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Khan SI, Shihata WA, Andrews KL, Lee MKS, Moore XL, Jefferis AM, Vinh A, Gaspari T, Dragoljevic D, Jennings GL, Murphy AJ, Chin-Dusting JPF. Effects of high- and low-dose aspirin on adaptive immunity and hypertension in the stroke-prone spontaneously hypertensive rat. FASEB J 2018; 33:1510-1521. [PMID: 30156911 DOI: 10.1096/fj.201701498rr] [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: 01/03/2023]
Abstract
Despite its well-known antithrombotic properties, the effect of aspirin on blood pressure (BP) and hypertension pathology is unclear. The hugely varying doses used clinically have contributed to this confusion, with high-dose aspirin still commonly used due to concerns about the efficacy of low-dose aspirin. Because prostaglandins have been shown to both promote and inhibit T-cell activation, we also explored the immunomodulatory properties of aspirin in hypertension. Although the common preclinical high dose of 100 mg/kg/d improved vascular dysfunction and cardiac hypertrophy, this effect was accompanied by indices of elevated adaptive immunity, renal T-cell infiltration, renal fibrosis, and BP elevation in stroke-prone spontaneously hypertensive rats and in angiotensin II-induced hypertensive mice. The cardioprotective effects of aspirin were conserved with a lower dose (10 mg/kg/d) while circumventing heightened adaptive immunity and elevated BP. We also show that low-dose aspirin improves renal fibrosis. Differential inhibition of the COX-2 isoform may underlie the disparate effects of the 2 doses. Our results demonstrate the efficacy of low-dose aspirin in treating a vast array of cardiovascular parameters and suggest modulation of adaptive immunity as a novel mechanism underlying adverse cardiovascular profiles associated with COX-2 inhibitors. Clinical studies should identify the dose of aspirin that achieves maximal cardioprotection with a new awareness that higher doses of aspirin could trigger undesired autoimmunity in hypertensive individuals. This work also warrants an evaluation of high-dose aspirin and COX-2 inhibitor therapy in sufferers of inflammatory conditions who are already at increased risk for cardiovascular disease.-Khan, S. I., Shihata, W. A., Andrews, K. L., Lee, M. K. S., Moore, X.-L., Jefferis, A.-M., Vinh, A., Gaspari, T., Dragoljevic, D., Jennings, G. L., Murphy, A. J., Chin-Dusting, J. P. F. Effects of high- and low-dose aspirin on adaptive immunity and hypertension in the stroke-prone spontaneously hypertensive rat.
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Affiliation(s)
- Shanzana I Khan
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Waled A Shihata
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karen L Andrews
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Man K S Lee
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Xiao-Lei Moore
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Ann-Maree Jefferis
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Antony Vinh
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Tracey Gaspari
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Dragana Dragoljevic
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Garry L Jennings
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew J Murphy
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jaye P F Chin-Dusting
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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Diwan V, Brown L, Gobe GC. Adenine-induced chronic kidney disease in rats. Nephrology (Carlton) 2018; 23:5-11. [PMID: 29030945 DOI: 10.1111/nep.13180] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2017] [Indexed: 12/24/2022]
Abstract
Many animal models have been developed to study the causes and treatments of chronic kidney disease (CKD) in humans, an insidious disease resulting from kidney injury and characterized by persistent functional decline for more than 3 months, with or without evidence of structural deficit. The eventual outcome of CKD may be end-stage kidney disease (ESKD), where patients need dialysis or transplantation to survive. Cardiovascular disease is accelerated in patients with CKD and contributes to increased mortality, with the relationship between CKD and cardiovascular disease being bi-directional. Most animal models do not mimic the complexity of the human disease as many do not develop CKD-associated cardiovascular disease. The adenine diet model of CKD in rodents is an exception. The original adenine diet model produced rapid-onset kidney disease with extensive tubulointerstitial fibrosis, tubular atrophy, crystal formation and marked vessel calcification. Since then, lower adenine intake in rats has been found to induce slowly progressive kidney damage and cardiovascular disease. These chronic adenine diet models allow the characterization of relatively stable kidney and cardiovascular disease, similar to CKD in humans. In addition, interventions for reversal can be tested. Here the key features of the adenine diet model of CKD are noted, along with some limitations of other available models. In summary, the data presented here support the use of chronic low-dose adenine diet in rats as an easy and effective model for understanding human CKD, especially the links with cardiovascular disease, and developing potential therapeutic interventions.
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Affiliation(s)
- Vishal Diwan
- UQ Diamantina Institute, Translational Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Lindsay Brown
- School of Health and Wellbeing, The University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Glenda C Gobe
- UQ Diamantina Institute, Translational Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,NHMRC Centre for Research Excellence, Centre for Chronic Disease, The University of Queensland, Brisbane, Queensland, Australia
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Chaabouni Y, Yaich S, Khedhiri A, Zayen MA, Kharrat M, Kammoun K, Jarraya F, Hmida MB, Damak J, Hachicha J. [Epidemiological profile of terminal chronic renal failure in the region of Sfax]. Pan Afr Med J 2018; 29:64. [PMID: 29875945 PMCID: PMC5987075 DOI: 10.11604/pamj.2018.29.64.12159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/25/2017] [Indexed: 11/11/2022] Open
Abstract
Introduction Terminal chronic renal failure is a truly global public health problem. In 2011, the cost of management of patients on dialysis has surpassed 90 million dinars (37.000 euro) in Tunisia, nearly 5% of the overall health spending. A better knowledge of the epidemiological profile of terminal chronic renal failure contributes to the implementation and evaluation of health strategies aimed to improve prevention and disease management. This study aimed to describe the epidemiological profile of incident cases in the Sfax Governorate over the period of 10 years. Methods We conducted a descriptive retrospective study over the period from January 2003 to December 2012. The incident cases of terminal chronic renal failure in the Sfax Governorate were included in the study. Results The diagnosis of terminal chronic renal failure was made in 1708 cases: 957 men and 751 women (sex-ratio = 1.27). The average age was 58.4 years [10-100 years]. The study of the evolution of the average age during the study period showed a tendency to increase with positive correlation coefficient (0.749) and p = 0.006. The main causal nephropathy was diabetic nephropathy (21.5%), with a significant increase in its frequency from one year to the other (positive correlation coefficient (0.770) with p = 0.009). Hemodialysis was the dialysis technique of choice, performed in 96% of patients. Conclusion A national registry is indispensable in order to better understand the epidemiological profile of terminal chronic renal failure in Tunisia and to improve its management.
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Affiliation(s)
- Yosr Chaabouni
- Service de Néphrologie, CHU Hedi Chaker, Sfax, Tunisie, Unité de Recherche de Pathologie Rénale, Faculté de Médecine, Sfax, Tunisie
| | - Sourour Yaich
- Service de Médecine Communautaire, CHU Hedi Chaker, Sfax, Tunisie
| | - Azza Khedhiri
- Service de Néphrologie, CHU HediChaker, Sfax, Tunisie
| | | | - Mahmoud Kharrat
- Service de Néphrologie, CHU Hedi Chaker, Sfax, Tunisie, Unité de Recherche de Pathologie Rénale, Faculté de Médecine, Sfax, Tunisie
| | - Khawla Kammoun
- Service de Néphrologie, CHU Hedi Chaker, Sfax, Tunisie, Unité de Recherche de Pathologie Rénale, Faculté de Médecine, Sfax, Tunisie
| | - Faical Jarraya
- Service de Néphrologie, CHU Hedi Chaker, Sfax, Tunisie, Unité de Recherche de Pathologie Rénale, Faculté de Médecine, Sfax, Tunisie
| | - Mohamed Ben Hmida
- Service de Néphrologie, CHU Hedi Chaker, Sfax, Tunisie, Unité de Recherche de Pathologie Rénale, Faculté de Médecine, Sfax, Tunisie
| | - Jamal Damak
- Service de Médecine Communautaire, CHU Hedi Chaker, Sfax, Tunisie
| | - Jamil Hachicha
- Service de Néphrologie, CHU Hedi Chaker, Sfax, Tunisie, Unité de Recherche de Pathologie Rénale, Faculté de Médecine, Sfax, Tunisie
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54
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Thakur R, Sharma A, Lingaraju MC, Begum J, Kumar D, Mathesh K, Kumar P, Singh TU, Kumar D. Ameliorative effect of ursolic acid on renal fibrosis in adenine-induced chronic kidney disease in rats. Biomed Pharmacother 2018; 101:972-980. [PMID: 29635907 DOI: 10.1016/j.biopha.2018.02.143] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/27/2018] [Accepted: 02/27/2018] [Indexed: 12/18/2022] Open
Abstract
Ursolic acid (UA), an ursane-type pentacyclic triterpenoid commonly found in apple peels and holy basil has been shown to possess many beneficial effects. Renal fibrosis is a complication of kidney injury and associated with increased risk of morbidity and mortality. In our previous investigation, a lupane-type pentacyclic triterpenoid, betulinic acid (BA) was found to have protective effect on chronic kidney disease (CKD) and renal fibrosis. This prompted us to explore the therapeutic value of UA, a chemically related compound to BA in CKD. CKD was induced by feeding adenine with the feed at a concentration of 0.75% for 28 days. UA at the dose rate of 30 mg/kg in 0.5% carboxy methyl cellulose (CMC) was administered by oral route, simultaneously with adenine feeding for 28 days. Adenine feeding increased the kidney weight to body weight index, decreased the kidney function due to injury as indicated by increased markers like serum urea, uric acid, creatinine, cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) and initiated the fibrotic response in kidney by increasing the profibrotic proteins viz. transforming growth factor-beta (TGF-β), connective tissue growth factor (CTGF), fibronectin and collagen. However, treatment with UA reversed the damage induced by adenine as shown by reduced kidney injury and fibrosis markers which was further clearly evident in histological picture indicating the suitability of UA for use in CKD.
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Affiliation(s)
- Richa Thakur
- Division of Pharmacology and Toxicology, Indian Veterinary Research Institute, Izatnagar, 243 122, UP, India
| | - Anshuk Sharma
- Division of Pharmacology and Toxicology, Indian Veterinary Research Institute, Izatnagar, 243 122, UP, India
| | - Madhu C Lingaraju
- Division of Pharmacology and Toxicology, Indian Veterinary Research Institute, Izatnagar, 243 122, UP, India.
| | - Jubeda Begum
- Department of Veterinary Microbiology, College of Veterinary & Animal Sciences, G. B. Pant University of Agriculture and Technology, Pantnagar, 263153, UK, India
| | - Dhirendra Kumar
- Division of Pharmacology and Toxicology, Indian Veterinary Research Institute, Izatnagar, 243 122, UP, India
| | - Karikalan Mathesh
- Centre for Wildlife Conservation Management and Disease Surveillance, Indian Veterinary Research Institute, Izatnagar, 243 122, UP, India
| | - Pawan Kumar
- Division of Pathology, Indian Veterinary Research Institute, Izatnagar, 243 122, UP, India
| | - Thakur Uttam Singh
- Division of Pharmacology and Toxicology, Indian Veterinary Research Institute, Izatnagar, 243 122, UP, India
| | - Dinesh Kumar
- Division of Pharmacology and Toxicology, Indian Veterinary Research Institute, Izatnagar, 243 122, UP, India
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Progression of chronic kidney disease in children - role of glomerular hemodynamics and interstitial fibrosis. Curr Opin Pediatr 2018; 30:220-227. [PMID: 29389683 DOI: 10.1097/mop.0000000000000594] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE OF REVIEW The aim of this review is to provide an overview of the current advances in the understanding of the mechanisms involved in the progression of chronic kidney disease (CKD) with emphasis on the role of glomerular hemodynamics and tubulointerstitial fibrosis. RECENT FINDINGS Despite the varied causes of CKD, the progressive destruction of renal tissue processes through a complex common pathway. Current studies have highlighted both the role of the abnormal intrarenal hemodynamics and of the activation of fibrogenic biochemical pathway in the replacement of normal renal structure by extracellular matrix and ultimately by fibrosis. Molecular markers with the potential to contribute to the detection of tubular cell damage and tubulointerstitial fibrosis in the kidney has been identified. SUMMARY There is a clear need to understand and elucidate the mechanisms of progression of CKD to develop efficient therapeutic strategies to halt decline of renal function in children.
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Abstract
PURPOSE OF REVIEW The purposes of this review are to identify population characteristics of important risk factors for the development and progression of diabetic kidney disease (DKD) in the United States and to discuss barriers and opportunities to improve awareness, management, and outcomes in patients with DKD. RECENT FINDINGS The major risk factors for the development and progression of DKD include hyperglycemia, hypertension, and albuminuria. DKD disproportionately affects minorities and individuals with low educational and socioeconomic status. Barriers to effective management of DKD include the following: (a) limited patient and healthcare provider awareness of DKD, (b) lack of timely referrals of patients to a nephrologist, (c) low patient healthcare literacy, and (d) insufficient access to healthcare and health insurance. Increased patient and physician awareness of DKD has been shown to enhance patient outcomes. Multifactorial and multidisciplinary interventions targeting multiple risk factors and patient/physician education may provide better outcomes in patients with DKD.
