From the Department of Internal Medicine, Rheumatology and Clinical Immunology Unit.
Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
J Clin Rheumatol. 2021 Dec 1;27(8):e469-e476. doi: 10.1097/RHU.0000000000001553.
BACKGROUND/OBJECTIVE: A search for the ideal biomarker for lupus nephritis (LN) is still underway, one that can be used for early detection and correlate with the class and activity of LN. Urine is normally devoid of leukocytes; however, it has been observed that macrophages and T lymphocytes are routinely present in the urine of LN patients and those with other proliferative renal diseases. This provides the idea for their potential use as biomarkers for proliferative LN. Here, we measured the urinary CD4+, CD8+ T lymphocytes, and CD14+ monocytes in patients with systemic lupus erythematosus (SLE) as potential biomarkers for LN.
A longitudinal case-control study included 30 SLE patients with LN, 30 SLE patients without past or current LN, and 20 healthy subjects as a control group. The flow cytometric analysis was done using BD FACS Calibur multiparameter flow cytometer equipped with BD CellQuest Pro software for data analysis.
CD14+ cells were the most abundant cells in the urine of LN patients. The mean numbers of urinary CD8+, CD4+, and CD14+ cells/mL were significantly higher in patients with LN than in those without. The cell counts correlated significantly with proteinuria. Urinary CD14+ cells seem to occur in much higher counts in class IV than class III LN.
Urinary CD8+, CD4+, and CD14+ cells are highly sensitive and specific markers for detecting proliferative LN. A low CD4:CD8 ratio provides a further clue. Urinary CD14 cell counts may be a potential biomarker to differentiate between the different classes of proliferative LN.
背景/目的：目前仍在寻找狼疮肾炎（LN）的理想生物标志物，该标志物可用于早期检测，并与 LN 的类型和活动相关。尿液通常不含白细胞；然而，已经观察到 LN 患者和其他增殖性肾脏疾病患者的尿液中经常存在巨噬细胞和 T 淋巴细胞。这为它们作为增殖性 LN 的潜在生物标志物提供了思路。在这里，我们测量了系统性红斑狼疮（SLE）患者尿液中的 CD4+、CD8+T 淋巴细胞和 CD14+单核细胞，作为 LN 的潜在生物标志物。
一项纵向病例对照研究纳入了 30 例 LN 患者、30 例无既往或当前 LN 的 SLE 患者和 20 名健康受试者作为对照组。使用配备有 BD CellQuest Pro 软件的 BD FACS Calibur 多参数流式细胞仪进行流式细胞术分析。
LN 患者尿液中 CD14+细胞最为丰富。LN 患者尿液中 CD8+、CD4+和 CD14+细胞的平均数量明显高于无 LN 患者。细胞计数与蛋白尿显著相关。尿液 CD14+细胞在 IV 级 LN 中似乎出现更高的计数。
尿液 CD8+、CD4+和 CD14+细胞是检测增殖性 LN 的高度敏感和特异标志物。CD4:CD8 比值降低提供了进一步的线索。尿 CD14 细胞计数可能是区分不同类型增殖性 LN 的潜在生物标志物。
