A Panel of Urinary Proteins Predicts Active Lupus Nephritis and Response to Rituximab Treatment

Davies, Jennifer, Carlsson, Emil, Midgley, Angela, Smith, Eve, Bruce, Ian, Beresford, Michael ORCID: 0000-0002-5400-9911 and Hedrich, Christian ORCID: 0000-0002-1295-6179 (2020) A Panel of Urinary Proteins Predicts Active Lupus Nephritis and Response to Rituximab Treatment. ARTHRITIS & RHEUMATOLOGY, 72 (8). pp. 3747-3759.

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Abstract

<h4>Objectives</h4>∼30% of patients with SLE develop LN. Presence and/or severity of LN are currently assessed by renal biopsy, but biomarkers in serum or urine samples may provide an avenue for non-invasive routine testing. We aimed to validate a urinary protein panel for its ability to predict active renal involvement in SLE.<h4>Methods</h4>A total of 197 SLE patients and 48 healthy controls were recruited, and urine samples collected. Seventy-five of the SLE patients had active LN and 104 had no or inactive renal disease. Concentrations of lipocalin-like prostaglandin D synthase (LPGDS), transferrin, alpha-1-acid glycoprotein (AGP-1), ceruloplasmin, monocyte chemoattractant protein 1 (MCP-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were quantified by MILLIPLEX® Assays using the MAGPIX Luminex platform. Binary logistic regression was conducted to examine whether proteins levels associate with active renal involvement and/or response to rituximab treatment.<h4>Results</h4>Urine levels of transferrin (P <0.005), AGP-1 (P <0.0001), MCP-1 (P <0.001) and sVCAM-1 (P <0.005) were significantly higher in SLE patients when compared with healthy controls. Furthermore, levels of transferrin, AGP-1, ceruloplasmin, MCP-1 and sVCAM-1 (all P <0.0001) were higher in SLE patients with active LN when compared with patients without active LN. A combination of five urine proteins, namely LPGDS, transferrin, ceruloplasmin, MCP-1 and sVCAM-1 was a good predictor of active LN (AUC 0.898). A combined model of LPGDS, transferrin, AGP-1, ceruloplasmin, MCP-1 and sVCAM-1 predicted response to rituximab treatment at 12 months (AUC 0.818).<h4>Conclusions</h4>Findings support the use of a urinary protein panel to identify active LN and potentially predict response to treatment with rituximab in adult SLE patients. Prospective studies are required to confirm findings.

Item Type:	Article
Uncontrolled Keywords:	lupus nephritis, biomarker, renal, inflammation, stratification, SLE, treatment, rituximab
Depositing User:	Symplectic Admin
Date Deposited:	18 Dec 2020 11:07
Last Modified:	18 Jan 2023 23:05
DOI:	10.1093/rheumatology/keaa851
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3110776