- 作者：Yuping Wang ; Yang Gu
- 刊名：Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health
- 出版年：2016
- 出版时间：July 2016
- 年：2016
- 卷：6
- 期：3
- 页码：148
- 全文大小：36 K
2">Objective
To determine if podocyte glycoprotein nephrin and podocalyxin, and tubular injury biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule 1 (KIM-1) could serve as biomarkers to evaluate kidney injury and postpartum kidney functional recovery in PE.
Methods
Urine specimen was collected from 88 pregnant women (28 normal pregnancy, 15 complicated with chronic hypertension (CHT), 11 mild PE, and 34 severe PE). Among the study subjects, urine specimens were also obtained from 11 normal and 9 severe PE pregnancies 6–8 weeks after delivery. Urine concentrations of nephrin, podocalyxin, soluble vascular cell adhesion molecule 1 (sVCAM-1), NGAL, KIM-1, and creatinine were measured by enzyme-linked immunosorbent assay (ELISA). Creatinine concentration was used to normalize urine levels of testing biomarkers for each sample. ANOVA and paired t-test were used for statistical analysis. Pearson product-moment correlation coefficient (Pearson r) was used to analyze the correlation of urine biomarkers with the urine proteinuria-to-creatinine ratio in severe PE. A p value of <0.05 was considered statistically significant.
Results
20">(1) Urine levels of nephrin, podocalyxin, sVCAM-1, NGAL, and KIM-1 were significantly higher in severe PE than in normal pregnant women before delivery, p <01 or p < 0.05, respectively. The elevated urine concentrations of nephrin, podocalyxin, sVCAM-1, NGAL, and KIM-1 were also correlated to urine protein/creatinine ratio. (2) Urine levels of nephrin, podocalyxin, sVCAM-1, NGAL, and KIM-1 were significantly reduced 6–8 weeks post partum in severe PE, p < 0.01.
Conclusions
25">Nephrin and podocalyxin are podocyte glycoproteins. Increased nephrin and/or podocalyxin shedding are indicators of podocyte injury. sVCAM could be released from dysfunctioned glomerular endothelial cells or leaked from maternal plasma through the glomerular basement barrier. NGAL and KIM-1 are considered biomarkers of both acute or chronic kidney tubular injury. Thus, our results suggest that not only podocyte injury, but also tubular dysfunction occur in severe PE. Reduced shedding of these biomarkers in severe PE after delivery is an indicator of kidney function recovery in PE. Therefore, our data suggest that these urine biomarkers could serve as biomarkers to assess kidney injury during pregnancy and to evaluate postpartum kidney functional recovery in PE and pregnancy-associated kidney disorders.