尿液中的铜分泌与接受脏移植的人的长期移植失败有关
Manuela Yepes-Calderon1, Daan Kremer1, Adrian Post1
1Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands.
American journal of nephrology
|May 26, 2023
概括
在移植接受者 (KTRs) 中,尿道铜分泌量增加,与蛋白尿有关,增加了移植失败的风险. 这是由氧化管状损伤介导的,这表明潜在的铜向干预措施.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 环境健康 环境健康
背景情况:
- 慢性病中的蛋白尿增加尿铜,导致管道损伤和恶化功能.
- 尿中铜分泌对移植受体 (KTRs) 的影响及其与移植失败的关联尚未得到充分了解.
研究的目的:
- 调查KTRs尿中铜分泌与移植衰竭之间的关联.
- 检查尿中铜分泌,氧化管状损伤 (使用尿肝类型脂肪酸结合蛋白[u-LFABP]) 和移植结果之间的关系.
主要方法:
- 对693名带有功能移植的门诊KTR进行前性队列研究.
- 使用感应合血质谱法测量24小时尿液中的铜分泌量.
- 多变量回归分析以评估与移植失败和u-LFABP的关联.
主要成果:
- 尿中的蛋白质分泌与尿中的铜分泌正相关 (β = 0.39,p < 0.001).
- 尿中更高的铜分泌独立地与长期移植失败的风险增加有关 (HR:1.57,p < 0.001),具有剂量反应关系.
- 尿液中的铜分泌与u-LFABP (β = 0.29,p < 0.001) 有积极的关联,介导了对移植失败的间接影响的74%.
结论:
- 在KTR中,由蛋白尿引起的尿铜分泌量增加是移植失败的独立风险因素.
- 氧化性管道损伤显著介导了铜分泌和移植失败之间的关联.
- 针对铜分泌的干预措施可能为改善移植存活率提供一种新的策略.
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