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Immunoassays distin...
Immunoassays distinguishing between HNL/NGAL released in urine from kidney epithelial cells and neutrophils
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- Martensson, Johan (author)
- Karolinska Institutet
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- Xu, Shengyuan (author)
- Uppsala universitet,Biokemisk struktur och funktion
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- Bell, Max (author)
- Karolinska Institutet
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- Martling, Claes-Roland (author)
- Karolinska Institutet
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- Venge, Per (author)
- Uppsala universitet,Biokemisk struktur och funktion
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(creator_code:org_t)
- Elsevier BV, 2012
- 2012
- English.
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In: Clinica Chimica Acta. - : Elsevier BV. - 0009-8981 .- 1873-3492. ; 413:19-20, s. 1661-1667
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Abstract
Subject headings
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- Background: The distinction between monomeric human neutrophil lipocalin/neutrophil gelatinase-associated lipocalin (HNL/NGAL), secreted by injured kidney tubular cells, and dimeric HNL/NGAL, released by activated neutrophils, is important to accurately diagnose acute kidney injury (AKI).Methods: 132 urine samples from 44 intensive care unit (ICU) patients and five urine samples from non-ICU patients with urinary tract infections (UTIs) were analyzed by two monoclonal enzyme-linked immunosorbent assays (ELISA-1 and ELISA-2). The presence of monomeric and/or dimeric HNL/NGAL in each sample was visualized by Western blotting.Results: The ELISA-1 detected both monomeric and dimeric HNL/NGAL whereas the ELISA-2 almost exclusively detected dimeric HNL/NGAL with an area under the receiver-operating characteristics curve (AuROC) of 0.90. The ELISA-1/ELISA-2 ratio detected the monomeric form with an AuROC of 0.92. In 32 AKI patients, dimer-specific EUSA-2 levels decreased pre-AKI whereas the monomer-specific ELISA-1/ELISA-2 ratio gradually increased beyond AKI diagnosis. High EUSA-2 levels and/or low ELISA-1/ELISA-2 ratios detected a predominance of dimeric HNL/NGAL in urine from the patients with tills.Conclusions: In combination, our two ELISAs distinguish monomeric HNL/NGAL, produced by the kidney epithelium, from dimeric HNL/NGAL, released by neutrophils during AKI development, as well as reduce the confounding effect of neutrophil involvement when bacteriuria is present.
Keyword
- Acute kidney injury
- AKIN
- Biomarker
- HNL
- NGAL
- RIFLE
Publication and Content Type
- ref (subject category)
- art (subject category)
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