La proteína KIM-1, un biomarcador asociado a la enfermedad renal
Resumen
La enfermedad renal o de riñón es una anormalidad funcional de los riñones que tiene implicaciones en la salud. El daño agudo de riñón y la enfermedad renal crónica presentan una elevada incidencia en México y representan un problema de salud pública con repercusiones económicas importantes. El diagnóstico oportuno de la enfermedad renal tendría un efecto positivo en la eficacia del tratamiento y en el pronóstico de la enfermedad. KIM-1(Kidney Injury Molecule-1) es una glicoproteína que actúa como receptor para fosfatidilserina y TIM-4 (T-Cell Immunoglobulin and Mucin Domain-4); aunque se expresa en diferentes células y tejidos, su expresión se produce principalmente en células del epitelio tubular proximal de las nefronas. En personas sanas KIM-1 no se expresa, pero durante el daño en las células epiteliales tubulares, se sobreexpresa y su fracción soluble es secretada en orina y/o filtrada a la sangre, lo que aumenta su concentración y permite su detección en estos fluidos; por esta razón, se ha propuesto como un biomarcador de daño renal. En fases tempranas, KIM-1 tiene una función protectora ante el insulto renal, pero su expresión sostenida en células del epitelio tubular se ha asociado con la enfermedad renal crónica y la fibrosis renal. En esta revisión, describimos la estructura de KIM-1, su expresión y su función tanto en el sistema inmunológico como en la enfermedad renal.
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