Abstract:
:Low molecular-mass plasma proteins play a key role in health and disease. Cystatin C is an endogenous cysteine proteinase inhibitor belonging to the type 2 cystatin superfamily. The mature, active form of human cystatin C is a single non-glycosylated polypeptide chain consisting of 120 amino acid residues, with a molecular mass of 13,343-13,359 Da, and containing four characteristic disulfide-paired cysteine residues. Human cystatin C is encoded by the CST3 gene, ubiquitously expressed at moderate levels. Cystatin C monomer is present in all human body fluids; it is preferentially abundant in cerebrospinal fluid, seminal plasma, and milk. Cystatin C L68Q variant is an amyloid fibril-forming protein with a high tendency to dimerize. It forms self-aggregates with massive amyloid deposits in the brain arteries of young adults, leading to lethal cerebral hemorrhage. The main catabolic site of cystatin C is the kidney: more than 99% of the protein is cleared from the circulation by glomerular ultrafiltration and tubular reabsorption. The diagnostic value of cystatin C as a marker of kidney dysfunction has been extensively investigated in multiple clinical studies on adults, children, and in the elderly. In almost all the clinical studies, cystatin C demonstrated a better diagnostic accuracy than serum creatinine in discriminating normal from impaired kidney function, but controversial results have been obtained by comparing this protein with other indices of kidney disease, especially serum creatinine-based equations. In this review, we present and discuss most of the available data from the literature, critically reviewing conclusions and suggestions for the use of cystatin C in clinical practice. Despite the multitude of clinical data in the literature, cystatin C has not been widely used, perhaps because of a combination of factors, such as a general diffidence among clinicians, the absence of definitive cut-off values, conflicting results in clinical studies, no clear evidence on when and how to request the test, the poor commutability of results, and no accurate examination of costs and of its routine use in a stat laboratory.
journal_name
Crit Rev Clin Lab Scijournal_title
Critical reviews in clinical laboratory sciencesauthors
Mussap M,Plebani Mdoi
10.1080/10408360490504934keywords:
subject
Has Abstractpub_date
2004-01-01 00:00:00pages
467-550issue
5-6eissn
1040-8363issn
1549-781Xjournal_volume
41pub_type
杂志文章,评审abstract::The physical properties and chemical composition of urine are highly variable and are determined in large measure by the quantity and the type of food consumed. The specific gravity is the ratio of the density to that of water, and it is dependent on the number and weight of solute particles and on the temperature of ...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368809105890
更新日期:1988-01-01 00:00:00
abstract::Alpha fetoprotein (AFP) is the major protein of fetal serum and most resembles albumen, which replaces it shortly after birth. It is produced by fetal liver and passes into the amniotic fluid (AF) via fetal urine. A small amount crosses the membranes into the maternal circulation. Excluding fetal blood contamination, ...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368109105870
更新日期:1981-01-01 00:00:00
abstract::Serum gamma-glutamyl transferase (GGT) has been widely used as an index of liver dysfunction and marker of alcohol intake. The last few years have seen improvements in these areas and advances in understanding of its physiological role in counteracting oxidative stress by breaking down extracellular glutathione and ma...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/20014091084227
更新日期:2001-08-01 00:00:00
abstract::The constrained economic context leads laboratories to centralize their routine analyses on high-throughput platforms, to which blood collection tubes are sent from peripheral sampling sites that are sometimes distantly located. Providing biochemistry results as quickly as possible implies to consolidate the maximum n...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408363.2018.1499708
更新日期:2018-11-01 00:00:00
abstract::There have been numerous reports of spectrophotometric and volume problems caused by elevated levels of lipids in blood. The offending lipids, primarily triglycerides, not only cause turbidity leading to optical aberrations when added to analytical reagents, but also result in short-sampling errors leading to the meas...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368709105876
更新日期:1987-01-01 00:00:00
abstract::Cancer is a major and increasing public health problem worldwide. Traditionally, the diagnosis and staging of cancer, as well as the evaluation of response to therapy have been primarily based on morphology, with relatively few cancer biomarkers currently in use. Conventional biomarker studies have been focused on sin...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408360600922632
更新日期:2006-01-01 00:00:00
