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Kidney Biomarkers Investigated to Track Lupus

By LabMedica International staff writers
Posted on 04 Jan 2017
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Image: A histopathology of a kidney biopsy showing diffuse proliferative lupus nephritis with increased mesangial matrix and mesangial hypercellularity (Photo courtesy of Nephron).
Image: A histopathology of a kidney biopsy showing diffuse proliferative lupus nephritis with increased mesangial matrix and mesangial hypercellularity (Photo courtesy of Nephron).
Lupus is a chronic autoimmune disease in which the body's immune system becomes hyperactive and attacks normal, healthy tissue. This results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs.

The most useful tests to aid a diagnosis identify certain autoantibodies often present in the blood of people with lupus. For example, the antinuclear antibody (ANA) test is commonly used to look for autoantibodies that react against components of the nucleus of the body's cells.

Scientists at the Centers for Disease Control and Prevention (Atlanta, GA, USA) working with their colleagues at the University of Michigan School of Public Health (Ann Arbor, MI, USA) measured the urinary epidermal growth factor in patients with lupus. They had previously showed this protein to be a promising, noninvasive biomarker of kidney disease progression. Their team found a decrease in urinary epidermal growth factor protein was an indication of diminishing kidney function in people with chronic kidney disease.

In the latest study, they extended these findings to show that levels of epidermal growth factor in the urine of 394 lupus patients provided improved ability over standard markers, such as protein-to-creatinine ratio, to distinguish those with kidney involvement from those without. Moreover, they found that urinary epidermal growth factor, but not the standard markers, was associated with a global score representing lupus damage accumulated across all organ systems. This suggests that epidermal growth factor might play a role in overall lupus outcomes.

Emily Somers, PhD, ScM, an associate professor of internal medicine and a senior author of the study said, “Lupus patients have a high risk of kidney involvement, which can lead to end-stage renal disease requiring dialysis or transplant. In addition, there is a great need for biomarkers to detect early kidney involvement and to monitor progression. Validating this biomarker as a way to monitor lupus severity and progression is an exciting step in piecing together the complexity of lupus. Ultimately we aim to enhance our ability to identify and treat those affected sooner, before the disease has caused even more complications.” The study was presented at the American Society of Nephrology Kidney Week 2016 meeting held October 31 to November 5, 2016, in New Orleans, LA, USA.

Related Links:
Centers for Disease Control and Prevention
University of Michigan School of Public Health
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