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Kit to predict success of lupus nephritis treatment

The CSIC and the Hospital Vall d’Hebron have developed a prognosis method for lupus nephritis based on the quantification of the level of gene expression in urine of Neuropilin 1 gene (NRP1). Companies interested in manufacturing and marketing the prognosis kit based on this technology are sought.

Structure of the NRPI protein. A high percentage of people affected by lupus (40-75%) will develop lupus nephritis, which can progress to kidney failure. The evolution of lupus nephritis is unpredictable and causes an increased morbidity. Up to 25% of the patients will  progress to renal damage even when they have received an aggressive treatment. Therefore the issue is how to know a priori which is the best treatment for every patient.

Nowadays, renal biopsy is one of the methods to diagnose and predict the response to treatment, but as it is invasive it cannot be used as a general rule. There are also some serological biomarkers, but they are not always correlated with renal damage. Besides, renal biopsies and serological biomarkers are not fully reliable until after 6 months of immunosuppressive therapy, and renal fibrosis that occurs in this period determines the long term prognosis. There are other urinary biomarkers such as IL-2, TWEAK, MCP-1 and NGAL, but they do not have a prognostic nature.  Therefore they cannot guide the physician toward the best treatment.

A team led by Georgina Hotter at the CSIC’s Instituto de Investigaciones Biomédicas, has discovered a biomarker that can predict the response to the treatment to standard therapy for lupus Nephritis.

The scientists have analyzed many samples from patients who were treated in the Hospital  Vall d’Hebron and they found out that the protein neurophilin1 (NRP1) was higher in all the patients who had a good response to the treatment and were recovered after a year. On the contrary, patients with low NRP1, relapsed.

Scientists at the CSIC and at the Hospital Vall d’Hebron have seen that quantifying the gene or protein NRP1 expression in urine of patients at diagnosis can predict the clinical response to standard therapy, which would allow the introduction of new treatments that can modify the course of the disease.

The advantage of the biomarker is that it is a non-invasive method that offers the prognosis of the disease at the moment of the diagnoses and throughout the treatment. It improves the morbidity and mortality of the patients, as well as their quality of life.


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