Serum Neutrophil Gelatinase-associated Lipocalin Correlates Nrog raum Function hauv Renal Allograft Recipients

Hu rau: Audrey Hu Whatsapp / hp: 0086 13880143964 Email:audrey.hu@wecistanche.com

Malyszko J, et al

Abstract:Tus nqi ntawm neutrophil gelatinase-associated lipocalin (NGAL) ua tus cim tshiab rau kev tshawb pom ntxov ntawm lub raum tsis ua haujlwm tau teeb pom kev siab tsis ntev los no. Lub hom phiaj ntawm txoj kev tshawb no yog los soj ntsuam seb cov ntshav NGAL cuam tshuam nrograummuaj nuj nqinyob rau hauv lub raum allograft tau txais. SerumNGAL, creatinine, thiab kwv yees glomerular filtration rate (GFR) raug soj ntsuam hauv 100 raum allograft tau txais kev kho peb zaug: calcineurininhibitor, mycophenolate mofetil lossis azathioprine, prednisone, thiab noj qab haus huv pab dawb. Cov neeg tau txais kev hloov pauv hauv lub raum tau nce siab dua NGAL dua li pawg tswj hwm. Serum NGAL hauv kev tshuaj ntsuam univariate tau sib raug zoo nrog cov ntshav creatinine (r=0.78). Kwv yees GFR (r=){{10}}.69), ntawm qhov tod tes, muaj feem cuam tshuam nrog cov qe ntshav dawb suav (r=0.43) thiab tsuas yog qaug zog. nrog rau lwm yam parameter. Hauv ntau qhov kev rov ua dua tshiab, qhov kev kwv yees zoo tshaj plaws ntawm cov ntshav NGAL yog eGFR (beta ) 0.69), nrog rau lwm qhov kev kwv yees yog cov qe ntshav dawb suav (beta 0.25) thiab siab C-reactive protein (hsCRP) (beta 0.23) piav qhia 82 feem pua ntawm NGAL concentration. Txawm muaj kev vam meejraumhloov pauvyog txuam nrog rau lub raum kev raug mob raws li tau pom los ntawm cov ntshav siab NGAL thiab txo eGFR. Yog li ntawd, NGAL yuav tsum tau tshawb xyuas raws li qhov muaj peev xwm ua rau lub raum tsis zoo muaj nuj nqi/ raum raug mob, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas muaj lwm yam kev pheej hmoo rau lub raum puas, piv txwv li, kub siab los yog ntshav qab zib.

