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Urinary Cytokines Reflect Renal Inflammation in Acute Tubulointerstitial Nephritis: A Multiplex Bead-Based Assay
Laura Martinez Valenzuela1, Juliana Draibe1, Oriol Bestard1,2
1Nephrology Unit, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain.
Journal of Clinical Medicine
|July 19, 2021
Summary
Urinary cytokines like I-TAC/CXCL11, IL-6, and MCP-1 can help diagnose acute tubulointerstitial nephritis (ATIN) non-invasively. These biomarkers show promise in distinguishing ATIN from acute tubular necrosis (ATN).
Area of Science:
- Nephrology
- Immunology
- Biomarker Discovery
Background:
- Acute tubulointerstitial nephritis (ATIN) diagnosis relies on invasive kidney biopsies due to a lack of non-invasive biomarkers.
- Distinguishing ATIN from acute tubular necrosis (ATN) is clinically significant but challenging without definitive markers.
Purpose of the Study:
- To evaluate the diagnostic accuracy of urinary inflammation-related cytokines for ATIN.
- To assess the potential of these cytokines in differentiating ATIN from ATN.
Main Methods:
- Analyzed urinary cytokine levels (10 markers) in 33 patients (ATIN, ATN) and 6 healthy controls (HC) using Luminex assay.
- Correlated cytokine levels with clinical, analytical, and histological data, including tubulointerstitial infiltrates.
Main Results:
- Urinary I-TAC/CXCL11, CXCL10, IL-6, TNFα, and MCP-1 were elevated in ATIN patients compared to HC.
- I-TAC/CXCL11, IL-6, and MCP-1 levels were significantly higher in ATIN than ATN, with I-TAC/CXCL11 showing the best discriminative ability (AUC 0.77).
- A combined model of these cytokines, plus blood eosinophils and urinary leukocytes, improved ATIN/ATN distinction.
Conclusions:
- Urinary I-TAC/CXCL11, CXCL10, IL-6, and MCP-1 levels are accurate non-invasive biomarkers for distinguishing ATIN from ATN and healthy individuals.
- These cytokines may serve as novel diagnostic tools for ATIN, reducing reliance on kidney biopsies.
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