Update of Lupus Nephritis Overview and Diagnostic Biomarkers

Abstract

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multi‐organ involvement, among which kidney is one of the most commonly affected organs.Systemic lupus erythematosus is a multisystem autoimmune disorder where interplay of environmental and genetic risk factors leads to progressive loss of tolerance to nuclear antigens over time, finally culminating in clinical disease. It is a disease that can affect persons of all ages and ethnic groups and both sexes, but more than 90% of new patients presenting with SLE are women in the childbearing years. SLE is a disease that affects multiple systems. SLE is a complex disease process demonstrating dysregulation of the immune system at multiple levels. Autoantibodies that have been implicated in disease include anti-Ro, La, Sm, nucleosome, NMDA receptor, phospholipid, and α-actinin. Two major theories exist on how these autoantibodies cause tissue damage. The first model suggests that anti-double-stranded DNA antibodies bind to circulating nucleosomes to form immune complexes that then get deposited in end-organ capillary beds such as the renal glomerulus and activate immune/inflammatory responses. The second hypothesizes that these autoantibodies cross-react with normal renal proteins causing tissue destruction. The source of autoantigens that trigger the formation of the aforementioned antibodies is thought to arise from apoptotic cells

Objective:The aim of the present literature is to focus on lupus nephritis and the update of diagnostic biomarkers that reflect disease activity and also being predictors for the complications especially urinary angiostatin.

Conclusion:There are multiple urinary serum and traditional biomarkers for diagnosing lupus nephritis. The novel urinary biomarker angiostatin could be helping for differentiation between active renal from active non-renal disease in patients with SLE.