Urinary Interleukin 6: A Prognostic Bio Marker in Lupus Nephritis

Authors

  • Vijay Pratap Singh Consultant nephrologists Gorakhpur, Uttar Pradesh, India
  • Deba Prasad Kar Department of Nephrology, IMS and SUM hospital, Siksha “O” Anusandhan University (Deemed to be), K8, Kalinga nagar, Bhubaneswar-751003, Odisha, India
  • Bandita Dash Department of health centre, National Institute of Science Education and Research, Bhubaneswar, Khurda 752050, Odisha, India
  • Jatindra Nath Mohanty Medical Research Laboratory, IMS and SUM hospital, Siksha “O” Anusandhan University (Deemed to be), K8, Kalinga nagar,Bhubaneswar-751003, Odisha, India.

DOI:

https://doi.org/10.48165/z0mbme45

Keywords:

Urinary IL-6, Lupus nephritis, Bio marker, Urinary protein

Abstract

Background: Lupus nephritis is an frequent and potentially serious complication of SLE. It is an inflammatory disease of connective tissue  and immune system, where we find organs and cells undergo damage initially mediated by tissue-restricting auto antibodies and immune  complexes. Our aim was to evaluate the association of urinary interleukin 6 in lupus nephritis patients and validate its use as a prognostic  marker. For this we took the complete demographic profiling of the participant patients along with all biochemical parameter were checked.  For IL-6 analysis, we analyzed the whole immunological profile and correlated the level of urinary proteins, serum creatinine and urinary IL-6.  The mean values of urinary IL-6 at presentation and after 6 months of treatment were calculated. Any change after 6 months was noted and  correlation of Il-6 with disease activity scores was observed. Urinary IL-6 was found to be significantly high in patients of lupus nephritis than  controls. Urinary IL-6 was higher in patients of severe form of lupus nephritis such as Class IV than other classes of lupus nephritis. Urinary  IL-6 may be used as a prognostic marker of lupus nephritis. The patients who achieved complete remission had near normal levels of urinary  IL-6 and patients with partial remission had decreased level of urinary IL-6 than at presentation after 6 months of induction phase treatment.  But patients with no remission did not show any significant decrease in urinary IL-6 levels at 6 months. So, urinary Il-6 may be used to  monitor the response to therapy. 

References

1. Bevra Hannahs H. (2015) Harrison’s Principles of Internal Medicine;19th Edition, McGrawHill Education; 378: 2124-34. 2. Bernard R, Lauwerys FA. Houssiau, Matthias Schneider (2015) Systemic Lupus Erythematosus: Treatment: eular Textbook on Rheumatic Diseases: 2nd Edition, BMJ 558-575.

3. Brochers AT, Leibushor N, Naguwa SM, Cheema GS, Shoenfeld Y, Gershwin ME. (2012) Lupus Nephritis: a clinical review;Autoimmun. Rev, 2:174-194.

4. Pons-Estel GJ, Serrano R, Plasin MA, Espinosa G, Cervera R. (2011) Epidemiology and Management of Refractory Lupus Nephritis; Autoimmun. Rev, 11: 655-663.

5. Bertsias GK, Salmon JE, Boumpas DT. (2010) Therapeutic opportunities in systemic lupus erythematosus: state of the art and prospects for the new decade. Ann Rheum Dis, 69:1603–11.

6. Dienz O, Rincon M (2009) The effects of IL-6 on CD4 T cell responses. Clin Immunol 130: 27–33.

7. Richards HB, Satoh M, Shaw M, Libert C, Poli V, Reeves WH (1998) Interleukin 6 dependence of anti-DNA antibody production: evidence for two pathways of autoantibody formation in pristaneinduced lupus. J Exp Med 188:985–990

8. Iwano M, Dohi K, Hirata E et al (1993) Urinary levels of IL-6 in patients with active lupus nephritis. Clin Nephrol 40:16–21. 9. Bogdanović R, Nikolić V, Pašić S, Dimitrijević J, Lipkovska Marković J, Erić-Marinković J, Ognjanović M, Minić A, Stajić N. (2004) Lupus nephritis in childhood: a review of 53 patients followed at a single center. Pediatric Nephrology. 19(1):36-44.

10. Rothfield N, Sontheimer RD, Bernstein M. (2006) Lupus erythematosus: systemic and cutaneous manifestations. Clinics in dermatology 24(5): 348-62.

11. Neumann K, Wallace DJ, Azen C, Nessim S, Fichman M, Metzger AL, Klinenberg JR. (1995) Lupus in the 1980s: III. Influence of clinical variables, biopsy, and treatment on the outcome in 150 patients with lupus nephritis seen at a single center. In Seminars in arthritis and rheumatism. 25 (1): 47-55.

12. Chinnadurai R, Lin YJ, Agarwal S, Nair B, Ponnusamy A. (2018) SP176 a ssociations of renal function decline in lupus nephritis-a single centre experience of over 12 years. Nephrology Dialysis Transplantation. 33(1): 403-4.

13. Tunnicliffe DJ, Palmer SC. (2018) Immunosuppressive treatment for proliferative lupus nephritis: summary of a Cochrane Review. American Journal of Kidney Diseases. 72(5):756-7.

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Published

2019-11-30

How to Cite

Urinary Interleukin 6: A Prognostic Bio Marker in Lupus Nephritis . (2019). Academia Journal of Medicine, 2(2), 81–85. https://doi.org/10.48165/z0mbme45