Germ cell tumors (GCTs) are a heterogenous group of neoplasms in children and young adults, in which serum tumor markers have been demonstrated to be highly sensitive diagnostic and monitoring tools. The known "old" serum biomarkers, alpha-fetoprotein (AFP), human choriogonadotropin (β-hCG) and lactate dehydrogenase (LDH), have some limitations in sensitivity and specificity. MIRNAs from the miR-371~373 (chromosomal locus 19q13.41) and miR-302/367 (4q25) clusters are universally over-expressed in malignant GCT tissue samples. The levels of miRNAs from these clusters are elevated in the serum. They seem to be highly sensitive and specific in malignant GCTs diagnosis and disease assessment during treatment and follow-up. The aim of our review was to present the role of serum tumor markers in the clinical staging, treatment monitoring and follow-up of pediatric patients with GCTs and show new possibilities. The serum levels of miRNAs seem to be a new, promising essential tool in the clinical management of GCTs.
Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), inhibitors of nitric oxide synthase, play important roles in many processes in the body. Most data in the literature concern their importance in adult chronic kidney disease (CKD). According to them, SDMA well reflects the glomerular filtration rate (GFR), and higher ADMA concentrations are associated with hypertension and higher mortality. In addition, both substances are recognised cardiovascular risk factors in CKD. The purpose of this review was to summarise the studies on dimethylarginines in renal diseases in children, about which we have much fewer data. The review focuses specifically on dimethylarginine’s relation to routinely used renal function parameters. Finally, we analysed 21 of the 55 articles published between 2003 and 2022 on dimethylarginines in kidney diseases in children (from birth to 18 years of age), obtained by searching PubMed/MEDLINE (search terms: “dimethylarginine” and “kidney”).
Introduction: Nephrotoxicity, as a side effect of antineoplastic treatment, can occur in childhood cancer survivors (CCSs). It worsens their quality of life especially if it leads to chronic kidney disease (CKD). Collagen turnover is known to be disturbed in CKD. Urinary type IV collagen (U-Col4) is recognized as an exponent of extracellular matrix synthesis and degradation in glomeruli and is thus involved in this turnover. The purpose of this study was to evaluate the usefulness of U-Col4 in assessing early renal impairment in CCSs.Material and methods: Seventy-eight CCSs, without CKD, bilateral kidney tumors, congenital kidney defects, urinary tract infections and diabetes, at least one year after ending antineoplastic treatment, and aged 1-18 years, were divided into three groups: 1) patients after nephroblastoma treatment (n = 18); 2) patients after other solid tumors treatment (n = 42); and 3) patients after anti-hamatopoietic and lymphatic system proliferative treatment (n = 18). Concentrations of creatinine and cystatin C in serum, and of albumin, creatinine, N-acetyl-β-D-glucosaminidase (NAG), and U-Col4 in urine, were measured, and a general urine analysis was performed. The albumin-creatinine ratio (ACR), the urine U-Col4/creatinine ratio, the urine NAG/creatinine ratio and the estimated glomerular filtration rate were according to the Schwartz and the Filler equations were calculated. Results:We did not find any differences between the groups in the evaluated biochemical parameters. Weak negative correlations were found between U-Col4 and urine NAG/creatinine ratio (p = 0.02, R = -0.27) and ACR (p = 0.00, R = -0.39).Conclusions: Evaluation of the usefulness of U-Col4 in assessing early renal impairment in CCSs requires further study.CCSs should be monitored for potential complications of antineoplastic treatment, even many years after its completion.
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