Article Text

PDF

CE-06 Urinary neutrophil gelatinase – associated lipocalin and monocyte chemoattractant protein-1 as biomarkers for lupus nephritis in colombian SLE patients
  1. Jose A Gómez-Puerta1,2,
  2. Blanca L Ortiz Reyes1,
  3. Tomás Urrego1,
  4. Adriana L Vanegas2,3,
  5. Carlos H Muñoz2,3,
  6. Mauricio Restrepo2,
  7. Luis A González2 and
  8. Gloria Vásquez1,2
  1. 1Grupo de Inmunología Celular e Inmunogenética, Universidad de Antioquia, Medellín
  2. 2Sección de Reumatología, Universidad de Antioquia
  3. 3Hospital Universitario de San Vicente Fundación, Medellín, Colombia

Abstract

Background Some previous studies in Caucasian, Asian, and African-American patients have shown that urine levels of Neutrophil Gelatinase–Associated Lipocalin (uNGAL) and Monocyte Chemoattractant Protein-1 (uMCP-1) were significantly greater in patients with LN. However, information in Mestizo and Afro-Latin American patients is very limited. Our aim was to evaluate diagnostic value of uNGAL and uMCP-1 as potential markers for the diagnosis of LN in Colombian SLE patients

Materials and methods We examined urinary levels of NGAL and MCP-1 in 93 consecutive SLE patients (ACR criteria 1982) from Hospital San Vicente Fundación, at Medellín, Colombia. uNGAL and uMCP-1 were measured by ELISA techniques (R&D system, Minneapolis, USA). In addition, serum Anti-C1q antibodies were measured (Inova, San Diego, USA). Several clinical and serological features were analysed as well as disease activity (SLEDAI). Mann-Whitney tests were used to compare data and Spearman’s rho for correlations. Additionally, ROC curves relating the specificity and sensitivity profiles of the 2 biomarkers were done.

Results Ninety-three SLE patients were recruited (88% female) with median age of 33.6 ± 12.4 years and median disease duration of 11.5 ± 14.8 years. Mestizo (75%) and Afro-Latin American (22%) were majority. One quarter of patients had an early SLE (< 2 years of duration) and 64 were admitted at the time of urine collection. Hematologic disease (89%), arthritis (83%), cutaneous involvement (82%), and renal disease (66%) were among most common manifestations. 63% of patients were positive for anti-C1q. We found significant positive correlation between uNGAL levels and SLEDAI (r = 0.331, p = 0.02) and between uMCP1 with SLEDAI (r = 0.428, p < 0.02) and with uNGAL (r = 0.467, p < 0.0001). uNGAL and uMCP-1 were significantly higher in patients with LN than in patients without LN (53.0 ± 56.3 vs 16.0 ± 16.6 pg/ml, p = 0.001 and 2340.4 ± 4521.4 vs 472.4 ± 596.5, p = 0.015, respectively). uNGAL levels were also significantly higher in patients with active LN (>500 mg proteinuria/24 hrs) than in inactive LN (66.1 ± 61.9 vs 9.0 ± 8.6, p < 0.001). A ROC curve constructed for uNGAL, uMCP-1, and anti-C1q for LN in all SLE patients showed a good level of sensitivity and specificity (Figure 1).

Conclusions Colombian LN patients had 4 times and 5 times higher levels of uNGAL and uMPC-1, respectively than patients without LN. Additionally, uNGAL was significantly higher in patients with active LN. Both markers were correlated with disease activity. A multinational prospective study is ongoing under GLADEL cohort, in order to evaluate those biomarkers in 14 Latin American countries.

Abstract CE-06 Figure 1

Receiver operating characteristic (ROC) curve of urinary NGAL, MCP-1 and anti C1q for the identification of LN (dotted line for uNGAL, solid green line for uMCP-1 and solid red line for anti C1q)

Acknowledgements JA Gómez-Puerta was supported by Colciencias (conv. 656 de 2014). Anti-C1q antibodies were provided by Inova, Werfen, Colombia

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.