title: Urinary TWEAK and the activity of lupus nephritis.
abstract: 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.
authors.affiliation: Division of Rheumatology, Forchheimer 701N, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Noa
authors.initials: N
authors.lastname: Schwartz
authors.forename: Lihe
authors.initials: L
authors.lastname: Su
authors.forename: Linda C
authors.initials: LC
authors.lastname: Burkly
authors.forename: Meggan
authors.initials: M
authors.lastname: Mackay
authors.forename: Cynthia
authors.initials: C
authors.lastname: Aranow
authors.forename: Maria
authors.initials: M
authors.lastname: Kollaros
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Michaelson
authors.forename: Brad
authors.initials: B
authors.lastname: Rovin
authors.forename: Chaim
authors.initials: C
authors.lastname: Putterman
mesh_terms: 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
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D000074049:Cytokine TWEAK; C109743:TNFSF12 protein, human; D048069:Tumor Necrosis Factors