PMID- 23547217
OWN - NLM
STAT- MEDLINE
DCOM- 20131210
LR  - 20220408
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Print)
IS  - 0315-162X (Linking)
VI  - 40
IP  - 5
DP  - 2013 May
TI  - urinary biomarkers in relapsing antineutrophil cytoplasmic antibody-associated 
      vasculitis.
PG  - 674-83
LID - 10.3899/jrheum.120879 [doi]
AB  - OBJECTIVE: Glomerulonephritis (GN) is common in antineutrophil cytoplasmic 
      antibody (ANCA)-associated vasculitis (AAV), but tools for early detection of 
      renal involvement are imperfect. We investigated 4 urinary proteins as markers of 
      active renal AAV: alpha-1 acid glycoprotein (AGP), kidney injury molecule-1 
      (KIM-1), monocyte chemoattractant protein-1 (MCP-1), and neutrophil 
      gelatinase-associated lipocalin (NGAL). METHODS: Patients with active renal AAV 
      (n = 20), active nonrenal AAV (n = 16), and AAV in longterm remission (n = 14) 
      were identified within a longitudinal cohort. Urinary biomarker concentrations 
      (by ELISA) were normalized for urine creatinine. Marker levels during active AAV 
      were compared to baseline remission levels (from 1-4 visits) for each patient. 
      Areas under receiver-operating characteristic curves (AUC), sensitivities, 
      specificities, and likelihood ratios (LR) comparing disease states were 
      calculated. RESULTS: Baseline biomarker levels varied among patients. All 4 
      markers increased during renal flares (p < 0.05). MCP-1 discriminated best 
      between active renal disease and remission: a 1.3-fold increase in MCP-1 had 94% 
      sensitivity and 89% specificity for active renal disease (AUC = 0.93, positive LR 
      8.5, negative LR 0.07). Increased MCP-1 also characterized 50% of apparently 
      nonrenal flares. Change in AGP, KIM-1, or NGAL showed more modest ability to 
      distinguish active renal disease from remission (AUC 0.71-0.75). Hematuria was 
      noted in 83% of active renal episodes, but also 43% of nonrenal flares and 25% of 
      remission samples. CONCLUSION: Either urinary MCP-1 is not specific for GN in 
      AAV, or it identifies early GN not detected by standard assessment and thus has 
      potential to improve care. A followup study with kidney biopsy as the gold 
      standard is needed.
FAU - Lieberthal, Jason G
AU  - Lieberthal JG
AD  - Department of Medicine, Section of Rheumatology, Boston University School of 
      Medicine, Boston, Massachusetts, USA.
FAU - Cuthbertson, David
AU  - Cuthbertson D
FAU - Carette, Simon
AU  - Carette S
FAU - Hoffman, Gary S
AU  - Hoffman GS
FAU - Khalidi, Nader A
AU  - Khalidi NA
FAU - Koening, Curry L
AU  - Koening CL
FAU - Langford, Carol A
AU  - Langford CA
FAU - Maksimowicz-McKinnon, Kathleen
AU  - Maksimowicz-McKinnon K
FAU - Seo, Philip
AU  - Seo P
FAU - Specks, Ulrich
AU  - Specks U
FAU - Ytterberg, Steven R
AU  - Ytterberg SR
FAU - Merkel, Peter A
AU  - Merkel PA
FAU - Monach, Paul A
AU  - Monach PA
CN  - Vasculitis Clinical Research Consortium
LA  - eng
GR  - RC1 AR058303/AR/NIAMS NIH HHS/United States
GR  - U01 AR051874/AR/NIAMS NIH HHS/United States
GR  - M01 RR000533/RR/NCRR NIH HHS/United States
GR  - K24 AR002224/AR/NIAMS NIH HHS/United States
GR  - RC1 AR0508303-01/AR/NIAMS NIH HHS/United States
GR  - U54 RR019497/RR/NCRR NIH HHS/United States
GR  - M01 RR001066/RR/NCRR NIH HHS/United States
GR  - UL1 TR000439/TR/NCATS NIH HHS/United States
GR  - U54 AR057319/AR/NIAMS NIH HHS/United States
GR  - U01 AR51874-0/AR/NIAMS NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
DEP - 20130401
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
RN  - 0 (Acute-Phase Proteins)
RN  - 0 (Biomarkers)
RN  - 0 (Chemokine CCL2)
RN  - 0 (HAVCR1 protein, human)
RN  - 0 (Hepatitis A Virus Cellular Receptor 1)
RN  - 0 (LCN2 protein, human)
RN  - 0 (Lipocalin-2)
RN  - 0 (Lipocalins)
RN  - 0 (Membrane Glycoproteins)
RN  - 0 (Orosomucoid)
RN  - 0 (Proto-Oncogene Proteins)
RN  - 0 (Receptors, Virus)
SB  - IM
MH  - Acute-Phase Proteins/urine
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated 
      Vasculitis/complications/*diagnosis/urine
MH  - Biomarkers/*urine
MH  - Chemokine CCL2/urine
MH  - Female
MH  - Glomerulonephritis/*diagnosis/etiology/urine
MH  - Hepatitis A Virus Cellular Receptor 1
MH  - Humans
MH  - Lipocalin-2
MH  - Lipocalins/urine
MH  - Male
MH  - Membrane Glycoproteins/urine
MH  - Middle Aged
MH  - Orosomucoid/urine
MH  - Predictive Value of Tests
MH  - Proto-Oncogene Proteins/urine
MH  - ROC Curve
MH  - Receptors, Virus
MH  - Recurrence
MH  - Time Factors
MH  - Young Adult
PMC - PMC4505819
MID - NIHMS703967
OTO - NOTNLM
OT  - BIOMARKERS
OT  - GLOMERULONEPHRITIS
OT  - MONOCYTE CHEMOATTRACTANT PROTEIN-1
OT  - VASCULITIS
OT  - WEGENER GRANULOMATOSIS
EDAT- 2013/04/03 06:00
MHDA- 2013/12/16 06:00
PMCR- 2015/07/17
CRDT- 2013/04/03 06:00
PHST- 2013/04/03 06:00 [entrez]
PHST- 2013/04/03 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
PHST- 2015/07/17 00:00 [pmc-release]
AID - jrheum.120879 [pii]
AID - 10.3899/jrheum.120879 [doi]
PST - ppublish
SO  - J Rheumatol. 2013 May;40(5):674-83. doi: 10.3899/jrheum.120879. Epub 2013 Apr 1.