Urinary TWEAK and the activity of lupus nephritis.
The TNF superfamily cytokine TWEAK induces mesangial cells, podocytes, and endothelial cells to secrete pro-inflammatory chemokines including MCP-1, IP-10 and RANTES, which are crucial in the pathogenesis of lupus nephritis (LN). As TWEAK regulates the secretion of these inflammatory mediators, we studied whether urinary TWEAK (uTWEAK) levels might be predictive and/or diagnostic in LN. In a cross-sectional study of a large, multi-center cohort of systemic lupus erythematosus (SLE) patients, uTWEAK levels were higher in patients with active as compared to never or non-active nephritis (median (IQR): 16.3 (9.9-23.0) versus 5.5 (2.3-16.8) pg/mg creatinine, p=0.001), and levels of uTWEAK correlated with the renal SLE disease activity index (rSLEDAI) score (r=0.405, p<0.001). uTWEAK levels were higher in patients undergoing a flare as compared to patients with chronic stable disease (11.1 (8.1-18.2) and 5.2 (2.3-15.3) pg/mg creatinine, respectively; p=0.036). Moreover, uTWEAK levels were significantly higher in patients undergoing a renal flare, as opposed to a non-renal flare (12.4 (9.1-18.2) and 5.2 (3.0-11.9) pg/mg creatinine, respectively; p=0.029). An accurate, non-invasive method to repeatedly assess kidney disease in lupus would be very helpful in managing these often challenging patients. Our study indicates that urinary TWEAK levels may be useful as a novel biomarker in LN.
Schwartz
Noa
N
Division of Rheumatology, Forchheimer 701N, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
Su
Lihe
L
Burkly
Linda C
LC
Mackay
Meggan
M
Aranow
Cynthia
C
Kollaros
Maria
M
Michaelson
Jennifer S
JS
Rovin
Brad
B
Putterman
Chaim
C
D000328:Adult; D015415:Biomarkers / Q000652:urine; D018932:Chemokine CCL2 / Q000096:biosynthesis / Q000276:immunology / Q000652:urine; D003430:Cross-Sectional Studies; D000074049:Cytokine TWEAK; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000276:immunology / Q000652:urine*; D008181:Lupus Nephritis / Q000188:drug therapy / Q000276:immunology / Q000652:urine*; D008297:Male; D008875:Middle Aged; D048069:Tumor Necrosis Factors / Q000276:immunology / Q000652:urine*; D014556:Urine / Q000737:chemistry
D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D000074049:Cytokine TWEAK; C109743:TNFSF12 protein, human; D048069:Tumor Necrosis Factors