title: Biomarkers of lupus nephritis determined by serial urine proteomics.
abstract: Lupus nephritis is a frequent and serious complication of systemic lupus erythematosus (SLE), the treatment of which often requires the use of immunosuppressives that can have severe side effects. Here we determined the low-molecular weight proteome of serial lupus urine samples to uncover novel and predictive biomarkers of SLE renal flare. Urine from 25 flare cycles of 19 patients with WHO Class III, IV, and V SLE nephritis were obtained at baseline, pre-flare, flare and post-flare. Each sample was first fractionated to remove proteins larger than 30 kDa, then applied onto weak cation exchanger protein chips for analysis by SELDI-TOF mass spectrometry. We found 176 protein ions of which 27 were differentially expressed between specific flare intervals. On-chip peptide sequencing by integrated tandem mass spectrometry positively identified the 20 and 25 amino-acid isoforms of hepcidin, as well as fragments of alpha1-antitrypsin and albumin among the selected differentially expressed protein ions. Hepcidin 20 increased 4 months before renal flare and returned to baseline at renal flare, whereas hepcidin 25 decreased at renal flare and returned to baseline 4 months after the flare. These studies provide a beginning proteomic analysis aimed at predicting impending renal relapse, relapse severity, and the potential for recovery after SLE nephritis flare.
authors.affiliation: 1Department of Internal Medicine, Ohio State University, Columbus, Ohio, USA.
authors.forename: Xiaolan
authors.initials: X
authors.lastname: Zhang
authors.forename: Ming
authors.initials: M
authors.lastname: Jin
authors.forename: Haifeng
authors.initials: H
authors.lastname: Wu
authors.forename: Tibor
authors.initials: T
authors.lastname: Nadasdy
authors.forename: Gyongyi
authors.initials: G
authors.lastname: Nadasdy
authors.forename: Nathan
authors.initials: N
authors.lastname: Harris
authors.forename: Kari
authors.initials: K
authors.lastname: Green-Church
authors.forename: Haikady
authors.initials: H
authors.lastname: Nagaraja
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Birmingham
authors.forename: Chack-Yung
authors.initials: CY
authors.lastname: Yu
authors.forename: Lee A
authors.initials: LA
authors.lastname: Hebert
authors.forename: Brad H
authors.initials: BH
authors.lastname: Rovin
mesh_terms: D000419:Albuminuria / Q000175:diagnosis; D000595:Amino Acid Sequence; D023181:Antimicrobial Cationic Peptides / Q000652:urine; D015415:Biomarkers / Q000652:urine*; D064451:Hepcidins; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008181:Lupus Nephritis / Q000175:diagnosis*; D008970:Molecular Weight; D011237:Predictive Value of Tests; D040081:Protein Array Analysis; D020033:Protein Isoforms; D011507:Proteinuria / Q000175:diagnosis; D040901:Proteomics / Q000379:methods*; D053719:Tandem Mass Spectrometry; D000515:alpha 1-Antitrypsin / Q000652:urine
chemical_list: D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; C578702:HAMP protein, human; D064451:Hepcidins; D020033:Protein Isoforms; D000515:alpha 1-Antitrypsin