Urinary TWEAK and the Activity of Lupus Nephritis

J Autoimmun. 2006 Dec;27(4):242-50. doi: 10.1016/j.jaut.2006.12.003. Epub 2007 Jan 24.

Abstract

The TNF superfamily cytokine TWEAK induces mesangial cells, podocytes, and endothelial cells to secrete pro-inflammatory chemokines including MCP-1, IP-10 and RANTES, which are crucial in the pathogenesis of lupus nephritis (LN). As TWEAK regulates the secretion of these inflammatory mediators, we studied whether urinary TWEAK (uTWEAK) levels might be predictive and/or diagnostic in LN. In a cross-sectional study of a large, multi-center cohort of systemic lupus erythematosus (SLE) patients, uTWEAK levels were higher in patients with active as compared to never or non-active nephritis (median (IQR): 16.3 (9.9-23.0) versus 5.5 (2.3-16.8) pg/mg creatinine, p=0.001), and levels of uTWEAK correlated with the renal SLE disease activity index (rSLEDAI) score (r=0.405, p<0.001). uTWEAK levels were higher in patients undergoing a flare as compared to patients with chronic stable disease (11.1 (8.1-18.2) and 5.2 (2.3-15.3) pg/mg creatinine, respectively; p=0.036). Moreover, uTWEAK levels were significantly higher in patients undergoing a renal flare, as opposed to a non-renal flare (12.4 (9.1-18.2) and 5.2 (3.0-11.9) pg/mg creatinine, respectively; p=0.029). An accurate, non-invasive method to repeatedly assess kidney disease in lupus would be very helpful in managing these often challenging patients. Our study indicates that urinary TWEAK levels may be useful as a novel biomarker in LN.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / urine
  • Chemokine CCL2 / biosynthesis
  • Chemokine CCL2 / immunology
  • Chemokine CCL2 / urine
  • Cross-Sectional Studies
  • Cytokine TWEAK
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / urine*
  • Lupus Nephritis / drug therapy
  • Lupus Nephritis / immunology
  • Lupus Nephritis / urine*
  • Male
  • Middle Aged
  • Tumor Necrosis Factors / immunology
  • Tumor Necrosis Factors / urine*
  • Urine / chemistry

Substances

  • Biomarkers
  • CCL2 protein, human
  • Chemokine CCL2
  • Cytokine TWEAK
  • TNFSF12 protein, human
  • Tumor Necrosis Factors