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Urinary MCP-1/creatinine in Henoch–Schönlein purpura and its relationship with nephritis

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Abstract

Background

Monocyte chemotactic protein-1 (MCP-1) plays a direct role in the infiltration of macrophages and monocytes during the early stages of Henoch-Schönlein purpura (HSP) nephritis. The aim of this study was to compare the urinary MCP-1/creatinine levels in children with and without HSP nephritis and determine if they are associated with the severity of renal lesions.

Methods

We included 77 patients with HSP and 25 healthy control children. Levels of serum creatinine, urinalysis, and 12-h proteinuria assessments were performed. Urinary MCP-1 levels were determined by ELISA.

Results

Fifty-seven patients had nephritis (74 %). Urinary MCP-1/creatinine levels were significantly higher in patients with HSP nephritis (median, 653 pg/mg) compared to those with HSP without nephritis (median, 269 pg/mg) or healthy children (191 pg/mg). In addition, higher MCP-1/creatinine levels were observed in HSP patients who had renal biopsy (median, 1,412 pg/mg) in comparison to HSP patients without renal biopsy (median, 302 pg/mg). The urinary MCP-1 cut-off value of 530 pg/mg could be used to distinguish patients who undergo renal biopsy with a sensitivity of 81 % and specificity of 77 %.

Conclusions

Urinary MCP-1/creatinine levels are elevated in the early stages of severe HSP nephritis and can be used as a biomarker for HSP nephritis.

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References

  1. Gardner-Medwin JM, Dolezalova P, Cummins C, Southwood TR (2002) Incidence of Henoch–Schönlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet 360:1197–1202

    Article  PubMed  Google Scholar 

  2. Weiss PF (2012) Pediatric vasculitis. Pediatr Clin North Am 59:407–423

    Article  PubMed Central  PubMed  Google Scholar 

  3. Saulsbury FT (2010) Henoch–Schönlein purpura. Curr Opin Rheumatol 22:598–602

    Article  PubMed  Google Scholar 

  4. Kawasaki Y (2011) The pathogenesis and treatment of pediatric Henoch–Schönlein purpura nephritis. Clin Exp Nephrol 15:648–657

    Article  PubMed  Google Scholar 

  5. Piram M, Mahr A (2013) Epidemiology of immunoglobulin A vasculitis (Henoch–Schönlein): current state of knowledge. Curr Opin Rheumatol 25:171–178

    Article  CAS  PubMed  Google Scholar 

  6. Xia Y, Mao J, Chen Y, Wang D, Cao L, Yao S, Fu H, Du L, Liu A (2011) Clinical outcomes in children with Henoch–Schönlein purpura nephritis grade IIIa or IIIb. Pediatr Nephrol 26:1083–1088

    Article  PubMed  Google Scholar 

  7. Watson L, Richardson AR, Holt RC, Jones CA, Beresford MW (2012) Henoch–Schönlein purpura–a 5-year review and proposed pathway. PloS One 7:e29512

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Cáceres J, Fuentes Y, Hernández A, Ortiz L, García P, Valverde S, Velasquez L, Romero B, Gomezchico R, Ramón G, Medeiros M (2006) Henoch–Schönlein purpura in children: report of 105 patients. Bol Med Hosp Infant Mex 63:314–321

    Google Scholar 

  9. Kurose K (1994) Macrophage infiltration in IgA nephropathy and Henoch–Schönlein purpura nephritis-1. Relationship to clinicopathological findings. Nippon Jinzo Gakkai Shi 36:982–989

    CAS  PubMed  Google Scholar 

  10. Kurts C (2006) Dendritic cells: not just another cell type in the kidney, but a complex immune sentinel network. Kidney Int 70:412–414

    Article  CAS  PubMed  Google Scholar 

  11. Li L, Huang L, Sung SS, Vergis AL, Rosin DL, Rose CE Jr, Lobo PI, Okusa MD (2008) The chemokine receptors CCR2 and CX3CR1 mediate monocyte/macrophage trafficking in kidney ischemia-reperfusion injury. Kidney Int 74:1526–1537

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Wada T, Furuichi K, Segawa-Takaeda C, Shimizu M, Sakai N, Takeda SI, Takasawa K, Kida H, Kobayashi KI, Mukaida N, Ohmoto Y, Matsushima K, Yokoyama H (1999) MIP-1alpha and MCP-1 contribute to crescents and interstitial lesions in human crescentic glomerulonephritis. Kidney Int 56:995–1003

    Article  CAS  PubMed  Google Scholar 

  13. Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, Buoncompagni A, Lazar C, Bilge I, Uziel Y, Rigante D, Cantarini L, Hilario MO, Silva CA, Alegria M, Norambuena X, Belot A, Berkun Y, Estrella AI, Olivieri AN, Alpigiani MG, Rumba I, Sztajnbok F, Tambic-Bukovac L, Breda L, Al-Mayouf S, Mihaylova D, Chasnyk V, Sengler C, Klein-Gitelman M, Djeddi D, Nuno L, Pruunsild C, Brunner J, Kondi A, Pagava K, Pederzoli S, Martini A, Ruperto N, Paediatric Rheumatology International Trials O (2010) EULAR/PRINTO/PRES criteria for Henoch–Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: final classification criteria. Ann Rheum Dis 69:798–806

