Evaluating new biomarkers for diabetic nephropathy: Role of α2-macroglobulin, podocalyxin, α-L-fucosidase, retinol-binding protein-4, and cystatin C.

BACKGROUND: The intricate relationship between type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) presents a challenge in understanding the significance of various biomarkers in diagnosis. AIM: To elucidate the roles and diagnostic values of α2-macroglobulin (α2-MG), podocalyxin (PCX), α-L-fucosidase (AFU), retinol-binding protein-4 (RBP-4), and cystatin C (CysC) in DN. METHODS: From December 2018 to December 2020, 203 T2DM patients were enrolled in the study. Of these, 115 were diagnosed with DN (115 patients), while the remaining 88 patients were classified as non-DN. The urinary levels of α2-MG, PCX, and AFU and the serum concentrations RBP-4 and CysC were measured in conjunction with other relevant clinical indicators to evaluate their potential correlations and diagnostic utility. RESULTS: After adjustments for age and gender, significant positive correlations were observed between the biomarkers CysC, RBP-4, α2-MG/urinary creatinine (UCr), PCX/UCr, and AFU/UCr, and clinical indicators such as urinary albumin-to-creatinine ratio (UACR), serum creatinine, urea, 24-h total urine protein, and neutrophil-to-lymphocyte ratio (NLR). Conversely, these biomarkers exhibited negative correlations with the estimated glomerular filtration rate (P < 0.05). Receiver operating characteristic (ROC) curve analysis further demonstrated the diagnostic performance of these biomarkers, with UACR showcasing the highest area under the ROC curve (AUCROC) at 0.97. CONCLUSION: This study underscores the diagnostic significance of α2-MG, PCX, and AFU in the development of DN. The biomarkers RBP-4, CysC, PCX, AFU, and α2-MG provide promising diagnostic insights, while UACR is the most potent diagnostic biomarker in assessing DN.

The association between platelet glycoprotein-specific antibodies and response to short-term high-dose dexamethasone with prednisone maintenance treatment in adult patients with primary immune thrombocytopenia.

OBJECTIVE: The aim of the present study was to detect the association between platelet glycoprotein-specific autoantibodies and the patient response to short-term high-dose dexamethasone (HD-DXM) + prednisone maintenance treatment. METHODS: The data from 112 adult patients newly diagnosed with ITP who were administered first-line HD-DXM + prednisone maintenance therapy between January 2016 and January 2021 were retrospectively analyzed. RESULTS: A total of 72 patients positive for platelet glycoprotein-specific antibodies were enrolled in the antibody-positive group, and 40 patients not positive for platelet glycoprotein-specific antibodies were enrolled in the antibody-negative group. In the antibody-positive group, six platelet glycoprotein-specific antibody types were found: 41.67% of the patients were anti-GP IIb/IIIa-positive only, 5.56% were anti-GP Ib/IX-positive only, 5.56% were anti-P-selectin-positive only, 19.44% were anti-GP IIb/IIIa- and anti-GP Ib/IX-positive, 16.67% were anti-GP Ib/IX- and P-selectin-positive and 11.11% were positive for all three antibodies. There was no significant difference in the overall response rate between the antibody-positive group and the antibody-negative group (94.44 versus 80.00%, p = .221). However, the CR rate was significantly higher in the antibody-positive group than in the antibody-negative group (69.44% versus 40.00%, p = .032). The logistic regression analysis revealed that platelet glycoprotein-specific antibody positivity and age were two factors that could affect patient response. CONCLUSIONS: The present study discovered that adult patients newly diagnosed with ITP who had positive platelet glycoprotein-specific antibody test results were likely to achieve a better response after treatment with HD-DXM + prednisone maintenance.

Emission characteristics of water-soluble ions in PM2.5 released by forest fuel combustion in Great Xing'an Mountains, Inner Mongolia, China.

Understanding the emission factors of fine particulate matter (PM2.5) released by forest fuel combustion is important for revealing the impacts of forest fire on atmosphere and ecosystem. Water-soluble ions are important components of fine particulate matter, with great significance to the formation of particulate matter. A self-designed biomass combustion system was used to simulate the combustion of three components (trunks, branches, barks) and their surface dead fuel (litter, semi-humus, humus) of five tree species (Quercus mongolica, Betula platyphylla, Larix gmelinii, Betula dahurica, Populus davidiana) and branches of three shrub species (Corylus heterophylla, Lespedeza bicolor, Rhododendron dauricum) in Great Xing'an Mountains in Inner Mongolia. The water-soluble ion emission factors (Na+, NH4+, K+, Mg2+, Ca2+, F-, Cl-, NO3-, NO2-, SO42-) in PM2.5 under two combustion conditions (smoldering and flaming) were measured by ISC1100 ion chromatograph. The results showed that for the water-soluble ion detected in PM2.5 from combustion of all types of materials, K+, Cl- and Na+ were the main components in smoldering, while K+, Cl- and SO42- were the main components in flaming. There was significant difference in the total amount of water-soluble ions in PM2.5 from the same type of material under different combustion conditions. During the smoldering period, the emission factor of water-soluble inorganic ions in PM2.5 of shrub branches was higher than that of flaming. The cation to anion ratio in PM2.5 was 1.26 for all trees, 1.12 for surface dead fuel of trees, and 2.0 for branch of shrub, indicating that the particulate matter was alkaline. Forest fires in Great Xing'an Mountains could not result in ecosystem acidification by releasing water-soluble ions.