Voss Jens-Uwe, Roller Markus, Brinkmann Elke, Mangelsdorf Inge
Fraunhofer Institute of Toxicology and Experimental Medicine, Nikolai-Fuchs-Str. 1, 30625 Hannover, Federal Republic of Germany.
Int Arch Occup Environ Health. 2005 Jul;78(6):475-85. doi: 10.1007/s00420-005-0611-0. Epub 2005 May 13.
Evidence for a relationship between chronic kidney diseases or progression of already existing diseases (glomerulonephritides) and occupational solvent exposure has been found in case reports, in case-control studies and also in cross-sectional studies. An analysis of the available literature was performed with respect to markers measured in cross-sectional studies that might be useful for an early detection of solvent-induced effects on the kidney.
The relevant cross-sectional studies were evaluated and the following markers were analyzed with respect to their suitability as biomarker for renal damage: total protein, albumin, transferrin, IgG, beta(2)-microglobulin, retinol-binding protein, N-acetyl-beta-D: -glucosaminidase, alanine aminopeptidase, beta-galactosidase, beta-glucuronidase, leucin aminopeptidase, alkaline phosphatase, lysozyme, Tamm-Horsfall protein and laminin fragments in urine as well as E-selectin, laminin and anti-laminin antibodies and anti-glomerular basement membrane antibodies in serum.
An increased albumin excretion was observed more frequently in groups of workers exposed to various solvents (like toluene, styrene, aliphatic/aromatic hydrocarbon mixtures, tetrachloroethene, mixtures of chlorinated hydrocarbons) than in controls. No clear pattern emerged for the other markers.
The determination of albumin excretion in the urine appears to be a useful parameter for monitoring solvent-exposed workers.
在病例报告、病例对照研究以及横断面研究中均已发现慢性肾脏疾病或现有疾病（肾小球肾炎）进展与职业性溶剂暴露之间存在关联的证据。针对横断面研究中所测量的可能有助于早期检测溶剂对肾脏影响的标志物，对现有文献进行了分析。
对相关横断面研究进行评估，并就以下标志物作为肾损伤生物标志物的适用性进行分析：尿液中的总蛋白、白蛋白、转铁蛋白、IgG、β₂-微球蛋白、视黄醇结合蛋白、N-乙酰-β-D-氨基葡萄糖苷酶、丙氨酸氨基肽酶、β-半乳糖苷酶、β-葡萄糖醛酸酶、亮氨酸氨基肽酶、碱性磷酸酶、溶菌酶、Tamm-Horsfall蛋白和层粘连蛋白片段，以及血清中的E-选择素、层粘连蛋白、抗层粘连蛋白抗体和抗肾小球基底膜抗体。
与对照组相比，在接触各种溶剂（如甲苯、苯乙烯、脂肪族/芳香族烃混合物、四氯乙烯、氯代烃混合物）的工人群体中，白蛋白排泄增加的情况更为常见。其他标志物未呈现出明确的模式。
测定尿中白蛋白排泄量似乎是监测接触溶剂工人的一个有用参数。
