Lupus Nephritis Biomarkers: A Critical Review

Abstract

Lupus nephritis (LN), a major complication in individuals diagnosed with systemic lupus erythematosus, substantially increases morbidity and mortality. Despite marked improvements in the survival of patients with severe LN over the past 50 years, complete clinical remission after immunosuppressive therapy is achieved in only half of the patients. Therefore, timely detection of LN is vital for initiating prompt therapeutic interventions and improving patient outcomes. Biomarkers have emerged as valuable tools for LN detection and monitoring; however, the complex role of these biomarkers in LN pathogenesis remains unclear. Renal biopsy remains the gold standard for the identification of the histological phenotypes of LN and guides disease management. However, the molecular pathophysiology of specific renal lesions remains poorly understood. In this review, we provide a critical, up-to-date overview of the latest developments in the field of LN biomarkers.

Does the esv3587290 Copy-Number Variation in the VANGL1 Gene Differ as a Genetic Factor for Developing Nephritis in Mexican versus European Childhood-Onset Systemic Lupus Erythematosus Patients?

“…Nonetheless, our study had several limitations: It is possible that our study sample was underrepresentative or phenotypically heterogeneous, given the lack of renal biopsy-proven LN in most of our patients (N=15/37 LN cSLE patients, 59.5%), which is still considered the diagnostic gold standard [7]. Obtaining such information could allow us to perform an association analysis stratified by histopathological classes, as previously recommended [11].…”

“…Identification of biomarkers for the diagnosis, prognosis, and non-invasive evaluation of renal disease activity in SLE is a rapidly evolving field [7]. Numerous potential serum or urinary biomarkers have been identified for diagnosing LN, renal flares, or predicting the development of severe histopathological kidney abnormalities predisposing to ESKD.…”

“…), assessment of urinary biomarkers (urine sediment, proteinuria, albumin:creatinine ratio, etc. ), and histological evaluation of renal biopsies [7][8][9].…”

“…To date, genome-wide association studies (GWAS) have identified around 100 susceptibility genes for developing SLE [7]. The relevant genetic changes have been mainly related to singlenucleotide variations in immune-response genes (e.g., HLA-DR3 in patients of European ancestry) [10], along with some gene copy-number variations (CNV) in non-immune-related genes, such as VANGL1 (1p13.1, MIM*610132) [11].…”

Does the esv3587290 Copy-Number Variation in the <em>VANGL1 </em>Gene Differ as a Genetic Factor for Developing Nephritis in Mexican Childhood-Onset Systemic Lupus Erythematosus Patients?

“…Identifying biomarkers for diagnosing, prognosis, and non-invasive evaluation of renal disease activity in SLE is a rapidly evolving field [6]. However, in the clinical setting, diagnosis of LN and evaluation of renal flares still rely on the assessment of traditional serum (e.g., serum creatinine (SCr), erythrocyte sedimentation rate, complement components C3 and C4, glomerular filtration rate, anti-C1q or anti-dsDNA autoantibody titers, etc.…”