Role of metabolomics in precision medicine in the context of systemic lupus erythematosus and lupus nephritis

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune, multisystemic disease, the underlying causes of which are not fully understood. Clinically, SLE is a heterogeneous disease, and its clinical spectrum overlaps with other rheumatic diseases. Even though multiple organs can be involved in the progression of the disease, the kidney is the main indicator of morbidity and mortality in SLE, a condition known as lupus nephritis (LN). The diagnosis of LN still requires an invasive procedure that becomes impractical when monitoring patients with a confirmed diagnosis, and the described biomarkers do not meet the characteristics of a good biomarker. Recently, “omics” technologies have revolutionized the field of the molecular diagnosis, including autoimmune diseases. Metabolomics has been an extremely useful tool for identifying non-invasive biomarkers in the clinical context and is proposed as a powerful and promising tool to differentiate between individuals with SLE without renal damage and patients with SLE with renal involvement. In addition, this methodology will allow the categorization of patients according to renal damage, promising personalized management of LN in the context of SLE. Here, we review the potential of untargeted metabolomic approaches using LC/GC-MS and MNR to identify potential biomarkers for renal damage in patients with SLE.