scholarly journals Clinical significance of beta-2-microglobulin, enzymes, cytokines in serum and urine in patients with chronic renal allograft dysfunction

2015 ◽  
Vol 3 (1) ◽  
pp. 13-19
Author(s):  
A. Trailin ◽  
M. Pleten ◽  
A. Nikonenko ◽  
T. Ostapenko ◽  
N. Yefimenko

The most investigations of the biomarkers of renal allograft dysfunction (RAD) are limited by early post-operational period and are aimed at diagnosis of acute rejection of renal transplant. This work has aimed to establish additional characteristics of chronic RAD by using non-invasive biomarkers of the blood serum and urine.Materials and methods. 79 patients aged 16 to 59 years (47 men and 32 women) took part in our retrospective study. The alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamil transferase (GGT), alkaline phosphatase (ALP), N-acetyl-β-D-glucosaminidase (NAG); interleukins (IL-2, IL-8, IL-10) and beta-2-microglobulin were evaluated.Results. Increased IL-10 and β2-MG serum concentration, and increased urinary concentration and activity of β2-MG, IL-2, IL-8, NAG, AP, AST, GGT were typical for chronic RAD. Only NAG was independently significantly associated with chronic RAD in multivariate regression. From the area under ROC-curves were derived, that β2-MG level in serum and urine, and the activity of NAG in urine had the excellent and good power to classify patients with satisfactory function and chronic RAD.Conclusions. The increase of β2-MG in serum and urine may indicate glomerular and tubular dysfunction, respectively. An increase of urinary NAG indicates the ongoing damage of the tubules. The increase of IL-2 and IL-8 in the urine and IL-10 in serum may indicate the etiology of chronic RAD.

1980 ◽  
Vol 26 (8) ◽  
pp. 1193-1197 ◽  
Author(s):  
J Woo ◽  
M Floyd ◽  
M A Longley ◽  
D C Cannon

Abstract We describe a radioimmunoassay for beta 2-microglobulin (beta 2 mu) in serum and urine. We incubated aliquots of diluted samples at room temperature for 1 h with 125I-labeled beta 2 mu and a rabbit antiserum monospecific for human beta 2 mu, and separated the phases by the double-antibody technique. The logit-log transformed dose-response curve was linear in the range 2 to 64 ng, equivalent to 0.5 to 16 mg/L of serum and 0.5 to 320 mg/L of urine. Assay sensitivity was 2.4 ng of beta 2 mu. Validation studies included tests of precision, accuracy, antibody specificity, and parallelism of the dose-response curves for standard and unknown. In a study of 25 normal individuals, serum and urine beta 2 mu ranged from 1.1 to 2.3 mg/L and 40 to 360 micrograms/24 h; the clearance of beta 2 mu was 8 to 130 microL/min. In 21 renal allograft recipients tested one to five weeks after transplantation, serum and urine beta 2 mu ranged from 3.9 to 15.6 mg/L and 7.2 to 611 mg/24 h; beta 2 mu clearance was 0.60 to 33.3 mL/min. Values for both serum and urine correlated well with severity of allograft rejection.


2019 ◽  
Vol 20 (8) ◽  
pp. 656-664 ◽  
Author(s):  
Yi Da ◽  
K. Akalya ◽  
Tanusya Murali ◽  
Anantharaman Vathsala ◽  
Chuen-Seng Tan ◽  
...  

Background: : Drug-induced Acute Kidney Injury (AKI) develops in 10-15% of patients who receive nephrotoxic medications. Urinary biomarkers of renal tubular dysfunction may detect nephrotoxicity early and predict AKI. Methods:: We prospectively studied patients who received aminoglycosides, vancomycin, amphotericin, or calcineurin inhibitors, and collected their serial urine while on therapy. Patients who developed drug-induced AKI (fulfilling KDIGO criteria) were matched with non-AKI controls in a 1:2 ratio. Their urine samples were batch-analyzed at time-intervals leading up to AKI onset; the latter benchmarked against the final day of nephrotoxic therapy in non- AKI controls. Biomarkers examined include clusterin, beta-2-microglobulin, KIM1, MCP1, cystatin-C, trefoil-factor- 3, NGAL, interleukin-18, GST-Pi, calbindin, and osteopontin; biomarkers were normalized with corresponding urine creatinine. Results:: Nine of 84 (11%) patients developed drug-induced AKI. Biomarkers from 7 AKI cases with pre-AKI samples were compared with those from 14 non-AKI controls. Corresponding mean ages were 55(±17) and 52(±16) years; baseline eGFR were 99(±21) and 101(±24) mL/min/1.73m2 (all p=NS). Most biomarker levels peaked before the onset of AKI. Median levels of 5 biomarkers were significantly higher in AKI cases than controls at 1-3 days before AKI onset (all µg/mmol): clusterin [58(8-411) versus 7(3-17)], beta-2-microglobulin [1632(913-3823) versus 253(61-791)], KIM1 [0.16(0.13-0.76) versus 0.07(0.05-0.15)], MCP1 [0.40(0.16-1.90) versus 0.07(0.04-0.17)], and cystatin-C [33(27-2990) versus 11(7-19)], all p<0.05; their AUROC for AKI prediction were >0.80 (confidence intervals >0.50), with average accuracy highest for clusterin (86%), followed by beta-2-microglobulin, cystatin-C, MCP1, and KIM1 (57%) after cross-validation. Conclusion: : Serial surveillance of these biomarkers could improve the lead time for nephrotoxicity detection by days.


