Elevated urine heparanase levels are associated with proteinuria and decreased renal allograft function

• Published in: PloS one Vol. 7; no. 9; p. e44076
• Main Authors: Shafat, Itay, Agbaria, Amir, Boaz, Mona, Schwartz, Doron, Baruch, Ronny, Nakash, Richard, Ilan, Neta, Vlodavsky, Israel, Weinstein, Talia
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.09.2012; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Aged, 80 and over; Angiogenesis; Biology; Cancer; Cancer metastasis; Chronic kidney failure; Consent; Creatine - urine; Diabetes; Diabetes mellitus; Epidermal growth factor receptors; Extracellular matrix; Female; Gene expression; Glomerular Filtration Rate; Glucuronidase - blood; Glucuronidase - urine; Heparan sulfate proteoglycans; Humans; Hypertension; Kidney diseases; Kidney Transplantation; Kidneys; Lupus; Male; Medical research; Medicine; Membranous nephropathy; Metastases; Middle Aged; Nephrology; Nephropathy; Organ transplant recipients; Patients; Plasma; Proteins; Proteinuria; Proteinuria - urine; Proteoglycans; Renal function; Renal Insufficiency, Chronic - therapy; Renal Insufficiency, Chronic - urine; Rodents; Sulfates; Tissues; Transplantation, Homologous; Transplants & implants; Type 2 diabetes; Urine; Tel Aviv Israel; Israel
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0044076

Heparanase is an endo-β-glucuronidase that cleaves heparan sulfate side chains, leading to structural modifications that loosen the extracellular matrix barrier and associated with tumor metastasis, inflammation and angiogenesis. In addition, the highly sulfated heparan sulfate proteoglycans are important constituents of the glomerular basement membrane and its permselective properties. Recent studies suggest a role for heparanase in several experimental and human glomerular diseases associated with proteinuria such as diabetes, minimal change disease, and membranous nephropathy. Here, we quantified blood and urine heparanase levels in renal transplant recipients and patients with chronic kidney disease (CKD), and assessed whether alterations in heparanase levels correlate with proteinuria and renal function. We report that in transplanted patients, urinary heparanase was markedly elevated, inversely associated with estimated glomerular filtration rate (eGFR), suggesting a relationship between heparanase and graft function. In CKD patients, urinary heparanase was markedly elevated and associated with proteinuria, but not with eGFR. In addition, urinary heparanase correlated significantly with plasma heparanase in transplanted patients. Such a systemic spread of heparanase may lead to damage of cells and tissues alongside the kidney.The newly described association between heparanase, proteinuria and decreased renal function is expected to pave the way for new therapeutic options aimed at attenuating chronic renal allograft nephropathy, leading to improved graft survival and patient outcome.