Ntsiab lus: raummuaj nuj nqi- hloov raum - NUG

Cistanche yog qhov zoo rauraummuaj nuj nqi

Lub raumhloov pauvyog lub raum hloov kho kev xaiv rau feem ntau cov neeg mob uas muaj kab mob raum kawg, tsis tsuas yog txhim kho lub neej zoo, tab sis kuj muab ncua lub neej expectancy piv nrog rau kev lim ntshav. Txawm tiasraumhloov pauvtej zaum yuav muaj kev vam meej, nws txoj haujlwm tsis tas yuav rov qab zoo li qub. Kev puas tsuajraummuaj nuj nqimuaj feem cuam tshuam nrog kev pheej hmoo siab dua ntawm kev mob thiab kev tuag piv nrog cov pej xeem, feem ntau yog los ntawm cov kab mob plawv (1). Qhov teeb meem tseem ceeb tseem nyob nrog kev ntsuas ntawmraummuaj nuj nqitom qab hloov lub raum. Hmoov tsis zoo, creatinine yog qhov tsis ntseeg tau piav qhiaraummuaj nuj nqi(2). Ua ntej, siv cov ntshav creatinine los ntsuas qhov tseeb ntawm lub raum ua haujlwm tau lees paub qhov tsis raug thiab kev txwv (2). Kev txo qis hauv GFR tuaj yeem tshwm sim ua ntej nws tshwm sim hauv kev nce hauv cov ntshav creatinine (txog 50 feem pua ntawmraummuaj nuj nqitwb tau ploj lawm ua ntej creatinine yuav hloov). Neutrophil gelatinase-associated lipocalin (NGAL) tsis yog tsuas yog cov tswv cuab ntawm tsev neeg lipocalin (3) nkaus xwb tab sis kuj tau qhia nyob rau theem qis hauv lwm cov tib neeg cov ntaub so ntswg xws li ob lub raum, prostate, thiab epithelia ntawm cov pa ua pa thiab alimentary tracts (4). Mishra et al. (5) qhia txog tus nqi ntawm NGAL ua tus cim tshiab rau kev tshawb pom ntxov ntawm lub raum raug mob. Vim nws qhov me me molecular (25 kDa) thiab tsis kam mus rau degradation, NGAL tau nkag tau tawm thiab kuaj pom hauv cov zis. NGAL muaj ntau heev nyob rau hauv tib neeg lub raum cortical tubules, ntshav, thiab zis tom qab nephrotoxic thiab/los yog ischemic raug mob (6). Hauv kev tshaj tawm tsis ntev los no, tus nqi ntawm cov zis NGAL raws li biomarker thaum ntxov rau tubulointerstitial raug mob ntawm IgA nephropathy thiab tej zaum lwm hom kab mob raum, feem ntau, tau hais txog (7, 8). Ntxiv mus, qib ntshav thiab zis NGAL tau raug soj ntsuam hauv cov neeg mob uas muaj tus mob polycystic raum (9). Ob theem tau nce siab dua hauv cov neeg mob thiab kev sib raug zoo tau pom ntawm cov kev txwv no thiab lub raum tsis ua haujlwm (9). Hauv peb txoj kev tshawb fawb yav dhau los ntawm cov neeg mob ntshav siab thiab tsis muaj zog, peb pom muaj kev sib raug zoo ntawm NGAL, ntshav cystatin C, thiab eGFR hauv cov neeg mob no (10). Raws li tus kws sau ntawv paub, tsis muaj cov ntaub ntawv hais txog kev ntsuas ib txhij ntawm cov ntshav thiab cov zis NGAL ntsig txog creatinine thiab eGFR hauv cov kab mob hauv lub raum los qhia txog qhov sib txawv no tab sis tseem ceeb sib npaug ntawm cov kab mob raum (CKD). Yog li ntawd, raws li creatinine yog ib qho kev qhia tsis txaus ntseeg ntawmraummuaj nuj nqi, lub hom phiaj ntawm txoj kev tshawb no yog los ntsuas seb NGAL cuam tshuam nrograummuaj nuj nqinyob rau hauv lub raum allograft tau txais.

Echinacoside in cistanche is good for kidney function

Echinacoside hauv cistanche yog qhov zoo raulub raum ua haujlwm

Cov neeg mob thiab cov txheej txheem

Txoj kev tshawb nrhiav hla ntu no tau ua tiav ntawm 100 cov neeg tau txais lub raum allograft (48 tus poj niam, 52 tus txiv neej, hnub nyoog 26-74 xyoo), suav nrog 15 tus neeg mob ntshav qab zib.Cov tshuaj tiv thaiv kab mob muaj CsA (ntshav. trough CsA qib: 100–250 ng/mL), prednisone (5–10 mg txhua hnub) thiab azathioprine (100–150 mg txhua hnub, n=46) lossis MMF (mycophenolatemofetil, koob 2 g /dn=54). Tag nrho cov ntawm lawv tau khaws cia txaus thiab ruaj khov ua haujlwm, tsis pom cov tsos mob ntawm kev tsis lees paub, tsis muaj qhov mob (C reactive protein hauv qab 6 mg / L siv cov qauv kev kuaj), thiab tsis muaj lub siab ua haujlwm tsis zoo (lub sijhawm prothrombin, alanine aminotransferase kev ua haujlwm nyob rau hauv ib txwm muaj). Lub sijhawm tom qab hloov pauv yog 75 lub hlis. Pawg tswj hwm muaj 30 tus neeg ua haujlwm noj qab haus huv (eGFR tshaj 90 mL / min) tau txais los ntawm cov neeg ua haujlwm kho mob, cov phooj ywg, thiab lawv tsev neeg. Txhua yam kev kawm tau txais kev pom zoo, thiab cov txheej txheem tau pom zoo los ntawm Medical University Ethics Committee. Cov ntshav raug muab rho tawm thaum sawv ntxov thaum cov neeg mob tau tshwm sim rau qhov kev soj ntsuam hauv chaw ua haujlwm tom qab ib hmos ceev ceev. Cov ntshav kuaj tau muab sau rau hauv cov hlab ntsha vacutainer. Cov ntshav tau centrifuged ntawm 2500 g rau 15 min nyob rau hauv chav tsev kub nyob rau hauv lub clinicallaboratory kom yield serum. Cov qauv coj mus kuaj thiab khaws cia ntawm )40 C ua ntej kuaj.Assays tau ua tiav hauv ib hlis tom qab kuaj. Kev ntsuam xyuas NGAL tau ua los ntawm thawj aliquot (cov qauv tsis khov thiab thawed).GFR tau kwv yees siv kev hloov kho yooj yim ntawm Kev Noj Qab Haus Huv Hauv Lub Raum Kab Mob (MDRD) formula(eGFR=186.3 · serum creatinine (mg/dL)) 1.14 · hnub nyoog) 0.203 · 0.742 yog poj niam · 1.21 yog AfricanAmerican) thiab Cockcroft-Gault formula[creatinine clearance=(140)age) · lub cev hnyav / serum creatinine · 72 yog poj niam · 0.85]. CKDstages tau txhais raws li NKF/DOQIguidelines (11).

