Niwa Shunsuke, Tanaka Akihito, Furuhashi Kazuhiro, Hattori Keita, Onogi Chikao, Sunohara Keisuke, Owaki Akiko, Kato Akihisa, Kawazoe Tomohiro, Watanabe Yu, Koshi-Ito Eri, Kato Noritoshi, Kosugi Tomoki, Maruyama Shoichi
Department of Nephrology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, Japan.
Department of Nephrology, Nagoya University Hospital, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, Japan.
Sci Rep. 2024 Dec 3;14(1):30088. doi: 10.1038/s41598-024-80686-7.
Serum presepsin levels are elevated during sepsis and are widely employed in clinical practice. However, the association between urinary presepsin and kidney diseases remains elusive. Given that monocytes/macrophages, primary presepsin producers, are closely associated with the pathophysiology of nephritis, we explored the potential of urinary presepsin as a kidney disease biomarker. In a cross-sectional study involving patients who underwent kidney biopsy (n = 463 patients; 43% female, median age 58 years), the median urinary presepsin/creatinine levels were 590 (interquartile range [IQR], 244-1276), 1023 (IQR, 491-2749), 1429 (IQR, 644-2725), and 3518 (IQR, 2084-6321) ng/g creatinine, indicating minimal (< 5%), mild (5-25%), moderate (26-50%), and severe (> 50%) interstitial inflammatory cell infiltration in biopsy samples, respectively. The area under the curve of urinary presepsin/creatinine (0.81) had a higher accuracy for distinguishing severe interstitial inflammatory cell infiltration than that of the N-acetyl-β-D-glucosaminidase/creatinine (0.70) (P = 0.003). The tubulointerstitial nephritis group had the highest urinary presepsin/creatinine level. Immunofluorescence staining revealed that monocytes and macrophages predominantly expressed presepsin in the kidney interstitium, with the stained area positively and significantly correlated with presepsin/creatinine values (r = 0.57, P = 0.02). Urinary presepsin could be a biomarker for directly assessing monocyte/macrophage infiltration in kidney disease.
脓毒症期间血清前降钙素水平会升高，并且在临床实践中被广泛应用。然而，尿前降钙素与肾脏疾病之间的关联仍不明确。鉴于单核细胞/巨噬细胞作为前降钙素的主要产生者，与肾炎的病理生理学密切相关，我们探讨了尿前降钙素作为肾脏疾病生物标志物的潜力。在一项横断面研究中，纳入了接受肾活检的患者（n = 463例患者；43%为女性，中位年龄58岁），尿前降钙素/肌酐水平的中位数分别为590（四分位间距[IQR]，244 - 1276）、1023（IQR，491 - 2749）、1429（IQR，644 - 2725）和3518（IQR，2084 - 6321）ng/g肌酐，分别表明活检样本中存在极少（<5%）、轻度（5 - 25%）、中度（26 - 50%）和重度（>50%）的间质炎性细胞浸润。尿前降钙素/肌酐曲线下面积（0.81）在区分重度间质炎性细胞浸润方面比N - 乙酰 - β - D - 氨基葡萄糖苷酶/肌酐（0.70）具有更高的准确性（P = 0.003）。肾小管间质性肾炎组的尿前降钙素/肌酐水平最高。免疫荧光染色显示，单核细胞和巨噬细胞在肾间质中主要表达前降钙素，染色面积与前降钙素/肌酐值呈正相关且具有显著性（r = 0.57，P = 0.02）。尿前降钙素可能是直接评估肾脏疾病中单核细胞/巨噬细胞浸润的生物标志物。
