Biomarkers in cardiology: lipocalin associated with neutrophil gelatinase (NGAL) and cardiovascular diseases


DOI: https://dx.doi.org/10.18565/therapy.2022.1.50-59

Alieva A.M., Teplova N.V., Reznik E.V., Valiev R.K., Rakhaev A.M., Kudaeva M.V., Akhmatov I.Z., Arakelyan R.A., Nikitin I.G.

1) N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 2) A.S. Loginov Moscow Clinical Research Center of the Healthcare Department of Moscow; 3) Main Bureau of Medical and Social Expertise in the Kabardino-Balkarian Republic of the Ministry of Labor and Social Protection of Russia, Nalchik; 4) V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia
Abstract. The purpose of this review is to consider neutrophil gelatinase-associated lipocalin (NGAL) as a diagnostic and prognostic marker in cardiovascular diseases. The results of various studies show that there is a huge scientific interest in the study of NGAL in cardiovascular pathology. It has been suggested that NGAL may be a marker of atherosclerosis, which was confirmed by a number of studies that demonstrated the overexpression of NGAL in atherosclerotic plaques in areas with high proteolytic activity. It has also been suggested that the role of NGAL in patients with coronary artery disease is associated with matrix metalloproteinase-9. Several studies have reported that NGAL is a marker of adverse cardiovascular events in patients with heart failure.

Literature



  1. Roth G.A., Mensah G.A., Johnson C.O. et al. GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update from the GBD 2019 Study. J Am Coll Cardiol. 2020; 76(25): 2982–3021. https://dx.doi.org/10.1016/j.jacc.2020.11.010.

  2. Алиева А.М., Резник Е.В., Гасанова Э.Т. с соавт. Клиническое значение определения биомаркеров крови у больных с хронической сердечной недостаточностью. Архивъ внутренней медицины. 2018; 5: 333–345. [Alieva A.M., Reznik E.V., Hasanova E.T. et al. Clinical significance of the determination of blood biomarkers in patients with chronic heart failure. Arkhiv vnutrenney meditsiny = Archive of Internal Medicine. 2018; 5: 333–345 (In Russ.)]. https://dx.doi.org/10.20514/2226-6704-2018-8-5-333-345.

  3. Алиева А.М., Пинчук Т.В., Алмазова И.И. с соавт. Клиническое значение определения биомаркера крови ST2 у больных с хронической сердечной недостаточностью. Consilium Medicum. 2021; 6: 522–526. [Alieva A.M., Pinchuk T.V., Almazova I.I. et al. Сlinical value of blood biomarker ST2 in patients with chronic heart failure. Consilium Medicum. 2021; 6: 522–526 (In Russ.)]. https://dx.doi.org/10.26442/20751753.2021.6.200606.

  4. Xu S.Y., Carlson M., Engström A. et al. Purification and characterization of a human neutrophil lipocalin (HNL) from the secondary granules of human neutrophils. Scand J Clin Lab Invest. 1994; 54(5): 365–76. https://dx.doi.org/10.3109/00365519409088436.

  5. Kjeldsen L., Johnsen A.H., Sengeløv H. et al. Isolation and primary structure of NGAL, a novel protein associated with human neutrophil gelatinase. J Biol Chem. 1993; 268(14): 10425–32.

  6. Yan Q.W., Yang Q., Mody N. et al. The adipokine lipocalin 2 is regulated by obesity and promotes insulin resistance. Diabetes. 2007; 56(10): 2533–40. https://dx.doi.org/10.2337/db07-0007.

  7. Yang J., Blum A., Novak T. et al. An epithelial precursor is regulated by the ureteric bud and by the renal stroma. Dev Biol. 2002; 246(2): 296–310. https://dx.doi.org/10.1006/dbio.2002.0646.

  8. Meldrum K.K., Hile K., Meldrum D.R. et al. Simulated ischemia induces renal tubular cell apoptosis through a nuclear factor-kappaB dependent mechanism. J Urol. 2002; 168(1): 248–52. https://dx.doi.org/10.1006/jsre.2001.6201.

  9. Bauvois B., Susin S.A. Revisiting neutrophil gelatinase-associated lipocalin (NGAL) in cancer: Saint or sinner? Cancers (Basel). 2018; 10(9): 336. https://dx.doi.org/10.3390/cancers10090336.

