Roes E M, Raijmakers M T M, Roelofs H M, Peters W H, Steegers E A
Department of Obstetrics and Gynecology University Medical Center, Nijmegen - The Netherlands.
J Nephrol. 2005 Jul-Aug;18(4):405-8.
Glutathione S-transferases (GSTs) are present in large amounts in the human kidney, where they demonstrate a specific distribution. The assessment of urinary excretion of GST alpha (proximal tubules) and pi (distal and collecting tubules) could be helpful in determining if, and to what degree renal tubular damage is present in preeclampsia and whether this damage is in the proximal or distal region.
Urine samples were collected from 22 women with severe preeclampsia and/or HELLP syndrome (PE), from 30 non-pregnant women with a history of severe preeclampsia (HPE), from 18 women with uncomplicated pregnancies (PC) and from 30 non-pregnant women with a history of uncomplicated pregnancies (HPC). GSTA1-1 and GSTP1-1 were assayed by ELISA and were expressed as nanograms per 10 mmol creatinine (Cr).
Median urinary GSTP1-1 concentrations were significantly (p<0.001) higher in women with preeclampsia [62.2 (4.3-291.2) ng/10 mmol Cr] compared to non-pregnant women with a history of preeclampsia [22.3 (0-142.6) ng/10 mmol Cr]). In addition, in normotensive pregnant women, urinary GSTP1-1 concentrations were significantly (p<0.01) higher [82.6 (8.3-206.7) ng/10 mmol Cr]) compared to non-pregnant controls [5.1 (0-66.7) ng/10 mmol Cr]. No difference in GSTP1-1 concentrations was found between women with preeclampsia and normotensive pregnant women. GSTA1-1 concentrations were not significantly different between the four groups of women investigated. There were no correlations between the degree of proteinuria and urinary GSTP1-1 or GSTA1-1 concentrations.
GSTP1-1 metabolism in the distal tubule changes during normotensive as well as preeclamptic pregnancy. Whether this is due to tubular cell damage, disturbed resorption or an increase in cellular levels cannot be determined as yet.
谷胱甘肽S-转移酶（GSTs）在人肾脏中大量存在，且呈现特定分布。评估GSTα（近端小管）和pi（远端及集合小管）的尿排泄情况，可能有助于确定子痫前期是否存在肾小管损伤以及损伤程度，以及这种损伤是发生在近端还是远端区域。
收集了22例重度子痫前期和/或HELLP综合征（PE）患者、30例有重度子痫前期病史的非妊娠女性（HPE）、18例正常妊娠女性（PC）以及30例有正常妊娠病史的非妊娠女性（HPC）的尿液样本。通过酶联免疫吸附测定法检测GSTA1-1和GSTP1-1，并以每10 mmol肌酐（Cr）中的纳克数表示。
子痫前期患者尿GSTP1-1浓度中位数[62.2（4.3 - 291.2）ng/10 mmol Cr]显著高于有子痫前期病史的非妊娠女性[22.3（0 - 142.6）ng/10 mmol Cr]（p<0.001）。此外，血压正常的孕妇尿GSTP1-1浓度[82.6（8.3 - 206.7）ng/10 mmol Cr]显著高于非妊娠对照组[5.1（0 - 66.7）ng/10 mmol Cr]（p<0.01）。子痫前期患者与血压正常的孕妇之间GSTP1-1浓度无差异。所研究的四组女性之间GSTA1-1浓度无显著差异。蛋白尿程度与尿GSTP1-1或GSTA1-1浓度之间无相关性。
在血压正常及子痫前期妊娠期间，远端小管中的GSTP1-1代谢发生变化。目前尚无法确定这是由于肾小管细胞损伤、重吸收障碍还是细胞水平升高所致。
