Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


Urinary and Serum Monocyte Chemotactic Protein-1 and Interferon Gamma-Induced Protein-10 Are Good Markers to Assess Lupus Activity.

Abujam,  Bonnie, Swamy,  Satyanarayana, Aggarwal,  Amita

Background/Purpose:

Interferon gamma-induced protein-10 (IP-10) and Monocyte chemoattractant protein-1 (MCP–1) are pro-inflammatory chemokines. IP-10 promotes the recruitment of monocytes, T and NK cells bearing CXCR3 receptor into inf lamed sites whereas MCP-1 plays a role in recruitment of monocytes and lymphocytes. These chemokines may be involved in the immunopathogenesis of lupus nephritis. Data on urinary MCP-1 and IP-10 are limited in human SLE.

Methods:

SLE patients fulfilling ACR 1997 criteria and providing consent were included. SLEDAI was assessed and blood and urine samples collected. Active lupus was defined as SLEDAI>=4. Active patients were divided into active renal lupus if they had proteinuria >=500mg/day or active sediment (>=5 RBC or 5 WBC or any cellular casts per hpf) and active non-renal lupus. 'Renal SLEDAI' was calculated using four urinary parameters of SLEDAI. Patients with active renal lupus were followed till the nephritis became inactive when a second sample of urine and blood were collected. Serum and urinary levels of MCP-1 and IP-10 (pg/ml) were measured by ELISA (BD Opt EIA). Urinary values were normalised for urinary spot creatinine (pg/mg creatinine).

Results:

The study included 78 active and 58 inactive lupus patients. Of 78 active patients, 46 were active renal whereas 32 were active non-renal. Their median age was 25 (IQR 10–55) years and SLE duration was 23 (IQR 6–48) months. The levels of MCP-1 and IP-10 in different groups is given below:

ParameterActive renal (N = 46)Active non renal (N = 32)Active total (N = 78)Inactive (N = 58)
Urinary MCP-146.2 (19.9–125.3) ##12.7 (5.8–43.9)35.1 (12.7–71.8)**9.5 (4.4–17)
Urinary IP-1012.5 (5.6–22.7) #5.2 (2.9–12.1)9.5 (4.4–17.9)**3.9 (1.9–9.3)
Serum IP-10690 (465–1000)477 (327.5–1307.5)665 (387–1189.3)**334 (220–512.3)
Serum MCP-1703.5 (542.5–1000)680 (455–987.5)700 (500–1000)*520 (354.5–789.5)
[Values are median (Inter Quartile Range);*p<0.05,** p<0.001 as compared to inactive lupus,#p=0.01,##p<0.001 as compared to active non-renal lupus]

Most markers had good correlation with SLEDAI, urinary MCP-1 (r= 0.57, 95% CI 0.38–0.70), urinary IP-10 (r= 0.40; 95% CI 0.19–0.57), serum IP-10 (r=0.51; 95% CI 0.32–0.66) and serum MCP-1 (r= 0.21; 95% CI 0.01–0.38). On longitudinal follow (n=24) of active renal patients, there was a significant decrease in urinary levels of MCP-1 and IP-10 (p=0.005) as well as serum levels of IP-10 (p=0.003) however there was no difference in serum MCP-1 levels.

Conclusion:

Urinary and serum IP-10 and urinary MCP-1 are good markers of lupus activity. Further, urinary MCP-1 and IP-10 can differentiate between renal and non-renal active disease. Urinary MCP-10 and IP-10 can also be used for follow up of lupus nephritis patients. Thus, urinary levels seem to be specific for renal inflammation whereas serum levels are reflective of generalised lupus activity.

To cite this abstract, please use the following information:
Abujam, Bonnie, Swamy, Satyanarayana, Aggarwal, Amita; Urinary and Serum Monocyte Chemotactic Protein-1 and Interferon Gamma-Induced Protein-10 Are Good Markers to Assess Lupus Activity. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1654
DOI:

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