2009 Biomarkers, Kidney
Non-Invasive Assessment of Lupus Nephritis
An invasive kidney biopsy is currently the only accurate way to determine what’s going on in the kidneys of people with lupus nephritis (inflammation). A precise diagnosis is necessary in order to distinguish those patients that need to be subjected to aggressive but potentially lifesaving treatment from those patients at less risk for serious problems. Although generally safe, a kidney biopsy usually requires an overnight stay in the hospital, and complications do occur.
With funding from LRI, Dr. Thurman and his colleagues developed a novel diagnostic tool, known as an MRI contrast agent, that makes it possible to see lupus kidney damage using MRI. The agent detects proteins deposited in the kidneys as part of the immune system’s attack, which then serves as a biomarker for disease. MRI scans of lupus mice injected with the agent showed a correlation between the amount of these proteins and the severity of kidney inflammation in early and mid-stages of disease. Using a biomarker to monitor disease may substitute for biopsy.
Results just published in the October 1 issue of Kidney International show that a novel investigational contrast agent he developed, when used with magnetic resonance imaging (MRI), can detect proteins in the kidney that indicate disease.
Dr. Thurman noted, “In addition to being potentially safer, the MRI approach should be more sensitive than biopsy by looking at the entire kidney rather than just a small sampling. MRI also could be used to track a patient’s disease over time and to measure response to treatment in a clinical trial. Based on these encouraging results, we plan to investigate the agent in lupus patients.”
“This project directly addresses the difficulties that I (and all nephrologists) face when trying to decide how much immunosuppression patients with kidney disease need. The methods we are working on, however, will also require the input of radiologists, chemists, and lots of expertise outside the research conducted in my laboratory. This funding will be invaluable in giving me the opportunity to bring this expertise together, and I think it will really permit us to develop a new and powerful diagnostic tool.”
Detection of glomerular complement C3 fragments by magnetic resonance imaging in murine lupus nephritis. Sargsyan SA, Serkova NJ, Renner B, Hasebroock KM, Larsen B, Stoldt C, McFann K, Pickering MC, Thurman JM. Kidney Int. 2012 Jan;81(2):152-9. doi: 10.1038/ki.2011.332. Epub 2011 Sep 28.