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Neutrophil gelatinase-associated lipocalin: pathophysiology and clinical applications.

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Title: Neutrophil gelatinase-associated lipocalin: pathophysiology and clinical applications.
Authors: Singer, E., Markó, L., Paragas, N., Barasch, J., Dragun, D., Müller, D. N., Budde, K., Schmidt‐Ott, K. M.
Source: Acta Physiologica. Apr2013, Vol. 207 Issue 4, p663-672. 10p. 3 Diagrams, 1 Chart.
Subjects: Neutrophils, Kidney injuries, Kidney tubules, Gelatinases, Lipocalin-2, Pathological physiology, Epithelial cells, Wounds & injuries, Therapeutics
Abstract: Neutrophil gelatinase-associated lipocalin (NGAL), a 25 kDa protein produced by injured nephron epithelia, is one of the most promising new markers of renal epithelial injury. In contrast to serum creatinine and urinary output, which are the measures of kidney function, NGAL is specifically induced in the damaged nephron and then released into blood and urine, where it can be readily measured. Careful proof-of-concept studies using defined animal models have uncovered the sources and trafficking of NGAL in acute kidney injury (AKI) and have addressed the contributions of renal and non-renal sources. Clinical studies indicate that NGAL, unlike creatinine, is a marker responsive to tissue stress and nephron injury, but less so to adaptive hemodynamic responses. In certain clinical settings, NGAL is an earlier marker compared with serum creatinine. In addition, clinical studies have shown that NGAL is a powerful predictor of poor clinical outcomes, which can be used to risk stratify patients when combined with serum creatinine. NGAL has important limitations, including its responsiveness in systemic inflammation, which is partially uncoupled from its response to kidney injury and which needs to be considered when interpreting NGAL results clinically. This review covers the biology and pathophysiology of NGAL and summarizes the results of the growing body of clinical studies that have addressed the utility of NGAL in the early diagnosis of AKI, in the distinction of intrinsic AKI and in the prognostic assessment of broad patient populations. [ABSTRACT FROM AUTHOR]
Copyright of Acta Physiologica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Neutrophil gelatinase-associated lipocalin: pathophysiology and clinical applications.
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  Data: <searchLink fieldCode="AR" term="%22Singer%2C+E%2E%22">Singer, E.</searchLink><br /><searchLink fieldCode="AR" term="%22Markó%2C+L%2E%22">Markó, L.</searchLink><br /><searchLink fieldCode="AR" term="%22Paragas%2C+N%2E%22">Paragas, N.</searchLink><br /><searchLink fieldCode="AR" term="%22Barasch%2C+J%2E%22">Barasch, J.</searchLink><br /><searchLink fieldCode="AR" term="%22Dragun%2C+D%2E%22">Dragun, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Müller%2C+D%2E+N%2E%22">Müller, D. N.</searchLink><br /><searchLink fieldCode="AR" term="%22Budde%2C+K%2E%22">Budde, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Schmidt‐Ott%2C+K%2E+M%2E%22">Schmidt‐Ott, K. M.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Acta+Physiologica%22">Acta Physiologica</searchLink>. Apr2013, Vol. 207 Issue 4, p663-672. 10p. 3 Diagrams, 1 Chart.
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  Data: <searchLink fieldCode="DE" term="%22Neutrophils%22">Neutrophils</searchLink><br /><searchLink fieldCode="DE" term="%22Kidney+injuries%22">Kidney injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Kidney+tubules%22">Kidney tubules</searchLink><br /><searchLink fieldCode="DE" term="%22Gelatinases%22">Gelatinases</searchLink><br /><searchLink fieldCode="DE" term="%22Lipocalin-2%22">Lipocalin-2</searchLink><br /><searchLink fieldCode="DE" term="%22Pathological+physiology%22">Pathological physiology</searchLink><br /><searchLink fieldCode="DE" term="%22Epithelial+cells%22">Epithelial cells</searchLink><br /><searchLink fieldCode="DE" term="%22Wounds+%26+injuries%22">Wounds & injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Neutrophil gelatinase-associated lipocalin (NGAL), a 25 kDa protein produced by injured nephron epithelia, is one of the most promising new markers of renal epithelial injury. In contrast to serum creatinine and urinary output, which are the measures of kidney function, NGAL is specifically induced in the damaged nephron and then released into blood and urine, where it can be readily measured. Careful proof-of-concept studies using defined animal models have uncovered the sources and trafficking of NGAL in acute kidney injury (AKI) and have addressed the contributions of renal and non-renal sources. Clinical studies indicate that NGAL, unlike creatinine, is a marker responsive to tissue stress and nephron injury, but less so to adaptive hemodynamic responses. In certain clinical settings, NGAL is an earlier marker compared with serum creatinine. In addition, clinical studies have shown that NGAL is a powerful predictor of poor clinical outcomes, which can be used to risk stratify patients when combined with serum creatinine. NGAL has important limitations, including its responsiveness in systemic inflammation, which is partially uncoupled from its response to kidney injury and which needs to be considered when interpreting NGAL results clinically. This review covers the biology and pathophysiology of NGAL and summarizes the results of the growing body of clinical studies that have addressed the utility of NGAL in the early diagnosis of AKI, in the distinction of intrinsic AKI and in the prognostic assessment of broad patient populations. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Acta Physiologica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/apha.12054
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        Text: English
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        PageCount: 10
        StartPage: 663
    Subjects:
      – SubjectFull: Neutrophils
        Type: general
      – SubjectFull: Kidney injuries
        Type: general
      – SubjectFull: Kidney tubules
        Type: general
      – SubjectFull: Gelatinases
        Type: general
      – SubjectFull: Lipocalin-2
        Type: general
      – SubjectFull: Pathological physiology
        Type: general
      – SubjectFull: Epithelial cells
        Type: general
      – SubjectFull: Wounds & injuries
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      – SubjectFull: Therapeutics
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      – TitleFull: Neutrophil gelatinase-associated lipocalin: pathophysiology and clinical applications.
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              Text: Apr2013
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              Y: 2013
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