Serum syndecan-1, hyaluronan and thrombomodulin levels in patients with lupus nephritis.
OBJECTIVES
We investigated circulating syndecan-1, HA and thrombomodulin levels in patients with biopsy-proven Class III/IV ± V LN and their clinico-pathological associations. Patients with non-renal SLE or non-lupus chronic kidney disease, and healthy subjects served as controls.


METHODS
Serum syndecan-1, HA and thrombomodulin levels were determined by ELISAs.


RESULTS
Syndecan-1, HA and thrombomodulin levels were significantly higher during active LN compared with remission (P < 0.01, for all), and correlated with the level of proteinuria, estimated glomerular filtration rate, anti-dsDNA antibodies, complement 3 and serum creatinine. Longitudinal studies showed that syndecan-1 and thrombomodulin levels increased prior to clinical renal flare by 3.6 months, while HA level increased at the time of nephritic flare, and the levels decreased in parallel with treatment response. Receiver operating characteristic curve analysis showed that syndecan-1 and thrombomodulin levels distinguished patients with active LN from healthy subjects, LN patients in remission, patients with active non-renal lupus and patients with non-lupus chronic kidney disease (receiver operating characteristic area under curve of 0.98, 0.91, 0.82 and 0.95, respectively, for syndecan-1; and area under curve of 1.00, 0.84, 0.97 and 0.79, respectively, for thrombomodulin). HA level distinguished active LN from healthy subjects, LN patients in remission and non-lupus chronic kidney disease (receiver operating characteristic area under curve of 0.82, 0.71 and 0.90, respectively) but did not distinguish between renal vs non-renal lupus. Syndecan-1 and thrombomodulin levels correlated with the severity of interstitial inflammation, while HA level correlated with chronicity grading in kidney biopsies of active LN.


CONCLUSION
Our findings suggest potential utility of serum syndecan-1, thrombomodulin and HA levels in clinical management, and their potential contribution to LN pathogenesis.
['Yu|Kelvin Y C|KYC|', 'Yung|Susan|S|', 'Chau|Mel K M|MKM|', 'Tang|Colin S O|CSO|', 'Yap|Desmond Y H|DYH|', 'Tang|Alexander H N|AHN|', 'Ying|Shirley K Y|SKY|', 'Lee|Cheuk Kwong|CK|', 'Chan|Tak Mao|TM|']
D000328:Adult D015415:Biomarkers D004797:Enzyme-Linked Immunosorbent Assay D005260:Female D006801:Humans D006820:Hyaluronic Acid D008181:Lupus Nephritis D008297:Male D012372:ROC Curve D012189:Retrospective Studies D053668:Syndecan-1 D018180:Thrombomodulin
syndecan-1 hyaluronan thrombomodulin LN