Rheumatology: Urine protein can predict the response to active lupus nephritis and rituximab treatment

Purpose: About 30% of patients with systemic lupus erythematosus (SLE) may develop lupus nephritis (LN)
.
The severity of LN is currently assessed by renal biopsy, but biomarkers in serum or urine samples may provide a method for non-invasive examination

.

About 30% of patients with systemic lupus erythematosus (SLE) may develop lupus nephritis (LN)

Results: Urinary transferrin (P<0.
005), glycoprotein-1 (P<0.
0001), monocyte chemoattractant protein-1 (P<0.
001) and soluble vascular cell adhesion molecule-1 (P<0.
001) in patients with systemic lupus erythematosus <0.
005) The level is significantly higher than the normal control group
.
The levels of serum transferrin, AGP-1, ceruloplasmin, monocyte chemoattractant protein-1 and soluble vascular cell adhesion molecule-1 in patients with active SLE and LN were significantly higher than those in patients with inactive LN (all P<0.

0001)

Figure 1 Comparison of urine protein levels between patients with systemic lupus erythematosus and healthy people
.
SLE patients and normal human serum LPGDS (A), transferrin (B), AGP-1 (C), ceruloplasmin (D), monocyte chemoattractant protein-1 (E) and soluble vascular cell adhesion molecules- 1(F) content analysis

.

Figure 1 Comparison of urine protein levels between patients with systemic lupus erythematosus and healthy people

Figure 2 Comparison of urine protein levels in patients with systemic lupus erythematosus according to disease severity

.

Figure 2 Comparison of urine protein levels in patients with systemic lupus erythematosus according to disease severity

Figure 3 The study of urine protein levels in patients with systemic lupus erythematosus and active nephropathy

.

Figure 3 The study of urine protein levels in patients with systemic lupus erythematosus and active nephropathy

Table 1 Adding different proteins to the regression model shows the area under the curve (AUC)

.

Table 1 Adding different proteins to the regression model shows the area under the curve (AUC)
.
TF: transferrin, LPGDS: lipoprotein-like prostaglandin D synthetase, CP: ceruloplasmin, sVCAM-1: soluble vascular cell adhesion molecule-1, MCP-1: monocyte chemotactic protein 1, AGP- 1: α -1-acid glycoprotein
.

Table 2 Urine protein predicts response to rituximab treatment; rough and adjusted odds ratio (OR), confidence interval (CI) and p-value show the response of protein alone and combined rituximab treatment
.
The model used for correction includes confounding factors: age, disease course, kidney disease and disease activity, anti-dsdna antibody positive, low complement C3 and/or C4 (model A), or age, disease course, kidney disease and disease activity, Oral steroid dose (model B)
.
Significant p-values ​​marked in bold
.

Table 2 Urine protein predicts response to rituximab treatment; rough and adjusted odds ratio (OR), confidence interval (CI) and p-value show the response of protein alone and combined rituximab treatment
.
The model used for correction includes confounding factors: age, disease course, kidney disease and disease activity, anti-dsdna antibody positive, low complement C3 and/or C4 (model A), or age, disease course, kidney disease and disease activity, Oral steroid dose (model B)
.
Significant p-values ​​marked in bold
.

Conclusion: The findings support that urine protein in adult SLE patients suggests active LN and can predict the response to rituximab treatment
.
Prospective studies are needed to confirm the findings
.

The results of the study support that urine protein in adult SLE patients suggests active LN and can predict the response to rituximab treatment
.
Prospective studies are needed to confirm the findings
.

Original source

Davies JC, Carlsson E, Midgley A,et al, A panel of urinary proteins predicts active lupus nephritis and response to rituximab treatment.
Rheumatology (Oxford) 2020 Dec 12

A panel of urinary proteins predicts active lupus nephritis and response to rituximab treatment.
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