Value of Urinary Transferrin, Urinary Ceruloplasmin and Urinary Neutrophil Gelatinase Associated Lipocalin as biomarkers in Pediatric Lupus Nephritis

Sharaf, Mohammad A.; Hossny, Elham; Wahba, Nancy S.; Hegazy, Mohammad A.; Warsame, Abdulrahman A.; Abdelmottaleb, Sara E.; El-Owaidy, Rasha

doi:10.21608/ejpa.2023.321394

Value of Urinary Transferrin, Urinary Ceruloplasmin and Urinary Neutrophil Gelatinase Associated Lipocalin as biomarkers in Pediatric Lupus Nephritis

Document Type : Original Article

Authors

¹ Pediatric Nephrology Unit, Ain Shams University

² Professor of Pediatrics Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

³ Clinical Pathology Department, Faculty of Medicine, Ain Shams University

⁴ Ministry of Public Health Hospitals, Cairo, Egypt

⁵ Public Health Hospital, Benadir, Somalia.

⁶ Associate professor of Pediatrics and Pediatric Allergy, Immunology and Rheumatology, Ain-Shams University, Egypt. Member, ESPAI, WAO, EAACI, ESID, ASID

10.21608/ejpa.2023.321394

Abstract

Background: Lupus nephritis is an important cause of pediatric lupus morbidity and mortality. We sought to investigate the value of urinary transferrin (uTF), urinary ceruloplasmin (uCP) and urinary Neutrophil Gelatinase Associated Lipocalin (uNGAL) as non-invasive biomarkers of renal involvement in pediatric SLE. Methods: We conducted a comparative cross-sectional study over a period of 6 months at the Pediatric Allergy, Immunology and Rheumatology Unit, Ain Shams University. The study included a total number of 60 subjects; 40 patients with SLE and 20 age and sex-matched healthy subjects. Urinary levels of the three biomarkers (uTF, uCP and uNGAL) were measured by ELISA, in relation to other lupus clinical, urinary and serum parameters. Results: The studied patients had mean age 14.35 ± 2.3 years and 85 % (n = 34) were females. Among patients with LN (n=20), 8 (40%) had class II, 8 (40%) class III and 4 (20%) class IV LN. We observed significantly higher uTF levels, uCP expression and uNGAL levels among lupus patients compared to controls (p<0.001). In addition, the 3 studied biomarkers were significantly higher among LN group compared to SLE without LN (p<0.001). Levels of uTF, uCP and uNGAL showed significant positive correlations with 24-hour urinary proteins, serum creatinine and significant negative correlations with serum albumin, and estimated Glomerular Filtration Rate. Conclusion: Urinary TF, uCP and uNGAL might serve as non-invasive biomarkers of LN in pediatric and adolescent SLE. Their significant elevation in active cases may reflect a potential predictive value of renal flares and may serve as a valuable affordable tool in the follow-up of LN.

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