E-ISSN 2534-9821
 

Original Research 


Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis

Lakshita Singh, Atin Singhai, Suresh Babu, Vijay Kumar Singh, Anupam Wakhlu, Satyendra Sonkar, Vandana Tiwari, Uma Shankar Singh.

Abstract
BACKGROUND: Current laboratory biomarkers for lupus nephritis like proteinuria, urine protein to creatinine ratio, creatinine clearance, anti-ds DNA and complement levels lack sensitivity and specificity for predicting disease activity and damage. Free light chains (FLCs) released in circulation during antibodies production play a key role in the pathogenesis of autoimmune diseases. Expression of serum and urinary FLCs in lupus nephritis can act as non-invasive diagnostic and prognostic indicators and alleviate the dependency on the invasive procedure of biopsy to guide management.

AIMS & OBJECTIVES: Present study intends to adjudge the implications of serum and urinary FLCs as non-invasive biomarkers of disease activity in lupus nephritis.

MATERIALS & METHODS: Histomorphological diagnosis of lupus nephritis was done as per ISN-RPS classification. Cases were divided into 2 subgroups, classes I/II and III/IV in accordance with low to high histological grades and activity/chronicity scores. Concurrent serum and urinary FLCs levels were estimated by immunonephelometry and correlated with clinical presentation and histological grades of lupus nephritis. Control cases were selected from a pool of other native renal diseases with a non-immunological basis.

RESULTS: Urinary kappa and lambda FLCs were significantly elevated in lupus nephritis class III/IV as compared to class I/II and controls. Serum kappa FLCs exhibited significant/near significant increments on comparison of classes III/IV and I/II with controls, however, intra-comparison of classes I/II and III/IV was insignificant. Serum lambda FLCs showed significance only for the comparison of class III/IV with controls.

CONCLUSION: Urine FLCs have definite potential to be established as a non-invasive biomarker of activity in lupus nephritis. The role of serum FLCs needs further validation.

Key words: Lupus nephritis, Pathogenesis, Diagnosis, Prognosis


 
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How to Cite this Article
Pubmed Style

Singh L, Singhai A, Babu S, Singh VK, Wakhlu A, Sonkar S, Tiwari V, Singh US. Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis. doi:10.5455/IJMRCR.lupus-nephritis


Web Style

Singh L, Singhai A, Babu S, Singh VK, Wakhlu A, Sonkar S, Tiwari V, Singh US. Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis. http://www.mdpub.net/?mno=90189 [Access: March 10, 2021]. doi:10.5455/IJMRCR.lupus-nephritis


AMA (American Medical Association) Style

Singh L, Singhai A, Babu S, Singh VK, Wakhlu A, Sonkar S, Tiwari V, Singh US. Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis. doi:10.5455/IJMRCR.lupus-nephritis



Vancouver/ICMJE Style

Singh L, Singhai A, Babu S, Singh VK, Wakhlu A, Sonkar S, Tiwari V, Singh US. Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis. doi:10.5455/IJMRCR.lupus-nephritis



Harvard Style

Singh, L., Singhai, . A., Babu, . S., Singh, . V. K., Wakhlu, . A., Sonkar, . S., Tiwari, . V. & Singh, . U. S. (2021) Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis. doi:10.5455/IJMRCR.lupus-nephritis



Turabian Style

Singh, Lakshita, Atin Singhai, Suresh Babu, Vijay Kumar Singh, Anupam Wakhlu, Satyendra Sonkar, Vandana Tiwari, and Uma Shankar Singh. 2021. Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis. doi:10.5455/IJMRCR.lupus-nephritis



Chicago Style

Singh, Lakshita, Atin Singhai, Suresh Babu, Vijay Kumar Singh, Anupam Wakhlu, Satyendra Sonkar, Vandana Tiwari, and Uma Shankar Singh. "Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis." doi:10.5455/IJMRCR.lupus-nephritis



MLA (The Modern Language Association) Style

Singh, Lakshita, Atin Singhai, Suresh Babu, Vijay Kumar Singh, Anupam Wakhlu, Satyendra Sonkar, Vandana Tiwari, and Uma Shankar Singh. "Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis." doi:10.5455/IJMRCR.lupus-nephritis



APA (American Psychological Association) Style

Singh, L., Singhai, . A., Babu, . S., Singh, . V. K., Wakhlu, . A., Sonkar, . S., Tiwari, . V. & Singh, . U. S. (2021) Utility of serum and urinary free light chains as non-invasive biomarkers of activity in lupus nephritis. doi:10.5455/IJMRCR.lupus-nephritis