Mothusi W Moloi1,2,3, Jody A Rusch4, Fierdoz Omar4, Udeme Ekrikpo1,2,5, Collet Dandara6, Aminu K Bello7, David Jayne8, Ikechi G Okpechi9,10,11. 1. Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa. 2. Kidney and Hypertension Research Unit, University of Cape Town Cape Town, Cape Town, South Africa. 3. Department of Medicine, University of Botswana, Gaborone, Botswana. 4. Division of Chemical Pathology, University of Cape Town and National Health Laboratory Services (NHLS), Cape Town, South Africa. 5. Department of Medicine, University of Uyo, Uyo, Nigeria. 6. Division of Human Genetics, University of Cape Town, Cape Town, South Africa. 7. Department of Medicine, University of Alberta, Edmonton, Canada. 8. Department of Medicine, University of Cambridge, Cambridge, UK. 9. Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa. Ikechi.Okpechi@uct.ac.za. 10. Kidney and Hypertension Research Unit, University of Cape Town Cape Town, Cape Town, South Africa. Ikechi.Okpechi@uct.ac.za. 11. Department of Medicine, University of Alberta, Edmonton, Canada. Ikechi.Okpechi@uct.ac.za.
Abstract
BACKGROUND: Treatment of patients with lupus nephritis (LN) requires judicious use of immunosuppression. Novel biomarkers may be useful for monitoring disease activity and treatment response. We assessed the utility of urinary monocyte chemoattractant protein-1 (uMCP-1) and urinary tumour necrosis factor-like weak inducer of apoptosis (uTWEAK) for disease activity and treatment response monitoring in South Africans with LN. METHODS: We recruited consenting patients with active LN confirmed on kidney biopsy. Urinary levels of MCP-1 and TWEAK were assayed at baseline and after completion of induction therapy using ELISA methods. We also collected relevant demographic, clinical and biochemical data for patients included in this study. RESULTS: The mean age of patients in this study was 29.8 ± 10.7 years, 60% were patients of mixed ancestry, 70% had proliferative LN and mean spot urine proteinuria at baseline was 0.37 (0.18-0.59) g/mmolCr. At completion of induction therapy, the level of uMCP-1 had reduced to 314.5 (IQR: 197.0-622) pg/mgCr from a baseline of 1092.7 (IQR 578.6-1848) pg/mgCr (P = 0.06) while uTWEAK had reduced to 36.0 (IQR 17.0-88.0) pg/mgCr from 159.0 (IQR: 88.5-295.5) pg/mgCr (P = 0.03). For patients reaching early complete or partial remission (n = 17), both biomarkers had significantly declined in their urine: uMCP-1 (P = 0.018) and uTWEAK (P = 0.015). There was no reduction of both biomarkers in patients not achieving remission and no association between uMCP-1 or uTWEAK with renal histological features. CONCLUSION: Our study shows that uMCP-1 and uTWEAK are elevated in patients with active LN, correlated with the remission status (response to treatment) at the end of induction therapy and can, therefore, be useful for monitoring disease activity and treatment response.
BACKGROUND: Treatment of patients with lupus nephritis (LN) requires judicious use of immunosuppression. Novel biomarkers may be useful for monitoring disease activity and treatment response. We assessed the utility of urinary monocyte chemoattractant protein-1 (uMCP-1) and urinary tumour necrosis factor-like weak inducer of apoptosis (uTWEAK) for disease activity and treatment response monitoring in South Africans with LN. METHODS: We recruited consenting patients with active LN confirmed on kidney biopsy. Urinary levels of MCP-1 and TWEAK were assayed at baseline and after completion of induction therapy using ELISA methods. We also collected relevant demographic, clinical and biochemical data for patients included in this study. RESULTS: The mean age of patients in this study was 29.8 ± 10.7 years, 60% were patients of mixed ancestry, 70% had proliferative LN and mean spot urine proteinuria at baseline was 0.37 (0.18-0.59) g/mmolCr. At completion of induction therapy, the level of uMCP-1 had reduced to 314.5 (IQR: 197.0-622) pg/mgCr from a baseline of 1092.7 (IQR 578.6-1848) pg/mgCr (P = 0.06) while uTWEAK had reduced to 36.0 (IQR 17.0-88.0) pg/mgCr from 159.0 (IQR: 88.5-295.5) pg/mgCr (P = 0.03). For patients reaching early complete or partial remission (n = 17), both biomarkers had significantly declined in their urine: uMCP-1 (P = 0.018) and uTWEAK (P = 0.015). There was no reduction of both biomarkers in patients not achieving remission and no association between uMCP-1 or uTWEAK with renal histological features. CONCLUSION: Our study shows that uMCP-1 and uTWEAK are elevated in patients with active LN, correlated with the remission status (response to treatment) at the end of induction therapy and can, therefore, be useful for monitoring disease activity and treatment response.
Authors: Suzanne Wilhelmus; Ingeborg M Bajema; George K Bertsias; Dimitrios T Boumpas; Caroline Gordon; Liz Lightstone; Vladimir Tesar; David R Jayne Journal: Nephrol Dial Transplant Date: 2015-04-28 Impact factor: 5.992
Authors: Hua-Xin Gao; Sean R Campbell; Linda C Burkly; Aniela Jakubowski; Irene Jarchum; Bernhard Banas; Moin A Saleem; Peter W Mathieson; Joan W Berman; Jennifer S Michaelson; Chaim Putterman Journal: Cytokine Date: 2009-02-23 Impact factor: 3.861