ПОТЕНЦИАЛЬНЫЕ МИШЕНИ ДЛЯ РАННЕЙ ДИАГНОСТИКИ ОСТРОГО ПОВРЕЖДЕНИЯ ПОЧЕК У ПАЦИЕНТОВ С COVID-19 (ОБЗОР ЛИТЕРАТУРЫ)

Аннотация

Высокая частота встречаемости, неблагоприятный прогноз, отсутствие методов диагностики начальных этапов развития острого повреждения почек (ОПП) у пациентов с COVID-19 (coronavirus disease 2019 — коронавирусное заболевание 2019) предопределяют актуальность выбранной темы. Целью обзора явился анализ литературы для поиска и обоснования выбора маркеров ранней диагностики ОПП на основе механизмов его формирования. Проанализированы результаты белее двухсот работ следующих медицинских баз данных: РИНЦ, Scopus, The Cochrane Library, MEDLINE. Рассмотрены факторы риска развития и прогрессирования ОПП, такие как гипоксемия, повышение внутригрудного давления на фоне острого респираторного дистресс-синдрома (ОРДС), артериальная гипертония (АГ) с эндотелиальной дисфункцией, сахарный диабет. Раскрыты ключевые звенья патогенеза ОПП при COVID-19 как прямого цитопатического действием SARS-CoV-2, так и за счёт иммуноопосредованного (цитокининдуцированного) механизма. Обозначены различные методологические подходы к поиску и определению маркеров на основе анализа протеома и метаболома мочи. Выявлены перспективные направления в диагностике начальных этапов ОПП: определение маркеров повреждения проксимальных канальцев, как наиболее чувствительных к гипоксии, и метаболитов АТФ, отражающих начальные этапы расстройства энергетического обмена в эпителии канальцев. Для оценки прогноза течения патологии рассмотрена возможность одномоментного изучения ряда биомаркёров при помощи неинвазивных методов обследования. Идентификация высокочувствительных и специфичных маркёров начальных этапов развития ОПП позволит повысить точность диагностики, обосновать показания к раннему началу терапии, прогнозировать исход заболевания.

Об авторах

Список литературы

Yang X., Yu Y., Xu J., Shu H., Xia J., Liu H. et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir. Med. 2020; 8(5):475-481. https://doi.org/10.1016/S2213-2600(20)30079-5

Cheng Y., Luo R., Wang K., Zhang M., Wang Z., Dong L. et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney International. 2020;97(5):829-838. https://doi.org/10.1016/j.kint.2020.03.005

Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z. et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-1062. https://doi.org/10.1016/S0140-6736(20)30566-3

Zhang G., Hu C., Luo L., Fang F., Chen Y., Li J. et al. Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China. J. Clin. Virol. 2020; 127:104364. https://doi.org/10.1016/j.jcv.2020.104364

Fisher M., Neugarten J., Bellin E. Yunes M., Stahl L., Johns T.S. et al. AKI in hospitalized patients with and without COVID-19: a comparison study. J. Am. Soc. Nephrol. 2020; 31(9):2145-2157. https://doi.org/10.1681/ASN.2020040509

Pei G., Zhang Z., Peng J., Liu L., Zhang C., Yu C. et al. Renal involvement and early prognosis in patients with COVID19 pneumonia. J. Am. Soc. Nephrol. 2020; 31(6): 1157-65. https://doi.org/10.1681/ASN.2020030276

Ng J.H., Hirsch J.S., Hazzan A., Wanchoo R., Shah H.H., Malieckal D.A. et al. Northwell Nephrology COVID-19 Research Consortium. Outcomes Among Patients Hospitalized With COVID-19 and Acute Kidney Injury. Am. J. Kidney Dis. 2021; 77(2):204-215.e1. https://doi.org/10.1053/j.ajkd.2020.09.002

Peerapornratana S., Manrique-Caballero C.L., Gómez H., Kellum J.A. Acute kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment. Kidney Int. 2019;96:1083-1099. https://doi.org/10.1016/j.kint.2019.05.026

Grasselli G., Zangrillo A., Zanella A., Antonelli M., Cabrini L., Castelli A. et al. COVID-19 Lombardy ICU Network. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574-1581.https://doi.org/10.1001/jama.2020.5394

Imai Y., Parodo J., Kajikawa O., de Perrot M., Fischer S., Edwards V. et al. Injurious mechanical ventilation and end-organ epithelial cell apoptosis and organ dysfunction in an experimental model of acute respiratory distress syndrome. JAMA. 2003;289(16):2104-12. https://doi.org/10.1001/jama.289.16.2104

Wang M., Hao H., Leeper N.J., Zhu L. Thrombotic Regulation from the Endothelial Cell Perspectives. Arter.Thromb.Vasc.Biol. 2018;38:90-95. https://doi.org/10.1161/ATVBAHA.118.310367

