EVALUATION OF URINARY CD4 T-CELL LEVELS AS A BIO-MARKER FOR LUPUS NEPHRITIS AND ITS CORRELATION WITH DISEASE ACTIVITY.

Background:- Although renal biopsy is the most accurate method for assessing renal inflammation in patients with lupus nephritis (LN), the technique is invasive and cannot be performed frequently. There is a critical need to identify biomarkers for systemic lupus erythematosus (SLE) which has a high prevalence of renal failure. Objective:- Our objective was to evaluate the level of urinary CD4 T-cells as a biomarker of active LN and indicator of treatment response in patients with SLE compared with normal control and its correlation with disease activity. Subjects and methods:- 64 patients with SLE and 20 age & sex matched control group were included. Patients were classified into two groups A & B. Group A with LN and moderate to severe SLE disease activity, Group B without LN and mild to inactive SLE. Levels of urinary CD4 T-cell were quanti?ed using ?ow cytometry in both patients' groups and controls at baseline and repeated for patients' groups only after 6 months. Results:- We found that CD4 T-cell level in Group (A) was significantly higher at baseline than in Group (B). There was significant decrease in the CD4 T-cell number in group A, when repeated after 6 months. Number of CD4 T- cells was correlated significantly with the disease activity both at baseline and after 6 months. In healthy controls, the urine was almost devoid of CD4T-cells. Conclusion:- Urinary CD4 T-cells is a good non-invasive marker for detecting active LN in SLE patients and also is a good monitor for treatment efficacy.