Serum and urinary levels of alpha-1-microglobulin (A1M), beta-2-microglobulin (B2M) and retinol binding protein (RBP) were measured using a Mancini radial immunodiffusion technique in 52 children with renal disease, 36 with non-renal febrile illness and 29 controls. In controls the mean serum level for A1M was 25±4.6 (SD) mg/l for B2M 1.7±0.5 mg/l and for RBP 31±8 mg/l. A1M levels were not significantly altered by febrile illness while B2M was elevated and RBP markedly depressed. Serum A1M and B2M were elevated in the nephrotic syndrome, while serum B2M was also raised during infancy. Coefficients of log-transformed data with creatinine-derived glomerular filtration rate (GFR) were −0.87 for B2M, −0.71 for RBP, and −0.62 for A1M. In the urine A1M was always measurable in controls while B2M and RBP were undetectable in all but a small number. The urine levels of all three proteins increased in response to non-renal febrile illness, and rose invariably when GFR fell to below 40–50 ml/min per 1.73 m2. Of the three proteins A1M was most frequently elevated in the urine with febrile and renal illness. RBP was rarely detectable when the other two proteins were not. Urinary A1M was consistently elevated in the nephrotic syndrome in contrast to B2M, possibly as a reflection of the increased glomerular permeability. We conclude that serum B2M is superior to A1M and RBP as an index of glomerular filtration, although its levels should be interpreted with caution in febrile disease. With the Mancini assay both urinary A1M and B2M measurement are of value, especially when taken in combination, but further work is required to determine the specificity of A1M for tubular as opposed to glomerular dysfunction, especially in the nephrotic state.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Berggard I, Bearn AG (1968) Isolation and properties of a low molecular weight B2-globulin occurring in human biological fluids. J Biol Chem 243: 4095–4103
Peterson PA, Evrin PE, Berggard I (1969) Differentiation of glomerular tubular and normal proteinuria. Determination of urinary excretion of B2-microglobulin, albumin, and total protein. J Clin Invest 48: 1189–1198
Wibell L, Evrin PE, Berggard I (1973) Serum B2-microglobulin in renal disease. Nephron 10: 320–331
Hall PW, Ricanati ES (1981) Renal handling of Beta-2-microglobulin in renal disorders; with special reference to hepatorenal syndrome. Nephron 27: 62–66
Portman RJ, Kissane JM, Robson AM, Peterson LJ, Richardson A (1986) Use of B2-microglobulin to diagnose tubulo-interstitial renal lesions in children. Kidney Int 30: 91–98
Schardijn GHC, Statius van Eps LW (1987) B2-microglobulin: its significance in the evaluation of renal function. Kidney Int 32: 635–641
Vincent C, Pozet N, Revillard JP (1980) Plasma B2-microglobulin turnover in renal insufficiency. Acta Clin Belg 35 : 2–13
Trollfors B, Norrby R (1981) Estimation of glomerular filtration rate by serum creatinine and serum B2-microglobulin. Nephron 28: 196–199
Edwards LC, Helderman JH, Lee Hamm L, Ludwin D, Gailiunas JR, Hull AR (1983) Non-invasive monitoring of renal transplant function by analysis of beta2-microglobulin. Kidney Int 23: 767–770
Davey PG, Gosling P (1982) B2-microglobulin instability in pathological urine. Clin Chem 28: 1330–1333
Ekstrom B, Peterson PA, Berggard I (1975) A urinary and plasma A1-glycoprotein of low molecular weight: isolation and some properties. Biochem Biophys Res Commun 65: 1427–1433
Itoh Y, Kin K, Kasahara T, Sakurabayashi I, Kawai T, Shiori-Nakano K, Takagik K (1979) Synthesis and secretion of A1-microglobulin by human lymphocytes. Clin Exp Immunol 37: 134–139
Vincent C, Marceau M, Blangarin P, Bouic P, Madjar J, Revillard J (1987) Purification of A1-microglobulin produced by human hepatoma cell lines. Eur J Biochem 165: 699–704
Kanai M, Raz A, Goodman DS (1968) Retinol-binding protein: the transport protein for vitamin A in human plasma. J Clin Invest 47: 2025–2044
Peterson PA, Berggard I (1971) Isolation and properties of a human retinol-transporting protein. J Biol Chem 246: 25–33
Fex G, Johannesson G (1982) Purification and partial characterization of a cellular retinol binding protein from human liver. Biochim Biophys Acta 714: 536–542
Donaldson MDC, Chambers RE, Woolridge MW, Whicher JT (1989) Stability of Alpha1-microglobulin, Beta2-microglobulin and retinol binding protein in urine. Clin Chim Acta 179: 73–78
Mancini G, Carbonara AO, Heremans JF (1965) Immunochemical quantitation of antigens by single radial immunodiffusion. Immunochemistry 2: 235–254
Morris MC, Allanby CW, Toseland P, Haycock GB, Chantler C (1982) Evaluation of a height/plasma creatinine formula in the measurement of glomerular filtration rate. Arch Dis Child 57: 611–615
Itoh Y, Enomoto H, Takagi K, Kawai T (1983) Clinical usefulness of serum A1-microglobulin as a sensitive indicator for renal insufficiency. Nephron 33: 69–70
Yu H, Yanagisawa Y, Forbes MA, Cooper EH, Crockson RA, MacLennan ICM (1983) Alpha-1-microglobulin: an indicator protein for renal tubular function. J Clin Pathol 36: 253–259
Beetham R, Dawnay A, Landon J, Cattell WR (1985) A radioimmunoassay for retinol-binding protein in serum and urine. Clin Chem 31: 1364–1367
Bernier I, Dautigny A, Glatthaar BE, Lergier W, Jolles J, Gillessen D, Jolles P (1980) Alpha-1-microglobulin from normal and pathological urines. Biochim Biophys Acta 626: 188–196
Topping MD, Forster HW, Dolman C, Luczynaka CM, Bernard AM (1986) Measurement of urinary retinol binding protein by enzymelinked immunosorbent assay, and its application to the detection of tubular proteinuria. Clin chem 32: 1863–1866
Walton C, Bodansky HJ, Wales JK, Forbes MA, Cooper EH (1988) Tubular dysfunction and microalbuminuria in insulin dependent diabetes. Arch Dis Child 63: 244–249
Sandberg T, Cooper EH, Lidin-Janson G, Yu H (1985) Fever and proximal tubular function in acute pyelonephritis. Nephron 41: 39–44
About this article
Cite this article
Donaldson, M.D.C., Chambers, R.E., Woolridge, M.W. et al. Alpha1-microglobulin, beta2-microglobulin and retinol binding protein in childhood febrile illness and renal disease. Pediatr Nephrol 4, 314–318 (1990). https://doi.org/10.1007/BF00862506
- Retinol binding protein
- Nephrotic syndrome
- Febrile illness