Urinary CD4 T cells identify SLE patients with proliferative lupus nephritis and can be used to monitor treatment response

Tools

Item Type:	Article
Title:	Urinary CD4 T cells identify SLE patients with proliferative lupus nephritis and can be used to monitor treatment response
Creators Name:	Enghard, P., Rieder, C., Kopetschke, K., Klocke, J.R., Undeutsch, R., Biesen, R., Dragun, D., Gollasch, M., Schneider, U., Aupperle, K., Humrich, J.Y., Hiepe, F., Backhaus, M., Radbruch, A.H., Burmester, G.R. and Riemekasten, G.
Abstract:	OBJECTIVES: Proliferative lupus nephritis (LN) is one of the major concerns in the treatment of systemic lupus erythematosus (SLE). Here we evaluate urinary CD4 T cells as a biomarker of active LN and indicator of treatment response. METHODS: Urinary CD3CD4 T cells were quantified using flow cytometry in 186 urine samples from 147 patients with SLE. Fourteen patients were monitored as follow-up. Thirty-one patients with other nephropathies and 20 healthy volunteers were included as controls. RESULTS: In SLE, urinary CD4 T cell counts >/=800/100 ml were observed exclusively in patients with active LN. Receiver operator characteristic analysis documented clear separation of SLE patients with active and non-active LN (area under the curve 0.9969). All patients with up-to-date kidney biopsy results showing proliferative LN had high urinary CD4 T cell numbers. In patients monitored under therapy, normalisation of urinary CD4 T cell counts indicated lower disease activity and better renal function. In contrast, patients with persistence of, or increase in, urinary T cells displayed worse outcomes. CONCLUSIONS: Urinary CD4 T cells are a highly sensitive and specific marker for detecting proliferative LN in patients with SLE. Furthermore, monitoring urinary CD4 T cells may help to identify treatment responders and treatment failure and enable patient-tailored therapy in the future.
Keywords:	Biological Markers, CD4-Positive T-Lymphocytes, Cross-Sectional Studies, Drug Monitoring, Flow Cytometry, Follow-Up Studies, Immunosuppressive Agents, Lupus Nephritis, ROC Curve, Sensitivity and Specificity, Treatment Outcome, Urine
Source:	Annals of the Rheumatic Diseases
ISSN:	0003-4967
Publisher:	BMJ Publishing Group
Volume:	73
Number:	1
Page Range:	277-283
Date:	January 2014
Official Publication:	https://doi.org/10.1136/annrheumdis-2012-202784
PubMed:	View item in PubMed

Repository Staff Only: item control page