Kadar Antibodi Anti-dsDNA dan Urine Monocyte Chemoattractant Protein-1 pada Nefritis Lupus

Lupus eritematosus sistemik (LES) merupakan penyakit autoimun yang ditandai oleh peradangan kronis dan akut. Biomarker klasik untuk mendeteksi adanya penyakit LES adalah antibody anti-double stranded DNA (anti-dsDNA) dan urine Monocyte Chemoattractant Protein-1 (uMCP-1). Penelitian ini dilakukan untuk mengkaji hubungan antara kedua biomarker tersebut dengan klasifikasi histopatologis nefritis lupus untuk mengganti biopsi ginjal dalam penentuan kelas histopatologi nefritis lupus. Penelitian ini dilakukan selama 11 bulan berupa studi observasional dengan pengambilan sampel darah dan urin untuk mengetahui kadar antibodi anti-dsDNA dan MCP-1, serta biopsi ginjal untuk menentukan kelas nefritis lupus berdasarkan klasifikasi WHO tahun 1982. Data hasil penelitian menunjukkan tidak ada perbedaan yang signifikan (p=0,208>α) antara mean rank kadar anti-dsDNA pada kelompok kontrol dan kelompok kasus,begitu pula dengan hasil perbandingan mean rank kadar uMCP-1 (p=0,247>α). Uji korelasi Spearman's rho,menunjukkan hubungan signifikan kadar anti-dsDNA dan kadar uMCP-1 (r = 0,861; p<0,001). Dapat disimpulkan bahwa tidak terdapat perbedaan kadar biomarker antibodi anti-dsDNA dan urine MCP1 pada kejadian nefritis lupus dan klasifikasi histopatologi nefritis lupus, namun terdapat hubungan yang sangat erat antara kadar biomarker antibodi anti-dsDNA dengan kadar urine MCP- 1. Nilai sensitifitas kadar anti-dsDNA dan uMCP-1 lebih rendah yaitu 20% - 40% dibandingkan dengan nilai spesifisitasnya, yaitu 50% - 83,33%. Anti-dsDNA, uMCP-1, klasifikasi histopatologi, nefritis lupus Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by chronic and acute inflammation. The most common serious complications of SLE is lupus nephritis. Biomarkers that showed high specificity for SLE especially in lupus nephritis is antibodies anti-double stranded DNA (anti-dsDNA) and monocyte chemoattractant protein urine-1 (uMCP-1). This study was aimed to determine the correlation between uMCP-1 and anti ds-DNA antibodies with nephritis with histopathological classification of lupus nephritis. An cross sectional study was performed 11-month with blood and urine sampling to determine levels of anti-dsDNA antibodies and MCP-1 in patients with SLE, and renal biopsy to determine the class of lupus nephritis according to WHO (1982) classification. The results showed no significant difference (p = 0,208) between mean rank anti-dsDNA levels of control and cases group. Similarly, the comparison of mean rank levels of urinary uMCP-1. The Kruskal-Wallis test demonstrated the comparison of anti-dsDNA levels among 3 groups have no significant difference (p = 0,187), likewise the mean rank in urine MCP-1 levels among 3 groups (p= 0,197). The Spearman's rho correlation test, the results obtained a strong and significant correlation between the levels of anti-dsDNA and urine levels of MCP-1( r = 0,861; p = 0,000). It can be concluded that the levels of anti-dsDNA antibody biomarkers and urinary MCP1 was not associated with incidence and histopathological classification of lupus nephritis, but there is a strong correlation between anti-dsDNA antibodies and uMCP-1 levels and the sensitivity levels of anti-dsDNA and uMCP-1 was lower (20% - 40% ) than the specificity (50% - 83,33%).