Ua kom tiav cov ntshav suav, urea, roj cholesterol, triglycerides, yoo mov qabzib, tag nrho cov protein, thiab albumin tau kawm los ntawm cov qauv kev kuaj sim.Serum creatinine tau ntsuas los ntawm tus qauv qauv (Jaffe) hauv chav kuaj hauv nruab nrab hauv tsev kho mob. NGAL tau soj ntsuam cov tshuaj inserum siv cov khoom lag luam muaj enzyme-linkedimmunosorbent assay (ELISA) los ntawm ANTI BODYSHOP (Gentofte, Denmark). Nyob rau hauv luv luv, itis ib tug Sandwich monoclonal ELISA tus txheej txheem txiav txim nyob rau hauv tib neeg cov zis thiab cov ntshav.Microtiter platelets coated nrog monoclonal antibodies tiv thaiv tib neeg NGAL tau coated nrog cov qauv ( zis los yog ntshav) los yog cov qauv (NGALconcentrations xws li 1 txog 1000 lg / L) thiab incubated nrog monoclonaltiny cov tshuaj tiv thaiv kab mob rau tib neeg NGAL ua raws li bystreptavidin-conjugated horseradish peroxidase.Tetramethylbenzidine substrate tau ntxiv rau kev tsim xim, uas tau nyeem ntawm 450 nm nrog tus nyeem ntawv microplate. High-rhiab heev CRP raug ntsuas los ntawm kev siv cov khoom muag muag los ntawm American Diagnostica (Greenwich, CT, USA) thiab IL-6 siv cov khoom muag muag los ntawm R&D (Abingdon, UK). Tag nrho cov kev ntsuam xyuas tau ua raws li cov chaw tsim khoom cov lus qhia los ntawm tib tus neeg.

Cov ntaub ntawv tau qhia raws li txhais tau tias ± SD ormedian (tsawg kawg, qhov siab tshaj plaws). Kev ntsuam xyuas ntawm qhov kev faib tawm ntawm qhov hloov pauv tau ua tiav siv Shapiro-Wilk W-test. Cov kev sib piv ntawm cov pab pawg tau ua los ntawm ANOVA. Kev sib raug zoo ntawm NGAL thiab lwm yam hloov pauv tau raug soj ntsuam los ntawm Pearsons lossisSpearman qhov kev xeem raws li qhov tsim nyog. Cov nqi ntawm p< 0.05="" were="" taken="" as="" statistically="" significant.="" multiple="" regression="" analysis="" was="" used="" to="" determine="" independent="" factors="" affecting="" the="" dependent="" variable.="" the="" factors="" showing="" linear="" correlation="" with="" ngal="" (p="" <="" 0.1)="" were="" included="" in="" the="">

