Lupus is a disease that is hard to predict. Sometimes, it develops slowly and sometimes, it develops rapidly. It affects people of different ages and yes, that includes children. People who have lupus are likely to suffer complications with their organs like their heart and kidney, as a result from the
People with SLE or Systemic Lupus Erythematosus often manifest lupus nephritis. In fact, according to a study published on NCBI, up to 60% of SLE patients have it. Sadly, 10-15% of those who have been diagnosed with lupus nephritis have progressed to ESRD or end-stage renal disease. Their 5-year survival is also lesser than those who don’t have it.
However, here's some good news, two engineering professors from the University of Houston have been granted $1.4 million worth of funds by NIH or the National Institutes of Health to develop a home test kit for patients with Systemic Lupus Erythematosus. They are developing a test for candidate kidney inflammation biomarkers and have teamed up with a phosphor chemist, biostatistician, UH Assistant professor, chemical and biomolecular engineering research associate professor, and biochemistry and biomedical engineering graduates for this research.
The kit can be used in managing lupus nephritis that could then help the patients not only to keep track of the progression of the disease but also to monitor their responses to treatments. The team analyzed 16 urine biomarkers of 47 children who have lupus nephritis and underwent a kidney biopsy. After the analysis, the researchers concluded that there were 6 biomarkers excreted by lupus nephritis patients. The biomarkers are adiponectin, monocyte chemotactic protein 1, kidney injury molecule 1, neutrophil, gelatinase-associated lipocalin ceruloplasmin, and hemopexin. The accuracy of the detection was 71-85%.
How does it work?
The user just needs to take a photo of the sample test using their smartphone. Then, a custom app would read the results. The app and the prototype of the kit were based on home pregnancy tests, which according to Wilson, is one of the most remarkable developments on has ever made, especially since it allows one to measure the pregnancy hormone without the need for them to even undergo medical training.
Just like a pregnancy test kit, the nanoparticles inside the kit accumulate in a line. Also, apart from the kit and the app, the researchers have also created an accessory that the user can simply slip on to their iPhone. This accessory is meant to hold the test stick while the camera of the device takes shots of the particles through the app.
So, how will you know that you have a nephritis flare? The researchers consider proteins as a candidate biomarker for nephritis. When one has nephritis, their protein levels are high. The higher the target protein is, the brighter the particles would be. The photos taken play a very important role in providing an accurate measurement of the particles. On the other hand, the results can be seen almost in an instant.
Nephritis flares are hard to spot most of the time. In fact, some patients may think that they only have a flu or cold. This is the reason why researchers are very much determined in developing the kit. They believe that through the kit, patients would be able to recognize nephritis flares; thus, they can pay their doctor a visit and get treated.
The use of glow-in-the-dark nanoparticles
The test makes use of glow-in-the-dark particles, an idea that Wilson came up with when he was putting his daughter to sleep. He removed a glow-in-the-dark star on the ceiling of his daughter’s room and brought it to Andrew Patterson who then worked on a test that contains strontium aluminate nanoparticles. The antibodies that this stick has specifically targets protein.
Well, Wilson's team is not the only one who has received funding for lupus research. In fact, NIH has also granted funding, amounting to $387,000, to a team of researchers led by Mohan. They are developing a test that will help diagnose lupus with the use of saliva instead of the invasive methods that are commonly used like kidney biopsies and blood tests.
The main goal of Mohan’s team is to create a test that will detect the anti-dsDNA antibodies or the anti-double stranded DNA, which is a known lupus biomarker. For patients that have been diagnosed with lupus, they have a high level of anti-dsDNA antibodies in the blood and scientists have discovered that these antibodies can also be found in the saliva. So, this team of researchers is on a quest to find out whether these antibodies in the saliva are good enough to distinguish a person with lupus from a healthy person, and whether it can be used in determining whether a patient has lupus nephritis or not.
A kidney biopsy or a blood test can be used to determine the extent of the organ involvement. However, these tests are often uncomfortable, which is why some people find this option attractive, especially those whose blood is difficult to draw. It is also much easier to collect a saliva sample than a blood sample.
The kit that Mohan’s team is currently developing is quite similar to the home-based kit that Wilson’s team is working on, just that instead of using urine for the test, saliva is used instead. Mohan believes that the grant given to them will allow them to determine the proteins that can be used as biomarkers in the saliva.
Lupus and kidney disease
The kidney is responsible for regulating the hormones that control blood volume and pressure. It is also the one responsible for maintaining the right amont of fluids in the body. On the other hand, lupus nephritis is the term used for a SLE or Systemic Lupus Erythematosus complication that affects the kidney.
This complication causes inflammation to the small blood vessels that filter the wastes in the kidney. Oftentimes, it develops during the first 5 years of the symptoms of lupus starting to show up. Its symptoms may differ from one person to another. Some may experience protein or blood leaking into their urine while some experience weight gain as the body is not able to get rid of the excess fluid in the kidney. However, the symptoms of lupus nephritis are often unnoticeable, especially during its early stages. They also often come and go, which is why urine testing is important in diagnosing it.
If nephritis is left untreated, it can lead to permanent damage or scarring in the kidney. In the worst case, it can also lead to ESRD. People with ESRD need to undergo dialysis on a regular basis and may also need to undergo a kidney transplant, just so they have at least one working kidney.
Going back to the home test kit, according to Wilson, it is now quantitative and sensitive. Nevertheless, some refining still needs to be done. After that, it would then be safe to say that it has the potential to measure the markers of lupus nephritis accurately and people would then be able to recognize nephritis flares at the convenience of their very own home.