NON-TRADITIONAL KIDNEY BIOMARKERS IN PATIENTS WITH FABRY DISEASE

 

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NON-TRADITIONAL KIDNEY BIOMARKERS IN PATIENTS WITH FABRY DISEASE

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Geraldo
Bezerra da Silva Junior
Igor Moreira de Almeida igormdal@gmail.com Federal University of Ceara Pharmacy/Pharmacology Graduate Program Fortaleza Brazil -
Geraldo Bezerra da Silva Junior geraldobsilvajr@yahoo.com University of Fortaleza Medical Sciences and Public Health Graduate Programs Fortaleza Brazil *
Danielli Oliveira da Costa Lino danielli.lino.hm@gmail.com University of Fortaleza Public Health Graduate Program Fortaleza Brazil -
Amanda Jorge de Sousa Vasconcelos amandajorgesv@edu.unifor.br University of Fortaleza Medical School Fortaleza Brazil -
Gdayllon Cavalcante Meneses gdayllon@yahoo.com.br Federal University of Ceara Pharmacy/Pharmacology Graduate Program Fortaleza Brazil -
Elizabeth De Francesco Daher ef.daher@uol.com.br Federal University of Ceara Department of Internal Medicine Fortaleza Brazil -
Alice Maria Costa Martins martinsalice@gmail.com Federal University of Ceara Pharmacy/Pharmacology Graduate Program Fortaleza Brazil -
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Fabry Disease (FD) is a lysosomal storage disorder caused by genetic variants of the GLA gene on the X chromosome, resulting in absent or reduced activity of the enzyme alpha- galactosidase A. Studies with non-traditional biomarkers are important for detecting early organ dysfunction, even in asymptomatic cases, and identifying risk groups for complications, thus delaying disease progression. The present study aimed to evaluate non-traditional kidney biomarkers in FD.

Fourteen individuals from a family with confirmed FD diagnosis, without clinical kidney disease, from the Metropolitan Region of Fortaleza, Ceara, Brazil, were evaluated. After physical and clinical examinations, the patients underwent blood and urine sample collection for laboratory parameter analysis. The control group consisted of 31 healthy volunteers. Complete blood count and conventional kidney parameters were obtained using an automated biochemical analyzer. The unconventional biomarkers (urinary Nephrin, MCP-1, and NGAL) were evaluated by enzyme immunoassay. Statistical analysis was performed using R Studio software, considering a p-value <0.05 as the significance criterion. 

The studied patients had a mean age of 35±12 years, with 78.6% being female heterozygotes. The most recurrent clinical signs were headache (71.4%), neuropathic pain (57.1%), palpitations (50%), and angiokeratomas (42.9%). Urinary MCP-1 and NGAL levels were higher in the FD group than in the control group (p<0.001), with no changes in conventional markers. Elevated MCP-1 (p<0.001) and Nephrin (p=0.048) levels were associated with dermatological alterations in the patients. 

Non-traditional kidney biomarkers appear to have superior diagnostic sensitivity compared to conventional parameters for detecting subclinical kidney injury and may be related to dermatological manifestations in FD. These biomarkers abnormalities could be used as a possible parameter to indicate early specific treatment in FD.

Kewords