Abstract:
Objective To explore the clinical values of serum interleukin 17A(IL-17A)and IL- 23 in predicting the occurrence and progression of immunoglobulin A vasculitis(IgAV)complicated with nephritis.
Methods From January 2018 to October 2021,71 IgAV patients were selected along with 50 age/ gender-matched healthy volunteers as normal control group. IgAV patients were further divided into nephritis (
n=28)and non-nephritis(
n=43)subgroups based upon the presence or absence of renal involvement. Luminex xMAP liquid chip technology was utilized for detecting the serum levels of cytokines. Receiver operating characteristic(ROC)curves were plotted for determining the diagnostic value of serum IL-17A/ IL-23 for IgAV and IgAV-nephritis.
Results The levels of IL-17A and IL-23 were higher in IgAV group group than those in IgAV-non-nephritis group(
P<0.05). The area under the ROC curve(AUC)of serum IL-17A for IgAV or IgAV-nephritis was 0.804(95%
CI:0.725~0.882)and 0.778(95%
CI:0.670~ 0.886). Both were above 0.7. IgAV patients with an elevation of IL-17A or IL-23 had the higher proportion of patients with hematuria/proteinuria(
P<0.05);while serum IL-17A levels were correlated positively with serum creatinine(Scr)(
r=0.443,
P<0.001),blood urea nitrogen(BUN) (
r=0.259,
P=0.029),cystatin C(CYSC)(
r=0.391,
P<0.001)and clinical scores(
r=0.734,
P<0.001)and yet negatively with estimated glomerular filtration rate(eGFR)(
r=-0.474,
P<0.001). Also serum IL-23 level was correlated positively with serum CYSC(
r=0.400,
P<0.001)and clinical scores(
r=0.243,
P=0.041)and negatively with eGFR (
r=-0.373,
P<0.001). Furthermore,the serum levels of IL-17A and IL-23 were positively correlated with ISKD class in IgAV-nephritis group(r=0.718,0.648,
P<0.001).
Conclusion IL-17A and IL-23 may be employed as biochemical markers for monitoring the progression of secondary IgAV nephritis.