551
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Viral-host interaction in kidney reveals strategies to escape host immunity and persistently shed virus to the urine. Oncotarget 2018; 8:7336-7349. [PMID: 28038465 PMCID: PMC5352325 DOI: 10.18632/oncotarget.14227] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 12/20/2016] [Indexed: 11/25/2022] Open
Abstract
Hepatitis A virus is one of five types of hepatotropic viruses that cause human liver disease. A similar liver disease is also identified in ducks caused by Duck Hepatitis A virus (DHAV). Notably, many types of hepatotropic viruses can be detected in urine. However, how those viruses enter into the urine is largely unexplored. To elucidate the potential mechanism, we used the avian hepatotropic virus to investigate replication strategies and immune responses in kidney until 280 days after infection. Immunohistochemistry and qPCR were used to detect viral distribution and copies in the kidney. Double staining of CD4+ or CD8+ T cells and virus and qPCR were used to investigate T cell immune responses and expression levels of cytokines. Histopathology was detected by standard HE staining. In this study, viruses were persistently located at scattered renal tubules. No CD4+ or CD8+ T cells were recruited to the kidney, which was only accompanied by transient cytokine storms. In conclusion, the extremely scattered infection was the viral strategy to escape host immunity and may persistently shed virus into urine. The deletion of Th or Tc cell responses and transient cytokine storms indeed provide an advantageous renal environment for their persistent survival.
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552
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Dolinina J, Rippe A, Bentzer P, Öberg CM. Glomerular hyperpermeability after acute unilateral ureteral obstruction: effects of Tempol, NOS, RhoA, and Rac-1 inhibition. Am J Physiol Renal Physiol 2018; 315:F445-F453. [PMID: 29465305 DOI: 10.1152/ajprenal.00610.2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
It is well known that proteinuria following urinary tract obstruction is mainly of a tubular nature. However, it is unknown whether there are also changes in glomerular permeability. In this study, we compared glomerular sieving coefficients (θ) of polydisperse fluorescein isothiocyanate (FITC)-Ficoll 70/400 following a 120- or 180-min unilateral ureteral obstruction (UUO) in anesthetized Sprague-Dawley rats. Samples were collected from the obstructed kidney at 5, 15, and 30 min postrelease and analyzed by means of high-pressure size-exclusion chromatography. After 120-min UUO, mean θ for Ficoll70Å was increased ( P < 0.01) from 2.2 ± 0.5 × 10-5 (baseline) to 10.6 ± 10 × 10-5 15 min postrelease (highest value). After 180-min UUO, mean θ for Ficoll70Å was further increased ( P < 0.001) from 1.4 ± 0.5 × 10-5 (baseline) to 40 ± 10 × 10-5 at 5 min postrelease (highest value). Administration of a reactive oxygen species (ROS) scavenger (Tempol; 1 mg·kg-1·min-1) partly abrogated the permeability effects following 120-min UUO but not after 180 min. Moreover, administration of the RhoA kinase inhibitor Y-27632, the nitric oxide synthase inhibitor NG-nitro-l-arginine methyl ester, or Rac-1 inhibition did not ameliorate glomerular hyperpermeability following 180-min UUO. We show, for the first time, that acute UUO results in marked elevations in glomerular permeability. In addition, our data suggest a time-dependent pathophysiology of UUO-induced hyperpermeability, where reactive oxygen species generation may play an important role in the early stages.
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Affiliation(s)
- Julia Dolinina
- Department of Nephrology, Clinical Sciences Lund, Lund University , Lund , Sweden
| | - Anna Rippe
- Department of Nephrology, Clinical Sciences Lund, Lund University , Lund , Sweden
| | - Peter Bentzer
- Department of Anesthesiology and Intensive Care, Clinical Sciences Lund, Lund University , Lund , Sweden.,Department of Anesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden
| | - Carl M Öberg
- Department of Nephrology, Clinical Sciences Lund, Lund University , Lund , Sweden
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553
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Tang C, Han H, Yan M, Zhu S, Liu J, Liu Z, He L, Tan J, Liu Y, Liu H, Sun L, Duan S, Peng Y, Liu F, Yin XM, Zhang Z, Dong Z. PINK1-PRKN/PARK2 pathway of mitophagy is activated to protect against renal ischemia-reperfusion injury. Autophagy 2018; 14:880-897. [PMID: 29172924 DOI: 10.1080/15548627.2017.1405880] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Damaged or dysfunctional mitochondria are toxic to the cell by producing reactive oxygen species and releasing cell death factors. Therefore, timely removal of these organelles is critical to cellular homeostasis and viability. Mitophagy is the mechanism of selective degradation of mitochondria via autophagy. The significance of mitophagy in kidney diseases, including ischemic acute kidney injury (AKI), has yet to be established, and the involved pathway of mitophagy remains poorly understood. Here, we show that mitophagy is induced in renal proximal tubular cells in both in vitro and in vivo models of ischemic AKI. Mitophagy under these conditions is abrogated by Pink1 and Park2 deficiency, supporting a critical role of the PINK1-PARK2 pathway in tubular cell mitophagy. Moreover, ischemic AKI is aggravated in pink1 andpark2 single- as well as double-knockout mice. Mechanistically, Pink1 and Park2 deficiency enhances mitochondrial damage, reactive oxygen species production, and inflammatory response. Taken together, these results indicate that PINK1-PARK2-mediated mitophagy plays an important role in mitochondrial quality control, tubular cell survival, and renal function during AKI.
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Affiliation(s)
- Chengyuan Tang
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Hailong Han
- b Institute of Precision Medicine, Xiangya Hospital and State Key Laboratory of Medical Genetics, Xiangya Medical School , Central South University , Changsha , Hunan , China
| | - Mingjuan Yan
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Shiyao Zhu
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Jing Liu
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Zhiwen Liu
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Liyu He
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Jieqiong Tan
- b Institute of Precision Medicine, Xiangya Hospital and State Key Laboratory of Medical Genetics, Xiangya Medical School , Central South University , Changsha , Hunan , China
| | - Yu Liu
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Hong Liu
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Lin Sun
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Shaobin Duan
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Youming Peng
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Fuyou Liu
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China
| | - Xiao-Ming Yin
- c Department of Pathology and Laboratory Medicine , Indiana University School of Medicine , Indianapolis , IN , USA
| | - Zhuohua Zhang
- b Institute of Precision Medicine, Xiangya Hospital and State Key Laboratory of Medical Genetics, Xiangya Medical School , Central South University , Changsha , Hunan , China
| | - Zheng Dong
- a Department of Nephrology, Second Xiangya Hospital , Central South University , Changsha , Hunan , China.,d Department of Cellular Biology and Anatomy , Medical College of Georgia at Augusta University and Charlie Norwood VA Medical Center , Augusta , GA , USA
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554
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Bondeva T, Schindler C, Schindler K, Wolf G. MORG1 +/- mice are protected from histological renal damage and inflammation in a murine model of endotoxemia. BMC Nephrol 2018; 19:29. [PMID: 29402223 PMCID: PMC5800025 DOI: 10.1186/s12882-018-0826-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 01/21/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The MAPK-organizer 1 (MORG1) play a scaffold function in the MAPK and/or the PHD3 signalling paths. Recently, we reported that MORG1+/- mice are protected from renal injury induced by systemic hypoxia and acute renal ischemia-reperfusion injury via increased hypoxia-inducible factors (HIFs). Here, we explore whether MORG1 heterozygosity could attenuate renal injury in a murine model of lipopolysaccharide (LPS) induced endotoxemia. METHODS Endotoxemia was induced in mice by an intraperitoneal (i.p) application of 5 mg/kg BW LPS. The renal damage was estimated by periodic acid Schiff's staining; renal injury was evaluated by detection of urinary and plasma levels of neutrophil gelatinase-associated lipocalin and albumin/creatinine ratio via ELISAs. Renal mRNA expression was assessed by real-time PCR, whereas the protein expression was determined by immunohistochemistry or Western blotting. RESULTS LPS administration increased tubular injury, microalbuminuria, IL-6 plasma levels and renal TNF-α expression in MORG1 +/+ mice. This was accompanied with enhanced infiltration of the inflammatory T-cells in renal tissue and activation of the NF-κB transcription factors. In contrast, endotoxemic MORG1 +/- showed significantly less tubular injury, reduced plasma IL-6 levels, significantly decreased renal TNF-α expression and T-cells infiltration. In support, the renal levels of activated caspase-3 were lower in endotoxemic MORG1 +/- mice compared with endotoxemic MORG1 +/+ mice. Interestingly, LPS application induced a significantly higher accumulation of renal HIF-2α in the kidneys of MORG1+/- mice than in wild-type mice, accompanied with a diminished phosphorylation of IκB-α and IKK α,β and decreased iNOS mRNA in the renal tissues of the LPS-challenged MORG1+/- mice, indicating an inhibition of the NF-κB transcriptional activation. CONCLUSIONS MORG1 heterozygosity protects against histological renal damage and shows anti-inflammatory effects in a murine endotoxemia model through modulation of HIF-2α stabilisation and/or simultaneous inhibition of the NF-κB signalling. Here, we show for the first time that MORG1 scaffold could represent the missing link between innate immunity and inflammation.
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Affiliation(s)
- Tzvetanka Bondeva
- Department of Internal Medicine III, Jena University Hospital, Am Klinikum 1, D-07740 Jena, Germany
| | - Claudia Schindler
- Department of Internal Medicine III, Jena University Hospital, Am Klinikum 1, D-07740 Jena, Germany
- Centre for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Katrin Schindler
- Department of Internal Medicine III, Jena University Hospital, Am Klinikum 1, D-07740 Jena, Germany
- Centre for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Gunter Wolf
- Department of Internal Medicine III, Jena University Hospital, Am Klinikum 1, D-07740 Jena, Germany
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555
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Mehrotra P, Collett JA, Gunst SJ, Basile DP. Th17 cells contribute to pulmonary fibrosis and inflammation during chronic kidney disease progression after acute ischemia. Am J Physiol Regul Integr Comp Physiol 2018; 314:R265-R273. [PMID: 29118018 PMCID: PMC5867669 DOI: 10.1152/ajpregu.00147.2017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 10/30/2017] [Accepted: 10/30/2017] [Indexed: 12/25/2022]
Abstract
Acute kidney injury (AKI) is associated with high mortality rates and predisposes development of chronic kidney disease (CKD). Distant organ damage, particularly in the lung, may contribute to mortality in AKI patients. Animal models of AKI demonstrate an increase in pulmonary infiltration of lymphocytes and reveal an acute compromise of lung function, but the chronic effects of AKI on pulmonary inflammation are unknown. We hypothesized that in response to renal ischemia/reperfusion (I/R), there is a persistent systemic increase in Th17 cells with potential effects on pulmonary structure and function. Renal I/R injury was performed on rats, and CKD progression was hastened by unilateral nephrectomy and exposure to 4.0% sodium diet between 35 and 63 days post-I/R. Th17 cells in peripheral blood showed a progressive increase up to 63 days after recovery from I/R injury. Infiltration of leukocytes including Th17 cells was also elevated in bronchiolar lavage (BAL) fluid 7 days after I/R and remained elevated for up to 63 days. Lung histology demonstrated an increase in alveolar cellularity and a significant increase in picrosirius red staining. Suppression of lymphocytes with mycophenolate mofetil (MMF) or an IL-17 antagonist significantly reduced Th17 cell infiltration and fibrosis in lung. In addition, tracheal smooth muscle contraction to acetylcholine was significantly enhanced 63-days after I/R relative to sham-operated controls. These data suggest that AKI is associated with a persistent increase in circulating and lung Th17 cells which may promote pulmonary fibrosis and the potential alteration in airway contractility.
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MESH Headings
- Acute Kidney Injury/complications
- Acute Kidney Injury/immunology
- Acute Kidney Injury/pathology
- Animals
- Disease Models, Animal
- Disease Progression
- Immunosuppressive Agents/pharmacology
- Lung/drug effects
- Lung/immunology
- Lung/pathology
- Lung/physiopathology
- Male
- Muscle Contraction
- Muscle, Smooth/immunology
- Muscle, Smooth/pathology
- Muscle, Smooth/physiopathology
- Phenotype
- Pneumonia/etiology
- Pneumonia/immunology
- Pneumonia/pathology
- Pneumonia/physiopathology
- Pulmonary Fibrosis/etiology
- Pulmonary Fibrosis/immunology
- Pulmonary Fibrosis/pathology
- Pulmonary Fibrosis/physiopathology
- Rats, Nude
- Rats, Sprague-Dawley
- Rats, Transgenic
- Renal Insufficiency, Chronic/etiology
- Renal Insufficiency, Chronic/immunology
- Renal Insufficiency, Chronic/pathology
- Risk Factors
- Sodium, Dietary/toxicity
- Th17 Cells/drug effects
- Th17 Cells/immunology
- Time Factors
- Trachea/immunology
- Trachea/pathology
- Trachea/physiopathology
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Affiliation(s)
- Purvi Mehrotra
- Department of Cellular and Integrative Physiology, Indiana University , Indianapolis, Indiana
| | - Jason A Collett
- Department of Cellular and Integrative Physiology, Indiana University , Indianapolis, Indiana
| | - Susan J Gunst
- Department of Cellular and Integrative Physiology, Indiana University , Indianapolis, Indiana
| | - David P Basile
- Department of Cellular and Integrative Physiology, Indiana University , Indianapolis, Indiana
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556
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Basile DP, Collett JA, Yoder MC. Endothelial colony-forming cells and pro-angiogenic cells: clarifying definitions and their potential role in mitigating acute kidney injury. Acta Physiol (Oxf) 2018; 222:10.1111/apha.12914. [PMID: 28656611 PMCID: PMC5745310 DOI: 10.1111/apha.12914] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 05/10/2017] [Accepted: 06/21/2017] [Indexed: 12/12/2022]
Abstract
Acute kidney injury (AKI) represents a significant clinical concern that is associated with high mortality rates and also represents a significant risk factor for the development of chronic kidney disease (CKD). This article will consider alterations in renal endothelial function in the setting of AKI that may underlie impairment in renal perfusion and how inefficient vascular repair may manifest post-AKI and contribute to the potential transition to CKD. We provide updated terminology for cells previously classified as 'endothelial progenitor' that may mediate vascular repair such as pro-angiogenic cells and endothelial colony-forming cells. We consider how endothelial repair may be mediated by these different cell types following vascular injury, particularly in models of AKI. We further summarize the potential ability of these different cells to mitigate the severity of AKI, improve perfusion and maintain vascular structure in pre-clinical studies.
