Globally, 3 out of 5 persons lose their lives to chronic inflammatory conditions, such as diabetes, cardiovascular disorders, cancer, chronic respiratory diseases, skin diseases, renal diseases and obesity. Inflammatory diseases are the most prevailing cause of death worldwide and the numbers keep rising.
The network focuses on reducing the burden of infectious and inflammatory diseases caused by pathogens, damaged cells, toxic compounds or radiation in order to develop new diagnostic and treatment technologies.
As a society, we need more knowledge about the correlation between e.g. inflammation and development of cancer, about biomarkers and about molecular mechanisms of autoimmunity in e.g. rheumatological conditions - not to mention chronic mucosal inflammation. In the inflammation network we collaborate interdisciplinearily in order to find answers.
We comprise a wide range of researchers with interest in diagnostic methods, epidemiological data, inflammatory markers and intracellular pathways, understanding of cell population and tissue structures, among others.
Kidney injury in systemic lupus erythematosus (SLE) occurs primarily due to the deposition of immune complexes and the subsequent activation of the complement pathway. The existence of antibodies targeting nuclear antigens leads to the formation of immune complexes that effectively activate the complement system, resulting in the generation of C5b-9 (the terminal complement complex, membrane attack complex). It has been demonstrated that the activation of C5b-9 plays a detrimental role in the pathogenesis of active lupus nephritis (LN).
Biomarkers can function as early indicators of the presence of specific diseases. However, in LN, specific biomarkers are lacking. In this new study, researchers assessed microvascular C5b-9 in individuals affected by active LN. Their hypothesis was the detection of C5b-9 in non-lesional skin (intact skin devoid of lesions) would have the potential to serve as a biomarker for LN activity.
Sixteen individuals diagnosed with lupus nephritis (LN) were enrolled in the study and were equally divided into two groups: those with active LN and those without active LN. Each participant underwent non-lesional skin biopsies, wherein intact skin devoid of lesions was examined for the presence of microvascular C5b-9.
The study findings revealed that the deposition of C5b-9 in non-lesional skin exhibited greater specificity in identifying active LN when compared to pyuria (an excessive presence of white blood cells in the urine), proteinuria, elevated levels of double-stranded DNA (a well-established diagnostic marker SLE), and hypocomplementemia (low levels of complement proteins C3 and/or C4).
The quest for novel biomarkers is of utmost importance, holding the potential to significantly enhance the diagnosis and assessment of LN. Although the results are preliminary and need validation, they hold great promise for the future.
Meghan Anderson, Cynthia Magro, H Michael Belmont. Microvascular C5b-9 deposition in non lesional skin in patients with SLE and its correlation with active lupus nephritis: a prospective observational study. Lupus Sci Med. 2023 Oct;10(2):e000996. doi: 10.1136/lupus-2023-000996.
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