OBJECTIVES To evaluate urinary activated leucocyte cell adhesion molecule (ALCAM) and CD6 as predictors of lupus nephritis (LN) progression or disease resolution across a 1-year study. METHODS Serum and urine samples from biopsy proven LN subjects (n = 122) were prospectively collected over the course of a year at 3- or 6-month intervals (weeks 0, 12, 26, and 52) across multiple study sites and assessed for soluble ALCAM and CD6 levels. Urine creatinine from the same urine sample was used to normalize the levels of urinary ALCAM and urinary CD6. Measured levels of serum and urine ALCAM and CD6 were then analyzed against disease metrics cross-sectionally and longitudinally. RESULTS Cross-sectional analysis at baseline revealed that urinary ALCAM significantly correlated with urine protein creatinine ratio (UPCR), renal SLEDAI, and the Physician Global Assessment (PGA), and negatively correlated with serum C3 and C4. Receiver operating characteristic (ROC) curve analysis demonstrated that urinary ALCAM is a predictor of LN with an area under the curve (AUC) of 0.97, compared with urinary CD6 with an AUC of 0.71. Importantly, the change in urinary ALCAM over a 3-month period distinguished between non-responders and responders at week 52. CONCLUSION Urinary ALCAM is reflective of changes in LN and may be predictive of response status.

中文翻译：

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可溶性尿激活的白细胞细胞粘附分子是狼疮性肾炎的强预测因子。


目的 在一项为期 1 年的研究中评估尿液活化白细胞细胞粘附分子 （ALCAM） 和 CD6 作为狼疮性肾炎 （LN） 进展或疾病消退的预测因子。方法 在一年内以 3 个月或 6 个月的间隔（第 0 、 12 、 26 和 52 周）在多个研究地点前瞻性收集来自活检证实的 LN 受试者 （n = 122） 的血清和尿液样本，并评估可溶性 ALCAM 和 CD6 水平。使用来自同一尿样的尿肌酐使尿 ALCAM 和尿 CD6 水平正常化。然后根据疾病指标对测得的血清和尿液 ALCAM 和 CD6 水平进行横断面和纵向分析。结果 基线横断面分析显示，尿 ALCAM 与尿蛋白肌酐比值 （UPCR） 、肾脏 SLEDAI 和医师整体评估 （PGA） 显著相关，与血清 C3 和 C4 呈负相关。受试者工作特征 （ROC） 曲线分析显示，尿 ALCAM 是 LN 的预测指标，曲线下面积 （AUC） 为 0.97，而尿 CD6 的 AUC 为 0.71。重要的是，3 个月内尿液 ALCAM 的变化在第 52 周时区分了无反应者和反应者。结论 尿液 ALCAM 反映了 LN 的变化，可能预测反应状态。