  10. Che K., Han W., Zhang M. et al. Role of neutrophil gelatinase-associated lipocalin in renal cell carcinoma. Oncol Lett. 2021; 21(2): 148. https://dx.doi.org/10.3892/ol.2020.12409.

  11. Tsakogiannis D., Kalogera E., Zagouri F. et al. Determination of FABP4, RBP4 and the MMP-9/NGAL complex in the serum of women with breast cancer. Oncol Lett. 2021; 21(2): 85. https://dx.doi.org/10.3892/ol.2020.12346.

  12. Hemdahl A.L., Gabrielsen A., Zhu C. et al. Expression of neutrophil gelatinase-associated lipocalin in atherosclerosis and myocardial infarction. Arterioscler Thromb Vasc Biol. 2006; 26(1):136–42. https://dx.doi.org/10.1161/01.ATV.0000193567. 88685.f4.

  13. Sivalingam Z., Larsen S.B., Grove E.L. et al. Neutrophil gelatinase-associated lipocalin as a risk marker in cardiovascular disease. Clin Chem Lab Med. 2017; 56(1): 5–18. https://dx.doi.org/10.1515/cclm-2017-0120.

  14. Eilenberg W., Stojkovic S., Kaider A. et al. NGAL and MMP-9/NGAL as biomarkers of plaque vulnerability and targets of statins in patients with carotid atherosclerosis. Clin Chem Lab Med. 2017; 56(1): 147–56. https://dx.doi.org/10.1515/cclm-2017-0156.

  15. Yan L., Borregaard N., Kjeldsen L. et al. The high molecular weight urinary matrix metalloproteinase (MMP) activity is a complex of gelatinase B/MMP-9 and neutrophil gelatinase-associated lipocalin (NGAL). Modulation of MMP-9 activity by NGAL. J Biol Chem. 2001; 276: 37258–65. https://dx.doi.org/10.1074/jbc.M106089200.

  16. Eilenberg W., Stojkovic S., Kaider A., et al. Neutrophil gelatinase associated lipocalin (NGAL) for identification of unstable plaques in patients with asymptomatic carotid stenosis. Eur J Vasc Endovasc Surg. 2019; 57(6): 768–77. https://dx.doi.org/10.1016/j.ejvs.2018.12.029.

  17. Paulsson J., Dadfar E., Held C. et al. Activation of peripheral and in vivo transmigrated neutrophils in patients with stable coronary artery disease. Atherosclerosis. 2007; 192(2): 328–34. https://dx.doi.org/10.1016/j.atherosclerosis.2006.08.003.

  18. Katagiri M., Takahashi M., Doi K. et al. Serum neutrophil gelatinase-associated lipocalin concentration reflects severity of coronary artery disease in patients without heart failure and chronic kidney disease. Heart Vessels. 2016; 31(10): 1595–602. https://dx.doi.org/10.1007/s00380-015-0776-8.

  19. Woitas R.P., Scharnagl H., Kleber M.E. et al. Neutrophil gelatinase-associated lipocalin levels are U-shaped in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study-Impact for mortality. PLoS One. 2017; 12(2): e0171574. https://dx.doi.org/10.1371/journal.pone.0171574.

  20. Li C., Zhang Z., Peng Y. et al. Plasma neutrophil gelatinase-associated lipocalin levels are associated with the presence and severity of coronary heart disease. PLoS One. 2019; 14(8): e0220841. https://dx.doi.org/10.1371/journal.pone.0220841.

  21. Chong J.J.H., Prince R.L., Thompson P.L. et al. Association between plasma neutrophil gelatinase-associated lipocalin and cardiac disease hospitalizations and deaths in older women. J Am Heart Assoc. 2019; 8(1): e011028. https://dx.doi.org/10.1161/JAHA.118.011028.

  22. Soylu K., Nar G., Aksan G. et al. Serum neutrophil gelatinase-associated lipocalin levels and aortic stiffness in noncritical coronary artery disease. Cardiorenal Med. 2014; 4(3–4): 147–54. https://dx.doi.org/10.1159/000365200.

