Biomarkers in lupus nephritis

Misra, Ramnath; Gupta, Ranjan

doi:10.1111/1756-185x.12602

Cited by 55 publications

(45 citation statements)

References 96 publications

(103 reference statements)

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“…Thus, an in-depth understanding of the pathogenesis of LN and a search for related biomarkers has important practical significance to the understanding of the severity of LN lesions, judging LN activity, evaluating prognosis, and guiding treatment. In recent years, more and more studies have focused on the pathogenesis of LN and related biomarkers, aiming to improve the prediction of LN activity and the sensitivity and specificity of disease progression [22]. …”

Section: Discussionmentioning

confidence: 99%

“…Immune complex deposition may induce a large number of inflammatory cytokines in the initial disease stage, resulting in lupus glomerulonephritis. IL-6 is a kind of inflammatory factor mainly secreted by T cells and macrophages, which plays an important role in activating T cells and B cells [22]. Cash et al [23] demonstrated that IL-6 knockout significantly alleviate the symptoms of proteinuria, hematuria, and lymphocyte infiltration in LN mice.…”

Section: Discussionmentioning

confidence: 99%

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Regulation of MiR-146a and TRAF6 in the Diagnose of Lupus Nephritis

Zhu

Xue

2017

Med Sci Monit

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BackgroundLupus nephritis (LN) is a major complication of systemic lupus erythematosus (SLE). This study tested miR-146a and its target gene TRAF6 expression in LN patients and discussed their relationship with LN.Material/MethodsOne hundred twenty-eight LN patients and 30 healthy controls were enrolled in this study. MiR-146a and TRAF6 expression in peripheral blood mononuclear cells (PBMCs) were detected. Serum cytokines content was determined by ELISA. The diagnostic role of miR-146a and TRAF6 in LN activity was evaluated by ROC curve. The impact of miR-146a and TRAF6 on end-stage renal disease (ESRD) was compared by survival curve. The effect of miR-146a and TRAF6 on LN recurrence was analyzed.ResultsCompared with healthy controls, miR-146a expression was significantly reduced and TRAF6 was upregulated in LN patients. The expression was related to LN activity. MiR-146a expression was negatively correlated, whereas TRAF6 was positively correlated with serum IL-1β, IL-6, IL-8, and TNF-α activity. The area under the ROC curve (AUC) of miR-146a and TRAF6 on the diagnosis of LN was 0.821 and 0.897, respectively. The AUC of miR-146a and TRAF6 on LN activity differentiation was 0.921 and 0.872, respectively. Downregulation of miR-146a and upregulation of TRAF6 increased the incidence of ESRD progression. Downregulation of miR-146a and upregulation of TRAF6 elevated the possibility of recurrence within one year.ConclusionsMiR-146a declined, while TRAF6 increased in LN patients compared with healthy controls. Their expression can be used to effectively differentiate LN and evaluate activity. MiR-146a reduction and TRAF6 upregulation increased the possibility of ESRD progress and recurrence within one year.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Regulation of MiR-146a and TRAF6 in the Diagnose of Lupus Nephritis

Zhu

Xue

2017

Med Sci Monit

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“…These new classification criteria take into account additional forms of cutaneous lupus and newly described autoantibodies, which may provide further guidance in clinical judgment of SLE. New promising biomarkers for SLE are currently under development, including microRNA [25], presence of urinary immune cells [26], and genetic biomarkers such as specific polymorphisms of MHC, interferon responsive factors, and integrins [27]. Together with updated classification criteria and new biomarkers, we are hopeful to see an increase in certainty of diagnosis for variable presentations of SLE.…”

Section: Discussionmentioning

confidence: 99%

ANA-Negative Presentation of SLE in Man with Severe Autoimmune Neutropenia

Zhao

2016

Case Reports in Medicine

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Background. Systemic lupus erythematosus (SLE) is a chronic, inflammatory, connective tissue disease that commonly affects the joints and a variety of organs due to an overactivation of the body's immune system. There is wide heterogeneity in presentation of SLE patients, including lung, central nervous system, skin, kidney, and hematologic manifestations. Case Presentation. We report a case of atypical manifestation of SLE in a 53-year-old man who presented with neutropenic fever. Physical findings of interest included oral ulcers on the lower lip, a malar-like rash across the bridge of the nose, and a discoid-like rash on extensor surfaces of the elbows and knees. Labs include ANC <100, weakly positive anti-dsDNA, negative ANA, ferritin 1237 ng/mL, low C3/C4, and positive direct Coombs' test. A thorough workup for infection and hematologic malignancy was negative. Two days after initiation of therapy with 25 mg IV solumedrol twice a day, the patient's daily fevers resolved. ANC drastically improved to 2000 after two weeks of steroid treatment. He was later found to have a high titer of anti-neutrophil antibodies. Discussion. Autoimmune leukopenia is a common presentation in SLE, occurring in 50–60% of patients. Severe autoimmune neutropenia is uncommon and may correlate with high anti-neutrophil antibody activity despite a negative ANA. As neutropenia is usually mild, there are currently no guidelines for therapy. For our patient, we started him on low dose IV solumedrol and found that he responded drastically to treatment. Given strongly positive nonspecific anti-neutrophil antibodies in the setting of a negative ANA noted in our patient, it is likely that there are other currently unknown antibodies associated with SLE which may correlate strongly with autoimmune neutropenia.

