Role Of Neutrophil Gelatinase-associated Lipocalin Research Articles

Systemic reserve dysfunction and contrast-associated acute kidney injury following percutaneous coronary intervention.

Developing contrast-associated acute kidney injury (CA-AKI) following percutaneous coronary intervention (PCI) is closely related to patient-related risk factors as well as contrast administration. The diagnostic and prognostic roles of neutrophil gelatinase-associated lipocalin (NGAL) in CA-AKI following PCI are not well established. Consecutive patients undergoing PCI were enrolled prospectively. CA-AKI was defined as an increase in the serum creatinine level ≥0.3 mg/dL within 48 hours or ≥1.5 times the baseline within 7 days after PCI. Serum NGAL concentrations were determined immediately before and 6 hours after PCI. The participants were classified into four NGAL groups according to the pre- and post-PCI NGAL values at 75th percentile. CA-AKI occurred in 38 (6.4%) of 590 patients. With chronic kidney disease status (hazard ratio [HR] 1.63, 95% confidence interval [CI]: 1.06-2.52), NGAL groups defined by the combination of pre- and 6 h post-PCI values were independently associated with the occurrence of CA-AKI (HR 1.69, 95% CI: 1.16-2.45). All-cause mortality for 29-month follow-ups was different among NGAL groups (log-rank p<0.001). Pre-PCI NGAL levels significantly correlated with baseline cardiac, inflammatory, and renal markers. Although post-PCI NGAL levels increased in patients with larger contrast administration, contrast media made a relatively limited contribution to the development of CA-AKI. In patients undergoing PCI, the combination of pre- and post-PCI NGAL values may be a useful adjunct to current risk-stratification of CA-AKI and long-term mortality. CA-AKI is likely caused by systemic reserve deficiency rather than contrast administration itself.

Neutrophil Gelatinase-Associated Lipocalin as a Marker of Disease Activity in Patients with Ulcerative Colitis Disease

Abstract Background Inflammatory bowel disease (IBD) is an idiopathic disease caused by a dysregulated immune response to host intestinal microflora. Although the etiology of IBD remains largely unknown, it involves a complex interaction between the genetic, environmental, or microbial factors and the immune responses. Aim of the Work This study will assess the the role of neutrophil gelatinase-associated lipocalin (NGAL) as a marker of disease activity in patients with Inflammatory bowel disease. Patients and Methods A cohort prospective study. The study conducted at Ain Shams University Hospitals. The study will take place from August 2020 to February 2021. Our study conducted on 60 Egyptian person over 18 years old visiting the outpatient clinics or admitted in Ain Shams University Hospitals. The study conducted on 40 Egyptian patients with inflammatory bowel disease. Results The present study revealed a highly significant elevation of serum NGAL in active IBD patients with p-value &amp;lt;0.001 which show direct relationship between the activity and severity of UC and CD disease and serum NGAL was positively correlated with inflammatory markers (CRP and ESR) in UC and CD patients. And there is negative relation between serum hemoglobin and NGAL. Conclusion Serum NGAL is a valuable noninvasive marker in the assessment of activity in IBD patients correlated positively with inflammatory markers (CRP and ESR) and markers of disease activity (UCAI and UC histopathology grading in UC patients and clinical CDAI in CD patients). Other studies should be done on larger size of participants to determine the the role of neutrophil gelatinase-associated lipocalin (NGAL) as a marker of disease activity in patients with Inflammatory bowel disease.

