Growing international evidence for urinary biomarker panels identifying lupus nephritis in children - verification within the South African Paediatric Lupus Cohort

Smith, EMD, Lewandowski, LB, Jorgensen, AL ORCID: 0000-0002-6977-9337, Phuti, A, Nourse, P, Scott, C and Beresford, MW ORCID: 0000-0002-5400-9911 (2018) Growing international evidence for urinary biomarker panels identifying lupus nephritis in children - verification within the South African Paediatric Lupus Cohort. LUPUS, 27 (14). pp. 2190-2199.

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Official URL: http://dx.doi.org/10.1177/0961203318808376

Abstract

<h4>Background</h4>A urinary biomarker panel including alpha-1-acid-glycoprotein (AGP), lipocalin-like-prostaglandin-D-synthase (LPGDS), transferrin and ceruloplasmin demonstrates an 'excellent' ability for identifying active lupus nephritis in UK/US children. This study aimed to assess whether this panel identifies active lupus nephritis within the South African Paediatric Lupus Cohort.<h4>Methods</h4>Juvenile-onset-systemic lupus erythematosus (JSLE) patients aged < 19 years at diagnosis and healthy controls were recruited. Patients were categorized as having active lupus nephritis (renal BILAG score; A/B and previous histological confirmation) or inactive lupus nephritis (renal BILAG score: D/E). Urinary biomarkers were quantified by ELISA. Mann-Whitney U-test compared biomarker levels between groups. Binary logistic regression and receiver operating curve analysis assessed biomarker combinations.<h4>Results</h4>Twenty-three juvenile-onset-systemic lupus erythematosus patients were recruited with a median age of 13.5 years (interquartile range (IQR) 12.7-14.9) and disease duration of 2.6 years (IQR 1.8-4.0). Eighteen healthy controls had a median age of 11.0 years (IQR 10.0-12.0). AGP, LPGDS, transferrin, ceruloplasmin and VCAM-1 were significantly higher in active than in inactive lupus nephritis patients (corrected p-values, all p<sub>c</sub> < 0.05), with no difference between inactive lupus nephritis patients and healthy controls (all p<sub>c</sub> = 1.0). The optimal biomarker combination included AGP, ceruloplasmin, LPGDS and transferrin (area under the curve = 1.0).<h4>Conclusions</h4>A urinary biomarker panel comprising AGP, ceruloplasmin, LPGDS and transferrin previously validated within UK/US cohorts also performed excellently within a racially distinct South African cohort which displayed more severe lupus nephritis.

Item Type:	Article
Uncontrolled Keywords:	Lupus nephritis, urine biomarkers, Africa, BILAG, systemic lupus erythematosus
Depositing User:	Symplectic Admin
Date Deposited:	30 Oct 2018 09:52
Last Modified:	19 Jan 2023 01:13
DOI:	10.1177/0961203318808376
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3028069