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Affiliation(s)
- O Kenrik Duru
- Department of Medicine, Division of General Internal Medicine/Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles, 10940 Wilshire Blvd, Suite 700, Los Angeles, CA, 90024, USA.
| | | | | | - Keith Norris
- Department of Medicine, Division of General Internal Medicine/Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles, 10940 Wilshire Blvd, Suite 700, Los Angeles, CA, 90024, USA
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57
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Wei J, Zhang J, Wang L, Cha BJ, Jiang S, Liu R. A new low-nephron CKD model with hypertension, progressive decline of renal function, and enhanced inflammation in C57BL/6 mice. Am J Physiol Renal Physiol 2018; 314:F1008-F1019. [PMID: 29412703 DOI: 10.1152/ajprenal.00574.2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Chronic kidney disease (CKD) is a major health issue in the US. The typical five-sixths nephrectomy (typical 5/6 NX) is a widely used experimental CKD model. However, the typical 5/6 NX model is hypertensive in rats but strain dependent in mice. In particular, C57BL/6 mice with the typical 5/6 NX exhibits normal blood pressure and well-preserved renal function. The goal of the present study was to create a new hypertensive CKD model in C57BL/6 mice. We first characterized the vascular architecture originated from each renal artery branch by confocal laser-scanning microscopy with fluorescent lectin. Then, a novel 5/6 NX-BL model was generated by uninephrectomy combined with 2/3 renal infarction via a ligation of upper renal artery branch on the contralateral kidney. Compared with 5/6 NX-C, the 5/6 NX-BL model exhibited elevated mean arterial pressure (137.6 ± 13.9 vs. 104.7 ± 8.2 mmHg), decreased glomerular filtration rate (82.9 ± 19.2 vs. 125.0 ± 13.9 µl/min) with a reciprocal increase in plasma creatinine (0.31 ± 0.03 vs. 0.19 ± 0.04 mg/dl), and significant renal injury as assessed by proteinuria, histology with light, and transmission electron microscopy. In addition, inflammatory status, as indicated by the level of proinflammatory cytokine TNFα and the leukocyte counts, was significantly upregulated in 5/6 NX-BL compared with the 5/6 NX-C. In summary, we developed a new hypertensive CKD model in C57BL/6 mice with 5/6 renal mass reduction by uninephrectomy and upper renal artery branch ligation on the contralateral kidney. This 5/6 NX-BL model exhibits an infarction zone-dependent hypertension and progressive deterioration of the renal function accompanied by enhanced inflammatory response.
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Affiliation(s)
- Jin Wei
- Department of Molecular Pharmacology and Physiology, University of South Florida College of Medicine , Tampa, Florida
| | - Jie Zhang
- Department of Molecular Pharmacology and Physiology, University of South Florida College of Medicine , Tampa, Florida
| | - Lei Wang
- Department of Molecular Pharmacology and Physiology, University of South Florida College of Medicine , Tampa, Florida
| | - Byeong Jake Cha
- Department of Molecular Pharmacology and Physiology, University of South Florida College of Medicine , Tampa, Florida
| | - Shan Jiang
- Department of Molecular Pharmacology and Physiology, University of South Florida College of Medicine , Tampa, Florida
| | - Ruisheng Liu
- Department of Molecular Pharmacology and Physiology, University of South Florida College of Medicine , Tampa, Florida
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Quantitative peptidomics of endogenous peptides involved in TGF-β1-induced epithelial mesenchymal transition of renal epithelial cells. Cell Death Discov 2018. [PMID: 29531806 PMCID: PMC5841401 DOI: 10.1038/s41420-017-0001-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
TGF-β1 is a key fibrotic factor mediating epithelial mesenchymal transition (EMT) of epithelial cells through various signaling pathways. However, roles of proteolytic cleavage and endogenous peptide dynamics in TGF-β1-induced EMT remain unknown. We therefore performed quantitative peptidomics of TGF-β1-induced EMT in renal tubular epithelial cells. The acquired mesenchymal characteristics were confirmed, including morphological change (from cobblestone-like to fibroblast-like), decreased epithelial marker (ZO-1), and increased mesenchymal marker (vimentin). Quantitative peptidomics using stable isotope labeling revealed significantly altered levels of 70 unique endogenous peptides (derived from internal and C-terminal parts of 39 unique precursor proteins) after EMT induction. Interestingly, the majority of these peptides were derived from non-short-lived proteins, and analysis of P1 position revealed predominance of hydrophobic residues, suggesting that these endogenous peptides were generated mainly from proteasome cleavage. This hypothesis was confirmed by treating the cells with MG132 (a proteasome inhibitor), which provided almost identical endogenous peptide pattern as of the TGF-β1-treated cells. Moreover, validation assay showed marked reduction of proteasome peptidase activity in both TGF-β1-treated and MG132-treated cells. This is the first peptidome dataset that provides several novel aspects of mechanisms for TGF-β1-induced EMT. Our data also suggest that TGF-β1 exerts inhibitory effect against proteasome activity during EMT induction.
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Yaribeygi H, Farrokhi FR, Rezaee R, Sahebkar A. Oxidative stress induces renal failure: A review of possible molecular pathways. J Cell Biochem 2018; 119:2990-2998. [DOI: 10.1002/jcb.26450] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 10/17/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Habib Yaribeygi
- Health Research CenterBaqiyatallah University of Medical SciencesTehranIran
- Chronic Kidney Diseases Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Farin R. Farrokhi
- Chronic Kidney Diseases Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Ramin Rezaee
- Clinical Research Unit, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Amirhossein Sahebkar
- Biotechnology Research CenterInstitute of Pharmaceutical TechnologyMashhad University of Medical SciencesMashhadIran
- School of PharmacyMashhad University of Medical SciencesMashhadIran
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Long-term treatment with chaethomellic acid A reduces glomerulosclerosis and arteriolosclerosis in a rat model of chronic kidney disease. Biomed Pharmacother 2017; 96:489-496. [PMID: 29032332 DOI: 10.1016/j.biopha.2017.09.137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 09/26/2017] [Accepted: 09/26/2017] [Indexed: 11/21/2022] Open
Abstract
The high prevalence of end-stage renal disease emphasizes the failure to provide therapies to effectively prevent and/or reverse renal fibrosis. Therefore, the aim of this study was to evaluate the effect of long-term treatment with chaethomellic acid A (CAA), which selectively blocks Ha-Ras farnesylation, on renal mass reduction-induced renal fibrosis. Male Wistar rats were sham-operated (SO) or subjected to 5/6 renal mass reduction (RMR). One week after surgery, rats were placed in four experimental groups: SO:SO rats without treatment (n=13); SO+CAA: SO rats treated with CAA (n=13); RMR:RMR rats without treatment (n=14); and RMR+CAA:RMR rats treated with CAA (n=13). CAA was intraperitoneally administered in a dose of 0.23μg/kg three times a week for six months. Renal fibrosis was evaluated by two-dimensional ultrasonography and histopathological analysis. The kidneys of the RMR animals treated with CAA showed a significantly decrease in the medullary echogenicity (p<0.05) compared with the RMR rats that received no treatment. Glomerulosclerosis and arteriolosclerosis scores were significantly lower (p<0.001) in the RMR+CAA group when compared with the RMR group. There were no significant differences in interstitial fibrosis, interstitial inflammation and tubular dilatation scores between the RMR+CAA and RMR groups. These data suggest that CAA can be a potential future drug to attenuate the progression of chronic kidney disease.
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Bami E, Ozakpınar OB, Ozdemir-Kumral ZN, Köroglu K, Ercan F, Cirakli Z, Sekerler T, Izzettin FV, Sancar M, Okuyan B. Protective effect of ferulic acid on cisplatin induced nephrotoxicity in rats. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2017; 54:105-111. [PMID: 28704751 DOI: 10.1016/j.etap.2017.06.026] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 06/13/2017] [Accepted: 06/26/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Erliasa Bami
- Clinical Pharmacy Department, Marmara University, Faculty of Pharmacy, Istanbul, Turkey
| | | | | | - Kutay Köroglu
- Department of Histology and Embryology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Feriha Ercan
- Department of Histology and Embryology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Cirakli
- Biochemistry Department, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Turgut Sekerler
- Department of Biochemistry, Marmara University, Faculty of Pharmacy, Istanbul, Turkey
| | - Fikret Vehbi Izzettin
- Clinical Pharmacy Department, Marmara University, Faculty of Pharmacy, Istanbul, Turkey
| | - Mesut Sancar
- Clinical Pharmacy Department, Marmara University, Faculty of Pharmacy, Istanbul, Turkey
| | - Betul Okuyan
- Clinical Pharmacy Department, Marmara University, Faculty of Pharmacy, Istanbul, Turkey.
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Al-Saleh I, Al-Rouqi R, Elkhatib R, Abduljabbar M, Al-Rajudi T. Risk assessment of environmental exposure to heavy metals in mothers and their respective infants. Int J Hyg Environ Health 2017; 220:1252-1278. [PMID: 28869188 DOI: 10.1016/j.ijheh.2017.07.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/26/2017] [Accepted: 07/31/2017] [Indexed: 12/17/2022]
Abstract
Exposure to heavy metals can cause renal injury, which has been well documented in occupational exposure. Studies of low exposure in the general population, however, are still scarce, particularly for vulnerable populations such as mothers and young children. This study evaluated exposure to heavy metals, and biomarkers of renal function and oxidative stress in 944 lactating mothers and their infants and investigated the role of the interaction between heavy metals and oxidative stress in altering renal function. Mother and infant urine samples were analyzed to measure mercury (Hg), cadmium (Cd), and lead (Pb) concentrations for determining body-burden exposure; N-acetyl-β-d-glucosaminidase (NAG), α1-microglobulin (α1-MG), albumin (ALB), and creatinine (Cr) concentrations for determining early renal injury; and 8-hydroxy-2-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) concentrations for determining oxidative stress. The median concentrclearlyations in mothers presented as μg/g Cr (infants as μg/l) for Hg, Cd, and Pb were 0.695 (0.716), 0.322 (0.343), and 3.97 (5.306) respectively. The mothers and their infants had clearly been exposed to heavy metals and had levels higher than the reference values reported for the general populations of USA, Germany, and Canada. Multiple regression analyses clearly demonstrated associations between urinary heavy metals in quartiles and several renal and oxidative biomarkers in mothers and to a lesser extent their infants. ß coefficients for urinary excretions of MDA, 8-OHdG, ALB, α1-MG, NAG, and Cr in mothers were high in the highest quartile of Hg (1.183-51.29μg/g Cr or 1.732-106.95μg/l), Cd (0.565-765.776μg/g Cr or 0.785-1347.0μg/l), and Pb (6.606-83.937μg/g Cr or 9.459-80.826μg/l), except Pb was not associated with ALB. Infants in the highest Pb quartile (9.293-263.098μg/l) had the highest ß coefficients of urinary excretion of MDA, 8-OHdG, ALB, NAG, and Cr. Significant increasing trend in biomarkers across the quartiles of the three metals was seen in both mothers and infants (ptrend <0.001). A receiver operating characteristic analysis supported the predictive abilities of the four renal biomarkers in discriminating between low versus high metal quartiles. The interaction between heavy metals and oxidative stress contributed to the high excretions of renal biomarkers, but the mechanism remains unclear. These findings add to the limited evidence that low exposure to heavy metals in the general population is associated with alterations in renal function that could eventually progress to renal damage if exposure continues and that children are more susceptible due to the immaturity of their body organs.
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Affiliation(s)
- Iman Al-Saleh
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia.
| | - Reem Al-Rouqi
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
| | - Rola Elkhatib
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
| | - Mai Abduljabbar
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
| | - Tahreer Al-Rajudi
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
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Broder A, Mowrey WB, Khan HN, Jovanovic B, Londono-Jimenez A, Izmirly P, Putterman C. Tubulointerstitial damage predicts end stage renal disease in lupus nephritis with preserved to moderately impaired renal function: A retrospective cohort study. Semin Arthritis Rheum 2017; 47:545-551. [PMID: 28803673 DOI: 10.1016/j.semarthrit.2017.07.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/11/2017] [Accepted: 07/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The presence of tubulointerstitial damage (TID) on renal biopsy is considered to be a late sequela of lupus nephritis (LN). The objective of this study was to determine if TID predicts progression to end stage renal disease (ESRD) in LN patients without advanced kidney disease. METHODS All SLE patients with an index biopsy consistent with LN between January 2005 and July 2015, and eGFR ≥ 30mL/min/1.73m2 were included. Moderate-to-severe TID was defined as the presence of moderate-to-severe tubular atrophy and/or interstitial fibrosis. Time to ESRD was defined as time from the index biopsy date to incident ESRD date; non-ESRD patients were censored at the time of death or the last visit before December 2015. Time-dependent analyses were conducted to evaluate whether moderate-to-severe TID was predictive of ESRD progression. RESULTS Of the 131 LN patients with eGFR ≥ 30mL/min/1.73m2, 17 (13%) patients progressed to ESRD. Moderate-to-severe TID was present in 13% of biopsies with eGFR ≥ 60mL/min/1.73m2 and in 33% of biopsies with eGFR between 30 and 60mL/min/1.73m2. Moderate-to-severe TID was associated with a higher risk of ESRD progression: adjusted hazard ratio (HR) = 4.1, 95% CI: 1.4-12.1, p = 0.01 for eGFR ≥ 30mL/min/1.73m2; HR = 6.2, 95% CI: 1.7-23.2, p = 0.008 for eGFR ≥ 60mL/min/1.73m2. There was no association between tubulointerstitial inflammation (TII) and ESRD progression. CONCLUSIONS Moderate-to-severe TID, but not TII, was a strong predictor of ESRD progression independent of eGFR or glomerular findings, therefore, providing an important window for potential early interventions.
