Urine Epidermal Growth Factor, Monocyte Chemoattractant Protein-1 or Their Ratio as Biomarkers for Interstitial Fibrosis and Tubular Atrophy in Primary Glomerulonephritis

作者：Worawichawong Supanat; Worawichawong Suchin; Radinahamed Piyanuch; Muntham Dittapol; Sathirapongsasuti Nuankanya; Nongnuch Arkom; Assanatham Montira; Kitiyakara Chagriya^*

来源：Kidney & Blood Pressure Research, 2016, 41(6): 997-1007.

DOI：10.1159/000452595

• Biomarker
• Chronic kidney disease
• EGF
• Epidermal Growth Factor
• Fibrosis
• Glomerulonephritis
• Kidney
• NGAL
• Neutrophil gelatinase-associated lipocalin
• MCP-1
• Monocyte chemoattractant protein-1
• Tubulointerstitial

Background/Aims:The degree of tubular atrophy and interstitial fibrosis (IFTA) is an important prognostic factor in glomerulonephritis. Imbalance between pro -inflammatory cytokines such as monocyte chemoattractant protein-1 (MCP-1) and protective cytokines such as epidermal growth factor (EGF) likely determine IFTA severity. In separate studies, elevated MCP-1 and decreased EGF have been shown to be associated with IFTA severity. In this study, we aim to evaluate the predictive value of urinary EGF/MCP-1 ratio compared to each biomarker individually for moderate to severe IFTA in primary glomerulonephritis (GN). Methods: Urine samples were collected at biopsy from primary GN (IgA nephropathy, focal and segmental glomerulosclerosis, minimal change disease, membranous nephropathy). MCP-1 and EGF were analyzed by enzyme-linked immunosorbent assay. Results: EGF, MCP-1 and EGF/MCP-1 ratio from primary GN, all correlated with IFTA (n=58). By univariate analysis, glomerular filtration rate. EGF, and EGF/MCP-1 ratio were associated with IFTA. By multivariate analysis, only EGF/MCP-1 ratio was independently associated with IFTA. EGF/MCP-1 ratio had a sensitivity of 88% and specificity of 74 % for IFTA. FGF/MCP-1 had good discrimination for IFTA (AUC=0.85), but the improvement over EGF alone was not significant. Conclusion: EGF/MCP-1 ratio is independently associated IFTA severity in primary glomerulonephritis, but the ability of EGF/MCP-1 ratio to discriminate moderate to severe IFTA may not be much better than EGF alone.

• 出版日期2016