OBJECTIVES: Urokinase-type plasminogen activator receptor (uPAR) is upregulated during inflammation and known to bind to β3 -integrins, receptors used by pathogenic hantaviruses to enter endothelial cells. It has been proposed that soluble uPAR (suPAR) is a circulating factor that causes focal segmental glomerulosclerosis and proteinuria by activating β3 -integrin in kidney podocytes. Proteinuria is also a characteristic feature of hantavirus infections. The aim of this study was to evaluate the relation between urine suPAR levels and disease severity in acute Puumala hantavirus (PUUV) infection. DESIGN: A single-centre, prospective cohort study. SUBJECTS AND METHODS: Urinary suPAR levels were measured twice during the acute phase and once during convalescence in 36 patients with serologically confirmed PUUV infection. Fractional excretion of suPAR (FE suPAR) and of albumin (FE alb) was calculated. RESULTS: The FE suPAR was significantly elevated during the acute phase of PUUV infection compared to the convalescent phase (median 3.2%, range 0.8-52.0%, vs. median 1.9%, range 1.0-5.8%, P = 0.005). Maximum FE suPAR was correlated markedly with maximum FE alb (r = 0.812, P < 0.001) and with several other variables that reflect disease severity. There was a positive correlation with the length of hospitalization (r = 0.455, P = 0.009) and maximum plasma creatinine level (r = 0.780, P < 0.001) and an inverse correlation with minimum urinary output (r = -0.411, P = 0.030). There was no correlation between FE suPAR and plasma suPAR (r = 0.180, P = 0.324). CONCLUSION: Urinary suPAR is markedly increased during acute PUUV infection and is correlated with proteinuria. High urine suPAR level may reflect local production of suPAR in the kidney during the acute infection.
OBJECTIVES:Urokinase-type plasminogen activator receptor (uPAR) is upregulated during inflammation and known to bind to β3 -integrins, receptors used by pathogenic hantaviruses to enter endothelial cells. It has been proposed that soluble uPAR (suPAR) is a circulating factor that causes focal segmental glomerulosclerosis and proteinuria by activating β3 -integrin in kidney podocytes. Proteinuria is also a characteristic feature of hantavirus infections. The aim of this study was to evaluate the relation between urine suPAR levels and disease severity in acute Puumala hantavirus (PUUV) infection. DESIGN: A single-centre, prospective cohort study. SUBJECTS AND METHODS: Urinary suPAR levels were measured twice during the acute phase and once during convalescence in 36 patients with serologically confirmed PUUV infection. Fractional excretion of suPAR (FE suPAR) and of albumin (FEalb) was calculated. RESULTS: The FE suPAR was significantly elevated during the acute phase of PUUV infection compared to the convalescent phase (median 3.2%, range 0.8-52.0%, vs. median 1.9%, range 1.0-5.8%, P = 0.005). Maximum FE suPAR was correlated markedly with maximum FEalb (r = 0.812, P < 0.001) and with several other variables that reflect disease severity. There was a positive correlation with the length of hospitalization (r = 0.455, P = 0.009) and maximum plasma creatinine level (r = 0.780, P < 0.001) and an inverse correlation with minimum urinary output (r = -0.411, P = 0.030). There was no correlation between FE suPAR and plasma suPAR (r = 0.180, P = 0.324). CONCLUSION: Urinary suPAR is markedly increased during acute PUUV infection and is correlated with proteinuria. High urine suPAR level may reflect local production of suPAR in the kidney during the acute infection.
Authors: Sisse R Ostrowski; Henrik Ullum; Bamenla Q Goka; Gunilla Høyer-Hansen; George Obeng-Adjei; Bente K Pedersen; Bartholomew D Akanmori; Jørgen A L Kurtzhals Journal: J Infect Dis Date: 2005-03-14 Impact factor: 5.226
Authors: Tuula K Outinen; Satu M Mäkelä; Ilpo O Ala-Houhala; Heini S A Huhtala; Mikko Hurme; Daniel H Libraty; Simo S Oja; Ilkka H Pörsti; Jaana T Syrjänen; Antti Vaheri; Jukka T Mustonen Journal: J Med Virol Date: 2011-04 Impact factor: 2.327
Authors: Salim S Hayek; Kwi Hye Koh; Morgan E Grams; Changli Wei; Yi-An Ko; Jing Li; Beata Samelko; Hyun Lee; Ranadheer R Dande; Ha Won Lee; Eunsil Hahm; Vasil Peev; Melissa Tracy; Nicholas J Tardi; Vineet Gupta; Mehmet M Altintas; Garrett Garborcauskas; Nikolina Stojanovic; Cheryl A Winkler; Michael S Lipkowitz; Adrienne Tin; Lesley A Inker; Andrew S Levey; Martin Zeier; Barry I Freedman; Jeffrey B Kopp; Karl Skorecki; Josef Coresh; Arshed A Quyyumi; Sanja Sever; Jochen Reiser Journal: Nat Med Date: 2017-06-26 Impact factor: 53.440
Authors: Markus Meier; Jan Kramer; Wolfram J Jabs; Claudia Nolte; Jörg Hofmann; Detlev H Krüger; Hendrik Lehnert; Martin Nitschke Journal: Nephron Extra Date: 2018-02-09
Authors: Paula S Mantula; Tuula K Outinen; Pia Jaatinen; Mari Hämäläinen; Heini Huhtala; Ilkka H Pörsti; Antti Vaheri; Jukka T Mustonen; Satu M Mäkelä Journal: PLoS One Date: 2018-12-05 Impact factor: 3.240
Authors: Paula Mantula; Johanna Tietäväinen; Jan Clement; Onni Niemelä; Ilkka Pörsti; Antti Vaheri; Jukka Mustonen; Satu Mäkelä; Tuula Outinen Journal: Pathogens Date: 2020-07-28