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Go DJ, Lee JY, Kang MJ, Lee EY, Lee EB, Yi EC, Song YW. Urinary vitamin D-binding protein, a novel biomarker for lupus nephritis, predicts the development of proteinuric flare. Lupus 2018; 27:1600-1615. [PMID: 29958502 DOI: 10.1177/0961203318778774] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Lupus nephritis (LN) is a major complication of systemic lupus erythematosus (SLE). Conventional biomarkers for assessing renal disease activity are imperfect in predicting clinical outcomes associated with LN. The aim of this study is to identify urinary protein biomarkers that reliably reflect the disease activity or predict clinical outcomes. A quantitative proteomic analysis was performed to identify protein biomarker candidates that can differentiate between SLE patients with and without LN. Selected biomarker candidates were further verified by enzyme-linked immunosorbent assay using urine samples from a larger cohort of SLE patients ( n = 121) to investigate their predictive values for LN activity measure. Furthermore, the association between urinary levels of a selected panel of potential biomarkers and prognosis of LN was assessed with a four-year follow-up study of renal outcomes. Urinary vitamin D-binding protein (VDBP), transthyretin (TTR), retinol binding protein 4 (RBP4), and prostaglandin D synthase (PTGDS) were significantly elevated in SLE patients with LN, especially in patients with active LN ( n = 21). Among them, VDBP well correlated with severity of proteinuria (rho = 0.661, p < 0.001) and renal SLE Disease Activity Index (renal SLEDAI) (rho = 0.520, p < 0.001). In the four-year follow-up, VDBP was a significant risk factor (hazard ratio 9.627, 95% confidence interval 1.698 to 54.571, p = 0.011) for the development of proteinuric flare in SLE patients without proteinuria ( n = 100) after adjustments for multiple confounders. Urinary VDBP correlated with proteinuria and renal SLEDAI, and predicted the development of proteinuria.
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Affiliation(s)
- D J Go
- 1 Division of Rheumatology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.,2 Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea
| | - J Y Lee
- 2 Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea
| | - M J Kang
- 2 Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea
| | - E Y Lee
- 3 Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - E B Lee
- 3 Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - E C Yi
- 2 Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea
| | - Y W Song
- 2 Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Institute, Seoul National University, Seoul, Korea.,3 Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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di Masi A, Trezza V, Leboffe L, Ascenzi P. Human plasma lipocalins and serum albumin: Plasma alternative carriers? J Control Release 2016; 228:191-205. [PMID: 26951925 DOI: 10.1016/j.jconrel.2016.02.049] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 02/23/2016] [Accepted: 02/24/2016] [Indexed: 01/14/2023]
Abstract
Lipocalins are an evolutionarily conserved family of proteins that bind and transport a variety of exogenous and endogenous ligands. Lipocalins share a conserved eight anti-parallel β-sheet structure. Among the different lipocalins identified in humans, α-1-acid glycoprotein (AGP), apolipoprotein D (apoD), apolipoprotein M (apoM), α1-microglobulin (α1-m) and retinol-binding protein (RBP) are plasma proteins. In particular, AGP is the most important transporter for basic and neutral drugs, apoD, apoM, and RBP mainly bind endogenous molecules such as progesterone, pregnenolone, bilirubin, sphingosine-1-phosphate, and retinol, while α1-m binds the heme. Human serum albumin (HSA) is a monomeric all-α protein that binds endogenous and exogenous molecules like fatty acids, heme, and acidic drugs. Changes in the plasmatic levels of lipocalins and HSA are responsible for the onset of pathological conditions associated with an altered drug transport and delivery. This, however, does not necessary result in potential adverse effects in patients because many drugs can bind both HSA and lipocalins, and therefore mutual compensatory binding mechanisms can be hypothesized. Here, molecular and clinical aspects of ligand transport by plasma lipocalins and HSA are reviewed, with special attention to their role as alterative carriers in health and disease.
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Affiliation(s)
- Alessandra di Masi
- Dipartimento di Scienze, Università Roma Tre, Viale Marconi 446, I-00146 Roma, Italy; Istituto Nazionale di Biostrutture e Biosistemi, Via delle Medaglie d'Oro 305, I-00136 Roma, Italy.
