Department of Laboratory Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary.
János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary.
Molecules. 2023 Sep 29;28(19):6864. doi: 10.3390/molecules28196864.
A major complication of sepsis is the development of acute kidney injury (AKI). In case of acute tubular damage, Gc-globulin, a known serum sepsis marker is increasingly filtrated into the urine therefore, urinary Gc-globulin (u-Gc) levels may predict septic AKI. We developed and validated a competitive fluorescence ELISA method for u-Gc measurement. Serum and urine samples from septic patients were collected in three consecutive days (T1, T2, T3) and data were compared to controls. Intra- and interassay imprecisions were CV < 14% and CV < 20%, respectively, with a recovery close to 100%. Controls and septic patients differed ( < 0.001) in their u-Gc/u-creatinine levels at admission (T1, median: 0.51 vs. 79.1 µg/mmol), T2 (median: 0.51 vs. 57.8 µg/mmol) and T3 (median: 0.51 vs. 55.6 µg/mmol). Septic patients with AKI expressed higher u-Gc/u-creatinine values than those without AKI at T1 (median: 23.6 vs. 136.5 µg/mmol, < 0.01) and T3 (median: 34.4 vs. 75.8 µg/mmol, < 0.05). AKI-2 stage patients exhibited more increased u-Gc/u-creatinine levels at T1 (median: 207.1 vs. 53.3 µg/mmol, < 0.05) than AKI-1 stage individuals. Moderate correlations ( < 0.001) were observed between u-Gc/u-creatinine and se-urea, se-creatinine, se-hsCRP, WBC, u-total protein, u-albumin, u-orosomucoid/u-creatinine, and u-Cystatin C/u-creatinine levels. U-Gc testing may have a predictive value for AKI in septic patients.
脓毒症的一个主要并发症是急性肾损伤 (AKI) 的发展。在急性肾小管损伤的情况下，Gc-球蛋白作为一种已知的血清脓毒症标志物，会越来越多地滤入尿液中，因此，尿 Gc-球蛋白 (u-Gc) 水平可能预测脓毒症 AKI。我们开发并验证了一种用于 u-Gc 测量的竞争性荧光 ELISA 方法。在连续三天（T1、T2、T3）采集脓毒症患者的血清和尿液样本，并将数据与对照组进行比较。内和批间精密度的 CV 值分别<14%和<20%，回收率接近 100%。对照组和脓毒症患者在入院时（T1，中位数：0.51 对 79.1µg/mmol）、T2（中位数：0.51 对 57.8µg/mmol）和 T3（中位数：0.51 对 55.6µg/mmol）的 u-Gc/尿肌酐水平存在差异（<0.001）。AKI 患者的 u-Gc/尿肌酐值高于非 AKI 患者，T1（中位数：23.6 对 136.5µg/mmol，<0.01）和 T3（中位数：34.4 对 75.8µg/mmol，<0.05）。AKI-2 期患者在 T1（中位数：207.1 对 53.3µg/mmol，<0.05）时 u-Gc/尿肌酐水平升高更为明显，高于 AKI-1 期患者。u-Gc/尿肌酐与 se-urea、se-creatinine、se-hsCRP、WBC、u-总蛋白、u-白蛋白、u-粘蛋白/尿肌酐和 u-Cystatin C/尿肌酐水平之间存在中度相关性（<0.001）。u-Gc 检测对脓毒症患者 AKI 可能具有预测价值。
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