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

Tawfik, Yara; Shaat, Reham M.; El-Bassiony, Sherif R.; Hawas, Samia; Effat, N.

doi:10.1016/j.ejr.2015.09.003

Cited by 6 publications

(10 citation statements)

References 34 publications

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“…Our result of enhanced serum values of NGAL in LN is in line with those reported in the literature; however, their results were not statistically significant (24,27,28,35). This may be due to different sample sizes.…”

Section: Discussionsupporting

confidence: 90%

The importance of serum neutrophil gelatinase-associated lipocalin level in patients with lupus nephritis

et al. 2019

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Introduction: The neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a biomarker of renal damage. Objectives: The aim of this study was to assess the serum levels of NGAL (sNGAL) as a marker of disease activity in individuals with lupus nephritis (LN). Patients and Methods: This study contained 50 systemic lupus erythematosus (SLE) individuals with (n = 25) and without (n = 25) nephritis, and 39 healthy controls. The sNGAL levels were measured by ELISA. Renal function test, urinary parameters, lupus serology activity, and also calculated SLE disease activity index (SLEDAI) were analyzed to determine their associations with sNGAL. Results: The results revealed that the SLE individuals with or without nephritis had a raised serum NGAL levels as compared to control subjects (P<0.001). Additionally, sNGAL levels in LN individuals were meaningfully higher compared to those in non-LN patients (P<0.001). Serum NGAL showed a significant correlation with the SLEDAI, serum creatinine, and 24-h urinary protein (P<0.05). More importantly, sNGAL had a significant positive correlation with the activity index of LN (r = 0.616, P=0.001). In the ROC curve analysis, the measurement of sNGAL level showed a good diagnostic performance for distinguishing individuals with LN from SLE patients without renal involvement with AUC=0.902 (P<0.001), 72% sensitivity, and 99% specificity. Moreover, sNGAL could identify all of SLE patients from controls with high accuracy, AUC= 0.99, P<0.001, with 99% sensitivity, and 97% specificity. Conclusion: Serum NGAL had an association with clinical parameters and could discriminate LN from SLE patients without renal involvement. Our result suggests that serum NGAL can be used for early diagnosis of LN and identifying active LN.

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Section: Discussionsupporting

confidence: 90%

The importance of serum neutrophil gelatinase-associated lipocalin level in patients with lupus nephritis

et al. 2019

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“…The detailed process of literature searching is illustrated by a flowchart (Figure 1). Initially, 315 articles were identified from electronic databases including [25,27,28,32,38], 5 in African countries [26,31,33,34,36], and 1 in South American country [37]. Four studies were conducted in children [20,22,26,30], and 17 studies investigated adults [ or "low concern": 1 score; "no"…”

Section: Resultsmentioning

confidence: 99%

“…A total of 1453 patients were enrolled in these studies, including 1269 female patients. Among the 21 eligible studies, 5 were conducted in the United States of America (USA) [ 20 – 24 ], 5 in European countries [ 23 , 29 , 30 , 35 ], 5 in Asian countries [ 25 , 27 , 28 , 32 , 38 ], 5 in African countries [ 26 , 31 , 33 , 34 , 36 ], and 1 in South American country [ 37 ]. Four studies were conducted in children [ 20 , 22 , 26 , 30 ], and 17 studies investigated adults [ 21 , 23 – 25 , 27 – 29 , 31 – 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, meta-regression (when the number of the included studies is greater than or equal to 10), subgroup analysis, and sensitivity analysis were conducted to explore possible sources of heterogeneity for part 1 to part 3. In part 1, as shown in Table 3, four studies [20,21,33,38] formed a subgroup with QUADAS − 2 scores ≥ 13, the pooled sensitivity decreased from 0.84 to 0.81, and specificity increased from 0.91 to 0.95. Specifically, the heterogeneity of sensitivity increased from 86.20% to 89.90%.…”

Section: Partmentioning

confidence: 99%

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Elevated Urinary Neutrophil Gelatinase‐Associated Lipocalin Is a Biomarker for Lupus Nephritis: A Systematic Review and Meta‐Analysis