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Affiliation(s)
- David P. Basile
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine
| | - Jason A. Collett
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine
| | - Mervin C. Yoder
- Department of Pediatrics, Indiana University School of Medicine
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557
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Myofibrillogenesis Regulator 1 Rescues Renal Ischemia/Reperfusion Injury by Recruitment of PI3K-Dependent P-AKT to Mitochondria. Shock 2018; 46:531-540. [PMID: 27219857 DOI: 10.1097/shk.0000000000000658] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To investigate whether myofibrillogenesis regulator 1 (MR-1) attenuates renal ischemia/reperfusion (I/R) injury via inhibiting phosphorylated Akt (p-Akt) mitochondrial translocation-mediated opening of the mitochondrial permeability transition pore (mPTP), we injected adenovirus containing MR-1 gene or its siRNAs to the left kidney subcapsular areas of Sprague-Dawley rats, which subsequently underwent experimental renal I/R injury. Renal functions and the severity of the tubular injury were evaluated by the serum creatinine and blood urea nitrogen levels and the pathological scores. We also examined the mitochondrial morphology and functions. Total/p-Akt were assessed by western blot using the mitochondrial and the cytosolic fractions of cortex of renal tissue, respectively. We found that mitochondrial and cytosolic MR-1 levels and mitochondrial p-Akt decreased, and cytosolic p-Akt increased after reperfusion. Subcapsular injection of adenovirus led to higher MR-1 expression in the mitochondria/cytosol, inhibited mPTP opening, and alleviated renal I/R injury; adenovirus injection also upregulated mitochondrial total and p-Akt levels more prominently compared with the normal saline (NS) group. Subcapsular injection of MR-1 siRNAs significantly lowered MR-1 expression and induced renal injury, with increased mPTP opening and mitochondrial damage, similar to I/R injury. MR-1 interacted with Akt in renal cortex homogenate. Wortmannin, a phosphatidylinositol 3 kinase (PI3K) inhibitor, abolished both mitochondrial p-Akt recruitment and the protective effect of MR-1 overexpression on I/R injury. To conclude, MR-1 protects kidney against I/R injury through inhibiting mPTP opening and maintaining mitochondrial integrity, through the recruitment of PI3K-dependent p-Akt to the mitochondria. MR-1 could be a new therapeutic strategy for renal I/R injury.
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558
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Kolb AL, Corridon PR, Zhang S, Xu W, Witzmann FA, Collett JA, Rhodes GJ, Winfree S, Bready D, Pfeffenberger ZJ, Pomerantz JM, Hato T, Nagami GT, Molitoris BA, Basile DP, Atkinson SJ, Bacallao RL. Exogenous Gene Transmission of Isocitrate Dehydrogenase 2 Mimics Ischemic Preconditioning Protection. J Am Soc Nephrol 2018; 29:1154-1164. [PMID: 29371417 DOI: 10.1681/asn.2017060675] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/11/2017] [Indexed: 01/20/2023] Open
Abstract
Ischemic preconditioning confers organ-wide protection against subsequent ischemic stress. A substantial body of evidence underscores the importance of mitochondria adaptation as a critical component of cell protection from ischemia. To identify changes in mitochondria protein expression in response to ischemic preconditioning, we isolated mitochondria from ischemic preconditioned kidneys and sham-treated kidneys as a basis for comparison. The proteomic screen identified highly upregulated proteins, including NADP+-dependent isocitrate dehydrogenase 2 (IDH2), and we confirmed the ability of this protein to confer cellular protection from injury in murine S3 proximal tubule cells subjected to hypoxia. To further evaluate the role of IDH2 in cell protection, we performed detailed analysis of the effects of Idh2 gene delivery on kidney susceptibility to ischemia-reperfusion injury. Gene delivery of IDH2 before injury attenuated the injury-induced rise in serum creatinine (P<0.05) observed in controls and increased the mitochondria membrane potential (P<0.05), maximal respiratory capacity (P<0.05), and intracellular ATP levels (P<0.05) above those in controls. This communication shows that gene delivery of Idh2 can confer organ-wide protection against subsequent ischemia-reperfusion injury and mimics ischemic preconditioning.
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Affiliation(s)
- Alexander L Kolb
- Department of Biology, Indiana University-Purdue University, Indianapolis, Indianapolis, Indiana.,Research Division, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana
| | | | - Shijun Zhang
- Department of Biology, Indiana University-Purdue University, Indianapolis, Indianapolis, Indiana
| | | | | | | | | | - Seth Winfree
- Division of Nephrology.,Indiana Center for Biological Microscopy, Indiana University School of Medicine, Indianapolis, Indiana
| | - Devin Bready
- Department of Biology, Indiana University-Purdue University, Indianapolis, Indianapolis, Indiana.,Division of Nephrology
| | | | | | | | - Glenn T Nagami
- Division of Nephrology, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; and.,Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles Veterans Affairs Medical Center, Los Angeles, California
| | - Bruce A Molitoris
- Division of Nephrology.,Indiana Center for Biological Microscopy, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Simon J Atkinson
- Department of Biology, Indiana University-Purdue University, Indianapolis, Indianapolis, Indiana.,Division of Nephrology
| | - Robert L Bacallao
- Research Division, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana; .,Division of Nephrology
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559
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Zhou D, Fu H, Xiao L, Mo H, Zhuo H, Tian X, Lin L, Xing J, Liu Y. Fibroblast-Specific β-Catenin Signaling Dictates the Outcome of AKI. J Am Soc Nephrol 2018; 29:1257-1271. [PMID: 29343518 DOI: 10.1681/asn.2017080903] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/18/2017] [Indexed: 01/10/2023] Open
Abstract
AKI is a devastating condition with high morbidity and mortality. The pathologic features of AKI are characterized by tubular injury, inflammation, and vascular impairment. Whether fibroblasts in the renal interstitium have a role in the pathogenesis of AKI is unknown. In this study, we investigated the role of fibroblast-specific β-catenin signaling in dictating the outcome of AKI, using conditional knockout mice in which β-catenin was specifically ablated in fibroblasts (Gli1-β-cat-/-). After ischemia-reperfusion injury (IRI), Gli1-β-cat-/- mice had lower serum creatinine levels and less morphologic injury than Gli1-β-cat+/+ littermate controls. Moreover, we detected fewer apoptotic cells, as well as decreased cytochrome C release; reduced expression of Bax, FasL, and p53; and increased phosphorylation of Akt, in the Gli1-β-cat-/- kidneys. Gli1-β-cat-/- kidneys also exhibited upregulated expression of proliferating cell nuclear antigen and Ki-67, which are markers of cell proliferation. Furthermore, Gli1-β-cat-/- kidneys displayed suppressed NF-κB signaling and cytokine expression and reduced infiltration of inflammatory cells. Notably, loss of β-catenin in fibroblasts induced renal expression of hepatocyte growth factor (HGF) and augmented the tyrosine phosphorylation of c-met receptor after IRI. In vitro, treatment with Wnt ligands or ectopic expression of active β-catenin inhibited HGF mRNA and protein expression and repressed HGF promoter activity. Collectively, these results suggest that fibroblast-specific β-catenin signaling can control tubular injury and repair in AKI by modulating HGF expression. Our studies uncover a previously unrecognized role for interstitial fibroblasts in the pathogenesis of AKI.
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Affiliation(s)
| | - Haiyan Fu
- State Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Liangxiang Xiao
- State Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | | | | | - Xiaojun Tian
- Computational and Systems Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | - Lin Lin
- Departments of Pathology and
| | - Jianhua Xing
- Computational and Systems Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | - Youhua Liu
- Departments of Pathology and .,State Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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560
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Fuentes-Delgado VH, Martínez-Saldaña MC, Rodríguez-Vázquez ML, Reyes-Romero MA, Reyes-Sánchez JL, Jaramillo-Juárez F. Renal damage induced by the pesticide methyl parathion in male Wistar rats. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2018; 81:130-141. [PMID: 29319433 DOI: 10.1080/15287394.2017.1394948] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Little information is apparently available regarding the nephrotoxic effects induced by pesticides. The aim of this study was to examine the influence of low doses of methyl parathion (MP) on the structure and function of the kidney of male Wistar rats. A corn oil (vehicle) was administered to control rats, whereas treated rats received MP at 0.56 mg/kg orally (1/25 of LD50), every third day, for 8 weeks. At the end of each week following MP exposure, creatinine and glucose levels were measured in plasma, while glucose, inorganic phosphate, total proteins, albumin, and activity of γ-glutamyltranspeptidase (GGT) were determined in urine. Kidney histological study was also performed. Compared with control rats, MP significantly increased plasma glucose and creatinine levels accompanied by decreased urinary flow rate and elevated urinary excretion rates of glucose, phosphate, and albumin. Further, the activity of GGT in urine was increased significantly. The proximal cells exhibited cytoplasmic vacuolization, positive periodic acid Schiff inclusions, and brush border edge loss after 2 or 4 weeks following MP treatment. Finally, renal cortex samples were obtained at 2, 4, 6, and 8 weeks of MP treatment, and the concentrations of reduced glutathione (GSH) and glutathione peroxidase (GPx) activity were measured. The mRNA expression levels of BAX and tumor necrosis factor-α (TNF-α) were also determined (RT-PCR). MP significantly decreased renal GSH levels, increased GPx activity, as well as downregulated the mRNA expression of TNF-α and BAX. Densitometry analysis showed a significant reduction in TNF-α and BAX mRNA expression levels at 2 and 4 weeks following MP treatment. Low doses of MP produced structural and functional damage to the proximal tubules of male rat kidney.
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Affiliation(s)
- Victor Hugo Fuentes-Delgado
- a Centro de Ciencias Básicas, Departamento de Fisiología y Farmacología , Universidad Autónoma de Aguascalientes , Aguascalientes , México
| | - María Consolación Martínez-Saldaña
- a Centro de Ciencias Básicas, Departamento de Fisiología y Farmacología , Universidad Autónoma de Aguascalientes , Aguascalientes , México
| | - María Luisa Rodríguez-Vázquez
- a Centro de Ciencias Básicas, Departamento de Fisiología y Farmacología , Universidad Autónoma de Aguascalientes , Aguascalientes , México
| | - Miguel Arturo Reyes-Romero
- b Facultad de Medicina. Departamento de Medicina Molecular , Universidad Juárez del Estado de Durango , Durango , México
| | | | - Fernando Jaramillo-Juárez
- a Centro de Ciencias Básicas, Departamento de Fisiología y Farmacología , Universidad Autónoma de Aguascalientes , Aguascalientes , México
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561
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Chen S. Kinetic Glomerular Filtration Rate in Routine Clinical Practice-Applications and Possibilities. Adv Chronic Kidney Dis 2018; 25:105-114. [PMID: 29499881 DOI: 10.1053/j.ackd.2017.10.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 10/23/2017] [Accepted: 10/29/2017] [Indexed: 01/23/2023]
Abstract
When the [creatinine] is changing, the kidney function can still be tracked with a quantitative technique called kinetic glomerular filtration rate (GFR). The equation yields useful information on the severity of acute kidney injury, the clinical course of kidney and dialysis clearances, and the timing of kidney recovery. It has been validated in at least 3 independent studies, where it performed sufficiently well in intensive care unit and kidney transplant settings, and in head-to-head comparisons with biomarkers. Because it is based on a mathematical model, the kinetic GFR faces limitations depending on the accuracy of its assumptions. As the assumptions more accurately reflect the complexities of biology, some of these limitations can be overcome in a more sophisticated model. Kinetic GFR is an easy-to-use, low-cost tool that should be more widely incorporated into medical practice.
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562
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Gadelkareem RA, Moeen AM, Reda A, Azoz NM, Elhadad AF, Taha TM, Mohammed N, Taha MI. Experience of a Tertiary-Level Urology Center in the Clinical Urological Events of Rare and Very Rare Incidence. III. Psychourological Events: 1. Psychic Anuria. Urol Int 2018; 101:80-84. [PMID: 29843132 DOI: 10.1159/000488881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/28/2018] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Psychic anuria is an old term, referring to a very rare psycho-urological event that has scarcely been studied so far. MATERIALS AND METHODS A retrospective study of the patients with psychic anuria presented to Assiut Urology and Nephrology Hospital during the period July 1991-June 2016 was done. Psychic anuria was defined, and the demographic and clinical characteristics including the methods of diagnosis and management were studied. RESULTS Of more than 3,800 cases of anuria, 9 female patients (0.24%) experienced psychic anuria in the age range of 17-43 years. Cardinal clinical findings included anuria for 36-72 h with absence of organic causes and normal renal function tests. Psychosocial risk factors were reported in the 9 cases. Anuria was documented by reliable history (56%) or observable urine collection (44%). Diagnosis was done by exclusion, where the investigations revealed no organic causes. Seven cases responded to the placebo intervention and 2 cases were self-limiting and resolved spontaneously. CONCLUSIONS Psychic anuria is an extremely rare urological emergency that presents, mainly, in young adult females with unknown mechanisms. Renal vasoconstriction following psychosocial stressors is suggested. It is diagnosed by exclusion and resolves spontaneously or responds to placebo intervention as a mental distraction technique.
