Toxic Nephropathy Biomarkers in Organic Solvents-Exposed Workers: Special Emphasis on Cystatin C and Transforming Growth Factor Beta1

Manal H. Ahmed1, Neveen A. El-Desouky1, Laila A. Rashed2, and Nermeen A. El-Desouky3

1 From Industrial Medicine & Occupational Disease, Forensic Medicine & Clinical Toxicology, 2 Medical Biochemistry,
and 3 Clinical Pathology, Faculty of Medicine, Cairo University, Egypt

Corresponding author: Prof. Dr. Manal Hassan Ahmed
    Department of Occupational Medicine and Industrial diseases,
    Faculty of Medicine, Cairo University
    Telephone: Telephone number: 33288687, 0123897715
    E-mail: manalmohy@hotmail.com

CEJOEM 2008, Vol.14. No.3.: 249-262

Key words:
organic solvents, cystatin C, nephrotoxicity, TGF β1, creatinine and markers

Abbreviations:
BM
GR
ELISA		 = Biomonitoring
= Glomerular filtration rate
= Enzyme Linked Immunoassay		 ROC
SPSS
TGF-β1		 = Receiver operator characteristics
= Statistical Package for the Social Science
= Transforming growth factor-beta1

Abstract:
Rationale and background:  The kidney is the target of numerous xenobiotic toxicants, including environmental chemicals. The aim of the present study was to evaluate some biomarkers of organic solvents nephrotoxicity.
    Subjects and methods:  28 subjects were included in this study, they were classified into 2 groups: Group I included 10 workers in Kasr El Eini outpatient clinic and not exposed to organic solvents (control group) and Group II included 18 workers working in an organic solvent factory (exposed group). The following investigations were performed for every subject: Serum cystatin C, urinary cystatin C, serum transforming growth factor (TGF β1) and serum creatinine.
    Results:  Group II had statistically significant higher serum cystatin C, TGF β1 and creatinine and statistically significant lower urinary cystatin C than Group I. Moreover, there was a statistically significant positive correlation between the serum cystatin C and creatinine and a statistically significant negative correlation between both markers and the urinary cystatin C. In addition, serum cystatin C had 100% sensitivity and specificity, serum TGF β1 had 94.4% sensitivity and 90% specificity while serum creatinine had 88.9% sensitivity and 80% specificity in detecting nephrotoxicity.
    Conclusion and recommendations:  Serum cystatin C is a better marker in detecting early nephrotoxicity than either serum TGF β1 or serum creatinine thus, we recommend its use as a routine marker for the evaluation of kidney functions in organic solvents nephrotoxicity.

Received: 7 March 2008
Accepted: 22 May 2009
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