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Correlation of urinary mcp-1 and tweak with renal histology and early response to therapy in newly biopsied patients with lupus nephritis in cape town, South Africa
Background: There is need for judicious use of immunosuppression in patients with active lupus nephritis (LN), however this is guided by renal biopsy which is invasive and not freely available in most centres. Novel urinary biomarkers such as monocyte chemoattractant protein-1 (MCP-1) and tumour nec...
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| Format: | Thesis |
| Language: | English |
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Department of Medicine
2020
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| _version_ | 1867613221314101248 |
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| access_status_str | Open Access |
| author | Moloi, Mothusi Walter |
| author2 | Okpechi, Ikechi |
| author_browse | Moloi, Mothusi Walter Okpechi, Ikechi |
| author_facet | Okpechi, Ikechi Moloi, Mothusi Walter |
| author_sort | Moloi, Mothusi Walter |
| collection | Thesis |
| description | Background: There is need for judicious use of immunosuppression in patients with active lupus nephritis (LN), however this is guided by renal biopsy which is invasive and not freely available in most centres. Novel urinary biomarkers such as monocyte chemoattractant protein-1 (MCP-1) and tumour necrosis factor-like weak inducer of apoptosis (TWEAK) are secreted in the kidney and may be useful for predicting histological class, monitoring flares and assessing response to therapy. We assessed the utility of urinary MCP-1 (uMCP-1) and TWEAK (uTWEAK) in predicting renal histological findings, disease flares and treatment response 6 months following initiation of treatment for LN in newly biopsied patients. Methods: We recruited consenting patients with active LN confirmed on kidney biopsy. Relevant baseline demographic, biochemical and histological information was collected from the patients. ELISA methods were used to assess uMCP-1 and uTWEAK at baseline and at 6 months after completion of induction therapy. Results: There were 14 females and 6 male patients with a mean age of 29.8 ± 10.7 years, 60% were of mixed ancestry, 70% had proliferative LN. There was no association between uMCP-1 and uTWEAK and histological features (LN class, activity index, chronicity index and interstitial fibrosis). At 6 months, 6 patients were lost to follow-up and of the remaining 14, 12 (85%) attained remission (partial remission (n = 7) or complete remission (n = 5)). Both biomarkers were elevated in patients with active disease and significantly declined amongst those attaining remission, p = 0.018 and p = 0.015 respectively. However, for those not attaining remission, no association was found for both biomarkers (p >0.05). Conclusion: Our study did not show correlation between uMCP-1 and uTWEAK with histological features of LN. However, both biomarkers were elevated in patients with active disease and correlated with the remission status at the end of induction phase of treatment. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/31724 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:41.376Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/31724 Correlation of urinary mcp-1 and tweak with renal histology and early response to therapy in newly biopsied patients with lupus nephritis in cape town, South Africa Moloi, Mothusi Walter Okpechi, Ikechi Rusch, Jody Alan Lupus nephritis urinary biomarkers activity index chronicity index monocyte chemoattractant protein-1 tumour necrosis factor-like weak inducer of apoptosis Background: There is need for judicious use of immunosuppression in patients with active lupus nephritis (LN), however this is guided by renal biopsy which is invasive and not freely available in most centres. Novel urinary biomarkers such as monocyte chemoattractant protein-1 (MCP-1) and tumour necrosis factor-like weak inducer of apoptosis (TWEAK) are secreted in the kidney and may be useful for predicting histological class, monitoring flares and assessing response to therapy. We assessed the utility of urinary MCP-1 (uMCP-1) and TWEAK (uTWEAK) in predicting renal histological findings, disease flares and treatment response 6 months following initiation of treatment for LN in newly biopsied patients. Methods: We recruited consenting patients with active LN confirmed on kidney biopsy. Relevant baseline demographic, biochemical and histological information was collected from the patients. ELISA methods were used to assess uMCP-1 and uTWEAK at baseline and at 6 months after completion of induction therapy. Results: There were 14 females and 6 male patients with a mean age of 29.8 ± 10.7 years, 60% were of mixed ancestry, 70% had proliferative LN. There was no association between uMCP-1 and uTWEAK and histological features (LN class, activity index, chronicity index and interstitial fibrosis). At 6 months, 6 patients were lost to follow-up and of the remaining 14, 12 (85%) attained remission (partial remission (n = 7) or complete remission (n = 5)). Both biomarkers were elevated in patients with active disease and significantly declined amongst those attaining remission, p = 0.018 and p = 0.015 respectively. However, for those not attaining remission, no association was found for both biomarkers (p >0.05). Conclusion: Our study did not show correlation between uMCP-1 and uTWEAK with histological features of LN. However, both biomarkers were elevated in patients with active disease and correlated with the remission status at the end of induction phase of treatment. 2020-04-30T07:59:31Z 2020-04-30T07:59:31Z 2019 2020-04-30T07:21:17Z Master Thesis Masters MPhil https://hdl.handle.net/11427/31724 eng application/pdf Department of Medicine Faculty of Health Sciences |
| spellingShingle | Lupus nephritis urinary biomarkers activity index chronicity index monocyte chemoattractant protein-1 tumour necrosis factor-like weak inducer of apoptosis Moloi, Mothusi Walter Correlation of urinary mcp-1 and tweak with renal histology and early response to therapy in newly biopsied patients with lupus nephritis in cape town, South Africa |
| thesis_degree_str | Master's |
| title | Correlation of urinary mcp-1 and tweak with renal histology and early response to therapy in newly biopsied patients with lupus nephritis in cape town, South Africa |
| title_full | Correlation of urinary mcp-1 and tweak with renal histology and early response to therapy in newly biopsied patients with lupus nephritis in cape town, South Africa |
| title_fullStr | Correlation of urinary mcp-1 and tweak with renal histology and early response to therapy in newly biopsied patients with lupus nephritis in cape town, South Africa |
| title_full_unstemmed | Correlation of urinary mcp-1 and tweak with renal histology and early response to therapy in newly biopsied patients with lupus nephritis in cape town, South Africa |
| title_short | Correlation of urinary mcp-1 and tweak with renal histology and early response to therapy in newly biopsied patients with lupus nephritis in cape town, South Africa |
| title_sort | correlation of urinary mcp 1 and tweak with renal histology and early response to therapy in newly biopsied patients with lupus nephritis in cape town south africa |
| topic | Lupus nephritis urinary biomarkers activity index chronicity index monocyte chemoattractant protein-1 tumour necrosis factor-like weak inducer of apoptosis |
| url | https://hdl.handle.net/11427/31724 |
| work_keys_str_mv | AT moloimothusiwalter correlationofurinarymcp1andtweakwithrenalhistologyandearlyresponsetotherapyinnewlybiopsiedpatientswithlupusnephritisincapetownsouthafrica |