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Published in: BMC Medicine 1/2014

Open Access 01-12-2014 | Commentary

suPAR and Team Nephrology

Author: Howard Trachtman

Published in: BMC Medicine | Issue 1/2014

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Abstract

Primary focal segmental glomerulosclerosis (FSGS) accounts for nearly 10 % of patients who require renal replacement therapy. Elevated circulating levels of soluble urokinase receptor (suPAR) have been identified as a biomarker to discriminate primary FSGS from other glomerulopathies. Subsequent reports have questioned the diagnostic utility of this test. In a study in BMC Medicine, Huang et al. demonstrate that urinary soluble urokinase receptor (suPAR) excretion assists in distinguishing primary FSGS from other glomerular diseases, and that high plasma suPAR concentrations are not directly linked to a decline in glomerular filtration rate (GFR). This observation suggests that further investigation of suPAR is warranted in patients with FSGS. It should be interpreted in light of a recent report that B7-1 is expressed in the podocytes of a subset of patients with FSGS, and that blocking this molecule may represent the first successful targeted intervention for this disease. These advances highlight the rapid pace of scientific progress in the field of nephrology. Nephrologists should work together, share resources, and expedite the design of protocols to evaluate these novel biomarkers in a comprehensive and scientifically valid manner.
Literature
1.
go back to reference Robbins B, Welser HT, Grigoryeva M, Gleave E: Power-use in cooperative competition: A power-dependence model and an empirical test of network structure and geographic mobility. Soc Sci Res. 2014, 45: 131-151.CrossRefPubMed Robbins B, Welser HT, Grigoryeva M, Gleave E: Power-use in cooperative competition: A power-dependence model and an empirical test of network structure and geographic mobility. Soc Sci Res. 2014, 45: 131-151.CrossRefPubMed
2.
go back to reference Keller BJ, Martini S, Sedor JR, Kretzler M: A systems view of genetics in chronic kidney disease. Kidney Int. 2012, 81: 14-21. 10.1038/ki.2011.359.CrossRefPubMed Keller BJ, Martini S, Sedor JR, Kretzler M: A systems view of genetics in chronic kidney disease. Kidney Int. 2012, 81: 14-21. 10.1038/ki.2011.359.CrossRefPubMed
3.
go back to reference D'Agati VD, Kaskel FJ, Falk RJ: Focal segmental glomerulosclerosis. N Engl J Med. 2011, 365: 2398-2411. 10.1056/NEJMra1106556.CrossRefPubMed D'Agati VD, Kaskel FJ, Falk RJ: Focal segmental glomerulosclerosis. N Engl J Med. 2011, 365: 2398-2411. 10.1056/NEJMra1106556.CrossRefPubMed
4.
go back to reference Raggam RB, Wagner J, Prüller F, Grisold A, Leitner E, Zollner-Schwetz I, Valentin T, Krause R, Hoenigl M: Soluble urokinase plasminogen activator receptor (suPAR) predicts mortality in patients with systemic inflammatory response syndrome (SIRS). J Intern Med. 2014, doi: 10.1111/joim.12238. [Epub ahead of print] Raggam RB, Wagner J, Prüller F, Grisold A, Leitner E, Zollner-Schwetz I, Valentin T, Krause R, Hoenigl M: Soluble urokinase plasminogen activator receptor (suPAR) predicts mortality in patients with systemic inflammatory response syndrome (SIRS). J Intern Med. 2014, doi: 10.1111/joim.12238. [Epub ahead of print]
5.
go back to reference Donadello K, Scolletta S, Taccone FS, Covajes C, Santonocito C, Cortes DO, Grazulyte D, Gottin L, Vincent JL: Soluble urokinase-type plasminogen activator receptor as a prognostic biomarker in critically ill patients. J Crit Care. 2014, 29: 144-149. 10.1016/j.jcrc.2013.08.005.CrossRefPubMed Donadello K, Scolletta S, Taccone FS, Covajes C, Santonocito C, Cortes DO, Grazulyte D, Gottin L, Vincent JL: Soluble urokinase-type plasminogen activator receptor as a prognostic biomarker in critically ill patients. J Crit Care. 2014, 29: 144-149. 10.1016/j.jcrc.2013.08.005.CrossRefPubMed
6.
