PROGNOSTIC INDICATORS IN LUPUS NEPHRITIS

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 系统性红斑狼疮（SLE）是一种病因不明的自身免疫性疾病，主要影响非洲裔美国人种族的妇女。肾炎的发展是SLE的显著特征，导致发病率和死亡率。尽管大多数狼疮患者都有一些肾脏受累，但只有15-30%的患者在初步诊断时有明显的肾炎。另有15-30%的SLE患者在病程后期发展为肾炎。目前用于筛查肾炎的方法不能检测早期无症状疾病。 肾活检是诊断狼疮性肾炎的金标准。然而，由于其侵入性和重复测量的不切实际性，它不适合作为筛查工具。肾炎的治疗选择是有限的，并与显着的毒性。治疗因相当大的危及生命的不良反应而复杂化。如果患者在发展狼疮性肾炎的风险可以早期识别，这可能允许毒性较小的治疗，可以潜在地避免发展明显的肾脏疾病。有必要开发标记物来筛查无症状狼疮性肾炎的存在。我们的目的是确定早期亚临床疾病的有用标志物。这些标志物也将有助于评估正在进行的治疗的疗效。我们将初步确定选定的生物标志物和肾功能的敏感测量与SLE患者活检时肾活检所定义的肾炎活动性之间的关系。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Systemic Lupus Erythematosus (SLE) is an autoimmune disease of uncertain etiology that affects predominantly women with a predilection for the African-American race. Development of nephritis is a prominent feature in SLE, contributing to morbidity and mortality. Although most patients with lupus have some renal involvement, only 15-30% have overt nephritis at the time of initial diagnosis. A further 15-30% of patients with SLE develop nephritis later in the course of their disease. The methods presently employed to screen for nephritis fail to detect early-silent-disease. Renal biopsy is the gold standard for the diagnosis of lupus nephritis. However, it is not suitable as a screening tool due to its invasive nature and the impracticability of repeated measures. Treatment options for nephritis are limited and associated with significant toxicity. Therapies are complicated by considerable life threatening adverse effects. If patients at risk of developing lupus nephritis could be identified early, this may allow for less toxic therapies to be employed which could potentially avert the development of overt renal disease. There is a need for the development of markers to screen for the presence of silent-lupus nephritis. Our aim is to identify useful markers of early sub-clinical disease. Such markers will also be helpful for the assessment of the efficacy of ongoing treatment. We will initially establish how selected biological markers and sensitive measurements of renal function relate to activity of nephritis as defined by renal biopsy in patients with SLE at the time of biopsy.