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Affiliation(s)
- Rabea A Gadelkareem
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed M Moeen
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed Reda
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nashwa M Azoz
- Department of Internal Medicine-Nephrology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ali F Elhadad
- Department of Neuropsychiatry, Faculty of Medicine, Al-Azhar University-Assiut Branch, Assiut, Egypt
| | - Taha M Taha
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nasreldin Mohammed
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Urology, Martin-Luther University, Halle, Germany
| | - Mohammed I Taha
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
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563
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Chakraborty A, Viswanathan P. Methylation-Demethylation Dynamics: Implications of Changes in Acute Kidney Injury. Anal Cell Pathol (Amst) 2018; 2018:8764384. [PMID: 30073137 PMCID: PMC6057397 DOI: 10.1155/2018/8764384] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 06/05/2018] [Accepted: 06/14/2018] [Indexed: 02/05/2023] Open
Abstract
Over the years, the epigenetic landscape has grown increasingly complex. Until recently, methylation of DNA and histones was considered one of the most important epigenetic modifications. However, with the discovery of enzymes involved in the demethylation process, several exciting prospects have emerged that focus on the dynamic regulation of methylation and its crucial role in development and disease. An interplay of the methylation-demethylation machinery controls the process of gene expression. Since acute kidney injury (AKI), a major risk factor for chronic kidney disease and death, is characterised by aberrant expression of genes, understanding the dynamics of methylation and demethylation will provide new insights into the intricacies of the disease. Research on epigenetics in AKI has only made its mark in the recent years but has provided compelling evidence that implicates the involvement of methylation and demethylation changes in its pathophysiology. In this review, we explore the role of methylation and demethylation machinery in cellular epigenetic control and further discuss the contribution of methylomic changes and histone modifications to the pathophysiology of AKI.
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Affiliation(s)
- Anubhav Chakraborty
- Renal Research Lab, Centre for Bio-Medical Research, School of Bio-Sciences and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Pragasam Viswanathan
- Renal Research Lab, Centre for Bio-Medical Research, School of Bio-Sciences and Technology, Vellore Institute of Technology, Vellore 632014, India
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564
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Uchida N, Kumagai N, Kondo Y. Application of Muse Cell Therapy for Kidney Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1103:199-218. [PMID: 30484231 DOI: 10.1007/978-4-431-56847-6_11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The kidney plays an essential role in the maintenance of homeostasis in healthy individuals, e.g., by regulating the amount of water and concentration of electrolyte in the body. Owing to the structural complexity, renal dysfunction is caused by a myriad of diseases and conditions, and in severe cases, it progresses to end-stage renal disease in which patients require renal replacement therapy, i.e., maintenance dialysis or kidney transplantation. The currently available therapeutic modalities, with the exception of renal transplantation, cannot recover severely deteriorated renal function. Thus, regenerative medicine holds considerable promise as a potential means for developing next-generation renal therapeutics. Mesenchymal stem cell (MSC) transplantation has been investigated in acute kidney injury and chronic kidney disease models, and clinical studies have already been started for some kinds of kidney diseases. However, most of these studies concluded that the main underlying mechanism of therapeutic effect of MSC transplantation was paracrine. Recently, we reported that Muse cell therapy in a murine model of chronic kidney disease resulted in differentiation of intravenously injected Muse cells into glomerular cells after preferential homing to damaged glomerulus and improvement in renal function. The result suggested the potentiality of Muse cell therapy for glomerular regeneration. Muse cells are a promising cell source for regenerative therapy for kidney diseases.
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Affiliation(s)
- Nao Uchida
- Departments of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Naonori Kumagai
- Departments of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiaki Kondo
- Department of Healthcare Services Management, Nihon University School of Medicine, Tokyo, Japan
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565
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Qureshi SH, Patel NN, Murphy GJ. Vascular endothelial cell changes in postcardiac surgery acute kidney injury. Am J Physiol Renal Physiol 2017; 314:F726-F735. [PMID: 29357431 DOI: 10.1152/ajprenal.00319.2017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Acute kidney injury (AKI) is common complication of cardiac surgery; however, the phenotype of this condition is poorly defined. The aim of this study was to characterize changes in endothelial structure and function that underlie postcardiopulmonary bypass (post-CPB) AKI. Adult pigs ( n = 16) were randomized to undergo the following procedures ( n = 8 per group): group 1: sham operation, neck dissection with 2.5 h of general anesthesia; and group 2: CPB, 2.5 h of cardiopulmonary bypass. CPB resulted in the depletion of specific epitopes of glycosaminoglycans side chains of the endothelial glycocalyx: Dolichos biflorus agglutinin: mean difference (MD) [95% confidence interval (CI)], P value: -0.26 (-0.42, -0.09), P = 0.0024, Triticum vulgaris (wheat germ) agglutinin: -0.83 (-1.2, -0.38), P = 0.0005, and Ulex europaeus agglutinin 1: -0.25 (-0.49, -0.009), P = 0.041; endothelial membrane protein: thrombomodulin: -3.13 (-5.6, -0.65), P = 0.02; and adherens junction: VE-cadherin: -1.06 (-1.98, -0.145), P = 0.02. CPB also resulted in reductions in microvascular cortical perfusion: -0.62 (-1.02, -0.22), P = 0.006, and increased renal cortex adenosine levels: 2.32 (0.83, 3.8), P = 0.0059. These changes were accompanied by significant reduction in creatinine clearance at 1.5 h postintervention, MD 95% CI; -51.7 (-99.7, -3.7), P = 0.037, and at 24 h, MD (95% CI): -47.3 (-87.7, -7.6), P = 0.023, and proteinuria immediately postintervention MD (95% CI): 18.79 (2.17, 35.4), P = 0.03 vs. sham. In our experimental CPB model, endothelial injury was associated with loss of autoregulation, increase in microvascular permeability, and reduced glomerular filtration. Interventions that promote endothelial homeostasis may have clinical utility in the prevention of postcardiac surgery AKI.
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Affiliation(s)
- Saqib H Qureshi
- University of Leicester, Clinical Sciences Wing, Glenfield General Hospital , Leicester , United Kingdom
| | - Nishith N Patel
- National Heart and Lung Institute, Hammersmith Hospital Campus, Imperial College London , London , United Kingdom
| | - Gavin J Murphy
- University of Leicester, Clinical Sciences Wing, Glenfield General Hospital , Leicester , United Kingdom
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566
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Greene CJ, Attwood K, Sharma NJ, Gross KW, Smith GJ, Xu B, Kauffman EC. Transferrin receptor 1 upregulation in primary tumor and downregulation in benign kidney is associated with progression and mortality in renal cell carcinoma patients. Oncotarget 2017; 8:107052-107075. [PMID: 29291011 PMCID: PMC5739796 DOI: 10.18632/oncotarget.22323] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/31/2017] [Indexed: 12/19/2022] Open
Abstract
The central dysregulated pathway of clear cell (cc) renal cell carcinoma (RCC), the von Hippel Lindau/hypoxia inducible factor-α axis, is a key regulator of intracellular iron levels, however the role of iron uptake in human RCC tumorigenesis and progression remains unknown. We conducted a thorough, large-scale investigation of the expression and prognostic significance of the primary iron uptake protein, transferrin receptor 1 (TfR1/CD71/TFRC), in RCC patients. TfR1 immunohistochemistry was performed in over 1500 cores from 574 renal cell tumor patient tissues (primary tumors, matched benign kidneys, metastases) and non-neoplastic tissues from 36 different body sites. TfR1 levels in RCC tumors, particularly ccRCC, were significantly associated with adverse clinical prognostic features (anemia, lower body mass index, smoking), worse tumor pathology (size, stage, grade, multifocality, sarcomatoid dedifferentiation) and worse survival outcomes, including after adjustments for tumor pathology. Highest TfR1 tissue levels in the non-gravid body were detected in benign renal tubule epithelium. Opposite to TfR1 changes in the primary tumor, TfR1 levels in benign kidney dropped during tumor progression and were inversely associated with worse survival outcomes, independent of tumor pathology. Quantitative measurement of TfR1 subcellular localization in cell lines demonstrated mixed cytoplasmic and membranous expression with increased TfR1 in clusters in ccRCC versus benign renal cell lines. Results of this study support an important role for TfR1 in RCC progression and identify TfR1 as a novel RCC biomarker and therapeutic target.
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Affiliation(s)
| | - Kristopher Attwood
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Nitika J. Sharma
- Department of Urology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Kenneth W. Gross
- Department of Molecular and Cellular Biology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Gary J. Smith
- Department of Urology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Bo Xu
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Eric C. Kauffman
- Department of Urology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
- Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
- Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA
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567
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Mullins LJ, Conway BR, Menzies RI, Denby L, Mullins JJ. Renal disease pathophysiology and treatment: contributions from the rat. Dis Model Mech 2017; 9:1419-1433. [PMID: 27935823 PMCID: PMC5200898 DOI: 10.1242/dmm.027276] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The rat has classically been the species of choice for pharmacological studies and disease modeling, providing a source of high-quality physiological data on cardiovascular and renal pathophysiology over many decades. Recent developments in genome engineering now allow us to capitalize on the wealth of knowledge acquired over the last century. Here, we review rat models of hypertension, diabetic nephropathy, and acute and chronic kidney disease. These models have made important contributions to our understanding of renal diseases and have revealed key genes, such as Ace and P2rx7, involved in renal pathogenic processes. By targeting these genes of interest, researchers are gaining a better understanding of the etiology of renal pathologies, with the promised potential of slowing disease progression or even reversing the damage caused. Some, but not all, of these target genes have proved to be of clinical relevance. However, it is now possible to generate more sophisticated and appropriate disease models in the rat, which can recapitulate key aspects of human renal pathology. These advances will ultimately be used to identify new treatments and therapeutic targets of much greater clinical relevance. Summary: This Review highlights the key role that the rat continues to play in improving our understanding of the etiologies of renal pathologies, and how these insights have opened up new therapeutic avenues.
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Affiliation(s)
- Linda J Mullins
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Bryan R Conway
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Robert I Menzies
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Laura Denby
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - John J Mullins
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
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568
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Dewitte A, Lepreux S, Villeneuve J, Rigothier C, Combe C, Ouattara A, Ripoche J. Blood platelets and sepsis pathophysiology: A new therapeutic prospect in critically [corrected] ill patients? Ann Intensive Care 2017; 7:115. [PMID: 29192366 PMCID: PMC5709271 DOI: 10.1186/s13613-017-0337-7] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 11/12/2017] [Indexed: 02/06/2023] Open
Abstract
Beyond haemostasis, platelets have emerged as versatile effectors of the immune response. The contribution of platelets in inflammation, tissue integrity and defence against infections has considerably widened the spectrum of their role in health and disease. Here, we propose a narrative review that first describes these new platelet attributes. We then examine their relevance to microcirculatory alterations in multi-organ dysfunction, a major sepsis complication. Rapid progresses that are made on the knowledge of novel platelet functions should improve the understanding of thrombocytopenia, a common condition and a predictor of adverse outcome in sepsis, and may provide potential avenues for management and therapy.
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Affiliation(s)
- Antoine Dewitte
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France. .,Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, CHU Bordeaux, 33000, Bordeaux, France.
| | - Sébastien Lepreux
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France.,Department of Pathology, CHU Bordeaux, 33000, Bordeaux, France
| | - Julien Villeneuve
- Cell and Developmental Biology Department, Centre for Genomic Regulation, The Barcelona Institute for Science and Technology, 08003, Barcelona, Spain
| | - Claire Rigothier
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France.,Department of Nephrology, Transplantation and Haemodialysis, CHU Bordeaux, 33000, Bordeaux, France
| | - Christian Combe
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France.,Department of Nephrology, Transplantation and Haemodialysis, CHU Bordeaux, 33000, Bordeaux, France
| | - Alexandre Ouattara
- Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, CHU Bordeaux, 33000, Bordeaux, France.,INSERM U1034, Biology of Cardiovascular Diseases, Univ. Bordeaux, 33600, Pessac, France
| | - Jean Ripoche
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France
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569
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Pressly JD, Mustafa SM, Adibi AH, Alghamdi S, Pandey P, Roy KK, Doerksen RJ, Moore BM, Park F. Selective Cannabinoid 2 Receptor Stimulation Reduces Tubular Epithelial Cell Damage after Renal Ischemia-Reperfusion Injury. J Pharmacol Exp Ther 2017; 364:287-299. [PMID: 29187590 DOI: 10.1124/jpet.117.245522] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 11/22/2017] [Indexed: 01/27/2023] Open
Abstract
Ischemia-reperfusion injury (IRI) is a common cause of acute kidney injury (AKI), which is an increasing problem in the clinic and has been associated with elevated rates of mortality. Therapies to treat AKI are currently not available, so identification of new targets that can be modulated to ameliorate renal damage upon diagnosis of AKI is essential. In this study, a novel cannabinoid receptor 2 (CB2) agonist, SMM-295 [3'-methyl-4-(2-(thiophen-2-yl)propan-2-yl)biphenyl-2,6-diol], was designed, synthesized, and tested in vitro and in silico. Molecular docking of SMM-295 into a CB2 active-state homology model showed that SMM-295 interacts well with key amino acids to stabilize the active state. In human embryonic kidney 293 cells, SMM-295 was capable of reducing cAMP production with 66-fold selectivity for CB2 versus cannabinoid receptor 1 and dose-dependently increased mitogen-activated protein kinase and Akt phosphorylation. In vivo testing of the CB2 agonist was performed using a mouse model of bilateral IRI, which is a common model to mimic human AKI, where SMM-295 was immediately administered upon reperfusion of the kidneys after the ischemia episode. Histologic damage assessment 48 hours after reperfusion demonstrated reduced tubular damage in the presence of SMM-295. This was consistent with reduced plasma markers of renal dysfunction (i.e., creatinine and neutrophil gelatinase-associated lipocalin) in SMM-295-treated mice. Mechanistically, kidneys treated with SMM-295 were shown to have elevated activation of Akt with reduced terminal deoxynucleotidyl transferase-mediated digoxigenin-deoxyuridine nick-end labeling (TUNEL)-positive cells compared with vehicle-treated kidneys after IRI. These data suggest that selective CB2 receptor activation could be a potential therapeutic target in the treatment of AKI.
