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2017 ; 188
(2
): 254-262
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Urinary haptoglobin, alpha-1 anti-chymotrypsin and retinol binding protein
identified by proteomics as potential biomarkers for lupus nephritis
#MMPMID28120479
Aggarwal A
; Gupta R
; Negi VS
; Rajasekhar L
; Misra R
; Singh P
; Chaturvedi V
; Sinha S
Clin Exp Immunol
2017[May]; 188
(2
): 254-262
PMID28120479
show ga
The study was aimed at identification by proteomics and validation by
enzyme-linked immunosorbent assay (ELISA) of potential urinary biomarkers for
lupus nephritis. Study subjects comprised 88 systemic lupus erythematosus (SLE)
patients and 60 controls (rheumatoid arthritis, diabetes mellitus and healthy
individuals). Based on the SLE disease activity index (SLEDAI), patients were
classified as active renal (AR), active non-renal (ANR) or inactive disease (ID).
Urinary proteins from a group of patients with AR or ID were resolved by
two-dimensional gel electrophoresis and identified by matrix-assisted laser
desorption ionization-time of flight-mass spectrometry (MALDI-TOF-MS/MS). The
selected biomarkers were validated by ELISA using samples from all patients and
controls. AR patients were followed-up for 12 months after start of therapy.
Three urinary proteins, alpha-1 anti-chymotrypsin (ACT), haptoglobin (HAP) and
retinol binding protein (RBP), were detected in patients with AR and not ID. Upon
validation, ACT levels were higher in AR patients than the other groups
(P?0·001) and showed good correlation with renal SLEDAI (r?=?0·577, P?0·001)
as well as SLEDAI (r?=?0·461, P?0·001). Similarly, HAP levels were > 10-fold
higher in AR than other groups (P?0·001) and correlated well with renal SLEDAI
(r?=?0·594, P?0·001) and SLEDAI (r?=?0·371, P?0·01). RBP levels were also
higher in AR patients than in other groups (P?0·05), except diabetes, and
showed moderate correlation with renal SLEDAI (r?=?0·284, P?0·008) and SLEDAI
(r?=?0·316, P?0·003). Upon follow-up with treatment, levels of all three
proteins declined at 6 and 12 months (P?0·01). Multiple logistic regression
identified ACT as the best marker to differentiate AR from ANR. Urinary HAP, ACT
and RBP are potential biomarkers for lupus nephritis activity.