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Affiliation(s)
- Anna Broder
- Division of Rheumatology, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
| | - Wenzhu B Mowrey
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Hina N Khan
- Department of Medicine, Montefiore Medical Center, Bronx, NY
| | - Bojana Jovanovic
- Division of Rheumatology, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | | | - Peter Izmirly
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, NY
| | - Chaim Putterman
- Division of Rheumatology, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
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Singh H, Panta OB, Khanal U, Ghimire RK. Renal Cortical Elastography: Normal Values and Variations. J Med Ultrasound 2017; 25:215-220. [PMID: 30065495 PMCID: PMC6029337 DOI: 10.1016/j.jmu.2017.04.003] [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: 01/17/2017] [Accepted: 03/22/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction Renal cortical elastography has shown conflicting but promising results in evaluation of chronic kidney disease and other renal disorders. The purpose of this study was to establish a normogram of renal cortical elasticity values and assess their variation between right and left kidney and their relation with age, gender, body mass index, renal dimensions and skin to cortex distance. Methods The study was a hospital based cross sectional study performed at Tribhuvan University Teaching Hospital, a tertiary care center in Kathmandu, Nepal. All individuals referred for Ultrasound from General Health Check up clinic were included in the study. Patient with abnormal ultrasound findings and abnormal renal function test were excluded from the study. Renal morphometry including length, cortical thickness, and skin to cortex distance were measured in B mode imaging and renal cortical elastography was measured with region of interest box of 1 × 0.5 cm. All analyses were done using Statistical Package for Social Sciences 20.0 soft ware. Results A total of 95 individuals who met the inclusion criteria were included in the study. The mean values of right and left renal cortical shear wave velocity were 1.49 ± 0.19 m/s and 1.54 ± 0.19 m/s respectively. Statistical significant difference was observed between the renal cortical shear wave velocity of right and left kidney. The renal shear wave velocity was seen to decrease with age, however the correlation was not statistically significant. No significant difference was also noted in renal shear wave velocity among various sex or Body mass index groups. Statistically significant negative correlation was noted between skin to cortex distance and renal cortical shear wave velocities. However no statistically significant correlation was noted between renal dimensions and renal cortical shear wave velocities. Conclusions The normal cortical elasticity values in terms of shear wave velocity of right and left kidney were established. Renal elasticity is independent of the age, gender, Body mass index and renal dimensions.
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Affiliation(s)
- Harsh Singh
- Department of Radiodiagnosis, King George Medical University, Lucknow, India
| | - Om Biju Panta
- Department of Intervention Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand
| | - Umesh Khanal
- Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Nepal
| | - Ram Kumar Ghimire
- Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Nepal
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Ghosh R, Siddarth M, Singh N, Tyagi V, Kare PK, Banerjee BD, Kalra OP, Tripathi AK. Organochlorine pesticide level in patients with chronic kidney disease of unknown etiology and its association with renal function. Environ Health Prev Med 2017. [PMID: 29165145 DOI: 10.1186/s12199‐017‐0660‐5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Involvement of agrochemicals have been suggested in the development of chronic kidney disease of unknown etiology (CKDu). The association between CKDu and blood level of organochlorine pesticides (OCPs) in CKDu patients has been examined in the present study. METHODS All the recruited study subjects (n = 300) were divided in three groups, namely, healthy control (n = 100), patients with chronic kidney disease of unknown etiology (n = 100), and patients with chronic kidney disease of known etiology (CKDk) (n = 100). Blood OCP levels of all three study groups were analyzed by gas chromatography. RESULTS Increased level of OCPs, namely α-HCH, aldrin, and β-endosulfan, were observed in CKDu patients as compared to healthy control and CKD patients of known etiology. The levels of these pesticides significantly correlated negatively with the estimated glomerular filtration rate (eGFR) and positively with urinary albumin of CKD patients. Logistic regression analysis revealed association of γ-HCH, p, p'-DDE, and β-endosulfan with CKDu on adjustment of age, sex, BMI, and total lipid content. CONCLUSIONS Increased blood level of certain organochlorine pesticides is associated with the development of chronic kidney disease of unknown etiology.
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Affiliation(s)
- Rishila Ghosh
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Manushi Siddarth
- Multidisciplinary Research Unit, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Neeru Singh
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Vipin Tyagi
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Pawan Kumar Kare
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Basu Dev Banerjee
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Om Prakash Kalra
- Department of Medicine, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Ashok Kumar Tripathi
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India.
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Ghosh R, Siddarth M, Singh N, Tyagi V, Kare PK, Banerjee BD, Kalra OP, Tripathi AK. Organochlorine pesticide level in patients with chronic kidney disease of unknown etiology and its association with renal function. Environ Health Prev Med 2017; 22:49. [PMID: 29165145 PMCID: PMC5664840 DOI: 10.1186/s12199-017-0660-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 05/17/2017] [Indexed: 12/18/2022] Open
Abstract
Background Involvement of agrochemicals have been suggested in the development of chronic kidney disease of unknown etiology (CKDu). The association between CKDu and blood level of organochlorine pesticides (OCPs) in CKDu patients has been examined in the present study. Methods All the recruited study subjects (n = 300) were divided in three groups, namely, healthy control (n = 100), patients with chronic kidney disease of unknown etiology (n = 100), and patients with chronic kidney disease of known etiology (CKDk) (n = 100). Blood OCP levels of all three study groups were analyzed by gas chromatography. Results Increased level of OCPs, namely α-HCH, aldrin, and β-endosulfan, were observed in CKDu patients as compared to healthy control and CKD patients of known etiology. The levels of these pesticides significantly correlated negatively with the estimated glomerular filtration rate (eGFR) and positively with urinary albumin of CKD patients. Logistic regression analysis revealed association of γ-HCH, p, p′-DDE, and β-endosulfan with CKDu on adjustment of age, sex, BMI, and total lipid content. Conclusions Increased blood level of certain organochlorine pesticides is associated with the development of chronic kidney disease of unknown etiology.
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Affiliation(s)
- Rishila Ghosh
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Manushi Siddarth
- Multidisciplinary Research Unit, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Neeru Singh
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Vipin Tyagi
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Pawan Kumar Kare
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Basu Dev Banerjee
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Om Prakash Kalra
- Department of Medicine, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India
| | - Ashok Kumar Tripathi
- Department of Biochemistry, Environmental Biochemistry and Immunology Laboratory, University College of Medical Sciences (University of Delhi) and G.T.B. Hospital, Dilshad Garden, Delhi, 110095, India.
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Pejchinovski M, Siwy J, Mullen W, Mischak H, Petri MA, Burkly LC, Wei R. Urine peptidomic biomarkers for diagnosis of patients with systematic lupus erythematosus. Lupus 2017; 27:6-16. [PMID: 28474961 DOI: 10.1177/0961203317707827] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Systematic lupus erythematosus (SLE) is characterized with various complications which can cause serious organ damage in the human body. Despite the significant improvements in disease management of SLE patients, the non-invasive diagnosis is entirely missing. In this study, we used urinary peptidomic biomarkers for early diagnosis of disease onset to improve patient risk stratification, vital for effective drug treatment. Methods Urine samples from patients with SLE, lupus nephritis (LN) and healthy controls (HCs) were analyzed using capillary electrophoresis coupled to mass spectrometry (CE-MS) for state-of-the-art biomarker discovery. Results A biomarker panel made up of 65 urinary peptides was developed that accurately discriminated SLE without renal involvement from HC patients. The performance of the SLE-specific panel was validated in a multicentric independent cohort consisting of patients without SLE but with different renal disease and LN. This resulted in an area under the receiver operating characteristic (ROC) curve (AUC) of 0.80 ( p < 0.0001, 95% confidence interval (CI) 0.65-0.90) corresponding to a sensitivity and a specificity of 83% and 73%, respectively. Based on the end terminal amino acid sequences of the biomarker peptides, an in silico methodology was used to identify the proteases that were up or down-regulated. This identified matrix metalloproteinases (MMPs) as being mainly responsible for the peptides fragmentation. Conclusions A laboratory-based urine test was successfully established for early diagnosis of SLE patients. Our approach determined the activity of several proteases and provided novel molecular information that could potentially influence treatment efficacy.
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Affiliation(s)
| | - J Siwy
- 1 Mosaiques Diagnostics GmbH, Hannover, Germany
| | - W Mullen
- 2 BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - H Mischak
- 1 Mosaiques Diagnostics GmbH, Hannover, Germany.,2 BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - M A Petri
- 3 Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - L C Burkly
- 4 Biogen Inc, Cambridge, Cambridge, MA, USA
| | - R Wei
- 4 Biogen Inc, Cambridge, Cambridge, MA, USA
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Pons M, Ali L, Beghdadi W, Danelli L, Alison M, Madjène LC, Calvo J, Claver J, Vibhushan S, Åbrink M, Pejler G, Poli-Mérol ML, Peuchmaur M, El Ghoneimi A, Blank U. Mast Cells and MCPT4 Chymase Promote Renal Impairment after Partial Ureteral Obstruction. Front Immunol 2017; 8:450. [PMID: 28523000 PMCID: PMC5415561 DOI: 10.3389/fimmu.2017.00450] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/31/2017] [Indexed: 11/29/2022] Open
Abstract
Obstructive nephropathy constitutes a major cause of pediatric renal progressive disease. The mechanisms leading to disease progression are still poorly understood. Kidney fibrotic lesions are reproduced using a model of partial unilateral ureteral obstruction (pUUO) in newborn mice. Based on data showing significant mast cell (MC) infiltration in patients, we investigated the role of MC and murine MCPT4, a MC-released chymase, in pUUO using MC- (Wsh/sh), MCPT4-deficient (Mcpt4−/−), and wild-type (WT) mice. Measurement of kidney length and volume by magnetic resonance imaging (MRI) as well as postmortem kidney weight revealed hypotrophy of operated right kidneys (RKs) and compensatory hypertrophy of left kidneys. Differences between kidneys were major for WT, minimal for Wsh/sh, and intermediate for Mcpt4−/− mice. Fibrosis development was focal and increased only in WT-obstructed kidneys. No differences were noticed for local inflammatory responses, but serum CCL2 was significantly higher in WT versus Mcpt4−/− and Wsh/sh mice. Alpha-smooth muscle actin (αSMA) expression, a marker of epithelial–mesenchymal transition (EMT), was high in WT, minimal for Wsh/sh, and intermediate for Mcpt4−/− RK. Supernatants of activated MC induced αSMA in co-culture experiments with proximal tubular epithelial cells. Our results support a role of MC in EMT and parenchyma lesions after pUUO involving, at least partly, MCPT4 chymase. They confirm the importance of morphologic impairment evaluation by MRI in pUUO.
