Decramer Stephane, Bascands Jean-Loup, Schanstra Joost P
INSERM, U858/I2MR, Team 5 Renal and Cardiac Remodeling, 1 Avenue Jean Poulhès, BP 84225, 31432 Toulouse Cedex 4, France.
World J Urol. 2007 Oct;25(5):457-65. doi: 10.1007/s00345-007-0201-8. Epub 2007 Aug 14.
Non-invasive prognosis of the clinical progression of disease is of high interest, especially in newborn and children. Neonatal ureteropelvic (UPJ) junction obstruction needs close and invasive surveillance to determine the necessity of pyeloplasty. A number of groups have initiated research with the aim to find non-invasive biomarkers for UPJ obstruction. Two different strategies have been followed. One strategy, based on the knowledge obtained in animal models of UPJ obstruction, has identified a number of individual urinary markers of severe UPJ obstruction. Combining these markers might allow prediction of which patients will require surgery and in which patients UPJ obstruction will spontaneously resolve. The other strategy is based on urinary proteomics. In this strategy the entire urinary proteome is probed for a set of biomarkers that correlates with the degree of UPJ obstruction. In subsequent steps, these sets of urinary biomarkers are used for prediction of the clinical evolution of UPJ obstruction patients. This proteomic-based strategy allowed prediction, several months in advance, of the clinical evolution of neonates with UPJ-obstruction. Both strategies will be complementary and will hopefully replace in the near future the invasive follow-up of newborns with UPJ obstruction.
疾病临床进展的无创预后备受关注，尤其是在新生儿和儿童中。新生儿肾盂输尿管连接部（UPJ）梗阻需要密切且侵入性的监测以确定肾盂成形术的必要性。许多研究团队已开展研究，旨在寻找UPJ梗阻的无创生物标志物。采用了两种不同的策略。一种策略基于在UPJ梗阻动物模型中获得的知识，已确定了一些严重UPJ梗阻的个体尿液标志物。将这些标志物结合起来可能有助于预测哪些患者需要手术以及哪些患者的UPJ梗阻会自行缓解。另一种策略基于尿液蛋白质组学。在该策略中，对整个尿液蛋白质组进行检测，寻找与UPJ梗阻程度相关的一组生物标志物。在后续步骤中，这些尿液生物标志物组用于预测UPJ梗阻患者的临床进展。这种基于蛋白质组学的策略能够提前数月预测UPJ梗阻新生儿的临床进展。这两种策略将相互补充，并有望在不久的将来取代对UPJ梗阻新生儿的侵入性随访。
