-
摘要: 心肾综合征(CRS)是一种心脏和肾脏功能障碍并存的疾病,显著影响患者预后。本文介绍了CRS相关生物标志物,包括利钠肽、致瘤抑制因子-2(suppression of tumorigenicity-2,ST2)、半乳糖凝集素-3(galectin-3,Gal-3)、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)等的研究新进展,重点探讨其在疾病诊断、预后评估及治疗指导中的作用,并强调了多种标志物联合应用可更准确反映疾病的复杂病理过程,提高诊断和治疗效果。新型标志物为改善CRS患者预后提供了潜在可能,但仍需进一步研究验证其临床价值。Abstract: Cardiorenal syndrome (CRS) represents a complex pathophysiological disorder characterized by concurrent cardiac and renal dysfunction, significantly impacting patient outcomes. Recent advances in biomarker research have enhanced our understanding of CRS pathophysiology and improved patient care. This review examines current evidence regarding established and emerging CRS biomarkers, with particular focus on natriuretic peptides, soluble ST2, galectin-3 (Gal-3), and neutrophil gelatinase-associated lipocalin (NGAL). These biomarkers demonstrate significant utility in disease diagnosis, prognostic assessment, and therapeutic monitoring. Multi-marker strategies show promise in capturing the complex pathophysiology of CRS, potentially leading to improved diagnostic accuracy and treatment optimization. While novel biomarkers offer encouraging prospects for enhancing patient outcomes, additional large-scale clinical validation studies are needed to establish their definitive role in clinical practice.
-
Key words:
- cardiorenal syndrome /
- biomarkers /
- heart failure /
- chronic kidney disease /
- acute kidney injury
-
-
[1] Rangaswami J, Bhalla V, Blair JEA, et al. Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies: A Scientific Statement From the American Heart Association[J]. Circulation, 2019, 139(16): e840-e78.
[2] Fu S, Zhao S, Ye P, et al. Biomarkers in Cardiorenal Syndromes[J]. BioMed Res Int, 2018: 9617363.
[3] Gallo G, Lanza O, Savoia C. New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy[J]. Int J Mol Sci, 2023, 24(6): 5089. doi: 10.3390/ijms24065089
[4] Liu C, Liang W, He X, et al. Prognostic Value of Cysteine-Rich Protein 61 Combined with N-Terminal Pro-B-Type Natriuretic Peptide for Mortality in Acute Heart Failure Patients with and without Chronic Kidney Disease[J]. Cardiorenal Med, 2020, 10(1): 11-21. doi: 10.1159/000501929
[5] de la Espriella R, Bayés-Genís A, Llàcer P, et al. Prognostic value of NT-proBNP and CA125 across glomerular filtration rate categories in acute heart failure[J]. Eur J Int Med, 2022, 95: 67-73. doi: 10.1016/j.ejim.2021.08.024
[6] Delalic ' D, Brežni T, Prka in I. Diagnostic value and utility of commonly used biomarkers of cardiac and renal function in cardiorenal syndromes: a narrative review[J]. Biochem Med, 2023, 33(3): 030502.
[7] Sciatti E, Merlo A, Scangiuzzi C, et al. Prognostic Value of sST2 in Heart Failure[J]. J Clin Med, 2023, 12(12): 3970. doi: 10.3390/jcm12123970
[8] Kim AJ, Ro H, Kim H, et al. Soluble ST2 and Galectin-3 as Predictors of Chronic Kidney Disease Progression and Outcomes[J]. Am J Nephrol, 2021, 52(2): 119-30. doi: 10.1159/000513663
[9] Ma H, Zhou J, Zhang M, et al. The Diagnostic Accuracy of N-Terminal Pro-B-Type Natriuretic Peptide and Soluble ST2 for Heart Failure in Chronic Kidney Disease Patients: A Comparative Analysis[J]. Med Sci Monit, 2023, 29: e940641.