go back to reference Wrotek A, Pawlik K, Jackowska T: Soluble receptor for urokinase plasminogen activator in community-acquired pneumonia in children. Adv Exp Med Biol. 2013, 788: 329-334. 10.1007/978-94-007-6627-3_44.CrossRefPubMed Wrotek A, Pawlik K, Jackowska T: Soluble receptor for urokinase plasminogen activator in community-acquired pneumonia in children. Adv Exp Med Biol. 2013, 788: 329-334. 10.1007/978-94-007-6627-3_44.CrossRefPubMed
7.
go back to reference Hoenigl M, Raggam RB, Wagner J, Valentin T, Leitner E, Seeber K, Zollner-Schwetz I, Krammer W, Prüller F, Grisold AJ, Krause R: Diagnostic accuracy of soluble urokinase plasminogen activator receptor (suPAR) for prediction of bacteremia in patients with systemic inflammatory response syndrome. Clin Biochem. 2013, 46: 225-229. 10.1016/j.clinbiochem.2012.11.004.CrossRefPubMed Hoenigl M, Raggam RB, Wagner J, Valentin T, Leitner E, Seeber K, Zollner-Schwetz I, Krammer W, Prüller F, Grisold AJ, Krause R: Diagnostic accuracy of soluble urokinase plasminogen activator receptor (suPAR) for prediction of bacteremia in patients with systemic inflammatory response syndrome. Clin Biochem. 2013, 46: 225-229. 10.1016/j.clinbiochem.2012.11.004.CrossRefPubMed
8.
go back to reference Wei C, El Hindi S, Li J, Fornoni A, Goes N, Sageshima J, Maiguel D, Karumanchi SA, Yap HK, Saleem M, Zhang Q, Nikolic B, Chaudhuri A, Daftarian P, Salido E, Torres A, Salifu M, Sarwal MM, Schaefer F, Morath C, Schwenger V, Zeier M, Gupta V, Roth D, Rastaldi MP, Burke G, Ruiz P, Reiser J: Circulating urokinase receptor as a cause of focal segmental glomerulosclerosis. Nat Med. 2011, 17: 952-960. 10.1038/nm.2411.CrossRefPubMedPubMedCentral Wei C, El Hindi S, Li J, Fornoni A, Goes N, Sageshima J, Maiguel D, Karumanchi SA, Yap HK, Saleem M, Zhang Q, Nikolic B, Chaudhuri A, Daftarian P, Salido E, Torres A, Salifu M, Sarwal MM, Schaefer F, Morath C, Schwenger V, Zeier M, Gupta V, Roth D, Rastaldi MP, Burke G, Ruiz P, Reiser J: Circulating urokinase receptor as a cause of focal segmental glomerulosclerosis. Nat Med. 2011, 17: 952-960. 10.1038/nm.2411.CrossRefPubMedPubMedCentral
9.
go back to reference Wei C, Trachtman H, Li J, Dong C, Friedman AL, Gassman JJ, McMahan JL, Radeva M, Heil KM, Trautmann A, Anarat A, Emre S, Ghiggeri GM, Ozaltin F, Haffner D, Gipson DS, Kaskel F, Fischer DC, Schaefer F, Reiser J: PodoNet and FSGS CT study consortia: circulating suPAR in two cohorts of primary FSGS. J Am Soc Nephrol. 2012, 23: 2051-2059. 10.1681/ASN.2012030302.CrossRefPubMedPubMedCentral Wei C, Trachtman H, Li J, Dong C, Friedman AL, Gassman JJ, McMahan JL, Radeva M, Heil KM, Trautmann A, Anarat A, Emre S, Ghiggeri GM, Ozaltin F, Haffner D, Gipson DS, Kaskel F, Fischer DC, Schaefer F, Reiser J: PodoNet and FSGS CT study consortia: circulating suPAR in two cohorts of primary FSGS. J Am Soc Nephrol. 2012, 23: 2051-2059. 10.1681/ASN.2012030302.CrossRefPubMedPubMedCentral
10.
