Neutrophil gelatinase-associated lipocalin (NGAL): a new  marker of cyclosporine nephrotoxicity?
The aim of work was to investigate whether serum and urinary neutrophil gelatinase-associated lipocalin(sNGAL and uNGAL, respectively) are potential biomarkers of early cyclosporine A (CsA) nephrotoxicity in steroid-dependent nephrotic children (SDNS). The study group (I) consisted of 19 children with SDNS aged 9.46+/-5.52 years treated with CsA. The children were examined four times: at proteinuria relapse, prior to CsA treatment,then after 3, 6, and 12 months of CsA treatment. The control group (II) consisted of 18 healthy children aged 3-15 years. A commercial enzyme-linked immunosorbent assay method was used to measure NGAL concentration.The sNGAL level in SDNS children prior to the administration of CsA was similar to that in the healthy controls (p>0.05), but it increased significantly during the course of treatment (p<0.01). The uNGAL/creatinine (cr) ratio in SDNS patients was higher before the withdrawal of CsA therapy (p<0.05), and was also increased at the consecutive examinations (p<0.01). There was a positive correlation between both sNGAL and uNGAL levels and CsA serum level. However, based on the serum and urinary NGAL/cr receiver operating characteristic curve and area under the curve (AUC) analysis, it remains uncertain whether uNGAL is a good predictor of cyclosporine nephropathy. Both sNGAL and uNGAL concentrations increased during the course of CsA treatment. Further studies in larger groups of patients are therefore necessary to confirm our experimental data that increased NGAL levels may be a non-invasive marker for the early detection of tubulointerstitial damage in CsA nephrotoxicity.
Wasilewska
Anna
A
Department of Paediatrics and Nephrology, Medical University of Białystok, ul. Waszyngtona 17, Białystok, Poland. annwasil@interia.pl
Zoch-Zwierz
Walentyna
W
Taranta-Janusz
Katarzyna
K
Michaluk-Skutnik
Joanna
J
D000209:Acute-Phase Proteins / Q000652:urine; D000293:Adolescent; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000009:adverse effects* / Q000097:blood; D016903:Drug Monitoring / Q000379:methods*; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000097:blood; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000652:urine; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood / Q000652:urine; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000188:drug therapy / Q000209:etiology; D011518:Proto-Oncogene Proteins / Q000097:blood / Q000652:urine; D012372:ROC Curve; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome
D000209:Acute-Phase Proteins; D015415:Biomarkers; D007166:Immunosuppressive Agents; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D013256:Steroids; D016572:Cyclosporine; D003404:Creatinine