Estimation of Urinary Monocyte-Chemoattractant Protein-1 level in Patients with Lupus Nephritis and its Relation to Disease Activity

Background: Augmented levels of Monocyte-Chemoattractant Protein-1 (MCP-1) have been accompanied by enhanced renal inflammation and fibrosis, demonstrating its viability as a clinical marker of disease progression in Lupus Nephritis (LN).
Objective: This study designed to assess urinary MCP-1 concentrations in individuals with systemic lupus erythematosus (SLE) and to examine its linkage to overall disorder severity, with particular emphasis on active nephritis.
Methods: The current research utilized a cross-sectional approach to examine 90 participants aged 18 years and older, of both sexes with confirmed diagnosis of SLE in accordance with the 2019 ACR/EULAR criteria. The participants were stratified into three groups: Group I comprised participants with SLE without nephritis; Group II encompassed participants with SLE presenting with active nephritis; and Group III functioned as the control group and composed of healthy subjects matched by age and sex.
Results: A notable positive linkage was observed among MCP-1 and various renal manifestations, including hematuria, proteinuria, ESR at the first hour, CRP, blood urea, serum creatinine, albumin/creatinine ratio, red blood cells in urine, urinary protein levels, and anti-dsDNA titres (P < 0.05). Conversely, no linkage was found among MCP-1 levels and extrarenal manifestations such as serositis, neurological symptoms, photosensitivity and oral ulcers. Furthermore, MCP-1 exhibited a significant negative linkage with Hb, platelet count, and complement components C3 and C4 (P < 0.001). Specifically, the linkage coefficients for MCP-1 with C3 and C4 were r = -0.545 and r = -0.367, respectively, with P <0.001 and 0.004.
Conclusions: Urinary MCP-1 levels were augmented in participants with active LN and demonstrated a strong linkage with disease activity when compared to participants without renal manifestations and healthy controls. Therefore, urinary MCP-1 may serve as a reliable indicator for surveillance of LN activity.