{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:52:14Z","timestamp":1760147534142,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH-1116504C"],"award-info":[{"award-number":["TCVGH-1116504C"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Lupus nephritis (LN) is a common and severe manifestation of pediatric-onset systemic lupus erythematosus (pSLE). It is one of the major causes of long-term glucocorticoid\/immune suppressants use in pSLE. It causes long-term glucocorticoid\/immune suppressants use and even end-stage renal disease (ESRD) in pSLE. It is now well known that high chronicity, especially the tubulointerstitial components in the renal biopsy, predicts a poor renal outcome. Interstitial inflammation (II), a component of activity in LN pathology, can be an early predictor for the renal outcome. With the advent of 3D pathology and CD19-targeted CAR-T cell therapy in the 2020s, the present study focuses on detailed pathology and B cell expression in II. We recruited 48 pSLE patients with class III\/IV LN to analyze the risk of ESRD based on different II scores. We also studied 3D renal pathology and immunofluorescence (IF) staining of CD3, 19, 20, and 138 in patients with a high II score but low chronicity. Those pSLE LN patients with II scores of 2 or 3 showed a higher risk for ESRD (p = 0.003) than those with II scores of 0 or 1. Excluding patients with chronicity &gt;3, high II scores still carried a higher risk for ESRD (p = 0.005). Checking the average scores from the renal specimens from different depths, the II, and chronicity showed good consistency between 3D and 2D pathology (interclass correlation coefficient [ICC], II = 0.91, p = 0.0015; chronicity = 0.86, p = 0.024). However, the sum of tubular atrophy plus interstitial fibrosis showed no good consistency (ICC = 0.79, p = 0.071). The selected LN patients with negative CD19\/20 IF stains showed scattered CD3 infiltration and a different IF pattern of Syndecan-1 expression. Our study provides unique data in LN, including 3D pathology and different in situ Syndecan-1 patterns in LN patients.<\/jats:p>","DOI":"10.3390\/ijms24043512","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T02:56:13Z","timestamp":1675997773000},"page":"3512","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of New 3D Pathology and Lymphocyte Expression of Interstitial Inflammation in Pediatric-Onset Lupus Nephritis"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2945-4404","authenticated-orcid":false,"given":"Yung-Chieh","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Taichung Veterans General Hospital, Taichung 40705, Taiwan"},{"name":"Department of Pediatrics, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong-Chen","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Taichung Veterans General Hospital, Taichung 40705, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Pen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4770-3208","authenticated-orcid":false,"given":"Lin-Shien","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Taichung Veterans General Hospital, Taichung 40705, Taiwan"},{"name":"Department of Pediatrics, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1093\/rheumatology\/kev311","article-title":"The frequency and outcome of lupus nephritis: Results from an international inception cohort study","volume":"55","author":"Hanly","year":"2016","journal-title":"Rheumatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1002\/acr.23887","article-title":"Racial and Ethnic Differences in the Prevalence and Time to Onset of Manifestations of Systemic Lupus Erythematosus: The California Lupus Surveillance Project","volume":"72","author":"Maningding","year":"2020","journal-title":"Arthritis Care Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1177\/0961203319889667","article-title":"Differences in clinical manifestations and increased severity of systemic lupus erythematosus between two groups of Hispanics: European Caucasians versus Latin American mestizos (data from the RELESSER registry)","volume":"29","author":"Alonso","year":"2020","journal-title":"Lupus"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1177\/0961203311416694","article-title":"Differences in clinical manifestations between childhood-onset lupus and adult-onset lupus: A meta-analysis","volume":"20","author":"Livingston","year":"2011","journal-title":"Lupus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"v39","DOI":"10.1093\/rheumatology\/keaa381","article-title":"Lupus nephritis: Clinical presentations and outcomes in the 21st century","volume":"59","author":"Gasparotto","year":"2020","journal-title":"Rheumatology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1136\/annrheumdis-2012-202443","article-title":"Annual direct medical cost of active systemic lupus erythematosus in five European countries","volume":"73","author":"Doria","year":"2014","journal-title":"Ann. 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