Potential Utility of Urinary Follistatin as a Non-Invasive Indicator of Acute Tubular Damage in Patients with Acute Kidney Injury
Activin A is known to impede tubular repair following renal ischemia, whereas exogenous follistatin, an activin A antagonist, has been shown to ameliorate kidney damage in rats. Despite these findings, the precise role of endogenous follistatin in the kidney has yet to be elucidated. In this study,...
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MDPI AG
2024-03-01
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| Online Access: | https://www.mdpi.com/2073-4409/13/6/525 |
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| author | Izumi Nagayama Kaori Takayanagi Daisuke Nagata Hajime Hasegawa Akito Maeshima |
| author_facet | Izumi Nagayama Kaori Takayanagi Daisuke Nagata Hajime Hasegawa Akito Maeshima |
| author_sort | Izumi Nagayama |
| collection | DOAJ |
| description | Activin A is known to impede tubular repair following renal ischemia, whereas exogenous follistatin, an activin A antagonist, has been shown to ameliorate kidney damage in rats. Despite these findings, the precise role of endogenous follistatin in the kidney has yet to be elucidated. In this study, we investigated the localization of follistatin in the normal human kidney and its potential utility as a marker for acute kidney injury (AKI). In a total of 118 AKI patients and 16 healthy adults, follistatin levels in serum and urine were quantified using ELISA, and correlations with clinical parameters were analyzed. Follistatin-producing cells were positive for Na-Cl co-transporter and uromodulin, but negative for aquaporin 1 and aquaporin 2. Unlike healthy adults, urinary follistatin significantly increased in AKI patients, correlating positively with AKI severity. Urinary follistatin levels were notably higher in patients needing renal replacement therapy. Significant correlations were observed with urinary protein, α1 microglobulin, and urinary NGAL, but not with urinary KIM-1, urinary L-FABP, urinary NAG, urinary β2 microglobulin, or serum creatinine. Interestingly, no correlation between urinary and serum follistatin levels was identified, indicating a renal origin for urinary follistatin. In conclusion, follistatin, produced by distal tubules, is detectable in the urine of AKI patients, suggesting its potential as a valuable marker for monitoring acute tubular damage severity in AKI. |
| first_indexed | 2024-04-24T18:27:26Z |
| format | Article |
| id | doaj.art-f166ca40669945c48dd6f6381c05bf95 |
| institution | Directory Open Access Journal |
| issn | 2073-4409 |
| language | English |
| last_indexed | 2024-04-24T18:27:26Z |
| publishDate | 2024-03-01 |
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| series | Cells |
| spelling | doaj.art-f166ca40669945c48dd6f6381c05bf952024-03-27T13:30:39ZengMDPI AGCells2073-44092024-03-0113652510.3390/cells13060525Potential Utility of Urinary Follistatin as a Non-Invasive Indicator of Acute Tubular Damage in Patients with Acute Kidney InjuryIzumi Nagayama0Kaori Takayanagi1Daisuke Nagata2Hajime Hasegawa3Akito Maeshima4Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe 350-8550, JapanDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe 350-8550, JapanDivision of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke 329-0431, JapanDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe 350-8550, JapanDepartment of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe 350-8550, JapanActivin A is known to impede tubular repair following renal ischemia, whereas exogenous follistatin, an activin A antagonist, has been shown to ameliorate kidney damage in rats. Despite these findings, the precise role of endogenous follistatin in the kidney has yet to be elucidated. In this study, we investigated the localization of follistatin in the normal human kidney and its potential utility as a marker for acute kidney injury (AKI). In a total of 118 AKI patients and 16 healthy adults, follistatin levels in serum and urine were quantified using ELISA, and correlations with clinical parameters were analyzed. Follistatin-producing cells were positive for Na-Cl co-transporter and uromodulin, but negative for aquaporin 1 and aquaporin 2. Unlike healthy adults, urinary follistatin significantly increased in AKI patients, correlating positively with AKI severity. Urinary follistatin levels were notably higher in patients needing renal replacement therapy. Significant correlations were observed with urinary protein, α1 microglobulin, and urinary NGAL, but not with urinary KIM-1, urinary L-FABP, urinary NAG, urinary β2 microglobulin, or serum creatinine. Interestingly, no correlation between urinary and serum follistatin levels was identified, indicating a renal origin for urinary follistatin. In conclusion, follistatin, produced by distal tubules, is detectable in the urine of AKI patients, suggesting its potential as a valuable marker for monitoring acute tubular damage severity in AKI.https://www.mdpi.com/2073-4409/13/6/525follistatinacute kidney injuryurinary biomarker |
| spellingShingle | Izumi Nagayama Kaori Takayanagi Daisuke Nagata Hajime Hasegawa Akito Maeshima Potential Utility of Urinary Follistatin as a Non-Invasive Indicator of Acute Tubular Damage in Patients with Acute Kidney Injury Cells follistatin acute kidney injury urinary biomarker |
| title | Potential Utility of Urinary Follistatin as a Non-Invasive Indicator of Acute Tubular Damage in Patients with Acute Kidney Injury |
| title_full | Potential Utility of Urinary Follistatin as a Non-Invasive Indicator of Acute Tubular Damage in Patients with Acute Kidney Injury |
| title_fullStr | Potential Utility of Urinary Follistatin as a Non-Invasive Indicator of Acute Tubular Damage in Patients with Acute Kidney Injury |
| title_full_unstemmed | Potential Utility of Urinary Follistatin as a Non-Invasive Indicator of Acute Tubular Damage in Patients with Acute Kidney Injury |
| title_short | Potential Utility of Urinary Follistatin as a Non-Invasive Indicator of Acute Tubular Damage in Patients with Acute Kidney Injury |
| title_sort | potential utility of urinary follistatin as a non invasive indicator of acute tubular damage in patients with acute kidney injury |
| topic | follistatin acute kidney injury urinary biomarker |
| url | https://www.mdpi.com/2073-4409/13/6/525 |
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