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Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study
Arthritis Research & Therapy, 09/30/09

Schwartz N et al. – High uTWEAK levels are indicative of LN, as opposed to non-LN SLE and other healthy and disease control populations, and reflect renal disease activity in longitudinal followup. Thus, our study further supports a role for TWEAK in the pathogenesis of LN, and provides strong evidence for uTWEAK as a candidate clinical biomarker for LN.

Methods

Multicenter cohorts of SLE patients and controls
Analysis of urinary TWEAK (uTWEAK) and/or serum TWEAK (sTWEAK) levels as potential biomarkers of LN
Performance of TWEAK as a biomarker for nephritis compared to routinely used laboratory tests in lupus patients, including anti-double stranded DNA antibodies and levels of C3 and C4

Results

uTWEAK levels significantly higher in LN patients than in non-LN SLE patients and other disease control groups
uTWEAK was better at distinguishing between LN and non-LN SLE patients than anti-DNA antibodies and complement levels
High uTWEAK levels predicted LN in SLE patients with odds ratio of 7.36 (95% CI: 2.25 to 24.07)
uTWEAK levels peaked during LN flares, and significantly higher during the flare than at 4 and 6 months prior or following the flare event
A linear mixed-effects model showed significant association between uTWEAK levels in SLE patients and their disease activity over time
sTWEAK levels not found to correlate with presence of LN or degree of nephritis activity

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