Urine VCAM-1 as a marker of renal pathology activity index in lupus nephritis

Sandeep Singh, Tianfu Wu, Chun Xie, Kamala Vanarsa, Jie Han, Tina Mahajan, Ho B. Oei, Chul Ahn, Xin J. Zhou, Chaim Putterman, Ramesh Saxena, Chandra Mohan

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Abstract

Introduction: Although renal pathology is highly predictive of the disease course in lupus nephritis, it cannot be performed serially because of its invasive nature and associated morbidity. The goal of this study is to investigate whether urinary levels of CXC ligand 16 (CXCL16), monocyte chemotactic protein-1 (MCP-1) or vascular cell adhesion molecule-1 (VCAM-1) in patients with lupus nephritis are predictive of particular features of renal pathology in renal biopsies obtained on the day of urine procurement.Methods: CXCL16, MCP-1, and VCAM-1 levels were measured in urine samples from 74 lupus nephritis patients and 13 healthy volunteers. Of the patients enrolled, 24 patients had a concomitant kidney biopsy performed at the time of urine collection. In addition, patients with other renal diatheses were also included as controls.Results: All three molecules were elevated in the urine of systemic lupus erythematosus patients, although VCAM-1 (area under curve = 0.92) and MCP-1 (area under curve = 0.87) were best at distinguishing the systemic lupus erythematosus samples from the healthy controls, and were also most strongly associated with clinical disease severity and active renal disease. For patients in whom concurrent renal biopsies had also been performed, urine VCAM-1 exhibited the strongest association with the renal pathology activity index and glomerulonephritis class IV, although it correlated negatively with the chronicity index. Interestingly, urinary VCAM-1 was also elevated in anti-neutrophil cytoplasmic antibodies-associated glomerulonephritis, focal segmental glomerulosclerosis and membranous nephropathy but not in minimal-change disease.Conclusion: Urinary VCAM-1 emerges as a reliable indicator of the activity:chronicity ratios that mark the underlying renal pathology in lupus nephritis. Since VCAM-1 is involved in the acute phase of inflammation when leukocytic infiltration is ongoing, longitudinal studies are warranted to establish whether tracking urine VCAM-1 levels may help monitor clinical and pathological disease activity over time.

Original languageEnglish (US)
Article numberR164
JournalArthritis Research and Therapy
Volume14
Issue number4
DOIs
StatePublished - Jul 13 2012

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Lupus Nephritis
Vascular Cell Adhesion Molecule-1
Urine
Pathology
Kidney
Chemokine CCL2
Glomerulonephritis
Biopsy
Systemic Lupus Erythematosus
Area Under Curve
Ligands
Lipoid Nephrosis
Focal Segmental Glomerulosclerosis
Membranous Glomerulonephritis
Antineutrophil Cytoplasmic Antibodies
Urine Specimen Collection
Disease Susceptibility
Longitudinal Studies
Healthy Volunteers
Inflammation

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Singh, S., Wu, T., Xie, C., Vanarsa, K., Han, J., Mahajan, T., ... Mohan, C. (2012). Urine VCAM-1 as a marker of renal pathology activity index in lupus nephritis. Arthritis Research and Therapy, 14(4), [R164]. https://doi.org/10.1186/ar3912

Urine VCAM-1 as a marker of renal pathology activity index in lupus nephritis. / Singh, Sandeep; Wu, Tianfu; Xie, Chun; Vanarsa, Kamala; Han, Jie; Mahajan, Tina; Oei, Ho B.; Ahn, Chul; Zhou, Xin J.; Putterman, Chaim; Saxena, Ramesh; Mohan, Chandra.

In: Arthritis Research and Therapy, Vol. 14, No. 4, R164, 13.07.2012.

Research output: Contribution to journalArticle

Singh, S, Wu, T, Xie, C, Vanarsa, K, Han, J, Mahajan, T, Oei, HB, Ahn, C, Zhou, XJ, Putterman, C, Saxena, R & Mohan, C 2012, 'Urine VCAM-1 as a marker of renal pathology activity index in lupus nephritis', Arthritis Research and Therapy, vol. 14, no. 4, R164. https://doi.org/10.1186/ar3912
Singh, Sandeep ; Wu, Tianfu ; Xie, Chun ; Vanarsa, Kamala ; Han, Jie ; Mahajan, Tina ; Oei, Ho B. ; Ahn, Chul ; Zhou, Xin J. ; Putterman, Chaim ; Saxena, Ramesh ; Mohan, Chandra. / Urine VCAM-1 as a marker of renal pathology activity index in lupus nephritis. In: Arthritis Research and Therapy. 2012 ; Vol. 14, No. 4.
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abstract = "Introduction: Although renal pathology is highly predictive of the disease course in lupus nephritis, it cannot be performed serially because of its invasive nature and associated morbidity. The goal of this study is to investigate whether urinary levels of CXC ligand 16 (CXCL16), monocyte chemotactic protein-1 (MCP-1) or vascular cell adhesion molecule-1 (VCAM-1) in patients with lupus nephritis are predictive of particular features of renal pathology in renal biopsies obtained on the day of urine procurement.Methods: CXCL16, MCP-1, and VCAM-1 levels were measured in urine samples from 74 lupus nephritis patients and 13 healthy volunteers. Of the patients enrolled, 24 patients had a concomitant kidney biopsy performed at the time of urine collection. In addition, patients with other renal diatheses were also included as controls.Results: All three molecules were elevated in the urine of systemic lupus erythematosus patients, although VCAM-1 (area under curve = 0.92) and MCP-1 (area under curve = 0.87) were best at distinguishing the systemic lupus erythematosus samples from the healthy controls, and were also most strongly associated with clinical disease severity and active renal disease. For patients in whom concurrent renal biopsies had also been performed, urine VCAM-1 exhibited the strongest association with the renal pathology activity index and glomerulonephritis class IV, although it correlated negatively with the chronicity index. Interestingly, urinary VCAM-1 was also elevated in anti-neutrophil cytoplasmic antibodies-associated glomerulonephritis, focal segmental glomerulosclerosis and membranous nephropathy but not in minimal-change disease.Conclusion: Urinary VCAM-1 emerges as a reliable indicator of the activity:chronicity ratios that mark the underlying renal pathology in lupus nephritis. Since VCAM-1 is involved in the acute phase of inflammation when leukocytic infiltration is ongoing, longitudinal studies are warranted to establish whether tracking urine VCAM-1 levels may help monitor clinical and pathological disease activity over time.",
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AU - Singh, Sandeep

