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Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Transl+Res 2017 ; 182 (ä): 1-13 Nephropedia Template TP
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Molecular Imaging of the Kidney in Lupus Nephritis to Characterize Response to Treatment #MMPMID27842222
Transl Res 2017[Apr]; 182 (ä): 1-13 PMID27842222show ga
The consequences of treatment for the kidney at the molecular level have not been explored in human lupus nephritis (LN). In this investigation, changes in intra-renal transcript expression were measured and correlated with response in a LN cohort that underwent serial kidney biopsies. The intra-renal transcript expression of 19 patients with proliferative LN (Class III or IV) was measured at diagnostic biopsy (Bx1) and after induction therapy was completed (Bx2) using Nanostring® technology. Patients were segregated by clinical response into complete responders (n=5, CR) or nonresponders (n=4, NR). Transcript expression for each biopsy was compared to normal controls (n=4) and the change in expression was compared in each responder group and between groups. Compared to controls, the CR group had 21 and 28 while NR had 45 and 103 differentially-expressed transcripts at Bx1 and Bx2, respectively. The profiles of these differentially-expressed genes indicated that the type I and II interferon, alternative complement and T cell signaling pathways discriminated CR from NR. Comparing the change in transcript expression from Bx1 to Bx2 revealed a 5-gene signature that differentiated NR from CR and included increased IL1RAP and FCAR in NR and increased NCAM1 in CR. In summary, molecular imaging of serial kidney biopsies from LN patients shows several immune and inflammatory pathways that are dysregulated in the kidneys during active disease that may serve as therapeutic targets to improve clinical response. This approach to LN biomarker development may facilitate personalized medicine in LN and improve long-term kidney outcomes.