  23. Wong Y.K., Cheung C.Y.Y., Tang C.S. et al. Age-biomarkers-clinical risk factors for prediction of cardiovascular events in patients with coronary artery disease. Arterioscler Thromb Vasc Biol. 2018; 38(10): 2519–27. https://dx.doi.org/10.1161/ATVBAHA.118.311726.

  24. Liu H., Wan X., Shi Y. et al. Neutrophil gelatinase-associated lipocalin contributes to increased risk of cardiovascular death after acute coronary syndrome. Int J Gen Med. 2021; 14: 4887–95. https://dx.doi.org/10.2147/IJGM.S328022.

  25. Зыков М.В., Кашталап В.В., Быкова И.С. с соавт. Клиническое и прогностическое значение сывороточного интерлейкина-18 у больных инфарктом миокарда с подъемом сегмента ST. Российский кардиологический журнал. 2015; 11: 70–74. [Zykov M.V., Kashtalap V.V., Bykova I.S. et al. Clinical and prognostic value of serum interleukin-18 in patients with ST-segment elevation myocardial infarction. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2015; 11: 70–74 (In Russ.)]. https://dx.doi.org/10.15829/1560-4071-2015-11-70-74.

  26. Avci A., Ozturk B., Demir K. et al. The prognostic utility of plasma NGAL levels in ST segment elevation in myocardial infarction patients. Adv Prev Med. 2020; 2020: 4637043. https://dx.doi.org/10.1155/2020/4637043.

  27. Шаленкова М.А., Михайлова З.Д., Климкин П.Ф. NGAL как маркер некоторых внепочечных осложнений при остром коронарном синдроме. Кардиология. 2018; S3: 19–26. [Shalenkova M.A., Mikhailova Z.D., Klimkin P.F. NGAL as a marker of some extrarenal complications in acute coronary syndrome. Kardiologiya = Cardiology. 2018; S3: 19–26 (In Russ.)]. https://dx.doi.org/10.18087/cardio.2416.

  28. Sabanovic-Bajramovic N., Hodzic E., Iglica A. et al. Neutrophil gelatinase-associated lipocalin is a predictor of complications in the early phase of ST-elevation myocardial infarction. Med Glas (Zenica). 2020; 17(2): 328–34. https://dx.doi.org/10.17392/1139-20.

  29. Nymo S.H., Hartford M., Ueland T. et al. Serum neutrophil gelatinase-associated lipocalin (NGAL) concentration is independently associated with mortality in patients with acute coronary syndrome. Int J Cardiol. 2018; 262: 79–84. https://dx.doi.org/10.1016/j.ijcard.2018.03.028.

  30. Lahiri A., Alex A.G., George P.V. Estimating the prevalence of elevated plasma neutrophil gelatinase associated lipocalin level in patients with acute coronary syndromes and its association with outcomes. Indian Heart J. 2018; 70(2): 220–24. https://dx.doi.org/10.1016/j.ihj.2017.06.005.

  31. Frydland M., Mogelvang R., Moller J.E. et al. Neutrophil gelatinase-associated lipocalin (NGAL) measured at admission is associated with development of late cardiogenic shock and mortality in patients with ST-segment elevation myocardial infarction. Shock. 2021; 56(2): 255–59. https://dx.doi.org/10.1097/SHK.0000000000001721.

  32. Yndestad A., Landrø L., Ueland T. et al. Increased systemic and myocardial expression of neutrophil gelatinase-associated lipocalin in clinical and experimental heart failure. Eur Heart J. 2009; 30(10): 1229–36. https://dx.doi.org/10.1093/eurheartj/ehp088.

  33. Villacorta H., Santos R.A., Marroig M.A. et al. Prognostic value of plasma neutrophil gelatinase-associated lipocalin in patients with heart failure. Rev Port Cardiol. 2015; 34(7–8): 473–78. https://dx.doi.org/10.1016/j.repc.2015.02.003.

  34. Damman K., Masson S., Hillege H.L. et al. Clinical outcome of renal tubular damage in chronic heart failure. Eur Heart J. 2011; 32(21): 2705–12. https://dx.doi.org/10.1093/eurheartj/ehr190.

  35. Maisel A.S., Mueller C., Fitzgerald R. et al. Prognostic utility of plasma neutrophil gelatinase-associated lipocalin in patients with acute heart failure: the NGAL EvaLuation Along with B-type NaTriuretic Peptide in acutely decompensated heart failure (GALLANT) trial. Eur J Heart Fail. 2011; 13(8): 846–51. https://dx.doi.org/10.1093/eurjhf/hfr087.

