Urinary Cellular Profile as a Biomarker for Lupus Nephritis

Abstract

Background/ObjectiveA search for the ideal biomarker for lupus nephritis (LN) is still underway, one that can be used for early detection and correlate with the class and activity of LN. Urine is normally devoid of leukocytes; however, it has been observed that macrophages and T lymphocytes are routinely present in the urine of LN patients and those with other proliferative renal diseases. This provides the idea for their potential use as biomarkers for proliferative LN. Here, we measured the urinary CD4+, CD8+ T lymphocytes, and CD14+ monocytes in patients with systemic lupus erythematosus (SLE) as potential biomarkers for LN.MethodsA longitudinal case-control study included 30 SLE patients with LN, 30 SLE patients without past or current LN, and 20 healthy subjects as a control group. The flow cytometric analysis was done using BD FACS Calibur multiparameter flow cytometer equipped with BD CellQuest Pro software for data analysis.ResultsCD14+ cells were the most abundant cells in the urine of LN patients. The mean numbers of urinary CD8+, CD4+, and CD14+ cells/mL were significantly higher in patients with LN than in those without. The cell counts correlated significantly with proteinuria. Urinary CD14+ cells seem to occur in much higher counts in class IV than class III LN.ConclusionsUrinary CD8+, CD4+, and CD14+ cells are highly sensitive and specific markers for detecting proliferative LN. A low CD4:CD8 ratio provides a further clue. Urinary CD14 cell counts may be a potential biomarker to differentiate between the different classes of proliferative LN.

Role of Some Apoptotic Proteins in Pathogenesis of Juvenile Systemic Lupus Erytheromatosis and Lupus Nephritis

“…In the current study, CD4/CD8 ratio showed significant decrease between patients and controls with inversed signeficant correlation to disease activity. Agreed with our results Robinson et al [27], Sonawale et al study [11], Shah et al study [30] and Jiang et al study [31] In the present study we found low CD4/CD8 ratio was not correlated with LN and against our results El-Girby et al [32] and Kopetschke et al study [33].…”

Exploration of Potential Integrated Models of N6-Methyladenosine Immunity in Systemic Lupus Erythematosus by Bioinformatic Analyses

“…The CD14 (C-159T) polymorphism was related to increased susceptibility to SLE and could be a promising biomarker for the diagnosis of lupus nephritis (40). Moreover, a study demonstrated that urinary CD14 mononuclear cells could serve as a biomarker for lupus nephritis (LN) (41). The enzyme indoleamine 2,3-dioxygenase 1 (IDO1) is a heme enzyme that regulates immune responses to arrest inflammation (42).…”

Immune-Related Urine Biomarkers for the Diagnosis of Lupus Nephritis

“…Other authors have also described CD14 + cells as a major population in the urine of LN. CD14 + cells were more abundant in LN compared to non-renal SLE and healthy controls, and associated with class IV but not in class III nephritis [62]. More precisely, Kim et al [63], found higher numbers of CD11c + macrophages in the urine of patients with proliferative LN, with a strong association with the serum anti-dsDNA titers and chronicity indexes.…”

“…It may indicate patients at increased risk for long-term renal function loss [57]. ALCAM levels correlated positively with activity index [58] Effective LN therapy reduced uVCAM-1 levels over the time [56] Leukocytes Monocytes/macrophages in proliferative LN [62][63][64] Higher eosinophils numbers in LN [65] CD4+CD25-Foxp3+ T cells in active LN [66] CD4+ and CD8+ T cells in active LN [67,68] Th17 associated with less severe disease [69] pDC and PB/PC in severe LN [70,71] Lower numbers of CD8+ T cells in remission [67,68] Soluble leukocyte marker sCD163 in active LN [72,73], mostly in proliferative classes [74] sCD11b correlates with histological activity [75] T-bet mRNA in higher in active LN [76,77] sCD163 increases from 6 months before flare [78] Higher T-bet mRNA gives higher risk of severe flare [77] sCD163 decreases after treatment in drug responders [73,78] sCD11b decreases with clinical remission [75] However, other studies failed to detect anti-dsDNA antibodies. Yamada et al [79], studied the presence of anti-dsDNA in serum and urine of nine SLE patients presenting heavy proteinuria.…”