title: Serum thiols as a biomarker of disease activity in lupus nephritis.
abstract: Lupus Nephritis (LN) develops in more than half of the Systemic Lupus Erythematous (SLE) patients. However, lack of reliable, specific biomarkers for LN hampers clinical management of patients and impedes development of new therapeutics. The goal of this study was to investigate whether oxidative stress biomarkers in patients with SLE is predictive of renal pathology. Serum biochemical and oxidative stress markers were measured in patients with inactive lupus, active lupus with and without nephritis and compared to healthy control group. To assess the predictive performance of biomarkers, Receiver Operating Characteristic (ROC) curves were constructed and cut-offs were used to identify SLE patients with nephritis. We observed an increased oxidative stress response in all SLE patients compared to healthy controls. Among the several biomarkers tested, serum thiols had a significant inverse association with SLE Disease Activity Index (SLEDAI). Interestingly, thiols were able too aptly differentiate between SLE patients with and without renal pathology, and serum thiol levels were not affected by immunosuppressive drug therapy. The decreased thiols in SLE correlated significantly with serum creatinine and serum C3 levels. Further retrospective evaluation using serum creatinine or C3 levels in combination with thiol's cutoff values from ROC analysis, we could positively predict chronicity of renal pathology in SLE patients. In summary, serum thiols emerge as an inexpensive and reliable indicator of LN, which may not only help in early identification of renal pathology but also aid in the therapeutic management of the disease, in developing countries with resource poor settings.
authors: Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Amazonas, Manaus, Brazil; Centro de Pesquisa Leônidas e Maria Deane (CPqL&MD)-FIOCRUZ, Amazônia, Manaus, Brazil.
authors: Pritesh
authors: P
authors: Lalwani
authors: Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Amazonas, Manaus, Brazil; Faculdade de Ciências Farmacêuticas, Universidade Federal do Amazonas, Manaus, Brazil.
authors: Giselle Katiane Bonfim Bacelar
authors: GK
authors: de Souza
authors: Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.
authors: Domingos Savio Nunes
authors: DS
authors: de Lima
authors: Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, Brazil.
authors: Luiz Fernando Souza
authors: LF
authors: Passos
authors: Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Brazil.
authors: Antonio Luiz
authors: AL
authors: Boechat
authors: Programa de Pós-Graduação em Ciências Farmacêuticas (PPGCF), Universidade Federal do Amazonas, Manaus, Brazil; Faculdade de Ciências Farmacêuticas, Universidade Federal do Amazonas, Manaus, Brazil.
authors: Emerson Silva
authors: ES
authors: Lima
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000175:diagnosis*; D008181:Lupus Nephritis / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D012372:ROC Curve; D012720:Severity of Illness Index; D013438:Sulfhydryl Compounds / Q000097:blood*
chemical_list: D015415:Biomarkers; D013438:Sulfhydryl Compounds