title: Alpha 1-microglobulin: clinical laboratory aspects and applications.
abstract: BACKGROUND
  Urinary microproteins are becoming increasingly important in clinical diagnostics. They can contribute in the non-invasive early detection of renal abnormalities and the differentiation of various nephrological and urological pathologies. Alpha 1-microglobulin (A1M) is an immunomodulatory protein with a broad spectrum of possible clinical applications and seems a promising marker for evaluation of tubular function.
  
  
  METHODS
  We performed a systematic review of the peer-reviewed literature (until end of November 2003) on A1M with emphasis on clinical diagnostic utility and laboratory aspects.
  
  
  CONCLUSIONS
  A1M is a 27-kDa glycoprotein, present in various body fluids, with unknown exact biological function. The protein acts as a mediator of bacterial adhesion to polymer surfaces and is involved in inhibiting renal lithogenesis. Because A1M is not an acute phase protein, is stable in a broad range of physiological conditions and sensitive immunoassays have been developed, its measurement can be used for clinical purposes. Unfortunately, international standardisation is still lacking. Altered plasma/serum levels are usually due to impaired liver or kidney functions but are also observed in clinical conditions such as HIV and mood disorders. Urinary A1M provides a non-invasive, inexpensive diagnostic alternative for the diagnosis and monitoring of urinary tract disorders (early detection of tubular disorders such as heavy metal intoxications, diabetic nephropathy, urinary outflow disorders and pyelonephritis).
authors.affiliation: Department of Clinical Chemistry, University Hospital Ghent-2P8, De Pintelaan 185, B-9000 Ghent, Belgium.
authors.forename: Joris
authors.initials: J
authors.lastname: Penders
authors.forename: Joris R
authors.initials: JR
authors.lastname: Delanghe
mesh_terms: D000510:Alpha-Globulins / Q000652:urine*; D015415:Biomarkers; D019411:Clinical Laboratory Techniques / Q000379:methods* / Q000639:trends; D007118:Immunoassay; D007674:Kidney Diseases / Q000175:diagnosis; D007677:Kidney Function Tests; D007687:Kidney Tubules, Proximal / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D011480:Protease Inhibitors / Q000652:urine; D014552:Urinary Tract Infections / Q000175:diagnosis
chemical_list: D000510:Alpha-Globulins; D015415:Biomarkers; D011480:Protease Inhibitors; C016001:alpha-1-microglobulin