2021 Fiscal Year Final Research Report
Verification of the utility of urinary thrombin levels as a novel urinary biomarker for differential diagnosis of renal diseases
| Project/Area Number |
19K08681
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 53040:Nephrology-related
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| Research Institution | Kumamoto University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
向山 政志 熊本大学, 大学院生命科学研究部(医), 教授 (40270558)
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| Project Period (FY) |
2019-04-01 – 2022-03-31
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| Keywords | セリンプロテアーゼ |
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| Outline of Final Research Achievements |
Thrombin (TB) is produced during glomerular inflammation and secreted in urine, however the TB levels in several kidney diseases are unknown. We focused on urinary TB and quantitatively measured urinary TB levels in 170 patients with biopsy-proven renal diseases using the original ELISA system. We further examined if urinary TB secretion can be a novel urinary biomarker for diagnosing renal disease using the urinary TB-creatinine ratio (TB/Cr). Thrombinuria was seen in membranoproliferative glomerulonephritis (MPGN, 50%), focal segmental glomerulosclerosis (FSGS, 50%), malignant nephrosclerosis (50%), diabetic nephropathy (38.5%), minimal change nephrotic syndrome (MCNS, 36.4%), membranous nephropathy (MN, 31.6%), microscopic polyangiitis (MPA, 30.4%), IgA nephropathy (25.0%), Amyloid light chain amyloidosis (10%), and lupus nephritis (9.1%). Thus, these results show that urinary TB measurement could be useful as an adjunct to diagnose MPGN, FSGS, and malignant nephrosclerosis.
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| Free Research Field |
腎臓内科学
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| Academic Significance and Societal Importance of the Research Achievements |
これまでに腎疾患患者でELISA測定系を用いて大規模に尿中TB排泄量を検討した研究はない。尿中TB排泄量を測定することにより、①腎疾患の早期診断、②疾患活動性の評価や疾患再発の早期発見、③腎疾患の予後の推測、④治療効果の判定が可能となれば、迅速な診断かつ最適な治療介入により疾患の増悪による末期腎不全への進行を抑制することに繋がり、臨床医学的見地からも多大な恩恵をもたらすことが期待され、先進的な研究になると考える。最終的には年々増加し続けている透析導入患者数を減少させることが可能となれば、CKD領域における医療費の抑制に繋がり、医療経済的にも極めて意義深いものになると考える。
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