Xu Shengyuan, Hultström Michael, Larsson Anders, Lipcsey Miklos, Lindskog Cecilia, Bülow Sara, Frithiof Robert, Venge Per
Department of Medical Sciences, Clinical Chemistry, Uppsala University, SE-751 85 Uppsala, Sweden.
Diagnostics Development a P&M Venge Company, SE-753 12 Uppsala, Sweden.
J Clin Med. 2024 Apr 26;13(9):2540. doi: 10.3390/jcm13092540.
The human phospholipase B-II precursor (HPLBII-P) was originally purified from white blood cells but is also found in other cellular structures, such as kidney glomeruli and tubuli. The objective of this report was to investigate the relationship of HPLBII-P in urine to acute kidney injury in patients with COVID-19. Urine was collected at admission from 132 patients with COVID-19 admitted to the intensive care units (ICUs) because of respiratory failure. HPLBII-P was measured using a sensitive ELISA. For comparison, human neutrophil lipocalin (HNL) was measured in urine, using the ELISA configured with the monoclonal antibody 763/8F, as a sign of tubular affection in addition to routine biomarkers of kidney disease. Overall, the concentrations of urinary HPLBII-P were almost 3-fold higher in patients with COVID-19 compared to healthy controls ( < 0.0001) and with significantly higher concentrations even in patients with COVID-19 without signs of acute kidney injury (AKI) ( < 0.001). HPLBII-P was further increased in patients with AKI ( < 0.02). HPLBII-P was significantly increased in patients with diabetes mellitus ( = 0.0008) and correlated to plasma glucose (r = 0.29, = 0.001) and urine albumin concentrations (r = 0.55, < 0.001). Urine concentrations of HPLBII-P are highly raised in the urine of patients with COVID-19 and relate to AKI and diabetes mellitus. HPLBII-P may reflect glomerular injury and/or increased glomerular cell activity in SARS-CoV-2 infections.
人磷脂酶B-II前体（HPLBII-P）最初是从白细胞中纯化出来的，但在其他细胞结构中也有发现，如肾小球和肾小管。本报告的目的是研究COVID-19患者尿液中HPLBII-P与急性肾损伤的关系。从132名因呼吸衰竭入住重症监护病房（ICU）的COVID-19患者入院时收集尿液。使用灵敏的酶联免疫吸附测定（ELISA）法检测HPLBII-P。为作比较，除了肾病常规生物标志物外，还使用配置有单克隆抗体763/8F的ELISA法检测尿液中的人嗜中性粒细胞脂质运载蛋白（HNL），作为肾小管病变的指标。总体而言，COVID-19患者尿液中HPLBII-P的浓度比健康对照者高出近3倍（<0.0001），即使在没有急性肾损伤（AKI）迹象的COVID-19患者中浓度也显著更高（<0.001）。AKI患者的HPLBII-P进一步升高（<0.02）。糖尿病患者的HPLBII-P显著升高（=0.0008），且与血糖（r=0.29，=0.001）和尿白蛋白浓度相关（r=0.55，<0.001）。COVID-19患者尿液中HPLBII-P的浓度大幅升高，且与AKI和糖尿病有关。HPLBII-P可能反映了SARS-CoV-2感染中的肾小球损伤和/或肾小球细胞活性增加。
