Urinary neutrophil gelatinase-associated lipocalin for diagnosis and estimating activity in lupus nephritis: a meta-analysis

Fāng, Yīng; Chen, N N; Cheng, Yuanjuan; Sun, Sujuan; Li, H X; Sun, Fangui; Xiang, Yong

doi:10.1177/0961203315600244

Cited by 17 publications

(21 citation statements)

References 45 publications

(154 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, a meta-analysis performed on fourteen studies has confirmed that uNGAL relatively has reasonable sensitivity and specificity in identifying LN and approximating LN activity, and also guessing kidney flares. The result suggests that uNGAL is a possible biomarker in monitoring LN activity and diagnosing LN with a pooled sensitivity of 73.6% and specificity of 78.1% (26). Brunner et al indicated that the measurement of NGAL together with GFR and MCP-1 was an admirable diagnostic tool for LN chronicity with AUC = 0.83 (37).…”

Section: Discussionmentioning

confidence: 99%

“…In a mouse model of LN, NGAL level in the kidney, urine, and serum is elevated in connection with disease severity (20). Likewise, human studies have displayed that urinary NGAL (uNGAL) levels can reflect the decline of renal function and the disease activity in LN (5,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Furthermore, it may predict poor response after induction therapy (31).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2019

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

View full text Add to dashboard Cite

show abstract

“…For all these reasons, NGAL may become one of the most promising next-generation biomarkers in immune mediated nephritis including LN patients. At present, several studies have reported that high levels of urinary NGAL was detected among SLE individuals in the presence of nephritis and urine NGAL may be a predictor of LN disease activity and flares and predicts worsening of LN disease activity [ 19 – 21 ]. In our study, urine NGAL from LN patients related to conventional biomarkers of LN disease activity including urine protein and serum C3 complement.…”

Section: Discussionmentioning

confidence: 99%

“…The sensitivity and specificity in predicting renal response were 75% and 66.7%, respectively. Previous studies among SLE patients have also reported the strong association of urine NGAL [ 19 – 21 ] and serum C3 complement in active LN [ 28 , 29 ], but data from the Aspreva Lupus Management Study (ALMS) study indicated that only baseline C4 complement level, and early normalization of complement but not C3 complement independently predicted renal response to therapy at 6 months [ 30 ]. Proteinuria and estimated GFR are commonly used in clinical practice to evaluate LN activity and response to treatment.…”

Section: Discussionmentioning

confidence: 99%

Urine neutrophil gelatinase-associated lipocalin to predict renal response after induction therapy in active lupus nephritis

et al. 2017

View full text Add to dashboard Cite

BackgroundTubulointerstitial injury is important to predict the progression of lupus nephritis (LN). Urine neutrophil gelatinase-associated lipocalin (NGAL) has been reported to detect worsening LN disease activity. Thus, urine NGAL may predict renal outcomes among lupus patients.MethodsWe conducted a prospective multi-center study among active LN patients with biopsy-proven. All patients provided urine samples for NGAL measurement by ELISA collected from all patients at baseline and at 6-month follow-up after induction therapy.ResultsIn all, 68 active LN patients were enrolled (mean age 31.7 ± 10.0 years, median UPCR 4.8 g/g creatinine level with interquartile range (IQR) 2.5 to 6.9 and mean estimated glomerular filtration rate (GFR) 89.6 ± 33.7 mL/min/1.73 m2). At baseline measurement, median urinary NGAL in complete response, partial response and nonresponse groups was 10.86 (IQR; 6.16, 22.4), 19.91 (IQR; 9.05, 41.91) and 65.5 (IQR; 18.3, 103) ng/mL, respectively (p = 0.006). Urinary NGAL (ng/mL) correlated positively with proteinuria and blood pressure, and correlated negatively with serum complement C3 level and estimated GFR. Based on ROC analysis, urinary NGAL (AUC; 0.724, 95%CI 0.491–0.957) outperformed conventional biomarkers (serum creatinine, urine protein, and GFR) in differentiating complete and partial response groups from the nonresponse group. The urine NGAL cut-off value in the ROC curve, 28.08 ng/mL, discriminated nonresponse with 72.7% sensitivity and 68.4% specificity.ConclusionUrine NGAL at baseline performed better than conventional markers in predicting a clinical response to treatment of active LN except serum complement C3 level. It may have the potential to predict poor response after induction therapy.

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

Urinary neutrophil gelatinase-associated lipocalin for diagnosis and estimating activity in lupus nephritis: a meta-analysis

Cited by 17 publications

References 45 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

Urine neutrophil gelatinase-associated lipocalin to predict renal response after induction therapy in active lupus nephritis

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

Contact Info

Product

Resources

About