Prognostic role of neutrophil gelatinase-associated lipocalin in patients with coronary artery disease and abdominal obesity

Aim. To study the prognostic role of neutrophil gelatinase-associated lipocalin (NGAL) as a marker of adverse cardiovascular events (CVEs) in patients with coro­nary artery disease (CAD) associated with abdominal obesity (AO).Material and methods. This 12-month prospective study included 68 patients diagnosed with CAD who were hospitalized for elective percutaneous coronary intervention (PCI). The median age was 61 [55;65] years. Depending on the presence of obesity according to the World Health Organization (1999) criteria, patients were divided into 2 groups. The 1st group included 30 patients with AO, while the 2nd group — 38 patients without obesity. Patients were measured for waist circumference and hip circumference, and waist-to-hip ratio was calculated. Lipid profile and NGAL concentration were determined. During the study, body mass index (BMI), visceral adiposity index (VAI), triglycerides (TG)/glucose index, lipid accumulation product (LAP), metabolic index (MI), TG to high-density lipoprotein cholesterol ratio (HDL-C). During this period, data was collected on the disease course and intervention outcome. After 12 months an extended examination was performed to assess the endpoints.Results. During the follow-up period, unfavorable cardiovascular events in the 1st group of patients were registered in 33,3% of patients, and in the 2nd group — in 26,3%. In the group of patients with obesity, higher values of anthropometric indices and NGAL were established. The concentration of NGAL has the highest correlation with BMI, MI, LAP and slightly less with total cholesterol and VAI levels. The analysis showed that NGAL &gt;47,1 ng/ml is a predictor of adverse CVEs in patients with CAD and obesity after PCI.Conclusion. Thus, NGAL has the highest correlation with the following indices: BMI, MI, LAP, total cholesterol, and VAI. NGAL &gt;47,1 ng/ml is a predictor of adverse CVEs in patients with CAD and obesity after PCI. NGAL may serve as a promising marker for predicting adverse CVEs. This biomarker already at the stage of hos­pitalization can assess the risk adverse outcomes in patients with CAD and AO, including those who underwent PCI.

Role of Neutrophil Gelatinase-associated Lipocalin (NGAL) and Other Clinical Parameters as Predictors of Bacterial Sepsis in Patients Presenting to the Emergency Department with Fever.

Bacterial sepsis is associated with significant morbidity and mortality. However, to date, there is no single test that predicts sepsis with reproducible results. We proposed that using a combination of clinical and laboratory parameters and a novel biomarker, plasma neutrophil gelatinase-associated lipocalin (NGAL) may aid in early diagnosis. A prospective cohort study was conducted at a tertiary care center in South India (June 2017 to April 2018) on patients with acute febrile episodes fulfilling the Systemic Inflammatory Response Syndrome (SIRS) criteria. Plasma NGAL and standard clinical and laboratory parameters were collected at the admission. Bacterial sepsis was diagnosed based on blood culture positivity or clinical diagnosis. Clinically relevant plasma NGAL cut-off values were identified using the receive operating characteristic (ROC) curve. Clinically relevant clinical parameters along with plasma NGAL's risk ratios estimated from the multivariable Poisson regression model were rounded and used as weights to create a new scoring tool. Of 100 patients enrolled, 37 had bacterial sepsis. The optimal plasma NGAL cut-off value to predict sepsis was 570 ng/mL [area under the curve (AUC): 0.69]. The NGAL sepsis screening tool consists of the following clinical parameter: diabetes mellitus, the presence of rigors, quick sequential organ failure assessment (qSOFA) >2, a clear focus of infection, and the plasma NGAL >570 ng/mL. A score of <3 ruled out bacterial sepsis and a score >7 were highly suggestive of bacterial sepsis with an interval likelihood ratio (LR) of 7.77. The NGAL sepsis screening tool with a score >7 can be used in the emergency department (ED) to identify bacterial sepsis. Paul A, Newbigging NS, Lenin A, Gowri M, Varghese JS, Nell AJ, et al. Role of Neutrophil Gelatinase-associated Lipocalin (NGAL) and Other Clinical Parameters as Predictors of Bacterial Sepsis in Patients Presenting to the Emergency Department with Fever. Indian J Crit Care Med 2023;27(3):176-182.

