scholarly journals Urinary and serum neutrophil gelatinase-associated lipocalin as a biomarker in Egyptian systemic lupus erythematosus patients: Relation to lupus nephritis and disease activity

2015 ◽  
Vol 37 (4) ◽  
pp. S25-S31 ◽  
Author(s):  
Yara Tawfik ◽  
Reham M. Shaat ◽  
Sherif R. El-Bassiony ◽  
Salah Hawas ◽  
Narmen Effat
Author(s):  
Sonia L La’ulu ◽  
Brenda B Suh-Lailam ◽  
K Wayne Davis ◽  
Joely A Straseski ◽  
Anne E Tebo

Background Lupus nephritis is one of the most serious complications of systemic lupus erythematosus. This study evaluates the prevalence and correlation between neutrophil gelatinase-associated lipocalin and other biomarkers associated with renal involvement in systemic lupus erythematosus. Methods Paired serum and urine specimens from 50 suspected systemic lupus erythematosus patients, characterized by antinuclear antibodies detected by indirect immunofluorescence assay and varying positive concentrations of anti-double stranded DNA antibodies by Crithidia luciliae immunofluorescence assay, were investigated. Of these 50 patients, 18 were identified with renal involvement based upon laboratory serology. Patients and healthy control serum samples ( n = 50) were also evaluated for high avidity double stranded DNA IgG antibodies, anti-C1q IgG antibodies, and serum creatinine. The prevalence and relationship between biomarkers were evaluated using statistical methods. Results Serum and urine neutrophil gelatinase-associated lipocalin concentrations were significantly elevated in patients compared to controls, with a prevalence of 24% and 36%, respectively. These concentrations were also more markedly increased in systemic lupus erythematosus patients with renal involvement than those without. Spearman’s correlations between neutrophil gelatinase-associated lipocalin and other biomarkers tested ranged from 0.06 to 0.66 in all patients. Combined concordance as determined by Cronbach alpha coefficient between biomarkers was reduced from 0.71 to 0.58 (serum) and 0.62 (urine) when neutrophil gelatinase-associated lipocalin was removed. Conclusions Neutrophil gelatinase-associated lipocalin concentrations are elevated and demonstrate variable associated with other laboratory markers for renal involvement in systemic lupus erythematosus. Prospective longitudinal studies are needed to determine the optimal biomarker combinations for use in routine management of systemic lupus erythematosus patients at-risk for lupus nephritis.


