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Correlations of Urinary Biomarkers, TNF-Like Weak Inducer of Apoptosis (TWEAK), Osteoprotegerin (OPG), Monocyte Chemoattractant Protein-1 (MCP-1), and IL-8 with Lupus Nephritis

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Abstract

Objective

This case-controlled study was designed to correlate urinary biomarkers, TNF-like weak inducer of apoptosis (TWEAK), osteoprotegerin (OPG), monocyte chemoattractant protein-1 (MCP-1), and interleukin-8 (IL-8) levels, with renal involvement in a cohort of systemic lupus erythematosus (SLE) patients to examine their diagnostic performance.

Patients and Methods

In 73 SLE patients, and in 23 healthy volunteers, urinary levels of TWEAK, OPG, MCP-1, and IL-8 levels were measured. Disease activity was assessed by total SLE disease activity index, and renal activity by renal activity index (rSLEDAI), and both were correlated with urinary biomarkers. Sensitivity, specificity, and predictive values of individual biomarkers to predict lupus nephritis were also calculated.

Results

Significantly higher levels of urinary biomarkers were observed in SLE patients with lupus nephritis (LN) compared with those without LN (TWEAK, p < 0.001; MCP-1, p < 0.001; OPG, p < 0.001; IL-8, p < 0.032). Other significantly higher levels were observed in SLE patients with LN compared with control subjects (TWEAK, MCP-1, OPG, and IL-8 p < 0.001). Positive correlations were observed between rSLEDAI and TWEAK (r = 0.612 and p < 0.001), MCP-1 (r = 0.635 and p < 0.001), and OPG (r = 0.505 and p < 0.001).

Conclusions

Urinary levels of TWEAK, OPG, and MCP-1 positively correlate with renal involvement as assessed by rSLEDAI with reasonable sensitivity, specificity, and predictive values to detect lupus nephritis while IL-8 was not significantly associated with global or rSLEDAI.

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References

  1. Seshan SV, Jennette JC. Renal disease in systemic lupus erythematosus with emphasis on classification of lupus glomerulonephritis: advances and implications. Arch Pathol Lab Med. 2009;133:233–48.

    PubMed  Google Scholar 

  2. Korbet SM, Lewis EJ, Schwartz MM. Factors predictive of outcome in severe lupus nephritis. Lupus Nephritis Collaborative Study Group. Am J Kidney Dis. 2000;35:904–14.

    Article  PubMed  CAS  Google Scholar 

  3. Illei GG, Tackey E, Lapteva L, Lipsky PE. Biomarkers in systemic lupus erythematosus: II. Markers of disease activity. Arthritis Rheum. 2004;50(7):2048–65.

    Article  PubMed  CAS  Google Scholar 

  4. Chicheportiche Y, Bourdon PR, Xu H, Hsu YM, Scott H, Hession C, et al. TWEAK a new secreted ligand in the tumor necrosis factor family that weakly induces apoptosis. J Biol Chem. 1997;272:32401–10.

    Article  PubMed  CAS  Google Scholar 

  5. Wiley SR, Cassiano L, Lofton T, Davis-Smith T, Winkles JA, Lindner V, et al. A novel TNF receptor family member binds TWEAK and is implicated in angiogenesis. Immunity. 2001;15:837–46.

    Article  PubMed  CAS  Google Scholar 

  6. Campbell S, Michaelson J, Burkly LC, Putterman C. The role of TWEAK/Fn14 in the pathogenesis of inflammation and systemic autoimmunity. Front Biosci. 2004;8:2273–84.

    Article  Google Scholar 

  7. Zhao Z, Burkly LC, Campbell S, Schwartz N, Molano A, Choudhury A, et al. TWEAK/Fn14 interactions are instrumental in the pathogenesis of nephritis in the chronic graft-versus-host model of systemic lupus erythematosus. J Immunol. 2007;179:7949–58.