The Role of Neutrophil Gelatinase-Associated Lipocalin and N-Terminal Pro B-Type Natriuretic Peptide in the Prediction of Heart Failure in Patients with Acute Coronary Syndrome

BACKGROUND: Heart failure, where the heart cannot pump blood effectively, significantly affects patient quality of life and impacts national health-care services. Acute coronary syndrome is a common underlying cause of acute heart failure. Neutrophil gelatinase-binding lipocalin (NGAL) and N-terminal pro B-type natriuretic peptide (NT-proBNP) are biomarkers released during myocardial injury. Thus, the measured levels of these chemicals may be associated with heart failure events in patients with acute coronary syndrome. AIM: The present study determined the serum levels and measured increases in NGAL and NT-proBNP, as well as recorded heart failure events in patients with acute coronary syndrome in Vietnam. METHODS: A descriptive cross-sectional method was used to recruit 58 patients with acute coronary syndrome and assess the degree to which the two markers could predict ejection fraction (EF). RESULTS: The median values of NGAL and NT-proBNP concentrations in the group with EF ≥40% (7.14 ng/mL and 952.00 pg/mL) were significantly lower than those with EF &lt;40% (166.10 ng/mL and 27,498.00 pg/mL). NGAL was used to predict heart failure events at a threshold of 94.86 ng/mL with a sensitivity of 83.3%, a specificity of 90.4%, and an area under the curve (AUC) of 0.83. Similarly, NT-proBNP predicted heart failure events at a threshold of 8660.5 pg/mL with a sensitivity of 83.3%, a specificity of 84.6%, and an AUC of 0.79. CONCLUSIONS: Serum NGAL and NT-proBNP levels can be used as reliable biomarkers for predicting heart failure events in patients with acute coronary syndrome.

Role of neutrophil gelatinase-associated lipocalin (NGAL) as a acute prerenal kidney injury marker: Exploring factors associated with its postoperative levels in hypotension-controlled otorhinolaryngology surgery

Introduction: Acute kidney injury (AKI) is a sudden decrease in kidney function due to damage within seven days or less, thus inducing an early stress response that can be promptly detected by biomarkers, such as Neutrophil Gelatinase-Associated Lipocalin (NGAL). The aim of this study was to analyse the role of NGAL level as a biomarker of postoperative prerenal AKI in patients who underwent otorhinolaryngology surgery with controlled hypotension. Methods: A prospective study was conducted among patients that underwent otorhinolaryngology surgery with controlled hypotension. Patients were selected with purposive sampling. NGAL level was measured using enzyme-linked immunosorbent assay (ELISA) from venous blood collected 1-hour pre- and 2-hour post-surgery. NGAL levels were compared between preoperative and postoperative states. Wilcoxon and Spearman test were used to determine the correlation between NGAL levels and parameters of AKI. Results: A total of 30 patients underwent a varies of otorhinolaryngology surgeries were recruited in this study. Our data suggested no significant different between the level of NGAL during preoperative and postoperative (184.73±120.09 ng/mL vs 175.80±129.97 ng/mL). Pre-operative laboratory parameters of AKI such as blood urea nitrogen (BUN), serum creatine (SCr), BUN/SCr ratio, and GFR had no correlation with postoperative NGAL level. In addition, systolic blood pressure, diastolic blood pressure, MAP, heart rate, EtCO2, duration of surgery and the duration of controlled hypotension had no correlation with postoperative NGAL. Conclusion: NGAL levels have nonsignificant role as biomarker of incidence of postoperative prerenal AKI in patients who receiving otorhinolaryngology surgery with controlled hypotension. However, further study with the bigger sample size is warrant to confirm the findings of this study.

Association of neutrophil gelatinase associated lipocalin, ischemia modified albumin with uric acid in the etiopathogenesis of preeclampsia.

