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Proteolytic markers associated with kidney disease in HIV positive

individuals before initiation of anti-retroviral therapy (ART)

CB Mahachi , KH Myburgh , WD Bates , RM Moosa 4
1,2
3
2
1 Physiology Unit, Department of Biomedical Sciences, University of Zimbabwe, P.O Box MP 167 Mount Pleasant, Harare, Zimbabwe
2 Department of Physiological Sciences, Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7602, South Africa.
3 Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National
Health Laboratory Service, Cape Town, South Africa
4 Division of Nephrology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Background Discussion and Conclusion
Tissue destruction contributes to chronic kidney disease progression with proteolytic enzymes, neutrophil gelatinase (NGAL) and matrix • NGAL and MMP-9 were higher in plasma
metalloproteinase-9 (MMP-9), playing individual and interactive roles. When MMP-9 is complexed to than urine, even when expressed relative
NGAL , this enables the activity of MMP-9 by inhibiting it inactivation to Creatinine
Objective • HIVAN participants formed more
complex than HIV-NKD in urine
To determine if NGAL and MMP-9 in urine or plasma differentiate between different forms of • The more severe the renal disease the
kidney diseases in patients with treatment naïve human immunodeficiency virus (HIV) infection higher the NGAL in urine and plasma
(HIV ) to those with focal segmental glomerulosclerosis and no HIV infection and if the complex fails to • Plasma MMP9 and MMP9-NGAL complex
+
differentiate whether measured in urine or plasma. were not statistically significant different
between the groups
References
Results Results
Material & Methods NGAL: Plasma NGAL was significantly 1. Xiang D, Zhang H, Bai J, Ma J, Li M, Gao J, et al.
Clinical application of neutrophil gelatinase-
36 participants (25% male) participated were higher in HIVAN compared to other groups associated lipocalin in the revised chronic kidney
recruited from Tygerberg Hospital Renal Clinic at p<0.05. disease classification. Int J Clin Exp Pathol.
2014;7(10):7172–81.
and OI Clinic, : Urine NGAL (ng/mg) was significant 2. Moriya, H., Mochida, Y., Ishioka, K. et al. Plasma
10 HIV controls, no kidney disease (HIV- different in neutrophil gelatinase-associated lipocalin (NGAL) is
+
NKD), 10 HIV-associated nephropathy • HIVAN compared to HIV-NKD at p<0.01 an indicator of interstitial damage and a predictor of
(HIVAN), 6 HIV focal segmental • HIVAN and HIV-FSGS at p<0.05. kidney function worsening of chronic kidney disease
glomerulosclerosis (HIV-FSGS) and 10 FSGS no in the early stage: a pilot study. Clin Exp
HIV (KD-FSGS). HIVAN and FSGS features MMP-9: Urine MMP-9 (ng/mg) differed Nephrol 21, 1053–1059 (2017).
were established on histology of biopsied renal significantly between HIVAN and HIV-NKD
tissue. Urine and plasma free NGAL, free at p<0.05.
MMP-9 and MMP-9/NGAL-complex were
analysed using enzyme-linked immunosorbent MMP-9/NGAL-complex: Urine MMP-9/NGAL-
assay and normalized to urine creatinine and complex (ng.mg) was significantly higher in
expressed as ng/mg. HIVAN compared to HIV-NKD at p<0.05.