Acteoside in Cistanche is good for kidney function

Acteoside hauv Cistanche yog qhov zoo raulub raum ua haujlwm

Cov txiaj ntsig

Tag nrho cov ntaub ntawv tau nthuav tawm nyob rau hauv Table 1. Cov neeg tau txais kev hloov hauv lub raum tau nce ntau dua creatinine, urea, roj cholesterol, triglycerides, yoo mov qabzib, ntshav siab, ntshav cell suav, hsCRP, IL-6, ntshav NGAL, thiab qis dua eGFR dua li kev tswj hwm. pab pawg. Hauv cov neeg tau txais kev hloov hauv lub raum tsuas yog 1 tus neeg mob muaj eGFR siab dua 90 mL/min (CKD theem 1), 41 tus neeg mob tau theem 2 CKD (eGFR ntawm 90 thiab 60 mL/min) ,49 cov neeg mob muaj theem 3 CKD (eGFR ntawm 60 txog 30 mL / min) thiab 9 cov neeg mob muaj theem 4 CKD (eGFR ntawm 30 thiab 15 mL / min). Cov neeg tau txais kev hloov pauv hauv lub raum tau muaj NGAL ntau dua li pawg tswj hwm. Qhov nruab nrab serumNGAL tus nqi nyob rau theem 2 CKD yog 107.34 ± 36.76 ng / mL, hauv theem 3 CKD yog 141.26 ± 47.54 ng / mL (p < 0.01="" vs.="" theem="" 2)="" thiab="" hauv="" theem="" 4="" ckd="" yog="" 198.87="" ±="" 3="" ng="" 5="" ml="" (p=""><0.01 vs.="" theem="" 3,="" p=""><0.001 vs.="" theem="" 2),="">

Kev tsom xam tsis sib xws

Nyob rau hauv univariate tsom xam serum NGAL tau muaj kev sib raug zoo, nrog rau cov ntshav creatinine (r=0.78, p.< 0.001)="" (fig.="" 1),="" egfr="" by="" mdrd="" (r=")0.69," p="" <="" 0.001)="" (fig.="" 2)="" and="" cockcroft–gault="" (r=")0.56," p="" <="" 0.001),="" moderately="" correlated="" with="" white="" blood="" cell="" count="" (r="0.43," p="" <="" 0.001),="" urea="" (r="0.45," p="" <="" 0.001),="" and="" only="" weakly="" correlated="" with="" other="" parameters:="" hemoglobin="" (r=")0.25," p="" <="" 0.05),="" hematocrit="" (r=")0.27," p="" <="" 0.05),="" duration="" of="" hypertension="" (r="0.25," p="" <="" 0.05),="" age="" (r="0.24," p="" <="" 0.05),="" presence="" of="" diabetes="" (r="0.27," p="" <="" 0.05),="" albumin="" r=")0.27," p="" <="" 0.05),="" hscrp="" (r="0.26," p="" <="" 0.05),="" cyclosporine="" (csa)="" concentration="" (r="0.25," p="" <="" 0.05),="" and="" proinflammatory="" cytokine:="" il-6="" (r="0.28," p="" <="">

figure 1 Acteoside in Cistanche is good for kidney function

fiure 2 Acteoside in Cistanche is good for kidney function

Kev ntsuam xyuas ntau regression

Cov tsis sib xws los yog muaj feem cuam tshuam nrog NGAL (p < 0.1)="" tau="" suav="" nrog="" hauv="" cov="" qauv="" ntawm="" ntau="" qhov="" kev="" ntsuam="" xyuas="" rov="" qab.="" thaum="" tag="" nrho="" cov="" kev="" ntsuas="">raummuaj nuj nqi(creatinine, eGFR los ntawm ob lub mis) tau suav nrog hauv cov qauv ntawm ntau qhov kev ntsuas kev rov qab, qhov kev kwv yees zoo tshaj plaws ntawm cov ntshav NGAL hauv ntau qhov kev ntsuam xyuas rov qab, tau los ua eGFR (beta ){{0}}.69, p < 0.="" 0.23,="" p=""><0.05) piav="" qhia="" 82="" feem="" pua="" ntawm="" ngal="" concentration.="" thaum="" egfr="" tau="" hloov="" los="" ntawm="" creatinine,="" cov="" txiaj="" ntsig="" tau="" zoo="" ib="" yam.="" kho="" r="" 2="" rau="" qhov="" hloov="" pauv="" hauv="" kab="" zauv="0.82," f="7.15," p="">< 0.00001,="" se="" ntawm="" kwv="" yees="">

Kev cuam tshuam ntawm ntshav qab zib, ntshav siab, thiab poj niam txiv neej ntawm cov neeg tau txais lub raum ntawm cov ntshav