abstract::Hemophilia care depends on several factors for the production of purified FVIII: plasma procurement, plasma logistics, production method, and efficacy. The latter two are restrictive factors, both for the supply and the safety of FVIII preparations. Conventional production methodology unavoidably recovers only 10 to 2...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368609111596
更新日期:1986-01-01 00:00:00
abstract::The substrate spectrum of human UDP-glucuronosyltransferase 1A (UGT1A) proteins includes the glucuronidation of non-steroidal anti-inflammatory drugs, anticonvulsants, chemotherapeutics, steroid hormones, bile acids, and bilirubin. The unique genetic organization of the human UGT1A gene locus, and an increasing number...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408360802374624
更新日期:2008-01-01 00:00:00
abstract::Iron deficiency is the most common micronutrient deficiency in the world and represents a major challenge for public health, notably in terms of morbidity and mortality. It remains largely under-diagnosed due to the low level of exploration and the absence of international harmonization for biological tests and thresh...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章
doi:10.1080/10408363.2019.1653820
更新日期:2019-12-01 00:00:00
abstract::Bartter's and Gitelman's syndromes can be used as models to gain insight into the mechanisms responsible for maintaining/controlling vascular tone. In fact, the study of patients with these syndromes provides important insights into mechanistic details of the most relevant pathways of vascular tone. So far, several ex...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408360091174295
更新日期:2000-12-01 00:00:00
abstract::Reviewed are the phosphorylation events reporting activation of protein kinases and the key substrates critical for the DNA damage signaling (DDS). These DDS events are detected immunocytochemically using phospho-specific Abs; flow cytometry or image-assisted cytometry provide the means to quantitatively assess them o...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408363.2012.738808
更新日期:2012-09-01 00:00:00
abstract::Oncogenes and tumor suppressor genes are genes involved in cell proliferation and differentiation. They play a crucial role in the initiation and progression of cancer. Some of these genes are found to be altered in human cancers, i.e., mutated, amplified, deleted, translocated, or abnormally regulated. Recently, the ...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408369209114603
更新日期:1992-01-01 00:00:00
abstract::Muscle wasting in patients with sepsis, severe injury, and cancer is associated with increased transcription of several genes regulating different proteolytic pathways. The involvement of gene activation in muscle wasting suggests that transcription factors and nuclear cofactors play important roles in the regulation ...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章
doi:10.3109/10408363.2011.591365
更新日期:2011-03-01 00:00:00
abstract::The discovery of vitamin D receptor (VDR) expression in immune cells has opened up a new area of research into immunoregulation by vitamin D, a niche that is distinct from its classical role in skeletal health. Today, about three decades since this discovery, numerous cellular and molecular targets of vitamin D in the...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408363.2015.1094443
更新日期:2016-01-01 00:00:00
abstract::The presence of circulating tumor cells (CTCs) in peripheral blood can serve as a "liquid biopsy" approach and has thus emerged lately as one of the hottest fields in cancer research. CTCs can be isolated from blood in a non-invasive approach, and can be used to follow patients over time since these cells can provide ...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408363.2014.896316
更新日期:2014-06-01 00:00:00
abstract::Cardiac diseases have been extensively studied following diabetes and altered metabolism has been implicated in its initiation. In this context, there is a shift from glucose utilization to predominantly fatty acid metabolism. We have focused on the micro- and macro-environments that the heart uses to provide fatty ac...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408363.2014.997931
更新日期:2015-01-01 00:00:00
abstract::This review focuses on the laboratory biochemical tests that are useful in the diagnostic approach to the hypertensive patient. A "minimal" diagnostic laboratory work-up, including a small number of tests that are simple and relatively inexpensive, is first described. Because these tests provide basic information on t...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408360500295600
更新日期:2005-01-01 00:00:00
abstract::Allogeneic bone marrow transplantation now has an established place in the treatment of severe aplastic anemia and acute leukemia. Major problems to be overcome in transplantation in patients with aplastic anemia are marrow graft rejection and graft vs. host disease. Results are better in younger patients and in patie...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368309165762
更新日期:1983-01-01 00:00:00
