Liver Fatty-Acid-Binding Protein in Heart and Kidney Allograft Recipients in Relation to Kidney Function
Liver Fatty-Acid-Binding Protein in Heart and Kidney Allograft Recipients in Relation to Kidney Function
复制标题
DOI：
10.1016/j.transproceed.2011.08.038
复制
发表时间：
2011-10-01
影响因子：
0.9
通讯作者：
Malyszko, J.
中科院分区：
文献类型：
--
作者：
Przybylowski, P.;Koc-Zorawska, E.;Malyszko, J.
哺乳动物细胞内脂肪酸结合蛋白 (FABP) 是一个大型多基因家族，编码 14-kD 蛋白，这些蛋白是脂质结合蛋白超家族的成员。 FABP 具有组织特异性。肝型 FABP (L-FABP) 由于其分子尺寸小，与胱抑素 C 类似，可通过肾小球过滤，但与其他小蛋白一样，可被近曲小管上皮细胞重吸收。在人肾中，L-FABP 主要在近端肾小管中表达。有人提出，尿液中 L-FABP 的存在反映了肾小管周围毛细血管流量减少导致的缺氧状况，可作为急性肾损伤的标志。本研究的目的是评估 111 名心脏移植受者和 76 名肾移植受者的尿 L-FABP 与肾功能的关系。通过标准实验室方法研究全血细胞计数、尿素、空腹血糖、肌酐和脑钠尿蛋白 N 末端片段； L-FABP 和胱抑素 C，通过 ELISA 使用市售试剂盒进行检测。肾移植受者的 L-FABP 显着高于心脏受者。经过单变量分析，同种异体肾移植受者的尿液 L-FABP 与血清肌酐、胱抑素 C 和估计肾小球滤过率 (eGFR) 相关。然而，在心脏移植受者中，它与肾功能无关，如肌酐或 eGFR 所反映的那样；与胱抑素 C (r = 0.34；P < .001)、尿肌酐 (r = -0.29；P < .01) 和 NGAL (r = 0.29；P < .01) 密切相关。经过多元回归分析，同种异体肾移植受者中尿液 L-FABP 的最佳预测因子是 eGFR，而在心脏受者中，没有参数独立预测 L-FABP。 成功的心脏移植与肾损伤相关，如 eGFR 降低所反映；然而，在该人群中，L-FABP 并不能作为肾功能的标志物。相反，在同种异体肾移植受者中，L-FABP 可能是肾功能受损/损伤的潜在早期标志物。
Mammalian intracellular fatty-acid binding proteins (FABPs), a large multigene family, encode 14-kD proteins that are members of a superfamily of lipid-binding proteins. FABPs are tissue specific. Liver-type FABP (L-FABP) can be filtered through the glomerulus owing to its small molecular size, similar to cystatin C, but it is reabsorbed by proximal tubule epithelial cells like other small proteins. In the human kidney, L-FABP is expressed predominantly in proximal tubules. It had been suggested that the presence of L-FABP in urine reflects hypoxic conditions resulting from decreased peritubular capillary flow, serving as a marker of acute kidney injury. The aim of this study was to assess urinary L-FABP in 111 heart and 76 kidney transplant recipients in relation to kidney function.Complete blood count, urea, fasting glucose, creatinine, and the N-terminal fragment of brain natriuretic protein were studied by standard laboratory methods; L-FABP and cystatin C, by ELISA using commercially available kits.Kidney transplant recipients displayed significantly higher L-FABP than heart recipients. Upon univariate analysis, urinary L-FABP correlated, with serum creatinine, cystatin C and estimated glomerular filtration ratio (eGFR) in kidney allograft recipients. However, in heart transplant recipients it was not related to kidney function, as reflected by creatinine or eGFR; was strongly related to cystatin C (r = 0.34; P < .001) and urinary creatinine (r = -0.29; P < .01), and NGAL (r = 0.29; P < .01). Upon multiple regression analysis, the best predictor of urinary L-FABP in kidney allograft recipients, was eGFR whereas in heart recipients, no parameter independently predicted L-FABP.Successful heart transplantation is associated with kidney injury as reflected by a reduced eGFR; however, in this population, L-FABP did not serve as a marker of kidney function. In contrast, in kidney allograft recipients, L-FABP may be a potential early marker for impaired kidney function/injury.