Renal tubular and glomerular estrogen receptor ß levels are lower in lupus nephritis than in familial Mediterranean fever-associated renal amyloidosis

Abstract

Background

Estrogen has been thought to play an essential role in the disease pathogenesis of systemic lupus erythematosus, which is 9–10 times more prevalent in the female population. It has been shown that irregular estrogen/estrogen receptor signaling pathways may contribute to the pathophysiology of various renal diseases. In this study, we compared renal estrogen receptors between lupus nephritis, familial Mediterranean fever-associated renal amyloidosis, ANCA-associated nephritis, and intact kidney to investigate their role in the pathophysiology of renal diseases.

Methods

This study was designed as a retrospective cohort study. Thirty systemic lupus erythematosus patients with lupus nephritis, 12 familial Mediterranean fever amyloidosis and 10 ANCA-associated glomerulonephrites, and 14 individuals with normal renal histology were included in the study.

Results

Tubular estrogen receptor ß expression score was found to be significantly higher in the familial Mediterranean fever [5 (1–8)] group than in the lupus nephritis [0 (0–1)] (B = 1.385, OR = 3.996, CI %95 = 1.805–8.846, p = .001) and ANCA [4 (1–6.5)] (B = −1.431, OR = 0.239, CI 95% = 0.093–0.614, p = .003) groups. A significant correlation was found between serum creatinine values and tubular estrogen receptor ß expression score (OR = 0.565, CI 95% = 0.622–1.402, p < .0001). In ANCA-associated glomerulonephritis, a significant relationship was found between fibro cellular crescents in renal biopsy and glomerular estrogen receptor ß expression score (OR = 0.247, CI 95% = 0.11–0.999, p = .045) and tubular estrogen receptor ß expression score (OR = 0.282, CI 95% = −0.180–2.812, p = .026).

Conclusions

This study showed that tubular estrogen receptor ß expression score was elevated in familial Mediterranean fever amyloidosis and correlated with serum creatinine levels and renal crescents.