title: Urinary vascular cell adhesion molecule, but not neutrophil gelatinase-associated lipocalin, is associated with lupus nephritis.
abstract: OBJECTIVE
  Vascular cell adhesion molecule-1 (VCAM-1), an adhesion molecule, is involved in the progression of glomerular and tubulointerstitial injury. Neutrophil gelatinase-associated lipocalin (NGAL), a member of the lipocalin superfamily, has been shown to rise in both acute and chronic kidney damage. Both VCAM-1 and NGAL have been found at high levels in the urine of patients with active lupus nephritis. We investigated both as potential biomarkers for lupus nephritis.
  
  
  METHODS
  VCAM-1 and NGAL were measured by ELISA during 1 to 8 clinic visits in 107 patients with systemic lupus erythematosus (SLE; 91% women, 51% black, 36% white, 4% Asian, 4% Hispanic, and 5% others) for a total of 190 visits. Patients' mean age was 41 years. We analyzed the relationship between these potential urine biomarkers and the urine protein/creatinine ratio (urine Pr/Cr), the Systemic Lupus International Collaborating Clinics (SLICC) renal activity score, SLE Disease Activity Index renal descriptors, and other clinical variables.
  
  
  RESULTS
  VCAM-1 levels were strongly associated with the physician's global estimate of disease activity (p = 0.0002), the renal visual analog scale (p < 0.0001), the urine Pr/Cr (p < 0.0001), and SLICC renal activity score (p < 0.0001). VCAM-1 levels were also associated with a urine Pr/Cr ≥ 0.5 (p < 0.0001). NGAL was not associated with any measure of disease activity or with lupus serologies.
  
  
  CONCLUSIONS
  Urine VCAM-1 had a strong association with measures of disease activity, including multiple renal activity descriptors. In contrast to previous SLE studies, NGAL failed to show any association with lupus nephritis.
authors.affiliation: Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
authors.forename: Adnan N
authors.initials: AN
authors.lastname: Kiani
authors.forename: Tianfu
authors.initials: T
authors.lastname: Wu
authors.forename: Hong
authors.initials: H
authors.lastname: Fang
authors.forename: Xin J
authors.initials: XJ
authors.lastname: Zhou
authors.forename: Chul W
authors.initials: CW
authors.lastname: Ahn
authors.forename: Laurence S
authors.initials: LS
authors.lastname: Magder
authors.forename: Chandra
authors.initials: C
authors.lastname: Mohan
authors.forename: Michelle
authors.initials: M
authors.lastname: Petri
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000328:Adult; D015415:Biomarkers / Q000652:urine; D005260:Female; D006304:Health Status; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000503:physiopathology / Q000652:urine; D008297:Male; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012720:Severity of Illness Index; D019010:Vascular Cell Adhesion Molecule-1 / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D019010:Vascular Cell Adhesion Molecule-1