Bennett Michael R, Ravipati Neelima, Ross Gary, Nguyen Mai T, Hirsch Russel, Beekman Robert H, Rovner Leon, Devarajan Prasad
Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Proteomics Clin Appl. 2008;2(7-8):1058-1064. doi: 10.1002/prca.200780141.
Contrast induced nephropathy (CIN) is the third leading cause of hospital acquired acute kidney injury (AKI). We conducted a cross-sectional study in children undergoing elective cardiac catheterization to determine if there is a distinct preprocedural urinary proteomic profile in subjects who subsequently develop CIN. Of 90 patients enrolled, AKI due to CIN (defined as a 50% or greater increase in serum creatinine) occurred in 10 participants by the 24 h postcontrast time point. Seven patients who did not develop AKI served as age and gender matched controls. SELDI-TOF-MS was performed using Protein Chips with different chromatographic surfaces. A 4480 Da biomarker displayed significantly greater peat intensities on three chromatographic surfaces (p = 0.02-0.001) in control patients at time = 0 with an area under the curve (AUC) of 0.89-0.99. This biomarker was identified as the 41 amino acid (a.a.) variant of human beta-defensin-1. Another biomarker of 4631 Da was found to have a significantly greater peak intensity (p = 0.03) in AKI patients at time = 0, with an AUC of 0.84. Thus, the presence of a 4631 Da peptide, as well as the absence of the 41 a.a. variant of human beta-defensin-1 in the pre-procedural urine, may prove to be useful biomarkers for the early prediction of CIN.
对比剂肾病（CIN）是医院获得性急性肾损伤（AKI）的第三大主要原因。我们对接受择期心导管插入术的儿童进行了一项横断面研究，以确定在随后发生CIN的受试者中是否存在独特的术前尿蛋白质组学特征。在纳入的90例患者中，到对比剂注射后24小时时间点，10例参与者发生了因CIN导致的AKI（定义为血清肌酐升高50%或更多）。7例未发生AKI的患者作为年龄和性别匹配的对照。使用具有不同色谱表面的蛋白质芯片进行表面增强激光解吸电离飞行时间质谱（SELDI-TOF-MS）分析。一种4480 Da的生物标志物在0时刻的对照患者中，在三种色谱表面上显示出显著更高的峰强度（p = 0.02 - 0.001），曲线下面积（AUC）为0.89 - 0.99。该生物标志物被鉴定为人β-防御素-1的41个氨基酸（aa）变体。另一种4631 Da的生物标志物在0时刻的AKI患者中被发现具有显著更高的峰强度（p = 0.03），AUC为0.84。因此，术前尿液中存在4631 Da的肽以及人β-防御素-1的41 aa变体缺失，可能被证明是早期预测CIN的有用生物标志物。
