ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1845

HMGB1 Early Marker in  Lupus Nephritis

Aisha Badawy1, Randa Salam2, Hanan Fouad3, Amira Bassam4 and Sahar Lashen5, 1Internal medicine cairo university, professor of internal medicine and rheumatology, cairo, Egypt, 2Internal medicine cairo university, Assistant professor internal medicine, cairo, Egypt, 3medical biochemistry cairo university, Professor of medical biochemistry, cairo, Egypt, 4pathology Cairo university, Lecturer of Pathology Cairo university, cairo, Egypt, 5Internal medicine, assistant lecturer of internal medicine cairo university, cairo, Egypt

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Monday, November 9, 2015

Title: Systemic Lupus Erythematosus - Human Etiology and Pathogenesis Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

Systemic Lupus Erythematosis  is a systemic autoimmune disease characterised by involvement of multiple organ systems     Lupus nephritis (LN) is a severe and frequent manifestation of systemic lupus erythematosis (SLE). Its pathogenesis has not been fully elucidated but immune complexes are considered to contribute to the inflammatory pathology in LN.

The aim of the study  to assess the potential role of HMGB1 (high-mobility group box proteins) in SLE and whether urinary and serum levels of HMGB1 reflect renal inflammation and correlate with disease activity,

Methods:

In a Case control study 61 Systemic lupus patients fulfilling the classification criteria for the diagnosis of SLE ( divided in 4 groups )selected from Internal Medicine Department, Kasr Al-Aini Hospital, Cairo University after ethical committee approval and getting written informed consent from each patient.

Group 1: 21 patients with lupus nephritis ,Group 2: 21 patients with lupus activity without nephritis .Group 3: 19 patients without activity as estimated by SLEDAI < 4 ,Group 4:included 13 healthy volunteers age and sex matched. 

Participants were subjected to: Detailed medical history., Complete physical examination. disease activity   scoring  using SLEDAI.

Laboratory investigations:  Complete blood count.  ,Kidney function tests , Urine analysis,ESR,ANA,,Anti dsDNA. ,C3, C4 levels.  plasma and urinary levels of HMGB1 assessed by ELISA

Study of HMGB1 in renal biopsy from 21 patients with active lupus nephritis The activity index (AI) and chronicity index (CI) were calculated for each specimen with maximum scores of 24 for the AI and 12 for the CI.

Cellular distribution of HMGB1 was determined in the kidney by counting one hundred nuclei (glomerular, tubular, and stromal) in three bright field pictures and scoring both HMGB1-positive (brown) and HMGB1-negative (blue) nuclei  

Results:

 Plasma and urinary HMGB1 were in lupus with activity however  significantly elevated in patients with active LN compared to patients without active nephritis(p<0.037).  and control(p<0.001).Plasma and urinary HMGB1 and renal tissue levels HMGB1 levels correlated with SLEDAI differentiating SLE without nephritis from SLE with nephritis  using ROC curve a higher sensitivity and specificity of HMGB1 in lupus nephritis compared  with other groups 95.1% and 100% respectively Similarly, renal tissue of active LN patients showed strong expression of HMGB1 at cytoplasmic and extracellular sites suggesting active release of HMGB1

Conclusion:

The present study demonstrates increase in plasma, urine, renal tissue HMGB1 levels in SLE patients, in particular in those with active LN. Increase in HMGB1 levels correlated to SLE activity index (SLEDAI). Thus  we suggest that HMGB1 may play an important role in renal pathology in SLE patients and HMGB1 blocking may be of future interest in  development  new treatment strategies for lupus nephritis

Disclosure: A. Badawy, None; R. Salam, None; H. Fouad, None; A. Bassam, None; S. Lashen, None.

To cite this abstract in AMA style:

Badawy A, Salam R, Fouad H, Bassam A, Lashen S. HMGB1 Early Marker in  Lupus Nephritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/hmgb1-early-marker-in-lupus-nephritis/. Accessed .

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