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尿中性粒细胞明胶酶相关脂质运载蛋白和单核细胞趋化蛋白1作为哥伦比亚系统性红斑狼疮患者狼疮性肾炎的生物标志物

Urinary neutrophil gelatinase-associated lipocalin and monocyte chemoattractant protein 1 as biomarkers for lupus nephritis in Colombian SLE patients.

作者信息

Gómez-Puerta J A, Ortiz-Reyes B, Urrego T, Vanegas-García A L, Muñoz C H, González L A, Cervera R, Vásquez G

机构信息

1 Grupo de Inmunología Celular e Inmunogenética, 27983 Universidad de Antioquia , Medellín, Colombia.

2 Grupo de Reumatología, Facultad de Medicina, 27983 Universidad de Antioquia , Medellín, Colombia.

出版信息

Lupus. 2018 Apr;27(4):637-646. doi: 10.1177/0961203317738226. Epub 2017 Oct 26.

Abstract

Background Information regarding urinary biomarkers in Mestizo and Afro-Latin-American patients is very limited. We investigated whether levels of urinary neutrophil gelatinase-associated lipocalin (NGAL), and monocyte chemoattractant protein 1 (MCP-1) are good biomarkers to differentiate patients with lupus nephritis among Latin-American systemic lupus erythematosus (SLE) patients. Methods SLE patients meeting the revised American College of Rheumatology classification criteria for SLE were recruited. Urinary levels of NGAL and MCP-1 were measured using a commercial ELISA kit. Serum anti-C1q antibodies were measured by ELISA. SLE activity was measured with the systemic lupus erythematosus disease activity index (SLEDAI). Mann-Whitney tests were used to compare data and Spearman's rank correlations were used to examine associations between continuous variables. In addition, receiver operating characteristic curves were performed. Results One hundred and twenty SLE patients were recruited (87% women) with a median age of 32.8 ± 12.1 years and median disease duration of 7.3 ± 6.9 years. Afro-Latin-Americans had a significantly higher prevalence of lupus nephritis and higher SLEDAI scores than Mestizos. The three biomarkers were significantly higher in patients with lupus nephritis than in patients without lupus nephritis. In addition, urinary NGAL and MCP-1 were significantly higher in patients with active lupus nephritis than in inactive lupus nephritis. Urinary NGAL levels were significantly higher in Afro-Latin-American patients. A receiver operating characteristic curve for urinary biomarkers for lupus nephritis in all SLE patients showed a good level of sensitivity and specificity. Conclusion In our cohort of SLE patients, we found that urinary NGAL and MCP-1 in addition to anti-C1q antibodies were useful biomarkers for the identification of renal involvement and discrimination of active lupus nephritis among patients with renal disease.

摘要

背景

关于混血和非洲裔拉丁美洲患者尿液生物标志物的信息非常有限。我们调查了尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和单核细胞趋化蛋白1(MCP-1)水平是否是区分拉丁美洲系统性红斑狼疮(SLE)患者中狼疮性肾炎患者的良好生物标志物。方法:招募符合美国风湿病学会修订的SLE分类标准的SLE患者。使用商用ELISA试剂盒测量尿液中NGAL和MCP-1的水平。通过ELISA测量血清抗C1q抗体。用系统性红斑狼疮疾病活动指数(SLEDAI)测量SLE活动度。采用曼-惠特尼检验比较数据,用斯皮尔曼等级相关分析连续变量之间的关联。此外,绘制了受试者工作特征曲线。结果:招募了120例SLE患者(87%为女性),中位年龄为32.8±12.1岁,中位病程为7.3±6.9年。非洲裔拉丁美洲人狼疮性肾炎的患病率和SLEDAI评分显著高于混血儿。这三种生物标志物在狼疮性肾炎患者中显著高于无狼疮性肾炎的患者。此外,活动性狼疮性肾炎患者的尿NGAL和MCP-1显著高于非活动性狼疮性肾炎患者。非洲裔拉丁美洲患者的尿NGAL水平显著更高。所有SLE患者狼疮性肾炎尿液生物标志物的受试者工作特征曲线显示出良好的敏感性和特异性水平。结论:在我们的SLE患者队列中,我们发现除抗C1q抗体外,尿NGAL和MCP-1是识别肾脏受累以及区分肾病患者中活动性狼疮性肾炎的有用生物标志物。

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