Cyclophilin A (CyPA) as a Novel Biomarker for Early Detection of Diabetic Nephropathy in an Animal Model.

BACKGROUND AND AIM: Type 2 diabetes mellitus (DM) is the most common single cause of the end-stage renal disease (ESRD). Cyclophilin A (CyPA) is an 18-kD protein. The connection between diabetic nephropathy (DN) and the secreted form of CyPA (sCyPA) has been elucidated in this study that aims to investigate sCyPA correlation with renal dysfunction. MATERIALS AND METHODS: Thirty-four male adult Wistar rats weighing 180-220 g were used. Animals were divided into a study group and a control group, 17 rats in each. Streptozotocin (STZ) and nicotine amide were used to damage some pancreatic cells for induction of type 2 DM. Comparison was made between the study and the control groups. Moreover, a comparison was made between the members of the study group before and after induction of DN. RESULTS: The rat model that exhibited a higher concentration of urinary sCyPA was detected early in the eighth week. There was a significantly higher level of 24-h urinary CyPA in the study group compared to the control group (p-value=0.004) and there was a significant elevation in the 24-h urinary Cyp-A in the study group after injection of STZ compared to the values before injection (p-value <0.001). Immunohistochemical analysis of renal tissue revealed that the mean expression of CyPA was higher in the study group than in the control group. For the urinary 24-h CYP-A, using a cutoff of 1.15 ng/mL, the accuracy was 72.4%, sensitivity was (77.8%) and specificity was (67%). CONCLUSION: According to this animal study, we proved that CyPA is a valuable marker for DN. It is a more sensitive, noninvasive and rapid biomarker for early detection of any renal affection in human diabetic patients.

Serological detection of Toxoplasma gondii in chronic renal failure patients and renal transplant recipients.

Toxoplasma gondii antibodies were detected in 78 patients with renal disease by ELISA. Patients were classified according to the renal status; chronic renal failure patients not on haemodialysis (G1 = 19), chronic renal failure patients on regular haemodialysis (G2 = 30), renal transplant recipient (G3 = 29) and 13 normal controls. Anti-Toxoplasma IgG & IgM antibodies were 36.8% & 10.5% in renal failure patients not on haemodialysis, 56.7% &16.7% in patients on regular haemodialysis and 69% & 24.1% in renal transplant recipients versus 23.1% & 0% in controls with statistical significant difference for Toxoplasma IgG antibodies only. Anti-Toxoplasma IgG antibodies levels of G3 were lower than that of G1. It was observed that the more the exposure to dialysis, the more the risk of toxoplasmosis. It was found that 85.71% of renal transplant recipient seropositive cases for anti-Toxoplasma IgM antibodies were detected in one year post-transplantation and 14.28% of cases after the first year of transplantation.

Risk factors predisposing to toxoplasmosis in chronic renal failure patients and renal transplant recipients.

This work evaluated risk factors predisposing to toxoplasmosis in chronic renal failure patients and renal transplant recipients. The present study included 91 cases classified according to their renal status into four groups; control group, renal failure patients not on haemodialysis, renal failure patients on regular haemodialysis and renal transplant recipients group. The age groups (< 20) and (30-) had the highest positivity for anti-Toxoplasma IgG & IgM antibodies in comparison to the other age groups. The results showed no sex difference in positivity rate for anti-Toxoplasma IgG & IgM in groups. There was no significant difference between groups regarding risk factors for contracting toxoplasmosis, clinical presentation suggestive of toxoplasmosis and diabetes mellitus. There was significant difference between all groups as regarding intake of immunosuppressive drugs and blood transfusion.