The symptomatology of
lupus nephritis (LN) consists of foamy urine and lower leg
edema, as well as such systemic manifestations as
oral ulcers,
arthralgia/
arthritis, and
lymphadenopathy. However, these symptoms may appear mild and non-specific. If these symptoms are unrecognized, thus delaying treatment, approximately 10% of LN patients will develop permanent kidney damage and
end-stage kidney disease. Therefore, the purpose of this study is to identify a surrogate
biomarker for the early detection of LN. In this study, we first adopted next generation sequencing (NGS) in order to screen differential expression levels of
microRNA between SLE patients with and without LN. The results of both the NGS and the literature review confirmed the potential of 15
microRNAs through real-time qPCR. We further considered clinical laboratory data for additional analysis. In total, 41
microRNAs demonstrated significant differences through NGS screening. We then verified eight
microRNAs from NGS and seven
microRNAs from the literature review using the real-time qPCR method in peripheral mononuclear cells. Ultimately, mir-125a-5p, miR-146a-5p, and mir-221-3p were found to be statistically significant not only in the screening study but also in the real-time qPCR verification studies. miR-146a-5p was observed to have a significant correlation with clinical biochemistry markers, as well as to be a surrogate
biomarker for the early detection of
lupus nephritis. This study is the first to show that the intracellular
biomarker miR-146a-5p may serve as a useful specific
biomarker for the detection of
lupus nephritis among lupus patients in the future, regardless of
serum albumin levels and spot urine
protein/
creatinine ratio.