尿中性粒细胞明胶酶相关脂质运载蛋白与儿童肾脏病

Urinary neutrophil gelatinase-associated lipocalin and nephrology in children

尿中性粒细胞明胶酶相关脂质运载蛋白(uNGAL)具有直观反映泌尿系统上皮损伤的特性,当肾小管上皮细胞受损伤刺激时,其被显著诱导并高表达。uNGAL的检测方法具有简单、快速、无创的优点。近年来,国内外学者就uNGAL进行了大量研究,在儿童肾脏病中,如泌尿系统感染、急性肾损伤、原发性肾病综合征及继发性肾小球疾病、膀胱输尿管反流、反流性肾病肾瘢痕形成等,检测uNGAL水平可以起早期诊断及疗效评估的作用。现系统阐述在儿童肾脏病的诊治中uNGAL的作用,以供临床医师在临床工作中参考。

Urinary neutrophil gelatinase-associated lipocalin (uNGAL) characterizes with obvious indication of urinary epithelial injury.It is induced significantly and secreted predominantly by the injured epithelial cells of the kidney.Recent published reports have described additional utility of uNGAL in various pathologic conditions within the pediatric urinary tract, including urinary tract infection, vesicoureteral reflux, renal scarring, and obstructive uropathy.And it was recommended as a good biomarker for diagnosis and treatment monitoring of acute pyelonephritis in children.Furthermore, uNGAL is one of the earliest and most indicative biomarkers of acute kidney injury. Recent studies suggested that uNGAL excretion could be helpful in diagnosis and monitoring of treatment and progressing of various renal diseases, such as nephrotic syndrome, diabetes nephropathy, immunoglobulin A(IgA) vasculitis nephritis, lupus nephritis, et al.Additionally, the ability to assay the marker noninvasively in urine represents a significant advantage over current methods, especially for the pediatric population.These improvements will increase the clinical utility of uNGAL and may lead to more effective and personalized treatments for children with uropoietic system diseases.The role of uNGAL in the diagnosis and treatment of children′s kidney disease is systematically described in this article, so as to provide a reference for clinicians in their daily work.