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Affiliation(s)
- Jeffrey D Pressly
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee (J.D.P., S.M.M., A.A., S.A., B.M.M., F.P.); Division of Medicinal Chemistry, Department of Biomolecular Sciences (P.P., K.K.R., R.J.D.) and Research Institute of Pharmaceutical Sciences (R.J.D.), School of Pharmacy, University of Mississippi, University, Mississippi; and National Institute of Pharmaceutical Education and Research, Jadavpur, Kolkata, West Bengal, India (K.K.R.)
| | - Suni M Mustafa
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee (J.D.P., S.M.M., A.A., S.A., B.M.M., F.P.); Division of Medicinal Chemistry, Department of Biomolecular Sciences (P.P., K.K.R., R.J.D.) and Research Institute of Pharmaceutical Sciences (R.J.D.), School of Pharmacy, University of Mississippi, University, Mississippi; and National Institute of Pharmaceutical Education and Research, Jadavpur, Kolkata, West Bengal, India (K.K.R.)
| | - Ammaar H Adibi
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee (J.D.P., S.M.M., A.A., S.A., B.M.M., F.P.); Division of Medicinal Chemistry, Department of Biomolecular Sciences (P.P., K.K.R., R.J.D.) and Research Institute of Pharmaceutical Sciences (R.J.D.), School of Pharmacy, University of Mississippi, University, Mississippi; and National Institute of Pharmaceutical Education and Research, Jadavpur, Kolkata, West Bengal, India (K.K.R.)
| | - Sahar Alghamdi
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee (J.D.P., S.M.M., A.A., S.A., B.M.M., F.P.); Division of Medicinal Chemistry, Department of Biomolecular Sciences (P.P., K.K.R., R.J.D.) and Research Institute of Pharmaceutical Sciences (R.J.D.), School of Pharmacy, University of Mississippi, University, Mississippi; and National Institute of Pharmaceutical Education and Research, Jadavpur, Kolkata, West Bengal, India (K.K.R.)
| | - Pankaj Pandey
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee (J.D.P., S.M.M., A.A., S.A., B.M.M., F.P.); Division of Medicinal Chemistry, Department of Biomolecular Sciences (P.P., K.K.R., R.J.D.) and Research Institute of Pharmaceutical Sciences (R.J.D.), School of Pharmacy, University of Mississippi, University, Mississippi; and National Institute of Pharmaceutical Education and Research, Jadavpur, Kolkata, West Bengal, India (K.K.R.)
| | - Kuldeep K Roy
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee (J.D.P., S.M.M., A.A., S.A., B.M.M., F.P.); Division of Medicinal Chemistry, Department of Biomolecular Sciences (P.P., K.K.R., R.J.D.) and Research Institute of Pharmaceutical Sciences (R.J.D.), School of Pharmacy, University of Mississippi, University, Mississippi; and National Institute of Pharmaceutical Education and Research, Jadavpur, Kolkata, West Bengal, India (K.K.R.)
| | - Robert J Doerksen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee (J.D.P., S.M.M., A.A., S.A., B.M.M., F.P.); Division of Medicinal Chemistry, Department of Biomolecular Sciences (P.P., K.K.R., R.J.D.) and Research Institute of Pharmaceutical Sciences (R.J.D.), School of Pharmacy, University of Mississippi, University, Mississippi; and National Institute of Pharmaceutical Education and Research, Jadavpur, Kolkata, West Bengal, India (K.K.R.)
| | - Bob M Moore
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee (J.D.P., S.M.M., A.A., S.A., B.M.M., F.P.); Division of Medicinal Chemistry, Department of Biomolecular Sciences (P.P., K.K.R., R.J.D.) and Research Institute of Pharmaceutical Sciences (R.J.D.), School of Pharmacy, University of Mississippi, University, Mississippi; and National Institute of Pharmaceutical Education and Research, Jadavpur, Kolkata, West Bengal, India (K.K.R.)
| | - Frank Park
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee (J.D.P., S.M.M., A.A., S.A., B.M.M., F.P.); Division of Medicinal Chemistry, Department of Biomolecular Sciences (P.P., K.K.R., R.J.D.) and Research Institute of Pharmaceutical Sciences (R.J.D.), School of Pharmacy, University of Mississippi, University, Mississippi; and National Institute of Pharmaceutical Education and Research, Jadavpur, Kolkata, West Bengal, India (K.K.R.)
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570
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Shi M, Flores B, Li P, Gillings N, McMillan KL, Ye J, Huang LJS, Sidhu SS, Zhong YP, Grompe MT, Streeter PR, Moe OW, Hu MC. Effects of erythropoietin receptor activity on angiogenesis, tubular injury, and fibrosis in acute kidney injury: a "U-shaped" relationship. Am J Physiol Renal Physiol 2017; 314:F501-F516. [PMID: 29187371 DOI: 10.1152/ajprenal.00306.2017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The erythropoietin receptor (EpoR) is widely expressed but its renoprotective action is unexplored. To examine the role of EpoR in vivo in the kidney, we induced acute kidney injury (AKI) by ischemia-reperfusion in mice with different EpoR bioactivities in the kidney. EpoR bioactivity was reduced by knockin of wild-type human EpoR, which is hypofunctional relative to murine EpoR, and a renal tubule-specific EpoR knockout. These mice had lower EPO/EpoR activity and lower autophagy flux in renal tubules. Upon AKI induction, they exhibited worse renal function and structural damage, more apoptosis at the acute stage (<7 days), and slower recovery with more tubulointerstitial fibrosis at the subacute stage (14 days). In contrast, mice with hyperactive EpoR signaling from knockin of a constitutively active human EpoR had higher autophagic flux, milder kidney damage, and better renal function at the acute stage but, surprisingly, worse tubulointerstitial fibrosis and renal function at the subacute stage. Either excess or deficient EpoR activity in the kidney was associated with abnormal peritubular capillaries and tubular hypoxia, creating a "U-shaped" relationship. The direct effects of EpoR on tubular cells were confirmed in vitro by a hydrogen peroxide model using primary cultured proximal tubule cells with different EpoR activities. In summary, normal erythropoietin (EPO)/EpoR signaling in renal tubules provides defense against renal tubular injury maintains the autophagy-apoptosis balance and peritubular capillary integrity. High and low EPO/EpoR bioactivities both lead to vascular defect, and high EpoR activity overides the tubular protective effects in AKI recovery.
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Affiliation(s)
- Mingjun Shi
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Brianna Flores
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Peng Li
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center , Dallas, Texas.,Department of Nephrology, Yu-Huang-Ding Hospital, Qingdao University , Yantai, Shandong , People's Republic of China
| | - Nancy Gillings
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Kathryn L McMillan
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Jianfeng Ye
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Lily Jun-Shen Huang
- Department of Cell Biology, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Sachdev S Sidhu
- Banting and Best Department of Medical Research and Department of Molecular Genetics, The Donnelly Centre, University of Toronto , Toronto, Ontario , Canada
| | - Yong-Ping Zhong
- Pape Family Pediatric Research Institute, Department of Pediatrics, Oregon Health and Science University , Portland, Oregon
| | - Maria T Grompe
- Pape Family Pediatric Research Institute, Department of Pediatrics, Oregon Health and Science University , Portland, Oregon
| | - Philip R Streeter
- Pape Family Pediatric Research Institute, Department of Pediatrics, Oregon Health and Science University , Portland, Oregon
| | - Orson W Moe
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center , Dallas, Texas.,Department of Internal Medicine, University of Texas Southwestern Medical Center , Dallas, Texas.,Department of Physiology, University of Texas Southwestern Medical Center , Dallas, Texas
| | - Ming Chang Hu
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center , Dallas, Texas.,Department of Internal Medicine, University of Texas Southwestern Medical Center , Dallas, Texas
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571
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Najafi H, Mohamadi Yarijani Z, Changizi-Ashtiyani S, Mansouri K, Modarresi M, Madani SH, Bastani B. Protective effect of Malva sylvestris L. extract in ischemia-reperfusion induced acute kidney and remote liver injury. PLoS One 2017; 12:e0188270. [PMID: 29155898 PMCID: PMC5695808 DOI: 10.1371/journal.pone.0188270] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/03/2017] [Indexed: 01/02/2023] Open
Abstract
Mallow (Malva sylvestris L.) has had medicinal and therapeutic uses in addition to its oral consumption. The present study was conducted to examine the protective effect of Malva sylvestris L. extract on ischemia-reperfusion-induced kidney injury and remote organ injuries in the liver. Before ischemia-reperfusion, rats in the different groups received intraperitoneal normal saline or mallow extract at the doses of 200, 400 or 600 mg/kg of body weight. After 30-minutes of bilateral renal ischemia followed by 24-hours of reperfusion, tissue damage in the kidney and liver samples were determined through studying H&E-stained slides under a light microscope. The degree of leukocyte infiltration and tissue mRNA expressions of TNF- and ICAM-1 were then measured to examine the degree of renal inflammation. The renal tissue MDA and FRAP levels were measured for determining the amount of oxidative stress. Plasma concentrations of creatinine, urea, ALT and ALP were also measured. Ischemia-reperfusion led to a significant increase in plasma concentrations of creatinine, urea, ALT and ALP, and renal tissue MDA, and a significant decrease in renal tissue FRAP. The expression of pro-inflammatory factors in the kidney tissue, the level of leukocyte infiltration and the amount of tissue damage in the kidney and liver also increased. Pretreatment by mallow extract led to a significant improvement in all the variables measured. The 200- and 400-mg doses yielded better results in most parameters compared to the 600-mg dose. The findings showed that mallow extract protects the kidney against ischemia-reperfusion and reduces remote organ injury in the liver.
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Affiliation(s)
- Houshang Najafi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Saeed Changizi-Ashtiyani
- Department of Physiology, School of Paramedical Sciences, Arak University of Medical Sciences, Arak, Iran
| | - Kamran Mansouri
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Modarresi
- Pharmacognosy and Biotechnology Department, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Hamid Madani
- Department of Pathology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bahar Bastani
- Division of Nephrology, School of Medicine, Saint Louis University, Saint Louis, Missouri, United States of America
- * E-mail:
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572
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Moore JK, Chen J, Pan H, Gaut JP, Jain S, Wickline SA. Quantification of vascular damage in acute kidney injury with fluorine magnetic resonance imaging and spectroscopy. Magn Reson Med 2017; 79:3144-3153. [PMID: 29148253 DOI: 10.1002/mrm.26985] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE To design a fluorine MRI/MR spectroscopy approach to quantify renal vascular damage after ischemia-reperfusion injury, and the therapeutic response to antithrombin nanoparticles (NPs) to protect kidney function. METHODS A total of 53 rats underwent 45 min of bilateral renal artery occlusion and were treated at reperfusion with either plain perfluorocarbon NPs or NPs functionalized with a direct thrombin inhibitor (PPACK:phenyalanine-proline-arginine-chloromethylketone). Three hours after reperfusion, kidneys underwent ex vivo fluorine MRI/MR spectroscopy at 4.7 T to quantify the extent and volume of trapped NPs, as an index of vascular damage and ischemia-reperfusion injury. Microscopic evaluation of structural damage and NP trapping in non-reperfused renal segments was performed. Serum creatinine was quantified serially over 7 days. RESULTS The damaged renal cortico-medullary junction trapped a significant volume of NPs (P = 0.04), which correlated linearly (r = 0.64) with the severity of kidney injury 3 h after reperfusion. Despite global large vessel reperfusion, non-reperfusion in medullary peritubular capillaries was confirmed by MRI and microscopy, indicative of continuing hypoxia due to vascular compromise. Treatment of animals with PPACK NPs after acute kidney injury did not accelerate kidney functional recovery. CONCLUSIONS Quantification of ischemia-reperfusion injury after acute kidney injury with fluorine MRI/MR spectroscopy of perfluorocarbon NPs objectively depicts the extent and severity of vascular injury and its linear relationship to renal dysfunction. The lack of kidney function improvement after early posttreatment thrombin inhibition confirms the rapid onset of ischemia-reperfusion injury as a consequence of vascular damage and non-reperfusion. The prolongation of medullary ischemia renders cortico-medullary tubular structures susceptible to continued necrosis despite restoration of large vessel flow, which suggests limitations to acute interventions after acute kidney injury, designed to interdict renal tubular damage. Magn Reson Med 79:3144-3153, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Jeremy K Moore
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Junjie Chen
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Hua Pan
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joseph P Gaut
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sanjay Jain
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Samuel A Wickline
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Biomedical Engineering, Washington University, St. Louis, Missouri, USA.,Department of Cardiovascular Science, University of South Florida, Tampa, Florida, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida, USA
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573
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Xu JR, Zhuang YM, Liu L, Shen B, Wang YM, Luo Z, Teng J, Wang CS, Ding XQ. Reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery. Ther Clin Risk Manag 2017; 13:1499-1505. [PMID: 29184415 PMCID: PMC5689023 DOI: 10.2147/tcrm.s148549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective To evaluate the impact of the renal dysfunction (RD) type and change of postoperative cardiac function on the risk of developing acute kidney injury (AKI) in patients who underwent cardiac valve surgery. Method Reversible renal dysfunction (RRD) was defined as preoperative RD in patients who had not been initially diagnosed with chronic kidney disease (CKD). Cardiac function improvement (CFI) was defined as postoperative left ventricular ejection function – preoperative left ventricular ejection function (ΔEF) >0%, and cardiac function not improved (CFNI) as ΔEF ≤0%. Results Of the 4,805 (94%) cardiac valve surgery patients, 301 (6%) were RD cases. The AKI incidence in the RRD group (n=252) was significantly lower than in the CKD group (n=49) (36.5% vs 63.3%, P=0.018). The AKI and renal replacement therapy incidences in the CFI group (n=174) were significantly lower than in the CFNI group (n=127) (33.9% vs 50.4%, P=0.004; 6.3% vs 13.4%, P=0.037). After adjustment for age, gender, and other confounding factors, CKD and CKD + CFNI were identified as independent risk factors for AKI in all patients after cardiac valve surgery. Multivariate logistic regression analysis showed that the risk factors for postoperative AKI in preoperative RD patients were age, gender (male), hypertension, diabetes, chronic heart failure, cardiopulmonary bypass time (every 1 min added), and intraoperative hypotension, while CFI after surgery could reduce the risk. Conclusion For cardiac valve surgery patients, preoperative CKD was an independent risk factor for postoperative AKI, but RRD did not add to the risk. Improved postoperative cardiac function can significantly reduce the risk of postoperative AKI.
