Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a New Biomarker for Non – Acute Kidney Injury (AKI) Diseases

Abstract

Neutrophil gelatinase-associated lipocalin, or NGAL, an acute phase protein, is part of the lipocalin family. NGAL is highly induced in inflammatory conditions and ischemia, and is a critical component of innate immunity to bacterial infection. Recently, NGAL has been proven as an emerging biomarker for predicting acute kidney injury (AKI). Meanwhile, numerous studies have also demonstrated that NGAL may be a potential biomarker for the diagnosis, prediction, prevention, and prognosis of non--AKI diseases such as chronic kidney diseases, vascular disorders, cancer, preeclampsia, and allergies. This article systematically reviews the clinical utilities of NGAL as a new biomarker for non--AKI diseases.

Prognostic Role of Maternal Neutrophil Gelatinase-Associated Lipocalin in Women with Severe Early-Onset Preeclampsia

“…It is considered an acute-phase reactant protein, highly induced in inflammatory conditions [16] and endothelial damage [17,27]. In nonpregnant individuals, elevated serum levels of NGAL have been related with hypertension [28], acute kidney injury (for its prediction and prognosis) [29], and with the severity of renal impairment in chronic kidney disease [30]. It is then plausible that NGAL levels are increased in women with preeclampsia that is characterized by placental hypoxia and ischemia leading to systemic excessive oxidative stress in association with inflammation and endothelial dysfunction [31].…”

Novel Bio-Markers for Prediction of Preeclampsia

“…Its expression is highly upregulated in damaged epithelial cells, during infl ammation, neoplastic conditions, cardiovascular diseases, infections and renal disorders. 50 NGAL can be detected in urine within two hours of kidney damage, hence it is considered as the best and the earliest markers of acute kidney damage. 50,51 In some recent studies serum level of NGAL was found to be increased at the end of second trimester in women who subsequently developed PE compared to control group.…”

“…50 NGAL can be detected in urine within two hours of kidney damage, hence it is considered as the best and the earliest markers of acute kidney damage. 50,51 In some recent studies serum level of NGAL was found to be increased at the end of second trimester in women who subsequently developed PE compared to control group. 47,49,52 A positive correlation of serum NGAL was found with the systolic and diastolic blood pressure and with proteinuria.…”

Acute kidney injury: We’ve got the diagnosis, now what?

“…Elevation of NGAL occurs in many other conditions, including chronic kidney disease, vascular disorders, cancer, preeclampsia, and allergy. 16 Thus, although urinary NGAL may represent an early sensitive noninvasive urinary biomarker for populations with ischemic and nephrotoxic AKI, it is not useful for management decisions in an individual patient. 17 A number of other potential biomarkers have been studied, including interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), and liver-type fatty acid-binding protein (L-FABP) ( Table 2).…”

“…L'élévation de la NGAL survient dans de nombreuses autres circonstances, y compris la maladie rénale chronique, les troubles vasculaires, la prééclampsie et l'allergie. 16 Ainsi, même si la NGAL urinaire peut représenter un biomarqueur urinaire précoce, sensible et non invasif, chez les populations ayant une LRA ischémique et néphrotoxique, elle n'est pas utilisable pour les décisions de prise en charge d'un patient particulier. 17 Plusieurs autres biomarqueurs potentiels ont été étudiés, y compris l'interleukine-18 (IL-18), la kidney injury molecule-1 (KIM-1, molécule de lésion rénale) et la protéine de liaison des acides gras de type hépatique (L-FABP, liver-type fatty acid-binding protein) (Tableau 2).…”