Abstract
BackgroundUrine is increasingly becoming an attractive biological fluid in clinical practice due to being an easily obtained, non-invasive sampling method, containing proteins and peptides. The aim of this study was to investigate eosinophiluria, urinary eosinophil cationic protein (uECP) and urinary IL-5 (uIL-5) in patients with Lupus Nephritis.MethodsSeventy-four patients with SLE—20 with clinical and laboratory evidence of lupus nephritis (LN group) and 54 without evidence of renal involvement (non-LN group)—were analyzed regarding eosinophiluria, uECP and uIL-5. Eosinophiluria was observed by Hansel's stain, ECP by fluoroenzymeimmunoassay and uIL-5 by quantitative sandwich enzyme immunoassay. Both uECP and urinary IL-5 (uIL-5) were corrected by urinary creatinine. Eosinophiluria and uECP were compared with glomerular erythrocyturia, protein/creatinine ratio (Pr/Cr ratio), serum creatinine, estimated glomerular filtration rate (eGFR), anti-double-stranded DNA (anti-dsDNA), serum levels of complement (C3 and C4), uIL-5/Cr ratio, and SLE disease activity index.ResultsPatients of the LN group had higher eosinophiluria, uECP, uECP/Cr ratio levels, and uIL-5 than patients of the non-LN group (p<0.001 for all). These variables showed a statistically significant correlation with glomerular erythrocyturia, casts, Pr/Cr ratio, serum creatinine, eGFR, anti-dsDNA, uIL-5/Cr, and SLE disease activity index (all p<0.05).ConclusionThese results provide evidence of increased urinary eosinophils, ECP and IL-5 in patients with SLE and LN; uECP/Cr ratio showed better correlation with markers of renal function and SLE disease activity.
Highlights
Urine is increasingly becoming an attractive biological fluid in clinical practice due to being an obtained, non-invasive sampling method, containing proteins and peptides
The precise pathogenesis of Lupus nephritis (LN) has not been fully elucidated, it is mostly attributable to the glomerular deposition of immune complexes and imbalance of the cytokine homeostasis, [7] which leads to a cascade of inflammatory events with recruitment of mononuclear cells, such as T cells, macrophages, and dendritic cells [8]
Proteinuria was defined as Pr/Cr ratio, due to a strong correlation between the results found by two methods and in accordance with the recommendation of the Renal Disease Subcommittee of the American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Response Criteria [19]
Summary
Urine is increasingly becoming an attractive biological fluid in clinical practice due to being an obtained, non-invasive sampling method, containing proteins and peptides. In response to the diverse stimuli, eosinophils are recruited from the circulation to inflammatory foci where they modulate immune responses through an array of mechanisms, such as secretion of cationic proteins and expression of receptors for cytokines, immunoglobulins, complement, and mRNA for a number of Toll-like receptors. They can initiate antigen-specific immune responses by acting as antigen-presenting cells [10,11,12,13,14]
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