    PubMed  CAS  Google Scholar 

  8. Schwartz N, Rubinstein T, Burkly LC, Collins CE, Blanco I, Su L, et al. Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study. Arthritis Res Ther. 2009;11(5):R143.

    Article  PubMed  Google Scholar 

  9. Gao HX, Campbell S, Burkly LC, Jarchun I, Banas B, Schlondorff D, et al. TNF-like weak inducer of apoptosis (TWEAK) stimulates human kidney cells to elaborate chemokines central to the pathogenesis of lupus nephritis [Abstract]. Arthritis Rheum. 2006;54(Suppl):S602.

    Google Scholar 

  10. Schwartz N, Su L, Burkly LC, Mackay M, Aranow C, Kollaros M, et al. Urinary TWEAK and the activity of lupus nephritis. J Autoimmun. 2006;27(4):242–50.

    Article  PubMed  CAS  Google Scholar 

  11. Rovin BH, Birmingham DJ, Nagaraja HN, Yu CY, Hebert LA. Biomarker discovery in human SLE nephritis. Bull NYU Hosp Jt Dis. 2007;65(3):187–93.

    PubMed  Google Scholar 

  12. Wada T, Yokoyama H, Su SB, Mukaida N, Iwano M, Dohi K, et al. Monitoring urinary levels of monocyte chemotactic and activating factor reflects disease activity of lupus nephritis. Kidney Int. 1996;49(3):761–7.

    Article  PubMed  CAS  Google Scholar 

  13. Noris M, Bernasconi S, Casiraghi F, Sozzani S, Gotti E, Remuzzi G, et al. Monocyte chemoattractant protein-1 is excreted in excessive amounts in the urine of patients with lupus nephritis. Lab Invest. 1995;73(6):804–9.

    PubMed  CAS  Google Scholar 

  14. Segerer S, Nelson PJ, Schlondorff D. Chemokines, chemokine receptors, and renal disease: from basic science to pathophysiologic and therapeutic studies. J Am Soc Nephrol. 2000;11:152–76.

    PubMed  CAS  Google Scholar 

  15. Kelley VR, Rovin BH. Chemokines: therapeutic targets for autoimmune and inflammatory renal disease. Springer Semin Immunopathol. 2003;24:411–21.

    Article  PubMed  Google Scholar 

  16. Rovin BH, Phan LT. Chemotactic factors and renal inflammation. Am J Kidney Dis. 1998;31:1065–84.

    Article  PubMed  CAS  Google Scholar 

  17. Kiani AN, Johnson K, Chen C, Diehl E, Hu H, Vasudevan G, et al. Urine osteoprotegerin and monocyte chemoattractant protein-1 in lupus nephritis. J Rheumatol. 2009;36(10):2224–30.

    Article  PubMed  CAS  Google Scholar 

  18. Tesar V, Masek Z, Rychlík I, Merta M, Bartůnková J, Stejskalová A, et al. Cytokines and adhesion molecules in renal vasculitis and lupus nephritis. Nephrol Dial Transplant. 1998;13:1662–7.

    Article  PubMed  CAS  Google Scholar 

  19. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25(11):1271–7.

    Article  PubMed  CAS  Google Scholar 

  20. Bombardier C, Gladman D, Urowitz M. Committee on prognosis studies in systemic lupus erythematosus. The derivation of the SLEDAI: a disease activity index for lupus patients. Arthritis Rheum. 1992;35:630–40.

    Article  PubMed  CAS  Google Scholar 

  21. Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29:288–91.

    PubMed  Google Scholar 

  22. Churg J, Sobin LH. Renal disease: classification and atlas of glomerular disease. Tokyo: Igaku-Shoin; 1982.

    Google Scholar 

  23. Campbell S, Burkly LC, Gao H, Berman JW, So L, Browning B, et al. Proinflammatory effects of TWEAK/Fn14 interactions in glomerular mesangial cells. J Immunol. 2006;176:1889–98.

