Transferrina y ceruloplasmina en orina de pacientes con lupus eritematoso sistémico. ¿Son útiles para diferenciar pacientes con nefritis lúpica? |
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| Institution: | 1. Grupo de Inmunología Celular e Inmunogenética, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia;2. Grupo de Reumatología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia;3. Hospital Universitario San Vicente Fundación, Medellín, Colombia;4. Servicio de Reumatología, Hospital Clínic, Barcelona, España;1. Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España;2. Sección de Reumatología, Hospital Arnau de Vilanova, Valencia, España;3. Servicio de Reumatología, Hospital Universitario y Politécnico la Fe, Valencia, España;1. Reumatología Pediátrica, Hospital General, Centro Médico Nacional La Raza, IMSS, Ciudad de México, México;2. Cirugía Oncológica Pediátrica, Hospital General, Centro Médico Nacional La Raza, IMSS, Ciudad de México, México;3. Hematología Pediátrica, Hospital General, Centro Médico Nacional La Raza, IMSS, Ciudad de México, México;1. Servei de Reumatologia, Hospital Moisès Broggi/Hospital General de L’Hospitalet, Consorci Sanitari Integral (CSI), Sant Joan Despí/L’Hospitalet, Barcelona, España;2. Servei de Medicina Interna, Hospital Moisès Broggi/Hospital General de L’Hospitalet, Consorci Sanitari Integral (CSI), Sant Joan Despí/L’Hospitalet, Barcelona, España;1. Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan;2. Department of Nephrology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan;3. Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute, Aichi, Japan;4. Department of Nephrology and Rheumatology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan;5. Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Iruma, Saitama, Japan |
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| Abstract: | Background and objectiveDiagnosis of lupus nephritis (LN) is usually based on renal biopsy, which is an invasive technique that involves multiple risks. Therefore, different biomarkers have emerged as alternatives for the diagnosis of LN. Nonetheless, studies regarding urinary biomarkers in Latin American patients are limited. The objective of this study was to assess the diagnostic value of urinary transferrin and ceruloplasmin to differentiate patients who have renal involvement from those who do not.Materials and methodsSystemic lupus erythematosus (SLE) patients that met the revised American College of Rheumatology (ACR) classification criteria were recruited. Patients with another autoimmune disease, active infection (urinary tract or systemic infection), renal replacement therapy, human immunodeficiency virus infection or pregnancy were excluded. A urine sample was collected from each patient. LN was diagnosed according to ACR criteria. The activity and chronicity of LN were measured using the Austin indices. Urinary transferrin and ceruloplasmin levels were measured using commercial enzyme-linked immunosorbent assay (ELISA) kits. Mann-Whitney U test and Student's t-test were used to compare data. Spearman's rank correlation was used to determine associations. Lastly, receiver operating characteristic (ROC) curves were created.ResultsThe study involved 120 SLE patients. In all, 85% were female, 76% mestizo, the mean age was 32.8 ± 12.1 years and mean systemic lupus erythematosus disease activity index (SLEDAI) was 8.4 ± 8.9; 64% had renal involvement. Urinary levels of the two biomarkers were significantly higher in patients with LN compared to those without LN. Similarly, urinary levels of both biomarkers were significantly higher in patients with active LN compared to those with inactive LN. Furthermore, urinary transferrin levels were significantly higher in Afro-Latin American patients. On the other hand, urinary transferrin levels correlated with SLEDAI and proteinuria, and transferrin and ceruloplasmin levels correlated with each other. The diagnostic value of ROC curves for these urinary biomarkers for LN were good.ConclusionsIn our cohort of SLE patients, we found that transferrin and ceruloplasmin were potential biomarkers for LN, and can even differentiate active LN. |
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| Keywords: | Transferrin Ceruloplasmin Nephritis Biomarkers Systemic lupus erythematosus |
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