Gao

Wang

Cao

et al. 2020

BioMed Research International

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Objective. Lupus nephritis (LN) is a major and severe complication of systemic lupus erythematosus (SLE). Neutrophil gelatinase-associated lipocalin (NGAL), as a promising next-generation biomarker in clinical nephrology, has received extensive attention. However, its diagnostic performance in LN has high variability. Therefore, we performed an updated meta-analysis to further evaluate the diagnostic accuracy of urinary NGAL (uNGAL). Materials and Methods. PubMed, Embase, and Cochrane Library were searched from inception to October 27, 2019. Meta-analysis was performed with a bivariate random effects model. Additionally, the summary receiver operating characteristic (SROC) curves were established. The sources of heterogeneity were explored by meta-regression, subgroup analysis, and sensitivity analysis. Publication bias was assessed using the Deeks test. Results. 19 articles consisting of 21 eligible studies were included. In diagnosing LN, the estimates (95% confidence interval (CI)) were as follows: sensitivity, 0.84 (0.71-0.91); specificity, 0.91 (0.70-0.98); and the SROC-AUC value, 0.92 (0.90-0.94). In identifying active LN, the estimates were as follows: sensitivity, 0.72 (0.56-0.84); specificity, 0.71 (0.51-0.84); and the AUC value, 0.77 (0.74-0.81). With respect to predicting renal flare, the estimates were as follows: sensitivity, 0.80 (0.57-0.92); specificity, 0.67 (0.58-0.75); and the AUC value, 0.74 (0.70-0.78). For the studies to distinguish proliferative LN, the estimates were as follows: sensitivity, 0.87 (0.66-0.97), and specificity, 0.69 (0.39-0.91). Deeks’ funnel plot suggested that there was no significant publication bias. Conclusions. Our meta-analysis indicates that uNGAL was a useful biomarker for diagnosis, estimation of activity, and prediction of renal flare of LN. In addition, the usefulness of uNGAL to distinguish pathological types of LN needs to be further investigated.

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“…Contrarily, no NETs were observed in renal specimen of fulminant Henoch-Schonlein purpura [16].Additional evidence, supporting that neutrophil components are contributing to renal damage and lupus nephritis, comes from many studies undertaking the investigation of urinary neutrophil gelatinase-associated lipocalin (UNGAL) in lupus nephritis. UNGAL is proposed to be a marker of SLE and an indicator of renal activity, moreover, the UNGAL levels were seen correlating to the lupus nephritis grading [105][106][107][108][109][110]. Anti-lipocalin IgG has also been reported as a new marker in SLE that can assist in the diagnosis of SLE with high sensitivity and specificity in disease distinguishes [111].…”

Section: Interferons B Cells and Neutrophils: Innate And Adaptive Almentioning

confidence: 99%

Interferons, B Cells and Neutrophils: Innate and Adaptive Allies in Systemic Lupus Erythematosus

Mohamed¹,

Gheita²

2018

JRAD

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Systemic lupus erythematosus (SLE) is clinically and immunologically heterogeneous with variable organ involvement, severity and therapeutic responses. B cells are known as mediators of disease manifestations. Therefore, disease control is targeted by inhibiting proliferation and inducing apoptosis of B cells via conventional cytotoxic drugs or newly developing biologics. However, the outcome of therapy is sometimes heterogeneous which further attracts to understand other immune mechanisms influencing B cell functions such as interferons (IFNs) cytokines and the innate cells, neutrophils. Successful management of SLE requires an understanding of how these factors interact, taking into consideration the patients' variations in these factors which might confer heterogeneity in disease outcome. In this review, it will be focused on the existing data in literature on the mutual influence between interferons, B cells and neutrophils in disease pathogenesis and the clinical impact in disease assessment and their potential blocking.

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

Cited by 6 publications

References 34 publications

The importance of serum neutrophil gelatinase-associated lipocalin level in patients with lupus nephritis

The importance of serum neutrophil gelatinase-associated lipocalin level in patients with lupus nephritis

Elevated Urinary Neutrophil Gelatinase‐Associated Lipocalin Is a Biomarker for Lupus Nephritis: A Systematic Review and Meta‐Analysis

Interferons, B Cells and Neutrophils: Innate and Adaptive Allies in Systemic Lupus Erythematosus

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