Biomedicines ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 86 ◽  
Author(s):  
Maifata ◽  
Hod ◽  
Zakaria ◽  
Abd Ghani

The detection of phospholipase A2 receptor (PLA2R) and thrombospondin domain containing 7A THSD7A among primary membranous glomerulonephritis (MGN) patients transformed the diagnosis, treatment monitoring, and prognosis. Anti-PLA2R can be detected in 70–90% of primary MGN patients while anti-THSD7A in 2–3% of anti-PLA2R negative primary MGN patients depending on the technique used. Serum and urine samples are less invasive and non-invasive, respectively, and thus can detect the presence of anti-PLA2R and anti-THSD7A with higher sensitivity and specificity, which is significant in patient monitoring and prognosis. It is better than exposing patients to a frequent biopsy, which is an invasive procedure. Different techniques of detection of PLA2R and THSD7A in patients’ urine and sera were reviewed to provide newer and alternative techniques. We proposed the use of biomarkers (PLA2R and THSD7A) in the diagnosis, treatment decision, and follow-up of patients with primary MGN. In addition, other prognostic renal biomarkers like retinol binding protein (RBP) and beta-2 microglobulin were reviewed to detect the progression of renal damage for early intervention.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E H Nashaat ◽  
M M Mohamed ◽  
T M Aziz ◽  
M W Nakhla

Abstract Background ulcerative colitis (UC) is a chronic, idiopathic, inflammatory bowel disease that causes inflammation and ulcers in the innermost layers of the large intestine (colon) and rectum. Assessment of intestinal inflammation in UC is crucial and still remains a difficult challenge for the clinician. Although endoscopic modalities with biopsy sampling seem to be the most reliable method for estimating disease severity, they are invasive and costly. Apart from endoscopic interventions, disease severity can be assessed using both laboratory studies and non-invasive imaging tests. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBCs), acid glycoprotein, platelet count and albumin are in common use but have only modest accuracy in reflecting UC disease activity. Therefore, adjunctive use of additional serum markers that will be more sensitive and specific for determination of disease activity and achieving diagnostic accuracy is strongly needed in daily clinical practice. Aim of the Work to investigate the diagnostic utility of beta 2 microglobulin (B2-M) levels and analyze this correlation with the activity of ulcerative colitis disease. Patients and Methods a case control study that was conducted at the Gastroenterology Clinic, Internal Medicine Department, Ain Shams University during the period of January to July 2018. 60 patients were recruited for the study. They were divided as follows; Group “A”: 40 patients newly diagnosed as ulcerative colitis based on colonoscopy and biopsy, subdivided as follows; 20 patients with active ulcerative colitis and 20 patients with inactive ulcerative colitis. Group “B”: 20 healthy individuals free from any systemic diseases serving as a control group. Results in this study, the serum levels of serum B2-microglobulins were highest in patients with active ulcerative colitis compared to those with inactive ulcerative colitis and the control groups. Also B2-microglobulins values become higher with higher number of presenting symptoms and endoscopic activity, which becomes higher in severe disease. Conclusion our results revealed that serum B2-microglobulin was simple and non-invasive marker that could be helpful for differentiating active UC from inactive disease. Moreover, it was more helpful when used together with serum laboratory inflammatory indices (ESR and CRP).


1981 ◽  
Vol 27 (5) ◽  
pp. 709-713 ◽  
Author(s):  
J Woo ◽  
M Floyd ◽  
D C Cannon

Abstract Blood and urine were samples daily from 11 renal-allograft recipients from one to six weeks after the transplant. Clearances of both albumin (Calb) and beta2-microglobulin (C beta 2 mu) were significantly increased in all 11 patients. Five patients (Group I) with acute allograft rejection showed markedly increased Calb and moderately increased C beta 2 mu, concurrent with decreased creatinine clearance (CCr). Five other patients (Group II) with no evidence of rejection demonstrated episodes of grossly increased C beta 2 mu with minimally increased but stable Calb and normal CCr. One patient had no evidence of rejection nor indications of glomerular or tubular proteinuria. While changes in serum beta 2-microglobulin concentration closely paralleled those of serum creatinine in the Group II patients, the results diverged in the Group I patients because the increase in serum beta 2-microglobulin exceeded that of serum creatinine and preceded the increased in creatinine by one to five days, suggesting that measurement of serum beta 2-microglobulin might afford earlier indication of the nature and extent of renal damage in the allograft recipients.