[10] Hara A, Niwa M, Noguchi K, et al. Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases[J]. Biomolecules, 2020, 10(3): 389. doi: 10.3390/biom10030389
[11] Chung EYM, Trinh K, Li J, et al. Biomarkers in Cardiorenal Syndrome and Potential Insights Into Novel Therapeutics[J]. Front Cardiovasc Med, 2022, 9: 868658. doi: 10.3389/fcvm.2022.868658
[12] Blanda V, Bracale UM, Di Taranto MD, et al. Galectin-3 in Cardiovascular Diseases[J]. Int J Mol Sci, 2020, 21(23): 9232. doi: 10.3390/ijms21239232
[13] Ghorbani A, Bhambhani V, Christenson RH, et al. Longitudinal Change in Galectin-3 and Incident Cardiovascular Outcomes[J]. J Am Coll Cardiol, 2018, 72(25): 3246-3254. doi: 10.1016/j.jacc.2018.09.076
[14] Tuegel C, Katz R, Alam M, et al. GDF-15, Galectin 3, Soluble ST2, and Risk of Mortality and Cardiovascular Events in CKD[J]. Am J Kidney Dis, 2018, 72(4): 519-528. doi: 10.1053/j.ajkd.2018.03.025
[15] Han X, Zhang S, Chen Z, et al. Cardiac biomarkers of heart failure in chronic kidney disease[J]. Clin Chim Acta, 2020, 510: 298-310. doi: 10.1016/j.cca.2020.07.040
[16] Romejko K, Markowska M, Niemczyk S. The Review of Current Knowledge on Neutrophil Gelatinase-Associated Lipocalin(NGAL)[J]. Int J Mol Sci, 2023, 24(13): 10470. doi: 10.3390/ijms241310470
[17] Karmakova Т, Sergeeva NS, Kanukoev КY, et al. Kidney Injury Molecule 1(KIM-1): a Multifunctional Glycoprotein and Biological Marker(Review)[J]. Sovrem Tekhnologii Med, 2021, 13(3): 64-78. doi: 10.17691/stm2021.13.3.08
[18] Josa-Laorden C, Rubio-Gracia J, Sánchez-Marteles M, et al. Elevated urinary kidney injury molecule 1 at discharge strongly predicts early mortality following an episode of acute decompensated heart failure[J]. Pol Arch Int Med, 2022, 132(9): 16284.
[19] Fu K, Hu Y, Zhang H, et al. Insights of Worsening Renal Function in Type 1 Cardiorenal Syndrome: From the Pathogenesis, Biomarkers to Treatment[J]. Front Cardiovasc Med, 2021 8: 760152. doi: 10.3389/fcvm.2021.760152
[20] Kaplanski G. Interleukin-18: Biological properties and role in disease pathogenesis[J]. Immunol Rev, 2018, 281(1): 138-153. doi: 10.1111/imr.12616
[21] Udzik J, Waszczyk A, Wojciechowska-Koszko I, et al. The Utility of Novel Kidney Injury Biomarkers in Early Detection of CSA-AKI[J]. Int J Mol Sci, 2022, 23(24): 15864. doi: 10.3390/ijms232415864
[22] Zhang J, Zhu P, Li S, et al. From heart failure and kidney dysfunction to cardiorenal syndrome: TMAO may be a bridge[J]. Front Pharmacol, 2023, 14: 1291922. doi: 10.3389/fphar.2023.1291922
[23] Su LJ, Li YM, Kellum JA, et al. Predictive value of cell cycle arrest biomarkers for cardiac surgery-associated acute kidney injury: a meta-analysis[J]. Br J Anaesth, 2018, 121(2): 350-357. doi: 10.1016/j.bja.2018.02.069
[24] Wang W, Shen Q, Zhou X. The predictive value of[TIMP-2]*[IGFBP7]in adverse outcomes for acute kidney injury: a systematic review and meta-analysis[J]. Renal Fail, 2023, 45(2): 2253933. doi: 10.1080/0886022X.2023.2253933
[25] Gembillo G, Visconti L, Giusti MA, et al. Cardiorenal Syndrome: New Pathways and Novel Biomarkers[J]. Biomolecules, 2021, 11(11): 1581. doi: 10.3390/biom11111581
[26] Huang CK, Bär C, Thum T. miR-21, Mediator, and Potential Therapeutic Target in the Cardiorenal Syndrome[J]. Front Pharmacol, 2020, 11: 726. doi: 10.3389/fphar.2020.00726
[27] Dhaliwal S, Kalogeropoulos AP. Markers of Iron Metabolism and Outcomes in Patients with Heart Failure: A Systematic Review[J]. Int J Mol Sci, 2023, 24(6): 5645. doi: 10.3390/ijms24065645
[28] Mohamed ON, Mady AM, Sedik MM, et al. The relationship between asymptomatic atherosclerosis and hepcidin-25 in chronic kidney disease patients[J]. Ann Saudi Med, 2023, 43(5): 298-308. doi: 10.5144/0256-4947.2023.298
[29] Julovi SM, Sanganeria B, Minhas N, et al. Blocking thrombospondin-1 signaling via CD47 mitigates renal interstitial fibrosis[J]. Lab Invest, 2020, 100(9): 1184-1196. doi: 10.1038/s41374-020-0434-3
[30] Zhou Y, Ng DYE, Richards AM, et al. microRNA-221 Inhibits Latent TGF-β1 Activation through Targeting Thrombospondin-1 to Attenuate Kidney Failure-Induced Cardiac Fibrosis[J]. Mol Ther Nucleic Acids, 2020, 22: 803-814. doi: 10.1016/j.omtn.2020.09.041
[31] 贺彩红, 刘金武, 朱照贺, 等. 联合预测因子对急性心肌梗死患者院内并发1型心肾综合征风险的预测价值[J]. 中华心血管病杂志, 2021, 49(8): 802-808.
[32] Song X, Cai D, Zhang B. Clinical values of serum NGAL combined with NT-proBNP in the early prognosis of type 1 cardiorenal syndrome[J]. Am J Transl Res, 2021, 13(4): 3363-3368.
-
计量
- 文章访问数: 1193
- PDF下载数: 60
- 施引文献: 0