Urinary biomarkers of IgA nephropathy and other IgA-associated renal diseases

IgA nephropathy is the most common primary glomerulonephritis and is a frequent cause for chronic kidney disease in children and young adults. Glomerular deposition of IgA also characterizes other renal disorders, including Henoch-Schoenlein purpura nephritis and immune-complex glomerulonephritis af...

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Veröffentlicht in:World journal of urology 2007-10, Vol.25 (5), p.467-476
Hauptverfasser: JULIAN, Bruce A, WITTKE, Stefan, HAUBITZ, Marion, ZURBIG, Petra, SCHIFFER, Eric, MCGUIRE, Brendan M, WYATT, Robert J, NOVAK, Jan
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container_issue 5
container_start_page 467
container_title World journal of urology
container_volume 25
creator JULIAN, Bruce A
WITTKE, Stefan
HAUBITZ, Marion
ZURBIG, Petra
SCHIFFER, Eric
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WYATT, Robert J
NOVAK, Jan
description IgA nephropathy is the most common primary glomerulonephritis and is a frequent cause for chronic kidney disease in children and young adults. Glomerular deposition of IgA also characterizes other renal disorders, including Henoch-Schoenlein purpura nephritis and immune-complex glomerulonephritis afflicting patients with liver disease due to chronic infection with the hepatitis C virus. Several treatment options are often considered, with the goal to prevent end-stage renal failure. Unfortunately, the diagnosis currently requires an invasive procedure, a renal biopsy. Because of the inherent risks, repetitive renal biopsy is frequently foregone as a means to monitor the clinical course or response to treatment. Recent advances in the analysis of the urinary proteome suggest that the excreted polypeptides include disease-specific patterns. We review recent studies of the various techniques for the identification and validation of such urinary biomarkers of IgA-associated glomerulonephritides. Currently, capillary electrophoresis coupled with mass spectrometry (MS) offers the greatest promise. To date, it seems more likely that disease-specific urinary polypeptide biomarkers are comprised of a panel of several distinct and well-defined peptides rather than a single molecule. Even most patients in clinical remission with normal clinical testing (dipstick urinalysis and quantitative proteinuria) were correctly classified by the pattern of polypeptides identified by capillary electrophoresis coupled with MS. With confirmation and refinement, such urinary testing may provide a tool for the diagnosis and monitoring of patients with IgA-associated renal diseases that is more sensitive than current standard clinical testing and far less risky than renal biopsy.
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Glomerular deposition of IgA also characterizes other renal disorders, including Henoch-Schoenlein purpura nephritis and immune-complex glomerulonephritis afflicting patients with liver disease due to chronic infection with the hepatitis C virus. Several treatment options are often considered, with the goal to prevent end-stage renal failure. Unfortunately, the diagnosis currently requires an invasive procedure, a renal biopsy. Because of the inherent risks, repetitive renal biopsy is frequently foregone as a means to monitor the clinical course or response to treatment. Recent advances in the analysis of the urinary proteome suggest that the excreted polypeptides include disease-specific patterns. We review recent studies of the various techniques for the identification and validation of such urinary biomarkers of IgA-associated glomerulonephritides. Currently, capillary electrophoresis coupled with mass spectrometry (MS) offers the greatest promise. 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subjects Biological and medical sciences
Biomarkers
Biomarkers - urine
Biopsy
Capillary electrophoresis
Chronic infection
Diagnosis
Down-Regulation
Electrophoresis, Capillary - methods
End-stage renal disease
Glomerulonephritis
Glomerulonephritis, IGA - diagnosis
Glomerulonephritis, IGA - physiopathology
Glomerulonephritis, IGA - urine
Hepatitis C
Humans
IgA nephropathy
Immunoglobulin A
Kidney diseases
Liver diseases
Mass Spectrometry - methods
Mass spectroscopy
Medical sciences
Nephritis
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Patients
Polypeptides
Proteinuria
Proteomes
Proteomics - methods
Purpura
Purpura, Schoenlein-Henoch - complications
Purpura, Schoenlein-Henoch - physiopathology
Remission
Renal failure
Up-Regulation
Urinalysis
Young adults
title Urinary biomarkers of IgA nephropathy and other IgA-associated renal diseases
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