Urine biomarkers for monitoring juvenile lupus nephritis: a prospective longitudinal study
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- 作者：Louise Watson (1) (2) (7)
Kjell Tullus (3)
Clarissa Pilkington (4)
Christine Chesters (5)
Stephen D. Marks (4)
Paul Newland (5)
Caroline A. Jones (2)
Michael W. Beresford (1) (6) - 关键词：Lupus ; Biomarker ; Nephritis ; MCP1 ; NGAL ; Lipocalin
- 刊名：Pediatric Nephrology
- 出版年：2014
- 出版时间：March 2014
- 年：2014
- 卷：29
- 期：3
- 页码：397-405
- 全文大小：255 KB
- 作者单位：Louise Watson (1) (2) (7)
Kjell Tullus (3)
Clarissa Pilkington (4)
Christine Chesters (5)
Stephen D. Marks (4)
Paul Newland (5)
Caroline A. Jones (2)
Michael W. Beresford (1) (6)
1. Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK
2. Department of Paediatric Nephrology, Alder Hey Children’s NHS Foundation Trust Hospital, Liverpool, UK
7. Department of Women’s and Children’s Health, Institute of Translational Medicine, Alder Hey Children’s NHS Foundation Trust Hospital, Eaton Road, Liverpool, L12 2AP, UK
3. Department of Paediatric Nephrology, Great Ormond Street NHS Hospital, London, UK
4. Department of Paediatric Rheumatology, Great Ormond Street NHS Hospital, London, UK
5. Department of Clinical Biochemistry, Alder Hey Children’s NHS Foundation Trust Hospital, Liverpool, UK
6. Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust Hospital, Liverpool, UK - ISSN：1432-198X
文摘
Background In juvenile-onset systemic lupus erythematosus (JSLE), renal involvement (lupus nephritis) is frequently seen and can result in long-term morbidity. This prospective longitudinal study aimed to identify the utility of standard and/or novel biomarkers for monitoring and predicting lupus nephritis in a real world setting. Methods Using an unselected JSLE cohort, urine samples were collected during routine clinical review. Protein concentrations of urinary monocyte chemo-attractant protein 1 (uMCP1) and neutrophil gelatinase-associated lipocalin (uNGAL) were analysed along with standard disease activity markers, and were compared with current and subsequent disease activity. Results JSLE patients (n--4; median age 14.1?years) were seen at 3 (interquartile range: 2-) clinical reviews over 364 (182-32) days. Multivariate analysis demonstrated uMCP1 and serum C3 as independent variables (p-lt;-.001) for active renal disease at the time of the current review. uMCP1 was an excellent predictor of improved renal disease over time (AUC: 0.81; p--.013). uNGAL was a good predictor of worsened renal disease activity (AUC 0.76; p--.04) over time. Conclusion Biomarkers (uMCP1, serum C3) can indicate current renal involvement in JSLE, whilst uMCP1 and uNGAL are able to predict subsequent renal disease activity changes. Moving towards biomarker-led monitoring may improve the renal outcome for our patients.