1986 ◽  
Vol 32 (10) ◽  
pp. 1818-1822 ◽  
Author(s):  
K Shima ◽  
M Hirota ◽  
M Fukuda ◽  
A Tanaka

Abstract Seeking to study whether measurement of lysozyme (EC 3.2.1.17) in urine by a reliable radioimmunoassay can provide a suitable index of renal tubular function and how lysozymuria develops in temporal relation to proteinuria in diabetic nephropathy, we have compared the urinary excretion of lysozyme and beta 2-microglobulin with the 15-min excretion rate of phenolsulfonphthalein in 39 patients with Type 2 (non-insulin-dependent) diabetes and investigated the temporal relation between the onset of lysozymuria and proteinuria in 15 patients with Type 1 (insulin-dependent) diabetes. The concentrations of lysozyme and beta 2-microglobulin in urine increased in proportion to the decrease in the rate of excretion of phenolsulfonphthalein in these patients. The coefficient of correlation between lysozyme concentration and the 15-min excretion rate of phenolsulfonphthalein (r = -0.70) was higher than that between beta 2-microglobulin concentration and the 15-min excretion rate of phenolsulfonphthalein (r = -0.46). Abnormally high lysozymuria, suggesting the existence of tubular dysfunction, was demonstrated in six of the patients with Type 1 diabetes who showed no proteinuria or only a slight increase in urinary protein excretion. Lysozymuria may thus be added to a list of the indicators for diabetic nephropathy.


Author(s):  
Sadiq Mu'azu Maifata ◽  
Rafidah Hod ◽  
Nor Fadhina Zakaria ◽  
Fauzah Abd Ghani

Detection of PLA2R and THSD7A among primary membranous glomerulonephritis (MGN) patients transformed the diagnosis, treatment monitoring and prognosis. Anti-PLA2R can be detected in 70-90% of primary MGN patients while anti-THSD7A in 2-3% of anti-PLA2R negative primary MGN patients depending on the technique used. Serum and urine samples are less invasive and non-invasive respectively and can detect the presence of anti-PLA2R and anti-THSD7A with higher sensitivity and specificity, significant in patients&rsquo; monitoring and prognosis better than exposing patients to frequent biopsy which is an invasive procedure. Different techniques of detection of PLA2R and THSD7A in patients&rsquo; urine and sera were reviewed with the aim of providing newer and alternative techniques. We proposed the use of biomarkers (PLA2R and THSD7A) in making the diagnosis, treatment decision and follow up of patients with primary MGN. We also reviewed other prognostic renal biomarkers like retinol binding protein (RBP) and beta-2 microglobulin in order to detect progression of renal damage for early intervention.


2013 ◽  
Vol 35 ◽  
pp. 811-818 ◽  
Author(s):  
Małgorzata Zubowska ◽  
Krystyna Wyka ◽  
Wojciech Fendler ◽  
Wojciech Młynarski ◽  
Beata Zalewska-Szewczyk

Novel markers of nephrotoxicity, including kidney injury molecule 1 (KIM-1), interleukin 18 (IL-18), and beta-2 microglobulin, were used in the detection of acute renal injury. The aim of the study was to establish the frequency of postchemotherapy chronic kidney dysfunction in children and to assess the efficacy of IL-18, KIM-1, and beta-2 microglobulin in the detection of chronic nephropathy. We examined eighty-five patients after chemotherapy (median age of twelve years). The median age at the point of diagnosis was 4.2 years, and the median follow-up time was 4.6 years. We performed classic laboratory tests assessing kidney function and compared the results with novel markers (KIM-1, beta-2 microglobulin, and IL-18). Features of subclinical renal injury were identified in forty-eight children (56.3% of the examined group). Nephropathy, especially tubulopathy, appeared more frequently in patients treated with ifosfamide, cisplatin, and/or carboplatin, following nephrectomy or abdominal radiotherapy (P=0.14,P=0.11, andP=0.08, resp.). Concentrations of IL-18 and beta-2 microglobulin were comparable with classic signs of tubulopathy (P=0.0001andP=0.05). Concentrations of IL-18 were also significantly higher in children treated with highly nephrotoxic drugs (P=0.0004) following nephrectomy (P=0.0007) and abdominal radiotherapy (P=0.01). Concentrations of beta-2 microglobulin were higher after highly toxic chemotherapy (P=0.004) and after radiotherapy (P=0.02). ROC curves created utilizing IL-18 data allowed us to distinguish between children with nephropathy (value 28.8 pg/mL) and tubulopathy (37.1 pg/mL). Beta-2 microglobulin and IL-18 seem to be promising markers of chronic renal injury in children after chemotherapy.


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