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Serum Wnt3A levels are significantly associated with cross-sectional vasculitis activity and end-stage kidney disease during follow-up of patients with antineutrophil cytoplasmic antibody-associated vasculitis
T. Yoon1, J.W. Ha2, Y.-B. Park3, S.-W. Lee4
- Department of Medical Science, BK21 Plus Project, Yonsei University, College of Medicine, Seoul, Republic of Korea.
- Division of Rheumatology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea.
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, and Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, and Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea. sangwonlee@yuhs.ac
CER17965
2025 Vol.43, N°4
PI 0674, PF 0682
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PMID: 39436730 [PubMed]
Received: 04/07/2024
Accepted : 07/10/2024
In Press: 21/10/2024
Published: 08/04/2025
Abstract
OBJECTIVES:
In this study, we investigated whether serum Wnt3A levels at diagnosis reflected cross-sectional activity and predicted poor outcomes during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
METHODS:
This study included 80 patients who were newly diagnosed with AAV at a tertiary hospital. At diagnosis, whole blood was obtained from patients and sera was immediately isolated and stored at -80℃. Moreover, AAV activity was assessed using the Birmingham Vasculitis Activity Score (BVAS), and a high BVAS was defined as the highest tertile. Poor outcomes including all-cause mortality and end-stage kidney disease (ESKD) were recorded.
RESULTS:
The patients had a median age of 63.5 years, with 40% being male and 60% female patients. Serum levels of Wnt3A at diagnosis were correlated with the cross-sectional BVAS and serum Wnt3A ≥411.7 pg/mL exhibited an increased risk of high BVAS. In addition, serum Wnt3A levels at diagnosis significantly correlated with cross-sectional acute-phase reactants and serum albumin levels. Furthermore, serum Wnt3A levels at diagnosis were associated with AAV exacerbation, leading to ESKD. Particularly, serum Wnt3A ≥407.1 pg/mL also demonstrated an elevated risk of ESKD (relative risk 3.867). Additionally, patients with serum Wnt3A ≥407.1 pg/mL exhibited a significantly lower cumulative ESKD-free survival rate than those with lower serum Wnt3A levels.
CONCLUSIONS:
This study is the first to demonstrate the clinical potential of serum Wnt3A levels at diagnosis for estimating cross-sectional activity and partially predicting the advancement to ESKD during follow-up in patients with AAV
