biostudies-literatureHorisberger ANCATS NIH HHSNational Institutes of HealthNIAMS NIH HHSe181034https://www.ebi.ac.uk/biostudies/studies/S-EPMC12352894biostudies-literatureUnknown135(16)Lupus nephritis (LN) is a frequent manifestation of systemic lupus erythematosus, and fewer than half of patients achieve complete renal response with standard immunosuppressants. Identifying noninvasive, blood-based immune alterations associated with renal injury could aid therapeutic decisions. Here, we used mass cytometry immunophenotyping of peripheral blood mononuclear cells in 145 patients with biopsy-proven LN and 40 healthy controls to evaluate the heterogeneity of immune activation and identify correlates of renal parameters. Unbiased analysis identified 3 immunologically distinct groups of patients that were associated with different patterns of histopathology, renal cell infiltrates, urine proteomic profiles, and treatment response at 1 year. Patients with enriched circulating gThe Journal of clinical investigationBlood immunophenotyping identifies distinct kidney histopathology and outcomes in patients with lupus nephritis.PMC12352894UH2 AR067689UH2 AR067679UL1 TR002541UH2-AR067691UH2 AR067694UH2-AR067681UH2 AR067681and UM2- AR067678UH2-AR067694UH2 AR067676UH2 AR067688UH2 AR067677UH2 AR067685UH2-AR067690UM2 AR067678UH2-AR067677UH2-AR067688UH2-AR067689UH2-AR067679UH2 AR067690UH2 AR067691UH2-AR067685UH2-AR067676Pulford JZhang FWofsy DDavidson ARaychaudhuri SGuthridge JBuyon JPHancock BPayan-Schober FGutierrez-Arcelus MWeisman MEisenhaure TMFurie RBerthier CCAccelerating Medicines Partnership Rheumatoid Arthritis and Systemic Lupus Erythematosus (AMP RA/SLE) NetworkJames JADall'Era MKalunian KCGrossman JKeegan JKretzler MBrenner MBHacohen NIshimori MGriffith AMcMahon MADiamond BBarnas JLSasaki THoward KDemeke DSClancy RArazi ABelmont MLederer JAHorisberger AApruzzese WPreisinger KBeuschel RIzmirly PPetri MAFava AHodgin JBRao DAHoover PJAnolik JHInamo JGhosh TWoodle ESPutterman CCao YHildeman DMurzin EKamen DLfalseBlood immunophenotyping identifies distinct kidney histopathology and outcomes in patients with lupus nephritis.Lupus nephritis (LN) is a frequent manifestation of systemic lupus erythematosus, and fewer than half of patients achieve complete renal response with standard immunosuppressants. Identifying noninvasive, blood-based immune alterations associated with renal injury could aid therapeutic decisions. Here, we used mass cytometry immunophenotyping of peripheral blood mononuclear cells in 145 patients with biopsy-proven LN and 40 healthy controls to evaluate the heterogeneity of immune activation and identify correlates of renal parameters. Unbiased analysis identified 3 immunologically distinct groups of patients that were associated with different patterns of histopathology, renal cell infiltrates, urine proteomic profiles, and treatment response at 1 year. Patients with enriched circulating g2025-01-01T00:00:00Z2025 Aug2026-05-29T15:28:44.456Z2026-04-08T05:20:15.866ZS-EPMC123528944053681310.1172/JCI181034