Understanding Role of Biomarkers for Lupus Nephritis Treatment Prediction

Initial research by Lupus Foundation of America Gina M. Finzi Memorial Fellowship Awardee Farnoosh Naderinabi, under the supervision of Dr. Murray Urowitz and Dr. Laura Whittall-Garcia, reveals a possible connection between biomarkers in plasma and reaction to treatment for lupus kidney disease or lupus nephritis (LN).

The levels of neutrophil extracellular trap cells, or “NETs,” (specifically, Elastase-DNA and Elastase-oxDNA complexes) in the plasma of 47 people with active lupus and 20 people with inactive disease were analyzed. NETs are like “traps” used by the immune system to stop and kill invading viruses and bacteria and, they can be an indication of heightened immune response. Those with active disease exhibited higher levels of the complexes and 17 (36.2%) had kidney involvement. This group also exhibited higher levels of Elastase-DNA, and those with proliferative LN also had higher levels of the same complex. Proliferative LN is associated with a higher risk of progression to end stage kidney disease.

To further test a possible connection of these complexes with LN, the levels of plasma at the time of renal flare were assessed in another group of 113 people with active LN disease, 90 of which had a kidney biopsy at the time of the flare. Again, those with active proliferative LN exhibited higher levels of Elastase-DNA.

Overall, those with higher levels of Elastase-DNA did not respond well to LN treatment.

“Our hope is to increase the quality of life of lupus patients by preserving their kidney function. To reach this goal, we need sensitive and specific biomarkers that can predict if a patient will respond to the available therapies and which ones will be the best option for each individual patient,” says Farnoosh Naderinabi, Gina M. Finzi Fellow with the Lupus Foundation of America.

Studies indicate that over time up to 60% of people with lupus will develop LN. Better understanding of potential biomarkers to predict response to LN treatment is important. Naderinabi’s research contributes to growing knowledge of the disease, ultimately growing closer to better treatment. Learn more about Naderinabi and her research efforts.