PMID- 19648301
OWN - NLM
STAT- MEDLINE
DCOM- 20100211
LR  - 20151119
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Linking)
VI  - 36
IP  - 10
DP  - 2009 Oct
TI  - Urine osteoprotegerin and monocyte chemoattractant protein-1 in lupus nephritis.
PG  - 2224-30
LID - 10.3899/jrheum.081112 [doi]
AB  - OBJECTIVE: Renal biopsy is the "gold standard" to determine renal activity in 
      systemic lupus erythematosus (SLE), but it is expensive, invasive, and carries 
      risk. Osteoprotegerin (OPG) is produced by the heart, lungs, kidney, and bone. 
      Monocyte chemoattractant protein-1 (MCP-1), a chemotactic cytokine, is involved 
      in the progression of glomerular and tubulointerstitial injury. We investigated 
      both urine OPG and MCP-1 as potential biomarkers for lupus nephritis. METHODS: 
      Our subjects, 87 patients with SLE (88% women; 48% African American, 41% 
      Caucasian, 11% other), mean age 44 years, were followed monthly to quarterly. 
      Urinary OPG (pg/ml) and MCP-1 (pg/ml) were measured (Luminex MAP bead assay). 
      RESULTS: OPG concentrations were strongly associated with global disease activity 
      and with both renal activity on a visual analog scale (VAS) (p = 0.0006) and 
      renal disease activity descriptors of the SELENA SLEDAI, including hematuria (p = 
      0.001) and a positive anti-dsDNA (p = 0.013). MCP-1 was also associated with the 
      renal VAS (p = 0.032), renal disease activity descriptors of SELENA SLEDAI, 
      including hematuria (p = 0.027), and with a positive anti-dsDNA (p = 0.016). We 
      also examined the relationship between the biomarkers and having a urine protein 
      to creatinine ratio (pr/cr) > or = 0.5. Among patients with medium or high OPG, 
      46% had urine pr/cr > or = 0.5, compared to only 23% among those with low OPG (p 
      = 0.032). The 2 biomarkers were strongly correlated with each other (Spearman 
      correlation coefficient 0.77, p < 0.0001). CONCLUSION: The lack of availability 
      of urine biomarkers has hampered development of new therapies for lupus 
      nephritis. Urine MCP-1 and OPG were both associated with measures of lupus renal 
      disease activity. Medium or high levels of OPG were predictive of a urine 
      protein/creatinine ratio of > or = 0.5. Further study, including longitudinal 
      assessment and correlation with concurrent renal biopsies, is necessary before 
      this assay can be used in the routine clinic setting.
FAU - Kiani, Adnan N
AU  - Kiani AN
AD  - Division of Rheumatology, Johns Hopkins University School of Medicine, 1830 East 
      Monument Street, Baltimore, MD 21205, USA.
FAU - Johnson, Kristen
AU  - Johnson K
FAU - Chen, Catherine
AU  - Chen C
FAU - Diehl, Edward
AU  - Diehl E
FAU - Hu, Huaizhong
AU  - Hu H
FAU - Vasudevan, Ganesh
AU  - Vasudevan G
FAU - Singh, Sukhminder
AU  - Singh S
FAU - Magder, Laurence S
AU  - Magder LS
FAU - Knechtle, Stuart J
AU  - Knechtle SJ
FAU - Petri, Michelle
AU  - Petri M
LA  - eng
GR  - AR43727/AR/NIAMS NIH HHS/United States
GR  - UL1 RR 025005/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20090731
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
RN  - 0 (Biomarkers)
RN  - 0 (CCL2 protein, human)
RN  - 0 (Chemokine CCL2)
RN  - 0 (Osteoprotegerin)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biomarkers/urine
MH  - Biopsy
MH  - Chemokine CCL2/*urine
MH  - Cohort Studies
MH  - Creatinine/urine
MH  - *Disease Progression
MH  - Female
MH  - Glomerular Filtration Rate/physiology
MH  - Humans
MH  - Kidney/pathology
MH  - Longitudinal Studies
MH  - Lupus Nephritis/physiopathology/*urine
MH  - Male
MH  - Middle Aged
MH  - Osteoprotegerin/*urine
MH  - Prospective Studies
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
EDAT- 2009/08/04 09:00
MHDA- 2010/02/12 06:00
CRDT- 2009/08/04 09:00
PHST- 2009/08/04 09:00 [entrez]
PHST- 2009/08/04 09:00 [pubmed]
PHST- 2010/02/12 06:00 [medline]
AID - jrheum.081112 [pii]
AID - 10.3899/jrheum.081112 [doi]
PST - ppublish
SO  - J Rheumatol. 2009 Oct;36(10):2224-30. doi: 10.3899/jrheum.081112. Epub 2009 Jul 
      31.