Potential Pathogenic Role of Urinary and Renal Tissue Level of High Mobility Group Box 1 (HMGB1) in Lupus Nephritis,
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- Category: Vol. 84, March 2016
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Potential Pathogenic Role of Urinary and Renal Tissue Level of High Mobility Group Box 1 (HMGB1) in Lupus Nephritis, AYSHA I. BADAWI, HANAN H. FOUAD, RANDA F. SALAM, AMIRA M. BASSAM and SAHAR A. AHMED
Abstract
Introduction: Systemic Lupus Erythematosis (SLE) is a systemic autoimmune disease characterised by involvement of multiple organ systems. HMGB 1 is a nuclear non-histone protein secreted by many cells, during activation or cell death.
Aim of Work: We aim to study the potentialpathogenetic role of HMGB 1in SLE and whether urinary and renal biopsy levels reflect renal inflammation and correlate with disease activity.
Methods: In a case control study, 61 systemic lupus patients and 18 healthy volunteers, were divided in 4 groups. Group 1: 21 patients with lupus nephritis. Group 2: 21 patients with lupus activity without nephritis. Group 3: 19 patients without activity. Group 4: 18 healthy volunteers, age and sex matched. Participants were subjected to history taking, physical examination, activity scoring using SLEDAI, complete blood count, kidney function tests, ESR, ANA, Anti dsDNA, C3 and C4 level urinary levels of HMGB 1 by ELISA. Study of HMGB1immunohistochemical expression pattern in renal biopsy was conducted in Group 1.
Results: Urinary HMGB 1 levels and renal tissue extra-nuclear expression (cytoplasmic and extra-cytoplasmic) pattern of HMGB 1 were significantly increased in patients with active LN compared to patients without active LN and control (p< 0.001), suggesting active release of HMGB1. Plasma and urinary levels in patients without active LN were also signif-icantly higher compared to control group (p<0.001). Urinary HMGB 1 levels and renal tissue extra-nuclear expression pattern of HMGB1 levels were significantly correlated with SLEDAI.
Conclusion: HMGB 1 plays an important role in patho-genesis of lupus nephritis and reflects disease activity. Thus, HMGB 1 can be utilized as a biomarker for renal disease activity in patients with lupus and the therapeutic value of HMGB 1 blocking agents must be investigated.