Investigating Kidney Biomarkers to Track Lupus


Autoimmune disease treatment is getting challenging for doctors to handle as the numbers only keep increasing as the years pass by. Lupus is one such autoimmune disease affecting the skin, joints, kidneys, brain, and lungs.
Lupus Treatment
                                                                        

The chances of the disease affecting the kidneys are high in Lupus affected patients.  While there are many patients undergoing Lupus treatment in Pune, there is still a need for kidney biomarkers that can detect histopathological and clinical lupus activity and have a long-lasting treatment response.

What is a kidney biomarker?
A biomarker or a biological marker is a measuring indicator used to measure a specific biological state or activity of the disease.  A kidney biomarker detects the activity of a disease or kidney injury.

A Glimpse into kidney biomarkers:
Primitive methods such as serum criterion or BUN (blood urea nitrogen) fail to detect the actual renal activity damage. Moreover, conventional methods are not strong enough to detect continuous activities in lupus affected kidneys, and the chances of a relapse are high. Hence, a need for a novel biomarker that can detect early renal flare, monitor the response, diagnose sensitivity and accuracy of the disease has become a necessity. Such a biomarker will not only speed up the autoimmune disease treatment process but also reduce kidney damage.

An ideal biomarker should have the following characteristics:
•Correspond to the disease or activity occurring in the renal function.
•Should be sensitive to change and monitor kidney activities for appropriate treatment
•Able to detect early renal flare for specific treatment. Avoid further clinical changes and kidney damage.
•Kidney biomarkers should be able to detect early stages of lupus nephritis. It should easy to access, interpret and available.

Some of the biomarkers that seem to predict flare are:
1. MCP-1 or Monocyte chemoattractant protein-1 is a leukocyte chemotactic factor used as a biomarker to detect renal activity in Lupus kidneys. As it involves pathogenesis in renal injury and inflammation, the MCP-1 reflects higher nephritis activity in urine levels. Hence it is proved to be sensitive in detecting renal flare activity and severity of the flare.

2. NGAL or Neutrophil gelatinase-associated lipocalin is a low weight antibacterial molecular protein. Its levels seemed to increase in kidney injuries before the rise in serum creatinine. When tested on experimental models, it is seen to have a protective effect on renal tubules. It improves acute renal injury making it one of the components for biomarkers.

3. TF, AGP, CP, and L-PGDS were measured on children with Lupus kidneys. TF was seen consistent in forecasting renal flare only in patients having a flare.  AGP increased not only in patients having a flare but also the ones stable, consistent, active, improving nephritis conditions. L-PGDS increased in patients with active flares, stable, and active nephritis while, CP had no effects on flare-ups.

4. Anti c1q can be one of the biomarkers for detecting a flare-up. Its levels seemed to significantly increase before the renal flare and reduced post the flare.

Hospitals administering lupus treatment in Pune try their best to use novel biomarkers for effective treatments and reduce the toxicity levels.



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