ABSTRACT
ABSTRACT CONTEXT AND OBJECTIVE: Acute kidney injury (AKI) is still a headache for clinicians and scientists as a possible reason for increased death among intensive care unit (ICU) patients after invasive cardiac surgery. Furthermore, the diagnostic process for AKI using conventional biomarkers is not sufficient to ensure early warning of this condition because of the morbid influence of non-renal factors that definitively delay the time for the prognosis. These imposed limitations have led to significant amounts of research targeted towards identifying novel biomarkers for AKI with a sustained degree of sensitivity and specificity. Here, we reviewed previous studies conducted on the Klotho, CYR61 and YKL-40 biomarkers in relation to AKI. DESIGN AND SETTING: Review of the literature conducted in the Institute of Clinical Chemistry & Biochemistry, Ljubljana University Medical Center, Slovenia. METHODS: The literature was searched in PubMed and the Cochrane Library. From the database of this specialty, we selected 17 references that matched our context for detailed analysis and further investigation. RESULTS: The studies reviewed showed notable differences in their results relating to the diagnostic impact of Klotho, CYR61 and YKL-40 on early prediction of AKI. CONCLUSIONS: The results regarding the Klotho, CYR61 and YKL-40 biomarkers showed markedly equivocal performance in the previous studies and did not fulfill the expectations that these factors would form valid possible biomarkers for AKI.
RESUMO CONTEXTO E OBJETIVO: A lesão renal aguda (LRA) ainda é uma dor de cabeça para os clínicos e cientistas como possível razão para o aumento da mortalidade entre os pacientes de unidade de terapia intensiva (UTI) após cirurgia cardíaca invasiva. Além disso, o processo de diagnóstico para LRA usando biomarcadores convencionais não é suficiente para garantir um alerta precoce desta condição, devido à influência mórbida de fatores não renais que podem retardar o tempo para o prognóstico. Essas limitações geraram quantidades significativas de pesquisas orientadas para identificar novos biomarcadores para LRA com um grau adequado de sensibilidade e especificidade. Revisamos estudos anteriores realizados sobre os biomarcadores Klotho, CYR61, YKL-40 para LRA. TIPO DE ESTUDO E LOCAL: Revisão da literatura realizada no Instituto de Química Clínica e Bioquímica, Centro Médico da Universidade de Ljubljana, Eslovênia. MÉTODOS: A literatura foi pesquisada no PubMed e Cochrane Library. A partir da base de dados da especialidade, selecionamos 17 referências que combinavam com o contexto para uma análise detalhada e mais investigação. RESULTADOS: Os estudos revisados mostraram diferenças notáveis nos resultados sobre o impacto diagnóstico de Klotho, CYR61 e YKL-40 sobre a detecção precoce do LRA. CONCLUSÃO: Os resultados em relação aos biomarcadores Klotho, CYR61 e YKL-40 mostraram desempenho marcadamente equívoco nos estudos anteriores e não cumpriram as expectativas de que estes fatores constituam possíveis biomarcadores válidos para LRA.
Subject(s)
Humans , Biomarkers/analysis , Cysteine-Rich Protein 61/analysis , Acute Kidney Injury/diagnosis , Chitinase-3-Like Protein 1/analysis , Glucuronidase/analysis , Sensitivity and SpecificityABSTRACT
BACKGROUND/AIMS: The potential physiologic roles of Klotho in acute kidney injury (AKI) have recently been demonstrated in animal models. However, to date, there have been no human studies investigating the expression of renal Klotho in AKI. METHODS: We retrospectively collected biopsy specimens and clinical data of AKI patients between January 2001 and December 2012. Klotho expression was determined by immunohistochemical staining, and the clinical-pathological correlation was examined. RESULTS: Among the 34 patients diagnosed with acute tubular necrosis or acute tubulointerstitial nephritis, 21 patients without chronic histological lesions were included. The mean age was 37.3 +/- 18.5 years and the mean peak creatinine level was 8.2 +/- 5.5 mg/dL. In total, 10 patients (47.6%) received temporary renal replacement therapy (RRT); however, 17 patients (81%) showed functional recovery with creatinine levels of < 1.3 mg/dL after 1 month. The intensity of Klotho expression was scored as a percentage of Klotho-positive area. The renal Klotho score showed a significant negative correlation with the initial or peak creatinine level. When the patients were divided into three groups according to the Klotho score (low, middle, high), the low group had a significantly higher peak creatinine level and a more frequent requirement for RRT. However, the Klotho score was not a significant predictor of renal recovery. CONCLUSIONS: The results demonstrated that renal Klotho expression in humans decreased significantly according to the severity of AKI, regardless of the etiology, and that low expression was associated with a poor short-term outcome.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Acute Kidney Injury/diagnosis , Biomarkers/analysis , Biopsy , Down-Regulation , Glucuronidase/analysis , Immunohistochemistry , Kidney/chemistry , Kidney Tubular Necrosis, Acute/diagnosis , Necrosis , Predictive Value of Tests , Recovery of Function , Renal Replacement Therapy , Retrospective Studies , Risk Factors , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
Alteration in the testosterone levels in experimental animals is reflected by a corresponding change in kidney beta-glucuronidase activity. With a view to use change in renal beta-glucuronidase activity as a bioassay of androgens, the activity of renal beta-glucuronidase and serum testosterone levels were determined following treatment with cisplatin for 3 alternate days. Levels of both renal beta-glucuronidase activity and serum testosterone were significantly decreased in cisplatin-treated rats. It is therefore suggested that kidney beta-glucuronidase activity can be used as a bioassay of androgens.
Subject(s)
Animals , Biological Assay , Glucuronidase/analysis , Kidney/enzymology , Male , Rats , Rats, Wistar , Testosterone/bloodABSTRACT
Se realizó un estudio citoquímico de la reacción del PAS, beta-glucuronidasa y fosfatasa ácida en linfocitos y neutrófilos de personas con enfermedad de Chagas. Se compararon los valores de estas reacciones con extendidos sanguíneos de personas sanas. En los puntajes y porcentajes encontrados en enfermos de Chagas se notó un incremento significativo en la positividad en los linfocitos con la reacción del PAS y de la beta-glucuronidasa y en los neutrófilos un incremento significativo con la reacción de la beta-glucuronidasa
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Chagas Disease/immunology , Acid Phosphatase/analysis , Glucuronidase/analysis , Lymphocytes/enzymology , Neutrophils/enzymology , HistocytochemistryABSTRACT
Presence of Mycobacterium leprae in association with in vitro cultured macrophages, from bacillary negative long term treated lepromatous leprosy patients, induces reduced level of protein and lowering of hydrolytic enzymes like p-glucuronidase, Lysozyme and Lactic dehydrogenase. Alkaline phosphatase, on the other hand is increased. In the macrophages from normal healthy individuals or tuberculoid leprosy patients, presence of M.leprae increases both protein and levels of all the above enzymes. This observation shows that macrophages from lepromatous leprosy patients are unable to manifest in presence of M. leprae, the key enzymes involved in degradation of complex biological entities phagocytosed by the cells.