Inflammatory markers in saliva and urine reflect disease activity in patients with systemic lupus erythematosus

Abstract

BackgroundLaboratory tests of blood and sometimes urine are used to diagnose and to monitor disease activity (DA) in SLE. Clinical practice would be simplified if non-invasive urine and salivary tests could be introduced as alternatives to blood samples. We therefore explored the levels of innate immunity-related biomarkers in matched serum, urine and saliva samples from patients with SLE.MethodsA total of 84 patients with SLE selected to represent high and low general DA, and 21 controls were included. All participants underwent a thorough clinical examination. General DA and renal DA were measured. The levels of colony-stimulating factor (CSF)-1, interleukin (IL)-34, tumour necrosis factor (TNF)-α, interferon-γ-induced protein (IP)-10, monocyte chemoattractant protein (MCP)-1, calprotectin, macrophage inflammatory protein (MIP)-1α and MIP-1β were analysed by immunoassays and related to DA.ResultsCSF-1, TNF-α, IP-10 and MCP-1 in saliva, serum and urine, as well as calprotectin in saliva and urine were increased in patients with SLE as compared with controls (p<0.05). TNF-α, IP-10 and MCP-1 in saliva, serum and urine, and CSF-1 in saliva and serum distinguished patients with SLE from controls (area under the curve >0.659; p<0.05 for all). CSF-1 in serum and urine, and calprotectin in saliva and urine, as well as TNF- α, IP-10 and MCP-1 in urine correlated positively with measures of general DA (p<0.05). Patients with SLE with active renal disease presented elevated levels of TNF-α, IP-10 and MCP-1 in urine and CSF-1 and IP-10 in serum as compared with patients with SLE with non-active renal disease.ConclusionsOur investigation demonstrates that saliva is a novel alternative body fluid, with potential for surveillance of general DA in patients with SLE, but urine is more informative in patients with SLE with predominantly renal DA.

Identification of biomarkers related to immune and inflammation in membranous nephropathy: comprehensive bioinformatic analysis and validation

“…Several studies have identified CSF-1R as a pharmacological target for alleviating disease progression, including those of rheumatoid arthritis, Alzheimer’s disease, and cancer. Particularly, CSF-1 acted as a “master switch” and contributed to monocyte and macrophage phenotypes that was positively related with lupus activity in kidney diseases ( 31 ). Further, the treatment with CSF-1R inhibitor was confirmed to significantly ameliorate renal injury in murine lupus ( 32 ).…”

Serum and Urine Interferon Gamma-Induced Protein 10 (IP-10) Levels in Lupus Nephritis

“…From a limited number of studies analyzing urine, IP-10 levels in urine tended to be higher in patients with active versus inactive LN, but did not reach statistical significance. A recent report by Ruacho et al, which was not included in the meta-analysis, investigated serum and urine levels of a panel of inflammatory proteins, including IP-10 in a Swedish cohort of 84 SLE patients, and 21 healthy controls [ 17 ]. All SLE patients were divided into low or high SLE disease activity groups, and serum and urine IP-10 was significantly higher in SLE versus healthy controls, and there was a correlation of urine and serum IP-10 levels with SLE disease activity.…”

Cutaneous Manifestations and Neurological Diseases

“…Arsenic exposure is considered to have occurred at a concentration of 50 micrograms/liter or more. In cases of unknown chronic exposure, hair and nail clippings should be collected for laboratory investigation [43][44][45][46][47].…”