PURPOSE OF REVIEW: A focused review of the nature, source, physiological role and rapidly expanding evidence for glutathione S-transferase (GST) subtypes π and α as biomarkers of acute kidney injury (AKI) in patients undergoing cardiac surgery. Expanded insights into the site-specific expression of the GSTs in defined parts of the nephron during renal damage are presented, with particular emphasis on the pathogenesis of cardiac surgery and cardiopulmonary bypass (CPB)-associated AKI and the role of GSTs in oxygen radical disposal. RECENT FINDINGS: Recent developments have highlighted a potential role of urinary α-GST and π-GST in the diagnostic evaluation of cardiac surgery-associated AKI. Both urinary α-GST and π-GST are detected in the postoperative period. π-GST performed best at predicting AKI severity at the time of the initial diagnosis of AKI. α-GST was able to predict the future development of both stage 1 and stage 3 AKI. SUMMARY: The current data from a small number of patients suggest a potential role of urinary GSTs in the clinical diagnostic evaluation of AKI following cardiac surgery. The performance of the GSTs for the early diagnosis of AKI needs to be validated in larger multicentre studies and in other patient populations at increased risk of AKI (e.g. patients with acute transplant rejection, septic patients). Comparison with other emerging AKI biomarkers is required to continue the development of π-GST and α-GST. Finally, additional studies examining the pathophysiological role of the GSTs in minimizing oxygen free radical exposure in the renal tubules during CPB may shed further light into their role as promising biomarkers of cardiac surgery-associated AKI.
PURPOSE OF REVIEW: A focused review of the nature, source, physiological role and rapidly expanding evidence for glutathione S-transferase (GST) subtypes π and α as biomarkers of acute kidney injury (AKI) in patients undergoing cardiac surgery. Expanded insights into the site-specific expression of the GSTs in defined parts of the nephron during renal damage are presented, with particular emphasis on the pathogenesis of cardiac surgery and cardiopulmonary bypass (CPB)-associated AKI and the role of GSTs in oxygen radical disposal. RECENT FINDINGS: Recent developments have highlighted a potential role of urinary α-GST and π-GST in the diagnostic evaluation of cardiac surgery-associated AKI. Both urinary α-GST and π-GST are detected in the postoperative period. π-GST performed best at predicting AKI severity at the time of the initial diagnosis of AKI. α-GST was able to predict the future development of both stage 1 and stage 3 AKI. SUMMARY: The current data from a small number of patients suggest a potential role of urinary GSTs in the clinical diagnostic evaluation of AKI following cardiac surgery. The performance of the GSTs for the early diagnosis of AKI needs to be validated in larger multicentre studies and in other patient populations at increased risk of AKI (e.g. patients with acute transplant rejection, septic patients). Comparison with other emerging AKI biomarkers is required to continue the development of π-GST and α-GST. Finally, additional studies examining the pathophysiological role of the GSTs in minimizing oxygen free radical exposure in the renal tubules during CPB may shed further light into their role as promising biomarkers of cardiac surgery-associated AKI.
Authors: Jos J A Eijkenboom; Lucas T G J van Eijk; Peter Pickkers; Wilbert H M Peters; Jack F M Wetzels; Hans G van der Hoeven Journal: Intensive Care Med Date: 2005-04-06 Impact factor: 17.440
Authors: M Czerny; H Baumer; J Kilo; A Lassnigg; A Hamwi; T Vukovich; E Wolner; M Grimm Journal: Eur J Cardiothorac Surg Date: 2000-06 Impact factor: 4.191
Authors: Jay L Koyner; Vishal S Vaidya; Michael R Bennett; Qing Ma; Elaine Worcester; Shahab A Akhter; Jai Raman; Valluvan Jeevanandam; Micheal F O'Connor; Prasad Devarajan; Joseph V Bonventre; Patrick T Murray Journal: Clin J Am Soc Nephrol Date: 2010-08-26 Impact factor: 8.237
Authors: John Richard Prowle; Paolo Calzavacca; Elisa Licari; E Valentina Ligabo; Jorge E Echeverri; Sean M Bagshaw; Anja Haase-Fielitz; Michael Haase; Vaughn Ostland; Eisei Noiri; Mark Westerman; Prasad Devarajan; Rinaldo Bellomo Journal: Ren Fail Date: 2015-01-14 Impact factor: 2.606
Authors: I E Hall; R S Bhangoo; P P Reese; M D Doshi; F L Weng; K Hong; H Lin; G Han; R D Hasz; M J Goldstein; B Schröppel; C R Parikh Journal: Am J Transplant Date: 2014-02-24 Impact factor: 8.086
Authors: Vesna D Stojanović; Nenad A Barišić; Tanja D Radovanović; Nataša B Kovač; Jelena D Djuran; Amira Peco E Antić; Aleksandra D Doronjski Journal: Pediatr Nephrol Date: 2018-02-23 Impact factor: 3.714
Authors: Mohamed Diwan M AbdulHameed; Danielle L Ippolito; Jonathan D Stallings; Anders Wallqvist Journal: BMC Genomics Date: 2016-10-10 Impact factor: 3.969