Comparative Study of Serum and Urine Cell Free DNA, miRNA-27b, as Novel Biomarkers with INF-Y for Assessing Systemic Lupus Erythematosus and Lupus Nephritis Activity

Abstract

Background:  Systemic lupus erythematosus (SLE) disease a condition as one of the causes of loss of tolerance to several autoantigens triggering the involvement of the immune system to the destruction of tissues. One of the most disabling symptoms of systemic lupus erythematosus (SLE) refers to lupus nephritis (LN). It does also have a frequency-of-occurrence that is dependent on some level of kidney inflammation. Aim: This research paper set out to assess the use of blood and urine cell-free DNA (cfDNA) as a non-invasive lupus nephritis biomarker in patients. In addition, serum microRNA-27a and serum INF-Y evaluated whether there were any correlations with the severity of the disease. Methods: Three groups participated in a cross-sectional study was conducted based on 106 participants was classified as follows: 36 patients with SLE (6 men and 27 women), 35 patients with lupus nephritis (12 men and 24 women), and 35 as a control group (11 men and 24 women) without a history of systemic disease. The study was conducted from January 2024 to September 2024. All participants had been selected from Al-Sader Teaching Medical City in Najaf province and private labs. Results: The levels of pro-inflammatory cytokine INF-T was evaluated across the three studied groups, where  levels were significantly higher in both the lupus nephritis group  and the SLE group compared to the healthy control group,  The fold change of miRNA-27b was markedly reduced in the lupus nephritis group compared to both the SLE group and healthy controls, Serum cell-free DNA (cfDNA) levels between patients with lupus nephritis and SLE, expressed as fold change relative to healthy controls. In this analysis, the healthy control group showed no detectable Ct values in RT-PCR, indicating minimal or undetectable cfDNA levels; therefore, a default fold change value of 1 was assigned to the control group for quantification purposes.In Conclusion This research illustrates the potential of cell-free DNA (cfDNA) and specific microRNAs (miRNA-27b) as non-invasive biomarkers for assessing lupus nephritis (LN) in patients with systemic lupus erythematosus (SLE). The study presents evidence of increased levels of pro-inflammatory cytokine(INF-Y) in both SLE and LN groups when compared to healthy controls, highlighting a strong inflammatory response in these conditions. Furthermore, the expression levels of miRNA-27b was significantly reduced in LN and SLE patients, suggesting these microRNA  might serve as indicators of disease activity and severity.