Serum, Urinary and Tissue Monocyte Chemoattractant Protein 1 in Patients with Lupus Nephritis (A Comparative Study)

Background: Lupus Nephritis (LN) is one of the most common complications and is considered a crucial determinant of poor prognosis in Systemic Lupus Erythematosus (SLE) patients. Yet it is still a challenge for scientists to establish a sensitive and specific investigations that reflect renal status and can be linked to disease outcome and most importantly easy follow up with less hassle for the patient. Aim of the work: This study was done to estimate the serum and urinary Monocyte chemoattractant protein 1 (MCP-1) levels as non invasive markers in patients with SLE with comparison to tissue MCP1 and to evaluate the role of MCP-1 as an indicator for SLE disease activity and renal involvement (lupus nephritis). Patients and methods: Serum and urinary MCP-1 were determined in forty randomly selected adult SLE patients their ages in years ranged from 17-54 (27.7+/-7.9 years), the control group included twenty age and sex matched volunteers. SLE Disease Activity score (SLEDAI and the Systemic Lupus International Collaborating Clinics (SLICC) Damage Index was recorded in all SLE patients. All patients were subjected to clinical and routine lab investigations. Serum and Urinary MCP1 were evaluated by ELISA technique. Renal biopsy was performed in Lupus nephritis patients for Histopathological classification, Activity and Chronicity indices and immunohistochemistry for MCP1 protein expression. Results: There was significant difference in level of urinary MCP 1 only in active than in inactive patients. In SLE with LN, serum and urinary MCP 1 showed a highly significant positive correlation with SLEDAI, proteinuria and serum creatinine and significant negative correlations with Hemoglobin. Urinary MCP1 showed highly significant difference between LN (class III\&IV) and other classes of LN (p<0.001). Glomerular and tubulointerstitial MCP1 protein expression showed significant positive correlation with proteinuria (p=0.046 and 0.002 respectively). Tubulointerstitial MCP-1 protein expression showed significant difference between LN(class I, II, V) cases versus LN (class III, IV) cases (p=0.008). Glomerular MCP1 showed highly significant positive correlation with activity index, while Tubulointerstitial MCP1 showed highly significant positive correlation with chronicity index (p <0.001). Urinary MCP1 showed positive significant correlation with both glomerular and tubulointerstitial MCP1 protein expression(p <0.001 and 0.016 respectively). Urinary MCP1 showed highly significant correlation with activity index (p <0.001), while Serum MCP1 showed no significant correlation with activity or chronicity indices. Conclusion: MCP1 could be a valuable marker for LN and can help in assessment of disease outcome and follow up of patients, furthermore, Urinary MCP1 in our study proved to be a sensitive, non invasive tool for assessment of LN patients that can be linked to Histopathological classes and tissue MCP1 protein expression. {[}Eman E. El-Shahawy, Heba H. Gawish, Eman H. Abd El-Bary. Serum, Urinary and Tissue Monocyte Chemoattractant Protein 1 in Patients with Lupus Nephritis (A Comparative Study). Life Sci J 2012; 9(2): 865-873].