go back to reference Huang J, Liu G, Zhang YM, Cui Z, Wang F, Liu XJ, Chu R, Chen Y, Zhao MH: Plasma soluble urokinase receptor levels are increased but do not distinguish primary from secondary focal segmental glomerulosclerosis. Kidney Int. 2013, 84: 366-372. 10.1038/ki.2013.55.CrossRefPubMed Huang J, Liu G, Zhang YM, Cui Z, Wang F, Liu XJ, Chu R, Chen Y, Zhao MH: Plasma soluble urokinase receptor levels are increased but do not distinguish primary from secondary focal segmental glomerulosclerosis. Kidney Int. 2013, 84: 366-372. 10.1038/ki.2013.55.CrossRefPubMed
11.
go back to reference Cara-Fuentes G, Wei C, Segarra A, Ishimoto T, Rivard C, Johnson RJ, Reiser J, Garin EH: CD80 and suPAR in patients with minimal change disease and focal segmental glomerulosclerosis: diagnostic and pathogenic significance. Pediatr Nephrol. 2013, [Epub ahead of print] Cara-Fuentes G, Wei C, Segarra A, Ishimoto T, Rivard C, Johnson RJ, Reiser J, Garin EH: CD80 and suPAR in patients with minimal change disease and focal segmental glomerulosclerosis: diagnostic and pathogenic significance. Pediatr Nephrol. 2013, [Epub ahead of print]
12.
go back to reference Bock ME, Price HE, Gallon L, Langman CB: Serum soluble urokinase-type plasminogen activator receptor levels and idiopathic FSGS in children: a single-center report. Clin J Am Soc Nephrol. 2013, 8: 1304-1311. 10.2215/CJN.07680712.CrossRefPubMedPubMedCentral Bock ME, Price HE, Gallon L, Langman CB: Serum soluble urokinase-type plasminogen activator receptor levels and idiopathic FSGS in children: a single-center report. Clin J Am Soc Nephrol. 2013, 8: 1304-1311. 10.2215/CJN.07680712.CrossRefPubMedPubMedCentral
13.
go back to reference Meijers B, Maas RJ, Sprangers B, Claes K, Poesen R, Bammens B, Naesens M, Deegens JK, Dietrich R, Storr M, Wetzels JF, Evenepoel P, Kuypers D: The soluble urokinase receptor is not a clinical marker for focal segmental glomerulosclerosis. Kidney Int. 2014, 85: 636-640. 10.1038/ki.2013.505.CrossRefPubMed Meijers B, Maas RJ, Sprangers B, Claes K, Poesen R, Bammens B, Naesens M, Deegens JK, Dietrich R, Storr M, Wetzels JF, Evenepoel P, Kuypers D: The soluble urokinase receptor is not a clinical marker for focal segmental glomerulosclerosis. Kidney Int. 2014, 85: 636-640. 10.1038/ki.2013.505.CrossRefPubMed
14.
go back to reference Wada T, Nangaku M, Maruyama S, Imai E, Shoji K, Kato S, Endo T, Muso E, Kamata K, Yokoyama H, Fujimoto K, Obata Y, Nishino T, Kato H, Uchida S, Sasatomi Y, Saito T, Matsuo S: A multicenter cross-sectional study of circulating soluble urokinase receptor in Japanese patients with glomerular disease. Kidney Int. 2014, 85: 641-648. 10.1038/ki.2013.544.CrossRefPubMed Wada T, Nangaku M, Maruyama S, Imai E, Shoji K, Kato S, Endo T, Muso E, Kamata K, Yokoyama H, Fujimoto K, Obata Y, Nishino T, Kato H, Uchida S, Sasatomi Y, Saito T, Matsuo S: A multicenter cross-sectional study of circulating soluble urokinase receptor in Japanese patients with glomerular disease. Kidney Int. 2014, 85: 641-648. 10.1038/ki.2013.544.CrossRefPubMed
15.
