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Updated: Jan 25, 2026
An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
Activin A: a novel urinary biomarker of renal impairment in multiple myeloma
Hirono Iriuchishima1, Akito Maeshima2, Shunsuke Takahashi3
1Department of Hematology, Gunma University Graduate School of Medicine, Gunma, Japan iriuchishima.h@gmail.com amaesima@jichi.ac.jp.
Abstract:
Renal impairment (RI) is a common complication of multiple myeloma (MM) that significantly affects treatment efficacy and mortality. However, no useful biomarkers for early detection of renal damage in MM exist. Reports indicate that activin A, a multifunctional cytokine of the TGF-β superfamily, is involved in the development and progression of various kidney diseases. In the present study, we measured urinary activin A levels in patients with newly diagnosed MM (NDMM) (n=41), smoldering MM (SMM) (n=10), and monoclonal gammopathy of undetermined significance (MGUS) (n=28), including monoclonal gammopathy of renal significance (MGRS), and assessed the correlation between urinary activin A and several clinical parameters. Urinary activin A, undetectable in healthy volunteers, was significantly increased in NDMM patients but not in patients with SMM and MGUS (97.3, 25.0, and 6.61 mg/gCr, respectively, P<0.05). In all patients with NDMM, urinary activin A levels were significantly reduced after initial treatment regardless of the therapy regimen. There was a significant correlation of urinary activin A with spot urinary protein level (P<0.001) and serum M-protein (P=0.029) but not with estimated glomerular filtration rate (eGFR), serum creatinine (Cr), N-acetyl-glucosaminidase (NAG), and serum activin A level. Histological analysis using renal biopsy samples revealed that activin A, which was absent from normal kidneys, was detected in the renal tubular cells of patients with MGRS. These data suggest that urinary activin A reflects tubular injury in MM and might aid the early detection of RI in plasma cell neoplasms.
Insights
Urinary activin A is elevated in newly diagnosed multiple myeloma (MM) patients, indicating tubular injury. This biomarker may help in the early detection of renal impairment (RI) in plasma cell neoplasms.
Area of Science:
- Nephrology
- Hematology
- Biochemistry
Background:
- Renal impairment (RI) is a frequent and serious complication of multiple myeloma (MM).
- Early detection of renal damage in MM is challenging due to the lack of effective biomarkers.
- Activin A, a TGF-β superfamily cytokine, is implicated in kidney disease progression.
Purpose of the Study:
- To investigate urinary activin A levels in patients with various stages of MM and related conditions.
- To assess the correlation between urinary activin A and clinical parameters indicative of renal damage.
- To determine if urinary activin A can serve as an early biomarker for renal injury in MM.
Main Methods:
- Measurement of urinary activin A levels in healthy volunteers, MGUS, SMM, and NDMM patients.
- Assessment of urinary activin A levels before and after treatment in NDMM patients.
- Correlation analysis of urinary activin A with urinary protein, serum M-protein, eGFR, serum creatinine, NAG, and serum activin A.
- Histological examination of renal biopsy samples for activin A expression.
Main Results:
- Urinary activin A was undetectable in healthy volunteers but significantly elevated in NDMM patients (97.3 mg/gCr), unlike in SMM (25.0 mg/gCr) and MGUS (6.61 mg/gCr).
- Urinary activin A levels decreased significantly in NDMM patients post-treatment.
- Urinary activin A showed significant correlation with urinary protein and serum M-protein, but not with eGFR, serum creatinine, NAG, or serum activin A.
- Activin A was detected in renal tubular cells of MGRS patients, but absent in normal kidneys.
Conclusions:
- Urinary activin A is a sensitive indicator of tubular injury in multiple myeloma.
- Elevated urinary activin A levels in newly diagnosed MM patients suggest its potential as an early biomarker for renal impairment.
- Activin A may play a role in the pathogenesis of renal damage in plasma cell neoplasms.
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