Amniotic fluid peptides predict postnatal kidney survival in developmental kidney disease

نویسندگان

چکیده

Although a rare disease, bilateral congenital anomalies of the kidney and urinary tract (CAKUT) are leading cause end stage disease in children. Ultrasound-based prenatal prediction postnatal survival CAKUT pregnancies is far from accurate. To improve prediction, we conducted prospective multicenter peptidome analysis amniotic fluid spanning 140 evaluable fetuses with CAKUT. We identified signature 98 endogenous peptides, mainly composed fragments extracellular matrix proteins actin binding protein thymosin-?4. The peptide predicted outcome an area under curve 0.96 holdout validation set patients definite endpoint data. Additionally, this was validated geographically independent sub-cohort 12 (area 1.00) displayed high specificity non-CAKUT (82 94% 22 healthy 47 cytomegalovirus infection respectively). Change thymosin-?4 abundance confirmed ELISA. Knockout zebrafish altered proximal distal tubule pronephros growth suggesting possible role thymosin ?4 fetal development. Thus, recognition 98-peptide during diagnostic workup prenatally detected can provide long-sought evidence base for accurate management disorder that currently unavailable.

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ژورنال

عنوان ژورنال: Kidney International

سال: 2021

ISSN: ['0085-2538', '1523-1755']

DOI: https://doi.org/10.1016/j.kint.2020.06.043