Zhu Bin, Li Xian-fa, Zhu Xiao-ling, Lin Yi, Zhong Sen, Zhu Cai-feng, Tang Xuan-li, Hu Yun-qing, Cheng Xiao-xia, Wang Yong-jun
Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine (Guangxing Hospital), Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China,
J Nephrol. 2014 Aug;27(4):411-7. doi: 10.1007/s40620-014-0066-z. Epub 2014 Apr 16.
To investigate urinary nephrin and podocalyxin standardized by aquaporin (AQP)-2 using the enzyme-linked immunosorbent assay (ELISA) method in adult nephrotic syndrome (NS) patients.
In 107 adult NS patients (27 proliferative nephritis, 77 non-proliferative, and 3 amyloidosis) undergoing renal biopsy, urinary nephrin, podocalyxin and AQP2 were measured by ELISA. Urinary nephrin and podocalyxin were standardized by AQP2 (neph/AQP and PCX/AQP) and values were compared with 11 healthy controls.
Urinary neph/AQP correlated positively to PCX/AQP (r = 0.51, p < 0.001). Urinary neph/AQP and PCX/AQP were lower in controls than NS patients. Both proliferative and non-proliferative NS patients excreted high urinary neph/AQP and PCX/AQP without a significant difference between them (p > 0.05). Patients with focal segmental glomerular sclerosis (FSGS) excreted higher urinary neph/AQP (p = 0.09) and PCX/AQP (p < 0.05) compared to the other patients. Urinary neph/AQP and PCX/AQP were increased in the immunoglobulin M nephropathy patients. Amyloidosis patients excreted lower neph/AQP and PCX/AQP. The sensitivity was 0.87 and specificity 0.37 when the neph/AQP borderline value of 0.16 was adopted [area under the curve (AUC) = 0.61]. The sensitivity was 0.74 and specificity 0.61 when the PCX/AQP borderline value was 3.06 (AUC = 0.69).
Urinary neph/AQP and PCX/AQP are increased in NS patients, with FSGS patients showing the highest levels. To distinguish FSGS from other NS forms, the measurement of urinary PCX/AQP may be a practical method, and superior to neph/AQP.
采用酶联免疫吸附测定（ELISA）法，研究以水通道蛋白（AQP）-2标准化的尿nephrin和足突细胞蛋白在成人肾病综合征（NS）患者中的情况。
对107例接受肾活检的成人NS患者（27例增殖性肾炎、77例非增殖性肾炎和3例淀粉样变性），采用ELISA法检测尿nephrin、足突细胞蛋白和AQP2。尿nephrin和足突细胞蛋白以AQP2标准化（neph/AQP和PCX/AQP），并将这些值与11名健康对照者进行比较。
尿neph/AQP与PCX/AQP呈正相关（r = 0.51，p < 0.001）。对照组尿neph/AQP和PCX/AQP低于NS患者。增殖性和非增殖性NS患者尿neph/AQP和PCX/AQP均较高，两者之间无显著差异（p > 0.05）。与其他患者相比，局灶节段性肾小球硬化（FSGS）患者尿neph/AQP（p = 0.09）和PCX/AQP（p < 0.05）排泄更高。免疫球蛋白M肾病患者尿neph/AQP和PCX/AQP升高。淀粉样变性患者neph/AQP和PCX/AQP排泄较低。当采用neph/AQP临界值0.16时，敏感性为0.87，特异性为0.37[曲线下面积（AUC）= 0.61]。当PCX/AQP临界值为3.06时，敏感性为0.74，特异性为0.61（AUC = 0.69）。
NS患者尿neph/AQP和PCX/AQP升高，FSGS患者水平最高。为了将FSGS与其他NS形式区分开来，检测尿PCX/AQP可能是一种实用的方法，且优于neph/AQP。