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“…As cytokines are important participants in pathogenesis of LN, they are tested for their potential biomarker ability (Misra & Gupta, 2015). Autoantibodies were proved to play a pivotal role in LN (Rekvig & Nossent, 2003).…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of anti-C1q antibodies in SLE

Stiborová¹,

Král²,

Rovenský³

et al. 2015

Acta Facultatis Pharmaceuticae Universitatis Comenianae

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Lupus nephritis (LN) is a severe and frequent complication of systemic lupus erythematosus (SLE). Untreated cases very often lead to patients' death; therefore, it is important to use markers sensitive and specific enough for the diagnosis and subsequent monitoring of nephritis. Autoantibodies against double-stranded DNA (anti-dsDNA) are believed to play a major role in SLE in general and so their significance in prediction and monitoring of glomerular inflammation is low. For prediction of renal flares and effective, well-timed therapy, it is required to have an appropriate marker available. In our study, we have tested sera of 85 SLE patients with or without LN. The criterion for LN determination was the degree of proteinuria (persistent proteinuria > 0.5 g/day, according to ACR criteria for LN). Disease activity was described by SLE disease index (SLEDAI) score, renal functions were stated according to British Isles Lupus Assessment Group score. There were anti-C1q, total anti-dsDNA and high-avidity anti-dsDNA detected in the patients' sera. We did not find any significant difference in average SLEDAI value between patients with renal and non-renal organ complications. Positivity of anti-C1q was more frequent in patients with nephritis than in those without any history of renal disease (58.3 vs. 39.1%). Higher prevalence of these antibodies was evident in patients with clinically active LN than in those without renal improvement (73.1 vs. 39.1%). When comparing anti-C1q with antibodies against structures of DNA, significant differences were found in case of high avidity anti-dsDNA. Our results have confirmed the studies showing that anti-C1q antibodies could serve as a reliable serological marker of LN activity along with other laboratory tests. Detection of anti-C1q together with high avidity anti-dsDNA antibodies seems to be a good algorithm for the prediction of possible renal flares in SLE patients.Lupus nefrititída (LN) je závažnou a častou komplikáciou systémového lupus erythematosus (SLE). Neliečené prípady veľmi často vedú k úmrtiu pacienta, a preto je dôležité používať citlivé a dostatočne špecifické metódy na diagnostiku a sledovanie priebehu nefritídy. Autoprotilátky proti dvojzávitnicovej DNA (anti-dsDNA) hrajú významnú úlohu pri SLE, ale ich význam v predikcii a monitorovaní LN je malý. Preto sa hľadajú špecifickejšie paramatre na predikcie renálnych vzplanutí a sledovanie účinnej a včasnej terapie. V našej štúdii sme testovali séra od 85 SLE pacientov s alebo bez LN. Kritériom pre zaradenie do skupín podľa obličkového postihnutia bol stupeň proteinúrie (pretrvávajúca proteinúria> 0,5 g / deň, podľa kritérií ACR pre LN). Aktivita ochorenia bola popísaná SLEDAI skórom a stupeň obličkového poškodenia podľa BILAG skóre. Anti-C1q, celkové anti-dsDNA a vysoko aviditné anti-dsDNA boli detekované v sére pacientov. Medzi pacientami s poškodením obličiek a extrarenálnymi orgánovými komplikácií sme nezistili žiadny významný rozdiel v celkovej aktivite ochorenia podľa SLEDAI. Pozitivita anti-C1q je častejšia...

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Biomarkers in lupus nephritis

Cited by 55 publications

References 96 publications

Regulation of MiR-146a and TRAF6 in the Diagnose of Lupus Nephritis

Regulation of MiR-146a and TRAF6 in the Diagnose of Lupus Nephritis

ANA-Negative Presentation of SLE in Man with Severe Autoimmune Neutropenia

Clinical significance of anti-C1q antibodies in SLE

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