Kidney NGAL is a novel early marker of acute injury following transplantation
Kidney NGAL is a novel early marker of acute injury following transplantation
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DOI：
10.1007/s00467-006-0055-0
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发表时间：
2006-06-01
影响因子：
3
通讯作者：
Devarajan, Prasad
中科院分区：
文献类型：
--
作者：
Mishra, Jaya;Ma, Qing;Devarajan, Prasad
移植肾缺血再灌注后继发急性肾损伤常导致移植肾功能延迟恢复。我们检验了中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的表达是移植后急性肾损伤的早期标志物这一假设。石蜡包埋的协议活检标本获得约一小时后，移植13个尸体（CAD）和12个活体相关（LRD）肾移植后再灌注切片NGAL的表达进行了检查免疫组化。染色强度与冷缺血时间、术后血清肌酐峰值和透析要求相关。LRD组和CAD组在年龄、性别或术前血清肌酐方面无差异。使用0（无染色）至3（最强染色）的评分系统，CAD标本中NGAL表达显著增加（2.3 +/- 0.8对比LRD中的0.8 +/- 0.7，p < 0.001）。NGAL染色强度与冷缺血时间之间存在强相关性（R=0.87，p < 0.001）。重要的是，这些早期CAD活检组织中的NGAL染色与术后血清肌酐峰值密切相关，后者发生在数天后（R=0.86，p < 0.001）。4例患者在移植后第一周出现移植物功能延迟，需要透析;所有这些患者在其第一次方案活检中显示最强烈的NGAL染色。我们的结论是，NGAL染色强度在早期协议活检移植后急性肾损伤的一种新的预测生物标志物。
Acute kidney injury secondary to ischemia-reperfusion in renal allografts often results in delayed graft function. We tested the hypothesis that expression of neutrophil gelatinase-associated lipocalin (NGAL) is an early marker of acute kidney injury following transplantation. Sections from paraffin-embedded protocol biopsy specimens obtained at approximately one hour of reperfusion after transplantation of 13 cadaveric (CAD) and 12 living-related (LRD) renal allografts were examined by immunohistochemistry for expression of NGAL. The staining intensity was correlated with cold ischemia time, peak post-operative serum creatinine, and dialysis requirement. There were no differences between the LRD and CAD groups in age, gender or preoperative serum creatinine. Using a scoring system of 0 (no staining) to 3 (most intense staining), NGAL expression was significantly increased in CAD specimens (2.3 +/- 0.8 versus 0.8 +/- 0.7 in LRD, p < 0.001). There was a strong correlation between NGAL staining intensity and cold ischemia time (R=0.87, p < 0.001). Importantly, NGAL staining in these early CAD biopsies was strongly correlated with peak postoperative serum creatinine, which occurred days later (R=0.86, p < 0.001). Four patients developed delayed graft function requiring dialysis during the first week posttransplantation; all of these patients displayed the most intense NGAL staining in their first protocol biopsies. We conclude that NGAL staining intensity in early protocol biopsies represents a novel predictive biomarker of acute kidney injury following transplantation.