2017 ◽  
Author(s):  
Άρτεμις-Ωραιάνθη Κουτσονικολή

Εισαγωγή. Η νεφρίτιδα αποτελεί τον καθοριστικότερο παράγοντα της συνολικής βαρύτητας και πρόγνωσης του παιδιατρικού Συστηματικού Ερυθηματώδους Λύκου (πΣΕΛ). Η ανεύρεση νέων βιολογικών δεικτών, ειδικών για τη νεφρίτιδα του πΣΕΛ, θα επιτρέψει τη μη επεμβατική εκτίμηση της πορείας της και τη στοχευμένη θεραπεία. Τα επιστημονικά δεδομένα για τους παιδιατρικούς ασθενείς, ιδιαιτέρως για ομοιογενείς καυκάσιους πληθυσμούς, είναι ακόμη ελλειπή. Σκοπός. Να διερευνηθεί η σχέση των αντισωμάτων έναντι των νουκλεοσωμάτων (αντι-NCS) ορού, των αντισωμάτων έναντι της βασικής μεμβράνης του σπειράματος (αντι-GBM) ορού, των αντισωμάτων έναντι του παράγοντα C1q του συμπληρώματος (αντι-C1q) ορού, της πρωτεΐνης High-Mobility Group Box-1 (HMGB1) ορού και ούρων και της Neutrophil Gelatinase-Associated Lipocalin (NGAL) ούρων με: (α) την παρουσία νεφρίτιδας στον πΣΕΛ και (β) με την ενεργότητα του πΣΕΛ και της νεφρίτιδας ειδικότερα, σε έναν αμιγώς καυκάσιο πληθυσμό ασθενών από τη βόρεια Ελλάδα. Υλικό-Μέθοδοι. Ελήφθησαν δείγματα ορού και ούρων από 22 ασθενείς με πΣΕΛ και νεφρίτιδα, 20 ασθενείς με πΣΕΛ χωρίς νεφρίτιδα, 15 ασθενείς με νεφρίτιδα άλλης αυτοάνοσης αιτιολογίας (IgA νεφροπάθεια, νεφρίτιδα πορφύρας Henoch-Schönlein, μεταλοιμώδη νεφρίτιδα ή μεμβρανώδη σπειραματονεφρίτιδα) και 26 υγιείς μάρτυρες. Ο προσδιορισμός των βιολογικών δεικτών έγινε με τη μέθοδο ELISA. Η ενεργότητα του πΣΕΛ και της νεφρίτιδας του πΣΕΛ εκτιμήθηκε με το εργαλείο SLEDAI-2K (Systemic Lupus Erythematosus Disease Activity Index-2000). Αποτελέσματα. Α. Βιολογικοί δείκτες ορού. Τα επίπεδα των αντι-NCS, των αντι-GBM, των αντι-C1q και της HMGB1 βρέθηκαν στατιστικώς σημαντικά υψηλότερα στους ασθενείς με νεφρίτιδα του πΣΕΛ συγκριτικά με τους υγιείς μάρτυρες αλλά και συγκριτικά με τους ασθενείς με νεφρίτιδα άλλης αυτοάνοσης αιτιολογίας. Κατά τη σύγκριση των επιπέδων των βιολογικών δεικτών ορού μεταξύ των ασθενών με νεφρίτιδα του πΣΕΛ και των ασθενών με πΣΕΛ χωρίς νεφρίτιδα, τα αντι-NCS, τα αντι-GBM και η HMGB1 παρουσίαζαν στατιστικώς σημαντικά υψηλότερες τιμές στους ασθενείς με νεφρίτιδα, ενώ για τα αντι-C1q δεν παρατηρήθηκαν στατιστικώς σημαντικές διαφορές. Τα επίπεδα της HMGB1 παρουσίασαν υψηλή θετική συσχέτιση με την ενεργότητα της νεφρίτιδας του πΣΕΛ. Τα επίπεδα της HMGB1 και των αντι-C1q παρουσίασαν μέτρια θετική συσχέτιση με την ενεργότητα του πΣΕΛ συνολικά. Β. Βιολογικοί δείκτες ούρων. Τα επίπεδα της NGAL και της HMGB1 ήταν στατιστικώς σημαντικά υψηλότερα στους ασθενείς με νεφρίτιδα του πΣΕΛ συγκριτικά με τους ασθενείς με πΣΕΛ χωρίς νεφρίτιδα. Επιπλέον, τα επίπεδα της NGAL παρουσίασαν μέτρια θετική συσχέτιση και τα επίπεδα της HMGB1 υψηλή θετική συσχέτιση με την ενεργότητα της νεφρίτιδας του πΣΕΛ. Συμπεράσματα. Σε αυτόν τον ομοιογενή πληθυσμό Καυκάσιων ασθενών με πΣΕΛ, τα αντι-NCS, τα αντι-GBM, η HMGB1 ορού και ούρων και η NGAL ούρων προέκυψαν ως πιθανοί χρήσιμοι βιολογικοί δείκτες, ενδεικτικοί της νεφρικής προσβολής. Επιπλέον, τα αντι-NCS, τα αντι-GBM και η HMGB1 ορού δεν φαίνεται να παρουσιάζουν αύξηση σε νεφρίτιδες άλλης αυτοάνοσης αιτιολογίας. Η HMGB1 ορού και ούρων και η NGAL ούρων προέκυψαν ως πιθανοί χρήσιμοι βιολογικοί δείκτες παρακολούθησης της ενεργότητας της νεφρίτιδας του πΣΕΛ. Τα αντι-C1q και η HMGB1 ορού προέκυψαν ως πιθανοί χρήσιμοι βιολογικοί δείκτες παρακολούθησης της ενεργότητας του πΣΕΛ συνολικά.


