Li Yi, Tucci Marco, Narain Sonali, Barnes Elena V, Sobel Eric S, Segal Mark S, Richards Hanno B
Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Florida, Gainesville, FL 32610-0221, USA.
Autoimmun Rev. 2006 Jul;5(6):383-8. doi: 10.1016/j.autrev.2005.10.006. Epub 2005 Dec 9.
There has long been a need for biomarkers of disease activity in lupus nephritis (LN). Such markers ideally would be capable of detecting early sub-clinical disease and could be used to gauge response to therapy thus obviating the need for serial renal biopsies. Since urine can be readily obtained it lends itself as an obvious biological sample. Much of the focus has been on the measurement of urinary chemokines and cytokines in patients with LN. Elevations in urinary IL-6 and IL-10 had initially been reported to be associated with disease activity in LN but these markers have proven to be less reliable in larger studies. We and others have recently reported that MCP-1, a key chemokine involved in monocyte chemotaxis can be consistently found at high levels in the urine of patients with active LN. Moreover urinary MCP-1 levels decline with treatment of nephritis. In contrast urinary IL-8, a chemokine involved primarily in neutrophil chemotaxis is not a good predictor of disease activity in LN. Further longitudinal studies with larger numbers of patients are needed to determine the utility of urinary biomarkers such as MCP-1 which may act as surrogates of ongoing inflammation in LN.
狼疮性肾炎（LN）长期以来一直需要疾病活动的生物标志物。理想情况下，此类标志物应能够检测早期亚临床疾病，并可用于评估治疗反应，从而无需进行系列肾活检。由于尿液易于获取，它自然而然地成为一种明显的生物样本。LN患者尿液趋化因子和细胞因子的测量一直是研究的重点。最初有报道称，尿液中白细胞介素-6（IL-6）和白细胞介素-10（IL-10）水平升高与LN的疾病活动相关，但在更大规模的研究中，这些标志物已被证明不太可靠。我们和其他研究人员最近报告称，单核细胞趋化蛋白-1（MCP-1），一种参与单核细胞趋化作用的关键趋化因子，在活动性LN患者的尿液中始终处于高水平。此外，肾炎治疗后尿液中MCP-1水平会下降。相比之下，尿液中白细胞介素-8（IL-8），一种主要参与中性粒细胞趋化作用的趋化因子，并不是LN疾病活动的良好预测指标。需要对更多患者进行进一步的纵向研究，以确定尿液生物标志物如MCP-1的效用，其可能作为LN中持续炎症的替代指标。
