1.Use of beta 2 microglobulin as a kidney function marker
Narantuguldur D ; Khulan P ; Taikhar B ; Naranmandakh G ; Ariunbold J
Health Laboratory 2020;12(2):23-27
Purpose:
Kidney function assessment method is improving gradually. New biomarkers are studied and started using in clinical practice, such as beta 2 microglobulin. Beta 2 microglobulin is improving diagnostic and prognosis in CKD patients. We aimed to assess convenience usage of B2MG alone and B2MG based eGFR in Mongolian patients.
Materials and method:
We included 116 patients diagnosed with CKD and 55 donors whom with normal kidney function.
We collected participant's blood sample by venipuncture in plain vacutainer. Creatinine, urea, cystatin C, B2MG were tested by Roche Cobas C311 equipment in serum. eGFR was calculated by online calculation from NKF. B2MG based eGFR was calculated by eGFR=133*B2M-0.852
Result:
Assessment of kidney biomarkers and eGFR was significantly correlated in both groups. Measured serum creatinine was 3.37 mg/dl in CKD patients and 0.87 mg/dl in donors. Serum urea was 97.6 mg/dl, 31.1 mg/dl, cystatin C 3.05 mg/L, 1.49mg/L and beta 2 microglobulin 10.65 mg/L, 2.43 mg/L respectively. Estimated GFR was 21.5-28.4 ml/min/1.73m2 in CKD patients and 47.7-103.9 ml/min/1.73m2 in donors.
Assessing kidney function by biomarkers (r=0.720-0.918, p<0.05), and eGFR (r=0.495-0.996, p<0.05) were significantly correlated in both groups.
Conclusion
B2MG can be used in clinical practice in Mongolia. B2MG is optional with creatinine, urea, cystatin C for assessing and improving kidney function.
2.Evaluation the renal status of kidney donors in light of biomarcers and eGFR
Khulan P ; Narantuguldur D ; Naran G ; Bayan-Undur D ; Ganbold G ; Sarantsetseg G
Health Laboratory 2019;10(2):10-19
Purpose:
Follow-up examinations in kidney donors is an essential yet necessary process in organ transplantation. In this study, we aimed to evaluate kidney function using biomarkers and biomarker based eGFR in kidney donors within 5 years of organ transplantation.
Materials and method:
91 donors enrolled in our study. We measured body weight and blood and urine samples for laboratory tests. eGFR was calculated using 6 estimations.
Result:
The mean serum creatinine in participants was 0.81±0.22 mg/dL, cystatin C was 1.11±0.19 mg/dL, urea was 31.44±8.02 mg/L. Systolic hypertension in subjects was 130.0±16.5 mmHg while diastolic hypertension was 78.4±10.8 mmHg. In all donors, 15.9% (n=14) had hematuria, 23.6% (n=21) had proteinuria, 24.7% (n=19) had albuminuria. Body weight, creatinine, cystatin C and urea measurements had gradually increased over the years. The average eGFR was 72.9±17.9 to 112.8±34.0 ml/min/1.73m2 showing 0.15%-35.22% before donation. Follow – up rate was 28.3-59.2% of total donors.Having health insurance and living far from Ulaanbaatar city influenced follow – up rate. Donor registration data should be updated regularly.
Conclusion
1. Serum creatinine, cystatin C, urea was increasing in living kidney donors. Hypertension and microalbuminuria was greater than other donor study results.
2. eGFR decreased 0.15-35.22% in donor. CKD EPI combined equation was best for donor.
3. Health insurance and living far from Ulaanbaatar city were the influencing follow – up rate. Registration data is missing in 25.5%-82.4% of total donors suggesting enhancement in data collection.
3.A new diagnostic biomarker in early detection of Hepatocellular Carcinoma
Batchimeg B ; Baljinnyam T ; Khulan U ; Khaliun M ; Bilguun E ; Munkhtsetseg B ; Terguunbileg B ; Chinzorig M ; Gan-Erdene B ; Bilegtsaikhan Ts ; Erkhembulgan P ; Batbold B ; Munkhbat B ; Munkhtuvshin N ; Munkhbayar S
Mongolian Medical Sciences 2021;197(3):10-16
Background and Aims:
Hepatocellular carcinoma (HCC) is a common cause of cancer related death
in Mongolia. Early diagnosis is the very important management to increase successful treatment
and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC)
tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a
diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic
value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic
biomarker of HCC.