Lupus ◽  
2020 ◽  
pp. 096120332097904
Author(s):  
Eman Ahmed Hafez ◽  
Sameh Abd El-mottleb Hassan ◽  
Mohammed Abdel Monem Teama ◽  
Fatma Mohammed Badr

Objective Lupus nephritis (LN) is closely associated with hyperuricemia, and uric acid is considered a risk factor for renal involvement in systemic lupus erythematosus (SLE). This study aimed to examine the association between serum uric acid (SUA) level and LN development and progression in SLE patients with normal renal function. Methods A total of 60 SLE patients with normal renal function from Ain Shams University Hospital were selected and assigned to group 1 (30 patients with LN) and group 2 (30 patients without LN). All patients were subjected to history taking, clinical examination, disease activity assessment based on SLE disease activity index (SLEDAI) and renal SLEDAI (SLEDAI-R) scores, and laboratory investigations, including as SUA, complete blood count, blood urea nitrogen (BUN), serum creatinine, creatinine clearance, urine analysis, protein/creatinine ratio, 24-h urinary protein excretion, Antinuclear antibodies (ANA), anti-dsDNA antibody, and serum complement (C3, C4). Results Disease duration, SLEDAI score, and SUA level were higher in group 1 than in group 2 (p < 0.001). SUA level was positively correlated with SLEDAI and SLEDAI-R scores, proteinuria, urinary casts, renal biopsy class, disease activity and chronicity indices, BUN level, and serum creatinine level but was negatively correlated with creatinine clearance (p < 0.05). SUA was a predictor of LN development in SLE patients (sensitivity, 83.3%; specificity, 70%). Conclusion SUA is associated with the development of lupus nephritis in patients with normal kidney function also SUA in-dependently correlated with disease activity and chronicity in LN.


Lupus ◽  
2017 ◽  
Vol 26 (13) ◽  
pp. 1448-1456 ◽  
Author(s):  
K C Maloney ◽  
T S Ferguson ◽  
H D Stewart ◽  
A A Myers ◽  
K De Ceulaer

Background Epidemiological studies in systemic lupus erythematosus have been reported in the literature in many countries and ethnic groups. Although systemic lupus erythematosus in Jamaica has been described in the past, there has not been a detailed evaluation of systemic lupus erythematosus patients in urban Jamaica, a largely Afro-Caribbean population. The goal of this study was to describe the clinical features, particularly disease activity, damage index and immunological features, of 150 systemic lupus erythematosus subjects. Methods 150 adult patients (≥18 years) followed in rheumatology clinic at a tertiary rheumatology hospital centre (one of two of the major public referral centres in Jamaica) and the private rheumatology offices in urban Jamaica who fulfilled Systemic Lupus International Collaborating Clinics (SLICC) criteria were included. Data were collected by detailed clinical interview and examination and laboratory investigations. Hence demographics, SLICC criteria, immunological profile, systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K) and SLICC/American College of Rheumatology (ACR) damage index (SDI) were documented. Results Of the 150 patients, 145 (96.7%) were female and five (3.3%) were male. The mean age at systemic lupus erythematosus onset was 33.2 ± 10.9. Mean disease duration was 11.3 ± 8.6 years. The most prevalent clinical SLICC criteria were musculoskeletal, with 141 (94%) of subjects experiencing arthralgia/arthritis, followed by mucocutaneous manifestations of alopecia 103 (68.7%) and malar rash 46 (30.7%), discoid rash 45 (30%) and photosensitivity 40 (26.7%). Lupus nephritis (biopsy proven) occurred in 42 (28%) subjects and 25 (16.7%) met SLICC diagnostic criteria with only positive antinuclear antibodies/dsDNA antibodies and lupus nephritis on renal biopsy. The most common laboratory SLICC criteria were positive antinuclear antibodies 136 (90.7%) followed by anti-dsDNA antibodies 95 (63.3%) and low complement (C3) levels 38 (25.3%). Twenty-seven (18%) met SLICC diagnostic criteria with only positive antinuclear antibodies/anti-dsDNA antibodies and lupus nephritis on renal biopsy. Mean SLEDAI score was 6.9 ± 5.1 with a range of 0–32. Organ damage occurred in 129 (86%) patients; mean SDI was 2.4 ± 1.8, with a range of 0–9. Conclusion These results are similar to the clinical manifestations reported in other Afro-Caribbean populations; however, distinct differences exist with respect to organ involvement and damage, particularly with respect to renal involvement, which appears to be reduced in our participants.


Reumatismo ◽  
2018 ◽  
Vol 70 (4) ◽  
pp. 241-250 ◽  
Author(s):  
W.A. Wan Asyraf ◽  
M.S. Mohd Shahrir ◽  
W. Asrul ◽  
A.W. Norasyikin ◽  
O. Hanita ◽  
...  

