{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:58:45Z","timestamp":1777636725405,"version":"3.51.4"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease in which anti-double-stranded DNA (anti-dsDNA) antibodies are closely associated with disease activity and organ involvement. However, the relationships of 25-hydroxyvitamin D [25(OH)D], CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio, and prognostic nutritional index (PNI) with anti-dsDNA antibody status and titer stratification remain incompletely understood.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 126 patients with SLE were enrolled and classified into an anti-dsDNA-negative group and an anti-dsDNA-positive group. According to anti-dsDNA titers, patients were further stratified into low-titer and high-titer groups. Clinical characteristics and laboratory parameters, including 25(OH)D, CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio, and PNI, were compared among groups. Receiver operating characteristic curve analysis was performed to evaluate the discriminatory performance of 25(OH)D, CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio, PNI, and their combined model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with anti-dsDNA-negative patients, anti-dsDNA-positive patients had significantly lower levels of C3, C4, the CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio, 25(OH)D, and PNI, together with a higher prevalence of renal involvement (all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05). Significant differences in 25(OH)D, the CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio, and PNI were also observed across the anti-dsDNA-negative, low-positive, and high-positive groups. In ROC analysis, 25(OH)D showed the highest AUC among the individual biomarkers for anti-dsDNA serostatus, whereas the combined assessment achieved the highest overall AUC. For stratifying low-positive from high-positive anti-dsDNA titers, the combined assessment showed better discriminatory performance than PNI and C3.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Combined assessment of 25(OH)D, the CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio, and PNI may provide complementary value for anti-dsDNA-based stratification in SLE. Its performance was comparable to C3 for anti-dsDNA serostatus and superior to C3 for stratifying low-from high-positive anti-dsDNA titers. These findings should be considered exploratory and require validation in external cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1841620","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:53:39Z","timestamp":1777442019000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined assessment of 25(OH)D, CD4+\/CD8+ ratio, and prognostic nutritional index for anti-dsDNA-based stratification in systemic lupus erythematosus"],"prefix":"10.3389","volume":"17","author":[{"given":"Chaoju","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Key Laboratory of Molecular Medicine","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Clinical Research Center for Laboratory Medicine","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juntao","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Key Laboratory of Molecular Medicine","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Clinical Research Center for Laboratory Medicine","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Key Laboratory of Molecular Medicine","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Clinical Research Center for Laboratory Medicine","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanqing","family":"Tie","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Hebei General Hospital","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Key Laboratory of Molecular Medicine","place":["Shijiazhuang, Hebei, China"]},{"name":"Hebei Clinical Research Center for Laboratory Medicine","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00398-2","article-title":"Systemic lupus erythematosus","volume":"403","author":"Hoi","year":"2024","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.2315","article-title":"Systemic lupus erythematosus: a 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