Zager R A, Rubin N T, Ebert T, Maslov N
Nephron. 1980;26(1):7-12. doi: 10.1159/000181942.
A previously described method for recovering a proximal renal tubular epitheal antigen (HRTE-1) from normal human kidney was modified by using ion-exchange and immunoaffinity chromatography in order to create easily reproducible conditions for antigen isolation. Radioiodinated HRTE-1 was then used to establish a 3-hour, double-antibody radioimmunoassay (RIA) for the purpose of testing whether the urinary excretion of this antigen might seve as a useful marker of acute tubular necrosis (ATN). Urines from 51 patients (ATN, 22: chronic nephropathies, 24; prerenal azotemia, 5) and from 36 normal subjects were assayed for HRTE-1. 79% of ATN patients had abnormal antigen concentrations while 100% of all other urines had urine antigen concentrations within a previously established range for random normal urine samples. When used as a differential diagnostic test of either ATN versus chronic nephropathies, or of ATN versus prerenal azotemia, 90 and 81% discrimination was achieved, respectively. The majority of ATN and prerenal azotemia patients presenting with atypical conventional diagnostic parameters (urine Na, urine osmolality, urine sediment, fractional Na excretion) were correctly diagnosed by RIA. Further study of HRTE-1 excretion in acute and chronic renal diseases seems indicated, both to elucidate pathophysiologic mechanisms and to determine whether HRTE-1 is a clinically useful marker of ATN.
一种先前描述的从正常人肾脏中提取近端肾小管上皮抗原（HRTE-1）的方法，通过使用离子交换和免疫亲和层析进行了改进，以便为抗原分离创造易于重现的条件。然后，用放射性碘化的HRTE-1建立了一种3小时的双抗体放射免疫测定法（RIA），目的是检测该抗原的尿排泄是否可作为急性肾小管坏死（ATN）的有用标志物。对51例患者（ATN患者22例；慢性肾病患者24例；肾前性氮质血症患者5例）以及36名正常受试者的尿液进行了HRTE-1检测。79%的ATN患者抗原浓度异常，而所有其他尿液中有100%的尿抗原浓度在先前确定的随机正常尿液样本范围内。当用作ATN与慢性肾病或ATN与肾前性氮质血症的鉴别诊断试验时，分别实现了90%和81%的鉴别率。大多数呈现非典型传统诊断参数（尿钠、尿渗透压、尿沉渣、钠排泄分数）的ATN和肾前性氮质血症患者通过RIA得到了正确诊断。似乎有必要进一步研究急性和慢性肾病中HRTE-1的排泄情况，以阐明病理生理机制，并确定HRTE-1是否为ATN的临床有用标志物。
