Transgelin-2 in Multiple Myeloma: A New Marker of Renal Impairment?

Abstract

Transgelin is a 22-kDa protein involved in cytoskeletal organization and expressed in smooth muscle tissue. According to animal studies, it is a potential mediator of kidney injury and fibrosis, and moreover, its role in tumorigenesis is emerging in a variety of cancers. The study included 126 ambulatory patients with multiple myeloma (MM). Serum transgelin-2 concentrations were measured by enzyme-linked immunoassay. We evaluated associations between baseline transgelin and kidney function (serum creatinine, estimated glomerular filtration rate—eGFR, urinary markers of tubular injury: cystatin-C, neutrophil gelatinase associated lipocalin—NGAL monomer, cell cycle arrest biomarkers IGFBP-7 and TIMP-2) and markers of MM burden. Baseline serum transgelin was also evaluated as a predictor of kidney function after a follow-up of 27 months from the start of the study. Significant correlations were detected between serum transgelin-2 and serum creatinine (R = 0.29; p = 0.001) and eGFR (R = −0.25; p = 0.007). Transgelin significantly correlated with serum free light chains lambda (R = 0.18; p = 0.047) and serum periostin (R = −0.22; p = 0.013), after exclusion of smoldering MM patients. Patients with decreasing eGFR had higher transgelin levels (median 106.6 versus 83.9 ng/mL), although the difference was marginally significant (p = 0.05). However, baseline transgelin positively correlated with serum creatinine after the follow-up period (R = 0.37; p < 0.001) and negatively correlated with eGFR after the follow-up period (R = −0.33; p < 0.001). Moreover, higher baseline serum transgelin (beta = −0.11 ± 0.05; p = 0.032) significantly predicted lower eGFR values after the follow-up period, irrespective of baseline eGFR and follow-up duration. Our study shows for the first time that elevated serum transgelin is negatively associated with glomerular filtration in MM and predicts a decline in renal function over long-term follow-up.

Prognostic Value of Transgelin-2 As A Predictor of Renal Affection in Multiple Myeloma at Benha University Hospital

“…Woziwodzka et al [18] conducted a prospective observational study included 126 patients with MM. A total of 73 women and 53 men were included, aged 29 to 90 years.…”

“…Woziwodzka et al [18] highlighted that Symptomatic MM was diagnosed in 119 patients, the majority of whom were in ISS stage I 84 (67%), stage II 20 (16%), stage III 15 (12%). The remaining seven patients had smouldering MM.…”

“…Woziwodzka et al [18] reported that several immunoglobulins was identified where IgG in 92 (73) patients, IgM in 2 (2) patient, IgA in 23 (18) patients, κ in 79 (63) patients and λ in 44 (35) patients, and free light chains patients18 (14).…”

Short Survey on the Protein Modifications in Plasma during SARS-CoV-2 Infection

“…Thus, it is possible that transgelin-2 has a significant role in lung function in COVID-19 patients. However, transgelin-2 cannot be a COVID-19 prognostic biomarker because its high levels are also associated with other diseases such as asthma, type 2 diabetes, or cancer [ 33 , 34 , 35 ].…”

The Key Role of Hepcidin-25 in Anemia in Multiple Myeloma Patients with Renal Impairment

“…The focus on timely diagnosis and prevention of organ damage drives the interest in diagnostic and prognostic biomarkers. In theory, a validated biomarker can act as a surrogate of underlying disease pathways and inform the physician on the alterations in organ-specific processes; for example, our previous studies demonstrated that urinary insulin growth factor binding protein 7 (IGFBP-7), neutrophil gelatinase-associated lipocalin (NGAL) monomer, and transgelin-2 may be markers of renal impairment in patients with MM [ 3 , 4 ]. The use of appropriate biomarkers may be crucial for adequate tailoring of the treatment plan.…”