Autoimmunity

Introduction: Lupus nephritis is an ominous manifestation of Systemic Lupus Erythematosus (SLE) requiring aggressive immunosupressants. Biopsy is the gold standard for diagnosis. A lot of studies have investigated the possible role of various biomarkers in blood and/or urine to aiming to early discovery of kidney involvement in SLE with contradictory results. No single biomarker has been established as a screening tool for the Lupus nephritis. Soluble Triggering Receptor Expressed on Myelocytes (sTREM-1) has been correlated with activity score of SLE (SLEDAI) but few studies have been investigated sTREM-1 in Lupus nephritis Patients and methods: We investigated the levels of sTREM-1 in urine of 8 SLE patients with biopsy proven nephritis and 10 patients with active SLE but no kidney involvement ( according to EULAR criteria). The patients were choosen randomly by the Outpatient clinic of Clinical Immunology Unit of 2nd Internal Medicine Dpt. Th e overall severity of the disease in both groups was at the same class according the SLEDAI index. We performed enzyme linked immune sorbent assay in the urine by the commercially available ki (USCN Life Sciences) following the manufactures protocol. Results were expressed as mean+/- sd. Mann –Whitney test was performed to assess possible signifi cant diff erences, p<0.05 was considered significant.

 

Results: The mean value of sTREM-1 in patients with nephritis was 28+/-2.3 pg/ml and the mean SLEDAI index was 13+/-5.Patients with SLE without nephritis (mean SLEDAI 12+/-4) was signifi cantly lower 6+/-5 pg/ml.

 

Discussion: sTREM-1 is increased in urine of patients with Lupus Nephritis relative to SLE patients without kidney involvement. sTREM-1 could be a candidate biomarker measured in urine helping the physician to discriminate patients suspicious for SLE nephritis.