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Affiliation(s)
- Maguelonne Pons
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France.,Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Liza Ali
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France.,Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Walid Beghdadi
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Luca Danelli
- CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Marianne Alison
- Department of Pediatric Radiology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Lydia Celia Madjène
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Jessica Calvo
- Department of Pathology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Julien Claver
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Shamila Vibhushan
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
| | - Magnus Åbrink
- Section of Immunology, Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Gunnar Pejler
- Uppsala University, Department of Medical Biochemistry and Microbiology, Uppsala, Sweden.,Swedish University of Agricultural Sciences, Department of Anatomy, Physiology and Biochemistry, Uppsala, Sweden
| | - Marie-Laurence Poli-Mérol
- Pediatric Surgery Unit, American Memorial Hospital, Université Reims Champagne Ardennes, Reims, France
| | - Michel Peuchmaur
- Department of Pathology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Alaa El Ghoneimi
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France.,Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Ulrich Blank
- INSERM UMRS 1149, Paris, France.,CNRS ERL8252, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Laboratoire d'excellence INFLAMEX, Paris, France
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Sharma A, Thakur R, Lingaraju MC, Kumar D, Mathesh K, Telang AG, Singh TU, Kumar D. Betulinic acid attenuates renal fibrosis in rat chronic kidney disease model. Biomed Pharmacother 2017; 89:796-804. [DOI: 10.1016/j.biopha.2017.01.181] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 01/26/2017] [Accepted: 01/31/2017] [Indexed: 12/20/2022] Open
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Mehta T, Buzkova P, Kizer JR, Djousse L, Chonchol M, Mukamal KJ, Shlipak M, Ix JH, Jalal D. Higher plasma transforming growth factor (TGF)-β is associated with kidney disease in older community dwelling adults. BMC Nephrol 2017; 18:98. [PMID: 28327102 PMCID: PMC5359982 DOI: 10.1186/s12882-017-0509-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/09/2017] [Indexed: 12/04/2022] Open
Abstract
Background TGF-β is induced in the vasculature with aging suggesting that high plasma TGF-β levels may be a risk factor for chronic kidney disease (CKD) in older adults. Methods We conducted a cross-sectional analysis of the association between plasma TGF-β levels and CKD including data for 1722 older adults who had participated in the 1996/97 visit of the Cardiovascular Health Study (CHS). Prevalent CKD was defined as eGFR < 60 mL/min/1.73 m2 or urinary albumin/creatinine ratio (ACR) ≥30 mg/g. We also evaluated whether baseline TGF-β levels predicted change in eGFR, cardiovascular (CV) events, or mortality in longitudinal analysis. Results Plasma TGF-β levels were significantly and independently associated with lower eGFR in cross-sectional analysis. Doubling of TGF-β was significantly associated with lower eGFR (β estimate after adjusting for CV risk factors = −1.18, 95% CI −2.03, −0.32). We observed no association with albuminuria. There was no association between baseline TGF-β and change in eGFR, but each doubling of TGF-β at baseline was associated with increased risk of a composite outcome of CV events and mortality, adjusted HR 1.10 (95% C.I. 1.02– 1.20, p = 0.006). Conclusion In this large cohort of community-dwelling older individuals, high plasma TGF-β levels are modestly, but independently associated with lower eGFR but not with albuminuria in cross-sectional analysis. In addition, TGF-β levels are associated with increased risk of CV events and mortality. Further research is needed to determine the direction of association between plasma TGF-β and the risk of CKD and CKD-associated morbidities in older adults. Electronic supplementary material The online version of this article (doi:10.1186/s12882-017-0509-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tapan Mehta
- University of Colorado Anschutz Medical Center, Aurora, USA
| | | | | | - Luc Djousse
- Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | | | | | - Michael Shlipak
- University of California San Francisco School of Medicine, San Francisco, USA
| | | | - Diana Jalal
- University of Colorado Anschutz Medical Center, Aurora, USA. .,Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Campus Stop: C281, 12700 E. 19th Ave, Aurora, CO, 80015, USA.
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Khan YH, Sarriff A, Adnan AS, Khan AH, Mallhi TH, Jummaat F. Progression and outcomes of non-dialysis dependent chronic kidney disease patients: A single center longitudinal follow-up study. Nephrology (Carlton) 2017; 22:25-34. [PMID: 26718476 DOI: 10.1111/nep.12713] [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: 09/21/2015] [Revised: 12/21/2015] [Accepted: 12/26/2015] [Indexed: 01/02/2023]
Abstract
AIM Despite increase global prevalence of End stage renal disease (ESRD) and subsequent need for renal replacement therapy (RRT), relatively little is known about disease progression and prognosis of earlier stages of CKD. Current study was conducted to examine rate of CKD progression, predictors of ESRD and death. METHODS A total 621 patients with estimated glomerular filtration rate (eGFR) of 15-59ml/min/1.73m2 (CKD stage 3 & 4) were selected and followed up for 10 years or until ESRD or death, whichever occurred first. Subjects who did not meet inclusion criteria were excluded (n=1474). RESULTS Annual cumulative decline in eGFR was 3.01±0.40 ml/min/1.73m2 . Overall disease progression was observed in 60% patients while 18% died. Among patients with CKD stage 3, 21% progressed to stage 4, 10% to stage 5ND (non-dialysis) and 31% to RRT while mortality was observed in 16% patients. On the other hand, 8% patients with CKD stage 4 progressed to stage 5ND, 31% to RRT and mortality was observed in 24% cases. Patients with CVD, higher systolic blood pressure, elevated phosphate levels, heavy proteinuria, microscopic hematuria and use of diuretics were more likely to develop ESRD. Advancing age, low eGFR, low systolic blood pressure, low hemoglobin and baseline diabetes were found to be significant predictors of mortality while being female reduced risk of mortality. CONCLUSION Our data suggest that, in this CKD cohort, patients were more likely to develop ESRD than death. Prime importance should be given to mild forms of CKD to retard and even reverse CKD progression.
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Affiliation(s)
- Yusra Habib Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia.,Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, 16150, Kelantan, Malaysia
| | - Azmi Sarriff
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia
| | - Azreen Syazril Adnan
- Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, 16150, Kelantan, Malaysia
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia
| | - Tauqeer Hussain Mallhi
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia.,Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, 16150, Kelantan, Malaysia
| | - Fauziah Jummaat
- Department of Obstetrics and Gynecology, School of Medical Sciences, Health Campus University Sains Malaysia, Kubang Kerain, 16150, Kelantan, Malaysia
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Wei R, Gao B, Shih F, Ranger A, Dearth A, Mischak H, Siwy J, Wisniacki N, Petri M, Burkly LC. Alterations in urinary collagen peptides in lupus nephritis subjects correlate with renal dysfunction and renal histopathology. Nephrol Dial Transplant 2017; 32:1468-1477. [DOI: 10.1093/ndt/gfw446] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 12/01/2016] [Indexed: 02/02/2023] Open
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FTY720 Attenuates Angiotensin II-Induced Podocyte Damage via Inhibiting Inflammatory Cytokines. Mediators Inflamm 2017; 2017:3701385. [PMID: 28270699 PMCID: PMC5320072 DOI: 10.1155/2017/3701385] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/08/2016] [Accepted: 12/26/2016] [Indexed: 12/29/2022] Open
Abstract
FTY720, a new chemical substance derived from the ascomycete Isaria sinclairii, is used for treating multiple sclerosis, renal cancer, and asthma. Sphingosine 1-phosphate (S1P) is a bioactive sphingolipid metabolite and exists in red blood cells. FTY720 is a synthetic S1P analog which can block S1P evoking physiological effects. Recently studies show that S1P was participating in activated inflammation cells induced renal injury. The objective of this study was to assess the protective effect of FTY720 on kidney damage and the potential mechanism of FTY720 which alleviate podocyte injury in chronic kidney disease. In this study, we selected 40 patients with IgA nephropathy and examined their clinical characteristics. Ang II-infusion rat renal injury model was established to evaluate the glomeruli and tubulointerstitial lesion. The result showed that the concentration of S1P in serum and urine was positively correlated with IgA nephropathy patients' renal injury. FTY720 could reduce renal histological lesions induced by Ang II-infusion in rats. Moreover, FTY720 decreased S1P synthesis in Ang II-infusion rats via downregulation of inflammatory cytokines including TNF-α and IL-6. In addition, FTY720 alleviated exogenous S1P-induced podocyte damage. In conclusion, FTY720 is able to attenuate S1P-induced podocyte damage via reducing inflammatory cytokines.
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Botzenhardt S, Li N, Chan EW, Sing CW, Wong ICK, Neubert A. Safety profiles of iron chelators in young patients with haemoglobinopathies. Eur J Haematol 2017; 98:198-217. [PMID: 27893170 DOI: 10.1111/ejh.12833] [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] [Accepted: 11/08/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND This review describes the safety of deferoxamine (DFO), deferiprone (DFP), deferasirox (DFX) and combined therapy in young patients less than 25 yr of age with haemoglobinopathies. METHODS Searches in electronic literature databases were performed. Studies reporting adverse events associated with iron chelation therapy were included. Study and reporting quality was assessed using AHRQ Risk of Bias Assessment Tool and McMaster Quality Assessment Scale of Harms. Prospective clinical studies were pooled in a random-effects meta-analysis of proportions. RESULTS Safety data of 2040 patients from 34 studies were included. Ninety-two case reports of 246 patients were identified. DFX (937 patients) and DFP (667 patients) possess the largest published safety evidence. Fewer studies on combination regimens are available. Increased transaminases were seen in all regimens (3.9-31.3%) and gastrointestinal disorders with DFP and DFX (3.7-18.4% and 5.8-18.8%, respectively). Therapy discontinuations due to adverse events were low (0-4.1%). Reporting quality was selective and poor in most of the studies. CONCLUSION Iron chelation therapy is generally safe in young patients, and published data correspond to summary of product characteristics. Each iron chelation regimen has its specific safety risks. DFO seems not to be associated with serious adverse effects in recommended doses. In DFP and DFX, rare, but serious, adverse reactions can occur. Data on combined therapy are scarce, but it seems equally safe compared to monotherapy.
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Affiliation(s)
- Sebastian Botzenhardt
- Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Niya Li
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, University of Hong Kong, Hong Kong, China.,Clinical Trials Center, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Esther W Chan
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, University of Hong Kong, Hong Kong, China
| | - Chor Wing Sing
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, University of Hong Kong, Hong Kong, China
| | - Ian C K Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, University of Hong Kong, Hong Kong, China.,Research Department of Practice & Policy, University College London School of Pharmacy, London, UK
| | - Antje Neubert
- Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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75
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Sharma S, Mathew AB, Chugh J. miRNAs: Nanomachines That Micromanage the Pathophysiology of Diabetes Mellitus. Adv Clin Chem 2017; 82:199-264. [PMID: 28939211 DOI: 10.1016/bs.acc.2017.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Diabetes mellitus (DM) refers to a combination of heterogeneous complex metabolic disorders that are associated with episodes of hyperglycemia and glucose intolerance occurring as a result of defects in insulin secretion, action, or both. The prevalence of DM is increasing at an alarming rate, and there exists a need to develop better therapeutics and prognostic markers for earlier detection and diagnosis. In this review, after giving a brief introduction of diabetes mellitus and microRNA (miRNA) biogenesis pathway, we first describe various in vitro and animal model systems that have been developed to study diabetes. Further, we elaborate on the significant roles played by miRNAs as regulators of gene expression in the context of development of diabetes and its secondary complications. The different approaches to quantify miRNAs and their potential to be used as therapeutic targets for alleviation of diabetes have also been discussed.
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76
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Choi MS, Jeong MJ, Park YB, Kim SR, Jung UJ. The Leaf of Diospyros kaki Thumb Ameliorates Renal Oxidative Damage in Mice with Type 2 Diabetes. Prev Nutr Food Sci 2016; 21:378-383. [PMID: 28078262 PMCID: PMC5216891 DOI: 10.3746/pnf.2016.21.4.378] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 12/06/2016] [Indexed: 01/10/2023] Open
Abstract
Diabetic kidney disease is the most common and severe chronic complication of diabetes. The leaf of Diospyros kaki Thumb (persimmon) has been commonly used for herbal tea and medicinal purposes to treat a variety of conditions, including hypertension and atherosclerosis. However, the effect of persimmon leaf on kidney failure has not been investigated. This study aimed to examine the role of persimmon leaf in protecting the diabetes-associated kidney damage in a mouse model of type 2 diabetes. Mice were fed either a normal chow diet with or without powered persimmon leaf (5%, w/w) for 5 weeks. In addition to kidney morphology and blood markers of kidney function, we assessed levels of oxidative stress markers as well as antioxidant enzymes activities and mRNA expression in the kidney. Supplementation of the diet with powered persimmon leaf not only decreased the concentration of blood urea nitrogen in the plasma but also improved glomerular hypertrophy. Furthermore, the persimmon leaf significantly decreased the levels of hydrogen peroxide and lipid peroxide in the kidney. The activities of superoxide dismutase, catalase, and glutathione peroxidase and the mRNA expression of their respective genes were also increased in the kidney of persimmon leaf-supplemented db/db mice. Taken together, these results suggest that supplementation with the persimmon leaf may have protective effects against type 2 diabetes-induced kidney dysfunction and oxidative stress.