go back to reference Sinha A, Bajpai J, Saini S, Bhatia D, Gupta A, Puraswani M, Dinda AK, Agarwal SK, Sopory S, Pandey RM, Hari P, Bagga A: Serum-soluble urokinase receptor levels do not distinguish focal segmental glomerulosclerosis from other causes of nephrotic syndrome in children. Kidney Int. 2014, 85: 649-658. 10.1038/ki.2013.546.CrossRefPubMed Sinha A, Bajpai J, Saini S, Bhatia D, Gupta A, Puraswani M, Dinda AK, Agarwal SK, Sopory S, Pandey RM, Hari P, Bagga A: Serum-soluble urokinase receptor levels do not distinguish focal segmental glomerulosclerosis from other causes of nephrotic syndrome in children. Kidney Int. 2014, 85: 649-658. 10.1038/ki.2013.546.CrossRefPubMed
16.
go back to reference Segarra A, Jatem E, Quiles MT, Arbós MA, Ostos H, Valtierra N, Carnicer C, Agraz I, Salcedo MT: Diagnostic value of soluble urokinase-type plasminogen activator receptor serum levels in adults with idiopathic nephrotic syndrome [Article in Spanish]. Nefrologia. 2014, 34: 46-52.PubMed Segarra A, Jatem E, Quiles MT, Arbós MA, Ostos H, Valtierra N, Carnicer C, Agraz I, Salcedo MT: Diagnostic value of soluble urokinase-type plasminogen activator receptor serum levels in adults with idiopathic nephrotic syndrome [Article in Spanish]. Nefrologia. 2014, 34: 46-52.PubMed
17.
go back to reference Segarra A, Jatem E, Quiles MT, Arbós MA, Ostos H, Valtierra N, Carnicer C, Salcedo MT: Value of soluble urokinase receptor serum levels in the differential diagnosis between idiopathic and secondary focal segmental glomerulosclerosis [Article in Spanish]. Nefrologia. 2014, 34: 53-61.PubMed Segarra A, Jatem E, Quiles MT, Arbós MA, Ostos H, Valtierra N, Carnicer C, Salcedo MT: Value of soluble urokinase receptor serum levels in the differential diagnosis between idiopathic and secondary focal segmental glomerulosclerosis [Article in Spanish]. Nefrologia. 2014, 34: 53-61.PubMed
18.
go back to reference Huang J, Liu G, Zhang YM, Cui Z, Wang F, Liu XJ, Chu R, Zhao MH: Urinary soluble urokinase receptor levels are elevated and pathogenic in patients with primary focal segmental glomerulosclerosis. BMC Med. 2014, 12: 81.CrossRefPubMedPubMedCentral Huang J, Liu G, Zhang YM, Cui Z, Wang F, Liu XJ, Chu R, Zhao MH: Urinary soluble urokinase receptor levels are elevated and pathogenic in patients with primary focal segmental glomerulosclerosis. BMC Med. 2014, 12: 81.CrossRefPubMedPubMedCentral
19.
go back to reference Franco Palacios CR, Lieske JC, Wadei HM, Rule AD, Fervenza FC: Urine but not serum soluble urokinase receptor (suPAR) may identify cases of recurrent FSGS in kidney transplant candidates. Transplantation. 2013, 96: 394-399. 10.1097/TP.0b013e3182977ab1.CrossRefPubMed Franco Palacios CR, Lieske JC, Wadei HM, Rule AD, Fervenza FC: Urine but not serum soluble urokinase receptor (suPAR) may identify cases of recurrent FSGS in kidney transplant candidates. Transplantation. 2013, 96: 394-399. 10.1097/TP.0b013e3182977ab1.CrossRefPubMed
20.
go back to reference Reiser J: Circulating permeability factor suPAR: from concept to discovery to clinic. Trans Am Clin Climatol Assoc. 2013, 124: 133-138.PubMedPubMedCentral Reiser J: Circulating permeability factor suPAR: from concept to discovery to clinic. Trans Am Clin Climatol Assoc. 2013, 124: 133-138.PubMedPubMedCentral
21.
