Profiling Biomarkers in HIV Glomerular Disease - Potential for the Non-Invasive Diagnosis of HIVAN?
HIV chronic kidney disease
NGAL
bone morphogenetic protein (BMP)-7
cystatin C
neutrophil gelatinase-associated lipocalin
transforming growth factor (TGF)-β isoforms
Journal
International journal of nephrology and renovascular disease
ISSN: 1178-7058
Titre abrégé: Int J Nephrol Renovasc Dis
Pays: New Zealand
ID NLM: 101550217
Informations de publication
Date de publication:
2021
2021
Historique:
received:
29
07
2021
accepted:
08
10
2021
entrez:
17
12
2021
pubmed:
18
12
2021
medline:
18
12
2021
Statut:
epublish
Résumé
There is a wide spectrum of kidney pathology in human immunodeficiency virus (HIV) infection, affecting all structures of the kidney. The histology of HIV chronic kidney disease (CKD) is diverse, ranging from HIV-associated nephropathy (HIVAN) to focal glomerulosclerosis (FSGS), HIV-immune complex disease (HIV-ICD), other glomerulopathies and tubulo-interstitial nephritis. Definitive diagnosis is by kidney biopsy, an invasive procedure. However, serum and urinary biomarkers may be useful in predicting the histological diagnosis of HIVAN. We wished to determine the utility of serum and urinary biomarkers in predicting the histological diagnosis of HIVAN. We measured neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, transforming growth factor (TGF)-β isoforms and bone morphogenetic protein (BMP)-7 in the serum and urine in patients with different histological forms of HIV glomerular disease. In HIVAN, we demonstrated increased levels of serum cystatin C and increased levels of serum and urinary NGAL. Urinary TGF-β1 and TGF-β2 levels were elevated in HIV-positive patients with CKD but were not significantly different in the different HIV histologies, while urinary BMP-7 levels were elevated in minimal change disease. This study confirmed the presence of increased serum and urinary biomarkers of tubular injury in patients with HIVAN, and increased urinary biomarkers of fibrosis in HIV CKD, and may indicate their value as a non-invasive diagnostic tool for the diagnosis of HIVAN.
Sections du résumé
BACKGROUND
BACKGROUND
There is a wide spectrum of kidney pathology in human immunodeficiency virus (HIV) infection, affecting all structures of the kidney. The histology of HIV chronic kidney disease (CKD) is diverse, ranging from HIV-associated nephropathy (HIVAN) to focal glomerulosclerosis (FSGS), HIV-immune complex disease (HIV-ICD), other glomerulopathies and tubulo-interstitial nephritis. Definitive diagnosis is by kidney biopsy, an invasive procedure. However, serum and urinary biomarkers may be useful in predicting the histological diagnosis of HIVAN.
PURPOSE
OBJECTIVE
We wished to determine the utility of serum and urinary biomarkers in predicting the histological diagnosis of HIVAN.
PATIENTS AND METHODS
METHODS
We measured neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, transforming growth factor (TGF)-β isoforms and bone morphogenetic protein (BMP)-7 in the serum and urine in patients with different histological forms of HIV glomerular disease.
RESULTS
RESULTS
In HIVAN, we demonstrated increased levels of serum cystatin C and increased levels of serum and urinary NGAL. Urinary TGF-β1 and TGF-β2 levels were elevated in HIV-positive patients with CKD but were not significantly different in the different HIV histologies, while urinary BMP-7 levels were elevated in minimal change disease.
CONCLUSION
CONCLUSIONS
This study confirmed the presence of increased serum and urinary biomarkers of tubular injury in patients with HIVAN, and increased urinary biomarkers of fibrosis in HIV CKD, and may indicate their value as a non-invasive diagnostic tool for the diagnosis of HIVAN.
Identifiants
pubmed: 34916827
doi: 10.2147/IJNRD.S331484
pii: 331484
pmc: PMC8668162
doi:
Types de publication
Journal Article
Langues
eng
Pagination
427-440Informations de copyright
© 2021 Naicker et al.
Déclaration de conflit d'intérêts
Professor Saraladevi Naicker report grants from Medical Research Council of South Africa (MRC), during the conduct of the study. The authors report no other conflicts of interest in this work.
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