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Affiliation(s)
- Jia-Rui Xu
- Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai.,Shanghai Institute for Kidney and Dialysis, Shanghai.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai
| | - Ya-Min Zhuang
- Department of Cardiovascular Surgery, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai
| | - Lan Liu
- Department of Cardiovascular Surgery, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai
| | - Bo Shen
- Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai.,Shanghai Institute for Kidney and Dialysis, Shanghai.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai
| | - Yi-Mei Wang
- Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai.,Shanghai Institute for Kidney and Dialysis, Shanghai.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai
| | - Zhe Luo
- Department of Cardiovascular Surgery, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai
| | - Jie Teng
- Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai.,Shanghai Institute for Kidney and Dialysis, Shanghai.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai.,Department of Nephrology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
| | - Chun-Sheng Wang
- Department of Cardiovascular Surgery, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai
| | - Xiao-Qiang Ding
- Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai.,Shanghai Institute for Kidney and Dialysis, Shanghai.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai
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574
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Motayagheni N, Phan S, Eshraghi C, Nozari A, Atala A. A Review of Anesthetic Effects on Renal Function: Potential Organ Protection. Am J Nephrol 2017; 46:380-389. [PMID: 29131005 DOI: 10.1159/000482014] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Renal protection is a critical concept for anesthesiologists, nephrologists, and urologists, since anesthesia and renal function are highly interconnected and can potentially interfere with one another. Therefore, a comprehensive understanding of anesthetic drugs and their effects on renal function remains fundamental to the success of renal surgeries, especially transplant procedures. Some experimental studies have shown that some anesthetics provide protection against renal ischemia/reperfusion (IR) injury, but there is limited clinical evidence. SUMMARY The effects of anesthetic drugs on renal failure are particularly important in the context of kidney transplantation, since the conditions of preservation following removal profoundly influence the recovery of organ function. Currently, preservation procedures are typically based on the usage of a cold-storage solution. Some anesthetic drugs induce anti-inflammatory, anti-necrotic, and anti-apoptotic effects. A more thorough understanding of anesthetic effects on renal function can present a novel approach for developing organ-protective strategies. The aim of this review is to discuss the effects of different anesthetic drugs on renal function, with particular focus on IR injury. Many studies have demonstrated the organ-protective effects of some anesthetic drugs, specifically propofol, which indicate the potential of some anesthetics to introduce novel organ protective targets. This is not surprising, since lipid emulsions are major components of propofol, which accumulating data show provide organ protective effects against IR injury. Key Messages: Thorough understanding of the interaction between anesthetic drugs and renal function remains fundamental to the delivery of safe perioperative care and to optimizing outcomes after renal surgeries, particularly transplant procedures. Anesthetics can be repurposed for organ protection with more information about their effects, especially during transplant procedures. Here, we review the effects of different anesthetic drugs - specifically those that contain lipids in their structure, with special reference to IR injury.
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Affiliation(s)
- Negar Motayagheni
- Institute for Regenerative Medicine (Wake Forest Institute of Regenerative Medicine), Wake Forest School of Medicine Medical Center Boulevard, Winston-Salem, North Carolina, USA
| | - Sheshanna Phan
- Department of Anesthesiology, Division of Molecular Medicine, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - Crystal Eshraghi
- Department of Anesthesiology, Division of Molecular Medicine, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - Ala Nozari
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Anthony Atala
- Institute of Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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575
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Beharry KD, Cai CL, Soontarapornchai K, Ahmad T, Valencia GB, Aranda JV. Intermittent hypoxia alters dose dependent caffeine effects on renal prostanoids and receptors in neonatal rats. Prostaglandins Other Lipid Mediat 2017; 134:57-65. [PMID: 29107023 DOI: 10.1016/j.prostaglandins.2017.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/02/2017] [Accepted: 10/18/2017] [Indexed: 12/20/2022]
Abstract
Caffeine, one of the most commonly prescribed drugs in preterm neonates, is given in standard or suprapharmacologic doses. Although known as a diuretic, its effects in the neonatal kidneys are not well studied. We tested the hypothesis that neonatal intermittent hypoxia (IH) and high caffeine doses (HCD) alter renal regulators of vasomotor tone and water balance. Newborn rats were randomized to room air, hyperoxia, or IH and treated with standard or high caffeine doses; or placebo saline. Renal prostanoids; histopathology; and cyclooxygenase (COX), prostanoid receptor, and aquaporin (AQP) immunoreactivity were determined. HCD in IH caused severe pathological changes in the glomeruli and proximal tubules, consistent with acute kidney injury. This was associated with reductions in anthropometric growth, PGI2, and IP, DP, and AQP-4 immunoreactivity, well as a robust increase in COX-2, suggesting that the use of HCD should be avoided in preterm infants who experience frequent IH episodes.
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Affiliation(s)
- Kay D Beharry
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY, USA; Department of Ophthalmology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA; SUNY Eye Institute, New York, NY, USA.
| | - Charles L Cai
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Kultida Soontarapornchai
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Taimur Ahmad
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Gloria B Valencia
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Jacob V Aranda
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY, USA; Department of Ophthalmology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA; SUNY Eye Institute, New York, NY, USA
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576
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Oprea AD, Del Rio JM, Cooter M, Green CL, Karhausen JA, Nailer P, Guinn NR, Podgoreanu MV, Stafford-Smith M, Schroder JN, Fontes ML, Kertai MD. Pre- and postoperative anemia, acute kidney injury, and mortality after coronary artery bypass grafting surgery: a retrospective observational study. Can J Anaesth 2017; 65:46-59. [DOI: 10.1007/s12630-017-0991-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 09/06/2017] [Accepted: 10/11/2017] [Indexed: 11/25/2022] Open
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577
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Guerci P, Ergin B, Ince C. The macro- and microcirculation of the kidney. Best Pract Res Clin Anaesthesiol 2017; 31:315-329. [PMID: 29248139 DOI: 10.1016/j.bpa.2017.10.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 10/25/2017] [Indexed: 01/22/2023]
Abstract
Acute kidney injury (AKI) remains one of the main causes of morbidity and mortality in the intensive care medicine today. Its pathophysiology and progress to chronic kidney disease is still under investigation. In addition, the lack of techniques to adequately monitor renal function and microcirculation at the bedside makes its therapeutic resolution challenging. In this article, we review current concepts related to renal hemodynamics compromise as being the event underlying AKI. In doing so, we discuss the physiology of the renal circulation and the effects of alterations in systemic hemodynamics that lead to renal injury specifically in the context of reperfusion injury and sepsis. The ultimate key culprit of AKI leading to failure is the dysfunction of the renal microcirculation. The cellular and subcellular components of the renal microcirculation are discussed and how their injury contributes to AKI is described.
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Affiliation(s)
- Philippe Guerci
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Nancy, France; INSERM U1116, University of Lorraine, Vandoeuvre-Les-Nancy, France; Department of Translational Physiology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Bulent Ergin
- Department of Translational Physiology, Academic Medical Centre, Amsterdam, The Netherlands; Department of Intensive Care Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Can Ince
- Department of Translational Physiology, Academic Medical Centre, Amsterdam, The Netherlands; Department of Intensive Care Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
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578
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Bevc S, Ekart R, Hojs R. The assessment of acute kidney injury in critically ill patients. Eur J Intern Med 2017; 45:54-58. [PMID: 28982602 DOI: 10.1016/j.ejim.2017.09.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/28/2017] [Accepted: 09/29/2017] [Indexed: 01/10/2023]
Abstract
Acute kidney injury (AKI) is common in critically ill patients and is associated with high morbidity and mortality. The availability of several biomarkers of kidney injury offers new tools for its early recognition and management. The early identification of high-risk patients provides an opportunity to develop strategies for the prevention, early diagnosis and treatment of AKI. Despite progress in critical care medicine over the past decade, the treatment strategies for AKI in critically ill patients, such as when to start renal replacement therapy, remain controversial. A recently proposed risk prediction score for AKI, based on routinely available clinical variables, presents a new means of identifying patients at high risk of AKI.
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Affiliation(s)
- Sebastjan Bevc
- Clinic for Internal Medicine, Department of Nephrology, University Medical Centre Maribor, Maribor, Slovenia; Faculty of Medicine, University of Maribor, Maribor, Slovenia.
| | - Robert Ekart
- Department of Dialysis, University Medical Centre Maribor, Maribor, Slovenia; Faculty of Medicine, University of Maribor, Maribor, Slovenia.
| | - Radovan Hojs
- Clinic for Internal Medicine, Department of Nephrology, University Medical Centre Maribor, Maribor, Slovenia; Faculty of Medicine, University of Maribor, Maribor, Slovenia.
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579
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Kim IH, Kwon MJ, Jung JH, Nam TJ. Protein extracted from Porphyra yezoensis prevents cisplatin-induced nephrotoxicity by downregulating the MAPK and NF-κB pathways. Int J Mol Med 2017; 41:511-520. [PMID: 29115386 DOI: 10.3892/ijmm.2017.3214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/20/2017] [Indexed: 11/05/2022] Open
Abstract
Acute renal failure is a serious complication of treatment with the anticancer drug cisplatin. Cisplatin exerts a cytotoxic effect on renal cells by inducing apoptosis through activating the tumor suppressor p53, nuclear factor‑κB (NF‑κB) and mitogen‑activated protein kinase (MAPK)/p38 pathways. Effects of protein extracts of the brown seaweed Porphyra yezoensis (P. yezoensis) on cytotoxicity, inflammation and cell proliferation have been reported; however, the effects of P. yezoensis protein (PYP) extract on cisplatin‑induced renal injury have remained elusive. The present study investigated the effects of PYP on cisplatin‑induced nephrotoxicity in the HK2 human proximal tubular epithelial cell line. PYP treatment reduced cisplatin‑induced apoptosis and death of HK2 cells by restoring the B‑cell lymphoma‑2 (Bcl‑2)‑associated X protein (Bax)/Bcl‑2 imbalance, cytochrome c release and caspase‑3 activation. In addition, PYP activated the redox‑sensitive transcription factor NF‑κB via stimulating the nuclear translocation of p65 in HK2 cells. PYP also restored renal antioxidant levels and increased the total and nuclear accumulation of NF erythroid 2‑related factor 2 in HK2 cells. PYP markedly attenuated cisplatin‑induced p38, MAPK and c‑Jun N‑terminal kinase phosphorylation. Furthermore, treatment with PYP ameliorated cisplatin‑induced renal cell damage by upregulating antioxidant defense mechanisms and downregulating the MAPK and NF‑κB signaling pathways. In addition, mice were divided into three treatment groups (control, cisplatin and PYP + cisplatin) and the effects of PYP were evaluated in a mouse model of cisplatin‑induced acute kidney injury. The concentrations of blood urea nitrogen and serum creatinine in the PYP + cisplatin group were lower than those in the cisplatin group. The mRNA expression levels of inflammatory factors interleukin‑6 (IL‑6), IL‑1β, tumor necrosis factor‑α and monocyte chemoattractant protein‑1 in the kidney tissues of the PYP + cisplatin group were also lower than those in the cisplatin group. These results suggest that PYP treatment had a preventive effect on nephrotoxicity, specifically by downregulating the MAPK and NF‑κB signaling pathways and the mRNA levels of inflammatory genes.
