Identification and Quantitation of Novel Urinary Biomarkers of Lupus Nephritis

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder in which the body produces anti-ds DNA and anti-nuclear antibodies and leads to multi-system inflammation and tissue damage. One of the leading causes of mortality and morbidity of SLE is lupus nephritis (LN), a condition where SLE begins to manifest within the renal tissue; it has been estimated that more than half of all SLE patients will develop LN and 10-15% of those patients will experience end-stage renal failure. Early-stage disease diagnosis could allow for earlier treatment and preventative measures to be taken but is not presently possible because the currently used laboratory tests only detect disease activity at a severe stage, and the current gold standard of care to analyze renal involvement in SLE is a renal biopsy. While renal biopsies are highly informative, they cannot be performed routinely, and come with several risks to the patient, including the highly invasive nature of the procedure, the risk of infection, and the possibility of sampling error that the biopsy taken is not representative of the entire kidney. The need for earlier diagnostic tools for LN has sparked a large research interest in urine proteins to identify a noninvasive biomarker specific to LN, but insofar no ideal biomarker has been identified. Thus, the overall goal of this thesis is to identify new urinary biomarkers for lupus nephritis and assess various detection technologies and their effectiveness at measuring urinary proteins.