    Article  PubMed  Google Scholar 

  14. Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 34:571–590

    CAS  PubMed  Google Scholar 

  15. (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576

  16. Szeto CC, Choi PC, To KF, Li PK, Hui J, Chow KM, Leung CB, Lui SF, Mac-Moune Lai F (2001) Grading of acute and chronic renal lesions in Henoch–Schönlein purpura. Mod Pathol 14:635–640

    Article  CAS  PubMed  Google Scholar 

  17. Ronkainen J, Nuutinen M, Koskimies O (2002) The adult kidney 24 years after childhood Henoch–Schönlein purpura: a retrospective cohort study. Lancet 360:666–670

    Article  PubMed  Google Scholar 

  18. Jauhola O, Ronkainen J, Koskimies O, Ala-Houhala M, Arikoski P, Holtta T, Jahnukainen T, Rajantie J, Ormala T, Nuutinen M (2012) Outcome of Henoch–Schönlein purpura 8 years after treatment with a placebo or prednisone at disease onset. Pediatr Nephrol 27:933–939

    Article  PubMed  Google Scholar 

  19. Yoshioka K, Takemura T, Aya N, Akano N, Miyamoto H, Maki S (1989) Monocyte infiltration and cross-linked fibrin deposition in IgA nephritis and Henoch–Schönlein purpura nephritis. Clin Nephrol 32:107–112

    CAS  PubMed  Google Scholar 

  20. Grandaliano G, Gesualdo L, Ranieri E, Monno R, Montinaro V, Marra F, Schena FP (1996) Monocyte chemotactic peptide-1 expression in acute and chronic human nephritides: a pathogenetic role in interstitial monocytes recruitment. J Am Soc Nephrol 7:906–913

    CAS  PubMed  Google Scholar 

  21. Watson L, Midgley A, Pilkington C, Tullus K, Marks S, Holt R, Jones C, Beresford M (2012) Urinary monocyte chemoattractant protein 1 and alpha 1 acid glycoprotein as biomarkers of renal disease activity in juvenile-onset systemic lupus erythematosus. Lupus 21:496–501

    Article  CAS  PubMed  Google Scholar 

  22. Munshi R, Johnson A, Siew ED, Ikizler TA, Ware LB, Wurfel MM, Himmelfarb J, Zager RA (2011) MCP-1 gene activation marks acute kidney injury. J Am Soc Nephrol 22:165–175

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Nishihara K, Masuda S, Shinke H, Ozawa A, Ichimura T, Yonezawa A, Nakagawa S, Inui K, Bonventre JV, Matsubara K (2013) Urinary chemokine (C-C motif) ligand 2 (monocyte chemotactic protein-1) as a tubular injury marker for early detection of cisplatin-induced nephrotoxicity. Biochem Pharmacol 85:570–582

    Article  CAS  PubMed  Google Scholar 

  24. Ho J, Wiebe C, Rush DN, Rigatto C, Storsley L, Karpinski M, Gao A, Gibson IW, Nickerson PW (2013) Increased urinary CCL2: Cr ratio at 6 months is associated with late renal allograft loss. Transplantation 95:595–602

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This study received financial support of Fondos Federales Hospital Infantil de Mexico Federico Gomez Protocol SSa. 745. Yolanda Fuentes was a CONACYT fellow.

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Authors and Affiliations

  1. Laboratorio de Investigación en Nefrología, Hospital Infantil de México Federico Gómez, Calle Dr. Márquez 162, Col. Doctores, Deleg. Cuauhtémoc, C. P. 06720, México, D. F., México

    Yolanda Fuentes, Ana María Hernández, Pilar García-Roca & Mara Medeiros

  2. Departamento de Nefrología, Hospital Infantil de México Federico Gómez, Calle Dr. Márquez 162, Col. Doctores, Deleg. Cuauhtémoc, C. P. 06720, México, D. F., México

    Saúl Valverde, Luis Fernando Velásquez-Jones, Germán Sosa, Uriel Oswaldo Duarte-Durán & Lourdes Ortíz

  3. Departamento de Reumatologia, Hospital Infantil de México Federico Gómez, Calle Dr. Márquez 162, Col. Doctores, Deleg. Cuauhtémoc, C. P. 06720, México, D. F., México

    Rocío Maldonado & Enrique Faugier

  4. Departamento de Patología, Hospital Infantil de México Federico Gómez, Calle Dr. Márquez 162, Col. Doctores, Deleg. Cuauhtémoc, C. P. 06720, México, D. F., México

    Guillermo Ramón-García

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  1. Yolanda Fuentes
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  2. Ana María Hernández
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  3. Pilar García-Roca
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  9. Rocío Maldonado
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Correspondence to Mara Medeiros.

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Fuentes, Y., Hernández, A.M., García-Roca, P. et al. Urinary MCP-1/creatinine in Henoch–Schönlein purpura and its relationship with nephritis. Pediatr Nephrol 29, 1047–1052 (2014). https://doi.org/10.1007/s00467-013-2740-0

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  • DOI: https://doi.org/10.1007/s00467-013-2740-0

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