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Affiliation(s)
- Myung-Sook Choi
- Department of Food Science and Nutrition, Kyungpook National University, Daegu 41566, Korea
| | - Mi Ji Jeong
- Department of Food Science and Nutrition, Pukyong National University, Busan 48513, Korea
| | - Yong Bok Park
- School of Life Sciences and Biotechnology, Kyungpook National University, Daegu 41566, Korea
| | - Sang Ryong Kim
- School of Life Sciences and Biotechnology, Kyungpook National University, Daegu 41566, Korea
| | - Un Ju Jung
- Department of Food Science and Nutrition, Pukyong National University, Busan 48513, Korea
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77
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Pijacka W, McBryde FD, Marvar PJ, Lincevicius GS, Abdala APL, Woodward L, Li D, Paterson DJ, Paton JFR. Carotid sinus denervation ameliorates renovascular hypertension in adult Wistar rats. J Physiol 2016; 594:6255-6266. [PMID: 27510951 DOI: 10.1113/jp272708] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/03/2016] [Indexed: 01/24/2023] Open
Abstract
KEY POINTS Peripheral chemoreflex sensitization is a feature of renovascular hypertension. Carotid sinus nerve denervation (CSD) has recently been shown to relieve hypertension and reduce sympathetic activity in other rat models of hypertension. We show that CSD in renovascular hypertension halts further increases in blood pressure. Possible mechanisms include improvements in baroreceptor reflex sensitivity and renal function, restoration of cardiac calcium signalling towards control levels, and reduced neural inflammation. Our data suggest that the peripheral chemoreflex may be a viable therapeutic target for renovascular hypertension. ABSTRACT The peripheral chemoreflex is known to be hyper-responsive in both spontaneously hypertensive (SHR) and Goldblatt hypertensive (two kidney one clip; 2K1C) rats. We have previously shown that carotid sinus nerve denervation (CSD) reduces arterial blood pressure (ABP) in SHR. In the present study, we show that CSD ameliorates 2K1C hypertension and reveal the potential underlying mechanisms. Adult Wistar rats were instrumented to record ABP via telemetry, and then underwent CSD (n = 9) or sham CSD (n = 9) 5 weeks after renal artery clipping, in comparison with normal Wistar rats (n = 5). After 21 days, renal function was assessed, and tissue was collected to assess sympathetic postganglionic intracellular calcium transients ([Ca2+ ]i ) and immune cell infiltrates. Hypertensive 2K1C rats showed a profound elevation in ABP (Wistar: 98 ± 4 mmHg vs. 2K1C: 147 ± 8 mmHg; P < 0.001), coupled with impairments in renal function and baroreflex sensitivity, increased neuroinflammatory markers and enhanced [Ca2+ ]I in stellate neurons (P < 0.05). CSD reduced ABP in 2K1C+CSD rats and prevented the further progressive increase in ABP seen in 2K1C+sham CSD rats, with a between-group difference of 14 ± 2 mmHg by week 3 (P < 0.01), which was accompanied by improvements in both baroreflex control and spectral indicators of cardiac sympatho-vagal balance. Furthermore, CSD improved protein and albuminuria, decreased [Ca2+ ]i evoked responses from stellate neurons, and also reduced indicators of brainstem inflammation. In summary, CSD in 2K1C rats reduces the hypertensive burden and improves renal function. This may be mediated by improvements in autonomic balance, functional remodelling of post-ganglionic neurons and reduced inflammation. Our results suggest that the peripheral chemoreflex may be considered as a potential therapeutic target for controlling renovascular hypertension.
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Affiliation(s)
- Wioletta Pijacka
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, UK
| | - Fiona D McBryde
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, UK.,Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Paul J Marvar
- Department of Pharmacology and Physiology, The George Washington University School of Medical and Health Sciences, Washington, DC, USA
| | - Gisele S Lincevicius
- Cardiovascular Division - Department of Physiology, Escola Paulista de Medicina, Universidade Federal de, Sao Paulo, Brazil
| | - Ana P L Abdala
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, UK
| | - Lavinia Woodward
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, UK
| | - Dan Li
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, UK
| | - David J Paterson
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, UK
| | - Julian F R Paton
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, UK.
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78
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Wang L. Applications of acoustic radiation force impulse quantification in chronic kidney disease: a review. Ultrasonography 2016; 35:302-8. [PMID: 27599890 PMCID: PMC5040133 DOI: 10.14366/usg.16026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 07/10/2016] [Accepted: 07/18/2016] [Indexed: 12/18/2022] Open
Abstract
Acoustic radiation force impulse (ARFI) imaging is an emerging technique with great promise in the field of elastography. Previous studies have validated ARFI quantification as a method of estimating fibrosis in chronic liver disease. Similarly, fibrosis is the principal process underlying the progression of chronic kidney disease, which is the major cause of renal failure. However, the quantification of tissue stiffness using ARFI imaging is more complex in the kidney than in the liver. Moreover, not all previous studies are comparable because they employed different procedures. Therefore, subsequent studies are warranted, both in animal models and in clinical patients, in order to better understand the histopathological mechanisms associated with renal elasticity and to further improve this imaging method by developing a standardized guidelines for its implementation.
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Affiliation(s)
- Liang Wang
- Department of Ultrasound, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
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79
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Piccoli GB, Capizzi I, Vigotti FN, Leone F, D’Alessandro C, Giuffrida D, Nazha M, Roggero S, Colombi N, Mauro G, Castelluccia N, Cupisti A, Avagnina P. Low protein diets in patients with chronic kidney disease: a bridge between mainstream and complementary-alternative medicines? BMC Nephrol 2016; 17:76. [PMID: 27391228 PMCID: PMC4939031 DOI: 10.1186/s12882-016-0275-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 06/14/2016] [Indexed: 01/11/2023] Open
Abstract
Dietary therapy represents an important tool in the management of chronic kidney disease (CKD), mainly through a balanced reduction of protein intake aimed at giving the remnant nephrons in damaged kidneys a "functional rest". While dialysis, transplantation, and pharmacological therapies are usually seen as "high tech" medicine, non pharmacological interventions, including diets, are frequently considered lifestyle-complementary treatments. Diet is one of the oldest CKD treatments, and it is usually considered a part of "mainstream" management. In this narrative review we discuss how the lessons of complementary alternative medicines (CAMs) can be useful for the implementation and study of low-protein diets in CKD. While high tech medicine is mainly prescriptive, prescribing a "good" life-style change is usually not enough and comprehensive counselling is required; the empathic educational approach, on which CAMs are mainly, though not exclusively based, may support a successful personalized nutritional intervention.There is no gold-standard, low-protein diet for all CKD patients: from among a relatively vast choice, the best compliance is probably obtained by personalization. This approach interferes with the traditional RCT-based analyses which are grounded upon an assumption of equal preference of treatments (ideally blinded). Whole system approaches and narrative medicine, that are widely used in the study of CAMs, may offer ways to integrate EBM and personalised medicine in the search for innovative solutions respecting individualization, but gaining sound data, such as with partially-randomised patient preference trials.
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Affiliation(s)
- Giorgina Barbara Piccoli
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Irene Capizzi
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Federica Neve Vigotti
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Filomena Leone
- />Department of Surgery, SS Dietetics, città della salute e della scienza, University of Torino, Torino, Italy
| | - Claudia D’Alessandro
- />Department of Experimental and Clinical Medicine, SCDU Nephrology, University of Pisa, Pisa, Italy
| | - Domenica Giuffrida
- />Department of Surgery, SS Dietetics, città della salute e della scienza, University of Torino, Torino, Italy
| | - Marta Nazha
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Simona Roggero
- />Department of Clinical and Biological Sciences, SS Nephrology, ASOU san Luigi, University of Torino, Torino, Italy
- />Nephrologie, CH du Mans, Le Mans, France
| | - Nicoletta Colombi
- />Department of Clinical and Biological Sciences and of Oncology, Library, ASOU san Luigi, University of Torino, Torino, Italy
| | - Giuseppe Mauro
- />Department of Clinical and Biological Sciences and of Oncology, Library, ASOU san Luigi, University of Torino, Torino, Italy
| | - Natascia Castelluccia
- />Department of Clinical and Biological Sciences and of Oncology, Library, ASOU san Luigi, University of Torino, Torino, Italy
| | - Adamasco Cupisti
- />Department of Experimental and Clinical Medicine, SCDU Nephrology, University of Pisa, Pisa, Italy
| | - Paolo Avagnina
- />Department of Clinical and Biological Sciences, SSD Clinical Nutrition, ASOU san Luigi, University of Torino, Torino, Italy
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80
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JiaWeiDangGui Decoction Ameliorates Proteinuria and Kidney Injury in Adriamycin-Induced Rat by Blockade of TGF-β/Smad Signaling. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:5031890. [PMID: 27403197 PMCID: PMC4923567 DOI: 10.1155/2016/5031890] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/08/2016] [Accepted: 04/27/2016] [Indexed: 11/23/2022]
Abstract
JiaWeiDangGui (JWDG) decoction has anti-inflammatory and antifibrotic effects, which is used widely for the treatment of various kidney diseases. In previous studies, we have found that JWDG decoction can reduce the quantity of proteinuria, but the mechanism was unknown. Here, we studied the protective effect of JWDG decoction in adriamycin-induced nephropathy on rat. JWDG decoction, at 10 mL/kg/d, 20 mL/kg/d, and 40 mL/kg/d, was orally administered daily for 12 weeks. Therapeutic effects and mechanisms were further examined. The kidney function related biochemical indexes were measured by automatic biochemistry analyzer. The pathomorphological changes were observed using light and transmission electron microcopies. The proteins expressions of podocin, nephrin, collagen IV, and fibronectin (FN) were examined by immunohistochemical staining, and key proteins involved in TGF-β/Smad signaling were evaluated by RT-PCR and western blotting. Compared with vehicle-treated controls, JWDG decoction decreased the quantity of proteinuria; reduced glomerulosclerotic lesions induced by ADR; and preserved the expression of podocin and nephrin. JWDG decoction also inhibited the expression of the collagen IV, FN, and fibrogenic TGF-β. Further studies revealed that inhibition of renal fibrosis was associated with the blockade of TGF-β/Smad signaling and downregulation of snail expression dose dependently. JWDG decoction prevents proteinuria production, podocyte dysfunction, and kidney injury in adriamycin nephropathy by inhibiting TGF-β/Smad signaling.
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81
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Galluppi GR, Wisniacki N, Stebbins C. Population pharmacokinetic and pharmacodynamic analysis of BIIB023, an anti-TNF-like weak inducer of apoptosis (anti-TWEAK) monoclonal antibody. Br J Clin Pharmacol 2016; 82:118-28. [PMID: 26896828 DOI: 10.1111/bcp.12914] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/12/2016] [Accepted: 02/16/2016] [Indexed: 12/21/2022] Open
Abstract
AIMS Tumour necrosis factor-like weak inducer of apoptosis (TWEAK) is implicated in the pathogenesis of lupus nephritis. This study evaluated the pharmacokinetics, using the population approach, and pharmacodynamics of BIIB023, an anti-TWEAK monoclonal antibody, in healthy Chinese, Japanese and Caucasian volunteers. METHODS In this single-dose, randomized, double-blind, phase 1 study of BIIB023 in healthy volunteers, BIIB023 was administered by intravenous infusion (3 or 20 mg kg(-1) ) on Day 1; follow-up occurred through Day 71. BIIB023 serum concentration was measured using a validated enzyme-linked immunosorbent assay; BIIB023 concentration-time data were subjected to noncompartmental analysis. Population pharmacokinetic analysis was performed using data from this study and a prior phase 1 study of BIIB023 in subjects with rheumatoid arthritis. Soluble TWEAK and TWEAK BIIB023 complex were evaluated. RESULTS There were no differences in BIIB023 pharmacokinetics requiring dose adjustment among the three ethnic groups or between healthy volunteers and arthritis patients. BIIB023 central compartment volume (3050 ml) and clearance (7.42 ml h(-1) ) were comparable to those observed for other monoclonal antibody drugs. BIIB023 serum exposure increased in a dose-dependent manner in all groups, but not in direct proportion to dose level; at concentrations below ~10 μg ml(-1) , nonlinear clearance was observed. Soluble TWEAK levels decreased to below the level of quantitation after BIIB023 treatment, with concomitant changes in TWEAK BIIB023 complex levels. CONCLUSIONS No clinically meaningful differences were observed in BIIB023 pharmacokinetic and pharmacodynamic properties in healthy Chinese, Japanese and Caucasian volunteers; pharmacodynamic measures suggested target engagement. TWEAK may be an attractive therapeutic target for lupus nephritis treatment.
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Affiliation(s)
- Gerald R Galluppi
- Clinical Pharmacology and Pharmacometrics, Biogen, Cambridge, Massachusetts, USA
| | | | - Chris Stebbins
- Translational Sciences, Biogen, Cambridge, Massachusetts, USA
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82
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Lee E, Oh HJ, Park JT, Han SH, Ryu DR, Kang SW, Yoo TH. The Incidence of Cardiovascular Events Is Comparable Between Normoalbuminuric and Albuminuric Diabetic Patients With Chronic Kidney Disease. Medicine (Baltimore) 2016; 95:e3175. [PMID: 27082557 PMCID: PMC4839801 DOI: 10.1097/md.0000000000003175] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Diabetic kidney disease leads to microalbuminuria and gradually progresses to overt proteinuria with renal insufficiency. Recent studies have demonstrated that 20% to 40% of patients with diabetic kidney disease are normo- to microalbuminuric, despite reduced renal function. We investigated renal and cardiovascular outcomes in patients with diabetes and renal insufficiency who were normo-, micro-, and macroalbuminuric. Patients with diabetes and stage III or IV chronic kidney disease were recruited and divided into normoalbuminuric, microalbuminuric, and macroalbuminuric groups. New-onset cardiovascular events and renal outcomes, defined by end-stage renal disease or a 50% decline in estimated glomerular filtration rate, were evaluated. Among the 1136 study patients, 255 (22.4%) were normoalbuminuric. During a mean follow-up duration of 44 months, the incidence of cardiovascular disease was similar among groups (P = 0.68). However, renal outcomes were significantly more common in patients with macroalbuminuria than in those who were normoalbuminuric or microalbuminuric (P < 0.001). Multivariate Cox analysis identified macroalbuminuria and estimated glomerular filtration rate as independent predictors of renal outcomes. The amount of albuminuria was not associated with cardiovascular events in this population. Although cardiovascular events were similar in patients with diabetic kidney disease and renal insufficiency, renal outcomes differed significantly according to the amount of albuminuria.