go back to reference Yu CC, Fornoni A, Weins A, Hakroush S, Maiguel D, Sageshima J, Chen L, Ciancio G, Faridi MH, Behr D, Campbell KN, Chang JM, Chen HC, Oh J, Faul C, Arnaout MA, Fiorina P, Gupta V, Greka A, Burke GW, Mundel P: Abatacept in B7-1-positive proteinuric kidney disease. N Engl J Med. 2013, 369: 2416-2423. 10.1056/NEJMoa1304572.CrossRefPubMedPubMedCentral Yu CC, Fornoni A, Weins A, Hakroush S, Maiguel D, Sageshima J, Chen L, Ciancio G, Faridi MH, Behr D, Campbell KN, Chang JM, Chen HC, Oh J, Faul C, Arnaout MA, Fiorina P, Gupta V, Greka A, Burke GW, Mundel P: Abatacept in B7-1-positive proteinuric kidney disease. N Engl J Med. 2013, 369: 2416-2423. 10.1056/NEJMoa1304572.CrossRefPubMedPubMedCentral
22.
go back to reference Benigni A, Gagliardini E, Remuzzi G: Abatacept in B7-1-positive proteinuric kidney disease. N Engl J Med. 2014, 370: 1261-1263.CrossRefPubMed Benigni A, Gagliardini E, Remuzzi G: Abatacept in B7-1-positive proteinuric kidney disease. N Engl J Med. 2014, 370: 1261-1263.CrossRefPubMed
23.
go back to reference Alachkar N, Carter-Monroe N, Reiser J: Abatacept in B7–1-positive proteinuric kidney disease. N Engl J Med. 2014, 370: 1263-1264.PubMed Alachkar N, Carter-Monroe N, Reiser J: Abatacept in B7–1-positive proteinuric kidney disease. N Engl J Med. 2014, 370: 1263-1264.PubMed
24.
go back to reference Schlöndorff D: Are serum suPAR determinations by current ELISA methodology reliable diagnostic biomarkers for FSGS?. Kidney Int. 2014, 85: 499-501. 10.1038/ki.2013.549.CrossRefPubMed Schlöndorff D: Are serum suPAR determinations by current ELISA methodology reliable diagnostic biomarkers for FSGS?. Kidney Int. 2014, 85: 499-501. 10.1038/ki.2013.549.CrossRefPubMed
25.
go back to reference Gadegbeku CA, Gipson DS, Holzman LB, Ojo AO, Song PX, Barisoni L, Sampson MG, Kopp JB, Lemley KV, Nelson PJ, Lienczewski CC, Adler SG, Appel GB, Cattran DC, Choi MJ, Contreras G, Dell KM, Fervenza FC, Gibson KL, Greenbaum LA, Hernandez JD, Hewitt SM, Hingorani SR, Hladunewich M, Hogan MC, Hogan SL, Kaskel FJ, Lieske JC, Meyers KE, Nachman PH, et al: Design of the nephrotic syndrome study network (NEPTUNE) to evaluate primary glomerular nephropathy by a multidisciplinary approach. Kidney Int. 2013, 83: 749-756. 10.1038/ki.2012.428.CrossRefPubMedPubMedCentral Gadegbeku CA, Gipson DS, Holzman LB, Ojo AO, Song PX, Barisoni L, Sampson MG, Kopp JB, Lemley KV, Nelson PJ, Lienczewski CC, Adler SG, Appel GB, Cattran DC, Choi MJ, Contreras G, Dell KM, Fervenza FC, Gibson KL, Greenbaum LA, Hernandez JD, Hewitt SM, Hingorani SR, Hladunewich M, Hogan MC, Hogan SL, Kaskel FJ, Lieske JC, Meyers KE, Nachman PH, et al: Design of the nephrotic syndrome study network (NEPTUNE) to evaluate primary glomerular nephropathy by a multidisciplinary approach. Kidney Int. 2013, 83: 749-756. 10.1038/ki.2012.428.CrossRefPubMedPubMedCentral
Metadata
Title
suPAR and Team Nephrology
Author
Howard Trachtman
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2014
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-12-82

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