Urinary Fractalkine and Monocyte Chemoattractant Protein-1 as Possible Predictors of Disease Activity of Childhood Glomerulonephritis

Urinary Fractalkine and Monocyte Chemoattractant Protein-1 as Possible Predictors of Disease Activity of Childhood Glomerulonephritis

TOMOMI AIZAWA,¹ TADAATSU IMAIZUMI,² KAZUSHI TSURUGA,¹ SHOJIRO WATANABE,¹ HIDEMI YOSHIDA,² NAONORI KUMAGAI,³ ETSURO ITO¹ and HIROSHI TANAKA^1,4

¹Department of Pediatrics, Hirosaki University Hospital, Hirosaki, Aomori, Japan
²Department of Vascular Biology, Graduate School of Medicine Hirosaki University, Hirosaki, Aomori, Japan
³Department of Pediatrics, Tohoku University Hospital, Sendai, Miyagi, Japan
⁴Department of School Health Science, Faculty of Education, Hirosaki University, Hirosaki, Aomori, Japan

Renal biopsy is the gold standard for confirmation of disease severity and diagnosis of glomerulonephritis (GN), but its procedure is invasive with a risk of complications. Thus, a non-invasive monitoring method is desirable especially in pediatric patients. Fractalkine and monocyte chemoattractant protein-1 (MCP-1) are proinflammatory chemokines, and both have been reported to be involved in the pathogenesis of immunocomplex-mediated GN. Recently, it has been reported that urinary fractalkine and MCP-1 may serve as possible predictors of disease activity of adult patients with GN. We, therefore, examined whether urinary levels of fractalkine and MCP-1 correlate with clinical and histologic parameters. Twenty-six consecutive children with various types of GN were enrolled in this study, including lupus nephritis, IgA nephropathy, membranous nephropathy, acute GN, and thin basement membrane disease (served as a non-inflammatory control). Urinary fractalkine and MCP-1 concentrations in the first morning urine samples obtained at the time of renal biopsy were measured by enzyme-linked immunosorbent assay, and standardized for urinary creatinine concentrations. Urinary fractalkine concentration differed significantly among the disease categories. Urinary concentrations of fractalkine and MCP-1 showed a significant positive correlation with the degree of occult blood in urine and a significant inverse correlation with the estimated glomerular filtration rate. Furthermore, the urinary MCP-1 concentration was significantly correlated with histological chronicity indices in patients with lupus nephritis and IgA nephropathy. Measurement of urinary fractalkine and MCP-1 concentrations may be useful as a non-invasive method for predicting the disease activity of GN in children.

keywords —— fractalkine; glomerulonephritis; monocyte chemoattractant protein-1; non-invasive diagnostic procedure; urinary chemokines

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Tohoku J. Exp. Med., 2013, 231, 265-270

Correspondence: Hiroshi Tanaka, M.D., Ph.D., Department of School Health Science, Faculty of Education, Hirosaki University, 1 Bunkyo-cho, Hirosaki, Aomori 036-8560, Japan.

e-mail: hirotana@cc.hirosaki-u.ac.jp