NGALNormotensive raum allograft cov neeg tau txais txiaj ntsig tau qis dua NGAL (109.54 ± 23.65 vs.128.5 ± 57.74 ng/mL, p < {{10}}}05)="" dua="" li="" hypertensives.="" txawm="" hais="" tias="" cov="" qib="" creatinine="" zoo="" sib="" xws,="" egfr="" tau="" nce="" siab="" dua="" hauv="" normotensives="" (p="">< 0.05)="" dua="" li="" hauv="" cov="" ntshav="" siab.="" serum="" ngal="" tau="" nce="" siab="" dua="" hauv="" cov="" neeg="" mob="" ntshav="" qab="" zib="" ntau="" dua="" li="" cov="" neeg="" mob="" uas="" tsis="" muaj="" ntshav="" qab="" zib="" (132.14="" ±="" 99.34="" vs.93.63="" ±="" 50.05="" ng="" ml,="" p="">< 0.05),="" qhov="" creatinine="" tsis="" txawv="" ntawm="" cov="" pab="" pawg="" no.="" cov="" poj="" niam="" tau="" qis="" dua="" egfr="" (tag="" nrho="" cov="" qauv)="" piv="" rau="" txiv="" neej="" (mdrd="" 54.10="" ±="" 20.84="" vs.72.15="" ±="" 21.25="" ml/min,="" p="">< 0.01,="" cockcroft–gault="" 47.69="" ±="" 17.81="" vs.="">< 60.59="">

Flavonoid in Cistanche Acteoside in Cistanche is good for kidney function

Cov flavonoid hauv Cistanche Acteoside hauv Cistanche yog qhov zoo rauraummuaj nuj nqi

Kev sib tham

Txawm muaj kev vam meejraumhloov pauvtsis tau zoo li qubraummuaj nuj nqi. Feem ntau, cov neeg mob raug pauv los ntawm theem 5 CKD mus rau theem 2 lossis 3CKD. Hauv kev xyaum tam sim no, creatinine tsis yog qhov qhia tau meej ntawmraummuaj nuj nqi, tshwj xeeb tshaj yog thaum muaj kev hloov pauv loj. Ntxiv mus, calcineurininhibitors tau dav paub tias yog nephrotoxic.Yog li ntawd, kev tswj hwm ntawm cyclosporine ortacrolimus yuav tsum tau ua tib zoo saib xyuas cov ntshav los ntawm cov concentration. Hauv txoj kev tshawb no, peb pom tias cov serum NGAL cuam tshuam nrograummuaj nuj nqi/ tsis ua haujlwm hauv lub raum allograft tau txais. Qhov kev kwv yees muaj zog tshaj plaws ntawm cov ntshav NGAL yog eGFRindicating cov txiaj ntsig ntawm NGAL ntsuas hauv cov neeg no. Nws tau raug tshaj tawm tsis ntev los no tias NGAL tuaj yeem sawv cev rau lub raum ua haujlwm ntawm cov kab mob raum mob rau cov menyuam yaus (12) thiab cov neeg laus (13). NGAL yog synthesized systemically inresponse rau lub raum kev puas tsuaj raws li glomerularfiltration thiab tubular uptake, nws tuaj yeem tsim hauv zos los ntawm cov tubules raug mob. Raws li ib qho me me molecule, NGAL yog lim los ntawm glomerulus. Nws yog absorbed ntau nyob rau hauv cov tubules proximal byefficient megalin-dependent endocytosis (14). Moriet al. (6) qhia tau hais tias kev txhaj tshuaj ntawm cov ntawv sau npe NGAL ua rau muaj kev cuam tshuam ntawm NGAL hauv cov tubules ze ze yam tsis muaj qhov sib txuam hauv cov zis. Yog li, NGAL excretionin tso zis, nyob rau hauv cov ntaub ntawv ntawm kev sib raug zoo tubuleinjury, yuav yog vim NGAL reabsorptionand/los yog enhanced de novo NGAL synthesis. Tseeb, nyob rau hauv tus qauv ntawm mob raum raug mob, ib tug loj heev andrapid upregulation ntawm NGAL mRNA tau tshwm sim (15). Schmitt-Ott et al. (14) hypothesized tias txawm hais tias NGAL tau tsim nyob rau hauv distalnephron, nws kuj tau xa mus rau proximaltubule los ntawm kev ncig. Nws feem ntau yuav piav qhia los ntawm glomerular pom ntawm circulatingNGAL thiab tom qab uptake los ntawm proximal tubular epithelia los ntawm endocytosis (6). Hais txog lub pas dej ntshav / ntshav ntawm NGAL, nws tau tshaj tawm tias mob raum raug mob ua rau muaj qhov nce ntxiv ntawm NGAL mRNA hauv ntau lub cev, feem ntau hauv lub ntsws thiab lub siab (16). Yog li, NGAL tuaj yeem raug tso tawm rau hauv kev ncig thiab nthuav tawm lub pas dej ua ke. Qhov thib peb ntawm NGAL tuaj yeem qhib los ntawm neutrophils / macrophages lossis cov hlab ntsha tawg, feem ntau pom muaj kab mob plawv, ntshav siab, thiab mob raum (17), raws li NGALis nce hauv atherosclerotic plaques (18). Tej zaum nws kuj tso tawm rau hauv cov hlab ntsha los ntawm qhov mob / puas endothelium nyob rau hauv lub raum allograft tau txais, ib qho kev tshawb pom nyob rau hauv cov pejxeem no (19). Tsis tas li ntawd, cov kab mob raum ntev yog txuam nrog lub xeev subclinical inflammatory thiab feem ntau ntawm lub raum allograft cov neeg tau txais kev pom muaj theem 2 lossis 3CKD. Tonelli et al. (20) qhia txog kev sib raug zoo ntawm CRP thiabraummuaj nuj nqi. Lub raum tsis ua haujlwm kuj tseem tuaj yeem cuam tshuam rau qib ntawm cov kab mob inflammatory molecules vim lawv inverselycorrelated nrog creatinine clearance (21). Yog li ntawd, lub hauv paus ntawm cov ntshav thiab cov zis NGAL thaum lub raum raug mob tuaj yeem yog cov txiaj ntsig ntawm peb qhov chaw: raum, siab, thiab leukocytes (los ntawm cov ntaub so ntswg raug mob thiab ncig). Tsis tas li ntawd, ib qho impairmentinraummuaj nuj nqi, raws li kev cuam tshuam los ntawm qhov txo qis GFR, tuaj yeem ua rau txo qis kev tshem tawm ntawm NGAL thiab tom qab sib sau ua ke hauv kev ncig, raws li pom los ntawm qib NGAL siab rau cov neeg mob uas muaj kab mob raum (12, 13). Tej zaum nws yuav piav qhia tias qhov kev kwv yees zoo tshaj plaws ntawm NGAL waseGFR nrog rau lwm tus neeg kwv yees yog leukocyte suav thiab hs-CRP.