abstract::The CK-BB isoenzyme is ubiquitous in neoplastic tissue, but with low activity. Accordingly, it might be a nonspecific and insensitive tumor marker. Evaluation of BB isoenzyme in serum might indicate the extent of diseases or the response to therapy. The presence of CK-MB in patients with cancers may cause confusion wi...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368609165795
更新日期:1986-01-01 00:00:00
abstract::Sepsis is an unusual systemic reaction to what is sometimes an otherwise ordinary infection, and it probably represents a pattern of response by the immune system to injury. A hyper-inflammatory response is followed by an immunosuppressive phase during which multiple organ dysfunction is present and the patient is sus...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408363.2013.764490
更新日期:2013-01-01 00:00:00
abstract::Isoforms of the receptor for advanced glycation end-product (RAGE) protein, which lack the transmembrane and the signaling (soluble RAGE or sRAGE) domains are hypothesized to counteract the detrimental action of the full-length receptor by acting as a decoy, and they provide a potential tool to treat RAGE-associated d...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章
doi:10.1080/10408363.2020.1791045
更新日期:2020-07-15 00:00:00
abstract::The deoxyuridine suppression (dU) test, first described in 1964, has gained an important place both in the diagnosis of megaloblastic anemias and in the study of vitamin B12 folate interrelationships in the pathogenesis of megaloblastic anemia. The test measures the integrity of the de novo synthetic pathway of DNA sy...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368409165775
更新日期:1984-01-01 00:00:00
abstract::Regarding the widespread progression of diabetes, its related complications and detrimental effects on human health, investigations on this subject seems compulsory. AMP-activated protein kinase (AMPK) is a serine/threonine kinase and a key player in energy metabolism regulation. AMPK is also considered as a prime tar...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408363.2019.1648376
更新日期:2019-11-01 00:00:00
abstract::Infection with hepatitis delta virus (HDV), a satellite virus of hepatitis B virus (HBV), is associated with severe and sometimes fulminant hepatitis. The traditional methods for the diagnosis of HDV infection, such as detection of serum anti-HD antibodies, are sufficient for the clinical diagnosis of delta infection....
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408360091174178
更新日期:2000-02-01 00:00:00
abstract::Maximum stability of analytes in chemistry control materials is desired. Stability testing is customarily performed by manufacturers, both prior to distribution of products and during the period following distribution when the products are in the field. Users and evaluators of such materials periodically have reported...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368209107031
更新日期:1982-01-01 00:00:00
abstract::As the primary interface between the blood and various tissues of the body, the vascular endothelium exhibits a diverse range of roles and activities, all of which contribute to the overall health and function of the cardiovascular system. In this focused review, we discuss several key aspects of endothelial function,...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408363.2017.1394267
更新日期:2017-01-01 00:00:00
abstract::Isoelectric focusing (IEF) as a method for differentiating macromolecules with minor differences in isoelectric points has demonstrated an increase in the degree of genetic polymorphisms of the blood. Studies over the last 5 to 6 years have shown that genetic marker systems such as transferrin (TF), phosphoglucomutase...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368409165772
更新日期:1984-01-01 00:00:00
abstract::Hereditary hemochromatosis (HH) comprises a group of inherited disorders of iron metabolism that can result in progressive iron overload, morbidity, and mortality, generally in adulthood. HFE-related HH is the most common type of HH and will form the core of this discussion. The discovery of new proteins and gene muta...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408360802335716
更新日期:2008-01-01 00:00:00
abstract::The prevalence of secondary hypertension can be underestimated if appropriate tests are not performed. The importance of selecting patients with a high pre-test probability of secondary forms of hypertension is first discussed. The laboratory tests currently used for seeking a cause of hypertension are critically revi...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.1080/10408360600931831
更新日期:2007-01-01 00:00:00
abstract::Most clinical chemical analytes vary in a random manner around a homeostatic set point. Replicate analyses of a series of specimens collected from a group of subjects allows estimation of analytical, within and between subject components of variation. The preferred experimental procedures and statistical methods for e...
journal_title:Critical reviews in clinical laboratory sciences
pub_type: 杂志文章,评审
doi:10.3109/10408368909106595
更新日期:1989-01-01 00:00:00