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ALCAM and VCAM-1 as urine biomarkers of activity and long-term renal outcome in systemic lupus erythematosus.
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet..
Department of Biomedical Engineering, University of Houston, Houston, TX, USA..
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet..
Department of Biomedical Engineering, University of Houston, Houston, TX, USA..
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2019 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, article id kez528Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: We investigated the cell adhesion molecules (CAMs) Vascular CAM 1 (VCAM-1) and Activated Leucocyte CAM (ALCAM) as urinary biomarkers in SLE patients with and without renal involvement.

METHODS: Female SLE patients (n = 111) and non-SLE population-based controls (n = 99) were enrolled. We measured renal activity using the renal domain of the BILAG index and urine (U) and plasma (P) concentrations of soluble (s)VCAM 1 and U-sALCAM using ELISA. U-sCAM levels were next corrected by U-creatinine.

RESULTS: U-sVCAM-1/creatinine and U-sALCAM/creatinine ratios were higher in SLE patients vs non-SLE controls (P < 0.001 for both), as well as in patients with active/low-active (BILAG A-C; n = 11) vs quiescent (BILAG D; n = 19) LN (P = 0.023 and P = 0.001, respectively). U-sALCAM/creatinine but not U-sVCAM-1/creatinine ratios were higher in patients with nephritis history (BILAG A-D; n = 30) vs non-renal SLE (BILAG E; n = 79) (P = 0.014). Patients with baseline U-sVCAM-1/creatinine ratios ≥75th percentile showed a 23-fold increased risk of a deterioration in estimated glomerular filtration rate by ≥25% during a 10-year follow-up (odds ratio: 22.9; 95% CI: 2.8, 189.2; P = 0.004); this association remained significant after adjustments for age, disease duration and organ damage. Traditional markers including anti-dsDNA antibodies did not predict this outcome.

CONCLUSION: While high U-sVCAM-1 levels appear to reflect SLE disease activity, sALCAM might have particular importance in renal SLE. Both U-sVCAM-1 and U-sALCAM showed ability to distinguish SLE patients with active renal involvement from patients with quiescent or no prior nephritis. High U-sVCAM-1 levels may indicate patients at increased risk for long-term renal function loss.

Place, publisher, year, edition, pages
2019. article id kez528
Keywords [en]
adhesion molecules, biomarkers, lupus nephritis, systemic lupus erythematosus, urinary biomarkers
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:uu:diva-398555DOI: 10.1093/rheumatology/kez528PubMedID: 31722419OAI: oai:DiVA.org:uu-398555DiVA, id: diva2:1376031
Available from: 2019-12-06 Created: 2019-12-06 Last updated: 2019-12-06

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