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      Urinary Sediment Podocalyxin in Children with Glomerular Diseases

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          Abstract

          Background: In an immunofluorescence study using antibody to podocalyxin, we reported that urinary excretion of podocytes reflected podocyte injury in glomeruli. However, this method has some problems, since it is basically urine cytology. To overcome problems with this test, we measured whole podocalyxin content in urine sediment by enzyme-linked immunosorbent assay (ELISA). Methods: Urinary sediment podocalyxin (u-sed-PCX) content of the first morning urine was quantified by ELISA after solubilization by detergent. We measured urine samples from children with various glomerular diseases and from healthy volunteers as controls. The glomerular diseases were classified into two categories: group I (inflammatory glomerular, 5 diseases) and group II (non-inflammatory glomerular, 3 diseases). Results: (1) The level of u-sed-PCX was significantly higher in the urine from patients with glomerular diseases (groups I and II, median (interquartile range (IQR)): 2 (0.6–18.5), n = 111) compared with controls (0 (0–0.4), n = 135), and the level of u-sed-PCX in group I diseases (3.4 (0.6–27.2), n = 90) was significantly higher than those in group II diseases (0.9 (0.1–2.5), n = 21). (2) The presence of PCX in urine sediment was confirmed by Western blot analysis. (3) The degree of proteinuria was significantly correlated with the level of u-sed-PCX in group I (r<sub>s</sub> = 0.539, p < 0.001), but not in group II. (4) In group I, the level of u-sed-PCX was significantly higher in the acute phase than in the chronic phase (p < 0.01). (5) Comparison of histological findings of renal biopsies with u-sed-PCX showed a significant correlation in acute extracapillary lesions (p < 0.05). (6) Persistent high level of u-sed-PCX paralleled good histological progression in renal biopsies. Conclusion: Quantification of urinary sediment podocalyxin by ELISA is a reliable and useful laboratory marker for the estimation of the severity of active glomerular injury and a urinary index of acute extracapillary changes.

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          Urinary Excretion of Podocytes Reflects Disease Activity in Children with Glomerulonephritis

          The significance of the presence of podocytes in the urine was studied in various renal diseases in children. The podocytes were detected by immunofluorescence using monoclonal antibodies against the podocalyxin that is present on the surface of podocytes which serves as a glycocalyx. They were scored according to the numbers per partitioned area on cytospun urine sediments. Urine podocytes were absent in normal control, nonglomerular diseases such as urinary tract infection and nonglomerular hematuria, and glomerular, noninflammatory diseases such as minimal change nephrotic syndrome and membranous nephropathy. Conversely, the excretion of podocytes in the urine were detected in various glomerular, inflammatory diseases. A significantly higher level of the podocyte score was found in the acute state of glomerular diseases which was defined as within 6 months after disease onset. Positive correlations were obtained between the presence of urinary podocytes and the histological features of active extracapillary changes and mesangial proliferation. Urinary podocytes were examined monthly for 12 months in 7 cases with IgA nephropathy and 2 cases with Henoch-Schönlein purpura nephritis, and a consistently higher urinary podocyte score was observed in the patients with histological progression. The scoring of urinary podocytes was found to be useful clinically, as a diagnostic tool for glomerular or nonglomerular diseases, inflammatory or noninflammatory diseases, a marker for the estimation of the severity of active glomerular injury and also as a predictor of disease progression.
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            Author and article information

            Journal
            NEC
            Nephron Clin Pract
            10.1159/issn.1660-2110
            Nephron Clinical Practice
            S. Karger AG
            1660-2110
            2003
            November 2003
            17 November 2004
            : 95
            : 3
            : c91-c99
            Affiliations
            aDivision of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Science, Niigata, bDepartment of Pediatrics, Yoshida Hospital, Niigata, cDiagnostic Research Laboratories, Fujirebio Inc., Hachioji, Tokyo, and dDepartment of Cell Biology, Institute of Nephrology, Faculty of Medicine, Niigata University, Niigata, Japan
            Article
            74322 Nephron Clin Pract 2003;95:c91–c99
            10.1159/000074322
            14646369
            © 2003 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 6, Tables: 1, References: 22, Pages: 1
            Product
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/74322
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            Original Paper

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