Methods:
We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver
cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP)
levels were measured using commercially available enzyme-linked immunosorbent assay kits. The
diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and
estimated sensitivity and specificity of each biomarker.
Results:
sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and
healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity
was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999
(0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6
ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 %
with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%).
Conclusion
Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC.
Combination of two markers showed greatest diagnostic accuracy.
4.The effects of Particulate matter (PМ2.5) pollutants on cancer cells in in vitro model
Baljinnyam T ; Bilguun E ; Batchimeg B ; Zolzaya D ; Lkhaasuren N ; Oyungerel G ; Munkhtsetseg B ; Khaliun M ; Khulan U ; Batkhishig M ; Uranbileg U ; Sonomdagva Ch ; Bilegtsaikhan Ts ; Munkhbayar S ; Munkhtuvshin N ; Erkhembulgan P
Mongolian Medical Sciences 2021;197(3):17-25
Introduction:
Air pollution has become one of the major problems in socio-economic and health
issues in Mongolia. Among the various hazards of particulate matter (PM) pollutants, microorganisms
in PM2.5 and PM10 are thought to be responsible for various allergies and for the spread of respiratory
diseases. Recent studies have shown that PM2.5 particles can cause chronic heart failure, heart
arrhythmias, and strokes, as well as lung damage, cirrhosis, inflammation, cancer, cardiovascular
disease, and metabolic disorders. Furthermore, some studies have concluded that PM2.5 particles
in the environment are a risk factor for gastrointestinal, liver, colon, and lung cancer as well as it
affects the growth and metastasis of various cancer cells caused by other factors. In our country, the
health effects of air pollution and the relationship between the pathogenesis of cancer research are
scarce. Therefore, the study of the effects of PM2.5 particles on cancer cell proliferation, migration
(metastasis) can provide a significant role for cancer treatment, diagnosis, and prevention.
Purpose:
Determining the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis)
in in-vitro
Material and Methods:
A human liver cancer cell line (HepG2), human gastric cancer cell line (AGS)
were obtained from the central scientific research laboratory in the Institute of medical sciences.
HepG2, AGS cells were seeded at a concentration of 1*105 cells/mL in a culture flask and cultured
in RPMI-1640 medium supplemented with 10% FBS, 1% antibiotic mix (penicillin, streptomycin) in a
humidified atmosphere of 5% CO2 at 37 °C. The cytotoxic effect of PM 2.5 in AGS, HepG2 cells were
evaluated by MTT, CCK8 assays. AGS, HepG2 cells were incubated in 96 well plates for 24h then
treated with different concentrations (0, 5, 10, 25, 50 and 100 μg ) of Bayankhoshuu, Buhiin urguu,
and Zaisan samples for 24h, respectively.
Results:
Concentrations of 10, 25, and 50 μg/ml of samples collected from the Bukhiin urguu and
Zaisan in March increased HepG2 cell growth, while doses of 25, 50 μg/ml of samples collected from
Bayankhoshuu in March and December increased HepG2 cell growth. Therefore, concentrations of
25 and 50 μg/ml of samples collected from Bayankhoshuu in March increased AGS cell growth, while concentrations of 25, 100 and μg/ml of samples collected in December increased AGS cell growth.
However, no cytotoxic effect was observed in the sample collected from Zaisan in March, whereas
the PM2.5 sample enhanced AGS cell growth in dose dependent manner in December.(p <0.05)
Conclusion
High levels of heavy metals were detected in samples collected in December from
Bayankhoshuu, Bukhiin urguu and Zaisan of Ulaanbaatar. Concentration of 25 μg/ml of samples
collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth. Concentrations
of 25 μg/ml of PM2.5 collected from three regions around Ulaanbaatar increased HepG2 and AGS
cell migration.