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Van de Velde C, Blok E, Meershoek-Klein Kranenbarg E, Putter H, Van den Bosch J, Maartense E, Duijm-de Carpentier M, Van Leeuwen-Stok E, Liefers G, Nortier J, Rutgers E, Kroep J. Optimal duration of extended letrozole treatment after 5 years of adjuvant endocrine therapy; results of the randomized phase III IDEAL trial (BOOG 2006–05). Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30108-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jadot I, Declèves AE, Nortier J, Caron N. An Integrated View of Aristolochic Acid Nephropathy: Update of the Literature. Int J Mol Sci 2017; 18:ijms18020297. [PMID: 28146082 PMCID: PMC5343833 DOI: 10.3390/ijms18020297] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 01/09/2023] Open
Abstract
The term “aristolochic acid nephropathy” (AAN) is used to include any form of toxic interstitial nephropathy that is caused either by ingestion of plants containing aristolochic acids (AA) as part of traditional phytotherapies (formerly known as “Chinese herbs nephropathy”), or by the environmental contaminants in food (Balkan endemic nephropathy). It is frequently associated with urothelial malignancies. Although products containing AA have been banned in most of countries, AAN cases remain regularly reported all over the world. Moreover, AAN incidence is probably highly underestimated given the presence of AA in traditional herbal remedies worldwide and the weak awareness of the disease. During these two past decades, animal models for AAN have been developed to investigate underlying molecular and cellular mechanisms involved in AAN pathogenesis. Indeed, a more-in-depth understanding of these processes is essential to develop therapeutic strategies aimed to reduce the global and underestimated burden of this disease. In this regard, our purpose was to build a broad overview of what is currently known about AAN. To achieve this goal, we aimed to summarize the latest data available about underlying pathophysiological mechanisms leading to AAN development with a particular emphasis on the imbalance between vasoactive factors as well as a focus on the vascular events often not considered in AAN.
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Simon I, Legrand F, Des Grottes JM, Cotton F, Nortier J, Roumeguère T. [Diagnosis and treatment of nephrolithiasis and prevention of recurrences]. REVUE MEDICALE DE BRUXELLES 2017; 38:279-283. [PMID: 28981230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
despite fluctuations, the prevalence of nephrolithiasis has significantly increased during the last decades in industrialized nations worldwide (1 to 15 %), which has a significant impact on the cost of healthcare. This increased prevalence is mainly explained by diet modifications. Environmental, metabolic and genetic factors may also influence the formation of kidney stones. As a consequence, the medical management of this disease is preferentially multidisciplinary and involves urologists, nephrologists, radiologists, biologists and dietitians. Urological management : may be mandatory during any acute and/or remote phase of an episode of renal colic, in case of residual stones. Several techniques are available: insertion of double J stent, extracorporeal shock wave lithotripsy, ureteroscopy (flexible or rigid), percutaneous nephrolithotomy and more occasionally, open surgery. Nephrological management: is justified in the course of the acute episode and aims to identify the causal factor(s) of kidney stones formation. The diagnostic approach involves a thorough interrogation (personal medical and surgical history, details of the kidney stone disease and family medical history) as well as a metabolic assessment. Moreover, given the high rate of recurrence (about 50 % within 5 to 10 years), individualized secondary prevention measures are necessary. The recommendations should take into account the identified risk factors and any metabolic abnormalities.
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Nortier J, Plennevaux V, Nolf A, Hougardy JM, Petit AD. [Clinical care pathway for chronic kidney disease : development and perspectives]. REVUE MEDICALE DE BRUXELLES 2017; 38:271-278. [PMID: 28981229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Because of the significant costs related to the treatment of end-stage kidney disease by dialysis, Belgian Health Care Authorities proposed in June 2009 to launch an early multidisciplinary care plan for chronic kidney disease (CKD) patients in the form of a clinical care pathway (CCP) focusing on a combined follow-up by the general practitioner and the nephrologist. The objective was to increase nephro-protection measures, reduce patient morbidity and mortality, and delay admission on dialysis. Our Nephrology Department at Erasme Hospital took the opportunity of CCP to set up workshops on therapy education which promote CKD patients' compliance and autonomy regarding their treatment (" empowerment "). These workshops are conducted by a health professional together with a patient partner recruited by our team according to the model developed by the faculty of medicine at the University of Montreal. This model is based on the patient's valued experience of living with a chronic disease, a knowledge which is complementary to that acquired by any health professional. This patient partnership (PP) may also be implemented in teaching and research. In health care services, patient partners with a resource profile are involved not only in the organization of these services, but also in the development and management of health care political programs. The PP model currently developed in the Nephrology Department is part of the Quality project of our academic hospital and helps to further the co-construction of future health care networks.
