الفهرس 
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Abstract
Summary
The present study aimed to detect the role of circulating DKK-1 as a biomarker for identification of SLE patients and patients with LN and its relation to its activity and severity.
The study was a case control study conducted on fifty clinically diagnosed SLE patients (2 males and 48 females) who were collected from Rheumatology &Rehabilitation Department of Beni-Suef university hospital and diagnosed according to Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE. In addition to fifty healthy adults (2 males and 48 females) served as a control group.
All patients were subjected to full clinical and laboratory investigations. A clinical sheet was formulated and applied to all patients subjected to this study. Renal Biopsy was done if indicated and classified according to the classification of lupus nephritis by the International Society of Nephrology/Renal Pathology Society (ISN/RPS). Blood samples had been collected from patients SLE, active lupus nephritis and controls and were kept to assess DKK-1 in patients’ sera.
SLE disease activity was measured using Systemic Lupus Erythromatosus Disease Activity Index, (SLEDAI) measures disease activity within the last 10 days. The SLE disease severity was assessed using the Systemic Lupus International Collaborative clinics/America Collage of Rheumatology (SLICC/ACR) damage index.
DKK-1 level was significantly highest among Active Lupus Nephritis cases as compared with SLE cases with no LN (9197.60 ±2939.2 vs. 6405.15 ±2018.91) respectively, and with healthy controls (6405.15 ±2018.91 vs. 2790.33 ±833.49). DKK-1 level was significantly higher among SLE with no LN cases as compared with healthy controls (9197.60 ±2939.2 vs. 2790.33 ±833.49) respectively; p-values =0.001. DKK-1concentration was significantly higher among SLE patients with positive Anti-double strand DNA (dsDNA) antibodies as compared with SLE patients with negative Anti-double strand DNA (dsDNA) antibodies among the studied SLE patients; (p-value <0.001). According to receiver operating characteristic (ROC) curve analysis; the serum DKK-1 level diagnosed Active Lupus Nephritis at a statistically significant level with a 90% Sensitivity (true positive cases) and 37% Specificity (true negative cases) at a cutoff point level ≥ 6010.00 ug/uL.
This study confirms previous findings that circulating DKK-1 is a valuable biomarker for identification of SLE patients with LN. DKK-1 could be considered a good positive biomarker for LN. These results thus imply that DKK-1 is an independent biomarker for identification of LN in SLE patients, which warrants for further investigation in clinical settings.