Foreboding Lupus Nephritis in Minority Woman

狼疮是一种遗传学和免疫学起源复杂的全身性自身免疫性疾病。肾 疾病是狼疮发病率和死亡率的主要原因，特别是在少数族裔妇女中。 尽管连续肾活检可能是密切监测狼疮性肾炎进展的理想方法，但它也可能 不切实际或者不可行。因此，这些研究的长期目标是确定潜在的生物标志物 可用于监测狼疮肾脏疾病的进展。 使用不同的蛋白质组学方法，我们发现了几个出现在尿液中的分子 抗体介导的肾炎。我们完成的横断面研究帮助我们发现了6个潜在的 狼疮患者和小鼠尿液中的候选生物标记物。在这项建议中，我们将研究一组 狼疮患者，其中90%是少数族裔个体，以确定是否有 的候选尿液生物标志物可能更好地预测红斑、严重的组织性肾炎或 与目前使用的实验室标准相比，肾脏疾病分期。此外，我们建议设立 这些生物标志物对狼疮性肾炎以及其他引起蛋白尿和肾炎的原因的特异性。 鉴于狼疮终末期肾病的高发病率，早期诊断和及时治疗是 绝对必要。在这些患者的尿液中发现更具预测性的生物标志物可能会有 深刻影响狼疮性肾炎的临床治疗。

Lupus is a systemic autoimmune disease that is complex in genetics and its immunological origins. Renal disease is a leading cause of morbidity and mortality in lupus, particularly among minority women. Although serial renal biopsies may be ideal in closely monitoring the progression of lupus nephritis, it may not be practical or feasible. Hence, the long-term goal of these studies is to identify potential biomarkers that may be of use in monitoring the progression of renal disease in lupus. Using different proteomic approaches, we have uncovered several molecules that appear in the urine during antibody-mediated nephritis. Our completed cross-sectional studies have helped uncover 6 potential biomarker candidates in the urine of mice and patients with lupus. In this proposal, we will study a cohort of lupus patients, 90% of whom are minority individuals, in a longitudinal fashion in order to determine if any of the urinary biomarker candidates might be better at predicting flares, severe histological nephritis, or end stage renal disease, compared to currently used laboratory yardsticks. In addition, we propose to establish the specificity of these biomarkers for lupus nephritis, as well as other causes of proteinuria and nephritis. Given the high incidence of end stage renal disease in lupus, early diagnosis and prompt treatment is absolutely essential. Identification of more predictive biomarkers in the urine of these patients could have a profound impact on the clinical management of lupus nephritis.