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Yang K, Du C, Wang X, Li F, Xu Y, Wang S, Chen S, Chen F, Shen M, Chen M, Hu M, He T, Su Y, Wang J, Zhao J. Indoxyl sulfate induces platelet hyperactivity and contributes to chronic kidney disease-associated thrombosis in mice. Blood 2017; 129:2667-2679. [PMID: 28264799 DOI: 10.1182/blood-2016-10-744060] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/28/2017] [Indexed: 12/21/2022] Open
Abstract
Thrombosis is a common complication of chronic kidney disease (CKD), but the causes and mechanisms of CKD-associated thrombosis are not well clarified. Here, we show that platelet activity is remarkably enhanced in CKD mice, with increase of serum indoxyl sulfate (IS), a typical uremic toxin, which cannot be effectively cleared by routine dialysis. Ex vivo and in vitro experiments reveal that IS displays a distinct ability to enhance platelet activities, including elevated response to collagen and thrombin, increases in platelet-derived microparticles, and platelet-monocyte aggregates. The flow chamber assay and carotid artery thrombosis model demonstrate that IS-induced platelet hyperactivity contributes to thrombus formation. Further investigations disclose that reactive oxygen species (ROS)-mediated p38MAPK signaling plays a key role in IS-induced platelet hyperactivity. Moreover, we show that Klotho, which is expressed dominantly in the kidneys, has the capacity to counteract IS-induced platelet hyperactivity by inhibiting ROS/p38MAPK signaling, whereas Klotho reduction may aggravate the effect of IS on platelet activation in CKD and klotho+/- mice. Finally, we demonstrate that Klotho protein treatment can protect against IS-induced thrombosis and atherosclerosis in apoE-/- mice. Our findings uncover the mechanism of platelet hyperactivity induced by IS and provide new insights into the pathogenesis and treatment of CKD-associated thrombosis.
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Affiliation(s)
- Ke Yang
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing, China; and
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Changhong Du
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Xinmiao Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Fengju Li
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Yang Xu
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Song Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Shilei Chen
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Fang Chen
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Mingqiang Shen
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Mo Chen
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Mengjia Hu
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Ting He
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing, China; and
| | - Yongping Su
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Junping Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Combined Injury, Chongqing Engineering Research Center for Nanomedicine, College of Preventive Medicine, Chongqing, China
| | - Jinghong Zhao
- Department of Nephrology, Xinqiao Hospital, Third Military Medical University, Chongqing, China; and
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Tan X, Cao X, Zou J, Shen B, Zhang X, Liu Z, Lv W, Teng J, Ding X. Indoxyl sulfate, a valuable biomarker in chronic kidney disease and dialysis. Hemodial Int 2016; 21:161-167. [PMID: 27616754 DOI: 10.1111/hdi.12483] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 08/10/2016] [Indexed: 02/04/2023]
Abstract
Chronic kidney disease (CKD) is an increasingly recognized disease with high global incidence and mortality. Yet, the existing diagnostic tools are not sufficient enough to predict prognosis of CKD and CKD comorbidities. Indoxyl sulfate, a typical uremic toxin, is of great importance in the development of CKD with its nephrotoxicity, cardiovascular toxicity, and bone toxicity. Some reports suggest that indoxyl sulfate directly associate with renal function loss and mortality in CKD patients. This review discusses the diagnostic value of indoxyl sulfate from its biological characteristics, pathophysiological effects, related therapies, and its diagnostic value in clinical studies.
