Proverbio Daniela, Perego Roberta, Baggiani Luciana, Spada Eva
Department of Veterinary Medicine and Veterinary Science, University of Milan, via dell'Università 6, 26900 Lodi, Italy.
Vet World. 2024 Dec;17(12):2967-2974. doi: 10.14202/vetworld.2024.2967-2974. Epub 2024 Dec 26.
infection in dogs has several clinical manifestations. Glomerulonephritis, caused by circulating immune complexes, may cause proteinuria and progress to kidney failure, which is the primary cause of death in dogs with canine leishmaniasis (CanL). Renal proteinuria can be monitored in dogs with CanL for the early detection of renal involvement. Neutrophil gelatinase-associated lipocalin (NGAL) is a neutrophil-derived protein that is filtered by glomeruli and reabsorbed by proximal tubular cells. Urinary NGAL (uNGAL) is a sensitive marker of acute and chronic kidney disease in dogs. This study aimed to evaluate uNGAL concentrations in dogs naturally affected by CanL, to determine whether uNGAL concentration differs depending on the stage of disease based on the LeishVet and International Renal Interest Society (IRIS) classification systems, to compare uNGAL concentration with selected urinary and biochemical parameters related to kidney function, and to assess the clinicopathological status of dogs affected by CanL.
We assessed uNGAL concentrations in 37 privately owned dogs naturally affected by CanL, in which urinary tract infections were excluded based on negative urine culture. No dog exhibited clinical signs related to impaired renal function. uNGAL concentration evaluated in dogs affected by CanL was compared to the one previously analyzed in the control group. Furthermore, the uNGAL concentration was compared between leishmaniasis dogs with biochemical and urinary parameters inside or outside the normal range and between dogs with different clinical stages of leishmaniasis based on the LeishVet clinical staging guidelines and IRIS classification.
The median uNGAL concentration in affected dogs was 50.2 ng/mL, which was significantly higher than that in healthy dogs (9.74 ng/mL [p = 0.0025]). uNGAL concentration was significantly higher in proteinuric leishmaniosis dogs than in non-proteinuric leishmaniosis dogs (p = 0.0001). Dogs classified as LeishVet clinical stage III had a higher mean uNGAL concentration than those classified as stage II (p = 0.0001) and median uNGAL concentration was statistically higher in dogs classified as IRIS stage 1 than in dogs affected by CanL with no clinical and pathological signs of renal disease. The amount of proteinuria and urinary sediment hyaline cast per high-power field of the microscope and total serum protein concentrations were significantly correlated with uNGAL concentration.
To the best of our knowledge, only a few studies have measured uNGAL in dogs naturally affected by CanL. Although limited by the small number of cases, this study highlighted a significant increase in uNGAL levels in affected dogs compared with healthy dogs and confirmed the correlation between proteinuria and urinary excretion of uNGAL in dogs with leishmaniasis. This suggests that uNGAL can be used as a marker of kidney damage in dogs affected by CanL.
犬类感染有多种临床表现。由循环免疫复合物引起的肾小球肾炎可能导致蛋白尿,并进展为肾衰竭,这是犬利什曼病(CanL)犬死亡的主要原因。对于CanL犬,可监测肾蛋白尿以早期发现肾脏受累情况。中性粒细胞明胶酶相关脂质运载蛋白(NGAL)是一种源自中性粒细胞的蛋白质,可被肾小球滤过并被近端肾小管细胞重吸收。尿NGAL(uNGAL)是犬急性和慢性肾病的敏感标志物。本研究旨在评估自然感染CanL的犬的uNGAL浓度,根据LeishVet和国际肾脏研究学会(IRIS)分类系统确定uNGAL浓度是否因疾病阶段而异,将uNGAL浓度与选定的与肾功能相关的尿液和生化参数进行比较,并评估受CanL影响的犬的临床病理状态。
我们评估了37只自然感染CanL的私人饲养犬的uNGAL浓度,这些犬基于尿培养阴性排除了尿路感染。没有犬表现出与肾功能受损相关的临床症状。将受CanL影响的犬的uNGAL浓度与之前在对照组中分析的浓度进行比较。此外,根据LeishVet临床分期指南和IRIS分类,比较了生化和尿液参数在正常范围内外的利什曼病犬之间以及不同临床阶段利什曼病犬之间的uNGAL浓度。
受影响犬的uNGAL浓度中位数为50.2 ng/mL,显著高于健康犬(9.74 ng/mL [p = 0.0025])。蛋白尿性利什曼病犬的uNGAL浓度显著高于非蛋白尿性利什曼病犬(p = 0.0001)。分类为LeishVet临床III期的犬的平均uNGAL浓度高于分类为II期的犬(p = 0.0001),并且分类为IRIS 1期的犬的uNGAL浓度中位数在统计学上高于无肾脏疾病临床和病理体征的CanL感染犬。每高倍视野显微镜下的蛋白尿和尿沉渣透明管型数量以及总血清蛋白浓度与uNGAL浓度显著相关。
据我们所知,只有少数研究测量了自然感染CanL的犬的uNGAL。尽管受病例数量限制,但本研究强调了受影响犬的uNGAL水平与健康犬相比显著升高,并证实了利什曼病犬蛋白尿与uNGAL尿排泄之间的相关性。这表明uNGAL可作为受CanL影响的犬肾脏损伤的标志物。