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Fadel S, Dorthu L, Lespagnard J, Cornet G, Nortier J. Douleurs intenses au décours d’une angioplastie des membres inférieurs chez une patiente hémodialysée : quel est votre diagnostic ? Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Baudoux T, Hougardy J, Husson C, De Prez E, Antoine M, Nortier J. Rôles protecteurs des lymphocytes T dans un modèle murin de la néphropathie aux acides aristolochiques. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Duquesne M, Dika Z, Jelakovic B, Colet JM, Nortier J. Apport de la métabonomique urinaire en néphrologie environnementale : détection des sujets à risque de néphropathie endémique des Balkans. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sava R, Gastaldello K, Verset G, Fontanges Q, D’haene N, Nortier J. Lésion cæcale pseudo-tumorale chez un patient hémodialysé : quel est votre diagnostic ? Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nortier J, Duquesne M, Decleves A, Coulon F, De Prez E, Colet J. Profils métabonomiques urinaires des acides aristolochiques I et II comparés à trois toxiques tubulaires connues selon Comet : vers de nouveaux biomarqueurs de néphrotoxicité ? Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Castells X, Ardin M, Rorive S, Broeders N, Heguy A, Bringuier P, Quackels T, Roumeguere T, Nortier J, Zavadil J. Genome-wide sequencing identifies genetic relationship between first and late-onset second cancers in aristolochic acid nephropathy patients. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61121-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ben Omar Bridi S, PIennevaux V, Racapé J, Nortier J. [Not Available]. REVUE MEDICALE DE BRUXELLES 2016; 37:5-12. [PMID: 27120930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Because of the significant costs related to the treatment of end-stage kidney disease by dialysis, Belgian Health Care Authorities proposed in June 2009 an early multidisciplinary care of the chronic kidney disease (CKD) in a so-called clinical pathway (CP). Working on the hypothesis that inclusion into a CP could result in reduced morbidity and mortality and delayed admission on dialysis, we initiated a retrospective cohort study on dialyzed patients for whom a prior CKD diagnosis was made between June 1, 2009 and August 31, 2013 in the Nephrology Dept of Erasme Hospital. The exposed patient group was defined as enrolled patients into a CP (n = 25), the control patients were free of any CP (n = 25). Survival analyses were performed to search for an association between the inclusion into a CP and the time period needed to reach dialysis, but also to find a possible impact of CP on mortality and risk of hospitalization. The present study showed that CKD-CP significantly delayed the time of dialysis initiation (HR = 0.48 [0.27-0.87]; p = 0.015) but also reduced mortality (HR = 0.10 [0.02-0.53]; p = 0.007) and hospitalization risk (HR = 0.30 [0.11-0.83]; p = 0.020) after starting dialysis. These data suggest the benefit of a multidisciplinary care of CKD patients. However, a larger scale study is necessary to confirm these results.
