Abstract
Previous studies have shown that serum VEGF levels were elevated in patients with active systemic lupus erythematosus (SLE), especially in those with lupus nephritis (LN). In this case control study, we aimed to compare serum levels of VEGF in SLE patients between LN, non-LN and healthy participants to determine the association between serum VEGF levels and the activity and histological classes of lupus nephritis. Blood samples were obtained from 92 SLE patients (46 LN and 46 non-LN) and 26 controls. Data were collected from medical records. Serum VEGF assays were performed by specific, enzyme-linked immunosorbent assay kits (ELISA). Laboratory investigations included urinalysis, urine protein-creatinine ratio, serum creatinine, albumin and VEGF levels. Blood pressure, renal biopsy result and treatment were recorded. LN activity was evaluated using the renal subscale of the British Isles Lupus Assessment Group (rBILAG, 2004). The rBILAG measures blood pressure (diastolic and systolic), urine protein, serum creatinine, calculated glomerular filtration rate (GFR), presence of active urinary sediments and histological evidence of active nephritis. Serum VEGF was elevated in SLE patients with LN compared with the non-LN group and healthy controls. The levels found were significantly higher in the sera of patients with active nephritis compared to those with quiescent nephritis (P = 0.024). The study did not find a statistically significant relationship between serum VEGF levels and histological classes of LN. There was no significant difference of serum VEGF level between LN and non-LN SLE groups and between the non-LN group and healthy controls. However, there were increased levels of serum VEGF in the LN group, especially in patients with active nephritis as compared to quiescent nephritis group. This reflects the role of VEGF in the pathogenesis of lupus nephritis, however the clinical potential of this biomarker needs further study.
Highlights
Materials and MethodsSystemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with a broad spectrum of clinical presentations [1]
Our study found a significant increase of median serum vascular endothelial growth factor (VEGF) level as severity of nephritis increased, and the highest median VEGF level was seen in the severe nephritis group
Our study demonstrated that the level of serum VEGF was elevated in systemic lupus erythematosus (SLE) patients with lupus nephritis (LN) as compared to those with non-LN SLE and healthy controls
Summary
Materials and MethodsSystemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with a broad spectrum of clinical presentations [1]. Tests for proteinuria, urine protein–to–creatinine ratio, creatinine clearance, anti-dsDNA and complement levels currently used in the diagnosis of lupus nephritis are inadequate [4]. They lack sensitivity and specificity for differentiating renal activity and damage in lupus nephritis [5]. Previous studies have shown that serum VEGF levels were elevated in patients with active systemic lupus erythematosus (SLE), especially in those with lupus nephritis (LN). In this case control study, we aimed to compare serum levels of VEGF in SLE patients between LN, non-LN and healthy participants to determine the association between serum VEGF levels and the activity and histological classes of lupus nephritis
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