title: Pathological significance of a panel of urinary biomarkers in patients with drug-induced tubulointerstitial nephritis.
abstract: OBJECTIVE
  Although a renal biopsy is indispensable for depicting the severity of pathologic lesions in drug-induced tubulointerstitial nephritis (DTIN), it is not acceptable in some cases and cannot be performed serially because of its invasive nature. Therefore, the discovery of noninvasive markers that are closely related to the pathology of DTIN is of great value.
  
  
  METHODS
  In this study, the urinary levels of monocyte chemotactic peptide-1 (MCP-1), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-d-glucosaminidase, and α1-microglobulin were measured in 40 DTIN subjects, and the performances of these parameters for distinguishing different pathologic lesions were compared.
  
  
  RESULTS
  Linear correlation and receiver operating characteristic curve analyses showed that urinary MCP-1 levels were able to identify serious interstitial edema and inflammatory infiltration with greater accuracy than the other biomarkers (r = 0.501, P < 0.001 and r = 0.768, P < 0.001, respectively), whereas urinary NGAL levels showed the highest correlation coefficient with tubular atrophy (r = 0.692, P < 0.001).
  
  
  CONCLUSIONS
  These results suggest that these biomarker levels were higher in patients with DTIN than in controls. Urinary MCP-1 levels correlated and were predictive of the gradated severity of acute lesions in DTIN, whereas the roles of NGAL and α1-microglobulin in chronic alterations require further study.
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wu
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.forename: Tao
authors.initials: T
authors.lastname: Su
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.forename: Xiao-mei
authors.initials: XM
authors.lastname: Li
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D000209:Acute-Phase Proteins / Q000652:urine; D000293:Adolescent; D000328:Adult; D000368:Aged; D000510:Alpha-Globulins / Q000652:urine; D001284:Atrophy; D015415:Biomarkers / Q000652:urine; D001706:Biopsy; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000652:urine; D002681:China; D005260:Female; D005355:Fibrosis; D006801:Humans; D007684:Kidney Tubules / Q000187:drug effects / Q000473:pathology*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology / Q000652:urine; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000652:urine; D012372:ROC Curve; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000209:Acute-Phase Proteins; D000510:Alpha-Globulins; D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; C016001:alpha-1-microglobulin; D000118:Acetylglucosaminidase
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