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273 Urinary tweak levels as biomarker of lupus nephritis in colombian sle patients
  1. BL Ortiz Reyes1,
  2. T Urrego1,
  3. AL Vanegas2,3,
  4. G Aroca4,
  5. A Cadena Bonfanti4,
  6. L Almendrales4,
  7. CH Muñoz2,3,
  8. LA González2,
  9. A Iglesias4,5,
  10. G Vásquez1,2 and
  11. JA Gómez-Puerta1,2
  1. 1Universidad de Antioquia, Grupo de Inmunología Celular e Inmunogenética GICIC, Medellín, Colombia
  2. 2Universidad de Antioquia, Grupo de Reumatología, Medellín, Colombia
  3. 3Hospital San Vicente Fundación, Rheumatology, Medellín, Colombia
  4. 4Universidad Simón Bolivar, Grupo investigación Nefrología, Barranquilla, Colombia
  5. 5Universidad Nacional de Colombia, Facultad de Medicina, Bogotá, Colombia

Abstract

Background and aims TNF-like WEAK inducer of apoptosis (TWEAK), a TNF ligand superfamily is mainly produced by monocytes/macrophages, and is widely expressed at the RNA level in tissues including kidneys. The usefulness of urinary TWEAK (uTWEAK) to identify renal involvement in Mestizo and African-Latin American (ALA) SLE patients has not been examined yet.

Methods Patients meeting the revised ACR criteria for SLE were recruited from 2 different centres at Medellín and Baranquilla, Colombia. uTWEAK were measured using an ELISA kit (R and D system, USA)

Results 158 SLE patients were recruited (89% female) with median age of 32.8±12.1 years and median disease duration of 7.27±6.6 years. Mestizo (77%) and ALA (20%) were majority. 64% of patients had lupus nephritis (LN). 50 out of 71 biopsy proven LN had proliferative forms. Mean SLEDAI score was 8.5±8.7. LN patients (2803±6086 vs 672±1042, p=0.013) (Fig 1A) and ALA patients (3995±9656 vs 1618±2653, p=0.002) had significant higher levels of uTWEAK. uTWEAK levels were higher in patients with active LN and in Class V LN (Fig. 1B). uTWEAK levels were significantly correlated with 24 hours proteinuria, SLEDAI (Fig. 1C) and serum anti-C1q titers. An ROC curve constructed showed a good level of sensitivity and specificity (Fig. 1D)

Conclusions In our cohort of Colombian SLE patients, uTWEAK levels were 4 and 2 times higher in LN patients and ALA respectively. uTWEAK were significantly higher in active LN and were correlated with disease activity, proteinuria and anti-C1q antibodies.

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