Preeclampsia is a multisystem illness that manifests in the third trimester of pregnancy after 20weeks of gestation and is marked by proteinuria and hypertension (PE). Changes in lifestyle, such as eating a high-calorie dietand delaying delivery, have raised the likelihood of developing PE. Eclampsia, abrupt renal failure, thromboembolic episodes leading to cardiac and brain problems, pulmonary embolism, and coagulopathy associated with HELLP syndrome are a few of the complications that might follow preeclampsia in pregnant moms. The objects of this study is to estimate and correlate the levels of NGAL (neutrophil gelatinase associated lipocalin), IMA (ischemia modified albumin) and Uric acid in prreclampsia. 40 diagnosed cases of preeclampsia and 40 healthy age and gestational age matched healthy controls were included in the study. Blood samples were collected from them and serum NGAL, IMA and Uric acid levels were estimated. Estimation of NGAL (neutrophil gelatinase associated lipocalin), IMA (ischemia modified albumin) was done by commercially available ELISA kits standard spectrophotometry methods in autoanalyzer Mind ray BS300 using commercially available kits. The parameters of NGAL and IMA were significantly increased in patients with PE (p<0.001) when compared with the healthy control subjects. γ-glutamyl transferases and OPN were found in patients with ALD (p<0.001) when compared with the control subjects. OPN showed significant positive correlations with AST (r=0.76, p<0.001), ALT (r=0.64 p<0.001), ALP (r=0.68, p<0.001), and GGT (r=0.61, p<0.001). The current study focuses on the roles of NGAL and IMA, two sensitive markers of kidney injury thatare particularly useful in identifying widespread endothelial dysfunction. As a result, the pattern of elevated NGAL and IMA levels can be useful for diagnosis.

Neutrophil Gelatinase-Associated Lipocalin as Potential Predictive Biomarker of Melanoma and Non-Melanoma Skin Cancers in Psoriatic Patients: A Pilot Study.

Background: Studies have demonstrated a higher risk of nonmelanoma skin cancers (NMSC) and a modestly increased melanoma risk in patients with psoriasis. To date, no biomarkers predictive of evolution have been identified yet. Methods: The aim of this prospective case-control study was to investigate the potential role of neutrophil gelatinase-associated lipocalin (NGAL) as a predictive biomarker of skin cancers in psoriatic patients. Patients with a diagnosis of psoriasis were enrolled, as well as healthy subjects and patients with skin cancers as controls. Plasma protein expression of NGAL, metalloproteinases (MMP)-2, and MMP-9 was performed by an enzyme-linked immunosorbent assay (ELISA). In all the patients who developed skin cancer at follow-up, NGAL, MMP-2, and MMP-9 serum levels were dosed again. Results: Plasma NGAL levels were significantly higher in psoriatic patients with NMSC than without (182.3 ± 36.6 ng/mL vs. 139.9 ± 39.3 ng/mL) (p < 0.001). Plasma NGAL levels were significantly higher (p < 0.00001) in patients with psoriasis and NMSC than in patients with skin tumors without psoriasis (182.3 vs. 122.9). Patients with psoriasis who developed NMSC at follow-up showed increased plasma MMP-9 levels. Conclusion: NGAL seems to play a role in the pathogenesis of NMSC but not melanoma in patients with psoriasis.

The Role of Neutrophil Gelatinase-associated Lipocalin as a Predictive Biomarker of Acute Kidney Injury in Patients Undergoing Major Abdominal Surgery

The Role of Neutrophil Gelatinase-associated Lipocalin as a Predictive Biomarker of Acute Kidney Injury in Patients Undergoing Major Abdominal Surgery

The role of neutrophil gelatinase-associated lipocalin and iron homeostasis in object recognition impairment in aged sepsis-survivor rats

Older adult patients with sepsis frequently experience cognitive impairment. The roles of brain neutrophil gelatinase-associated lipocalin (NGAL) and iron in older sepsis patients remain unknown. We investigated the effects of lipopolysaccharide-induced sepsis on novel object recognition test, NGAL levels, an inflammatory mediator tumor necrosis factor-α (TNFα) levels, and iron ion levels in the hippocampus and cortex of young and aged rats. The effect of an iron chelator deferoxamine pretreatment on aged sepsis rats was also examined. Young sepsis-survivor rats did not show impaired novel object recognition, TNFα responses, or a Fe2+/Fe3+ imbalance. They showed hippocampal and cortical NGAL level elevations. Aged sepsis-survivor rats displayed a decreased object discrimination index, elevation of NGAL levels and Fe2+/Fe3+ ratio, and no TNFα responses. Pretreatment with deferoxamine prevented the reduction in the object recognition of aged sepsis-survivor rats. The elevation in hippocampal and cortical NGAL levels caused by lipopolysaccharide was not influenced by deferoxamine pretreatment. The lipopolysaccharide-induced Fe2+/Fe3+ ratio elevation was blocked by deferoxamine pretreatment. In conclusion, our findings suggest that iron homeostasis in the cortex and hippocampus contributes to the maintenance of object recognition ability in older sepsis survivors.