| | - Viviana Trezza
- Dipartimento di Scienze, Università Roma Tre, Viale Marconi 446, I-00146 Roma, Italy
| | - Loris Leboffe
- Dipartimento di Scienze, Università Roma Tre, Viale Marconi 446, I-00146 Roma, Italy; Istituto Nazionale di Biostrutture e Biosistemi, Via delle Medaglie d'Oro 305, I-00136 Roma, Italy
| | - Paolo Ascenzi
- Istituto Nazionale di Biostrutture e Biosistemi, Via delle Medaglie d'Oro 305, I-00136 Roma, Italy; Laboratorio Interdipartimentale di Microscopia Elettronica, Università Roma Tre, Via della Vasca Navale 79, I-00146 Roma, Italy
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Rana A, Minz RW, Aggarwal R, Sharma S, Pasricha N, Anand S, Singh S. A comparative proteomic study of sera in paediatric systemic lupus erythematosus patients and in healthy controls using MALDI-TOF-TOF and LC MS-A pilot study. Pediatr Rheumatol Online J 2012; 10:24. [PMID: 22901283 PMCID: PMC3551672 DOI: 10.1186/1546-0096-10-24] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 06/26/2012] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Paediatric systemic lupus erythematosus (pSLE) exhibits an aggressive clinical phenotype with severe complications and overall poor prognosis. The aim of this study was to analyse differential expression of low molecular weight (LMW) serum protein molecules of pSLE patients with active disease in comparison to sera of healthy age matched controls. Further, some of the differential expressed spots were characterised and identified by Matrix Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF-MS) and liquid chromatography (LC-MS). METHODS 2D-PAGE was performed using pooled sera of active pSLE and age matched healthy controls. Gels were silver-stained and differentially expressed protein spots were detected by automated image master platinum 2D software. 79 ± 17 protein spots were detected for control gels and 78 ± 17 protein spots for patient gels. Of these eleven protein spots were selected randomly and characterized by MALDI-TOF MS (five protein spots) and LC MS (six protein spots) techniques. RESULTS Out of the 11 protein spots, 5 protein spots were significantly upregulated viz., leiomodin 2 (LMOD2); epidermal cytokeratin 2; immunoglobulin kappa light chain variable region; keratin 1 and transthyretin (TTR). Three protein spots were significantly down regulated e.g., apolipoprotein A1 (APOA1); chain B human complement component C3c; campath antibody antigen complex. Two protein spots (complement component C3; retinol binding protein (RBP) were found to be expressed only in disease and one protein spot cyclohydrolase 2 was only expressed in controls. CONCLUSIONS We conclude that 2-D maps of patients with active pSLE and controls differ significantly. In this pilot study, using proteomic approach we have identified differential expressed proteins (of LMW) e.g., RBP, LMOD 2, TTR, Component C3c Chain B and APO A1. However, in future, further studies need to confirm the physiological and pathological role of these proteins in similar cohorts of pSLE.
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Affiliation(s)
- Anita Rana
- Department of Immunopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Ranjana W Minz
- Department of Immunopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Ritu Aggarwal
- Department of Immunopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Sadhna Sharma
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Neelam Pasricha
- Department of Immunopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Shashi Anand
- Department of Immunopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Surjit Singh
- Paediatric Allergy Immunology Unit Advanced Paediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
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Marks SD, Shah V, Pilkington C, Woo P, Dillon MJ. Renal tubular dysfunction in children with systemic lupus erythematosus. Pediatr Nephrol 2005; 20:141-8. [PMID: 15622502 DOI: 10.1007/s00467-004-1707-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2003] [Revised: 08/30/2004] [Accepted: 09/10/2004] [Indexed: 10/26/2022]
Abstract
Renal tubular and glomerular function was studied in patients under 18 years of age with childhood-onset systemic lupus erythematosus (SLE) in relation to disease activity in two groups: patients with clinical or laboratory evidence of lupus nephritis and those without (lupus non-nephritis). We reviewed 11 patients with lupus non-nephritis and 10 patients with lupus nephritis over a 12-month period. The measured glomerular filtration rates had a tendency to be lower in the lupus nephritis group. Glomerular dysfunction was manifest in the lupus nephritis group with elevated urinary albumin/creatinine ratios (P <0.001). Markers of tubular function were measured and compared with data from 94 controls. The lupus nephritis group had elevated urinary NAG [N-acetyl-beta-D-glucosaminidase (P =0.001)] and RBP [retinol-binding protein (P =0.03)] levels. Tubular dysfunction with elevated urinary NAG levels was present in 2 lupus non-nephritis patients with no evidence of glomerular disease. The cohort of patients in this study was followed and 2 lupus non-nephritis patients with the highest urinary RBP levels developed evidence of glomerular dysfunction and biopsy-proven lupus nephritis. Evidence of tubular dysfunction in lupus non-nephritis patients may help to identify lupus nephritis prior to the onset of albuminuria.
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Affiliation(s)
- Stephen D Marks
- Nephro-Urology Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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Abstract
Lipocalins as biochemical markers of disease have been used extensively. The clinical indications relate to almost any field of medicine, such as inflammatory disease, cancer, lipid disorders, liver and kidney function. Some of the more well-known lipocalins that have been used as markers of disease are orosomucoid, Protein HC (alpha(1)-microglobulin), apolipoprotein D, retinol-binding protein, complement C8 gamma, prostaglandin D synthase and human tear prealbumin, and these markers will be briefly reviewed in this article. Emphasis, however, will be put on the description of another newly described lipocalin, i.e. human neutrophil lipocalin/neutrophil gelatinase-associated lipocalin (HNL/NGAL), since the body fluid measurement of HNL/NGAL was shown to be a superior means to distinguish between acute viral and bacterial infections and also to accurately reflect the activity and involvement of neutrophils in a variety of other diseases.
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Affiliation(s)
- S Xu
- Department of Medical Sciences, Clinical Chemistry, University of Uppsala, S-751 85 Uppsala, Sweden.
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Momeni N, Ramanathan K, Larsson PO, Danielsson B, Bengmark S, Khayyami M. CCD-camera based capillary chemiluminescent detection of retinol binding protein. Anal Chim Acta 1999. [DOI: 10.1016/s0003-2670(99)00037-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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