Delphine Legrand

Neutrophil gelatinase-associated lipocalin (NGAL) determined in urine with the Abbott Architect or in plasma with the Biosite Triage? The laboratory's point of view.

Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a potential marker for the early detection of acute kidney injury (AKI) (1–3). However, most studies used cumbersome techniques (ELISA) that are particularly difficult to implement in routine practice (3, 4). Recently, two commercially available kits for determination of NGAL have appeared on the market. The first one, from Abbott Laboratories (Abbott Park, IL, USA), is an automated immunoassay that allows determination of urinary NGAL with the Architect platform. The second, the Triage NGAL Test (Biosite-Inverness Medical, Waltham, MA, USA) is a point-ofcare immunoassay for the quantitative determination of NGAL in EDTA anticoagulated whole blood or plasma. The aim of this study was to perform an analytical validation and a comparison of imprecision of these new tests. The Architect NGAL assay is a non-competitive two-site sandwich immunoassay that utilizes two mouse antibodies recognizing distinct NGAL epitopes. The Triage NGAL is a rapid fluorescence immunoassay that is used with the Triage Meters. All tests were performed by a trained laboratory technician according to the manufacturer’s instructions. Both tests have been correlated against an established and validated ELISA that uses mouse monoclonal antibody raised against human NGAL ( HYB211-05; AntibodyShop, Gentofte, Denmark) (5, 6). We used e-noval (Arlenda, Liège, Belgium) software for the statistical evaluation of results.

NGAL, biomarqueur de lésion rénale : point d’étape en 2012

Neutrophil Gelatinase Associated Lipocalin (NGAL) is one of the most promising biomarkers for acute kidney injury (AKI). Although urinary NGAL is intuitively more appropriate to apprehend renal injury, clinical data have accumulated on the potential interest of NGAL measured indifferently in serum or urine. Diagnostic performance of NGAL greatly varies across studies according to different factors such as the type of patients (pediatric versus adult) and the clinical situations (surgery versus intensive care). Overall, NGAL is presented as a useful tool to diagnose and predict AKI outcome but several issues (the absence of a unique pertinent threshold value, the incomplete analytical validation of its measurement and, its apparent limited clinical added value as compared to traditional AKI markers) remain to be addressed in order to definitely recommend its use in clinical practice.

NGAL biomarqueur de lésion rénale

Neutrophil Gelatinase Associated Lipocalin (NGAL) is one of the most promising biomarkers for acute kidney injury (AKI). Although urinary NGAL is intuitively more appropriate to apprehend renal injury, clinical data have accumulated on the potential interest of NGAL measured indifferently in serum or urine. Diagnostic performance of NGAL greatly varies across studies according to different factors such as the type of patients (pediatric versus adult) and the clinical situations (surgery versus intensive care). Overall, NGAL is presented as a useful tool to diagnose and predict AKI outcome but several issues (the absence of a unique pertinent threshold value, the incomplete analytical validation of its measurement and, its apparent limited clinical added value as compared to traditional AKI markers) remain to be addressed in order to definitely recommend its use in clinical practice.

Effets des médicaments antidiabétiques sur le risque de resténose et sur l’incidence des complications cardiaques après angioplastie coronaire

Les patients diabetiques presentent un risque accru d’insuffisance coronarienne et de complications apres la realisation d’une angioplastie, avec ou sans stent. En particulier, le risque de restenose est augmente, bien qu’il puisse etre significativement reduit avec l’utilisation d’endoprotheses pharmaco-actives. Differentes approches pharmacologiques systemiques ont egalement ete testees pour reduire le risque de restenose apres angioplastie coronaire, avec ou sans stent, mais avec un succes assez mitige. Le but de cet article est de decrire les effets des medicaments antidiabetiques sur le risque de restenose, la necessite de recourir a de nouvelles procedures de revascularisation et l’incidence des evenements cardiaques majeurs (deces, infarctus non mortels et revascularisations). Nous analyserons successivement les effets de la metformine, de l’insuline et des thiazolidinediones (glitazones). Ces dernieres molecules ont montre le meilleur effet protecteur, alors que, paradoxalement, elles font actuellement l’objet de controverse au sujet de leur securite cardiovasculaire dans le traitement du diabete de type 2.