Serum TNF-α Level Is Associated with Disease Severity in Adult Patients with Immunoglobulin A Vasculitis Nephritis

Abstract EN

Background.

Tumor necrosis factor-α (TNF-α) is a proinflammatory factor involved in the pathogenesis of immunoglobulin A vasculitis (IgAV).

The association between serum TNF-α and disease severity in adult patients with IgAV nephritis (IgAV-N) has been inadequately evaluated.

Methods.

Serum TNF-α was measured by chemiluminescence immunoassay in 53 renal biopsy-proved IgAV-N patients, 53 healthy controls, and 53 IgA nephropathy (IgAN) patients.

The correlations of clinicopathologic parameters of IgAV-N patients with serum TNF-α were analyzed.

Results.

In this cross-sectional study, the median age of IgAV-N patients was 29 (25-37) years, and 67.9% were female.

Serum TNF-α was significantly higher in the IgAV-N group than in the healthy group [7.4 (5.7-9.4) pg/mL vs.

5.9 (5.0, 7.1) pg/mL, P=0.001], but comparable with sex, age, and estimated glomerular filtration rate (eGFR) grade-matched IgAN patients.

Serum creatinine (P=0.006) and serum cystatin C (P=0.001) were positively correlated with serum TNF-α level, while albumin (P=0.014) and eGFR (P=0.021) were negatively correlated with serum TNF-α level.

Multivariate linear regression analysis revealed that eGFR (P=0.007) was an independent clinical predictor of serum TNF-α.

Patients with higher pathological classification grade also had higher serum TNF-α.

Conclusions.

Serum TNF-α is associated with renal function and the pathological classification of adult patients with IgAV-N.

TNF-α is a potential biomarker for the assessment of IgAV-N severity.