"R01 DK096177"
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ER stress has emerged as a signaling platform underlying the pathogenesis of various kidney diseases. Thus, there is an urgent need to develop ER stress biomarkers in the incipient stages of ER stress-mediated kidney disease, when a kidney biopsy is not yet clinically indicated, for early therapeutic intervention. Cysteine-rich with EGF-like domains 2 (CRELD2) is a newly identified protein that is induced and secreted under ER stress. For the first time to our knowledge, we demonstrate that CRELD2 can serve as a sensitive urinary biomarker for detecting ER stress in podocytes or renal tubular cells in murine models of podocyte ER stress-induced nephrotic syndrome and tunicamycin- or ischemia-reperfusion-induced acute kidney injury (AKI), respectively. Most importantly, urinary CRELD2 elevation occurs in patients with autosomal dominant tubulointerstitial kidney disease caused by UMOD mutations, a prototypical tubular ER stress disease. In addition, in pediatric patients undergoing cardiac surgery, detectable urine levels of CRELD2 within postoperative 6 hours strongly associate with severe AKI after surgery. In conclusion, our study has identified CRELD2 as a potentially novel urinary ER stress biomarker with potential utility in early diagnosis, risk stratification, treatment response monitoring, and directing of ER-targeted therapies in selected patient subgroups in the emerging era of precision nephrology.
- MeSH
- akutní poškození ledvin diagnóza etiologie patofyziologie moč MeSH
- biologické markery moč MeSH
- dítě MeSH
- extracelulární matrix - proteiny fyziologie moč MeSH
- intersticiální nefritida genetika patofyziologie moč MeSH
- kardiochirurgické výkony MeSH
- lidé MeSH
- molekuly buněčné adheze fyziologie moč MeSH
- mutace MeSH
- myši inbrední C57BL MeSH
- nefrotický syndrom diagnóza patofyziologie moč MeSH
- podocyty metabolismus MeSH
- pooperační komplikace moč MeSH
- stres endoplazmatického retikula fyziologie MeSH
- uromodulin genetika MeSH
- zvířata MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH