Urinary nephrin: A new predictive marker for pregnancies with preeclampsia and small-for-gestational age infants
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective The objective of this study was to determine the differences in urinary nephrin among controls, gravidas with preeclampsia (PE), and small-for-gestational age (SGA) infants. We also determined whether or not maternal urinary concentrations of nephrin are associated with the subsequent development of PE and SGA infants. Methods We analyzed maternal urinary levels of nephrin in women who were normal controls (n=50), women who were delivered SGA infants (n=40), and gravidas with PE (n=33) in the first, second and third trimesters. Urinary nephrin concentrations were measured with nephrin enzyme-linked immunosorbent assay kits. Results The levels of urinary nephrin were higher in gravida developing preeclampsia or SGA than in controls after adjusting serum creatinine (P<0.05 for both). Maternal urine concentrations of nephrin were higher in pregnancies complicated by SGA and PE in the third trimester (P<0.05), and also higher in pregnancies complicated by SGA in the first trimester (P<0.05). The sensitivity and specificity of nephrin in predicting SGA from normal pregnancies were 67% and 89% in the first trimester, 60% and 79% in the second trimester, and 80% and 84% in the third trimester, respectively. The sensitivity and specificity of nephrin in predicting PE from normal pregnancies were 67% and 83% in the first trimester and 73% and 79% in the third trimester, respectively. Conclusion We suggest that urinary nephrin can be used as an early marker in pregnancies at risk for developing PE and SGA infants.
Abstract
Objective The objective of this study was to determine the differences in urinary nephrin among controls, gravidas with preeclampsia (PE), and small-for-gestational age (SGA) infants. We also determined whether or not maternal urinary concentrations of nephrin are associated with the subsequent development of PE and SGA infants. Methods We analyzed maternal urinary levels of nephrin in women who were normal controls (n=50), women who were delivered SGA infants (n=40), and gravidas with PE (n=33) in the first, second and third trimesters. Urinary nephrin concentrations were measured with nephrin enzyme-linked immunosorbent assay kits. Results The levels of urinary nephrin were higher in gravida developing preeclampsia or SGA than in controls after adjusting serum creatinine (P<0.05 for both). Maternal urine concentrations of nephrin were higher in pregnancies complicated by SGA and PE in the third trimester (P<0.05), and also higher in pregnancies complicated by SGA in the first trimester (P<0.05). The sensitivity and specificity of nephrin in predicting SGA from normal pregnancies were 67% and 89% in the first trimester, 60% and 79% in the second trimester, and 80% and 84% in the third trimester, respectively. The sensitivity and specificity of nephrin in predicting PE from normal pregnancies were 67% and 83% in the first trimester and 73% and 79% in the third trimester, respectively. Conclusion We suggest that urinary nephrin can be used as an early marker in pregnancies at risk for developing PE and SGA infants.
참고문헌 (14)
- Lee JJ, "Birth weight for gestational age patterns by sex, plurality, and parity in Korean populations", Korean J Perinatol, 18, pp.1~11 (2007)
- Garovic VD, "Urinary podocyte excretion as a marker for preeclampsia", Am J Obstet Gynecol, 196, pp.320.e1~321.e7 (2007)
- Zhao S, "Decreased nephrin and GLEPP-1, but increased VEGF, Flt-1, and nitrotyrosine, expressions in kidney tissue sections from women with preeclampsia", Reprod Sci, 16, pp.970~979 (2009)
- Karumanchi SA, "Preeclampsia and the kidney: footprints in the urine", Am J Obstet Gynecol, 196, pp.287~288 (2007)
- Kestila M, "Positionally cloned gene for a novel glomerular protein--nephrin--is mutated in congenital nephrotic syndrome", Mol Cell, 1, pp.575~582 (1998)
- Lenkkeri U, "Structure of the gene for congenital nephrotic syndrome of the finnish type(NPHS1)and characterization of mutations", Am J Hum Genet, 64, pp.51~61 (1999)
- Patrakka J, "Nephrin: a unique structural and signaling protein of the kidney filter", Trends Mol Med, 13, pp.396~403 (2007)
- Son GH, "Urinary excretion of nephrin in patients with severe preeclampsia. Urinary nephrin in preeclampsia", Hypertens Pregnancy, 30, pp.408~413 (2011)
- "Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy", Am J Obstet Gynecol, 183, pp.S1~S22 (2000)
- Zhao S, "Altered nephrin and podoplanin distribution is associated with disturbed polarity protein PARD-3 and PARD-6 expressions in podocytes from preeclampsia", Reprod Sci, 18, pp.772~780 (2011)
- Sato Y, "Urine podocyte mRNAs mark progression of renal disease", J Am Soc Nephrol, 20, pp.1041~1052 (2009)
- Garovic VD, "Glomerular expression of nephrin and synaptopodin, but not podocin, is decreased in kidney sections from women with preeclampsia", Nephrol Dial Transplant, 22, pp.1136~1143 (2007)
- Collino F, "Preeclamptic sera induce nephrin shedding from podocytes through endothelin-1 release by endothelial glomerular cells", Am J Physiol Renal Physiol, 294, pp.F1185~F1194 (2008)
- Beall MH, "Placental and fetal membrane Nephrin and Neph1 gene expression : response to inflammation", J Soc Gynecol Investig, 12, pp.298~302 (2005)