    PubMed  CAS  Google Scholar 

  24. Mok CC. Biomarkers for lupus nephritis: a critical appraisal. J Biomed Biotechnol. 2010;2010:638413.

    Article  PubMed  Google Scholar 

  25. El-Gendi SS, El-Sherif WT. Anti-C1q antibodies, sCD40L, TWEAK and CD4/CD8 ratio in systemic lupus erythematosus and their relations to disease activity and renal involvement. Egypt J Immunol. 2009;16(1):135–48.

    Google Scholar 

  26. Molano A, Lakhani P, Aran A, Burkly LC, Michaelson JS, Putterman C. TWEAK stimulation of kidney resident cells in the pathogenesis of graft versus host induced lupus nephritis. Immunol Lett. 2009;125(2):119–28.

    Article  PubMed  CAS  Google Scholar 

  27. Rovin BH, Song H, Birmingham DJ, Hebert LA, Yu CY, Nagaraja HN. Urine chemokines as biomarkers of human systemic lupus erythematosus activity. J Am Soc Nephrol. 2005;16(2):467–73.

    Article  PubMed  CAS  Google Scholar 

  28. Tucci M, Barnes EV, Sobel ES, Croker BP, Segal MS, Reeves WH, et al. Strong association of a functional polymorphism in the monocyte chemoattractant protein 1 promoter gene with lupus nephritis. Arthritis Rheum. 2004;50(6):1842–9.

    Article  PubMed  CAS  Google Scholar 

  29. Alzawawy A, Zohary M, Ablordiny M, Eldalie M. Estimation of monocyte-chemoattractantprotein-1 (Mcp-1) level in patients with lupus nephritis. Int J Rheum Dis. 2009;12(4):311–8.

    Article  PubMed  Google Scholar 

  30. Tucci M, Calvani N, Richards HB, Qatar C, Silvestris F. The interplay of chemokines and dendritic cells in the pathogenesis of lupus nephritis. Ann N Y Acad Sci. 2005;1051:421–32.

    Article  PubMed  CAS  Google Scholar 

  31. Tian S, Li J, Wang L, Liu T, Liu H, Cheng G, et al. Urinary levels of RANTES and M-CSF are predictors of lupus nephritis flare. Inflamm Res. 2007;56(7):304–10.

    Article  PubMed  CAS  Google Scholar 

  32. Chan RW, Lai FM, Li EK, Tam LS, Chow KM, Li PK, et al. The effect of immunosuppressive therapy on the messenger RNA expression of target genes in the urinary sediment of patients with active lupus nephritis. Nephrol Dial Transplant. 2006;21(6):1534–40.

    Article  PubMed  CAS  Google Scholar 

  33. Rovin BH, Lu L, Zhang XA. Novel interleukin-8 polymorphism is associated with severe systemic lupus erythematosus nephritis. Kidney Int. 2002;62(1):261–5.

    Article  PubMed  CAS  Google Scholar 

  34. Wada T, Yokoyama H, Tomosugi N, Hisada Y, Ohta S, Naito T, et al. Detection of urinary interleukin-8 in glomerular diseases. Kidney Int. 1994;46(2):455–60.

    Article  PubMed  CAS  Google Scholar 

  35. Tsai CY, Wu TH, Yu CL, Lu JY, Tsai YY. Increased excretions of beta2-microglobulin, IL-6, and IL-8 and decreased excretion of Tamm-Horsfall glycoprotein in urine of patients with active lupus nephritis. Nephron. 2000;85(3):207–14.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Yasser Emad.

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El-shehaby, A., Darweesh, H., El-Khatib, M. et al. Correlations of Urinary Biomarkers, TNF-Like Weak Inducer of Apoptosis (TWEAK), Osteoprotegerin (OPG), Monocyte Chemoattractant Protein-1 (MCP-1), and IL-8 with Lupus Nephritis. J Clin Immunol 31, 848–856 (2011). https://doi.org/10.1007/s10875-011-9555-1

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