Diagnostic value of progranulin in patients with lupus nephritis and its correlation with disease activity

Abstract

The aim of this study was to explore whether progranulin (PGRN) can be a useful marker not only for accurate diagnosis of patients with active lupus nephritis (LN), but also for prediction of the disease activity in this population. A total of 154 LN patients were enrolled in this study, 76 of which were diagnosed as having active LN and 78 as having stable LN. Additionally, 71 age-matched non-LN patients were enrolled as controls. The serum and urine PGRN levels of each study population were measured using the enzyme-linked immunosorbent assay method. The diagnostic performance of both indicators and their correlation with the disease activity of LN were systematically investigated using receiver operating characteristic (ROC) analysis and correlation analysis. The active LN population had significantly higher serum and urine PGRN levels than the other two populations. ROC analysis further demonstrated that these two indicators, particularly in combination, appear to have a strong performance in discriminating active LN patients from the rest of the LN population. In the active LN population, serum and urine PGRN levels were not only significantly correlated with SLEDAI score, rSLEDAI score, and activity index, but also had a considerable association with several key markers reflecting the disease activity of LN, including serum levels of complement component 3 and ds-DNA. Nevertheless, neither of the two indicators were correlated with the pathological classification of LN, chronicity index, serum creatinine level, and 24-h urine protein levels. Our findings demonstrate that PGRN may have great potential as a diagnostic factor for active LN and as a predictor for its disease activity.

Progranulin and insulin-like Growth Factor Binding Protein-2 as Biomarkers of Disease Activity and Pathological Changes in Lupus Nephritis

“…Moreover, there was no significant difference between PGRN and IGFBP-2 and classes of renal biopsy. For PGRN, our results were consistent with those of Tanaka et al [13] and Wu et al [14]. For IGFBP-2, our results agreed with those of Ding et al [10].…”

“…Our results showed a significant difference between the 3 groups with respect to PGRN and IGFBP-2, except for ILGFBP-2, where no significant difference was noted between the CKD and control groups. These findings agreed with the findings of some studies on PGRN [14,34]. Tanaka et al [13] also found higher levels of PGRN in SLE patients than in controls.…”

“…Moreover, there was no correlation between arthritis, urea, creatinine, creatinine clearance, 24-hour protein, haemoglobin, and anti-dsD-NA, and both markers, except for the correlation of arthritis with IGFBP-2; the reason for these resultare unclear. However, Tanaka et al [13] and Wu et al [14] found a significantly higher serum level of PGRN in active LN compared to inactive LN and non-LN controls, while Ding et al [10] noted a similar pattern with IGFBP-2. Wu et al [14] also found no correlation between PGRN and serum creatinine and 24-hour protein in urine.…”

“…DNA with nucleosomal DNA and immune complexes stimulateTLR-9 on plasmacytoid dendritic cells [9,36]. Authors found that PGRN was involved in TLR-mediated stimulation in the pathogenesis of LN which is considered a part of disease activity [12][13][14].…”

“…Active SLE patients have increased TLR9 in the peripheral blood [13]. Thus, providing increased evidence that PGRN plays a role in the pathogenesis of LN [14].…”