Ab0568 clinical Use of Activated Leukocyte Cell Adhesion Molecule, Hemopexin, and Peroxiredoxin 6: A Potential Urine Biomarker for Korean Patients With Systemic Lupus Erythematosus

Abstract

BackgroundSystemic lupus erythematosus (SLE) is sometimes difficult to make a prompt and accurate diagnosis due to the heterogeneity of various clinical manifestations and autoantibody expression. Therefore, the development of surrogate markers specific to the diagnosis of SLE is necessary. Among biological samples, urine is non-invasive means with the advantage of being easily obtained.ObjectivesThis study aimed to evaluate the ability of Activated Leukocyte Cell Adhesion Molecule (ALCAM), Hemopexin, and Peroxiredoxin (PRDX) 6 as urine biomarkers in Korean patients with SLE.MethodsUrine samples were collected from 138 patients with SLE and 39 healthy controls (HC) with clinical data. The level of urine biomarkers were measured by enzyme-linked immunosorbent assay kits specific for ALCAM, hemopexin and PRDX 6, respectively, according to the manufacturer’s protocols. The diagnostic utility of urine biomarkers was evaluated using receiver operating characteristic (ROC) curve analysis, and Pearson’s correlation analysis was performed to assess the relationships between disease activity and urine biomarkers.ResultsUrinary ALCAM level was 6,760.5 ± 2,826.4 pg/ml and 1,192.6 ± 577 pg/ml in patients with SLE and HCs (p < 0.001). The mean levels in urinary hemopexin and PRDX6 were also significantly higher in patients with SLE compared to HCs (hemopexin, 649.8 ng/ml vs. 202 ng/ml, p < 0.001; PRDX6, 0.78 ng/ml vs. 0.17 ng/ml, p = 0.003). In patients with lupus nephritis (LN), ALCAM, hemopexin, and PRDX6 showed more significant diagnostic value, and the area under the ROC for LN was 0.850 for ALCAM (95% CI, 0.778–0.921), 0.781 for hemopexin (95% CI, 0.695–0.867), and 0.714 for salivary S100A8 (95% CI, 0.617–0.812). In addition, all urine biomarkers were significantly associated with anti-double stranded DNA (ALCAM, r = 0.350, p < 0.001; hemopexin, r = 0.346, p < 0.001; PRDX6, r = 0.191, p = 0.026) and SLEDAI (ALCAM, r = 0.526, p < 0.001; hemopexin, r = 0.479, p < 0.001; PRDX6, r = 0.262, p = 0.002) in correlation analysis.ConclusionUrinary ALCAM, hemopexin and PRDX 6 were significantly increased in patients with SLE compared to HCs. Thus, we propose that urinary ALCAM, hemopexin and PRDX 6 can be potential biomarkers for SLE, especially valuable in the diagnosis of LN.References[1]Ding H, Lin C, Cai J, Guo Q, Dai M, Mohan C et al., Urinary activated leukocyte cell adhesion molecule as a novel biomarker of lupus nephritis histology.Arthritis Res Ther(2020) 22(1):122. Doi: 10.1186/s13075-020-02209-9.[2]Soliman SA, Haque A, Vanarsa K, Zhang T, Ismail F, Lee KH et al., Urine ALCAM, PF4 and VCAM-1 surpass conventional metrics in identifying nephritis disease activity in childhood-onset systemic lupus erythematosus.Front Immunol(2022) 26;13:885307. Doi: 10.3389/fimmu.2022.885307.[3]Krata N, Foroncewicz B, Zagozdzon R, Moszczuk B, Zielenkiewicz M, Paczek L et al. Peroxiredoxins as markers of oxidative stress in IgA nephropathy, membranous nephropathy and lupus nephritis.Arch Immunol Ther Exp (Warsz) (2021) 70(1):3. Doi: 10.1007/s00005-021-00638-1.Figure 1.Urinary ALCAM, hemopexin and PRDX6 in patients with SLE and HCsAcknowledgements:NIL.Disclosure of InterestsNone Declared.

Clinico-serological associations of urinary activated leukocyte cell adhesion molecule in systemic lupus erythematosus and lupus nephritis

“…The present research revealed that uALCAM is highly positively correlated with ESR, proteinuria, and anti-dsDNA and positively correlated with serum creatinine. This finding is consistent with the results of previous studies conducted by Kim et al [ 23 ], Stanley et al[ 24 ], and Ding et al [ 16 ]. Kim and colleagues similarly reported a positive correlation between ALCAM and anti-dsDNA, while Stanley et al found that ALCAM positively correlated with ESR, proteinuria, and anti-dsDNA.…”

“…This work established the highly statistically significant positive correlation of uALCAM with SLEDAI and rSLEDAI scores which is consistent with the results of Parodis et al[ 22 ] , Lei et al [ 18 ] , Chalmer et al[ 19 ] , Kim et al[ 23 ] .…”