title: Pentraxin 3 as a novel early biomarker for the prediction of Henoch-Schönlein purpura nephritis in children.
abstract: We investigated the potential role of pentraxin 3 (PTX3) in Henoch-Schönlein purpura (HSP), a common multisystemic vasculitis affecting children, as a predictor of Henoch-Schönlein purpura nephritis (HSPN). A total of 108 cases consisting of 34 children with HSP, 37 children with HSPN, and 37 healthy control children were enrolled in this prospective study from March 2010 to February 2013. Blood and urine samples were collected to measure plasma PTX3, C-reactive protein (CRP), serum creatinine, blood urea nitrogen (BUN), urine microalbumin (MALB), and β2-microglobulin (β2-MG). Median plasma PTX3 concentrations were significantly higher in children with HSPN and HSP than in control subjects before treatment (6.99, 4.18-9.78 ng/ml; 3.19, 1.13-4.27 ng/ml; 1.24, 0.87-2.08 ng/ml, respectively; all p < 0.05). Median plasma PTX3 concentrations were also significantly higher in children with HSPN than in children with HSP before treatment (6.99, 4.18-9.78 vs. 3.19, 1.13-4.27 ng/ml; p < 0.05). After treatment, median plasma PTX3 concentrations significantly decreased in children with HSP (from 3.19, 1.13-4.27 to 1.08, 0.65-2.19 ng/ml; p < 0.05) and HSPN (from 6.99, 4.18-9.78 to 1.29, 1.01-2.26 ng/ml; p < 0.05). Plasma PTX3 concentration was positively correlated with CRP (rho = 0.532, p = 0.001), MALB (rho = 0.606, p < 0.001), β2-MG (rho = 0.490, p = 0.002), and 24-h urinary protein quantity (rho = 0.650, p < 0.001) in children with HSPN. Considering vasculitis, we found that PTX3 could be used as a more efficient potential predictor of HSPN than CRP as indicated by the area under the receiver operating characteristic (ROC) curve (AUCROC) of PTX3 (AUCROC = 0.837; p < 0.001) and CRP (AUCROC = 0.514; p = 0.845). The threshold PTX3 concentration with optimal sensitivity and specificity was 4.30 ng/ml (sensitivity 73.0 %, specificity 79.6 %).
  
  
  CONCLUSIONS
  PTX3 seems to have an important role in multisystemic vasculitis of HSP, may be involved in the development of HSPN, and used as an early biomarker to predict HSPN.
authors: Department of Pediatrics, Qilu Hospital, Shandong University, 107# Wenhua Xi Road, Jinan, 250012, China.
authors: Wei
authors: W
authors: Ge
authors: Hai-Lian
authors: HL
authors: Wang
authors: Ruo-Peng
authors: RP
authors: Sun
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D001806:Blood Urea Nitrogen; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003404:Creatinine / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000175:diagnosis*; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D011695:IgA Vasculitis / Q000097:blood / Q000175:diagnosis*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012016:Reference Values; D000683:Serum Amyloid P-Component / Q000378:metabolism*; D000099153:Pentraxins
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D002097:C-Reactive Protein; D003404:Creatinine; D006633:Histamine Antagonists; D007166:Immunosuppressive Agents; D000683:Serum Amyloid P-Component; D000099153:Pentraxins
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