3 (DKK3) has been suggested as a marker of tissue fibrosis in different conditions; however, its role in autoimmune diseases needs to be elucidated. Here, we investigated the prognostic role of DKK3 in systemic lupus erythematosus (SLE) patients with and without LN, assessing its changes in relation to kidney function, flares, and interstitial fibrosis. Methods: Overall, 132 SLE patients (57 with LN) were included and prospectively followed up for at least 36 months. DKK3 was measured in serum at baseline. Biopsies were evaluated for glomerular involvement, interstitial fibrosis, and tubular atrophy. Results: Patients with biopsy-proven LN had significantly higher levels of DKK3 than those without (median [min–max]: 215 ng/mL [81–341] vs. 21.1 ng/mL [1–69], p < 0.01). DKK3 levels were associated with prevalent chronic kidney diseases (OR: 4.31 [C.I. 2.01–6.61] per DKK3 doubling, p < 0.01), higher chronicity index at biopsy (1.75 [1.51–2.77] per DKK3 doubling, p < 0.01), and flares rate (OR: 1.45 [C.I. 1.1–5.71] per DKK3 doubling, p < 0.044). Conclusions: While kidney biopsy still represents the gold standard for diagnostic and prognostic assessment in LN, DKK3 could represent an additional prognostic tool to monitor SLE patients and guide therapeutic choices.
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spelling pubmed-91818092022-06-10 Dickkopf Homolog 3 (DKK3) as a Prognostic Marker in Lupus Nephritis: A Prospective Monocentric Experience Sciascia, Savino Barinotti, Alice Radin, Massimo Cecchi, Irene Menegatti, Elisa Terzolo, Edoardo Rossi, Daniela Baldovino, Simone Fenoglio, Roberta Roccatello, Dario J Clin Med Article Background: The gold standard for diagnosis of lupus nephritis (LN) is still represented by renal biopsy, and serological prognostic biomarkers are still lacking. Dickkopf homolog-3 (DKK3) has been suggested as a marker of tissue fibrosis in different conditions; however, its role in autoimmune diseases needs to be elucidated. Here, we investigated the prognostic role of DKK3 in systemic lupus erythematosus (SLE) patients with and without LN, assessing its changes in relation to kidney function, flares, and interstitial fibrosis. Methods: Overall, 132 SLE patients (57 with LN) were included and prospectively followed up for at least 36 months. DKK3 was measured in serum at baseline. Biopsies were evaluated for glomerular involvement, interstitial fibrosis, and tubular atrophy. Results: Patients with biopsy-proven LN had significantly higher levels of DKK3 than those without (median [min–max]: 215 ng/mL [81–341] vs. 21.1 ng/mL [1–69], p < 0.01). DKK3 levels were associated with prevalent chronic kidney diseases (OR: 4.31 [C.I. 2.01–6.61] per DKK3 doubling, p < 0.01), higher chronicity index at biopsy (1.75 [1.51–2.77] per DKK3 doubling, p < 0.01), and flares rate (OR: 1.45 [C.I. 1.1–5.71] per DKK3 doubling, p < 0.044). Conclusions: While kidney biopsy still represents the gold standard for diagnostic and prognostic assessment in LN, DKK3 could represent an additional prognostic tool to monitor SLE patients and guide therapeutic choices. MDPI 2022-05-25 /pmc/articles/PMC9181809/ /pubmed/35683365 http://dx.doi.org/10.3390/jcm11112977 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sciascia, Savino
Barinotti, Alice
Radin, Massimo
Cecchi, Irene
Menegatti, Elisa
Terzolo, Edoardo
Rossi, Daniela
Baldovino, Simone
Fenoglio, Roberta
Roccatello, Dario
Dickkopf Homolog 3 (DKK3) as a Prognostic Marker in Lupus Nephritis: A Prospective Monocentric Experience
title Dickkopf Homolog 3 (DKK3) as a Prognostic Marker in Lupus Nephritis: A Prospective Monocentric Experience
title_full Dickkopf Homolog 3 (DKK3) as a Prognostic Marker in Lupus Nephritis: A Prospective Monocentric Experience
title_fullStr Dickkopf Homolog 3 (DKK3) as a Prognostic Marker in Lupus Nephritis: A Prospective Monocentric Experience
title_full_unstemmed Dickkopf Homolog 3 (DKK3) as a Prognostic Marker in Lupus Nephritis: A Prospective Monocentric Experience
title_short Dickkopf Homolog 3 (DKK3) as a Prognostic Marker in Lupus Nephritis: A Prospective Monocentric Experience
title_sort dickkopf homolog 3 (dkk3) as a prognostic marker in lupus nephritis: a prospective monocentric experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181809/
https://www.ncbi.nlm.nih.gov/pubmed/35683365
http://dx.doi.org/10.3390/jcm11112977
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