Nyob rau hauv lub raum post-ischemic, NGAL yog upregulated nyob rau hauv proximal tubules thiab distal nephronsegments (22). Nephrotoxic raug mob tom qab cisplatinadministration nyob rau hauv nas ua rau ib tug zoo xws li cov qauv ntawm NGAL hloov (23). Parik et al. (24) hauv lawv txoj kev tshawb fawb hauv ib pawg me me ntawm lub raum hloov pauv cov neeg tau txais txiaj ntsig tau tshaj tawm tias cov zis NGAL tuaj yeem sawv cev rau qhov kev kwv yees ntxov ntawm kev ua haujlwm qeeb, lwm tus qauv ntawm ischemia-reperfusion raug mob. Hauv lawv txoj kev tshawb fawb yav dhau los, NGAL staining siv nyob rau hauv cov txheej txheem biopsies thaum ntxov tau pom zoo los ua qhov kev kwv yees tshiab biomarker ntawm mob raum raug mob tom qab hloov pauv (25).Hauv kev tshawb fawb tsis ntev los no, Kusaka li al. (26) qhia tias kev saib xyuas cov ntshav NGAL qib tuaj yeem ua rau nws muaj peev xwm los kwv yees kev rov qab los thiab qhov xav tau rau hemodialysis tom qabraumhloov pauvlos ntawm cov neeg pub dawb tom qab lub plawv tuag.

