Acute kidney injury (AKI) is one of the most frequent complications after cardiac surgery and is associated with poor outcomes. Biomarkers of AKI are crucial for the early diagnosis of this condition. Secretory leukocyte protease inhibitor (SLPI) is an alarm anti-protease that has been implicated in the pathogenesis of AKI but has not yet been studied as a diagnostic biomarker of AKI. Using two independent cohorts (development cohort (DC), n = 60; validation cohort (VC), n = 148), we investigated the performance of SLPI as a diagnostic marker of AKI after cardiac surgery. Serum and urinary levels of SLPI were quantified by ELISA. SLPI was significantly elevated in AKI patients compared with non-AKI patients (6 h, DC: 102.1 vs. 64.9 ng/mL, p < 0.001). The area under the receiver operating characteristic curve of serum SLPI 6 h after surgery was 0.87 ((0.76–0.97); DC). The addition of SLPI to standard clinical predictors significantly improved the predictive accuracy of AKI (24 h, VC: odds ratio (OR) = 3.91 (1.44–12.13)). In a subgroup, the increase in serum SLPI was evident before AKI was diagnosed on the basis of serum creatinine or urine output (24 h, VC: OR = 4.89 (1.54–19.92)). In this study, SLPI was identified as a novel candidate biomarker for the early diagnosis of AKI after cardiac surgery.
Сердечно-сосудистые заболевания остаются основной причиной смертности в Республике Беларусь. Поиск новых индикаторов повышенного кардиоваскулярного риска остается актуальной задачей медицинской науки. Поскольку ремоделирование артерий предшествует многим сосудистым катастрофам, то обнаружение факторов, способствующих негативным функциональным и морфологическим изменениям в артериальных сосудах, позволит активизировать лечебные и профилактические мероприятия. К таким факторам ремоделирования артерий относятся трансформирующий фактор роста β1 (ТФРβ1), коллаген IV типа, эндотелин-1 (ЭТ-1). Приведены данные исследований, подтверждающие их связь с атеросклерозом иартериосклерозом. В статье освещены вопросы участия ТФРβ1, коллаген IV типа и ЭТ-1 в возникновении сердечно-сосудистых катастроф. Особый интерес представляет изучение полиморфизмов единичных локусов представленных факторов ремоделирования. В статье систематизированы и обобщены научные сведения о некоторых полиморфизмах генов ТФРβ1, ЭТ-1, α1 цепи коллагена IV типа, сделан акцент на их ассоциации с сердечно-сосудистыми заболеваниями в различных популяциях. Cardiovascular diseases remain the main cause of death in the Republic of Belarus. The search for new indicators of the increased cardiovascular risk remains an urgent task of medical science. Since the remodeling of arteries precedes many vascular accidents, the detection of the factors that contribute to negative functional and morphological changes in arterial vessels will let to activate therapeutic and preventive measures. These factors of arterial remodeling include transforming growth factor β1 (TGFβ1), type IV collagen, endothelin-1 (ET-1). The research data that confirm their connection with atherosclerosis and arteriosclerosis are presented. The article highlights the participation of TGFβ1, type IV collagen, and ET-1 in the occurrence of cardiovascular accidents. The study of polymorphisms of single loci of the presented remodeling factors and their combinations is of particular interest. In the article, there is systematized and summarized the scientific information about some polymorphisms of the genes TGFβ1, ET-1, α1 chain of type IV collagen; the emphasis is placed on their association with cardiovascular diseases in various populations.
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