Role of Urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) in various types of hepatorenal syndrome (HRS) based on New definition

Background and Aim: Hepatorenal syndrome in cirrhosis is known for many years. Recently definition and subgroup of the hepatorenal syndrome had been updated. So, we conducted this study to evaluate the role of neutrophil gelatinase-associated lipocalin (NGAL) in a group of patients divided based on a new definition. Methods: We have enrolled 62 consecutive patients with cirrhosis with HRS based on new criteria given by Angeli et al.'s in their position paper. Patients were also subcategorized into three groups- HRS- AKI, HRS-AKD, and HRS-CKD. Urinary NGAL was measured on Day 3 of admission Results: Among 62 patients, the majority of patients were having HRS-AKI (49 patients, 79%). While 8 patients and 5 patients were having HRS-AKD and HRS-CKD. Urinary neutrophil gelatinase-associated lipocalin (NGAL) was higher in HRS-AKI than in HRS-AKD and HRS-CKD (Median- 463.6 vs 212.2 vs 53 drug/L respectively). Also, urinary NGAL was significantly higher in patients with persistent AKI (18 patients) than transient AKI (31 patients) (421 ± 322 vs 267 ± 188 drug/L). Overall mortality in the HRS-AKI group was 35.7% (31/49 patients). Urinary NGAL level in deceased patients with HRS-AKI was significantly higher than in survived patients (521 345 vs 260 ± 170 drug/L, p-value- 0.04). Conclusions: NGAL measured on day 3 is an important predictor of renal outcome and survival in patients with cirrhosis.

The Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a Biomarker for Monitoring Renal Function in Patients with Solitary Kidney Stones: A Single-Center, Retrospective Analysis of 23 Cases.

To assess the efficacy of flexible ureteroscopy (F-URS) in treating single kidney stones and the role of Neutrophil Gelatinase-Associated Lipocalin (NGAL) in detecting early renal function abnormalities in patients with solitary kidney stones. We retrospectively analyzed 23 patients with solitary kidney nephrolithiasis who underwent F-URS at the Sichuan Science City Hospital between January 2017 and November 2020. We collected data on the following variables: Age, gender, stone size, surgery time, perioperative outcomes, and complications; Stone-free rates (SFRs) were calculated using computed tomography (CT). Serum creatinine (SCr) and NGAL levels were tested before surgery and at one-day and one-month postoperatively. The average size of the stones was 1.53 ± 0.57 cm. The average operating time was 59.28 ± 21.25 minutes. For urethral stricture, three patients (13.0%) required second-stage F-URS. The SFRs were 91.3% following the first and second treatments. The mean NGAL levels were significantly increased at one-day postoperatively compared to baseline (768.91 ± 514.50 ng/mL vs. 173.39 ± 147.94 ng/mL, respectively, p < 0.001). Minor complications, including gross hematuria (n = 5) and mild fever (n = 3), occurred in 34.8% of cases (n = 8), who recovered quickly. F-URS is a safe and efficient therapeutic approach for patients with solitary kidney nephrolithiasis, and NGAL has huge prospects as an indicator of early-stage renal injury in this patient population.

NGAL as a Potential Target in Tumor Microenvironment.

