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Updated: Jul 12, 2025
Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
Endothelial cell activation and glycocalyx shedding - potential as biomarkers in patients with lupus nephritis
1Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Insights
Soluble glycocalyx components show promise as novel biomarkers for lupus nephritis (LN). These markers may help in early diagnosis and management of kidney injury in LN patients, especially when traditional tests are inconclusive.
Area of Science:
- Nephrology
- Immunology
- Biomarker Discovery
Background:
- Lupus nephritis (LN) is a severe systemic lupus erythematosus complication causing kidney injury.
- Accurate diagnosis and relapse prevention are crucial for preserving renal function in LN.
- Current diagnostic tools for LN are limited by invasiveness, lack of specificity, or inability to reflect kidney histopathology.
Purpose of the Study:
- To review the potential of soluble glycocalyx components as specific biomarkers for active lupus nephritis.
- To explore the role of endothelial glycocalyx changes in renal function deterioration in LN.
- To identify novel markers for improved clinical management of LN, particularly in challenging cases.
Main Methods:
- Literature review focusing on endothelial glycocalyx, inflammation, and lupus nephritis.
- Analysis of studies investigating soluble glycocalyx components as potential biomarkers.
- Discussion of the limitations of current diagnostic markers for LN.
Main Results:
- Endothelial glycocalyx alterations and shedding are linked to renal function decline in LN.
- Soluble glycocalyx components may serve as indicators of active LN and kidney injury.
- These novel markers could complement or overcome limitations of conventional serological and biochemical tests.
Conclusions:
- Soluble glycocalyx components represent a promising avenue for developing specific biomarkers for lupus nephritis.
- Further research into these markers could significantly improve the early diagnosis and monitoring of LN.
- Targeting glycocalyx integrity may offer new therapeutic strategies for managing LN-related kidney damage.
Abstract:
Lupus nephritis (LN) is a common and severe manifestation of systemic lupus erythematosus and an important cause of acute and chronic kidney injury. Early diagnosis of LN and preventing relapses are key to preserving renal reserve. However, due to the complexity and heterogeneity of the disease, clinical management remains challenging. Kidney biopsy remains the gold standard for confirming the diagnosis of LN and subsequent assessment of kidney histopathology, but it is invasive and cannot be repeated frequently. Current clinical indicators of kidney function such as proteinuria and serum creatinine level are non-specific and do not accurately reflect histopathological changes, while anti-dsDNA antibody and C3 levels reflect immunological status but not kidney injury. Identification of novel and specific biomarkers for LN is prerequisite to improve management. Renal function deterioration is associated with changes in the endothelial glycocalyx, a delicate gel-like layer located at the interface between the endothelium and bloodstream. Inflammation induces endothelial cell activation and shedding of glycocalyx constituents into the circulation. This review discusses the potential role of soluble glycocalyx components as biomarkers of active LN, especially in patients in whom conventional serological and biochemical markers do not appear helpful.