Buckley L.F., Cheng J.W.M., Desai A. Cardiovascular Pharmacology in the time of COVID-19: A focus on angiotensin converting enzyme 2. J. Cardiovasc. Pharmacol. 2020;75(6):526-529. https://doi.org/10.1097/FJC.0000000000000840

Reynolds H.R., Adhikari S., Pulgarin C., Troxel A.B., Iturrate E., Johnson S.B. et al. Renin-angiotensin-aldosterone system inhibitors and risk of COVID-19. N. Engl. J. Med. 2020; 382(25): 2441-8. https://doi.org/10.1056/NEJMoa2008975

Gabarre P., Duma G., Dupont T., Darmon M., Azoulay E., Zafrani L. Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med. 2020;46(7):1339-1348. doi:10.1007/s00134-020-06153-9

Ruan Q., Yang K., Wang W., Jiang L., Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846-848. https://doi.org/10.1007/s00134-020-05991-x

Golmai P., Larsen C.P., DeVita M.V., Wahl S.J., Weins A., Rennke H.G. et al. Histopathologic and ultrastructural findings in postmortem kidney biopsy material in 12 patients with AKI and COVID-19. J. Am. Soc. Nephrol. 2020;31(9):1944-1947. doi:10.1681/ASN.2020050683

Su H., Yang M., Wan C., Yi L.X., Tang F., Zhu H.Y. et al. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int. 2020;98(1):219-227. https://doi.org/10.1016/j.kint.2020.04.003

Gkogkou E., Barnasas G., Vougas K., Trougakos I.P. Expression profiling meta-analysis of ACE2 and TMPRSS2, the putative anti-inflammatory receptor and priming protease of SARS-CoV-2 in human cells, and identification of putative modulators. Redox Biol. 2020;36:101615. https://doi.org/10.1016/j.redox.2020.101615

Pan X.W., Xu D., Zhang H., Zhou W., Wang L., Cui X. Identification of a potential mechanism of acute kidney injury during the COVID-19 outbreak: a study based on single-cell transcriptome analysis. Intensive Care Med. 2020;46(6):1114-1116. https://doi.org/10.1007/s00134-020-06026-1

Martinez-Rojas M.A., Vega-Vega O., Bobadilla N.A. Is the kidney a target of SARS-CoV-2? Am. J. Physiol. Renal Physiol. 2020;318(6):F1454-F1462. https://doi.org/10.1152/ajprenal.00160.2020

Ding Y., He L., Zhang Q., Huang Z., Che X., Hou J. et al. Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J. Pathol. 2004;203(2):622-30. https://doi.org/10.1002/path.1560

Diao B., Wang C., Wang R., Feng Z., Tan Y., Wang H. et al. Human kidney is a target for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Infection. 2020 https://doi.org/10.1101/2020.03.04.20031120

Ng J.H., Bijol V., Sparks M.A., Sise M.E., Izzedine H., Jhaveri K.D. Pathophysiology and Pathology of Acute Kidney Injury in Patients With COVID-19. Adv. Chronic Kidney Dis. 2020;27(5):365-376. https://doi.org/10.1053/j.ackd.2020.09.003

Chousterman B.G., Swirski F.K., Weber G.F. Cytokine storm and sepsis disease pathogenesis. Semin. Immunopathol. 2017;39(5):517-528. https://doi.org/10.1007/s00281-017-0639-8

Wu C., Chen X., Cai Y., Xia Jia’an, Zhou X., Xu S. et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern. Med. 2020;180(7):934-943. https://doi.org/10.1001/jamainternmed.2020.0994

Kissling S., Rotman S., Gerber C., Halfon M., Lamoth F., Comte D. et al. Collapsing glomerulopathy in a COVID-19 patient. Kidney Int. 2020;98(1):228-231. https://doi.org/10.1016/j.kint.2020.04.006

Varga Z., Flammer A.J., Steiger P., Haberecker M., Andermatt R., Zinkernagel A.S. et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-1418. https://doi.org/10.1016/S0140-6736(20)30937-5

Lerolle N., Nochy D., Guérot E., Bruneval P., Fagon J.Y., Diehl J.L. et al. Histopathology of septic shock induced acute kidney injury: apoptosis and leukocytic infiltration. Intensive Care Med. 2010;36(3):471-8. https://doi.org/10.1007/s00134-009-1723-x

Wu H., Larsen C.P., Hernandez-Arroyo C.F., Mohamed M.M.B., Caza T., Sharshir M. et al. AKI and Collapsing Glomerulopathy Associated with COVID-19 and APOL1 High-Risk Genotype. J. Am. Soc. Nephrol. 2020;31(8):1688-1695. https://doi.org/10.1681/ASN.2020050558

Summary of the advantages and disadvantages of various… [Electronic resource] // ResearchGate. URL: https://www.researchgate.net/figure/Summary-of-the-advantages-and-disadvantages-of-various-bio-fluids-The-figure-shows-the_fig2_341702537 (accessed: 06.12.2020).

