鉴定原发性局灶节段性肾小球硬化的潜在生物标志物及其与移植后复发的关系。

Identifying a potential biomarker for primary focal segmental glomerulosclerosis and its association with recurrence after transplantation.

机构信息

Department of Pharmaceutical Chemistry, University of California, San Francisco, California.

Kidney Transplant Service, University of California, San Francisco, California.

出版信息

Clin Transplant. 2019 Mar;33(3):e13487. doi: 10.1111/ctr.13487. Epub 2019 Feb 21.

DOI:10.1111/ctr.13487

PMID:30689221

Abstract

BACKGROUND

We investigated circulating levels of individual soluble urokinase plasminogen activation receptor (suPAR) forms to determine if specific circulating fragments of suPAR (II-III) and (I) can better serve as clinical biomarkers for focal segmental glomerulosclerosis (FSGS) and the risk of recurrence after transplantation.

MATERIALS AND METHODS

Serum levels of intact suPAR and its cleaved forms were measured with two assays, ELISA and TR-FIA.

RESULTS

suPAR levels in healthy controls were significantly lower than those who had glomerular diseases but were not significantly different between FSGS patients and glomerular controls. Intact suPAR (I-II-III) levels were noted to be elevated in glomerular diseases including FSGS. uPAR fragment (I) levels measured with the TR-FIA 4 assay were significantly higher in FSGS (695.4 + 91.29 pMol/L) than glomerular controls (239.1 + 40.45 pMol/L, P = 0.001). However, suPAR(I) levels were not significantly different between recurrent FSGS and nonrecurrent FSGS patients.

CONCLUSION

Our analysis of suPAR using the ELISA assay used in all previous studies does not appear to be a useful marker for FSGS nor serve as a predictor for its recurrence after transplantation. The TR-FIA assay results suggest that uPAR(I) is a potential biomarker for FSGS but not of its recurrence.

摘要

背景

我们研究了个体可溶性尿激酶型纤溶酶原激活物受体（suPAR）形式的循环水平，以确定 suPAR 的特定循环片段（II-III）和（I）是否可以更好地作为局灶节段性肾小球硬化症（FSGS）和移植后复发的临床生物标志物。

材料和方法

使用两种测定法（ELISA 和 TR-FIA）测量完整 suPAR 及其裂解形式的血清水平。

结果

健康对照组的 suPAR 水平明显低于肾小球疾病患者，但与 FSGS 患者和肾小球对照组无显著差异。在包括 FSGS 在内的肾小球疾病中，完整 suPAR（I-II-III）水平升高。使用 TR-FIA 4 测定法测量的 uPAR 片段（I）水平在 FSGS（695.4 ± 91.29 pMol/L）中明显高于肾小球对照组（239.1 ± 40.45 pMol/L，P = 0.001）。然而，复发 FSGS 和非复发 FSGS 患者之间的 suPAR（I）水平没有显著差异。