Based on the recent evidence of association between hyperprolactinemia and systemic lupus erythematosus disease activity (SLEDAI), a study was conducted to analyze the association of hyperprolactinemia with lupus nephritis disease activity. In this cross-sectional study, the analysis was conducted on SLE patients who visited the University Kebangsaan Malaysia Medical Centre (UKMMC) Nephrology Clinic from August 2015 till February 2016. The disease activity was measured using the SLEDAI score, with more than 4 indicating active lupus nephritis. Basal resting prolactin level was analyzed in 43 patients with lupus nephritis, in 27.9% of them had raised serum prolactin. The median of serum prolactin level at 0 minutes was 19.91 ng/mL (IQR: 15.95-22.65 ng/ mL) for active lupus nephritis, which was significantly higher compared to the median of serum prolactin level of 14.34 ng/mL (IQR: 11.09-18.70 ng/mL) for patients in remission (p=0.014). The serum prolactin level positively correlated with SLEDAI (rhos: 0.449, p=0.003) and the UPCI level in lupus nephritis patients (rhos: 0.241, p=0.032). The results were reproduced when the serum prolactin was repeated after 30 minutes. However, the serum prolactin levels at 0 minutes were higher than those taken after 30 minutes (p=0.001). An assessment of serum IL-6 levels found that the active lupus nephritis patients had a higher median level of 65.91 pg/ mL (IQR: 21.96-146.14 pg/mL) compared to the in-remission level of 15.84 pg/mL (IQR: 8.38-92.84 pg/mL), (p=0.039). Further correlation analysis revealed that there was no statistical correlation between the interleukin (IL)-6 levels with serum prolactin, SLEDAI and other lupus nephritis parameters. An ROC curve analysis of serum prolactin at 0 minutes and serum prolactin after 30 minutes and IL-6 levels for prediction of SLE disease activity provided the cutoff value of serum prolactin at 0 minutes, which was 14.63 ng/mL with a sensitivity of 91.7% and specificity of 58.1% and AUC of 0.74 (p=0.015). This study concurred with the previous findings that stated that hyperprolactinemia is prevalent in SLE patients and correlated with clinical disease activity and UPCI level. The baseline of the fasting serum prolactin level was found to be a sensitive biomarker for the evaluation of lupus nephritis disease activity.


2018 ◽  
Author(s):  
Tim Dierckx ◽  
Sylvie Goletti ◽  
Laurent Chiche ◽  
Laurent Daniel ◽  
Bernard Lauwerys ◽  
...  

Objective: Glycoprotein acetylation (GlycA) is a novel biomarker for chronic inflammation, associated to cardiovascular risk. Serum GlycA levels are increased in several inflammatory diseases, including systemic lupus erythematosus (SLE). We investigated the relevance of serum GlycA measurement in SLE and lupus nephritis (LN). Methods: GlycA was measured by NMR in 194 serum samples from patients and controls. Comparisons were performed between groups. Clinical and biological parameters were tested for correlation with GlycA levels. The predictive value of GlycA to differentiate proliferative from non-proliferative LN was determined using logistic regression models. Results: GlycA was correlated to C-reactive protein (CRP), neutrophil count, proteinuria and the SLE disease activity index (SLEDAI), and inversely with serum albumin. GlycA was higher in active (n=105) than in quiescent (n=39) SLE patients, in healthy controls (n=29), and in patients with non-lupus nephritis (n=21), despite a more altered renal function in the latter. In patients with biopsy-proven active LN, GlycA was higher in proliferative (n=32) than non-proliferative (n=11) LN, independent of renal function and proteinuria level. Logistic regression models showed that, in univariate models, GlycA outperforms traditional biomarkers. A bivariate model using GlycA and BMI better predicted the proliferative status of LN than a model comprising CRP, renal function (eGFR), serum albumin, proteinuria, C3 consumption and the presence of anti-dsDNA antibodies. Conclusion: Serum GlycA is elevated in SLE, and correlates with disease activity and LN. Serum GlycA, which summarizes different inflammatory processes, could be a valuable biomarker to discriminate proliferative from non-proliferative LN and should be tested in large, prospective cohorts.


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