Nyob rau hauv txoj kev tshawb no, nyob rau hauv univariate tsom xam, weobserved ib tug correlation ntawm cyclosporineconcentration thiab serum NGAL. Cov kev tshawb fawb tau pom tias cyclosporine ua rau vasoconstriction ntawm afferent thiab efferent glomerular arterioles (27) thiab txo qis hauv lub raum ntshav thiab GFR. Qhov tseeb mechanism ntawm vasoconstriction tsis meej. Kev tswj hwm ntawm Cyclosporine yog txuam nrog kev txo qis hauv lub raum hauv cov ntshav plasma thiab glomerular filtration rate, uas cuam tshuam nrog ob qho tib si nrog cov koob tshuaj thiab nrog cov qib peakcyclosporine mus txog 2-4 teev tom qab oraldose (28). Hauv kev tshawb fawb tsis ntev los no ntawm Schaub et al.(29), kev hloov pauv ruaj khov nrog subclinical tubulitis pab pawg muaj qib siab dua me ntsis ntawm NGAL(p=0.06) dua li kev hloov pauv ruaj khov nrog pab pawg tubular histology. nrog ntau qhov sib txawv. Cov chaw kho mob tubulitis Ia/Ib thiab lwm pab pawg kho mob tubular pathology tau nce qib ntawm NGAL ntau dua li kev hloov pauv ruaj khov nrog cov tubular histology lossis kev hloov pauv ruaj khov nrog subclinical tubulitis (p <0.002). raws="" li="" cyclosporine="" paub="" tias="" yog="" nephrotoxic,="" nws="" cuam="" tshuam="" rau="" gfr="" thiab="" yog="" lub="" luag="" haujlwm="" rau="" kev="" hloov="" pauv="" hauv="" lub="" raum="" histology.="" peb="" tuaj="" yeem="" xav="" tias="" qhov="" kev="" sib="" raug="" zoo="" uas="" tau="" pom="" los="" yuav="" yog="" vim="" cov="" koom="" haum="">

Qhov kev kwv yees zoo tshaj plaws ntawm NGAL yog eGFR, yog li peb yuav tsum coj mus rau hauv tus account qhov txiaj ntsig ntawm NGALestimation hauv kev kho mob. Nyob rau hauv qhov kev xav ntawm txoj kev loj hlob ntawm cov zis (30) los yog wholeblood/plasma assays (31) rau NGAL estimation.Qhov no yuav muaj raws li ib tug tshiab cuab tam rau kev soj ntsuam ntawmraummuaj nuj nqi. Kev ntsuam xyuas tag nrho cov ntshav lossis ntshav ntshav yog ib qho yooj yim nrog cov txiaj ntsig muaj nyob hauv 15 min thiab tsuas yog xav tau cov qauv amicroliter nkaus xwb (31). Qhov kev ntsuam xyuas zis, ntawm qhov tod tes, yuav tsum tsuas yog 150 lL cov zis thiab cov txiaj ntsig muaj nyob hauv 35 min (30).

Raws li Mori thiab Nakao (32), yam tsawg kawg yog ob yam yuav tsum tau txiav txim siab los ntsuas qhov tseeb ntawm lub raum tsis ua haujlwm: qhov sib piv ntawm kev ua haujlwm ntawm atrophic nephrons thiab qhov hnyav ntawm kev puas tsuaj tsis tu ncua. Lawv tau hais tias NGAL qhia txog qhov ua rau mob raum. Niaj hnub no, ntau qhov kev sim tshuaj ntsuam xyuas tau txuas ntxiv mus rau kev lees paub NGAL ua lub peev xwm biomarker ntawm lub raum raug mob hauv cov chaw kho mob sib txawv (22 RCT ntawm lub vev xaib ClinicalTrials.gov). Txawm li cas los xij, lub sijhawm no creatinine tseem yog tus qauv kub ntsuasraummuaj nuj nqi. Qee qhov kev cog lus biomarkers yog nyob rau lub qab ntug thiab tos kev kho mob.

Yog li, NGAL yuav tsum raug tshawb xyuas raws li qhov muaj peev xwm ntxov thiab muaj txiaj ntsig ntawm lub raum tsis zoo / raug mob. Ntxiv mus, vim nws qhov rhiab heev, NGAL tuaj yeem nthuav tawm nephrotoxicity hauv cov tshuaj tshiab thiab tuaj yeem pab saib xyuas cov tshuaj tiv thaiv kab mob nrog calcineurin inhibitors (paub tias yog nephrotoxic) hauv cov neeg tsis muaj zog ntawm lub raum allograft tau txais.

Los ntawm: ' Serum neutrophil gelatinase-associated lipocalin correlates nrograummuaj nuj nqinyob rau hauv lub raum allograft tau txais 'los ntawmMalyszko J, et al

---Clin Transplant 2009: 23: 681–686 DOI: 10.1111/j.1399-0012.2009.01034.x

Cov ntaub ntawv
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