Faculty, Staff and Student Publications

Publication Date

1-1-2025

Journal

Frontiers in Immunology

Abstract

Introduction: Lupus nephritis (LN) leads to end stage renal disease (ESRD), and early diagnosis and disease monitoring of LN could significantly reduce the risk. however, there is not such a system clinically. In this study we aim to develop a biomarker-panel based point-of-care system for LN.

Methods: Immunoassay screening combined with genomic expression databases and machine learning techniques was used to identify a biomarker panel of LN. A quantitative biomarker-panel mini-array (BPMA) system was developed and the sensitivity, specificity, reproducibility, and stability of the were examined. The performance of BPMA in disease monitoring was validated with machine models using a larger cohort of LN. The BPMA was also used to determine LN flare using a machine-learning generated flare score (F-Score).

Results: Among 32 promising LN serum biomarkers, VSIG4, TNFRSF1b, VCAM1, ALCAM, OPN, and IgG anti-dsDNA antibody were selected to constitute an LN biomarker Panel, which exhibited excellent discriminative value in distinguishing LN from healthy controls (AUC = 1.0) and active LN from inactive LN (AUC = 0.92), respectively. Also, the 6-biomarker panel exhibited a strong correlation with key clinical parameters of LN. A multiplexed immunoarray was constructed with the 6-biomarker panel (named BPMA-S6 thereafter). An LN-specific 8-point standard curve was generated for each protein biomarker. Cross-reaction between these biomarkers was minimal (< 1%). BPMA-S6 test results were highly correlated with those from ELISA (Spearman's correlation: fluorescent detection, rs = 0.95; colorimetric detection, rs = 0.91). The discriminative value of BPMA-S6 for LN was further validated using an independent cohort (AUC = 0.94). Using a longitudinal cohort of LN, the derived F-Score exhibited superior discriminative value in the training dataset (AUC = 0.92) and testing dataset (AUC=0.82) to distinguish flare vs remission.

Conclusion: BPMA-S6 may represent a promising point-of-care test (POCT) for the diagnosis, disease monitoring, and assessment of LN flare.

Keywords

Humans, Lupus Nephritis, Biomarkers, Female, Adult, Male, Machine Learning, Middle Aged, Young Adult, Reproducibility of Results, Point-of-Care Systems, Immunoassay, biomarker panel, disease monitoring, flare assessment, lupus nephritis, point-of-care diagnostics.

DOI

10.3389/fimmu.2025.1541907

PMID

40375995

PMCID

PMC12078251

PubMedCentral® Posted Date

5-1-2025

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

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