Insulin‐like growth factor binding protein‐2 as a novel biomarker for disease activity and renal pathology changes in lupus nephritis

Summary Lupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus. Invasive renal biopsy remains the gold standard for the diagnosis and management of LN. The objective of this study is to validate serum insulin‐like growth factor binding protein‐2 (IGFBP‐2) as a...

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Published in:	Clinical and experimental immunology Vol. 184; no. 1; pp. 11 - 18
Main Authors:	Ding, H., Kharboutli, M., Saxena, R., Wu, T.
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 01-04-2016 John Wiley and Sons Inc
Subjects:	Adult Aged Area Under Curve biomarkers Biomarkers - blood Creatinine - blood Cross-Sectional Studies Diagnosis, Differential Enzyme-Linked Immunosorbent Assay Female Humans IGFBP2 Insulin-Like Growth Factor Binding Protein 2 - blood Kidney - metabolism Kidney - pathology lupus nephritis Lupus Nephritis - blood Lupus Nephritis - diagnosis Lupus Nephritis - pathology Male Middle Aged Original pathology Renal Insufficiency, Chronic - blood Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - pathology Severity of Illness Index lupus nephritis pathology biomarkers IGFBP2
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Summary:	Summary Lupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus. Invasive renal biopsy remains the gold standard for the diagnosis and management of LN. The objective of this study is to validate serum insulin‐like growth factor binding protein‐2 (IGFBP‐2) as a novel biomarker for clinical disease and renal pathology in LN. Eighty‐five biopsy‐proven lupus nephritis patients, 18 chronic kidney disease (CKD) patients and 20 healthy controls were recruited for enzyme‐linked immunosorbent assay (ELISA) testing of serum IGFBP‐2 levels. Compared to CKD patients of origins other than lupus or healthy controls, serum IGFBP‐2 levels were elevated significantly in LN patients. Serum IGFBP‐2 was able to discriminate LN patients from the other two groups of patients [area under the curve (AUC) = 0·65, 95% confidence interval (CI) = 0·52–0·78; P = 0·043 for LN versus CKD; 0·97, 95% CI = 0·93–1·00; P < 0·0001 for LN versus healthy controls]. Serum IGFBP‐2 was a potential indicator of both global disease activity and renal disease activity in LN patients, correlated with serum creatinine levels (r = 0·658, P < 0·001, n = 85) and urine protein‐to‐creatinine levels (r = 0·397, P < 0·001, n = 85). More importantly, in 19 concurrent patient samples, serum IGFBP‐2 correlated with the chronicity index of renal pathology (r = 0·576, P = 0·01, n = 19) but not renal pathological classification. In conclusion, serum IGFBP‐2 is a promising biomarker for lupus nephritis, reflective of disease activity and chronicity changes in renal pathology.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0009-9104 1365-2249
DOI:	10.1111/cei.12743