دراسة بعض الواسمات المناعية والكيميائية الحيوية لدى مرضى التهاب الكلية الذئبي

Study of Some Immunological and Biochemical Parameters in Patients with Lupus Nephritis

Lupus nephritis is caused by the formation of an immune complex that develops as a complication of systemic lupus erythematosus. The pathogenesis of lupus nephritis involves a variety of disease-causing mechanisms. The extrinsic etiology of systemic lupus erythematosus depends on multiple groups of genetic variants that affect those mechanisms responsible for immune tolerance to self-nuclear antigens. The increasing incidence of end-stage renal failure underscores the importance of early diagnosis of this disease.
This study aims to investigate some immune markers, which included estimating the concentrations of the phospholipase A2 receptor (PLA2R), the neutrophil gelatinase associated Lipocaline (NGAL), vascular cellular adhesion molecules (VCAM), and urinary epidermal growth factor (UEGF), in addition to studying some biochemical parameters such as urea and creatinine. The study also included estimating the concentrations of Extract nuclear antigen (ENA)., antinuclear antibodies (ANA), antibodies to double-stranded DNA (dsDNA), and concentrations of complement components (C1q, C3, C4).
The results of the phospholipase A2 receptor test on blood samples showed that (5) samples from the women gave a positive result and that they had primary glomerulonephritis, so they were excluded from the study, while the remaining (80) samples showed a negative result for this test so that they had systemic lupus erythematosus. The disease samples were divided based on traditional tests. It was divided into three groups: women with severe lupus nephritis 30 samples, moderate lupus nephritis 20 samples, and systemic lupus erythematosus 30 samples.
The results of the analyzes showed an increase in the concentrations of antinuclear antibodies (ANA) and antibodies to double-stranded deoxyribonucleic acid (dsDNA) in patients with severe lupus nephritis compared to patients with moderate lupus nephritis and patients with systemic lupus erythematosus, while the results of complement components showed a decrease in their concentrations in patients with Severe lupus nephritis compared to patients with moderate lupus nephritis and patients with systemic lupus erythematosus.
The results of the extracted nuclear antigen (ENA) study also showed that 77% of patients suffer from lupus nephritis alone, while 23% of patients suffer from lupus nephritis and other immune diseases.
The study showed an increase in the concentration of the neutrophil gelatinase associated lipocaline in patients with severe lupus nephritis compared to patients with moderate lupus nephritis and systemic lupus erythematosus, where the concentration reached (1027.53± 259.01, 768.82± 228.8, 715.89± 173.9 ng/ml), respectively. It also showed The study showed an increase in the concentration of vascular cellular adhesion molecules for the three groups, reaching (21.43± 5.83, 13.6± 2.63, 13.56± 12.28 ng/ml), respectively. The results also showed a significant decrease in urinary epidermal growth factor concentrations for patients with severe lupus nephritis compared to moderate lupus nephritis and systemic lupus erythematosus reaching (145.97± 45.55
, 195.78±60.38, 339.15± 85.59ng/ml), respectively.
The results showed that urea and creatinine concentrations increased significantly for patients with severe lupus nephritis compared to moderate lupus nephritis and systemic lupus erythematosus.
The results also showed a significant positive relationship between urinary epidermal growth factor and complement components, as well as a significant positive relationship between the neutrophils gelatinase associated Lipocaline concentration and vascular cellular adhesion molecules.
Decrease in urinary epidermal growth factor concentration in patients with moderate to severe lupus nephritis makes it a good marker for predicting kidney failure at an early stage.