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Lupus. 2018;27(10):1600-1615.

Urinary vitamin D-binding protein, a novel biomarker for lupus nephritis, predicts the development of proteinuric flare.

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제1저자 고동진 · 교신저자 송영욱

PMID 29958502 DOI 10.1177/0961203318778774 IF 1.8 류마티스내과
소속 (3)
  1. 1 Division of Rheumatology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
  2. 2 Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea.
  3. 3 Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Abstract

Lupus nephritis (LN) is a major complication of systemic lupus erythematosus (SLE). Conventional biomarkers for assessing renal disease activity are imperfect in predicting clinical outcomes associated with LN. The aim of this study is to identify urinary protein biomarkers that reliably reflect the disease activity or predict clinical outcomes. A quantitative proteomic analysis was performed to identify protein biomarker candidates that can differentiate between SLE patients with and without LN. Selected biomarker candidates were further verified by enzyme-linked immunosorbent assay using urine samples from a larger cohort of SLE patients ( n = 121) to investigate their predictive values for LN activity measure. Furthermore, the association between urinary levels of a selected panel of potential biomarkers and prognosis of LN was assessed with a four-year follow-up study of renal outcomes. Urinary vitamin D-binding protein (VDBP), transthyretin (TTR), retinol binding protein 4 (RBP4), and prostaglandin D synthase (PTGDS) were significantly elevated in SLE patients with LN, especially in patients with active LN ( n = 21). Among them, VDBP well correlated with severity of proteinuria (rho = 0.661, p < 0.001) and renal SLE Disease Activity Index (renal SLEDAI) (rho = 0.520, p < 0.001). In the four-year follow-up, VDBP was a significant risk factor (hazard ratio 9.627, 95% confidence interval 1.698 to 54.571, p = 0.011) for the development of proteinuric flare in SLE patients without proteinuria ( n = 100) after adjustments for multiple confounders. Urinary VDBP correlated with proteinuria and renal SLEDAI, and predicted the development of proteinuria.

Keywords

Systemic lupus erythematosuslupus nephritisurinary biomarkervitamin D-binding protein

그 밖의 정보
출판 형태
Comparative Study, Journal Article
저널
Lupus · eISSN 1477-0962
전자 출판
2018-06-29
MeSH
Adult · Biomarkers / urine · Cross-Sectional Studies · Disease Progression · Enzyme-Linked Immunosorbent Assay · Female · Humans · Lupus Nephritis / diagnosis / therapy / urine · Male · Middle Aged · Predictive Value of Tests · Prognosis · Proteinuria / diagnosis / therapy / urine · Proteomics / methods · Reproducibility of Results · Severity of Illness Index · Time Factors · Up-Regulation · Urinalysis · Vitamin D-Binding Protein / urine · Young Adult
Substances
Biomarkers · GC protein, human · Vitamin D-Binding Protein