Very small embryonic-like stem cells: A predictor synergizing with complement and inflammatory factors for immunoglobulin A nephropathy prognosis

doi:10.4252/wjsc.120694

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World Journal of Stem Cells

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1948-0210

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Stem Cells. Aug 26, 2026; 18(8): 120694
Published online Aug 26, 2026. doi: 10.4252/wjsc.120694

Table 1 Comparison of clinical baseline data between end-stage renal disease patients and non-end-stage renal disease patients, mean ± SD/n (%)

Indicators	Non-ESRD (n = 224)	ESRD (n = 31)	t/χ²	P value
Sex
Male	115 (51.3)	16 (51.0)	0.001	0.977
Female	109 (48.7)	15 (49.0)	0.001	0.977
Age (years)	38.46 ± 5.79	39.72 ± 9.21	0.996	0.320
BMI (kg/m²)	23.42 ± 3.13	22.98 ± 2.19	0.756	0.450
History of hypertension	63 (28.13)	9 (29.03)	0.011	0.916
Systolic pressure	129.64 ± 21.31	132.45 ± 22.32	0.684	0.495
Diastolic pressure	83.14 ± 11.14	86.47 ± 9.72	1.583	0.115
Thrombocyte (× 10⁹/L)	259.64 ± 45.87	267.91 ± 38.85	0.957	0.339
Neutrophil (× 10⁹/L)	3.88 ± 0.83	3.92 ± 0.77	0.381	0.801
White blood cell (× 10⁹/L)	6.29 ± 0.75	6.37 ± 0.81	0.543	0.588
Lymphocyte (× 10⁹/L)	1.71 ± 0.33	1.73 ± 0.37	0.324	0.746
24-hour proteinuria (g/d)	1.28 ± 0.17	1.31 ± 0.20	0.859	0.391
Albumin (g/L)	37.49 ± 5.96	38.71 ± 5.28	1.082	0.280
Urea nitrogen (mmol/L)	5.26 ± 0.53	5.31 ± 0.62	0.492	0.62.
Creatinine (μmol/L)	102.64 ± 12.53	98.89 ± 7.79	1.619	0.107
Uric acid (μmol/L)	321.90 ± 33.48	344.85 ± 30.88	3.609	< 0.001^a
Triglyceride (mmol/L)	1.59 ± 0.27	1.53 ± 0.19	1.178	0.240
Total cholesterol (mmol/L)	4.08 ± 0.57	4.26 ± 0.66	1.613	0.108
High-density lipoprotein cholesterol (mmol/L)	0.89 ± 0.13	0.87 ± 0.18	0.712	0.477
Low-density lipoprotein cholesterol (mmol/L)	3.74 ± 0.42	3.89 ± 0.51	1.810	0.071
Oxford classification
M1	183 (81.70)	27 (87.10)	0.546	0.460
E1	113 (50.45)	20 (64.52)	2.160	0.142
S1	133 (59.38)	11 (35.48)	6.323	0.012^a
T1-2	85 (37.95)	12 (38.71)	0.007	0.935
C1-2	121 (54.02)	16 (51.61)	0.063	0.801

^aP < 0.05.

ESRD: End-stage renal disease; BMI: Body mass index.

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Table 2 Comparison of the complement alternative pathway, inflammatory markers, and stem cell indicators between end-stage renal disease patients and non-end-stage renal disease patients, mean ± SD/n (%)

Indicators	Non-ESRD (n = 224)	ESRD (n = 31)	t/χ²	P value
CFH (mg/L)	612.75 ± 185.97	547.72 ± 149.54	1.864	0.063
CFB (mg/L)	395.88 ± 85.99	361.91 ± 77.08	4.112	< 0.001^a
CFI (mg/L)	55.44 ± 8.91	50.68 ± 6.95	9.452	< 0.001^a
SC5b-9 (mg/L)	0.52 ± 0.06	0.54 ± 0.18	1.330	0.185
C3a (mg/L)	0.79 ± 0.11	0.65 ± 0.07	6.366	< 0.001^a
BAFF (ng/mL)	4.34 ± 0.25	4.41 ± 0.31	1.431	0.154
MCP-1 (pg/mL)	227.98 ± 57.01	289.56 ± 55.42	5.463	< 0.001^a
CXCL-10 (pg/mL)	137.91 ± 25.94	145.05 ± 34.18	1.377	0.170
IL-6 (pg/mL)	19.58 ± 3.58	23.46 ± 5.66	5.211	< 0.001^a
TNF-α (pg/mL)	21.65 ± 3.95	26.95 ± 4.31	6.924	< 0.001^a
VSELs (events/600 μL whole blood)	52.87 ± 6.42	62.94 ± 12.93	6.986	< 0.001^a
HSCs (events/600 μL whole blood)	81.47 ± 6.88	83.32 ± 7.47	1.419	0.157
EPCs (events/600 μL whole blood)	40.25 ± 5.42	38.57 ± 3.99	1.673	0.096