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Affiliation(s)
- In-Hye Kim
- Cell Biology Laboratory, Institute of Fisheries Sciences, Pukyong National University, Busan 46041, Republic of Korea
| | - Mi-Jin Kwon
- Department of Food Science and Nutrition, Pukyong National University, Busan 48513, Republic of Korea
| | - Jae-Hun Jung
- Department of Food Science and Nutrition, Pukyong National University, Busan 48513, Republic of Korea
| | - Taek-Jeong Nam
- Cell Biology Laboratory, Institute of Fisheries Sciences, Pukyong National University, Busan 46041, Republic of Korea
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580
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Zhang Z, Qi D, Wang X, Gao Z, Li P, Liu W, Tian X, Liu Y, Yang M, Liu K, Fan H. Protective effect of Salvianolic acid A on ischaemia-reperfusion acute kidney injury in rats through protecting against peritubular capillary endothelium damages. Phytother Res 2017; 32:103-114. [DOI: 10.1002/ptr.5954] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 08/13/2017] [Accepted: 09/21/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Zuokai Zhang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong; Yantai University; Yantai 264005 P.R. China
| | - Dong Qi
- Department of Nephrology; Yu-Huang-Ding Hospital/Qingdao University; 264000 Yantai Shandong P.R. China
| | - Xuekai Wang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong; Yantai University; Yantai 264005 P.R. China
| | - Zhenfang Gao
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong; Yantai University; Yantai 264005 P.R. China
| | - Peng Li
- Department of Nephrology; Yu-Huang-Ding Hospital/Qingdao University; 264000 Yantai Shandong P.R. China
| | - Wenbo Liu
- Medical Research Center; Binzhou Medical University; 264003 Yantai Shandong China
| | - Xiao Tian
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong; Yantai University; Yantai 264005 P.R. China
| | - Yue Liu
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong; Yantai University; Yantai 264005 P.R. China
| | - Mingyan Yang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong; Yantai University; Yantai 264005 P.R. China
| | - Ke Liu
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong; Yantai University; Yantai 264005 P.R. China
| | - Huaying Fan
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong; Yantai University; Yantai 264005 P.R. China
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581
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McTavish RK, Richard L, McArthur E, Shariff SZ, Acedillo R, Parikh CR, Wald R, Wilk P, Garg AX. Association Between High Environmental Heat and Risk of Acute Kidney Injury Among Older Adults in a Northern Climate: A Matched Case-Control Study. Am J Kidney Dis 2017; 71:200-208. [PMID: 29074166 DOI: 10.1053/j.ajkd.2017.07.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/13/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND An association between high heat and acute kidney injury (AKI) has been reported in warm climates. However, whether this association generalizes to a northern climate, with more variable temperatures, is unknown. STUDY DESIGN Matched case-control study. SETTING & PARTICIPANTS Our study focused on older adults (mean age, 80 years) in the northern climate of Ontario, Canada. 52,913 case patients who had a hospital encounter with AKI in April through September 2005 to 2012 were matched with 174,222 controls for exact date, age, sex, rural residence, income, and history of chronic kidney disease. PREDICTOR Heat periods were defined as 3 consecutive days exceeding the 95th percentile of area-specific maximum temperature. OUTCOMES Hospital encounter (inpatient admission or emergency department visit) with a diagnosis of AKI. MEASUREMENTS ORs (95% CIs) were used to assess the association between heat periods and AKI. To quantify the effect in absolute terms, we multiplied the population incidence rate of AKI in the absence of heat periods by our adjusted OR (an approximate of relative risk). RESULTS Heat periods were significantly associated with higher risk for AKI (adjusted OR, 1.11; 95% CI, 1.00-1.23). Heat periods in absolute terms were associated with an additional 182 cases of AKI per 100,000 person-years during the warm season. LIMITATIONS We did not know how long persons were outside or if they had access to air conditioning. CONCLUSIONS In a northern climate, periods of higher environmental heat were associated with a modestly higher risk for hospital encounter with AKI among older adults.
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Affiliation(s)
- Rebecca K McTavish
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Lucie Richard
- Institute for Clinical Evaluative Sciences, London, Ontario, Canada
| | - Eric McArthur
- Institute for Clinical Evaluative Sciences, London, Ontario, Canada
| | | | - Rey Acedillo
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Division of Nephrology, Western University, London, Ontario, Canada
| | | | - Ron Wald
- Division of Nephrology, University of Toronto and St. Michael's Hospital, Toronto, Ontario, Canada
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Institute for Clinical Evaluative Sciences, London, Ontario, Canada
| | - Amit X Garg
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Institute for Clinical Evaluative Sciences, London, Ontario, Canada; Division of Nephrology, Western University, London, Ontario, Canada.
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582
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Dube S, Matam T, Yen J, Mang HE, Dagher PC, Hato T, Sutton TA. Endothelial STAT3 Modulates Protective Mechanisms in a Mouse Ischemia-Reperfusion Model of Acute Kidney Injury. J Immunol Res 2017; 2017:4609502. [PMID: 29181415 PMCID: PMC5664346 DOI: 10.1155/2017/4609502] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/29/2017] [Indexed: 01/24/2023] Open
Abstract
STAT3 is a transcriptional regulator that plays an important role in coordinating inflammation and immunity. In addition, there is a growing appreciation of the role STAT3 signaling plays in response to organ injury following diverse insults. Acute kidney injury (AKI) from ischemia-reperfusion injury is a common clinical entity with devastating consequences, and the recognition that endothelial alterations contribute to kidney dysfunction in this setting is of growing interest. Consequently, we used a mouse with a genetic deletion of Stat3 restricted to the endothelium to examine the role of STAT3 signaling in the pathophysiology of ischemic AKI. In a mouse model of ischemic AKI, the loss of endothelial STAT3 signaling significantly exacerbated kidney dysfunction, morphologic injury, and proximal tubular oxidative stress. The increased severity of ischemic AKI was associated with more robust endothelial-leukocyte adhesion and increased tissue accumulation of F4/80+ macrophages. Moreover, important proximal tubular adaptive mechanisms to injury were diminished in association with decreased tissue mRNA levels of the epithelial cell survival cytokine IL-22. In aggregate, these findings suggest that the endothelial STAT3 signaling plays an important role in limiting kidney dysfunction in ischemic AKI and that selective pharmacologic activation of endothelial STAT3 signaling could serve as a potential therapeutic target.
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Affiliation(s)
- Shataakshi Dube
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tejasvi Matam
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jessica Yen
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Henry E. Mang
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Pierre C. Dagher
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Takashi Hato
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Timothy A. Sutton
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
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583
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Ewart L, Dehne EM, Fabre K, Gibbs S, Hickman J, Hornberg E, Ingelman-Sundberg M, Jang KJ, Jones DR, Lauschke VM, Marx U, Mettetal JT, Pointon A, Williams D, Zimmermann WH, Newham P. Application of Microphysiological Systems to Enhance Safety Assessment in Drug Discovery. Annu Rev Pharmacol Toxicol 2017; 58:65-82. [PMID: 29029591 DOI: 10.1146/annurev-pharmtox-010617-052722] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Enhancing the early detection of new therapies that are likely to carry a safety liability in the context of the intended patient population would provide a major advance in drug discovery. Microphysiological systems (MPS) technology offers an opportunity to support enhanced preclinical to clinical translation through the generation of higher-quality preclinical physiological data. In this review, we highlight this technological opportunity by focusing on key target organs associated with drug safety and metabolism. By focusing on MPS models that have been developed for these organs, alongside other relevant in vitro models, we review the current state of the art and the challenges that still need to be overcome to ensure application of this technology in enhancing drug discovery.
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Affiliation(s)
- Lorna Ewart
- Drug Safety and Metabolism, Innovative Medicines and Early Development, AstraZeneca, Cambridge CB4 0WG, United Kingdom;
| | | | - Kristin Fabre
- Drug Safety and Metabolism, Innovative Medicines and Early Development, AstraZeneca, Waltham, Massachusetts 02451, USA
| | - Susan Gibbs
- Department of Dermatology, VU University Medical Center, 1081 HZ Amsterdam, The Netherlands.,Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, 1081 LA Amsterdam, The Netherlands
| | - James Hickman
- NanoScience Technology Center, University of Central Florida, Orlando, Florida 32826, USA
| | - Ellinor Hornberg
- Drug Safety and Metabolism, Innovative Medicines and Early Development, AstraZeneca, 431 83 Mölndal, Sweden
| | - Magnus Ingelman-Sundberg
- Department of Physiology and Pharmacology, Section of Pharmacogenetics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | | | - David R Jones
- Medicines & Healthcare Products Regulatory Agency, London SW1W 9SZ, United Kingdom
| | - Volker M Lauschke
- Department of Physiology and Pharmacology, Section of Pharmacogenetics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | | | - Jerome T Mettetal
- Drug Safety and Metabolism, Innovative Medicines and Early Development, AstraZeneca, Waltham, Massachusetts 02451, USA
| | - Amy Pointon
- Drug Safety and Metabolism, Innovative Medicines and Early Development, AstraZeneca, Cambridge CB4 0WG, United Kingdom;
| | - Dominic Williams
- Drug Safety and Metabolism, Innovative Medicines and Early Development, AstraZeneca, Cambridge CB4 0WG, United Kingdom;
| | - Wolfram-Hubertus Zimmermann
- Institute of Pharmacology and Toxicology, University Medical Center Goettingen, Goettingen 37075, Germany.,German Center for Cardiovascular Research (DZHK), Goettingen 37075, Germany
| | - Peter Newham
- Drug Safety and Metabolism, Innovative Medicines and Early Development, AstraZeneca, Cambridge CB4 0WG, United Kingdom;
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584
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Boozari M, Hosseinzadeh H. Natural medicines for acute renal failure: A review. Phytother Res 2017; 31:1824-1835. [PMID: 29027276 DOI: 10.1002/ptr.5943] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 12/17/2022]
Abstract
Acute renal failure (ARF) is a life-threating disease with high mortality percentage. Two important mechanisms of ARF are inflammation and oxidative stress. Plants are rich source of antioxidant compounds and have a strong anti-inflammatory activity, so they may be useful for the treatment of ARF. Some herbal medicines are effective against different models of experimentally induced ARF such as cisplatin, gentamicin, glycerol, and ischemia-reperfusion injury. Some of these plants such as ginseng, black seed, ginger, garlic, grape, pomegranate, saffron, and green tea are so famous and are effective against various models of ARF. However, we found several articles examining the effectiveness of different plants for treating ARF. In the current article, we discussed plants and natural products that are effective in the treatment of ARF.
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Affiliation(s)
- Motahareh Boozari
- Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Hosseinzadeh
- Pharmaceutical Research Center, Department of Pharmacodynamic and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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585
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Cortes AL, Gonsalez SR, Rioja LS, Oliveira SSC, Santos ALS, Prieto MC, Melo PA, Lara LS. Protective outcomes of low-dose doxycycline on renal function of Wistar rats subjected to acute ischemia/reperfusion injury. Biochim Biophys Acta Mol Basis Dis 2017; 1864:102-114. [PMID: 28987762 DOI: 10.1016/j.bbadis.2017.10.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 08/08/2017] [Accepted: 10/03/2017] [Indexed: 02/06/2023]
Abstract
Renal ischemia-reperfusion injury (IRI) is a major cause of acute renal failure. Doxycycline (Dc) belongs to the tetracycline-class of antibiotics with demonstrated beneficial molecular effects in the brain and heart, mainly through matrix metalloproteinases inhibition (MMP). However, Dc protection of renal function has not been demonstrated. We determined whether low doses of Dc would prevent decreases in glomerular filtration rate (GFR) and maintain tubular Na+ handling in Wistar rats subjected to kidney I/R. Male Wistar rats underwent bilateral kidney ischemia for 30min followed by 24h reperfusion (I/R). Doxycycline (1, 3, and 10mg/kg, i.p.) was administered 2h before surgery. Untreated I/R rats showed a 250% increase in urine volume and proteinuria, a 60% reduction in GFR, accumulation of urea-nitrogen in the blood, and a 60% decrease in the fractional Na+ excretion due to unbalanced Na+ transporter activity. Treatment with Dc 3mg/kg maintained control levels of urine volume, proteinuria, GFR, blood urea-nitrogen, fractional Na+ excretion, and equilibrated Na+ transporter activities. The Dc protection effects on renal function were associated with kidney structure preservation and prevention of TGFβ and fibronectin deposition. In vitro, total MMP activity was augmented in I/R and inhibited by 25 and 50μM Dc. In vivo, I/R augmented MMP-2 and -9 protein content without changing their activities. Doxycycline treatment downregulated total MMP activity and MMP-2 and -9 protein content. Our results suggest that treatment with low dose Dc protects from IRI, thereby preserving kidney function.
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Affiliation(s)
- Aline L Cortes
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sabrina R Gonsalez
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lilimar S Rioja
- Departamento de Patologia e Laboratórios, Universidade do Estado do Rio de Janeiro, Brazil
| | - Simone S C Oliveira
- Departamento de Microbiologia Geral, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - André L S Santos
- Departamento de Microbiologia Geral, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Minolfa C Prieto
- Department of Physiology, School of Medicine, Tulane University School of Medicine, New Orleans, LA, USA; Tulane Hypertension and Renal Center of Excellence, Tulane University, New Orleans, LA, USA
| | - Paulo A Melo
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucienne S Lara
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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586
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Chihanga T, Ma Q, Nicholson JD, Ruby HN, Edelmann RE, Devarajan P, Kennedy MA. NMR spectroscopy and electron microscopy identification of metabolic and ultrastructural changes to the kidney following ischemia-reperfusion injury. Am J Physiol Renal Physiol 2017; 314:F154-F166. [PMID: 28978534 DOI: 10.1152/ajprenal.00363.2017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Cellular, molecular, and ultrastructural nephron changes associated with ischemia-reperfusion injury-induced acute kidney injury (IRI-AKI) are not completely understood. Here, a multidisciplinary study was used to identify nephron changes in a mouse model of IRI-AKI. Histological analyses indicated distended Bowman's glomerular spaces and proximal and distal tubules. Increased filtrate volume in nephrons was caused by reduced water reabsorption by severely damaged proximal tubule brush borders and blocked flow of filtrate into collecting tubules by mucoprotein casts in distal tubules. Immunohistochemistry revealed protein AKI biomarkers in proximal tubules and glomeruli but not in distal tubules. Nuclear magnetic resonance spectroscopy revealed several metabolites that increased such as valine, alanine, and lactate. Other metabolites such as trigonelline, succinate, 2-oxoisocaproate, and 1- methyl-nicotinamide decreased or were absent in urine following IRI due to altered kidney function or metabolism. Urinary glucose increased due to reduced reabsorption by damaged proximal tubule brush borders. Scanning electron microscopy revealed flattening of podocytes and pedicals surrounding glomerular capillaries, and transmission electron microscopy (TEM) revealed effacement of podocyte pedicals, both consistent with increased hydrostatic pressure in nephrons following IRI-AKI. TEM revealed shortened proximal tubule microvilli in IRI kidneys with diminished lamina propia. TEM showed dramatic loss of mitochondria in distal tubule epithelia of IRI kidneys and emergence of multivesicular bodies of endosomes indicating ongoing cellular death. Collectively, the data define ultrastructural changes to nephrons and altered kidney metabolism associated with IRI-AKI.