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Bunel V, Antoine MH, Stévigny C, Nortier J, Duez P. New in vitro insights on a cell death pathway induced by magnolol and honokiol in aristolochic acid tubulotoxicity. Food Chem Toxicol 2016; 87:77-87. [DOI: 10.1016/j.fct.2015.11.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 11/21/2015] [Accepted: 11/23/2015] [Indexed: 12/18/2022]
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Pozdzik AA, Fernandez V, Demetter P, Tooulou M, Matos C, Gammar N, Broeders N, Dratwa M, Nortier J. Encapsulating Peritoneal Sclerosis In a Kidney Graft Recipient Unmasked by Everolimus Switch. Perit Dial Int 2015; 35:769-71. [PMID: 26703854 DOI: 10.3747/pdi.2014.00157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Declèves AÉ, Jadot I, Colombaro V, Martin B, Voisin V, Nortier J, Caron N. Protective effect of nitric oxide in aristolochic acid-induced toxic acute kidney injury: an old friend with new assets. Exp Physiol 2015; 101:193-206. [PMID: 26442795 DOI: 10.1113/ep085333] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 09/30/2015] [Indexed: 12/16/2022]
Abstract
Aristolochic acid (AA) nephropathy (AAN), a progressive tubulointerstitial injury of toxic origin, is characterized by early and transient acute tubular necrosis. This process has been demonstrated to be associated with reduced nitric oxide (NO) production, which can disrupt the regulation of renal function. In this study, we tested the hypothesis that L-arginine (L-Arg) supplementation could restore renal function and reduce renal injury after AA intoxication. C57BL/6 J male mice were randomly subjected to daily i.p. injection of either sterile saline solution or AA (2.5 mg kg(-1)) for 4 days. To determine whether AA-induced renal injuries were linked to reduced NO production, L-Arg, a substrate for NO synthase, was supplemented (5%) in drinking water. Mice intoxicated with AA exhibited features of rapid-onset acute kidney injury, including polyuria, significantly increased plasma creatinine concentrations, proteinuria and fractional excretion of sodium (P < 0.05), along with severe proximal tubular cell injury and increased NADPH oxidase 2 (Nox2)-derived oxidative stress (P < 0.05). This was associated with a significant reduction in NO bioavailability. L-Arg supplementation in AA-treated mice significantly increased NO bioavailability, which in turn improved renal function (creatininaemia, polyuria, proteinuria, fractional excreted sodium and N-acetyl-β-D-glucosaminidase enzymuria) and renal structure (tubular necrosis and tubular cell apoptosis). These changes were associated with significant reductions in Nox2 expression and in production of reactive oxygen species and with an increase in antioxidant concentrations. Our results demonstrate that preservation of NO bioavailability leads to renal protection in AA-induced acute kidney injury by reducing oxidative stress and maintaining renal function.
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Nortier J, Pozdzik A, Roumeguere T, Vanherweghem JL. Néphropathie aux acides aristolochiques (« néphropathie aux herbes chinoises »). Nephrol Ther 2015; 11:574-88. [DOI: 10.1016/j.nephro.2015.10.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bunel V, Antoine MH, Nortier J, Duez P, Stévigny C. Potential nephroprotective effects of the Chinese herb Angelica sinensis against cisplatin tubulotoxicity. PHARMACEUTICAL BIOLOGY 2015; 53:985-994. [PMID: 25495691 DOI: 10.3109/13880209.2014.951726] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
CONTEXT Acute kidney injury (AKI) is often encountered in patients receiving cisplatin (CisPt), a chemotherapeutic drug that induces numerous toxic side effects. Techniques used to limit nephrotoxicity during CisPt treatment are not fully effective; about a third of patients experience AKI. New nephroprotective strategies, including pharmacological approaches, must be developed. OBJECTIVE The present study investigated the nephroprotective potential of Angelica sinensis (Oliv.) Diels (Apiaceae) root towards CisPt tubulotoxicity. MATERIALS AND METHODS HK-2 cells were incubated with CisPt (10 µM) and/or with a methanolic extract of A. sinensis (AS). Nephroprotective capacity was evaluated by means of cellular viability (resazurin assay) and apoptosis (annexin-V/PI staining), oxidative stress generation (H2DCF-DA oxidation), Ki-67 index (immunofluorescence), cell cycle analysis (DNA staining), cell migration rate (scratch assay), extracellular matrix deposition (collagen determination), and β-catenin relocalization. RESULTS CisPt decreased cell viability [76% versus Ctrl], which was associated with an increased apoptosis. Simultaneous treatment with 50 µg/ml AS enhanced cell survival [84% versus Ctrl] and decreased the apoptosis rate. AS could not alleviate CisPt-induced oxidative stress; but doses of 5 and 50 µg/ml raised the Ki-67 index [135 and 244% versus Ctrl] and cell migration rates [1.2 and 1.3-fold versus Ctrl]. Finally, both doses of AS limited the amount of collagen deposition [121.6 and 119.6% for 5 and 50 µg/ml, respectively, versus 131.0% for CisPt-treated cells] and prevented the relocalization of β-catenin from the membrane to the nucleus. CONCLUSION These results confirm the nephroprotective potential of A. sinensis and require further investigations aiming at identifying its active compounds.
