Urinary HER2 as a biomarker for lupus nephritis (Year Four Update)
Clinical and translational pediatric lupus nephritis biomarker panel research conducted on behalf of the Lupus Foundation of America’s Michael Jon Barlin Pediatric Research Program
Children and teens with lupus typically have more severe lupus in general, more years of disease burden, and have a higher rate of kidney inflammation. These complications can lead to development of lupus nephritis (lupus kidney disease). Therefore, early detection and intervention of inflammation in the kidneys are absolutely essential.
Nephritis is a leading cause of disability and death in lupus.
In support of its goal to increase early diagnosis and treatment of lupus, the Lupus Foundation of America is funding a five-year study by Dr. Kathleen Sullivan and her team at The Children’s Hospital of Philadelphia. They are looking at the urine-based protein HER2 as a possible biomarker to pinpoint flares of lupus nephritis (lupus kidney disease). Earlier studies by Dr. Sullivan have shown HER2 to be successful in identifying kidney inflammation.
About Lupus Kidney Disease
There are two major categories of lupus kidney disease, proliferative and non-proliferative. The non proliferative disease is serious but has a better prognosis. The profilerative kidney disease requires early and aggressive therapy. For more information on lupus nephritis visit the National Resource Center on Lupus. A non-invasive lab test, based on examination of urine, has enormous potential to improve medical care for children (and potentially for adults) with proliferative disease.
The Goal of This Study
This research study is inline with the LFA’s objective to deliver the most significant impact on peoples' lives in the shortest time possible. Dr. Sullivan’s five-year project seeks to validate HER2 as a screening biomarker for a rapid test that will warn children and teens with lupus nephritis, their families, and their healthcare providers of impending flares and potential kidney damage.
This study is the largest ever conducted to date in lupus nephritis in children. It holds promise to significantly improve detection of a potentially life-threatening complication of lupus among children and teens.
Results Achieved to Date
In a 2017 analysis, HER2 demonstrated an 80% accuracy of indicating flares in lupus nephritis. As of October 1, 2018, comparisons to individuals who did not have lupus show that HER2 activity in lupus nephritis patients does indicate drastic changes in the kidneys. This finding further supports the original premise of using HER2 as a useful biomarker to predict diseae activity which is typically seen in proliferative lupus nephritis. These are encouraging and hopeful developments in efforts to solve the cruel mystery of lupus and improve care for everyone living with this disease.
Future Plans/Next Steps
Dr. Sullivan is working with Dr. Michele Petri at Johns Hopkins Medicine in Baltimore, Maryland to conduct the same research in adults. To date the results look promising; however, more analysis is needed. During the final year of the LFA-funded project, Dr. Sullivan and her colleagues will look further into whether HER2 can accurately test for lupus nephritis.