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Affiliation(s)
- Tafadzwa Chihanga
- Department of Chemistry and Biochemistry, Miami University , Oxford, Ohio
| | - Qing Ma
- Department of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati , Cincinnati, Ohio
| | - Jenna D Nicholson
- Department of Chemistry and Biochemistry, Miami University , Oxford, Ohio
| | - Hannah N Ruby
- Department of Chemistry and Biochemistry, Miami University , Oxford, Ohio
| | - Richard E Edelmann
- Center for Advanced Microscopy and Imaging, Miami University, Oxford, OH
| | - Prasad Devarajan
- Department of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati , Cincinnati, Ohio
| | - Michael A Kennedy
- Department of Chemistry and Biochemistry, Miami University , Oxford, Ohio
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587
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Kazama I, Nakajima T. Postrenal acute kidney injury in a patient with unilateral ureteral obstruction caused by urolithiasis: A case report. Medicine (Baltimore) 2017; 96:e8381. [PMID: 29069033 PMCID: PMC5671866 DOI: 10.1097/md.0000000000008381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
RATIONALE In patients with bilateral ureteral obstruction, the serum creatinine levels are often elevated, sometimes causing postrenal acute kidney injury (AKI). In contrast, those with unilateral ureteral obstruction present normal serum creatinine levels, as long as their contralateral kidneys are preserved intact. However, the unilateral obstruction of the ureter could affect the renal function, as it humorally influences the renal hemodynamics. PATIENT CONCERNS A 66-year-old man with a past medical history of hypertension and diabetes mellitus came to our outpatient clinic because of right abdominal dullness. DIAGNOSES Unilateral ureteral obstruction caused by a radio-opaque calculus in the right upper ureter and a secondary renal dysfunction. INTERVENTIONS As oral hydration and the use of calcium antagonists failed to allow the spontaneous stone passage, extracorporeal shock wave lithotripsy (ESWL) was performed. OUTCOMES Immediately after the passage of the stone, the number of red blood cells in the urine was dramatically decreased and the serum creatinine level almost returned to the normal range with the significant increase in glomerular filtration rate. LESSONS Unilateral ureteral obstruction by the calculus, which caused reflex vascular constriction and ureteral spasm in the contralateral kidney, was thought to be responsible for the deteriorating renal function.
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Affiliation(s)
- Itsuro Kazama
- Department of Physiology, Tohoku University Graduate School of Medicine, Seiryo-cho, Aoba-ku
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588
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Qin H, Wu H, Chen Y, Zhang N, Fan Z. Early Detection of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection With Doppler Renal Resistive Index. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:2105-2111. [PMID: 28586115 DOI: 10.1002/jum.14236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 01/19/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES This study aimed to evaluate the early efficiency of Doppler renal resistive index (DRRI) in prediction of acute kidney injury (AKI) after surgery in acute Stanford Type A aortic dissection (AAAD) patients. METHODS Sixty-one AAAD patients who planned to receive Sun's surgical management were prospectively enrolled. The DRRI was measured by ultrasonography Doppler on the day before surgery (DRRIpre ), on admission to the intensive care unit (DRRIT0 ), 6 hours after surgery (DRRIT6 ), 24 hours after surgery (DRRIT24 ), and 48 hours after surgery (DRRIT48 ). The maximum DRRI value (DRRImax ) was recorded. The AKI was evaluated according to the classifications of the Acute Kidney Injury Network. The DRRI and serum creatinine (sCr) were compared between the pre- and postoperative time stations, as well as between the AKI and no-AKI groups. RESULTS Thirty-nine (63.9%) patients suffered from AKI, and 12 (19.6%) patients received dialysis. No significant difference was found in DRRIpre (0.63 ± 0.04 versus 0.65 ± 0.06, P = .059) and sCrpre (84.13 ± 23.77 versus 94.29 ± 51.11, P = .383) between the two groups with and without AKI. Both the DRRI and sCr increased significantly after surgery in the AKI groups (P < .001). However, the DRRI reached its maximum 6 hours after surgery, whereas the sCr reached its maximum after 24 hours. Both the DRRI and sCr improved 48 hours after surgery. The area under the receiver operating characteristic curve for DRRImax (0.864, 95% confidence interval: 0.770-0.957) and DRRIT6 (0.861, 95% confidence interval: 0.766-0.957) was larger than the other three DRRIs measured at different time points. The cutoff value of DRRImax was 0.71, a sensitivity of 76.9% and specificity of 95.5%. CONCLUSIONS Postoperative DRRI predicts the AKI earlier than sCr after AAAD surgery. The best time to detect DRRI was 6 hours after surgery.
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Affiliation(s)
- Huai Qin
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Haibo Wu
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Yi Chen
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Zhanming Fan
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
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589
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Zepeda-Orozco D, Wen HM, Hamilton BA, Raikwar NS, Thomas CP. EGF regulation of proximal tubule cell proliferation and VEGF-A secretion. Physiol Rep 2017; 5:5/18/e13453. [PMID: 28963126 PMCID: PMC5617933 DOI: 10.14814/phy2.13453] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 07/31/2017] [Accepted: 08/17/2017] [Indexed: 11/24/2022] Open
Abstract
Proximal tubule cell (PTC) proliferation is critical for tubular regeneration and recovery from acute kidney injury. Epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF‐A) are important for the maintenance of tubulointerstitial integrity and can stimulate PTC proliferation. We utilized HK‐2 cells, an immortalized human PTC line, to characterize the EGF‐dependent regulation of VEGF‐A secretion and proliferation in PTCs. We demonstrate that EGF stimulates VEGF‐A secretion via the EGF receptor (EGFR) and stimulates cell proliferation via activation of the VEGF receptor, VEGFR‐2. EGFR activation promotes MAPK (ERK1/2) activation and HIF‐1α expression, which are required for basal and EGF‐stimulated VEGF‐A secretion. EGF also stimulates the phosphorylation of P70S6 kinase (P70S6K), the downstream target of mTORC1. Rapamycin decreased basal and EGF stimulated HIF‐1α and enhanced MAPK (ERK1/2) activation, while MAPK (ERK/12) inhibition downregulated HIF‐1α expression and the phosphorylation of p70S6K. EGF stimulation of p70S6K was also independent of p‐AKT. Inhibition of the mTORC1 pathway with rapamycin abolished phosphorylation of p70S6K but had no effect on VEGF‐A secretion, indicating that EGF‐stimulated VEGF‐A secretion did not require mTORC1 pathway activation. We demonstrate evidence of a complex crosstalk between the MAPK/ERK and mTORC1 pathways, wherein MAPK (ERK1/2) activation stimulates p‐P70S6K, while p‐P70S6K activation seems to inhibit MAPK (ERK1/2) in EGF‐treated HK‐2 cells. Our results suggest that EGF stimulates MAPK (ERK1/2) in HK‐2 cells, which in turn increases HIF‐1α expression and VEGF‐A secretion, indicating that VEGF‐A mediates EGF‐stimulated cell proliferation as an autocrine proximal tubular epithelial cell growth factor.
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Affiliation(s)
- Diana Zepeda-Orozco
- Division of Pediatric Nephrology, Stead Family Department of Pediatrics, Dialysis and Transplantation, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Hsiang M Wen
- Division of Pediatric Nephrology, Stead Family Department of Pediatrics, Dialysis and Transplantation, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Bradley A Hamilton
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Nandita S Raikwar
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Christie P Thomas
- Division of Pediatric Nephrology, Stead Family Department of Pediatrics, Dialysis and Transplantation, University of Iowa Carver College of Medicine, Iowa City, Iowa.,Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa.,VA Medical Center, Iowa City, Iowa
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590
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Abstract
Lysophosphatidic acid (LPA) is a bioactive phospholipid that can exert diverse biological effects in various diseased states of the kidney by activating at least six cognate G protein-coupled receptors and its complex network of heterotrimeric G proteins. In many models of acute and chronic kidney injury, pathological elevations in LPA promotes abnormal changes in renal tubular epithelial cell architecture by activating apoptotic signaling, recruits immune cells to the site of injury, and stimulates profibrotic signaling by increasing gene transcription. In renal cancers, LPA can promote vascular cell proliferation and tumor cell invasion. In this review, a summary will be provided to describe the involvement of LPA, its synthetic enzymes, and its associated receptors in normal and diseased kidneys. Further elucidation of the LPA system may open new doors in developing a lipid-receptor therapeutic platform for kidney diseases.
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Affiliation(s)
- Frank Park
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Duane D Miller
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee
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591
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Usefulness of zebrafish larvae to evaluate drug-induced functional and morphological renal tubular alterations. Arch Toxicol 2017; 92:411-423. [DOI: 10.1007/s00204-017-2063-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 09/11/2017] [Indexed: 10/18/2022]
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592
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Chen H, Busse LW. Novel Therapies for Acute Kidney Injury. Kidney Int Rep 2017; 2:785-799. [PMID: 29270486 PMCID: PMC5733745 DOI: 10.1016/j.ekir.2017.06.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/17/2017] [Accepted: 06/19/2017] [Indexed: 12/25/2022] Open
Abstract
Acute kidney injury (AKI) is a common disease with a complex pathophysiology. The old paradigm of identifying renal injury based on location-prerenal, intrarenal, and postrenal-is now being supplanted with a new paradigm based on observable kidney injury patterns. The pathophysiology of AKI on a molecular and microanatomical level includes inflammation, immune dysregulation, oxidative injury, and impaired microcirculation. Treatment has traditionally been supportive, including the avoidance of nephrotoxins, judicious volume and blood pressure management, hemodynamic monitoring, and renal replacement therapy. Fluid overload and chloride-rich fluids are now implicated in the development of AKI, and resuscitation with a balanced, buffered solution at a conservative rate will mitigate risk. Novel therapies, which address specific observable kidney injury patterns include direct oxygen-free radical scavengers such as α-lipoic acid, curcumin, sodium-2-mercaptoethane sulphonate, propofol, and selenium. In addition, angiotensin II and adenosine receptor antagonists hope to ameliorate kidney injury via manipulation of renal hemodynamics and tubulo-glomerular feedback. Alkaline phosphatase, sphingosine 1 phosphate analogues, and dipeptidylpeptidase-4 inhibitors counteract kidney injury via manipulation of inflammatory pathways. Finally, genetic modifiers such as 5INP may mitigate AKI via transcriptive processes.
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Affiliation(s)
- Huaizhen Chen
- Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Laurence William Busse
- Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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593
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Changes in Perioperative Systolic Blood Pressure in Percutaneous Renal Mass Cryoablation. Cardiovasc Intervent Radiol 2017; 41:291-297. [PMID: 28828515 DOI: 10.1007/s00270-017-1772-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/11/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To analyze changes in systolic blood pressure (SBP) in the perioperative period of percutaneous renal mass cryoablation and risk factors. METHODS This retrospective study included 54 patients who underwent percutaneous renal cryoablation. SBP before ablation (pre-Tx), during ablation (intra-Tx), immediately after ablation (post-Tx), and before discharge (discharge) were measured using a BP cuff. The highest SBP during cryoablation was regarded as SBP at intra-Tx. Antihypertensive agents were administrated when SBP was 160 mmHg or greater during cryoablation. Relationship between SBP at pre-Tx, pain degree, tumor size, cryoprobe number, or endophytic extension of the radiographic ice-ball, and SBP elevation or administration of antihypertensive agents was investigated. RESULTS Mean SBP elevation from pre-Tx to intra-Tx was 22.9 ± 18.0 mmHg (range -6-78 mmHg). SBP of intra-Tx was significantly higher than that of the other periods (p < .001), while SBP of post-Tx or discharge was similar with that of pre-Tx (p > .05). Tumor size (r = .324; p = .016), cryoprobe number (r = .300; p = .027), and endophytic extension (r = .348; p = .009) were correlated with SBP elevation, while SBP at pre-Tx or pain degree were not (p > .05). Antihypertensive agents were administrated for 24 patients (44.4%). In multivariate analysis, SBP at pre-Tx and endophytic ablation was associated with administration of antihypertensive agents during cryoablation (p < .05). CONCLUSIONS SBP elevation may occur during percutaneous renal mass cryoablation, but be improved before discharge. Endophytic extension of the radiographic ice-ball may be associated with significant BP elevation during ablation.
