Biomarkers In Lupus Nephritis

Objective:Lupus nephritis is one of the most common and severe complications of SLE affecting more than 60% patients.The management of lupus nephritis largely depends on renal histopathologic findings.Due to the invasive feature and complications of renal biopsy,it is significantly urgent to develop novel biomarkers to predict renal pathology.Methods and Materials:In this cross-sectional study,a total of 77 biopsy-proven active LN,61 active SLE without LN,75 inactive SLE patients,and 28 age and gender matched healthy controls were recruited.Determination of activated leukocyte adhesion molecule(ALCAM),galectin-3 binding protein and soluble Axl protein level by enzyme-linked immunosorbent assay in urine and serum samples.In addition,renal histopathology was reviewed by experienced renal pathologists in all patients.We normalize urinary ALCAM and Gal-3 levels with urinary creatinine.For LN patients in disease activity,all samples were collected on the same day as the patient underwent renal biopsy.Results:In this study,we found that all three protein molecules can be used as excellent biomarkers for lupus nephritis.Compared with traditional biomarkers such as antids DNA,C3,C4,ALCAM,Gal-3 and s Axl have superior diagnostic efficacy in distinguishing active lupus nephritis from healthy people or patients in inactive phase.Changes can reflect the severity of the disease.At the same time,we found that the level of urinary ALCAM can reflect the damage of the patient’s kidney and distinguish between different types of lupus nephritis,both membranous and proliferative.It suggests that ALCAM may play a special role in patients with lupus nephritis.Further study of the biological function of ALCAM may help us find its connection with the pathogenesis of lupus nephritis,to further understand the disease,and it could be a therapeutic target.Conclusion:Therefore,we focused on the biological functions of ALCAM,through immunohistochemistry,small interfering RNA knockdown gene expression and flow cytometry technology,found that ALCAM shows different expression in the kidney,and unique functions in cell proliferation,differentiation,migration and apoptosis.Therefore,we believe that ALCAM may be involved in the pathogenesis of lupus nephritis,including infiltration and migration of immune cells.ALCAM can not only be used as an excellent biomarker,but also a possible target in the study of the pathogenesis of lupus nephritis and proves this conjecture requires further exploration.