Ayşegül KESER, Yasin KENESARI, Banu DEVECİ, Emel ALTEKİN

İDRAR YOLU ENFEKSİYONLARINDA YENİ BİR BİYOBELİRTEÇ OLARAK NÖTROFİL JELATİNAZ İLİŞKİLİ LİPOKALİN (NGAL)

Amaç: İdrar yolları enfeksiyonu (İYE) tanısında altın standart olan idrar kültüründe bakterinin tanımlanması için 2- 3 gün gerekmektedir. İYE’nu hızlı ve doğru saptayan bir belirteç, şüpheli İYE olan hastalarda tedaviye erken başlamak için değerli olacaktır. Bu çalışmanın amacı idrar NGAL düzeylerinin İYE’nda artış gösterip göstermediğini araştırmak ve İYE’na duyarlı yeni bir biyobelirteç olup olmadığını değerlendirmektir. Gereç ve Yöntem: Dokuz Eylül Üniversitesi Merkez Laboratuvarına tetkik edilmek üzere gönderilmiş idrar örneklerinden lökosit sayısı 10/HPF (High Power Field) üzeri olan, pozitif lökosit esteraz, nitrit testi olan ve kültürde üreme saptanan 30 idrar örneği rastgele seçildi. İdrar mikroskobi ve kimyasal analiz sonuçları normal değer aralığında olan ve kültürde üreme saptanmayan 30 idrar örneği de kontrol grubu olarak seçildi. Sağlıklı ve patolojik 60 idrar örneğinde kemiluminesans mikropartikül immunoassay yöntemiyle NGAL analizi gerçekleştirildi. Bulgular: İYE olan ve olmayan gruplar arasında NGAL düzeyleri karşılaştırıldığında İYE olan grubun NGAL düzeyleri, İYE olmayan gruba kıyasla anlamlı derecede yüksek bulunmuştur(p

NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) AS A NEW BIOMARKER OF URINARY TRACT INFECTIONS

Introduction: Urine culture is the gold standard for diagnosing urinary tractus infections(UTI) and positive culture results require 2–3 days to complete identification of the bacteria found. A biomarker that identifies UTI quickly and accurately will be valuable to start treatment early in patients with suspected UTI. The aim of our study was to assess whether urine NGAL could represent a novel, sensitive marker of UTI. Material and Method: The urine samples of patiens who applied to the Central Laboratory of Dokuz Eylul University Hospital for urine analysis which leukocyte counts of 10 / HPF, leucocyte esterase positive, nitrite- positive, culture positive 30 urine samples were taken. 30 urine specimens with urine microscopic and chemical analysis results in normal range and no pozitif culture result were selected as control group. NGAL analysis was performed by chemiluminescence microparticle immunoassay in 60 healthy and pathological urine specimens. Results: When NGAL levels were compared between groups with and without urinary tract infections(UTI), the group of UTI results were found significantly higher than the group without UTI(p

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Yilmaz A, Sevketoglu E, Gedikbasi A, Karyagar S, Kiyak A, Mulazimoglu M, et al. Early prediction of urinary tract infection with urinary neutrophil gelatinase associated lipocalin. Pediatr Nephrol 2009; 24(12): 2387-92.
2.Urbschat A, Obermuller N, Paulus P, Reissig M, Hadji P, Hofmann R, et al. Upper and lower urinary tract infections can be detected early but not be discriminated by urinary NGAL in adults. Int Urol Nephrol 2014; 46(12): 2243-9.
Litwin MS, Saigal CS, Yano EM, Avila C, Geschwind SA, Hanley JM, et al. Urologic diseases in America Project: analytical methods and principal findings. J Urol 2005; 173(3): 933-7.
Barasch J, Mori K. Cell biology: iron thievery. Nature. 2004; 432(7019): 811-3.
Giasson J, Li GH, Chen Y. Neutrophil gelatinase-associated lipocalin (NGAL) as a new biomarker for non-acute kidney injury (AKI) diseases. Inflamm Allergy Drug Targets 2011; 10(4): 272-82.
Goetz DH, Holmes MA, Borregaard N, Bluhm ME, Raymond KN, Strong RK. The neutrophil lipocalin NGAL is a bacteriostatic agent that interferes with siderophore-mediated iron acquisition. Mol Cell 2002; 10(5): 1033-43.
Berger T, Togawa A, Duncan GS, Elia AJ, You-Ten A, Wakeham A, et al. Lipocalin 2-deficient mice exhibit increased sensitivity to Escherichia coli infection but not to ischemia-reperfusion injury. Proc Natl Acad 2006; 103(6): 1834-9.
Ichino M, Kuroyanagi Y, Kusaka M, Mori T, Ishikawa K, Shiroki R, et al. Increased urinary neutrophil gelatinase associated lipocalin levels in a rat model of upper urinary tract infection. J Urol, 2009; 181(5): 2326-31.
Xu SY, Pauksen K, Venge P. Serum measurements of human neutrophil lipocalin (HNL) discriminate between acute bacterial and viral infections. Scand J Clin Lab Invest 1995; 55(2): 125-31.
10. Bjorkqvist M, Kallman J, Fjaertoft G, Xu S, Venge P, Schollin J. Human neutrophil lipocalin: normal levels and use as a marker for invasive infection in the newborn. Acta Paediatr 2004; 93(4): 534-9.
Carlsson S, Wiklund NP, Engstrand L, Weitzberg E, Lundberg JO. Effects of pH, nitrite, and ascorbic acid on nonenzymatic nitric oxide generation and bacterial growth in urine. Nitric Oxide 2001; 5(6): 580-6.
Chen L, Zhang W. Kidney alpha-intercalated cells, NGAL and urinary tract infection. Austin J Nephrol Hypertens 2014; 1(4): 1017-22.
Paragas N, Kulkarni R, Werth M, Schmidt-Ott KM, Forster C, Deng R, et al. Alpha-intercalated cells defend the urinary system from bacterial infection. J Clin Invest 2014; 124(7): 2963-76.
Arinzon Z, Peisakh A, Shuval I, Shabat S, Berner YN. Detection of urinary tract infection (UTI) in long-term care setting: Is the multireagent strip an adequate diagnostic tool? Arch Gerontol Geriatr 2009; 48(2): 227-31.
dos Santos JC, Weber LP, Perez LR. Evaluation of urinalysis parameters to predict urinary-tract infection. Braz J Infect Dis 2007; 11(5): 479-81.
Valdimarsson S, Jodal U, Barregard L, Hansson S. Urine neutrophil gelatinase-associated lipocalin and other biomarkers in infants with urinary tract infection and in febrile controls. Pediatr Nephrol 2017; 32(11): 2079-87.
Clerico A, Galli C, Fortunato A, Ronco C. Neutrophil gelatinase-associated lipocalin (NGAL) as biomarker of acute kidney injury: a review of the laboratory characteristics and clinical evidences. Clin Chem Lab Med 2012; 50(9): 1505-17.