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Affiliation(s)
- Xiao Tan
- Shanghai Institute of Kidney and Dialysis, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xuesen Cao
- Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai, China.,Shanghai Quality Control Center for Hemodialysis, Shanghai, China
| | - Jianzhou Zou
- Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai, China.,Shanghai Quality Control Center for Hemodialysis, Shanghai, China
| | - Bo Shen
- Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai, China.,Shanghai Quality Control Center for Hemodialysis, Shanghai, China
| | - Xiaoyan Zhang
- Shanghai Institute of Kidney and Dialysis, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Zhonghua Liu
- Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai, China.,Shanghai Quality Control Center for Hemodialysis, Shanghai, China
| | - Wenlv Lv
- Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai, China.,Shanghai Quality Control Center for Hemodialysis, Shanghai, China
| | - Jie Teng
- Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai, China.,Shanghai Quality Control Center for Hemodialysis, Shanghai, China
| | - Xiaoqiang Ding
- Shanghai Institute of Kidney and Dialysis, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.,Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai, China.,Shanghai Quality Control Center for Hemodialysis, Shanghai, China
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Karbowska M, Kaminski T, Pawlak D. Methods of reducing the level of indoxyl sulfate – one of the most potent protein-bound uremic toxins. TOXIN REV 2016. [DOI: 10.1080/15569543.2016.1222442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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54
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Gonçalves-de-Albuquerque CF, Medeiros-de-Moraes IM, Oliveira FMDJ, Burth P, Bozza PT, Castro Faria MV, Silva AR, de Castro-Faria-Neto HC. Omega-9 Oleic Acid Induces Fatty Acid Oxidation and Decreases Organ Dysfunction and Mortality in Experimental Sepsis. PLoS One 2016; 11:e0153607. [PMID: 27078880 PMCID: PMC4831806 DOI: 10.1371/journal.pone.0153607] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 03/31/2016] [Indexed: 01/18/2023] Open
Abstract
Sepsis is characterized by inflammatory and metabolic alterations, which lead to massive cytokine production, oxidative stress and organ dysfunction. In severe systemic inflammatory response syndrome, plasma non-esterified fatty acids (NEFA) are increased. Several NEFA are deleterious to cells, activate Toll-like receptors and inhibit Na+/K+-ATPase, causing lung injury. A Mediterranean diet rich in olive oil is beneficial. The main component of olive oil is omega-9 oleic acid (OA), a monounsaturated fatty acid (MUFA). We analyzed the effect of OA supplementation on sepsis. OA ameliorated clinical symptoms, increased the survival rate, prevented liver and kidney injury and decreased NEFA plasma levels in mice subjected to cecal ligation and puncture (CLP). OA did not alter food intake and weight gain but diminished reactive oxygen species (ROS) production and NEFA plasma levels. Carnitine palmitoyltransferase IA (CPT1A) mRNA levels were increased, while uncoupling protein 2 (UCP2) liver expression was enhanced in mice treated with OA. OA also inhibited the decrease in 5' AMP-activated protein kinase (AMPK) expression and increased the enzyme expression in the liver of OA-treated mice compared to septic animals. We showed that OA pretreatment decreased NEFA concentration and increased CPT1A and UCP2 and AMPK levels, decreasing ROS production. We suggest that OA has a beneficial role in sepsis by decreasing metabolic dysfunction, supporting the benefits of diets high in monounsaturated fatty acids (MUFA).
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Affiliation(s)
| | | | | | - Patrícia Burth
- Departamento de Biologia Celular e Molecular, Instituto de Biologia, Universidade Federal Fluminense, 24020–15 Niterói, RJ, Brazil
| | - Patrícia Torres Bozza
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, FIOCRUZ, 21040–900 Rio de Janeiro, RJ, Brazil
| | - Mauro Velho Castro Faria
- Departamento de Medicina Interna, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, 20550–900 Rio de Janeiro, RJ, Brazil
| | - Adriana Ribeiro Silva
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, FIOCRUZ, 21040–900 Rio de Janeiro, RJ, Brazil
- * E-mail: (ARS); (HCCFN)
| | - Hugo Caire de Castro-Faria-Neto
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, FIOCRUZ, 21040–900 Rio de Janeiro, RJ, Brazil
- Universidade Estácio de Sá, Programa de Produtividade Científica, Rio de Janeiro, RJ, Brazil
- * E-mail: (ARS); (HCCFN)
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Stockler-Pinto MB, Saldanha JF, Yi D, Mafra D, Fouque D, Soulage CO. The uremic toxin indoxyl sulfate exacerbates reactive oxygen species production and inflammation in 3T3-L1 adipose cells. Free Radic Res 2016; 50:337-44. [PMID: 26617268 DOI: 10.3109/10715762.2015.1125996] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Inflammation and oxidative stress are common features of patients with chronic kidney disease (CKD) and many uremic solutes retained in these patients could be involved in these processes, among which protein-bound solutes such as indoxyl sulfate (IS). White adipose tissue recently gained attention as an important source of inflammation and oxidative stress. To examine the effect of IS on adipocytes, 3T3-L1 adipose cells were incubated with IS to mimic the conditions encountered in uremic patients. Incubation of adipose cells with IS increased reactive oxygen species production generated mainly through activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase since it was prevented by the NADPH oxidase inhibitor apocynin. Exposure to IS furthermore exacerbated the secretion of tumor necrosis factor-α and interleukin-6 by adipose cells. This inflammatory response was prevented by NADPH oxidase inhibition pinpointing the pivotal role of intracellular oxidative stress. IS induces adipocyte perturbation and promotes inflammatory state mainly through induction of oxidative stress. IS, a uremic toxin, accumulates in CKD patients could, therefore, be an important mediator of adipocyte dysfunction in these patients.