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Yamani A, Bunel V, Antoine MH, Husson C, Stévigny C, Duez P, Elachouri M, Nortier J. Substitution between Aristolochia and Bryonia genus in North-Eastern Morocco: toxicological implications. JOURNAL OF ETHNOPHARMACOLOGY 2015; 166:250-260. [PMID: 25797117 DOI: 10.1016/j.jep.2015.03.036] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 02/23/2015] [Accepted: 03/12/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Although acknowledged as toxic herbs, Aristolochia species are still widely used worldwide. The aristolochic acids (AA) they contain can induce the so-called "aristolochic acid nephropathy", leading to renal fibrosis and upper urinary tract cancer. Traditional Moroccan medicine still often uses Aristolochia species under the vernacular name of Bereztem for the treatment of numerous ailments, notably cancer, diabetes or digestive tract disorders. As the botanical identity and renal toxicity of used species remain unexplored, the safety of patients may be threatened. MATERIAL AND METHODS Ethnopharmacological data were collected from herbalists from the provinces of Oujda and Berkane, located in North-Eastern Morocco. Samples of Bereztem were collected at herbalist shops and checked for their content in AA using TLC and LC-MS methods. The toxicity of crude methanolic extracts of each herb was assessed on a HK-2 cell-based in vitro model by measurement of the cell survival to evaluate cytotoxicity and by assessment of renal-specific toxicity via (i) the evaluation of genes (E-cadherin and α-smooth muscle actin) expression by RT-qPCR; (ii) the quantities of β-catenin and vimentin by immunofluorescence microscopy; (iii) the secretion of fibronectin; and (iv) the excretion of interleukin-6. RESULTS The survey indicated that, among 42 herbalists visited, 33 were retailers of Bereztem, which was generally sold as a cancer treatment. Botanical investigations revealed that Aristolochia longa was frequently substituted by Bryonia dioica, which was associated with a higher cytotoxicity. Parameters specific to renal toxicity were also found to be enhanced, as compared to Aristolochia baetica and A. longa: down-regulation of β-catenin and E-cadherin and up-regulation of vimentin and α-smooth muscle actin, and secretion of fibronectin and interleukin-6. CONCLUSION In accordance with the Moroccan regulations, the use of so-called Aristolochia species should be discontinued. On one hand, the correctly identified aristolochia contain nephrotoxic aristolochic acids; on the other hand, aristolochia are massively substituted in North-Eastern Morocco and adulterated by a well-known toxic herb, B. dioica. Our data indicate that the bryony renal toxicity may be deleterious in shorter time periods than aristolochia. Reinforced on-site controls are needed to remind herbalists and harvesters that these herbs should be prohibited.
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Pozdzik AA, Debiec H, Husson C, Rorive S, Broeders N, Le Moine A, Ronco P, Nortier J. [Anti-NEP and anti-PLA2R antibodies in membranous nephropathy: an update]. REVUE MEDICALE DE BRUXELLES 2015; 36:166-171. [PMID: 26372979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Membranous nephropathy (MN) is the most common cause for nephrotic syndrome in adults and occurs as an idiopathic (primary) or secondary disease. Since the early 2000's, substantial advances have been made in the understanding of the molecular bases of MN. The neutral endopeptidase (NEP) and the receptor for secretory phospholipase A2 (PLA2R) have been identified as target antigens for circulating and deposited antibodies in allo-immune neonatal and adult " idiopathic " MN, respectively. These antibodies recognize specific antigens of podocytes, precipitate as subepithelial immune complexes and activate complement leading to proteinuria. Anti-PLA2R antibodies are of particular clinical importance. Indeed, they are detected in approximately 70% of primary MN in adults, demonstrating that MN actually is an autoimmune condition specific to the kidney. In Europeans, genome-wide studies have shown an association between alleles of PLA2R1 and HLA DQA1 (class II genes of tissue histocompatibility complex) genes and idiopathic MN. Newly developed diagnostic tests detecting circulating anti-PLA2R antibody and PLA2R antigen in glomerular deposits have induced a change in paradigm in the diagnostic approach of idiopathic MN. Measurement of circulating anti-PLA2R antibody is also very useful for the monitoring of MN activity. However, the mechanisms responsible for the formation of anti-PLA2R antibodies as well as those involved in the progression of MN to end-stage renal disease remain to be defined.
