社区获得性急性肾损伤(CA-AKI)是在全世界具有高发病率和死亡率的医院环境之外的其他健康个体中的突然的结构损伤和肾功能丧失。AKI的长期后遗症涉及进展为慢性肾病(CKD)的相关风险。血清肌酐(SCr),目前用于诊断AKI的临床参数,随着年龄的不同,性别,饮食,和肌肉质量。在本研究中,我们调查了从CA-AKI中恢复(R)和不完全恢复(IR)的受试者的尿蛋白质组学特征的差异,出院后4个月。
■研究对象从正在进行的CA-AKI队列研究中招募。在出院时招募性别或年龄>18岁且无下划线CKD的患者。CA-AKI的不完全恢复定义为出院后4个月eGFR<60mL/min/1.73m2或透析依赖性。第二天早上收集尿液样本,用LC-MS/MS进行蛋白质组分析。通过ProteomeDiscoverer平台2.2(ThermoScientific)使用统计和各种生物信息学工具分析蛋白质的丰度,细胞成分,在回收和未完全回收的组中分析了蛋白质类别和生物过程。
■共纳入28名受试者(每组14名)。总的来说,未完全恢复组中具有30个高丰度蛋白质的2019肽和蛋白质(R/IR<0.5,丰度比调整。p值<0.05)和未完全恢复组的11个高丰度蛋白(R/IR>2.0,丰度比调整。鉴定出p值<0.05)。组织特异性分析,GO富集分析,和途径富集分析显示,两组中的蛋白质都是不同途径的一部分,并且在出院后的4个月中可能在肾脏恢复中起关键作用。
■总而言之,这项研究有助于鉴定未完全恢复的CA-AKI患者在出院时上调或下调的潜在蛋白和相关通路,这些蛋白和通路可以进一步研究,以确定它们在疾病进展或修复中的确切作用.
UNASSIGNED: Community-acquired acute kidney injury (CA-AKI) is a sudden structural damage and loss of kidney function in otherwise healthy individuals outside of hospital settings having high morbidity and mortality rates worldwide. Long-term sequelae of AKI involve an associated risk of progression to chronic kidney disease (CKD). Serum creatinine (SCr), the currently used clinical parameter for diagnosing AKI, varies greatly with age, gender, diet, and muscle mass. In the present study, we investigated the difference in urinary
proteomic profile of subjects that recovered (R) and incompletely recovered (IR) from CA-AKI, 4 months after hospital discharge.
UNASSIGNED: Study subjects were recruited from ongoing study of CA-AKI cohort. Patients with either sex or age > 18 years with no underline CKD were enrolled at the time of hospital discharge. Incomplete recovery from CA-AKI was defined as eGFR < 60 mL/min/1.73 m2 or dialysis dependence at 4 months after discharge. Second-morning urine samples were collected, and proteome analysis was performed with LC-MS/MS. Data were analyzed by Proteome Discoverer platform 2.2 (Thermo Scientific) using statistical and various bioinformatics tools for abundance of protein, cellular component, protein class and biological process were analyzed in the recovered and incompletely recovered groups.
UNASSIGNED: A total of 28 subjects (14 in each group) were enrolled. Collectively, 2019 peptides and proteins with 30 high-abundance proteins in the incompletely recovered group (R/IR <0.5, abundance ratio adj. p-value <0.05) and 11 high-abundance proteins in the incompletely recovered group (R/IR >2.0, abundance ratio adj. p-value <0.05) were identified. Tissue specificity analysis, GO enrichment analysis, and pathway enrichment analysis revealed significant proteins in both the groups that are part of different pathways and might be playing crucial role in renal recovery during the 4-month span after hospital discharge.
UNASSIGNED: In conclusion, this study helped in identifying potential proteins and associated pathways that are either upregulated or downregulated at the time of hospital discharge in incompletely recovered CA-AKI patients that can be further investigated to check for their exact role in the disease progression or repair.