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Affiliation(s)
- Milena B Stockler-Pinto
- a Cardiovascular Sciences Graduate Program, Federal Fluminense University , Niterói , Brazil
| | - Juliana F Saldanha
- b Medical Sciences Graduate Program, Federal Fluminense University , Niterói , Brazil
| | - Dan Yi
- c Université De Lyon, INSA De Lyon, CarMeN, INSERM U1060 , Villeurbanne , France
| | - Denise Mafra
- a Cardiovascular Sciences Graduate Program, Federal Fluminense University , Niterói , Brazil ;,b Medical Sciences Graduate Program, Federal Fluminense University , Niterói , Brazil
| | - Denis Fouque
- c Université De Lyon, INSA De Lyon, CarMeN, INSERM U1060 , Villeurbanne , France ;,d Department of Nephrology , Centre Hopitalier Lyon Sud , Pierre-Bénite , France
| | - Christophe O Soulage
- c Université De Lyon, INSA De Lyon, CarMeN, INSERM U1060 , Villeurbanne , France
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Nagatomo Y, Tang WHW. Intersections Between Microbiome and Heart Failure: Revisiting the Gut Hypothesis. J Card Fail 2015; 21:973-80. [PMID: 26435097 DOI: 10.1016/j.cardfail.2015.09.017] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/14/2015] [Accepted: 09/25/2015] [Indexed: 02/07/2023]
Abstract
Microbes play an important role in human health and disease. In the setting of heart failure (HF), substantial hemodynamic changes, such as hypoperfusion and congestion in the intestines, can alter gut morphology, permeability, function, and possibly the growth and composition of gut microbiota. These changes can disrupt the barrier function of the intestines and exacerbate systemic inflammation via microbial or endotoxin translocation into systemic circulation. Furthermore, cardiorenal alterations via metabolites derived from gut microbiota can potentially mediate or modulate HF pathophysiology. Recently, trimethylamine N-oxide (TMAO) has emerged as a key mediator that provides a mechanistic link between gut microbiota and multiple cardiovascular diseases, including HF. Potential intervention strategies which may target this microbiota-driven pathology include dietary modification, prebiotics/probiotics, and selective binders of microbial enzymes or molecules, but further investigations into their safety and efficacy are warranted.
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Affiliation(s)
- Yuji Nagatomo
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - W H Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
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Hewitson TD, Holt SG, Smith ER. Animal Models to Study Links between Cardiovascular Disease and Renal Failure and Their Relevance to Human Pathology. Front Immunol 2015; 6:465. [PMID: 26441970 PMCID: PMC4585255 DOI: 10.3389/fimmu.2015.00465] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/26/2015] [Indexed: 12/24/2022] Open
Abstract
The close association between cardiovascular pathology and renal dysfunction is well documented and significant. Patients with conventional risk factors for cardiovascular disease like diabetes and hypertension also suffer renal dysfunction. This is unsurprising if the kidney is simply regarded as a “modified blood vessel” and thus, traditional risk factors will affect both systems. Consistent with this, it is relatively easy to comprehend how patients with either sudden or gradual cardiac and or vascular compromise have changes in both renal hemodynamic and regulatory systems. However, patients with pure or primary renal dysfunction also have metabolic changes (e.g., oxidant stress, inflammation, nitric oxide, or endocrine changes) that affect the cardiovascular system. Thus, cardiovascular and renal systems are intimately, bidirectionally and inextricably linked. Whilst we understand several of these links, some of the mechanisms for these connections remain incompletely explained. Animal models of cardiovascular and renal disease allow us to explore such mechanisms, and more importantly, potential therapeutic strategies. In this article, we review various experimental models used, and examine critically how representative they are of the human condition.
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Affiliation(s)
- Tim D Hewitson
- Department of Nephrology, Royal Melbourne Hospital (RMH) , Melbourne, VIC , Australia ; Department of Medicine - RMH, University of Melbourne , Melbourne, VIC , Australia
| | - Stephen G Holt
- Department of Nephrology, Royal Melbourne Hospital (RMH) , Melbourne, VIC , Australia ; Department of Medicine - RMH, University of Melbourne , Melbourne, VIC , Australia
| | - Edward R Smith
- Department of Nephrology, Royal Melbourne Hospital (RMH) , Melbourne, VIC , Australia
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