Title:Novel Biomarkers for Posterior Urethral Valve
Volume: 30
Issue: 15
Author(s): Beatriz Castello Branco, Bruno Wilnes, Pedro Alves Soares Vaz de Castro, Caio Ribeiro Vieira Leal and Ana Cristina Simões e Silva*
Affiliation:
- Laboratory of Medical Investigation, Unit of Pediatric Nephrology, Faculty of Medicine, Federal University
of Minas Gerais (UFMG), Brazil
Keywords:
Biomarkers, posterior urethral valve, congenital anomalies of the kidney and urinary tract, children, proteomics, metabolomics, genomics, therapeutic targets.
Abstract: The posterior urethral valve (PUV) is one of the main causes of congenital obstruction
of the lower urinary tract in pediatrics. Its occurrence, although rare, can cause
chronic kidney disease (CKD), with frequent progression to end stage kidney disease.
Therefore, the development of new diagnostic strategies, such as biomarkers, is crucial to
better assess the prognosis of patients with PUV. We aimed to review the literature on traditional
and new biomarkers in PUV. For that, searches were performed in
PubMed/MEDLINE, Scopus and SciELO databases. To systematize the search, terms
such as “Posterior Urethral Valve”, “Prognosis”, “Biomarkers” and variations described
in the Medical Subject Headings (MeSH) database were used. The literature showed new
biomarkers of disease prognosis, with emphasis on inflammatory cytokines, proteomics
and genomics techniques, as well as classic biomarkers, focusing on serum creatinine
and urine osmolality. As for biomarkers recently described in the literature, the 12PUV, a
set of 12 fetal urinary peptides that accurately predicted postnatal kidney function in fetuses
with PUV, stands out. Similarly, oxidative stress markers, inflammatory cytokines
and components of the renin-angiotensin system (RAS), when increased, were indicative
of severe kidney outcomes. Genetic alterations also correlated to worse prognosis among
patients with PUV, with emphasis on RAS polymorphisms and, specifically, those affecting
the angiotensin-converting enzyme (ACE) and the angiotensin II receptors types 1
and 2 (AGTR1 and AGTR2) genes. Considering the severity of the PUV condition, the
identification of sensitive and cost-effective biomarkers, beyond improving diagnosis,
may favor the investigation of new therapeutic strategies.
