ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1652

Biomarkers of Lupus Nephritis and Ethnic Disparities in Systemic Lupus Erythematosus

Adnan Kiani1, Laurence S. Magder2 and Michelle Petri3, 11830 E Monument St, Johns Hopkins University School of Medicine, Baltimore, MD, 2Department of Epidemiology and Public Health, University of Maryland, Baltimore, MD, 3Johns Hopkins University School of Medicine, Baltimore, MD

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment: Biomarker, Translational and Nephritis Studies

Session Type: Abstract Submissions (ACR)

Background/Purpose: Lupus nephritis eventually occurs in 50% of Caucasian SLE patients and 75% of African-Americans.  African Americans have a more severe presentation of SLE and more often progress to end stage renal disease (ESRD).  We have found a  number of serum and urine biomarkers that have been associated with lupus nephritis.  Therefore, we compared Caucasians and African-Americans with respect to levels of these biomarkers.

Methods: Urinary tumor necrosis factor-like weak inducer of apoptosis (TWEAK), vascular cell adhesion molecule 1 (VCAM-1), monocyte chemoattractant protein 1 (MCP-1) and osteoprotegrin (OPG) were measured in a longitudinal cohort of SLE patients by ELISA (R&D).  We analyzed the relationship between these potential urine biomarkers and Caucasian or African-American ethnicity.

Results: Urinary TWEAK levels were higher among Caucasians than African-Americans (p=.033).  Urinary VCAM-1, MCP-1 and OPG levels were higher among African-Americans than Caucasians, but the results were not statistically significant (Table 1). 

Table 1:  Mean (SD) of Each Biomarker by Ethnicity

 

TWEAK (p=.033)

VCAM-1 (p=0.62)

MCP-1 (p=0.16)

OPG (p=0.21)

N

Mean log-Tweak (SD)

N

Mean log OPG

(SD)

N

Mean (SD)

N

Mean (SD)

Caucasian

175

0.12 (0.10)

32

2.59 (0.96)

37

3.40 (2.00)

37

3.35 (2.44)

African-American

96

0.09 (0.09)

40

2.80 (0.85)

43

4.19 (1.77)

43

4.17 (1.94)

Conclusion:  Systemic lupus erythematosus and lupus nephritis disproportionately affect racial/ethnic minorities.  Renal outcome has not improved in African-Americans or in the South in United States.  Our results show that not all urine biomarkers are worse in African-Americans.  Surprisingly, urinary TWEAK was higher in Caucasians.  The others, however, were higher in African-Americans.  The identification of ethnicity-specific biomarkers of renal activity would allow ethnicity-specific regimens.  Further larger studies are needed to corroborate our findings.

 

Disclosure:

A. Kiani,
None;

L. S. Magder,
None;

M. Petri,
None.

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