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Simon I, Roumeguère T, Devuyst F, Cotton F, Tang BNT, Cappello M, Corbetta S, Idrissi M, Pozdzik A, Nortier J. [Recurrent episodes of brushite nephrolithiasis revealing primary hyperparathyroidism]. REVUE MEDICALE DE BRUXELLES 2015; 36:172-176. [PMID: 26372980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Nephrolithiasis is a frequent disease observed in 1 to 20 % of the general population. This disease predominates in male patients (2:1) and is characterized by a high rate of recurrences (about 50 %). CASE REPORT We report the case of a 45-year old male patient who experienced during about ten years recurrent bilateral renal colic episodes due to brushite lithiasis. These stones were treated with multiple extracorporeal shock wave lithotripsy sessions. A pyeloureteral junction syndrome predisposing to bulky stones formation has been put in evidence and required a pyeloplasty. After more than ten years of disease activity, a biochemical screening diagnosed primary hyperparathyroidism (PHPT). Radiological assessment identified a parathyroid gland adenoma. Successful surgical removal of this lesion was followed by resolution of the symptomatic kidney stones formation. DISCUSSION PHPT is associated with kidney stones in about 20 % of the patients. Hypercalciuria is the main risk factor of stones formation but other predisposing factors are also probably involved. Patients carrying a polymorphism located in the coding sequence of the calcium-sensing receptor gene or in the regulatory region of this gene seem to experience an increased occurrence of urinary lithiasis. CONCLUSION The present case stresses the importance of a metabolic assessment in all patients with recurrent nephrolithiasis, especially in case of bilateral episodes.
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Goldman M, Nortier J, Dhaene M, Amraoui Z, Vanherweghem JL. Fate of beta-2-microglobulin during dialysis on polysulfone and AN69 membranes. CONTRIBUTIONS TO NEPHROLOGY 2015; 74:127-31. [PMID: 2702129 DOI: 10.1159/000417481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Nortier J, Abramowicz D, Najdovski T, Kinnaert P, Vanherweghem JL, Goldman M, Deschodt-Lanckman M. Urinary endopeptidase 24.11 as a new marker of proximal tubular injury. Preliminary study in kidney transplant recipients. CONTRIBUTIONS TO NEPHROLOGY 2015; 101:169-76. [PMID: 8467672 DOI: 10.1159/000422127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Bunel V, Antoine MH, Nortier J, Duez P, Stévigny C. In vitro effects of Panax ginseng in aristolochic acid-mediated renal tubulotoxicity: apoptosis versus regeneration. PLANTA MEDICA 2015; 81:363-372. [PMID: 25798640 DOI: 10.1055/s-0035-1545839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This in vitro study aimed to determine the effects of a Panax ginseng extract on aristolochic acid-mediated toxicity in HK-2 cells. A methanolic extract of ginseng (50 µg/mL) was able to reduce cell survival after treatment with 50 µM aristolochic acid for 24, 48, and 72 h, as evidenced by a resazurin reduction assay. This result was confirmed by a flow cytometric evaluation of apoptosis using annexin V-PI staining, and indicated higher apoptosis rates in cells treated with aristolochic acid and P. ginseng extract compared with aristolochic acid alone. However, P. ginseng extract by itself (5 and 50 µg/mL) increased the Ki-67 index, indicating an enhancement in cellular proliferation. Cell cycle analysis excluded a P. ginseng extract-mediated induction of G2/M cell cycle arrest such as the one typically observed with aristolochic acid. Finally, β-catenin acquisition was found to be accelerated when cells were treated with both doses of ginseng, suggesting that the epithelial phenotype of renal proximal tubular epithelial cells was maintained. Also, ginseng treatment (5 and 50 µg/mL) reduced the oxidative stress activity induced by aristolochic acid after 24 and 48 h. These results indicate that the ginseng extract has a protective activity towards the generation of cytotoxic reactive oxygen species induced by aristolochic acid. However, the ginseng-mediated alleviation of oxidative stress did not correlate with a decrease but rather with an increase in aristolochic acid-induced apoptosis and death. This deleterious herb-herb interaction could worsen aristolochic acid tubulotoxicity and reinforce the severity and duration of the injury. Nevertheless, increased cellular proliferation and migration, along with the improvement in the epithelial phenotype maintenance, indicate that ginseng could be useful for improving tubular regeneration and the recovery following drug-induced kidney injury. Such dual activities of ginseng certainly warrant further in vivo studies.
