title: Urine Epidermal Growth Factor, Monocyte Chemoattractant Protein-1 or Their Ratio as Biomarkers for Interstitial Fibrosis and Tubular Atrophy in Primary Glomerulonephritis.
abstract: OBJECTIVE
  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. EGF/MCP-1 had good discrimination for IFTA (AUC=0.85), but the improvement over EGF alone was not significant.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Supanat
authors.initials: S
authors.lastname: Worawichawong
authors.forename: Suchin
authors.initials: S
authors.lastname: Worawichawong
authors.forename: Piyanuch
authors.initials: P
authors.lastname: Radinahamed
authors.forename: Dittapol
authors.initials: D
authors.lastname: Muntham
authors.forename: Nuankanya
authors.initials: N
authors.lastname: Sathirapongsasuti
authors.forename: Arkom
authors.initials: A
authors.lastname: Nongnuch
authors.forename: Montira
authors.initials: M
authors.lastname: Assanatham
authors.forename: Chagriya
authors.initials: C
authors.lastname: Kitiyakara
mesh_terms: D000328:Adult; D001284:Atrophy / Q000175:diagnosis / Q000473:pathology / Q000652:urine; D015415:Biomarkers / Q000652:urine; D018932:Chemokine CCL2 / Q000652:urine*; D004815:Epidermal Growth Factor / Q000652:urine*; D005260:Female; D005355:Fibrosis / Q000175:diagnosis* / Q000652:urine; D005921:Glomerulonephritis / Q000473:pathology*; D006801:Humans; D007684:Kidney Tubules / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D004815:Epidermal Growth Factor