Cara-Fuentes Gabriel, Wei Changli, Segarra Alfons, Ishimoto Takuji, Rivard Christopher, Johnson Richard J, Reiser Jochen, Garin Eduardo H
Division of Pediatric Nephrology, Department of Pediatrics, University of Florida, 1600 SW Archer Rd. HD214, Gainesville, FL, 32610, USA.
Pediatr Nephrol. 2014 Aug;29(8):1363-71. doi: 10.1007/s00467-013-2679-1. Epub 2013 Nov 22.
Minimal change disease (MCD) is characterized by increased urinary excretion of CD80, whereas focal segmental glomerulosclerosis (FSGS) is associated with increased serum soluble urokinase-type plasminogen activator receptor (suPAR). The aim of the study was to assess whether the simultaneous measurement of urinary CD80 and serum suPAR helps differentiate MCD and FSGS.
Urine and sera were collected from patients with MCD in relapse or in remission, from FSGS patients with nephrotic syndrome, and from healthy individuals. CD80 and suPAR were measured by ELISA.
Urinary CD80 was significantly increased in MCD patients in relapse compared with those in remission and with FSGS patients and control individuals. Serum suPAR levels were significantly higher in patients with FSGS when compared with MCD patients in relapse. Urinary suPAR showed a positive correlation with proteinuria in MCD in relapse and FSGS patients, whereas urinary CD80 correlated with proteinuria only in MCD patients in relapse.
Urinary CD80 is elevated in MCD patients in relapse compared with FSGS patients. In contrast, serum suPAR is significantly elevated in FSGS patients. The consistent pattern of these two biomarkers in MCD and FSGS suggests that these two conditions represent different entities rather than a continuum spectrum of one disease.
微小病变病(MCD)的特征是尿中CD80排泄增加,而局灶节段性肾小球硬化(FSGS)与血清可溶性尿激酶型纤溶酶原激活物受体(suPAR)升高有关。本研究的目的是评估同时检测尿CD80和血清suPAR是否有助于鉴别MCD和FSGS。
收集复发或缓解期的MCD患者、肾病综合征型FSGS患者及健康个体的尿液和血清。采用酶联免疫吸附测定法(ELISA)检测CD80和suPAR。
复发期MCD患者的尿CD80水平显著高于缓解期MCD患者、FSGS患者及对照个体。FSGS患者的血清suPAR水平显著高于复发期MCD患者。复发期MCD患者和FSGS患者的尿suPAR与蛋白尿呈正相关,而尿CD80仅在复发期MCD患者中与蛋白尿相关。
复发期MCD患者的尿CD80水平高于FSGS患者。相比之下,FSGS患者的血清suPAR显著升高。这两种生物标志物在MCD和FSGS中的一致模式表明,这两种疾病是不同的实体,而非一种疾病的连续谱。