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Nortier J. [Dialysis treatment for diabetic patients]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2015:S18-S20. [PMID: 26036125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Advanced-stage diabetic nephropathy requires multidisciplinary treatment for the patient. He/she must be informed, when necessary, of the possible dialysis methods and the assessment of the transplant options. Haemodialysis and peritoneal dialysis offer comparable survival rates. The enlightened choice of the patient is guided by the nephrology team. Survival on dialysis unfortunately remains uncertain due to numerous comorbidities, in particular cardiovascular conditions.
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Goubella A, Broeders N, Racapé J, Hamade A, Massart A, Hougardy JM, Hoang AD, Mikhalski D, Baudoux T, Gankam F, Madhoun P, Janssen F, Moine AL, Nortier J, Vereerstraeten P. Patient and graft outcome in current era of immunosuppression: a single centre pilot study. Acta Clin Belg 2015; 70:23-9. [PMID: 25257447 DOI: 10.1179/2295333714y.0000000078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The present single centre study aims at analyzing the impact on renal allograft outcome of the important changes which occurred in the transplant population and immunosuppressive therapy during the last two decades. METHODS From 2000 to 2013, 779 single kidney transplantations were performed on 635 patients who all received on an intent-to-treat basis steroids, a calcineurin inhibitor, mycophenolate mofetil and an induction therapy with either antithymocyte globulin or an antagonist directed to the interleukin (IL)-2 receptor. Uni- and multivariate analyses of patient and immunologic graft survival were conducted. RESULTS The sole factor predicting patient survival is recipient's age: 10-year survival rates are 94·7, 81·6 and 57·9% for the <45, 45-60 and >60 years age groups, respectively (P<0·001). Peak (>50% panel reactive antibodies) anti-human leucocyte antigens (HLA) sensitization, cold ischaemia time and HLA-B and -DR mismatches (MM) influence graft outcome: at 10 years, the difference in 10-year survival rates is 5·9% between grafts from sensitized and not sensitized patients (90·9 vs 96·8%, P = 0·002), 3·8% between grafts with <18 and ≧18 hours cold ischaemia (96·6 vs 92·8%, P = 0·003), 7·3% between grafts with no MM and either B or DR MM versus those with B and DR MM (96·8 vs 89·5%, P = 0·002). CONCLUSION In our single centre experience, graft survival was most strongly determined by HLA matching, offering excellent long term graft outcome to most patients.
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Bunel V, Antoine MH, Nortier J, Duez P, Stévigny C. Nephroprotective effects of ferulic acid, Z-ligustilide and E-ligustilide isolated from Angelica sinensis against cisplatin toxicity in vitro. Toxicol In Vitro 2015; 29:458-67. [PMID: 25561245 DOI: 10.1016/j.tiv.2014.12.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/20/2014] [Accepted: 12/24/2014] [Indexed: 01/23/2023]
Abstract
Cisplatin (CisPt), a chemotherapeutic drug applied against solid tumors, is highly detrimental to the kidney. The risk of acute kidney injury implies adequate patient hydration to ensure sufficient diuresis; this strategy, now implemented in clinical practice, remains however incompletely satisfactory. New pharmacological approaches relying on the discovery of bioactive compounds need to be developed. Based on previous studies reporting renoprotective activities for extracts of Angelica sinensis (Oliv.) Diels roots, three of its major active compounds, ferulic acid, Z-ligustilide and E-ligustilide, were investigated for possible alleviation of CisPt-induced nephrotoxicity. Five phenomena involved in acute kidney injury and subsequent fibrosis were investigated: (i) modulation of cell survival via reduction of the apoptosis rate; (ii) reduction of oxidative stress; (iii) improvement of tubular regeneration capacities through proliferation and migration; (iv) limitation of extracellular matrix and collagen deposition; and (v) prevention of the dedifferentiation processes via the β-catenin pathway. Ferulic acid emerged as the most potent compound for alleviating cell death and collagen deposition, and for enhancing cell regeneration capacities. It also partially inhibited the β-catenin pathway, but was ineffective in lowering oxidative stress. Z- and E-ligustilides, however, were effective for limiting the oxidative stress, but only moderately affected other parameters. Ferulic acid appears to be a promising nephroprotective drug lead deserving further preclinical investigation.
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