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Affiliation(s)
- Eunyoung Lee
- From the Department of Internal Medicine, Yonsei University College of Medicine (EL, HJO, JTP, SHH, S-WK, THY), Department of Internal Medicine, School of Medicine, Ewha Womans University (D-RR), and Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University (S-WK), Seoul, Republic of Korea
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83
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Racanicchi IACWS, Oliveira ABSD, Barbieri RL, Dellê H, Duarte IDS, Leme PLS. Experimental models of renal dysfunction in female rats. Functional and histological aspects after unilateral nephrectomy or ligation of right renal vein with kidney preservation. Acta Cir Bras 2016; 30:824-30. [PMID: 26735054 DOI: 10.1590/s0102-865020150120000006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/15/2015] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To compare renal dysfunction after right nephrectomy and ligation of the right renal vein with preservation of kidney. METHODS Animals' weight, pH, density, protein in urine and histological samples of the kidneys were evaluated. Fifteen female rats (Wistar) were divided into three groups. In the control group, right renal vein dissections were performed. In the second group, the right nephrectomy was performed. In the third group, the right renal vein was ligated and the kidney was preserved. Urine samples were taken before, three and seven days after the procedure. On the seventh postoperative day the kidneys were removed to histopathological study. Analysis by Student's t test was performed. RESULTS weight loss, alterations of urine pH (p<0.05), in specific gravity, proteinuria (p<0.05) were found in groups 2 and 3; hemorrhagic infarction and edema were found after ligation of the right renal vein; changes in the left kidney were also observed on the seventh day.
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Affiliation(s)
| | | | | | - Humberto Dellê
- Laboratory of Experimental Research on Physiology, UNINOVE, Sao Paulo, SP, Brazil
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84
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Raghu G, Jakhotia S, Yadagiri Reddy P, Anil Kumar P, Bhanuprakash Reddy G. Ellagic acid inhibits non-enzymatic glycation and prevents proteinuria in diabetic rats. Food Funct 2016; 7:1574-83. [DOI: 10.1039/c5fo01372k] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The formation of advanced glycation end products (AGEs) is a characteristic feature of diabetic tissues and accumulation of AGEs been implicated in the pathogenesis of diabetic nephropathy (DN). Ellagic acid prevented the accumulation of AGEs and in turn ameliorated proteinurea in diabetic rats.
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Affiliation(s)
- G. Raghu
- National Institute of Nutrition
- Hyderabad
- India
| | | | | | - P. Anil Kumar
- Department of Biochemistry
- University of Hyderabad
- Hyderabad
- India
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85
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Bôa ISF, Porto ML, Pereira ACH, Ramos JPL, Scherer R, Oliveira JP, Nogueira BV, Meyrelles SS, Vasquez EC, Endringer DC, Pereira TMC. Resin from Virola oleifera Protects Against Radiocontrast-Induced Nephropathy in Mice. PLoS One 2015; 10:e0144329. [PMID: 26674346 PMCID: PMC4684213 DOI: 10.1371/journal.pone.0144329] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/17/2015] [Indexed: 12/28/2022] Open
Abstract
Contrast-induced nephropathy (CIN) is an iatrogenic medical event for which there is not yet a successful therapy. Increasing evidence in rodents has suggested that this disease is associated with renal tubular and vascular injury that is triggered directly by oxidative stress. In the present study, we evaluated whether the antioxidant resin from Virola oleifera (RV) could attenuate renal damage in an experimental mouse model of CIN. Adult male Swiss mice were divided into six groups and pre-treated orally with RV (10, 100 and 300 mg/kg), N-acetylcysteine (200 mg/kg) or vehicle for 5 days before the induction of CIN and Control group. Renal function was assessed by measuring plasma creatinine and urea levels. Additionally, renal oxidative stress and apoptosis/cell viability were determined with flow cytometry. Finally, kidney tissues were sectioned for histopathological examination. In this CIN model, pre-treatment with RV improved renal function, lowered the mortality rate, and reduced oxidative stress and apoptosis in both the medulla and cortex renal cells in a dose-dependent manner. Moreover, the RV treatment had beneficial effects on kidney histopathology that were superior to the standard treatment with N-acetylcysteine. These data suggest that because of its antioxidative and antiapoptotic effects and its ability to preserve renal function, resin from Virola oleifera may have potential as a new therapeutic approach for preventing CIN.
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Affiliation(s)
- Igor Santos Fonte Bôa
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | - Marcella Leite Porto
- Laboratory of Translational Physiology, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | | | | | - Rodrigo Scherer
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | - Jairo Pinto Oliveira
- Department of Morphology, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Breno Valentim Nogueira
- Department of Morphology, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Silvana Santos Meyrelles
- Laboratory of Translational Physiology, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Elisardo Corral Vasquez
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
- Laboratory of Translational Physiology, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Denise Coutinho Endringer
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
- Federal Institute of Education, Science and Technology (IFES), Vila Velha, ES, Brazil
| | - Thiago Melo Costa Pereira
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
- Federal Institute of Education, Science and Technology (IFES), Vila Velha, ES, Brazil
- * E-mail:
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Craciun FL, Bijol V, Ajay AK, Rao P, Kumar RK, Hutchinson J, Hofmann O, Joshi N, Luyendyk JP, Kusebauch U, Moss CL, Srivastava A, Himmelfarb J, Waikar SS, Moritz RL, Vaidya VS. RNA Sequencing Identifies Novel Translational Biomarkers of Kidney Fibrosis. J Am Soc Nephrol 2015; 27:1702-13. [PMID: 26449608 DOI: 10.1681/asn.2015020225] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 08/17/2015] [Indexed: 01/08/2023] Open
Abstract
CKD is the gradual, asymptomatic loss of kidney function, but current tests only identify CKD when significant loss has already happened. Several potential biomarkers of CKD have been reported, but none have been approved for preclinical or clinical use. Using RNA sequencing in a mouse model of folic acid-induced nephropathy, we identified ten genes that track kidney fibrosis development, the common pathologic finding in patients with CKD. The gene expression of all ten candidates was confirmed to be significantly higher (approximately ten- to 150-fold) in three well established, mechanistically distinct mouse models of kidney fibrosis than in models of nonfibrotic AKI. Protein expression of these genes was also high in the folic acid model and in patients with biopsy-proven kidney fibrosis. mRNA expression of the ten genes increased with increasing severity of kidney fibrosis, decreased in response to therapeutic intervention, and increased only modestly (approximately two- to five-fold) with liver fibrosis in mice and humans, demonstrating specificity for kidney fibrosis. Using targeted selected reaction monitoring mass spectrometry, we detected three of the ten candidates in human urine: cadherin 11 (CDH11), macrophage mannose receptor C1 (MRC1), and phospholipid transfer protein (PLTP). Furthermore, urinary levels of each of these three proteins distinguished patients with CKD (n=53) from healthy individuals (n=53; P<0.05). In summary, we report the identification of urinary CDH11, MRC1, and PLTP as novel noninvasive biomarkers of CKD.
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Affiliation(s)
| | - Vanesa Bijol
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | | | | | | | - Nikita Joshi
- Department of Pathology and Diagnostic Investigation, Michigan State University, East Lansing, Michigan
| | - James P Luyendyk
- Department of Pathology and Diagnostic Investigation, Michigan State University, East Lansing, Michigan
| | | | | | | | - Jonathan Himmelfarb
- Kidney Research Institute, University of Washington, Seattle, Washington; and
| | | | | | - Vishal S Vaidya
- Renal Division, Department of Medicine and Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Harvard Program in Therapeutic Sciences, Harvard Medical School, Boston, Massachusetts
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87
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Wensink GE, Schoffelen AF, Tempelman HA, Rookmaaker MB, Hoepelman AIM, Barth RE. Albuminuria Is Associated with Traditional Cardiovascular Risk Factors and Viral Load in HIV-Infected Patients in Rural South Africa. PLoS One 2015; 10:e0136529. [PMID: 26309226 PMCID: PMC4550462 DOI: 10.1371/journal.pone.0136529] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 08/04/2015] [Indexed: 01/13/2023] Open
Abstract
Context As life expectancy improves among Human Immunodeficiency Virus (HIV) patients, renal and cardiovascular diseases are increasingly prevalent in this population. Renal and cardiovascular disease are mutual risk factors and are characterized by albuminuria. Understanding the interactions between HIV, cardiovascular risk factors and renal disease is the first step in tackling this new therapeutic frontier in HIV. Methods In a rural primary health care centre, 903 HIV-infected adult patients were randomly selected and data on HIV-infection and cardiovascular risk factors were collected. Glomerular filtration rate (eGFR) was estimated. Albuminuria was defined as an Albumin-Creatinine-Ratio above 30 mg/g. Multivariate logistic regression analysis was used to analyse albuminuria and demographic, clinical and HIV-associated variables. Results The study population consisted of 903 HIV-infected patients, with a median age of 40 years (Inter-Quartile Range (IQR) 34–48 years), and included 625 (69%) women. The median duration since HIV diagnosis was 26 months (IQR 12–58 months) and 787 (87%) received antiretroviral therapy. Thirty-six (4%) of the subjects were shown to have diabetes and 205 (23%) hypertension. In the cohort, 21% had albuminuria and 2% an eGFR <60 mL/min/1.73m2. Albuminuria was associated with hypertension (adjusted odds ratio (aOR) 1.59; 95% confidence interval (CI) 1.05–2.41; p<0.05), total cholesterol (aOR 1.31; 95% CI 1.11–1.54; p<0.05), eGFR (aOR 0.98; 95% CI 0.97–0.99; p<0.001) and detectable viral load (aOR 2.74; 95% CI 1.56–4.79; p<0.001). Hypertension was undertreated: 78% were not receiving treatment, while another 11% were inadequately treated. No patients were receiving lipid-lowering medication. Conclusion Glomerular filtration rate was well conserved, while albuminuria was common amongst HIV-infected patients in rural South Africa. Both cardiovascular and HIV-specific variables were associated with albuminuria. Improved cardiovascular risk prevention as well as adequate virus suppression might be the key to escape the vicious circle of renal failure and cardiovascular disease and improve the long-term prognosis of HIV-infected patients.
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Affiliation(s)
- G. Emerens Wensink
- Department of Internal Medicine & Infectious Diseases at the University Medical Centre in Utrecht, Utrecht, The Netherlands
- * E-mail:
| | - Annelot F. Schoffelen
- Department of Internal Medicine & Infectious Diseases at the University Medical Centre in Utrecht, Utrecht, The Netherlands
| | | | - Maarten B. Rookmaaker
- Department of Nephrology & Hypertension at the University Medical Centre in Utrecht, Utrecht, The Netherlands
| | - Andy I. M. Hoepelman
- Department of Internal Medicine & Infectious Diseases at the University Medical Centre in Utrecht, Utrecht, The Netherlands
| | - Roos E. Barth
- Department of Internal Medicine & Infectious Diseases at the University Medical Centre in Utrecht, Utrecht, The Netherlands
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Nasri H, Rafieian-Kopaei M. On the occasion of world kidney day 2016; work together to better protect the kidney. J Nephropathol 2015; 5:15-8. [PMID: 27047805 PMCID: PMC4790182 DOI: 10.15171/jnp.2016.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/14/2015] [Indexed: 11/09/2022] Open
Abstract
Context: World kidney day is a yearly global alertness and education ceremony, held on the second Thursday in March.
Evidence Acquisition: Directory of open access journals (DOAJ), EMBASE, Google Scholar, PubMed, EBSCO, and Web of Science have been searched.
Results: Once again we reached to March 14, the world kidney day of 2016. This is the 10th anniversary of world kidney day, a program of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF). World kidney day first began in 2006 and the worldwide campaign highlights a specific theme each year. The theme for 2015 was to invite everybody to drink a glass of water and give one, too, to celebrate their kidneys. This is a symbolic action to memorize that kidneys are vital organs and that they might be cared.
Conclusions: It is a manner to make individuals more conscious about their lifestyle choices. In this year, world kidney day will be celebrated on Thursday March 10, 2016. The theme for 2016 will highlight on renal disease and children.
