New "High Tech" Approach to "Low Tech" Urine Analysis May Provide Way for Doctors to Better Monitor Kidney Involvement of Their Lupus Patients
Rheumatology, Volume 45, Number 12, December 2006, Pages 1497-1504
Urinary proteomic profiles distinguish between active and inactive lupus nephritis
One of the most difficult complications of lupus to take care of is kidney involvement. This is a potentially serious condition that needs close monitoring, especially since inflammation can sometimes be occurring in the kidneys without the patient experiencing symptoms. Unfortunately, the tests that are currently available to determine whether there is disease in the kidney and/or whether the treatments are working are less than optimal.
A group of researchers in London may have come upon a solution, applying a sophisticated technology to patient urine samples to see whether such a "low-tech" sample could provide important information using "high-tech" advances. They used a special kind of mass spectrometry (SELDI-TOF MS) to compare the differences in very small proteins in urine samples from 49 lupus patients with inactive kidney disease and 26 patients with active kidney disease. This technology was able to identify proteins that were associated with active kidney involvement. Some patients were followed over time, and it turned out that the proteins that were picked up by this technology could predict both improving and relapsing kidney disease earlier than traditional clinical tests.
The sensitive mass spectrometry techniques used by the London research team have already been proven useful in identifying protein patterns associated with other kinds of kidney disease. With this study, the researchers have demonstrated that it can help detect proteins associated with kidney disease activity among lupus patients as well, especially proteins associated with remission (when the disease is inactive) and relapse (when disease activity comes back). Being able to detect these proteins earlier in the course of the disease could help doctors tailor their medical treatments for individual patients. In addition, if it turns out that the tiny proteins identified through this technique might also be involved in the process of kidney disease, they could become targets for new therapies to help treat kidney disease in lupus.
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