Urinary neutrophil gelatinase-associated lipocalin and urinary soluble CXCL16 as biomarkers of activity in pediatric lupus nephritis

Abstract

One of the challenges of treating patients with lupus nephritis (LN) is to assess disease activity. The aim of this study was to measure the urinary neutrophil gelatinase-associated lipocalin (uNGAL) and urinary soluble chemokine (C-X-C motif) ligand 16 (CXCL16) levels in children and adolescents with systemic lupus erythematosus (SLE) and investigate whether they are elevated in active LN. This study was conducted on 80 patients diagnosed as SLE by the Systemic Lupus International Collaborating Clinics criteria and 60 apparently healthy individuals as controls. Global and renal disease activities were evaluated by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and renal SLEDAI, respectively. uNGAL and urinary CXCL16 were measured for all participants by ELISA. Renal biopsy was done for all cases at initial diagnosis and was graded using ISN/RPS classification. uNGAL and CXCL16 were higher in patients than in the controls (8.9 ± 3.56 ng/dl and 1067 ± 367 ug/L vs. 2.26 ± 1.95 ng/dl and 471 ± 106 ug/L, respectively). uNGAL had higher sensitivity and specificity than urinary CXCL16 as predictor of LN (95% and 90% vs. 85% and 80%, respectively). There was significant positive correlations between uNGAL levels, 24-h urinary proteins (r = 0.732, P = 0.001), and SLEDAI (r = 0.359, P = 0.001). There was also significant positive correlations between urinary CXCL16 levels, 24-h urinary proteins (r = 0.47, P = 0.001), and SLEDAI (r = 0.17, P = 0.001). uNGAL and CXCL16 were reliable indicators of the activity of LN.

Association between Systemic Lupus Erythematosus and Autoimmune Thyroid Dysfunction in Pediatric Population Cross Sectional Study, Single Center Experience

“…This revealed a female to male ratio (7: 1). In addition, it is similar to the study carried out by El-Gamasy and El-Naghy [11] about the incidence, prevalence of JSLE and sex distribution. It shows that the prevalence was higher for girls.…”

Dysregulated serum lipid profile and its correlation to disease activity in young female adults diagnosed with systemic lupus erythematosus: a cross-sectional study

“…Thus, renal impairment and glucocorticoid treatment are involved in dyslipidemia in the patients with SLE. Additionally, diabetes mellitus, cardiovascular disease, liver and thyroid disease could also lead to changes in lipid profile [29][30][31]; menopaused or pregnant subjects showed increased TC and LDL-C [32]; abnormal BMI, smoking, alcohol use or taking any drugs known to influence lipid metabolism or the endocrine system could affect the results [33][34][35]. Therefore, based on these restricted inclusion criteria, our present analysis was able to assess the effects of the disease itself on lipid metabolism.…”

The role of CXCL family members in different diseases

“…After a series of analysis they found that SLE mice exhibited remarkable renal chemotaxis and increased renal mRNA expression of CXC chemokines such as CXCL13 and CXCL16 compared to Non SLE mice, whereas EET analog therapy altered this situation so that the mRNA expression levels of CXC chemokines and its receptors as well as immunocytes infiltration associated with kidney was decreased [90]. Other studies also clearly suggested the critical role of CXCL16 in the pathogenesis of LN and their clinical values as reliable indicator [91,92]. Hassan et al proposed that CXCL16 was an essential mediator in renal inflammation diseases like LN.…”