Awdishu L., Tsunoda S., Pearlman M., Kokoy-Mondragon C., Ghassemian M., Naviaux R.K. et al. Identification of Maltase Glucoamylase as a Biomarker of Acute Kidney Injury in Patients with Cirrhosis. Crit. Care Res. Pract. 2019; 2019: 5912804. https://doi.org/10.1155/2019/5912804

Soveri I., Helmersson-Karlqvist J., Fellström B., Larsson A. Day-to-day variation of the kidney proximal tubular injury markers urinary cystatin C, KIM1, and NGAL in patients with chronic kidney disease. Ren. Fail. 2020;42(1):400-404. https://doi.org/10.1080/0886022X.2020.1757463

Fattah H., Vallon V. Tubular Recovery after Acute Kidney Injury. Nephron. 2018;140(2):140-143. https://doi.org/10.1159/000490007

Nejat M., Pickering J.W., Walker R.J., Westhuyzen J., Shaw G.M., Frampton C.M. et al. Urinary cystatin C is diagnostic of acute kidney injury and sepsis, and predicts mortality in the intensive care unit. Crit. Care. 2010;14(3):R85. https://doi.org/10.1186/cc9014

Koyner J.L., Garg A.X., Coca S.G., Sint K., Thiessen-Philbrook H., Patel U.D. et al. TRIBE-AKI Consortium. Biomarkers predict progression of acute kidney injury after cardiac surgery. J. Am. Soc. Nephrol. 2012;23(5):905-14. https://doi.org/10.1681/ASN.2011090907

Husain-Syed F., Wilhelm J., Kassoumeh S., Birk H.W., Herold S., Vadász I. et al. Acute kidney injury and urinary biomarkers in hospitalized patients with coronavirus disease-2019. Nephrol. Dial. Transplant. 2020;35(7):1271-1274. https://doi.org/10.1093/ndt/gfaa162

Coca S.G, Nadkarni G.N., Garg A.X., Koyner J., Thiessen-Philbrook H., McArthur E. et al. TRIBE-AKI Consortium. First Post- Operative Urinary Kidney Injury Biomarkers and Association with the Duration of AKIin the TRIBE-AKI Cohort. PLoS One. 2016;11(8):e0161098. https://doi.org/10.1371/journal.pone.0161098

Luther T., Bülow-Anderberg S., Larsson A., Rubertsson S., Lipcsey M., Frithiof R. et al. COVID-19 patients in intensive care develop predominantly oliguric acute kidney injury. Acta Anaesthesiol. Scand. 2021;65(3):364-372. https://doi.org/10.1111/aas.13746

Katagiri D., Ishikane M., Asai Y., Kinoshita N., Ota M., Moriyama Y. et al. Evaluation of Coronavirus Disease 2019 Severity Using Urine Biomarkers. Crit. Care Explor. 2020;2(8):e0170. https://doi.org/10.1097/CCE.0000000000000170

Sun D.Q., Wang T.Y., Zheng K.I., Targher G., Byrne C.D., Chen Y.P. et al. Subclinical Acute Kidney Injury in COVID-19 Patients: A Retrospective Cohort Study. Nephron. 2020;144(7):347-350. https://doi.org/10.1159/000508502

LeBlanc L.M., Paré A.F., Jean-François J., Hébert M.J., Surette M.E., Touaibia M. Synthesis and antiradical/antioxidant activities of caffeic acid phenethyl ester and its related propionic, acetic, and benzoic acid analogues. Molecules. 2012;17(12):14637-50. https://doi.org/10.3390/molecules171214637

Pugia M.J., Valdes R. Jr., Jortani S.A. Bikunin (urinary trypsin inhibitor): structure, biological relevance, and measurement. Adv. Clin. Chem. 2007;44:223-45. https://doi.org/10.1016/s0065-2423(07)44007-0

Hong X.W., Chi Z.P., Liu G.Y., Huang H., Guo S.Q., Fan J.R. et al. Characteristics of Renal Function in Patients Diagnosed With COVID-19: An Observational Study. Front. Med (Lausanne). 2020;7:409. https://doi.org/10.3389/fmed.2020.00409

Gambardella J., Khondkar W., Morelli M.B., Wang X., Santulli G., Trimarco V. Arginine and Endothelial Function. Biomedicines. 2020;8(8): 277. https://doi.org/10.3390/biomedicines8080277

van Kempen TATG, Deixler E. SARS-CoV-2: influence of phosphate and magnesium, moderated by vitamin D, on energy (ATP) metabolism and on severity of COVID-19. Am. J. Physiol. Endocrinol. Metab. 2021;320(1):E2-E6. https://doi.org/10.1152/ajpendo.00474.2020

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