AU - Wu, Tianfu

AU - Xie, Chun

AU - Vanarsa, Kamala

AU - Han, Jie

AU - Mahajan, Tina

AU - Oei, Ho B.

AU - Ahn, Chul

AU - Zhou, Xin J.

AU - Putterman, Chaim

AU - Saxena, Ramesh

AU - Mohan, Chandra

PY - 2012/7/13

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N2 - Introduction: Although renal pathology is highly predictive of the disease course in lupus nephritis, it cannot be performed serially because of its invasive nature and associated morbidity. The goal of this study is to investigate whether urinary levels of CXC ligand 16 (CXCL16), monocyte chemotactic protein-1 (MCP-1) or vascular cell adhesion molecule-1 (VCAM-1) in patients with lupus nephritis are predictive of particular features of renal pathology in renal biopsies obtained on the day of urine procurement.Methods: CXCL16, MCP-1, and VCAM-1 levels were measured in urine samples from 74 lupus nephritis patients and 13 healthy volunteers. Of the patients enrolled, 24 patients had a concomitant kidney biopsy performed at the time of urine collection. In addition, patients with other renal diatheses were also included as controls.Results: All three molecules were elevated in the urine of systemic lupus erythematosus patients, although VCAM-1 (area under curve = 0.92) and MCP-1 (area under curve = 0.87) were best at distinguishing the systemic lupus erythematosus samples from the healthy controls, and were also most strongly associated with clinical disease severity and active renal disease. For patients in whom concurrent renal biopsies had also been performed, urine VCAM-1 exhibited the strongest association with the renal pathology activity index and glomerulonephritis class IV, although it correlated negatively with the chronicity index. Interestingly, urinary VCAM-1 was also elevated in anti-neutrophil cytoplasmic antibodies-associated glomerulonephritis, focal segmental glomerulosclerosis and membranous nephropathy but not in minimal-change disease.Conclusion: Urinary VCAM-1 emerges as a reliable indicator of the activity:chronicity ratios that mark the underlying renal pathology in lupus nephritis. Since VCAM-1 is involved in the acute phase of inflammation when leukocytic infiltration is ongoing, longitudinal studies are warranted to establish whether tracking urine VCAM-1 levels may help monitor clinical and pathological disease activity over time.

AB - Introduction: Although renal pathology is highly predictive of the disease course in lupus nephritis, it cannot be performed serially because of its invasive nature and associated morbidity. The goal of this study is to investigate whether urinary levels of CXC ligand 16 (CXCL16), monocyte chemotactic protein-1 (MCP-1) or vascular cell adhesion molecule-1 (VCAM-1) in patients with lupus nephritis are predictive of particular features of renal pathology in renal biopsies obtained on the day of urine procurement.Methods: CXCL16, MCP-1, and VCAM-1 levels were measured in urine samples from 74 lupus nephritis patients and 13 healthy volunteers. Of the patients enrolled, 24 patients had a concomitant kidney biopsy performed at the time of urine collection. In addition, patients with other renal diatheses were also included as controls.Results: All three molecules were elevated in the urine of systemic lupus erythematosus patients, although VCAM-1 (area under curve = 0.92) and MCP-1 (area under curve = 0.87) were best at distinguishing the systemic lupus erythematosus samples from the healthy controls, and were also most strongly associated with clinical disease severity and active renal disease. For patients in whom concurrent renal biopsies had also been performed, urine VCAM-1 exhibited the strongest association with the renal pathology activity index and glomerulonephritis class IV, although it correlated negatively with the chronicity index. Interestingly, urinary VCAM-1 was also elevated in anti-neutrophil cytoplasmic antibodies-associated glomerulonephritis, focal segmental glomerulosclerosis and membranous nephropathy but not in minimal-change disease.Conclusion: Urinary VCAM-1 emerges as a reliable indicator of the activity:chronicity ratios that mark the underlying renal pathology in lupus nephritis. Since VCAM-1 is involved in the acute phase of inflammation when leukocytic infiltration is ongoing, longitudinal studies are warranted to establish whether tracking urine VCAM-1 levels may help monitor clinical and pathological disease activity over time.

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