Presence of immunounreactive albumin in the urine of diabetic patients

Nakayama, Aki; Ida, Takashi; Hatano, Yoshiji; K, Oohara; Yoshida, Hiroshi; Baba, Toshiaki; Sakamoto, Hisashi; Shiba, Kiyoko

doi:10.1002/jcla.20100

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…This result suggests that at least part of the urinary albumin in cardiovascular disease becomes fragmented under reducing condition. Our results are partly congruent with those reported by Osicka et al 25) and we have previously observed a similar decrease in the albumin content in patients with diabetic mellitus 26) . The degree to which this unstable albumin relates to the decreased reactivity of the antibody is at present unclear and further examination is warranted.…”

Section: Resultssupporting

confidence: 94%

Reduced immunoreactivity of urinary albumin in patients with cardiovascular diseases: Analysis of immunochemically nonreactive albumin

et al. 2008

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We analyzed 55 spot urine samples from patients with cardiovascular diseases. Urinary albumin concentrations were measured with size exclusion high performance liquid chromatography (HPLC), turbidimetric immunoassay (TIA) using anti human serum albumin polyclonal antibody, and enzyme-linked immunosorbent assay (ELISA) using anti human serum albumin monoclonal antibody. Fractionated urine samples from the HPLC were also analyzed with the immunoprecipitation reactions using as same monoclonal antibody as ELISA. As a result, the urinary albumin concentration analyzed by the HPLC was systematically higher than that of immunoassays, however, 'albumin peak' from the HPLC contained other urinary proteins. Result of immunoprecipitation reaction showed the presence of monomer albumin that could not react with the monoclonal antibody. These results suggest that not only contamination of other proteins, the albumin fraction from the HPLC included albumin with reduced its reactivity to the specific monoclonal antibody.

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Section: Resultssupporting

confidence: 94%

Reduced immunoreactivity of urinary albumin in patients with cardiovascular diseases: Analysis of immunochemically nonreactive albumin

et al. 2008

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“…46 Immuno-unreactive intact albumin has also been found in urine from diabetic patients using high performance liquid chromatography (HPLC) analysis, which measures both immunoreactive intact albumin and immuno-unreactive intact albumin (total albumin). [47][48][49] Immuno-unreactive intact albumin has been isolated from diabetic urine through the use of anti-albumin immunosubtraction chromatography and HPLC purification. 50 The immunochemical nonreactive nature of this immunounreactive intact albumin molecule may be due to the fact that the epitope is altered by a conformational change as a result of incomplete processing by the lysosomal pathway, which is compromised in diabetes but not in healthy subjects, 28,40 or due to the attachment of ligands such as glucose or fatty acids which are increased in diabetes.…”

Section: Composition Of Albumin In Urinementioning

confidence: 99%

Albuminuria: Its Importance in Disease Detection

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Osicka

Comper

2007

Lab Med

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Healthy kidneys produce physiologically appropriate urinethey retain essential blood components while excreting waste materials. Excess albumin in the urine, or albuminuria, has been regarded for more than 40 years as a principal marker for renal disease, and the logic for this is clear-more albumin appears in the urine when the kidneys are no longer functioning properly.Testing for albuminuria is often also referred to as "microalbuminuria testing," although this title can be a source of confusion in terms of what is being measured. The term "microalbuminuria" refers to a stratified quantitative result of an albuminuria test, rather than a qualitative test for the presence of micro-or small-"albumin pieces." Interpretation of an albuminuria test is typically performed in relation to a common reference scale, where a urinary albumin excretion rate (AER) of less than 20 micrograms per minute (µg/min) is considered normal (termed normoalbuminuria), an AER between 20 and 200 µg/min is considered slightly elevated and a marker for disease (termed microalbuminuria), and an AER over 200 µg/min is called macroalbuminuria. It should be noted that AER may also be expressed in terms of milligrams per day (mg/day), in which case the range for microalbuminuria is 30 to 300 mg/day.To arrive at an AER, a timed urine sample must be obtained so that the rate of excretion can be calculated. An alternative to this is normalizing the urinary albumin concentration to the urinary creatinine concentration (since creatinine excretion rate is considered constant) for an untimed 'spot' urine sample. Therefore, many 'albuminuria' results will be reported in terms of albumin-to-creatinine ratio, or ACR with a value of <30 mg/g (or <3.4 mg/mmol) generally considered as normal. Relationship Between Microalbuminuria, Diabetes, Hypertension, and Cardiovascular DiseaseMicroalbuminuria is an important clinical marker in patients with diabetes because of its well-established association with progressive renal disease. 1-3 It is also becoming increasingly recognized as an independent risk factor for cardiovascular disease in patients with hypertension and diabetes, 1,4-6 and also in the general population. 7,8 Microalbuminuria has recently been recognized as one of the most significant factors for predicting morbidity and mortality in people with cardiovascular and peripheral vascular disease, 6,7 although some evidence suggests that the stratification of levels of albuminuria used are not indicative of 'levels' of risk, rather the albuminuria level is a continuum where risk is proportional to the level, not to the classification of normo-, micro-, or macro-albuminuria. 6,9 Microalbuminuria occurs in 11% to 40% of persons with hypertension, 10,11 the prevalence increasing with age and the duration of hypertension. 11 In a cross-sectional study of more than 10,000 nondiabetic patients with hypertension, patients with microalbuminuria had a significantly higher prevalence of cardiovascular disease symptoms and outcomes compared with normo-albuminuri...

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“…Therefore, immunoassays might underestimate and underdiagnose microalbuminuria. Furthermore, it is not clear whether there is a difference in the relative amount of urinary immunoreactive and immuno‐unreactive albumin among primary diseases since most reports concern albuminuria measured in diabetes .…”

Section: Introductionmentioning

confidence: 99%