Abstract
BackgroundTo date, the association of serum macrophage migration inhibitory factor (MIF) and serum adipokines with lupus nephritis is controversial.ObjectiveTo assess the utility of serum MIF, leptin, adiponectin and resistin levels as markers of proteinuria and renal dysfunction in lupus nephritis.MethodsCross-sectional study including 196 systemic lupus erythematosus (SLE) patients and 52 healthy controls (HCs). Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Renal SLE involvement was investigated by renal-SLEDAI. MIF, adiponectin, leptin and resistin levels were quantified by ELISA. We assessed the correlations of quantitative variables by Spearman correlation (rs). Multivariable linear regression adjusted the variables associated with the severity of proteinuria.ResultsSLE patients had higher MIF (p = 0.02) and adiponectin (p < 0.001) than HCs. Patients with renal SLE involvement (n = 43) had higher adiponectin (19.0 vs 13.3 μg/mL, p = 0.002) and resistin (10.7 vs 8.9 ng/mL, p = 0.01) than patients with non-renal SLE (n = 153). Proteinuria correlated with high adiponectin (rs = 0.19, p < 0.009) and resistin (rs = 0.26, p < 0.001). MIF (rs = 0.27, p = 0.04). Resistin correlated with increased creatinine (rs = 0.18, p = 0.02). High renal-SLEDAI correlated with adiponectin (rs = 0.21, p = 0.004). Multiple linear regression showed that elevated adiponectin (p = 0.02), younger age (p = 0.04) and low MIF (p = 0.02) were associated with the severity of proteinuria. Low MIF and high adiponectin levels interacted to explain the association with the severity of proteinuria (R2 = 0.41).ConclusionsHigh adiponectin combined with low MIF concentrations int+eract to explain the severity of proteinuria in renal SLE. These findings highlight the relevance of adiponectin, resistin and MIF as markers of LN.
Highlights
To date, the association of serum macrophage migration inhibitory factor (MIF) and serum adipokines with lupus nephritis is controversial
High adiponectin combined with low MIF concentrations int+eract to explain the severity of proteinuria in renal Systemic lupus erythematosus (SLE)
These findings highlight the relevance of adiponectin, resistin and MIF as markers of Lupus nephritis (LN)
Summary
The association of serum macrophage migration inhibitory factor (MIF) and serum adipokines with lupus nephritis is controversial. Traditional markers of LN, such as increased native double-stranded DNA antibody (anti-dsDNA) and decreased C3 and C4 complement fractions, are currently used in the clinical assessment of LN [5]; these markers do not appear to have sufficient sensitivity for detecting LN in a subgroup of SLE patients, new nontraditional markers should be tested [6]. Among these other markers of LN are included the serum levels of adipokines and cytokines. MIF is a pleiotropic cytokine with a wide variety of proinflammatory and immunomodulatory functions, including the regulation of the inflammatory response mediated by
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