Urinary MMP-9/NGAL ratio as a potential marker of FSGS in nephrotic children.

The study was undertaken to develop a potential new markers for distinguishing minimal change nephrotic syndrome (MCNS) and focal segmental glomerulosclerosis (FSGS) in children. We hypothesized that matrix metalloproteinase-9/neutrophil gelatinase-associated lipocalin (MMP-9/NGAL) is a better marker of focal sclerosis in the glomerulus then matrix metalloproteinase-9/tissue inhibitor of metalloproteinase-1 (MMP-9/TIMP-1) and matrix metalloproteinase-2/tissue inhibitor of metalloproteinase-2 MMP2/TIMP-2.
The present study used a sample of 36 children and adolescents subdivided into two groups: I - 20 children with MCNS, subjected to examination twice: A - in relapse of nephrotic syndrome, before treatment and B - after regression of proteinuria; II - 16 children with FSGS. MMPs and TIMPs and NGAL levels were measured in the urine using ELISA kit. MMP-9/TIMP-1, MMP-2/TIMP-2 and MMP-9/NGAL ratios were calculated.
Median NGAL/cr. was significantly higher in MCNS and FSGS patients when compared to healthy controls. Both, NGAL and MMP-9 urinary levels were significantly elevated in FSGS subjects, as compared with control subjects. Contrary to FSGS children, in MCNS group, before treatment only NGAL/cr., but not MMP-9/cr. was increased. Urinary concentrations of NGAL and MMP-9 were highly associated with each other (NGAL/cr. vs. MMP-9/cr., r=0.485, p<0.01). Median urine MMP-9/NGAL ratio in FSGS patients was significantly higher than in patients with MCNS. We also found that significant increase in MMP-9/NGAL was associated with FSGS [odds ratio (OR) - 9.0; confidence interval (CI) 1.97-41.07].
MMP-9/NGAL ratio may serve as differentiation marker between MCNS and FSGS in nephrotic children.
AuthorsAgata Korzeniecka-Kozerska, Anna Wasilewska, Edyta Tenderenda, Agnieszka Sulik, Kamil Cybulski
JournalDisease markers (Dis Markers) Vol. 34 Issue 5 Pg. 357-62 ( 2013) ISSN: 1875-8630 [Electronic] Netherlands
PMID23478276 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Acute-Phase Proteins
  • Biomarkers
  • LCN2 protein, human
  • Lipocalins
  • Proto-Oncogene Proteins
  • TIMP1 protein, human
  • TIMP2 protein, human
  • Tissue Inhibitor of Metalloproteinase-1
  • Tissue Inhibitor of Metalloproteinase-2
  • MMP2 protein, human
  • Matrix Metalloproteinase 2
  • MMP9 protein, human
  • Matrix Metalloproteinase 9
  • Acute-Phase Proteins (urine)
  • Adolescent
  • Biomarkers (urine)
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Glomerulosclerosis, Focal Segmental (diagnosis, urine)
  • Humans
  • Lipocalins (urine)
  • Male
  • Matrix Metalloproteinase 2 (urine)
  • Matrix Metalloproteinase 9 (urine)
  • Nephrotic Syndrome (diagnosis, urine)
  • Proto-Oncogene Proteins (urine)
  • Tissue Inhibitor of Metalloproteinase-1 (urine)
  • Tissue Inhibitor of Metalloproteinase-2 (urine)

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