Serum S100A8/A9 and RNA-binding protein, tristetraprolin as prognostic markers of renal damage
Authors: Mohammed Radhi Fatima Al-Zahra’a , Almzaie Anwar Jasib , Majeed Mohauman Mohammed 
Published: February 2024

Background & objective: The kidneys are vital and complex organs responsible for maintaining normal body functions. Kidney disease or a loss of kidney function and, in severe cases, complete kidney failure disrupt whole of the body systems. Tristetraprolin (TTP ZFP36) is an RNA-binding proteins (RBP), that regulates cytokine mRNAs by specific binding of its two conserved ZF domains to adenylate-uridylate-rich elements (AREs) at the untranslated region (UTR), leading to degradation of the RNA. Recently, it was suggested that S100 A8/A9 and TTP were involved in pathogenesis of renal diseases. However, the protective roles of S100 A8/A9 and TTP in renal disease is still unclear. The primary objective of this study was to explore the involvement of S100 A8/A9 and TTP in the inflammatory response among different groups of kidney diseases. These factors may hold therapeutic value in the treatment of these diseases by targeting and modulating the inflammatory response.
Methodology: The study was performed between October 2022 to April 2023. We included 150 subjects, including 30 patients with chronic kidney disease (CKD), (Female = 16, Male = 14) with mean age (58.33 ± 18.33 y), 30 patients with acute kidney injury (AKI), (Female = 15, Male = 15), with mean age (54.48 ± 18.10 y), 30 patients with diabetic nephropathy (DN), (Female = 18, Male = 12), with mean age (60.84 ± 12.38 y), 30 patients with nephrotic syndrome (NS), (Female = 13, Male = 17), with mean age (52.54 ± 14.02 y), and 30 healthy persons as a control group. NLR analysis was performed directly using the hematology analyzer CBC (Sysmex, Japan) technique, serum S100 A8/A9 were measured by ELISA, and TTP gene expression was measured by Quantitative Real Time-Polymerase Chain Reaction (RT-qPCR).
Results: In comparison to the healthy control group, all patient groups exhibited a significant increase in the NLR (P < 0.05). Furthermore, the findings clearly demonstrated elevated levels of S100 A8/A9 in all patient groups when compared to the control group (P ≤ 0.05). The results also demonstrated a significant down regulation in the expression of TTP in DN and nephrotic syndrome (NS) groups compared to the control (P ≤ 0.01). AKI showed highly significant increase in TTP expression in comparison to control and other patient groups (P ≤ 0.01). Non-significant decrease in TTP gene expression was indicated in CKD compared to healthy group (P ≥ 0.05).
Conclusions: The activation of Ca2+-binding protein S100A8/A9 is involved in the renal damage; thus, targeting it could have a therapeutic value in the treatment of kidney diseases. Tristetraprolin is contributed to the regulation of inflammatory events in kidney diseases especially in AKI group due to a rapid and robust inflammatory response that contributes to the pathogenesis of this disease.
Abbreviations: AKI- acute kidney injury ARE- Adenylate-Uridylate-Rich Element; DN- diabetic nephropathy; NS- Nephrotic Syndrome; NLR- Neutrophil-to-Lymphocyte Ratio; RT-qPCR= Quantitative Real Time-Polymerase Chain Reaction; RBP- RNA-Binding Proteins; TTP- Tristetraprolin; UTR- Untranslated Region;
Key words: Kidney diseases; S100 A8/A9, Anti-inflammatory RNA binding protein; Tristetraprolin; Neutrophil/Lymphocyte Ration
Citation: Mohammed Radhi FZ, Almzaie AJ, Majeed MM. Serum S100A8/A9 and RNA-binding protein, tristetraprolin as prognostic markers of renal damage. Anaesth. pain intensive care 2023;27(6):706−714; DOI: 10.35975/apic.v27i6.2342
Received: August 12, 2023; Revised: September 05, 2023; Accepted: September 07, 2023