ORIGINAL RESEARCH article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Urine Afamin as a biomarker of lupus nephritis
Provisionally accepted
- Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: The association between various biomarkers and the risk of lupus nephritis (LN) has been extensively investigated. However, a dearth of readily available, specific, and sensitive diagnostic biomarkers for LN remains. This study aimed to examine the levels of Afamin in the urine and plasma of patients with systemic lupus erythematosus (SLE) and to evaluate its potential utility for diagnosing LN. Methods: This study enrolled 31 LN-SLE patients, 31 non-LN SLE patients, and 27 healthy controls (HC). First, Tandem mass tag (TMT) -based proteomic screening of urine and plasma (n=15 per group) identified Afamin as a significantly upregulated protein in LN. Subsequently, ELISA validation confirmed that both uAfamin and pAfamin levels were markedly higher in the LN group. The diagnostic performance of uAfamin for active LN was further evaluated using receiver operating characteristic (ROC) curve analysis. Results: Levels of both urinary and plasma Afamin were significantly elevated in patients with LN-SLE compared to those with non-LN SLE. Moreover, uAfamin and pAfamin levels demonstrated robust correlations with multiple clinical indicators of disease activity, including 24-hour urinary total protein (24hUTP), creatinine, urea, hematuria, pyuria, SLEDAI, and renal SLEDAI. Multivariable linear regression analysis established uAfamin as an independent determinant of renal SLEDAI scores. Consistent with this, ROC curve analysis confirmed that uAfamin possesses a strong capacity to diagnose LN. Conclusion: The uAfamin level serves as a biomarker for LN, aiding in monitoring disease progression and suggesting a new avenue personalized treatment strategies.
Keywords: systemic lupus erythematosus, Lupus Nephritis, Afamin, RSLEDAI, SLEDAI-2K
Received: 31 Aug 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Lin, Du, Wang, Lai, Yao, Chen, Xu and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xue Xu, iamxuxue@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.