Division of Rheumatology, Albert Einstein College of Medicine, Forchheimer Building, Room 701N, 1300 Morris Park Ave, Bronx, New York, NY 10461, USA.
Clin Rev Allergy Immunol. 2011 Jun;40(3):138-50. doi: 10.1007/s12016-010-8197-z.
Renal involvement in patients with systemic lupus erythematosus in the form of severe lupus nephritis is associated with a significant burden of morbidity and mortality. Conventional laboratory biomarkers in current use have not been very successful in anticipating disease flares, predicting renal histology, or decreasing unwanted outcomes. Since early treatment is associated with improved clinical results, it is thus essential to identify new biomarkers with substantial predictive power to reduce the serious sequelae of this difficult to control lupus manifestation. Indeed, considerable efforts and progress have been made over the last few years in the search for novel biomarkers. Since urinary biomarkers are more easily obtainable with much less risk to the patient than repeat renal biopsies, and these may more accurately discern between renal disease and other organ manifestations than their serum counterparts, there has been tremendous interest in studying new candidate urine biomarkers. Below, we review several promising urinary biomarkers under investigation, including total proteinuria and microalbuminuria, urinary proteomic signatures, and the individual inflammatory mediators interleukin-6, vascular cell adhesion molecule-1, CXCL16, IP-10, and tumor necrosis factor-like weak inducer of apoptosis.
系统性红斑狼疮患者的肾脏受累表现为严重狼疮性肾炎，与较高的发病率和死亡率负担相关。目前常规使用的实验室生物标志物在预测疾病活动、预测肾脏组织学或减少不良结局方面并不十分成功。由于早期治疗与改善临床结果相关，因此识别具有较强预测能力的新型生物标志物对于减少这种难以控制的狼疮表现的严重后果至关重要。事实上，在过去几年中，人们在寻找新型生物标志物方面付出了巨大努力并取得了进展。由于与重复肾活检相比，尿液生物标志物更容易获得，而且与血清生物标志物相比，尿液生物标志物可能更能准确区分肾脏疾病和其他器官表现，因此人们对研究新的候选尿液生物标志物产生了浓厚的兴趣。下面，我们将回顾几种正在研究中的有前途的尿液生物标志物，包括总蛋白尿和微量白蛋白尿、尿蛋白质组学特征，以及白细胞介素-6、血管细胞黏附分子-1、CXCL16、IP-10 和肿瘤坏死因子样凋亡弱诱导物等单个炎症介质。