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594
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Abstract
The kidney requires a large number of mitochondria to remove waste from the blood and regulate fluid and electrolyte balance. Mitochondria provide the energy to drive these important functions and can adapt to different metabolic conditions through a number of signalling pathways (for example, mechanistic target of rapamycin (mTOR) and AMP-activated protein kinase (AMPK) pathways) that activate the transcriptional co-activator peroxisome proliferator-activated receptor-γ co-activator 1α (PGC1α), and by balancing mitochondrial dynamics and energetics to maintain mitochondrial homeostasis. Mitochondrial dysfunction leads to a decrease in ATP production, alterations in cellular functions and structure, and the loss of renal function. Persistent mitochondrial dysfunction has a role in the early stages and progression of renal diseases, such as acute kidney injury (AKI) and diabetic nephropathy, as it disrupts mitochondrial homeostasis and thus normal kidney function. Improving mitochondrial homeostasis and function has the potential to restore renal function, and administering compounds that stimulate mitochondrial biogenesis can restore mitochondrial and renal function in mouse models of AKI and diabetes mellitus. Furthermore, inhibiting the fission protein dynamin 1-like protein (DRP1) might ameliorate ischaemic renal injury by blocking mitochondrial fission.
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595
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Bulluck H, Maiti R, Chakraborty B, Candilio L, Clayton T, Evans R, Jenkins DP, Kolvekar S, Kunst G, Laing C, Nicholas J, Pepper J, Yellon DM, Hausenloy DJ. Neutrophil gelatinase-associated lipocalin prior to cardiac surgery predicts acute kidney injury and mortality. Heart 2017; 104:heartjnl-2017-311760. [PMID: 28794136 PMCID: PMC5861395 DOI: 10.1136/heartjnl-2017-311760] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE We aimed to investigate whether preoperative serum neutrophil gelatinase-associated lipocalin (sNGALpre-op) predicted postoperative acute kidney injury (AKI) during hospitalisation and 1-year cardiovascular and all-cause mortality following adult cardiac surgery. METHODS This study was a post hoc analysis of the Effect of Remote Ischemic Preconditioning on Clinical Outcomes in Patient Undergoing Coronary Artery Bypass Graft Surgery trial involving adult patients undergoing coronary artery bypass graft. Postoperative AKI within 72 hours was defined using the International Kidney Disease: Improving Global Outcomes classification. RESULTS 1371 out of 1612 patients had data on sNGALpre-op. The overall 1-year cardiovascular and all-cause mortality was 5.2% (71/1371) and 7.7% (105/1371), respectively. There was an observed increase in the incidence of AKI from the first to the third tertile of sNGALpre-op (30.5%, 41.5% and 45.9%, respectively, p<0.001). There was also an increase in both cardiovascular and all-cause mortality from the first to the third tertile of sNGALpre-op, linear trend test with adjusted p=0.018 and p=0.013, respectively. The adjusted HRs for those in the second and third tertiles of sNGALpre-op compared with the first tertile were 1.60 (95% CI 0.78 to 3.25) and 2.22 (95% CI 1.13 to 4.35) for cardiovascular mortality, and 1.25 (95% CI 0.71 to 2.22) and 1.91 (95% CI 1.13 to 3.25) for all-cause mortality at 1 year. CONCLUSION In a cohort of high-risk adult patients undergoing cardiac surgery, there was an increase in postoperative AKI and 1-year mortality from the first to the third tertile of preoperative serum NGAL. Those in the last tertile (>220 ng/L) had an estimated twofold increase risk of cardiovascular and all-cause mortality at 1 year. CLINICAL TRIAL REGISTRATION NCT101247545; Post-results.
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Affiliation(s)
- Heerajnarain Bulluck
- National Heart Research Institute Singapore, National Heart Centre, Singapore, Singapore
- The Hatter Cardiovascular Institute, University College, London, UK
- Papworth Hospital, Cambridge, UK
| | - Raju Maiti
- Centre for Quantitative Medicine Duke-NUS Medical School Academia, Singapore, Singapore
| | - Bibhas Chakraborty
- Centre for Quantitative Medicine Duke-NUS Medical School Academia, Singapore, Singapore
| | - Luciano Candilio
- The Hatter Cardiovascular Institute, University College, London, UK
| | - Tim Clayton
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard Evans
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Shyam Kolvekar
- Barts Heart Centre, St Bartholomew's Hospital, London, UK
| | - Gudrun Kunst
- Anaesthetics, Intensive Care Medicine and Perioperative Pain Medicine, King's College Hospital and King's College London, London, UK
| | | | - Jennifer Nicholas
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - John Pepper
- National Institute of Health Research Cardiovascular Biomedical Research Unit at Royal Brompton & Harefield National Health Service Trust, London, UK
| | - Derek M Yellon
- The Hatter Cardiovascular Institute, University College, London, UK
- The National Institute of Health Research, University College London Hospitals, Biomedical Research Centre, London, UK
| | - Derek J Hausenloy
- National Heart Research Institute Singapore, National Heart Centre, Singapore, Singapore
- The Hatter Cardiovascular Institute, University College, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, London, UK
- National Institute of Health Research Cardiovascular Biomedical Research Unit at Royal Brompton & Harefield National Health Service Trust, London, UK
- The National Institute of Health Research, University College London Hospitals, Biomedical Research Centre, London, UK
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
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596
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Huang J, Gretz N. Light-Emitting Agents for Noninvasive Assessment of Kidney Function. ChemistryOpen 2017; 6:456-471. [PMID: 28794936 PMCID: PMC5542756 DOI: 10.1002/open.201700065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Indexed: 02/03/2023] Open
Abstract
The noninvasive assessment of kidney function and diagnosis of kidney disease have long been challenges. Traditional methods are not routinely available, because the existing protocols are cumbersome, time consuming, and invasive. In the past few years, significant progress in the area of diagnosing kidney function and disease on the basis of light-emitting agents has been made. Herein, we briefly review light-emitting agents, including organic fluorescent agents and inorganic renal clearable luminescent nanoparticles for the noninvasive and real-time monitoring of kidney function and disease. Moreover, some significant requirements and strategies regarding the design of ideal glomerular filtration rate agents and renal clearable nanoparticles are discussed. Finally, we discuss future challenges in expediting clinical translation of these developed light-emitting agents, along with considerations of the efforts that need to be made to develop new agents and diagnosing kidney disease.
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Affiliation(s)
- Jiaguo Huang
- Medical Research Center, Medical Faculty MannheimUniversity of HeidelbergTheodor-Kutzer-Ufer 1–368167MannheimGermany
| | - Norbert Gretz
- Medical Research Center, Medical Faculty MannheimUniversity of HeidelbergTheodor-Kutzer-Ufer 1–368167MannheimGermany
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597
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Jämsä P, Jämsen E, Lyytikäinen LP, Kalliovalkama J, Eskelinen A, Oksala N. Risk factors associated with acute kidney injury in a cohort of 20,575 arthroplasty patients. Acta Orthop 2017; 88:370-376. [PMID: 28296531 PMCID: PMC5499326 DOI: 10.1080/17453674.2017.1301743] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Patients developing postoperative acute kidney injury (AKI) are at risk of higher morbidity and mortality. In arthroplasty patients, many pre- and perioperative factors are associated with AKI but some of the risk factors are unclear. We report the incidence of postoperative AKI, the conditions associated with it, and survival rates in AKI patients. Patients and methods - We obtained data from 20,575 consecutive hip or knee arthroplasties. Postoperative AKI, occurring within 7 days after the operation, was defined using the risk, injury, failure, loss, and end-stage (RIFLE) criteria. We analyzed independent risk factors for AKI using binary logistic regression. In addition, we reviewed the records of AKI patients and performed a survival analysis. Results - The AKI incidence was 3.3 per 1,000 operations. We found preoperative estimated glomerular filtration rate, ASA classification, body mass index, and duration of operation to be independent risk factors for AKI. Infections, paralytic ileus, and cardiac causes were the predominant underlying conditions, whereas half of all AKI cases occurred without any clear underlying condition. Survival rates were lower in AKI patients. Interpretation - Supporting earlier results, existing renal insufficiency and patient-related characteristics were found to be associated with an increased risk of postoperative AKI. Furthermore, duration of operation was identified as an independent risk factor. We suggest careful renal monitoring postoperatively for patients with these risk factors.
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Affiliation(s)
- Pyry Jämsä
- Coxa Hospital for Joint Replacement;,Correspondence:
| | - Esa Jämsen
- Coxa Hospital for Joint Replacement;,School of Medicine, University of Tampere
| | - Leo-Pekka Lyytikäinen
- School of Medicine, University of Tampere;,Department of Clinical Chemistry, University of Tampere;,Fimlab Laboratories
| | | | | | - Niku Oksala
- School of Medicine, University of Tampere;,Department of Surgery, Faculty of Medicine and life sciences, Tampere University Hospital, Tampere, Finland
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598
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Miners JO, Yang X, Knights KM, Zhang L. The Role of the Kidney in Drug Elimination: Transport, Metabolism, and the Impact of Kidney Disease on Drug Clearance. Clin Pharmacol Ther 2017; 102:436-449. [PMID: 28599065 DOI: 10.1002/cpt.757] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/09/2017] [Accepted: 05/31/2017] [Indexed: 12/14/2022]
Abstract
Recent advances in the identification and characterization of renal drug transporters and drug-metabolizing enzymes has led to greater understanding of their roles in drug and chemical elimination and in modulation of the intrarenal exposure and response to drugs, nephrotoxic compounds, and physiological mediators. Furthermore, there is increasing awareness of the potential importance of drug-drug interactions (DDIs) arising from inhibition of renal transporters, and regulatory agencies now provide recommendations for the evaluation of transporter-mediated DDIs. Apart from the well-recognized effects of kidney disease on renal drug clearance, there is a growing body of evidence demonstrating that the nonrenal clearances of drugs eliminated by certain transporters and drug-metabolizing enzymes are decreased in patients with chronic kidney disease (CKD). Based on these observations, renal impairment guidance documents of regulatory agencies recommend pharmacokinetic characterization of both renally cleared and nonrenally cleared drugs in CKD patients to inform possible dosage adjustment.
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Affiliation(s)
- J O Miners
- Department of Clinical Pharmacology and Flinders Centre for Innovation in Cancer, Flinders University School of Medicine, Adelaide, South Australia, Australia
| | - X Yang
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - K M Knights
- Department of Clinical Pharmacology and Flinders Centre for Innovation in Cancer, Flinders University School of Medicine, Adelaide, South Australia, Australia
| | - L Zhang
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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599
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Gholampour H, Moezi L, Shafaroodi H. Aripiprazole prevents renal ischemia/reperfusion injury in rats, probably through nitric oxide involvement. Eur J Pharmacol 2017; 813:17-23. [PMID: 28734929 DOI: 10.1016/j.ejphar.2017.07.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/15/2017] [Accepted: 07/17/2017] [Indexed: 01/06/2023]
Abstract
Renal ischemia/reperfusion (I/R) injury is strongly related to morbidity and mortality. Oxidative stress, inflammation, and apoptosis play key roles in renal dysfunction following renal I/R. Aripiprazole is an atypical antipsychotic which used for the treatment of schizophrenia and bipolar disorder. Recent studies have reported aripiprazole as displaying certain anti-inflammatory effects. Regarding the underlying mechanisms of renal ischemia-reperfusion, therefore, nephroprotective effects might be predicted to be seen with aripiprazole. I/R injury was induced by bilateral clamping of the renal pedicles (45min) followed by reperfusion (24h). The mechanism of aripiprazole-mediated nephroprotection was explored by a combined use of aripiprazole and L-NAME (non-selective nitric oxide synthase inhibitor). Animals were given aripiprazole (2.5, 5, 10 and 20mg/kg) intraperitoneally, 30min before ischemia. L-NAME was administered before the aripiprazole injection. Serum creatinine and blood urea nitrogen were assessed after 24h of reperfusion. Serum levels of malondialdehyde (MDA), TNF-α and IL-1β were measured for rats treated with aripiprazole. The extent of necrosis was measured by the stereology method. Ischemia/reperfusion caused significant renal dysfunction and marked renal injury. Aripiprazole reduced creatinine and blood urea nitrogen. Serum levels of MDA, IL-1β and TNF-α were significantly lower in the aripiprazole group. Aripiprazole treatment also decreased the volume of kidney necrosis. The administration of L-NAME reversed the renoprotective effect of aripiprazole on BUN and creatinine, but enhanced the anti-necrotic effect of aripiprazole. The results show that a single dose of aripiprazole significantly improved renal function following ischemia/reperfusion injury - probably through the involvement of nitric oxide.
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Affiliation(s)
- Hanieh Gholampour
- Department of Pharmacology and Toxicology, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Leila Moezi
- Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Shafaroodi
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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600
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Chen C, Wang C, Hu C, Han Y, Zhao L, Zhu X, Xiao L, Sun L. Normoalbuminuric diabetic kidney disease. Front Med 2017; 11:310-318. [PMID: 28721497 DOI: 10.1007/s11684-017-0542-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/26/2017] [Indexed: 12/20/2022]
Abstract
Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease (ESRD). Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate (UAER) and glomerular filtration rate (GFR) are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages: normoalbuminuria, microalbuminuria, and macroalbuminuria. However, this clinical paradigm has been questioned recently, as studies have shown that a portion of diabetes mellitus (DM) patients with normoalbuminuria have progressive renal insufficiency, referred to as normoalbuminuric diabetic kidney disease (NADKD) or nonalbuminuric diabetic nephropathy. Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common, and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted. Currently, the pathogenesis of NADKD remains unclear, but many clinical studies have identified some clinical and pathological features of NADKD. In addition, the long-term outcomes of NADKD patients remain controversial. In this article, we reviewed the latest studies addressing the pathogenesis, pathology, treatment and prevention of NADKD.
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Affiliation(s)
- Chao Chen
- Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Chang Wang
- Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Chun Hu
- Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Yachun Han
- Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Li Zhao
- Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Xuejing Zhu
- Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Li Xiao
- Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Lin Sun
- Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, 410011, China.
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