Urinary CXCL-10/IP-10 and MCP-1 as markers to assess activity of lupus nephritis
Urinary CXCL-10/IP-10 and MCP-1 as markers to assess activity of lupus nephritis
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DOI：
10.1177/0961203313484977
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发表时间：
2013-05-01
期刊：
影响因子：
2.6
通讯作者：
Aggarwal, A.
中科院分区：
文献类型：
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作者：
Abujam, B.;Cheekatla, S. S.;Aggarwal, A.
目的：IP-10和MCP-1是参与狼疮性肾炎免疫发病的促炎趋化因子，可能是有用的生物标志物。方法：纳入符合ACR 1997标准的SLE患者。计算SLEDAI并采集血样和尿样。活动期狼疮定义为SLEDAI >= 4。活动性患者分为活动性肾性狼疮（蛋白尿>= 500 mg/d或尿中有活动性沉淀物）和活动性非肾性狼疮。患者活动性肾狼疮被跟踪，直到肾炎变得不活跃，当第二次样本被收集。ELISA法测定血清和尿中MCP-1、IP-10水平（pg/ml）。尿点肌酐值归一化（mg/dL）。因此，数值表示为pg/mg肌酐x 100肌酐)。结果：共纳入136例SLE患者，其中活动性78例（活动性肾脏46例，活动性非肾脏32例）。中位年龄为25岁（10-55岁），SLE病程为23个月（6 - 48个月）。活动性SLE患者血清（数据未显示）和尿液MCP-1水平(35.2 （12.7-71.7),9.4 (4.4-17),p < 0.001）和IP-10水平(9.5 （4.4-17.9),3.9 (1.9-9.3),p < 0.001）均高于非活动性SLE患者。然而，活动性肾性SLE与活动性非肾性SLE相比，血清水平无差异；仅MCP-1（46.2（19.9-125）、12.7 (5.8-43.9),p < 0.001）和IP-10（12.5（5.6-22.7）、5.2 (2.3-12.2),p < 0.05）高于对照组。在对活动性肾患者（n = 24）的纵向随访中，尿中MCP-1和IP-10水平下降（p = 0.005）。在ROC分析中，尿MCP-1优于尿C4和尿IP-10，但与dsDNA和C3在鉴别活动性肾与非肾性SLE方面相似。结论：尿和血清IP-10和MCP-1是潜在有用的狼疮活动标志物；然而，只有尿中的水平是肾脏活动的指示。然而，在ROC分析上，它们并不比传统标记好。
Objective: IP-10 and MCP-1 are pro-inflammatory chemokines which are involved in the immunopathogenesis of lupus nephritis and may thus be useful biomarkers. Methods: SLE patients fulfilling ACR 1997 criteria were included. SLEDAI was calculated and blood and urine samples collected. Active lupus was defined as SLEDAI >= 4. Active patients were divided into active renal (proteinuria >= 500 mg/day or active sediment in urine) and active non-renal lupus. Patients with active renal lupus were followed until the nephritis became inactive, when a second sample was collected. Serum and urinary levels of MCP-1 and IP-10 (pg/ml) were measured by ELISA. Urinary values were normalized for urinary spot creatinine (in mg/dL. Thus the values were expressed as pg/mg creatinine x 100 creatinine). Results: A total of 136 patients with SLE including 78 active (46 active renal and 32 active non-renal) were included. Median age was 25 (10-55) years and SLE duration was 23 (six to 48) months. Both serum (data not shown) and urinary levels of MCP-1 (35.2 (12.7-71.7), 9.4 (4.4-17), p < 0.001) and IP-10 (9.5 (4.4-17.9), 3.9 (1.9-9.3), p < 0.001) were higher in active compared to inactive SLE. However, in active renal compared to active non-renal SLE, there was no difference in serum levels; only urinary levels of MCP-1 (46.2 (19.9-125), 12.7 (5.8-43.9), p < 0.001) and IP-10 (12.5 (5.6-22.7), 5.2 (2.3-12.2), p < 0.05) were higher. On longitudinal follow-up of active renal patients (n = 24), there was a decrease in urinary levels of MCP-1 and IP-10 (p = 0.005). On ROC analysis, urinary MCP-1 outperformed C4 and urinary IP-10, but was similar to dsDNA and C3 in differentiating active renal from non-renal SLE. Conclusions: Urinary and serum IP-10 and MCP-1 are potentially useful markers of lupus activity; however, only the urinary levels are indicative of renal activity. However, on ROC analysis, they are not better than conventional markers.