Assessment of Urinary TNF-like Weak Inducer of Apoptosis as a Marker of Lupus Nephritis | ||||
| Egyptian Journal of Medical Microbiology | ||||
| Volume 34, Issue 4, October 2025 | ||||
| Document Type: New and original researches in the field of Microbiology. | ||||
| DOI: 10.21608/ejmm.2025.384757.1639 | ||||
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| Authors | ||||
Rasha M. Elnagar   1; Hifaa G. Al-Noman2; Hanan E. Al-Rashidi3; Mohamed M. Elzayady4; Elshimaa S. Eleraky5; Safaa M. Elageery6; Nawal S. Gouda7; Mariam Selim8; Sofanah A. Alahmadi9; Rania Talaat10
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| 1Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt; Basic Medical Sciences Department, College of Medicine, AlMaarefa University, Riyadh, 11597 Saudi Arabia | ||||
| 2Nogoud Medical Center, Almadinah Almonawarah, Ministry of Health, Saudi Arabia | ||||
| 3Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, Taibah University, Saudi Arabia | ||||
| 4Internal Medicine Department, Faculty of Medicine, Mansoura University | ||||
| 5Internal Medicine Department, Faculty of Medicine, Horus University, Egypt | ||||
| 6Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Egypt | ||||
| 7Microbiology Department, Faculty of Medicine, Northern Border University, Ar,ar, Saudi Arabia | ||||
| 8Mansoura Manchester Medical Program, Faculty of Medicine, Mansoura University, Egypt | ||||
| 9Al-Rayan College of Medicine, Almadinah Almonawarah, Saudi Arabia | ||||
| 10Medical Microbiology and Immunology Department, Faculty of Medicine, Helwan University | ||||
| Abstract | ||||
| Background: TNF-related weak inducer of apoptosis (TWEAK) is a proinflammatory cytokine that may play a major role in the pathophysiology of lupus nephritis (LN). Aim: We investigated the correlation between LN and urinary TWEAK and its use as a biomarker in LN. Methodology: This study comprised 56 females with systemic lupus erythematosus (SLE) and 56 age-matched healthy female controls. Patients were grouped into 27 patients with non-renal SLE and 29 with LN. The LN group was also categorized into patients with active renal disease (n=19) and inactive renal disease (n=10). Urinary TWEAK was measured in all participants using ELISA. Results: The LN group had markedly elevated urinary TWEAK levels compared to non-renal SLE, inactive LN, and normal controls. Significant positive associations were observed between urinary TWEAK and tSLEDAI (P< 0.001), as well as rSLEDAI (P< 0.001). Negative associations were identified between urinary TWEAK and C3 and C4 (P< 0.001). Urinary TWEAK levels exhibited a positive correlation with elevated kidney biopsy grades (P< 0.001). The threshold values for urinary TWEAK were >2.06 for SLE, >5.91 for LN, and >6.5 for active LN, with corresponding sensitivity rates of 100%, 75.86%, and 84.21%, respectively. The specificity rates were 94.74%, 88.89%, and 70%, respectively. The positive and negative predictive values augmented the importance of urine TWEAK. The accuracy rates were 97.3% for SLE, 82.1% for LN, and 79.3% for active LN. Conclusion: Urinary TWEAK demonstrated a positive correlation with the activity parameters of LN, indicating its potential role as a marker for monitoring renal involvement and disease activity. | ||||
| Keywords | ||||
| Lupus; nephritis; urinary; TWEAK | ||||
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