Excreted albumin of diabetic microalbuminuria cases exhibits pseudo esterase activity: A new way to explore microalbuminuria, perhaps with more information

Clin Chim Acta. 2025 Jan 15:565:119947. doi: 10.1016/j.cca.2024.119947. Epub 2024 Aug 30.

Abstract

Background: Microalbuminuria is associated with several clinical conditions of public health concern. Particularly in diabetic patients, there is routine microalbuminuria screening to understand whether the renal complication has progressed to the microalbuminuria stage or not. Therefore, microalbuminuria detection is a matter of considerable interest. For such detection, the clinical labs rely on immunochemical methods. Nevertheless, the immunochemical methods are believed to be less sensitive for the purpose. So, the need arises for continuous research in the field. We believe that pseudoesterase activity of the excreted albumin in microalbuminuria cases is a potential target. This aspect is investigated here and it is shown that the excreted albumin in diabetic microalbuminuria cases retains its pseudoesterase activity, unlike the overt albuminuria cases.

Methods: The cases of diabetic nephropathy and healthy controls were included in the study. The patients were divided into diabetic controls microalbuminuria, and overt albuminuria group considering the albumin to creatinine ratio (ACR). The urinary proteins of the cases were isolated by centrifugation. The obtained protein pellet was then checked for pseudoesterase activity by electrophoretic and fluorescence-based methods. The CD spectroscopy and LC-MS study was carried out to show the suitability of the substrate for the detection of albumin pseudoesterase activity. To further, understand the structure-function relation, molecular docking studies were carried out.

Results: From the CD and LC-MS study the suitability of the used substrate was confirmed. The electrophoretic and fluorescence study showed that the protein of the microalbuminuria group retained the pseudoesterase activity whereas the same is lost in the overt albuminuria group. The molecular docking studies indicated that a change in albumin structure may result in a change in its pseudoesterase activity.

Conclusion: The urinary protein of diabetic microalbuminuria cases exhibits pseudoesterase activity. It distinguishes the excreted protein in the diabetic albuminuria group and the overt albuminuria group. This is the first study that showed the retention of pseudoesterase property in excreted albumin. Further, in this study a simple test is developed that distinguishes the excreted albumin in the microalbuminuria group and overt albuminuria group.

Keywords: Albumin to creatinine ratio (ACR); Diabetes; Diabetic Nephropathy; Human serum Albumin; Microalbuminuria; Pseudoesterase activity.

MeSH terms

  • Adult
  • Albumins / metabolism
  • Albuminuria* / urine
  • Case-Control Studies
  • Diabetic Nephropathies / diagnosis
  • Diabetic Nephropathies / metabolism
  • Diabetic Nephropathies / urine
  • Esterases* / metabolism
  • Female
  • Humans
  • Male
  • Middle Aged
  • Molecular Docking Simulation

Substances

  • Esterases
  • Albumins