  36. Oikonomou E., Tsalamandris S., Karlis D. et al. The association among biomarkers of renal and heart function in patients with heart failure: the role of NGAL. Biomark Med. 2018; 12(12): 1323–30. https://dx.doi.org/10.2217/bmm-2018-0100.

  37. Labr K., Spinar J., Parenica J. et al. Renal functions and prognosis stratification in chronic heart failure patients and the importance of neutrophil gelatinase-associated lipocalin. Kidney Blood Press Res. 2018; 43(6): 1865–77. https://dx.doi.org/10.1159/000495819.

  38. Алиева А.М., Алмазова И.И., Пинчук Т.В. с соавт. Фракталкин и сердечно-сосудистые заболевания. Consilium Medicum. 2020; 5: 83–86. [Alieva A.M., Almazova I.I., Pinchuk T.V. et al. Fractalkin and cardiovascular disease. Consilium Medicum. 2020; 5: 83–86 (In Russ.)]. https://dx.doi.org/10.26442/20751753.2020.5.200186.

  39. Алиева А.М., Байкова И.Е., Кисляков В.А. с соавт. Галектин-3: диагностическая и прогностическая ценность определения у пациентов с хронической сердечной недостаточностью. Терапевтический архив. 2019; 9: 145–149. [Alieva A.M., Baykova I.E., Kislyakov V.A. et al. Galectin-3: diagnostic and prognostic value in patients with chronic heart failure. Terapevticheskiy arkhiv = Therapeutic Archive. 2019; 9: 145–149 (In Russ.)]. https://dx.doi.org/10.26442/00403660.2019.09.000226.


About the Autors


Amina M. Alieva, PhD, associate professor of the Department of hospital therapy No. 2 of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str. E-mail: amisha_alieva@mail.ru.
ORCID: https://orcid.org/0000-0001-5416-8579. SPIN-code: 2749-6427
Natalia V. Teplova, MD, professor, head of the Department of clinical pharmacology of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str. ORCID: https://orcid.org/0000-0002-7181-4680
Elena V. Reznik, MD, professor, head of the Department of propaedeutics of internal diseases of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, general practitioner, cardiologist, doctor of functional diagnostics, ultrasound diagnostics at City Clinical Hospital No. 31 of the Healthcare Department of Moscow. Address: 117997, Moscow, 1 Ostrovityanova Str.
E-mail: elenaresnik@gmail.com. ORCID: https://orcid.org/0000-0001-7479-418X. SPIN-code: 3494-9080. Researcher ID: N-6856-2016
Ramiz K. Valiev, PhD, head of the Department of oncosurgery No. 2, A.S. Loginov Moscow Clinical Research Center of the Healthcare Department of Moscow. Address: 111123, Moscow, 86 Entuziastov Highway. E-mail: Radiosurgery@bk.ru. ORCID: https://orcid.org/0000-0003-1613-3716. SPIN-code: 2855-2867
Alik M. Rakhaev, MD, professor, head of the expert team of Main Bureau of Medical and Social Expertise in the Kabardino-Balkarian Republic of the Ministry of Labor and Social Protection of Russia. Address: 360051, Nalchik,
47 Gorkogo Str. Е-mail: alikrahaev@yandex.ru. ORCID: https://orcid.org/0000-0001-9601-1174
Madina V. Kudaeva, doctor for medical and social expertise, therapist of expert team of Main Bureau of Medical and Social Expertise in the Kabardino-Balkarian Republic of the Ministry of Labor and Social Protection of Russia. Address: 360009, Nalchik, 131В Tarchokova Str. Е-mail: lyalyusha1974@mail.ru
Islam Z. Akhmatov, student at the Faculty of general medicine, V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, 112 Bolshaya Kazachya Str.
Rosa A. Arakelyan, student at the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str.
E-mail: Elmira.sharm@yandex.ru
Igor G. Nikitin, MD, professor, head of the Department of hospital therapy No. 2 of the Faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str. E-mail: igor.nikitin.64@mail.ru. ORCID: https://orcid.org/0000-0003-1699-0881


Similar Articles


Бионика Медиа