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Affiliation(s)
- Hamid Nasri
- Department of Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
Tubulointerstitial fibrosis and glomerulosclerosis, are a major feature of end stage chronic kidney disease (CKD), characterised by an excessive accumulation of extracellular matrix (ECM) proteins. Transforming growth factor beta-1 (TGF-β1) is a cytokine with an important role in many steps of renal fibrosis such as myofibroblast activation and proliferation, ECM protein synthesis and inflammatory cell infiltration. Endoglin is a TGF-β co-receptor that modulates TGF-β responses in different cell types. In numerous cells types, such as mesangial cells or myoblasts, endoglin regulates negatively TGF-β-induced ECM protein expression. However, recently it has been demonstrated that 'in vivo' endoglin promotes fibrotic responses. Furthermore, several studies have demonstrated an increase of endoglin expression in experimental models of renal fibrosis in the kidney and other tissues. Nevertheless, the role of endoglin in renal fibrosis development is unclear and a question arises: Does endoglin protect against renal fibrosis or promotes its development? The purpose of this review is to critically analyse the recent knowledge relating to endoglin and renal fibrosis. Knowledge of endoglin role in this pathology is necessary to consider endoglin as a possible therapeutic target against renal fibrosis.
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90
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Abstract
Stem cell transplantation therapy has emerged as a promising regenerative medicine for ischemic stroke and other neurodegenerative disorders. However, many issues and problems remain to be resolved before successful clinical applications of the cell-based therapy. To this end, some recent investigations have sought to benefit from well-known mechanisms of ischemic/hypoxic preconditioning. Ischemic/hypoxic preconditioning activates endogenous defense mechanisms that show marked protective effects against multiple insults found in ischemic stroke and other acute attacks. As in many other cell types, a sub-lethal hypoxic exposure significantly increases the tolerance and regenerative properties of stem cells and progenitor cells. So far, a variety of preconditioning triggers have been tested on different stem cells and progenitor cells. Preconditioned stem cells and progenitors generally show much better cell survival, increased neuronal differentiation, enhanced paracrine effects leading to increased trophic support, and improved homing to the lesion site. Transplantation of preconditioned cells helps to suppress inflammatory factors and immune responses, and promote functional recovery. Although the preconditioning strategy in stem cell therapy is still an emerging research area, accumulating information from reports over the last few years already indicates it as an attractive, if not essential, prerequisite for transplanted cells. It is expected that stem cell preconditioning and its clinical applications will attract more attention in both the basic research field of preconditioning as well as in the field of stem cell translational research. This review summarizes the most important findings in this active research area, covering the preconditioning triggers, potential mechanisms, mediators, and functional benefits for stem cell transplant therapy.
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Affiliation(s)
- Shan Ping Yu
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA 30322, USA
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Blázquez-Medela AM, García-Sánchez O, Blanco-Gozalo V, Quiros Y, Montero MJ, Martínez-Salgado C, López-Novoa JM, López-Hernández FJ. Hypertension and hyperglycemia synergize to cause incipient renal tubular alterations resulting in increased NGAL urinary excretion in rats. PLoS One 2014; 9:e105988. [PMID: 25148248 PMCID: PMC4141836 DOI: 10.1371/journal.pone.0105988] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/25/2014] [Indexed: 01/12/2023] Open
Abstract
Background Hypertension and diabetes are the two leading causes of chronic kidney disease (CKD) eventually leading to end stage renal disease (ESRD) and the need of renal replacement therapy. Mortality among CKD and ESRD patients is high, mostly due to cardiovascular events. New early markers of risk are necessary to better anticipate the course of the disease, to detect the renal affection of additive risk factors, and to appropriately handle patients in a pre-emptive and personalized manner. Methods Renal function and NGAL urinary excretion was monitored in rats with spontaneous (SHR) or L-NAME induced hypertension rendered hyperglycemic (or not as controls). Results Combination of hypertension and hyperglycemia (but not each of these factors independently) causes an increased urinary excretion of neutrophil gelatinase-associated lipocalin (NGAL) in the rat, in the absence of signs of renal damage. Increased NGAL excretion is observed in diabetic animals with two independent models of hypertension. Elevated urinary NGAL results from a specific alteration in its tubular handling, rather than from an increase in its renal expression. In fact, when kidneys of hyperglycaemic-hypertensive rats are perfused in situ with Krebs-dextran solution containing exogenous NGAL, they excrete more NGAL in the urine than hypertensive rats. We also show that albuminuria is not capable of detecting the additive effect posed by the coexistence of these two risk factors. Conclusions Our results suggest that accumulation of hypertension and hyperglycemia induces an incipient and quite specific alteration in the tubular handling of NGAL resulting in its increased urinary excretion.
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Affiliation(s)
- Ana M. Blázquez-Medela
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
- Instituto Reina Sofía de Investigación Nefrológica, Fundación Iñigo Álvarez de Toledo, Madrid, Spain
| | - Omar García-Sánchez
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
- Instituto Reina Sofía de Investigación Nefrológica, Fundación Iñigo Álvarez de Toledo, Madrid, Spain
| | - Víctor Blanco-Gozalo
- Instituto de Estudios de Ciencias de la Salud de Castilla y León-Instituto de Investigación Biomédica de Salamanca (IECSCYL-IBSAL), Unidad de Investigación, Hospital Universitario de Salamanca, Salamanca, Spain
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
- Bio-inRen, S.L., Salamanca, Spain
| | - Yaremi Quiros
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
- Bio-inRen, S.L., Salamanca, Spain
| | - María J. Montero
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
| | - Carlos Martínez-Salgado
- Instituto de Estudios de Ciencias de la Salud de Castilla y León-Instituto de Investigación Biomédica de Salamanca (IECSCYL-IBSAL), Unidad de Investigación, Hospital Universitario de Salamanca, Salamanca, Spain
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
- Instituto Reina Sofía de Investigación Nefrológica, Fundación Iñigo Álvarez de Toledo, Madrid, Spain
| | - José M. López-Novoa
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
- Instituto Reina Sofía de Investigación Nefrológica, Fundación Iñigo Álvarez de Toledo, Madrid, Spain
| | - Francisco J. López-Hernández
- Instituto de Estudios de Ciencias de la Salud de Castilla y León-Instituto de Investigación Biomédica de Salamanca (IECSCYL-IBSAL), Unidad de Investigación, Hospital Universitario de Salamanca, Salamanca, Spain
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, Salamanca, Spain
- Instituto Reina Sofía de Investigación Nefrológica, Fundación Iñigo Álvarez de Toledo, Madrid, Spain
- * E-mail:
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Niu H, Nie L, Liu M, Chi Y, Zhang T, Li Y. Benazepril affects integrin-linked kinase and smooth muscle α-actin expression in diabetic rat glomerulus and cultured mesangial cells. BMC Nephrol 2014; 15:135. [PMID: 25142208 PMCID: PMC4151867 DOI: 10.1186/1471-2369-15-135] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 08/13/2014] [Indexed: 01/28/2023] Open
Abstract
Background Diabetic nephropathy (DN) is the leading cause of chronic kidney disease and is associated with excessive cardiovascular morbidity and mortality. The angiotensin converting enzyme inhibitor (ACEI) benazepril has been shown to slow the progression of chronic renal disease and have beneficial effects in patients with a combination of chronic renal disease and cardiovascular disease. Transforming growth factor-β1 (TGF-β1) plays a central role in the pathogenesis and progression of DN. Integrin-linked kinase (ILK) can modulate TGF-β1-induced glomerular mesangial cell (GMC) injury, which is a prominent characteristic of renal pathology in kidney diseases. As an integrin cytoplasmic-binding protein, ILK regulates fibronectin (FN) matrix deposition and the actin cytoskeleton. Smooth muscle α-actin (α-SMA) is involved in progressive renal dysfunction in both human and experimental renal disease. Methods To explore the mechanisms of benazepril’s reno-protective effects, we examined the expression of TGF-β1, ILK, and α-SMA in GMC exposed to high glucose (HG) and in the kidneys of streptozotocin (STZ)-induced diabetic rats using real-time quantitative RT-PCR and western blot analysis. To elucidate the mechanism(s) of the effect of benazepril on GMC cellular processes, we assessed the effect of benazepril on Angiotensin II (Ang II) signalling pathways using western blot analysis. Results The expression of TGF-β1, ILK, and α-SMA increased significantly in the diabetic group compared with the control group. Benazepril treatment inhibited the expression of these genes in DN but failed to rescue the same levels in the control group. Similar results were found in GMC treated with HG or benazepril. Ang II increased ERK and Akt phosphorylation in the HG group, and benazepril could not completely block these responses, suggesting that other molecules might be involved in the progression of DN. Our findings suggest that benazepril decreases ILK and α-SMA expression, at least in part, by affecting the interactions between Ang II and TGF-β1. Conclusions The findings described here support the hypothesis that the HG milieu of diabetes increases TGF-β1 secretion, which increases the synthesis of ILK and α-SMA that are involved in the progression of DN. This might be an important mechanism of the benazepril renal-protective function in the pathogenesis of DN.
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Affiliation(s)
| | | | | | | | | | - Ying Li
- Department of Nephrology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China.
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93
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Yang GX, Xu YY, Fan YP, Wang J, Chen XL, Zhang YD, Wu JH. A maladaptive role for EP4 receptors in mouse mesangial cells. PLoS One 2014; 9:e104091. [PMID: 25122504 PMCID: PMC4133176 DOI: 10.1371/journal.pone.0104091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 07/09/2014] [Indexed: 12/22/2022] Open
Abstract
Roles of the prostaglandin E2 E-prostanoid 4 receptor (EP4) on extracellular matrix (ECM) accumulation induced by TGF-β1 in mouse glomerular mesangial cells (GMCs) remain unknown. Previously, we have identified that TGF-β1 stimulates the expression of FN and Col I in mouse GMCs. Here we asked whether stimulation of EP4 receptors would exacerbate renal fibrosis associated with enhanced glomerular ECM accumulation. We generated EP4Flox/Flox and EP4+/− mice, cultured primary WT, EP4Flox/Flox and EP4+/− GMCs, AD-EP4 transfected WT GMCs (EP4 overexpression) and AD-Cre transfected EP4Flox/Flox GMCs (EP4 deleted). We found that TGF-β1-induced cAMP and PGE2 synthesis decreased in EP4 deleted GMCs and increased in EP4 overexpressed GMCs. Elevated EP4 expression in GMCs augmented the coupling of TGF-β1 to FN, Col I expression and COX2/PGE2 signaling, while TGF-β1 induced FN, Col I expression and COX2/PGE2 signaling were down-regulated in EP4 deficiency GMCs. 8 weeks after 5/6 nephrectomy (Nx), WT and EP4+/− mice exhibited markedly increased accumulation of ECM compared with sham-operated controls. Albuminuria, blood urea nitrogen and creatinine (BUN and Cr) concentrations were significantly increased in WT mice as compared to those of EP4+/− mice. Urine osmotic pressure was dramatically decreased after 5/6 Nx surgery in WT mice as compared to EP4+/− mice. The pathological changes in kidney of EP4+/− mice was markedly alleviated compared with WT mice. Immunohistochemical analysis showed significant reductions of Col I and FN in the kidney of EP4+/− mice compared with WT mice. Collectively, this investigation established EP4 as a potent mediator of the pro-TGF-β1 activities elicited by COX2/PGE2 in mice GMCs. Our findings suggested that prostaglandin E2, acting via EP4 receptors contributed to accumulation of ECM in GMCs and promoted renal fibrosis.
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Affiliation(s)
- Guang-xia Yang
- Department of Nephrology, Affiliated Hospital of Nantong university, Nantong, Jiangsu, China
- Department of Rheumatology, Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital), Wuxi, Jiangsu, China
| | - Yu-yin Xu
- Department of Nephrology, Affiliated Hospital of Nantong university, Nantong, Jiangsu, China
| | - Ya-ping Fan
- Department of Nephrology, Affiliated Hospital of Nantong university, Nantong, Jiangsu, China
| | - Jing Wang
- Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Xiao-lan Chen
- Department of Nephrology, Affiliated Hospital of Nantong university, Nantong, Jiangsu, China
- * E-mail:
| | - Yi-de Zhang
- Department of Nephrology, Affiliated Hospital of Nantong university, Nantong, Jiangsu, China
| | - Jian-hua Wu
- Department of Nephrology, Affiliated Hospital of Nantong university, Nantong, Jiangsu, China
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Craciun FL, Ajay AK, Hoffmann D, Saikumar J, Fabian SL, Bijol V, Humphreys BD, Vaidya VS. Pharmacological and genetic depletion of fibrinogen protects from kidney fibrosis. Am J Physiol Renal Physiol 2014; 307:F471-84. [PMID: 25007874 DOI: 10.1152/ajprenal.00189.2014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Fibrinogen (Fg) has been implicated in the pathogenesis of several fibrotic disorders by acting as a profibrotic ligand for a variety of cellular surface receptors and by modulating the provisional fibrin matrix formed after injury. We demonstrated increased renal Fg expression after unilateral ureteral obstruction and folic acid (FA) nephropathy in mice, respectively. Urinary Fg excretion was also increased in FA nephropathy. Using in vitro and in vivo approaches, our results suggested that IL-6 mediates STAT3 activation in kidney fibrosis and that phosphorylated (p)STAT3 binds to Fgα, Fgβ, and Fgγ promoters in the kidney to regulate their transcription. Genetically modified Fg heterozygous mice (∼75% of normal plasma Fg levels) exhibited only 3% kidney interstitial fibrosis and tubular atrophy after FA nephropathy compared with 24% for wild-type mice. Fibrinogenolysis through Ancrod administration after FA reduced interstitial fibrosis more than threefold compared with vehicle-treated control mice. Mechanistically, we show that Fg acts synergistically with transforming growth factor (TGF)-β1 to induce fibroblast proliferation and activates TGF-β1/pSMAD2 signaling. This study offers increased understanding of Fg expression and molecular interactions with TGF-β1 in the progression to kidney fibrosis and, importantly, indicates that fibrinogenolytics like Ancrod present a treatment opportunity for a yet intractable disease.