^aP < 0.05.

ESRD: End-stage renal disease; CFH: Complement factor H; CFB: Complement factor B; CFI: Complement factor I; BAFF: B-cell activating factor; MCP-1: Monocyte chemoattractant protein-1; CXCL-10: C-X-C motif chemokine ligand 10; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; VSELs: Very small embryonic-like stem cells; HSCs: Hematopoietic stem cells; EPCs: Endothelial progenitor cells.

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Table 3 Logistic regression model was used to analyze the influencing factors of end-stage renal disease occurrence in patients with immunoglobulin A nephropathy

Index	Univariate analysis		Multivariate analysis
Index	OR (95%CI)	P value	OR (95%CI)	P value
S1	0.376 (0.172-0.823)	0.014^a	0.019 (0.001-0.485)	0.016^a
Uric acid	1.022 (1.009-1.034)	< 0.001^a	1.160 (0.902-1.492)	0.246
CFB	0.995 (0.991-1.000)	0.040^a	0.987 (0.972-1.004)	0.128
CFI	0.938 (0.896-0.981)	0.006^a	0.656 (0.492-0.874)	0.004^a
C3a	0.989 (0.984-0.993)	< 0.001^a	0.970 (0.947-0.992)	0.009^a
MCP-1	1.019 (1.011-1.028)	< 0.001^a	1.032 (1.000-1.066)	0.051
IL-6	1.266 (1.141-1.404)	< 0.001^a	0.260 (0.023-2.895)	0.273
TNF-α	1.400 (1.238-1.583)	< 0.001^a	2.055 (1.262-3.347)	0.004^a
VSELs	1.159 (1.095-1.226)	< 0.001^a	1.859 (1.022-3.381)	0.042^a

^aP < 0.05.

OR: Odds ratio; CI: Confidence interval; CFB: Complement factor B; CFI: Complement factor I; MCP-1: Monocyte chemoattractant protein-1; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; VSELs: Very small embryonic-like stem cells.

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Table 4 The predictive value of individual and combined detection of complement factor I, tumor necrosis factor-α and very small embryonic-like stem cells for end-stage renal disease in patients with immunoglobulin A nephropathy

Index	AUC	95%CI	P value	Sensitivity (%)	Specificity (%)
CFI	0.660	0.598-0.718	< 0.001^a	80.65	54.46
TNF-α	0.818	0.765-0.863	< 0.001^a	61.29	91.52
VSELs	0.749	0.691-0.801	< 0.001^a	61.29	95.54
Combination	0.916	0.875-0.947	< 0.001^a	83.87	90.62

^aP < 0.05.

AUC: Area under the curve; CI: Confidence interval; CFI: Complement factor I; TNF-α: Tumor necrosis factor-α; VSELs: Very small embryonic-like stem cells.

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Citation: Lou CL, Ren KX, Xu XQ, Wang XJ, Fan XP, Feng B, Hu PX, Zhou YJ. Very small embryonic-like stem cells: A predictor synergizing with complement and inflammatory factors for immunoglobulin A nephropathy prognosis. World J Stem Cells 2026; 18(8): 120694
URL: https://www.wjgnet.com/1948-0210/full/v18/i8/120694.htm
DOI: https://dx.doi.org/10.4252/wjsc.120694

Lou CL, Ren KX, Xu XQ, Wang XJ, Fan XP, Feng B, Hu PX, Zhou YJ. Very small embryonic-like stem cells: A predictor synergizing with complement and inflammatory factors for immunoglobulin A nephropathy prognosis. World J Stem Cells 2026; 18(8): 120694 [DOI: 10.4252/wjsc.120694]

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