Department of Nephrology, Institute of Medical Sciences, Banaras Hindu University, India.
Lupus. 2012 Oct;21(11):1214-8. doi: 10.1177/0961203312452622. Epub 2012 Jun 27.
This study aimed to assess correlation of urinary monocytic chemoattractant protein-1 (UMCP-1) with severity of lupus nephritis and its role as predictor of outcome.
Twenty patients with lupus nephritis flare were included in the study. Ten patients in each group of stable systemic lupus erythematosus and non-renal flare were taken as controls. Biopsy was done to define lupus nephritis stage. UMCP-1 levels were measured in all patients at the time of entry and at four and eight weeks of follow-up.
Mild, moderate and severe lupus nephritis flare was noted in one, five and 15 patients, respectively. UMCP-1 levels were high in patients with severe lupus nephritis flare (2.74 ± 0.95 ng/mg creatinine) as compared to patients with moderate (1.43 ± 0.46 ng/mg creatinine) and mild lupus nephritis flare (0.76 ± 0.57 ng/mg creatinine) (P = 0.0093). Baseline mean UMCP-1 levels in lupus nephritis flare, non-renal flare and stable SLE patients were 2.32 ± 1.06, 0.171 ± 0.03 and 0.213 ± 0.026 ng/mg creatinine, respectively. The difference among the three groups was very significant (P < 0.001). Also, mean UMCP-1 levels correlated significantly with severity of lupus nephritis class (P = 0.0358). During follow-up, 15 patients achieved complete or partial remission, and in these patients mean UMCP-1 levels had significant decline at eight weeks (P < 0.0001). However, mean UMCP-1 levels in the remaining five non-responders did not show significant changes at four and eight weeks (P = 0.4858).
Mean UMCP-1 levels were significantly higher in the lupus nephritis flare group as compared to non-renal flare and stable patients. Baseline mean UMCP-1 levels significantly correlated with both lupus nephritis class and severity of lupus nephritis flare, hence UMCP-1 could be used as a non-invasive marker for the judgement of lupus flare and lupus nephritis class.
本研究旨在评估尿单核细胞趋化蛋白-1（UMCP-1）与狼疮肾炎严重程度的相关性及其作为预后预测因子的作用。
纳入 20 例狼疮肾炎发作患者。每例患者均设为 1 组，每组 10 例稳定系统性红斑狼疮患者和非肾性狼疮发作患者作为对照。行肾活检以明确狼疮肾炎分期。所有患者在入组时及随访 4 周和 8 周时检测 UMCP-1 水平。
轻度、中度和重度狼疮肾炎发作患者分别为 1 例、5 例和 15 例。重度狼疮肾炎发作患者的 UMCP-1 水平较高（2.74±0.95ng/mg 肌酐），中度（1.43±0.46ng/mg 肌酐）和轻度狼疮肾炎发作患者的 UMCP-1 水平较低（0.76±0.57ng/mg 肌酐）（P=0.0093）。狼疮肾炎发作、非肾性狼疮发作和稳定 SLE 患者的基线平均 UMCP-1 水平分别为 2.32±1.06ng/mg 肌酐、0.171±0.03ng/mg 肌酐和 0.213±0.026ng/mg 肌酐。三组间差异有统计学意义（P<0.001）。此外，UMCP-1 水平与狼疮肾炎分级的严重程度显著相关（P=0.0358）。随访期间，15 例患者获得完全或部分缓解，这些患者的 UMCP-1 水平在 8 周时显著下降（P<0.0001）。然而，其余 5 例无反应者的 UMCP-1 水平在 4 周和 8 周时无显著变化（P=0.4858）。
与非肾性狼疮发作和稳定患者相比，狼疮肾炎发作组的平均 UMCP-1 水平明显升高。基线平均 UMCP-1 水平与狼疮肾炎分级和狼疮肾炎发作严重程度显著相关，因此 UMCP-1 可作为判断狼疮发作和狼疮肾炎分级的非侵入性标志物。
