CD62L expression on blood basophils at diagnosis may predict future response to standard induction therapy for patients with the most severe lupus nephritis (LN) cases, a new study finds.
Of 83 patients with class 3, 4, or 5 LN, including pure class 5 with nephrotic syndrome, 64 patients achieved renal remission. CD62L expression on circulating blood basophils measuring greater than 105 geometric fluorescent intensity (gMF) at diagnosis significantly and independently associated with 74% lower odds of remission at 12 months after the start of induction therapy compared with a lower gMF, Eric Daugas, MD, PhD, of Hôpital Bichat, Assistance Publique-Hoôpitaux de Paris, Université de Paris in Paris, France, and colleagues reported in Nephrology Dialysis Transplantation. In addition, a CD62L measurement of less than 105 gMFI was associated with an 87% probability of LN remission in the ensuing 12 months after the start of induction therapy, indicating substantial renal response. Of note, patients with an estimated glomerular filtration rate less than 30 mL/min/1.73 m2 and more than 50% of glomeruli globally sclerosed were excluded from the study.
CD62L is also known as L-selectin. It is highly expressed on activated basophils and may prompt these basophils to exit circulating blood and travel to secondary lymphoid organs where they amplify immune complexes, the investigators explained. Therefore, low CD62L in blood might be an indirect marker of a higher amount of basophils in the lymph system.
“If validated, the measure of CD62L expression on circulating basophils at baseline could then be the first marker allowing the discrimination of high-risk and low-risk patients and could be useful for personalizing induction therapies and improving their benefit over risk ratios,” according to Dr Daugas’ team.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Halfon M, Bachelet D, Hanouna G, et al. CD62L on blood basophils: a first pre-treatment predictor of remission in severe lupus nephritis. Nephrol Dial Transplant 2020:1-7. doi:10.1093/ndt/gfaa263