Abdelsattar Shimaa, Al-Amodi Hiba S, Nazih Mahmoud, Salem Eman H M, Mostafa Rasha G, Menshawy Shymaa S, El-Banna Amany A, Abdelgawad Basma M, Nabih Omnia S, Mohsen Yasmin, Abozeid Elaf, Abd El-Hamid Mai El-Sayad, Shoman Nabil A, Ahmed Naglaa Abdelmawgoud, Nabil Mai Mohamed, Mohamed Dalia Abdel-Wahab
Clinical Biochemistry and Molecular Diagnostics Department, National Liver Institute, Menofia University, Menofia 32511, Egypt.
Biochemistry Department, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
Int J Mol Sci. 2025 Jul 14;26(14):6738. doi: 10.3390/ijms26146738.
Sepsis-associated acute kidney injury (S-AKI) represents a significant health problem associated with adverse outcomes. Our study aimed to assess the value of serum cystatin-C (sCysC) and TNF-α (rs361525) in combination for diagnosing S-AKI patients and predicting their adverse outcomes. The study included 100 critically ill neonates and 100 controls. Patients were categorized into an S-AKI group and a non-AKI group. TNF-α (-238, rs361525) genotyping was performed using RT-PCR, and sCysC was assessed using ELISA. Our study showed a fundamental difference in the genotype frequencies of TNF-α (-238, rs361525) and SNP between S-AKI and non-AKI patients. Furthermore, there was a significant relationship between cystatin C and TNF-α (-238, rs361525), where cystatin C was higher in patients with AA alleles than in patients with GA and GG alleles. Combining GA + AA genotypes with elevated serum cystatin-C levels can serve as a potential diagnostic and prognostic biomarker for AKI development in this population. The GA/AA genotypes independently predicted S-AKI risk (OR = 6.64, < 0.001). At the same time, elevated sCysC (>9.4 mg/L) emerged as a sensitive biomarker (AUC = 0.848) and independent predictor of adverse outcomes. Collectively, these findings contribute to the growing field of personalized medicine and represent a strategic advantage, enabling prevention-focused care rather than the treatment of established disease.
脓毒症相关急性肾损伤（S-AKI）是一个与不良预后相关的重大健康问题。我们的研究旨在评估血清胱抑素C（sCysC）和肿瘤坏死因子-α（rs361525）联合用于诊断S-AKI患者并预测其不良预后的价值。该研究纳入了100例危重新生儿和100例对照。患者被分为S-AKI组和非AKI组。采用逆转录聚合酶链反应（RT-PCR）进行肿瘤坏死因子-α（-238，rs361525）基因分型，采用酶联免疫吸附测定（ELISA）评估sCysC。我们的研究表明，S-AKI患者与非AKI患者在肿瘤坏死因子-α（-238，rs361525）的基因型频率和单核苷酸多态性（SNP）方面存在根本差异。此外，胱抑素C与肿瘤坏死因子-α（-238，rs361525）之间存在显著关系，其中AA等位基因患者的胱抑素C高于GA和GG等位基因患者。将GA + AA基因型与血清胱抑素C水平升高相结合可作为该人群急性肾损伤发生的潜在诊断和预后生物标志物。GA/AA基因型独立预测S-AKI风险（比值比[OR]=6.64，P<0.001）。同时，sCysC升高（>9.4 mg/L）是一种敏感的生物标志物（曲线下面积[AUC]=0.848），也是不良预后的独立预测因素。总体而言，这些发现为个性化医疗这一不断发展的领域做出了贡献，并代表了一种战略优势，能够实现以预防为主的护理，而非对已确诊疾病的治疗。