The signaling network between cancer and stromal cells plays a crucial role in tumor microenvironment. The fate of tumor progression mainly depends on the huge amount of information that these cell populations exchange from the onset of neoplastic transformation. Interfering with such signaling has been producing exciting results in cancer therapy: just think of anti-PD-1/anti-PD-L1/anti-CTLA-4 antibodies that, acting as immune checkpoint inhibitors, interrupt the inhibitory signaling exerted by cancer cells on immune cells or the CAR-T technology that fosters the reactivation of anti-tumoral immunity in a restricted group of leukemias and lymphomas. Nevertheless, many types of cancers, in particular solid tumors, are still refractory to these treatments, so the identification of novel molecular targets in tumor secretome would benefit from implementation of current anti-cancer therapeutical strategies. Neutrophil Gelatinase-Associated Lipocalin (NGAL) is a secreted protein abundantly expressed in the secretome of various human tumors. It represents a promising target for the multiple roles that are played inside cancer and stromal cells, and also overall in their cross-talk. The review focuses on the different roles of NGAL in tumor microenvironment and in cancer senescence-associated secretory phenotype (SASP), highlighting the most crucial functions that could be eventually targetable in cancer therapy.

The application of neutrophil gelatin-related lipid delivery protein in evaluation of renal function, nutrition, anemia and inflammation in patients with CKD

ObjectiveTo investigate the role of neutrophil gelatinase-associated lipocalin in the evaluation of renal function, nutrition, anemia and inflammation in patients with chronic kidney diseases. Materials and methodsA total of 302 patients with chronic kidney diseases were selected, and their clinical data, blood neutrophil gelatinase-associated lipocalin levels, renal function, nutrition, anemia, inflammation and calcium, and phosphorus metabolism were analyzed. ResultSerum neutrophil gelatinase-associated lipocalin level increased with the progression of chronic kidney diseases. Higher neutrophil gelatinase-associated lipocalin levels were observed in patients with chronic kidney diseases stage 3b compared with healthy individuals (P<0.05), while the patients with chronic kidney diseases stage 5 showed higher levels compared with other chronic kidney diseases stages (P<0.01). Moreover, the ROC curve showed that neutrophil gelatinase-associated lipocalin had a better diagnostic performance from the chronic kidney diseases stage 3b to 5 (P<0.05). In addition, the serum neutrophil gelatinase-associated lipocalin levels in patient with chronic kidney diseases were negatively correlated with body mass index, number of red blood cells, hemoglobin, transferrin, the estimatedglomerular filtration rate (eGFR), serum calcium (P<0.01); and were positively correlated with mean arterial blood pressure, blood BUN, SCr and alpha 1 microglobulin, beta 2 microglobulin, urinary inhibition C, homocysteine, PTH levels, neutrophils ratio, free serum ferritin and c-reactive protein (P<0.01); while no significant correlation was found with gender, and age (P>0.05). ConclusionSerum neutrophil gelatinase-associated lipocalin levels are closely related to renal function injury, inflammatory response and anemia-related indicators in patients with chronic kidney diseases, and thus could be used as a diagnostic biomarker for evaluating the degree of renal injury and related complications in patients with chronic kidney diseases.

Role of urinary neutrophil gelatinase-associated lipocalin in diabetic and nondiabetic patients with nephropathy

