This study aims to evaluate cognitive impairment utilizing the Montreal Cognitive Assessment (MoCA) scale, while also exploring the correlation between cognitive impairment and various serum biomarker Show more
This study aims to evaluate cognitive impairment utilizing the Montreal Cognitive Assessment (MoCA) scale, while also exploring the correlation between cognitive impairment and various serum biomarkers, including Brain-derived neurotrophic factor (BDNF), Beta Secretase-1 (BACE1), Vascular Endothelial Growth Factors (VEGF), Glial fibrillary acidic protein (GFAP), and Interleukin-1 (IL-1β) in adults living with epilepsy. In this study, 74 participants aged between 18 and 50 years, who were visiting neurology outpatient consultations, were included. The cognitive assessment was executed using the MoCA test. Serum levels of BDNF, BACE1, VEGF, GFAP, and IL-1β were evaluated through ELISA in patients with and without cognitive impairments. To determine the association between MoCA scores and the biomarkers, both Spearman and Pearson correlation analyses, as well as linear regression, were conducted. Among the 74 PWE, 61 exhibited cognitive impairment as determined by the MoCA assessment. Noteworthy alterations were detected across various MoCA subscales, encompassing visuospatial and executive functions, attention, language, abstraction, and delayed recall, with statistical significance established ( We conclude that adult PWE in India demonstrate a significant cognitive impairment. Further, our findings indicate that BDNF may serve as a potential biomarker for evaluating cognitive impairment in adult PWE. Further longitudinal, prospective and multi-center studies are required to confirm the same. Show less
The goal of these studies is to discover novel urinary biomarkers of lupus nephritis (LN). Urine from systemic lupus erythematosus (SLE) patients was interrogated for 1000 proteins using a novel, quan Show more
The goal of these studies is to discover novel urinary biomarkers of lupus nephritis (LN). Urine from systemic lupus erythematosus (SLE) patients was interrogated for 1000 proteins using a novel, quantitative planar protein microarray. Hits were validated in an independent SLE cohort with inactive, active non-renal (ANR) and active renal (AR) patients, in a cohort with concurrent renal biopsies, and in a longitudinal cohort. Single-cell renal RNA sequencing data from LN kidneys were examined to deduce the cellular origin of each biomarker. Screening of 1000 proteins revealed 64 proteins to be significantly elevated in SLE urine, of which 17 were ELISA validated in independent cohorts. Urine Angptl4 (area under the curve (AUC)=0.96), L-selectin (AUC=0.86), TPP1 (AUC=0.84), transforming growth factor-β1 (TGFβ1) (AUC=0.78), thrombospondin-1 (AUC=0.73), FOLR2 (AUC=0.72), platelet-derived growth factor receptor-β (AUC=0.67) and PRX2 (AUC=0.65) distinguished AR from ANR SLE, outperforming anti-dsDNA, C3 and C4, in terms of specificity, sensitivity and positive predictive value. In multivariate regression analysis, urine Angptl4, L-selectin, TPP1 and TGFβ1 were highly associated with disease activity, even after correction for demographic variables. In SLE patients with serial follow-up, urine L-selectin (followed by urine Angptl4 and TGFβ1) were best at tracking concurrent or pending disease flares. Importantly, several proteins elevated in LN urine were also expressed within the kidneys in LN, either within resident renal cells or infiltrating immune cells, based on single-cell RNA sequencing analysis. Unbiased planar array screening of 1000 proteins has led to the discovery of urine Angptl4, L-selectin and TGFβ1 as potential biomarker candidates for tracking disease activity in LN. Show less