Biomarcadores urinários para nefrite lúpica: NGAL, MCP-1, TWEAK — síntese crítica para adoção clínica
DOI:
https://doi.org/10.34119/bjhrv9n1-170Keywords:
nefrite lúpica, biomarcadores, lúpus eritematoso sistêmicoAbstract
A nefrite lúpica (NL) representa uma das manifestações mais graves do lúpus eritematoso sistêmico e, apesar do uso de marcadores clínicos e sorológicos tradicionais, como proteinúria, complementos e anti-dsDNA, esses parâmetros possuem limitações importantes para detectar atividade renal precoce e diferenciar inflamação de dano crônico. Diante disso, cresce o interesse por biomarcadores urinários capazes de refletir de forma mais sensível a inflamação renal. Objetiva-se revisar a evidência científica sobre três biomarcadores urinários, NGAL, MCP-1 e TWEAK, descrevendo suas funções biológicas, desempenho diagnóstico e valor prognóstico, além de comparar suas vantagens, limitações e aplicabilidade clínica. Para tal, realizou-se uma revisão narrativa qualitativa, com busca em PubMed e SciELO, incluindo estudos que abordassem aspectos biológicos, clínicos e diagnósticos desses marcadores. Assim, observa-se que o NGAL se destaca como marcador precoce de dano tubular; a MCP-1, como indicadora de inflamação glomerular e tubulointersticial; e o TWEAK, como refletor da ativação imune mediada pelo eixo TWEAK/Fn14. Os três apresentam acurácia superior a marcadores convencionais, sobretudo quando combinados em painéis multiparamétricos. Isso permite concluir que tais marcadores constituem ferramentas promissoras para monitoramento não invasivo da NL, embora sua incorporação clínica dependa de maior padronização metodológica, validação científica e definição de valores de referência.
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