ObjectiveThe aim was to study the role of neutrophil gelatinase-associated lipocalin (NGAL) in diabetic nephropathy patients with type 2 diabetes.BackgroundDue to the high morbidity and mortality associated with diabetic nephropathy, it is important to establish a diagnosis and initiate therapy as soon as possible.Patients and methodsThis observational study was conducted on 88 subjects who were divided into four groups: Group 1 included 22 healthy individuals; group 2 included 22 type 2 diabetic patients with normoalbuminuria;, group 3 included 22 type 2 diabetic nephropathy patients; and group 4 included 22 nondiabetic patients with chronic kidney disease (CKD). All patients were admitted to the Internal Medicine Department at Menoufia University Hospital in the period from 20 December to 13 March 2019. Complete history, examination, and investigations urea, creatinine, fasting blood glucose, postprandial blood glucose, HbA1C, albumin/creatinine ratio, estimated glomerular filtration rate, and urinary NGAL were investigated for all subjects.ResultsUrea, creatinine and albumin/creatinine ratio were statistically significantly increased in diabetic nephropathy groups (145.30 ± 57.93), (3.95 ± 1.57), (201.27 ± 50.04) than in the diabetic group, while estimated glomerular filtration rate was significantly decreased among CKDs (23.64 ± 8.57) and diabetic nephropathy group (30.65 ± 14.34) than the diabetic (174.35 ± 86.13) and control groups (183.27 ± 44.17). Also, the level of NGAL was significantly increased in diabetic nephropathy groups (474.48 ± 308.22) and CKDs (367.37 ± 272.63) than diabetic groups (36.65 ± 28.30) and the control group (22.47 ± 21.16).ConclusionDiagnosis of diabetic nephropathy is based on the rise of creatinine and urea, and albumin/creatinine ratio with a decrease in estimated glomerular filtration rate. NGAL is a marker of CKD and any causes affecting the kidney. Cutoff point for NGAL was greater than 45 in patients with diabetes mellitus and greater than 30 in patients without diabetes, which were the best cutoff point for early detection of diabetic nephropathy.

Role of neutrophil gelatinase-associated lipocalin in renal cell carcinoma.

Human neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein present in a wide variety of tissues and cell types. It exists as a monomer of 25 kDa, a homodimer of 45 kDa or a heterodimer of 135 kDa (disulfide bound to latent matrix metalloproteinase-9). NGAL is considered the biochemical gold standard for the early diagnosis of acute kidney injury and has attracted much attention as a diagnostic biomarker. NGAL has controversial (i.e. both beneficial and detrimental) effects on cellular processes associated with tumor development, such as cell proliferation, survival, migration, invasion and drug resistance. Therefore, the present review aimed at clarifying the role of NGAL in renal cell carcinoma (RCC). Relevant studies of NGAL and RCC were searched in PubMed and relevant information about the structure, expression, function and mechanism of NGAL in RCC were summarized. Finally, the following conclusions could be drawn from the literature: i) NGAL can be detected in cancer tissues, serum and urine of patients with RCC; ii) NGAL is not a suitable diagnostic marker for early screening of RCC; iii) NGAL expression may be used to predict the prognosis of patients with RCC; and iv) Further research on NGAL may be helpful to decrease sunitinib resistance and find new treatment strategies for RCC.

Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker of renal injury in patients with ureteric stones: a pilot study

Objective: The role of neutrophil gelatinase-associated lipocalin in renal obstruction remains unclear. The aim of this study is to assess neutrophil gelatinase-associated lipocalin kinetics and its potential role as a biomarker of renal damage in acute ureteric colic. Methods: Thirty-six patients with acute ureteric colic were prospectively recruited and compared with two control groups. Blood and urine samples for plasma neutrophil gelatinase-associated lipocalin and urinary neutrophil gelatinase-associated lipocalin levels were obtained at various time points. Results: There were significantly higher levels of urinary neutrophil gelatinase-associated lipocalin and the urinary neutrophil gelatinase-associated lipocalin/creatinine ratio at presentation when comparing patients with acute ureteric colic to healthy controls ( P=0.002 and P=0.004, respectively). In patients with acute ureteric colic managed with surgical intervention ( n=27) there was a significant reduction in plasma neutrophil gelatinase-associated lipocalin ( P=0.001) and an increase in the urinary neutrophil gelatinase-associated lipocalin/creatinine ratio 6 hours postoperatively ( P=0.03). Eight of nine patients managed conservatively for acute ureteric obstruction had spontaneous stone passage at follow-up (median 26 days) with a significant reduction in the urinary neutrophil gelatinase-associated lipocalin/creatinine ratio ( P=0.03). Conclusion: The observation of a reduction in plasma neutrophil gelatinase-associated lipocalin and urinary neutrophil gelatinase-associated lipocalin levels following relief of renal obstruction due to ureteric stones suggests the potential role of neutrophil gelatinase-associated lipocalin as a biomarker in this scenario and in the follow-up setting as a potential marker of relief of obstruction. Level of evidence: 3b

