Zen Renata de Cássia, Dominguez Wagner Vasques, Braga Ivone, Dos Reis Luciene Machado, Jorge Lectícia Barbosa, Yu Luis, Woronik Viktoria, Dias Cristiane Bitencourt
Nephrology Department, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil.
Laboratory of Renal Pathophysiology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil.
Diagnostics (Basel). 2023 Jan 5;13(2):203. doi: 10.3390/diagnostics13020203.
Urinary CD80 has been shown to have good specificity for minimal change disease (MCD) in children. However, the investigation of circulating factors such as soluble urokinase plasminogen activator receptor (suPAR) as biomarkers of focal segmental glomerulosclerosis (FSGS) is quite controversial. The objective of this study was to determine whether urinary CD80 and serum suPAR can be used for the diagnosis of MCD and FSGS, respectively, in the adult population of Brazil. We also attempted to determine whether those biomarkers assess the response to immunosuppressive treatment.
This was a prospective study in which urine and blood samples were collected for analysis of CD80 and suPAR, respectively, only in the moment of renal biopsy, from patients undergoing to diagnostic renal biopsy. At and six months after biopsy, we analyzed serum creatinine, serum albumin, and proteinuria in order to evaluate the use of the CD80 and suPAR collected in diagnosis as markers of response to immunosuppressive treatment. In healthy controls were collected urinary CD80 and proteinuria, serum suPAR, and creatinine.
The results of 70 renal biopsies were grouped, by diagnosis, as follows: FSGS ( = 18); membranous nephropathy ( = 14); MCD ( = 5); and other glomerulopathies ( = 33). There was no significant difference among the groups in terms of the urinary CD80 levels, and serum suPAR was not significantly higher in the FSGS group, as would have been expected. Urinary CD80 correlated positively with nephrotic syndrome, regardless of the type of glomerular disease. Neither biomarker correlated with proteinuria at six months after biopsy.
In adults, urinary CD80 can serve as a marker of nephrotic syndrome but is not specific for MCD, whereas serum suPAR does not appear to be useful as a diagnostic or treatment response marker.
尿CD80已被证明对儿童微小病变病（MCD）具有良好的特异性。然而，对诸如可溶性尿激酶型纤溶酶原激活物受体（suPAR）等循环因子作为局灶节段性肾小球硬化（FSGS）生物标志物的研究颇具争议。本研究的目的是确定尿CD80和血清suPAR是否可分别用于巴西成年人群中MCD和FSGS的诊断。我们还试图确定这些生物标志物是否能评估免疫抑制治疗的反应。
这是一项前瞻性研究，仅在诊断性肾活检时，从接受诊断性肾活检的患者中收集尿液和血液样本，分别用于分析CD80和suPAR。在活检时及活检后六个月，我们分析血清肌酐、血清白蛋白和蛋白尿，以评估诊断时收集的CD80和suPAR作为免疫抑制治疗反应标志物的用途。在健康对照中收集尿CD80和蛋白尿、血清suPAR及肌酐。
70例肾活检结果按诊断分组如下：FSGS（n = 18）；膜性肾病（n = 14）；MCD（n = 5）；以及其他肾小球病（n = 33）。各组间尿CD80水平无显著差异，且FSGS组血清suPAR并不像预期的那样显著升高。无论肾小球疾病类型如何，尿CD80与肾病综合征呈正相关。活检后六个月，这两种生物标志物均与蛋白尿无相关性。
在成年人中，尿CD80可作为肾病综合征的标志物，但对MCD不具有特异性，而血清suPAR似乎不能作为诊断或治疗反应标志物。
