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LO-005 Urinary L-selectin reflects clinical and histological renal disease activity and treatment response in lupus nephritis across multiple ethnicities
  1. Yiwei Shen1,
  2. Kamala Vanarsa2,
  3. Zhihua Yin3,
  4. Ramesh Saxena4,
  5. Michelle Petri5,
  6. Nan Shen1,6,7,
  7. Zhizhong Ye3,
  8. Chandra Mohan2 and
  9. Huihua Ding1
  1. 1Department of Rheumatology, Shanghai Jiao Tong University School of Medicine affiliated Renji Hospital, China
  2. 2Department of Biomedical Engineering, University of Houston, USA
  3. 3Department of Rheumatology, Shenzhen Futian Hospital for Rheumatic Diseases, China
  4. 4Division of Nephrology, University of Texas Southwestern Medical Center, USA
  5. 5Division of Rheumatology, Johns Hopkins University School of Medicine, USA
  6. 6State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Shanghai Jiao Tong University School of Medicine affiliated Renji Hospital, China
  7. 7Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, USA


Background There is an urgent need to identify novel biomarkers for lupus nephritis (LN) in disease diagnosis, assessment, monitoring, and prognosis prediction. Here, we report a new non-invasive urinary biomarker, L-selectin, in two independent multiple-ethnicity SLE cohorts from three centers.

Methods Urinary L-selectin (uL-selectin) was tested cross-sectionally in a Chinese-based cohort (n=255) and a US-based cohort (n=223) of SLE patients and controls using ELISA. A longitudinal cohort includes eighteen active Chinese LN patients who were followed up for a minimum of 6 months.

Results In the Chinese cross-sectional cohort, uL-selectin was significantly increased in active lupus nephritis (aLN) patients compared with active non-renal SLE patients (aNR), inactive LN patients (iLN), inactive non-renal SLE patients, chronic kidney disease (CKD) patients, and healthy controls (HC) (all p < 0.0001) (table 1, figure 1A). uL-selectin positively correlated with global and renal disease activities (all p < 0.0001) and was significantly associated with activity index (AI) and chronicity index (CI) (figure 1E-F). It also correlated with conventional metrics (serum C3, anti-dsDNA and 24h proteinuria) and histological characteristics (figure 1G). Univariate and multivariate logistic regression analyses revealed low uL-selectin as an independent risk factor for high CI (CI>3) (figure 1J). Similar results were noted in the US-based cohort consisting of Caucasian, African American and Hispanic subjects (figure 1B-D). In a longitudinal cohort of LN patients, uL-selectin levels decreased at the end of follow up in the remission group (p=0.001), but not in non-remission patients (p=0.58) (figure 1H-I).

Conclusions uL-selectin is a novel biomarker of clinical disease activity and renal histopathology in LN across multiple ethnicities. It also reflects treatment response in LN patients during follow up.

Abstract LO-005 Figure 1

Comparison of uL-selectin levels among subject subgroups in Asian (all were Chinese) (A), non-Hispanic Caucasian (B), non-Hispanic African American (C) and Hispanic (D) subjects. uL-selectin in LN patients correlated with AI (E) and CI (F) by Spearman correlation analysis in Chinese subjects. (G) Correlation matrix for comparison of uL-selectin and conventional metrics (serum C3, C4, anti-dsDNA and 24h proteinuria) with renal pathology AI, CI and their component attributes. Urinary L-selectin levels were compared in active LN patients at the endpoints of follow up and those at baseline in the remission group (CRR+PRR) (H) and the non-remission group (NR) (I, J) The forest plot summarizes results from univariate and multivariate logistic regression analysis for high renal pathology CI (CI>3)

Abstract LO-005 Table 1

Demographic and clinical characteristics of study subjects from the Chinese cohort (n=255)

  • Lupus nephritis
  • L-selectin
  • Urinary biomarker

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