Predicting lupus membranous nephritis using reduced picolinic acid to tryptophan ratio as a urinary biomarker

Krittima Anekthanakul; Siriphan Manocheewa; Kittiphan Chienwichai; Patcha Poungsombat; Suphitcha Limjiasahapong; Kwanjeera Wanichthanarak; Narumol Jariyasopit; Vivek Bhakta Mathema; Chutima Kuhakarn; Vichai Reutrakul; Jutarop Phetcharaburanin; Atikorn Panya; Natthaporn Phonsatta; Wonnop Visessanguan; Yotsawat Pomyen; Yongyut Sirivatanauksorn; Suchin Worawichawong; Nuankanya Sathirapongsasuti; Chagriya Kitiyakara; Sakda Khoomrung

doi:10.1016/j.isci.2021.103355

Predicting lupus membranous nephritis using reduced picolinic acid to tryptophan ratio as a urinary biomarker

iScience. 2021 Oct 25;24(11):103355. doi: 10.1016/j.isci.2021.103355. eCollection 2021 Nov 19.

Authors

Krittima Anekthanakul^{1

2}, Siriphan Manocheewa², Kittiphan Chienwichai^{3

4}, Patcha Poungsombat^{1

2}, Suphitcha Limjiasahapong², Kwanjeera Wanichthanarak^{1

2}, Narumol Jariyasopit^{1

2}, Vivek Bhakta Mathema^{1

2}, Chutima Kuhakarn⁵, Vichai Reutrakul⁵, Jutarop Phetcharaburanin^{6

7

8}, Atikorn Panya⁹, Natthaporn Phonsatta⁹, Wonnop Visessanguan⁹, Yotsawat Pomyen¹⁰, Yongyut Sirivatanauksorn², Suchin Worawichawong¹¹, Nuankanya Sathirapongsasuti^{12

13}, Chagriya Kitiyakara^{3

13}, Sakda Khoomrung^{1

2

5}

Affiliations

¹ Metabolomics and Systems Biology, Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
² Siriraj Metabolomics and Phenomics Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
³ Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
⁴ Hatyai hospital, Songkhla 90110, Thailand.
⁵ Department of Chemistry and Center of Excellence for Innovation in Chemistry (PERCH-CIC), Faculty of Science, Mahidol University, Bangkok 10400, Thailand.
⁶ Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
⁷ Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand.
⁸ Khon Kaen University International Phenome Laboratory, Khon Kaen University, Khon Kaen 40002, Thailand.
⁹ Functional Ingredients and Food Biotechnology Research Unit, National Center for Genetic Engineering and Biotechnology (BIOTEC), Pathumthani 12120, Thailand.
¹⁰ Translational Research Unit, Chulabhorn Research Institute, Bangkok 10210, Thailand.
¹¹ Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
¹² Section of Translational Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
¹³ Research Network of NANOTEC - MU Ramathibodi on Nanomedicine, Bangkok 10400, Thailand.

Abstract

The current gold standard for classifying lupus nephritis (LN) progression is a renal biopsy, which is an invasive procedure. Undergoing a series of biopsies for monitoring disease progression and treatments is unlikely suitable for patients with LN. Thus, there is an urgent need for non-invasive alternative biomarkers that can facilitate LN class diagnosis. Such biomarkers will be very useful in guiding intervention strategies to mitigate or treat patients with LN. Urine samples were collected from two independent cohorts. Patients with LN were classified into proliferative (class III/IV) and membranous (class V) by kidney histopathology. Metabolomics was performed to identify potential metabolites, which could be specific for the classification of membranous LN. The ratio of picolinic acid (Pic) to tryptophan (Trp) ([Pic/Trp] ratio) was found to be a promising candidate for LN diagnostic and membranous classification. It has high potential as an alternative biomarker for the non-invasive diagnosis of LN.

Keywords: Biopsy sample; Body substance sample; Metabolomics.