Study of the Potential Role of Serum Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels in the Diagnosis and Prognosis of Breast Cancer in Egyptian Females "A Case-Control Study"

Background: Breast cancer (BC) is the most common cause of malignancy in females all over the world. Continuous scientific research for the discovery of new markers helping is a cornerstone for early disease detection and proper management.&#x0D; Aim of the Study: This study aimed to evaluate the role of Neutrophil gelatinase-associated lipocalin (NGAL) as prognostic markers for breast cancer in an Egyptian female population.&#x0D; Patients and Methods: 120 BC patients and 30 healthy controls were the subjects of the study; serum NGAL levels were investigated and correlated with the clinicopathologic characteristics of the BC patients.&#x0D; Results: Our study showed that NGAL was significantly different between healthy controls and BC patients, and it revealed a gradual increase with disease severity.&#x0D; Conclusion: Our findings suggested that NGAL could be diagnostic marker for early case detection, and was shown to be associated with breast cancer prognosis, supporting its role as prognostic biomarker.

Can urinary neutrophil gelatinase-associated lipocalin have a role in the early diagnosis of acute kidney injury after coronary artery bypass graft?

Introduction: The role of urinary neutrophil gelatinase-associated lipocalin (NGAL) as a prognostic biomarker in acute kidney injury (AKI) associated with coronary bypass graft has been suggested in some studies. However, the results have been inconclusive in different studies. Objectives: In the present research, we investigated the diagnostic and prognostic roles of NGAL in Iranian patients who developed AKI after coronary bypass surgery. Patients and Methods: This study was cross-sectional conducted on adult patients undergoing coronary artery bypass graft (CABG) surgery. Postoperative AKI was defined based on the RIFLE (risk, injury, failure, loss and end-stage kidney disease) criteria. Patients were divided into AKI and non-AKI groups. The urinary NGAL and serum creatinine levels were measured at different times after surgery. Results: Out of 29 patients, men constituted 75.9% of cases. Mean age of the patients was 61.4±7.7 years old and the mean duration of surgery was 4.9±0.6 hours. Based on serum creatinine, AKI was diagnosed in 37.9%, 17.25%, and 13.8% of patients at first, second, and third day post-surgery, respectively. The urine NGAL increased by 48.35% and 34.5% at 2 and 6 hours after surgery, respectively. However, there was no significant association between the urinary NGAL level and the incidence of post-surgery AKI. Conclusion: This study showed that urinary NGAL was inapplicable to independently diagnose or predict the outcome of transient AKI associated with CABG.

Implication and role of neutrophil gelatinase-associated lipocalin in cancer: lipocalin-2 as a potential novel emerging comprehensive therapeutic target for a variety of cancer types.

Cancer is a leading cause of mortalities worldwide. Over the past few decades, exploration of molecular mechanisms behind cancer initiation and progression has been of great interest in the viewpoint of both basic and clinical scientists. It is generally believed that identification of key molecules implicated in cancer pathology not only improves our understanding of the disease, but also could result in introduction of novel therapeutic strategies. Neutrophil gelatinase-associated lipocalin (NGAL)/lipocalin-2 (LCN2) is a member of lipocalin superfamily with a variety of functions. Although the main function of LCN2 is still unknown, many studies confirmed its significant role in the initiation, progression, and metastasis of various types of cancer. Furthermore, aberrant expression of LCN2 is also concerned with the chemo- and radio-resistant phenotypes of tumors. Here, we will review the contribution of known functions of LCN2 to the pathophysiology of cancer. We also highlight how the deregulated expression of LCN2 is associated with a variety of fatal types of cancer for which there are no effective therapeutic modalities. The unique and multiple functions of LCN2 and its widespread expression in different types of cancer prompted us to suggest LCN2 could be considered either as a valuable diagnostic and prognostic biomarker or as a potential novel therapeutic target.