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Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study
INTRODUCTION: TNF-like weak inducer of apoptosis (TWEAK) has been implicated as a mediator of chronic inflammatory processes via prolonged activation of the NF-κB pathway in several tissues, including the kidney. Evidence for the importance of TWEAK in the pathogenesis of lupus nephritis (LN) has be...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2009
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2787265/ https://www.ncbi.nlm.nih.gov/pubmed/19785730 http://dx.doi.org/10.1186/ar2816 |
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author | Schwartz, Noa Rubinstein, Tamar Burkly, Linda C Collins, Christopher E Blanco, Irene Su, Lihe Hojaili, Bernard Mackay, Meggan Aranow, Cynthia Stohl, William Rovin, Brad H Michaelson, Jennifer S Putterman, Chaim |
author_facet | Schwartz, Noa Rubinstein, Tamar Burkly, Linda C Collins, Christopher E Blanco, Irene Su, Lihe Hojaili, Bernard Mackay, Meggan Aranow, Cynthia Stohl, William Rovin, Brad H Michaelson, Jennifer S Putterman, Chaim |
author_sort | Schwartz, Noa |
collection | PubMed |
description | INTRODUCTION: TNF-like weak inducer of apoptosis (TWEAK) has been implicated as a mediator of chronic inflammatory processes via prolonged activation of the NF-κB pathway in several tissues, including the kidney. Evidence for the importance of TWEAK in the pathogenesis of lupus nephritis (LN) has been recently introduced. Thus, TWEAK levels may serve as an indication of LN presence and activity. METHODS: Multicenter cohorts of systemic lupus erythematosus (SLE) patients and controls were recruited for cross-sectional and longitudinal analysis of urinary TWEAK (uTWEAK) and/or serum TWEAK (sTWEAK) levels as potential biomarkers of LN. The performance of TWEAK as a biomarker for nephritis was compared with routinely used laboratory tests in lupus patients, including anti-double stranded DNA antibodies and levels of C3 and C4. RESULTS: uTWEAK levels were significantly higher in LN patients than in non-LN SLE patients and other disease control groups (P = 0.039). Furthermore, uTWEAK was better at distinguishing between LN and non-LN SLE patients than anti-DNA antibodies and complement levels, while high uTWEAK levels predicted LN in SLE patients with an odds ratio of 7.36 (95% confidence interval = 2.25 to 24.07; P = 0.001). uTWEAK levels peaked during LN flares, and were significantly higher during the flare than at 4 and 6 months prior to or following the flare event. A linear mixed-effects model showed a significant association between uTWEAK levels in SLE patients and their disease activity over time (P = 0.008). sTWEAK levels, however, were not found to correlate with the presence of LN or the degree of nephritis activity. CONCLUSIONS: High uTWEAK levels are indicative of LN, as opposed to non-LN SLE and other healthy and disease control populations, and reflect renal disease activity in longitudinal follow-up. Thus, our study further supports a role for TWEAK in the pathogenesis of LN, and provides strong evidence for uTWEAK as a candidate clinical biomarker for LN. |
format | Text |
id | pubmed-2787265 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2009 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-27872652009-12-02 Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study Schwartz, Noa Rubinstein, Tamar Burkly, Linda C Collins, Christopher E Blanco, Irene Su, Lihe Hojaili, Bernard Mackay, Meggan Aranow, Cynthia Stohl, William Rovin, Brad H Michaelson, Jennifer S Putterman, Chaim Arthritis Res Ther Research article INTRODUCTION: TNF-like weak inducer of apoptosis (TWEAK) has been implicated as a mediator of chronic inflammatory processes via prolonged activation of the NF-κB pathway in several tissues, including the kidney. Evidence for the importance of TWEAK in the pathogenesis of lupus nephritis (LN) has been recently introduced. Thus, TWEAK levels may serve as an indication of LN presence and activity. METHODS: Multicenter cohorts of systemic lupus erythematosus (SLE) patients and controls were recruited for cross-sectional and longitudinal analysis of urinary TWEAK (uTWEAK) and/or serum TWEAK (sTWEAK) levels as potential biomarkers of LN. The performance of TWEAK as a biomarker for nephritis was compared with routinely used laboratory tests in lupus patients, including anti-double stranded DNA antibodies and levels of C3 and C4. RESULTS: uTWEAK levels were significantly higher in LN patients than in non-LN SLE patients and other disease control groups (P = 0.039). Furthermore, uTWEAK was better at distinguishing between LN and non-LN SLE patients than anti-DNA antibodies and complement levels, while high uTWEAK levels predicted LN in SLE patients with an odds ratio of 7.36 (95% confidence interval = 2.25 to 24.07; P = 0.001). uTWEAK levels peaked during LN flares, and were significantly higher during the flare than at 4 and 6 months prior to or following the flare event. A linear mixed-effects model showed a significant association between uTWEAK levels in SLE patients and their disease activity over time (P = 0.008). sTWEAK levels, however, were not found to correlate with the presence of LN or the degree of nephritis activity. CONCLUSIONS: High uTWEAK levels are indicative of LN, as opposed to non-LN SLE and other healthy and disease control populations, and reflect renal disease activity in longitudinal follow-up. Thus, our study further supports a role for TWEAK in the pathogenesis of LN, and provides strong evidence for uTWEAK as a candidate clinical biomarker for LN. BioMed Central 2009 2009-09-28 /pmc/articles/PMC2787265/ /pubmed/19785730 http://dx.doi.org/10.1186/ar2816 Text en Copyright ©2009 Schwartz et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research article Schwartz, Noa Rubinstein, Tamar Burkly, Linda C Collins, Christopher E Blanco, Irene Su, Lihe Hojaili, Bernard Mackay, Meggan Aranow, Cynthia Stohl, William Rovin, Brad H Michaelson, Jennifer S Putterman, Chaim Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study |
title | Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study |
title_full | Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study |
title_fullStr | Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study |
title_full_unstemmed | Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study |
title_short | Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study |
title_sort | urinary tweak as a biomarker of lupus nephritis: a multicenter cohort study |
topic | Research article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2787265/ https://www.ncbi.nlm.nih.gov/pubmed/19785730 http://dx.doi.org/10.1186/ar2816 |
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