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Affiliation(s)
- Florin L Craciun
- Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Amrendra K Ajay
- Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Dana Hoffmann
- Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Janani Saikumar
- Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Steven L Fabian
- Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Vanesa Bijol
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Benjamin D Humphreys
- Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Vishal S Vaidya
- Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston, Massachusetts; Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts; and Harvard Program in Therapeutic Sciences, Harvard Medical School, Boston, Massachusetts
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Martín P, Mora I, Cortes MA, Calleros L, García-Jerez A, Ortiz A, Rodríguez-Puyol M, Rodríguez-Puyol D, Olmos G. Relevant role of PKG in the progression of fibrosis induced by TNF-like weak inducer of apoptosis. Am J Physiol Renal Physiol 2014; 307:F75-85. [DOI: 10.1152/ajprenal.00398.2013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
TNF-like weak inducer of apoptosis (TWEAK) is an inflammatory cytokine that activates the FGF-inducible 14 receptor. Both TWEAK and the FGF-inducible 14 receptor are constitutively expressed in the kidney. TWEAK has been shown to modulate several biological responses, such as inflammation, proliferation, differentiation, and apoptosis, that contribute to kidney injury. However, the role of TWEAK in fibrosis and TWEAK-activated intracellular signaling pathways remain poorly understood. We tested the hypothesis that TWEAK can be a potent inducer of renal fibrosis by increasing transforming growth factor (TGF)-β1 expression (a well-known switch in the fibrosis process) through PKG-I downregulation. We showed that in human mesangial cells, TWEAK increased TGF-β1 expression and activity, leading to higher levels of the extracellular matrix protein fibronectin and decreased PKG-I expression and activity via the Ras pathway. PKG-I activation with 8-bromo-cGMP, Ras inactivation with dominant negative Ras, or Ras pathway inhibition with the ERK1/2 inhibitor PD-98059 resulted in the prevention of TWEAK-induced TGF-β1 upregulation. In vivo, exogenous administration of TWEAK to wild-type mice downregulated kidney PKG-I and increased kidney TGF-β1 expression. These effects were blunted in H-Ras knockout mice. Together, these data demonstrate, for the first time, the key role of PKG-I in TGF-β1 induction by TWEAK in kidney cells.
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Affiliation(s)
- Paloma Martín
- Department of System Biology, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- REDinREN (Instituto de Salud Carlos III), Madrid, Spain
- Instituto Reina Sofía de Investigaciones Nefrológicas, Madrid, Spain
| | - Inés Mora
- REDinREN (Instituto de Salud Carlos III), Madrid, Spain
- Instituto Reina Sofía de Investigaciones Nefrológicas, Madrid, Spain
| | - M. Alicia Cortes
- Department of System Biology, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- REDinREN (Instituto de Salud Carlos III), Madrid, Spain
- Instituto Reina Sofía de Investigaciones Nefrológicas, Madrid, Spain
| | - Laura Calleros
- Department of System Biology, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- REDinREN (Instituto de Salud Carlos III), Madrid, Spain
- Instituto Reina Sofía de Investigaciones Nefrológicas, Madrid, Spain
| | - Andrea García-Jerez
- Department of System Biology, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- REDinREN (Instituto de Salud Carlos III), Madrid, Spain
- Instituto Reina Sofía de Investigaciones Nefrológicas, Madrid, Spain
| | - Alberto Ortiz
- REDinREN (Instituto de Salud Carlos III), Madrid, Spain
- IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Manuel Rodríguez-Puyol
- Department of System Biology, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- REDinREN (Instituto de Salud Carlos III), Madrid, Spain
- Instituto Reina Sofía de Investigaciones Nefrológicas, Madrid, Spain
| | - Diego Rodríguez-Puyol
- REDinREN (Instituto de Salud Carlos III), Madrid, Spain
- Instituto Reina Sofía de Investigaciones Nefrológicas, Madrid, Spain
- Department of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Nephrology Section and Research Unit, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain; and
| | - Gemma Olmos
- Department of System Biology, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- REDinREN (Instituto de Salud Carlos III), Madrid, Spain
- Instituto Reina Sofía de Investigaciones Nefrológicas, Madrid, Spain
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de Cortie K, Russell NS, Coppes RP, Stewart FA, Scharpfenecker M. Bone marrow-derived macrophages incorporate into the endothelium and influence vascular and renal function after irradiation. Int J Radiat Biol 2014; 90:769-77. [DOI: 10.3109/09553002.2014.920967] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Wang L, Xia P, Lv K, Han J, Dai Q, Li XM, Chen LM, Jiang YX. Assessment of renal tissue elasticity by acoustic radiation force impulse quantification with histopathological correlation: preliminary experience in chronic kidney disease. Eur Radiol 2014; 24:1694-9. [PMID: 24744199 DOI: 10.1007/s00330-014-3162-5] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 03/21/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Chronic kidney disease (CKD), a progressive and irreversible pathological syndrome, is the major cause of renal failure. Renal fibrosis is the principal process underlying the progression of CKD. Acoustic radiation force impulse (ARFI) quantification is a promising noninvasive method for assessing tissue stiffness. We evaluated whether the technique could reveal renal tissue fibrosis in CKD patients. METHODS ARFI assessments were performed in 45 patients with CKD referred for renal biopsies to measure cortical shear wave velocity (SWV). During measurement, a standardized method was employed, which aimed to minimize the potential impact of variation of transducer force, sampling error of non-cortical tissue and structural anisotropy of the kidney. Then SWV was compared to patients' CKD stage and pathological fibrosis indicators. RESULTS ARFI could not predict the different stages of CKD. Spearman correlation analysis showed that SWV did not correlate with any pathological indicators of fibrosis. CONCLUSION ARFI assesses tissue stiffness of CKD kidneys by measuring cortical SWV. However, SWV did not show significant correlations with CKD stage and fibrosis indicators despite using standardized measurement methods. We therefore suggest that it would be necessary to evaluate the effect of pathological complexity and tissue perfusion of the kidney on stiffness assessment in future studies. KEY POINTS • Acoustic radiation force impulse (ARFI) can quantify tissue elasticity of CKD kidney. • Despite standardized measurement, ARFI-estimated elasticity did not correlate with renal fibrosis. • Effects of pathological complexity and tissue perfusion on renal stiffness warrant further study.
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Affiliation(s)
- Liang Wang
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, 1 Shuaifuyuan Wangfujing, Beijing, 100730, China
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Fu RG, Zhang T, Wang L, Du Y, Jia LN, Hou JJ, Yao GL, Liu XD, Zhang L, Chen L, Gui BS, Xue RL. Inhibition of the K+ channel K(Ca)3.1 reduces TGF-β1-induced premature senescence, myofibroblast phenotype transition and proliferation of mesangial cells. PLoS One 2014; 9:e87410. [PMID: 24489911 PMCID: PMC3905019 DOI: 10.1371/journal.pone.0087410] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 12/25/2013] [Indexed: 01/15/2023] Open
Abstract
Objective KCa3.1 channel participates in many important cellular functions. This study planned to investigate the potential involvement of KCa3.1 channel in premature senescence, myofibroblast phenotype transition and proliferation of mesangial cells. Methods & Materials Rat mesangial cells were cultured together with TGF-β1 (2 ng/ml) and TGF-β1 (2 ng/ml) + TRAM-34 (16 nM) separately for specified times from 0 min to 60 min. The cells without treatment served as controls. The location of KCa3.1 channels in mesangial cells was determined with Confocal laser microscope, the cell cycle of mesangial cells was assessed with flow cytometry, the protein and mRNA expression of KCa3.1, α-smooth muscle actin (α-SMA) and fibroblast-specific protein-1 (FSP-1) were detected with Western blot and RT-PCR. One-way analysis of variance (ANOVA) and Student-Newman-Keuls-q test (SNK-q) were used to do statistical analysis. Statistical significance was considered at P<0.05. Results Kca3.1 channels were located in the cell membranes and/or in the cytoplasm of mesangial cells. The percentage of cells in G0-G1 phase and the expression of Kca3.1, α-SMA and FSP-1 were elevated under the induction of TGF-β1 when compared to the control and decreased under the induction of TGF-β1+TRAM-34 when compared to the TGF-β1 induced (P<0.05 or P<0.01). Conclusion Targeted disruption of KCa3.1 inhibits TGF-β1-induced premature aging, myofibroblast-like phenotype transdifferentiation and proliferation of mesangial cells.
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Affiliation(s)
- Rong-Guo Fu
- Department of Nephrology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
| | - Tao Zhang
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
| | - Li Wang
- Department of Nephrology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
| | - Yan Du
- Department of Nephrology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
| | - Li-Ning Jia
- Department of Nephrology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
| | - Jing-Jing Hou
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
| | - Gang-Lian Yao
- Department of Nephrology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
| | - Xiao-Dan Liu
- Cadre's ward, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, P.R. China
| | - Lei Zhang
- Medical Laboratory, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, P.R. China
| | - Ling Chen
- Department of Oncology, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
| | - Bao-Song Gui
- Department of Nephrology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
- * E-mail: (RLX); (BSG)
| | - Rong-Liang Xue
- Department of Anesthesia, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China
- * E-mail: (RLX); (BSG)
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García-Sánchez O, López-Novoa JM, López-Hernández FJ. Interferon-γ Reduces the Proliferation of Primed Human Renal Tubular Cells. NEPHRON EXTRA 2014; 4:1-7. [PMID: 24575118 PMCID: PMC3934603 DOI: 10.1159/000353587] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIMS Chronic kidney disease (CKD) is a progressive deterioration of the kidney function, which may eventually lead to renal failure and the need for dialysis or kidney transplant. Whether initiated in the glomeruli or the tubuli, CKD is characterized by progressive nephron loss, for which the process of tubular deletion is of key importance. Tubular deletion results from tubular epithelial cell death and defective repair, leading to scarring of the renal parenchyma. Several cytokines and signaling pathways, including transforming growth factor-β (TGF-β) and the Fas pathway, have been shown to participate in vivo in tubular cell death. However, there is some controversy about their mode of action, since a direct effect on normal tubular cells has not been demonstrated. We hypothesized that epithelial cells would require specific priming to become sensitive to TGF-β or Fas stimulation and that this priming would be brought about by specific mediators found in the pathological scenario. METHODS Herein we studied whether the combined effect of several stimuli known to take part in CKD progression, namely TGF-β, tumor necrosis factor-α, interferon-γ (IFN-γ), and Fas stimulation, on primed resistant human tubular cells caused cell death or reduced proliferation. RESULTS We demonstrate that these cytokines have no synergistic effect on the proliferation or viability of human kidney (HK2) cells. We also demonstrate that IFN-γ, but not the other stimuli, reduces the proliferation of cycloheximide-primed HK2 cells without affecting their viability. CONCLUSION Our results point at a potentially important role of IFN-γ in defective repair, leading to nephron loss during CKD.
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Affiliation(s)
- Omar García-Sánchez
- Unidad de Fisiopatología Renal y Cardiovascular, Departamento de Fisiología y Farmacología, Universidad de Salamanca, Madrid, Spain ; Fundación Renal Íñigo Álvarez de Toledo, Madrid, Spain
| | - José Miguel López-Novoa
- Unidad de Fisiopatología Renal y Cardiovascular, Departamento de Fisiología y Farmacología, Universidad de Salamanca, Madrid, Spain ; Instituto de Investigación Biomédica de Salamanca (IBSAL), Madrid, Spain ; Fundación Renal Íñigo Álvarez de Toledo, Madrid, Spain
| | - Francisco J López-Hernández
- Unidad de Fisiopatología Renal y Cardiovascular, Departamento de Fisiología y Farmacología, Universidad de Salamanca, Madrid, Spain ; Instituto de Investigación Biomédica de Salamanca (IBSAL), Madrid, Spain ; Unidad de Investigación, Instituto de Estudios de Ciencias de la Salud (IECSCYL)-Hospital Universitario de Salamanca, Salamanca, Madrid, Spain ; Fundación Renal Íñigo Álvarez de Toledo, Madrid, Spain
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Oral intoxication of mice with Shiga toxin type 2a (Stx2a) and protection by anti-Stx2a monoclonal antibody 11E10. Infect Immun 2013; 82:1213-21. [PMID: 24379294 DOI: 10.1128/iai.01264-13] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Shiga toxin (Stx)-producing Escherichia coli (STEC) strains cause food-borne outbreaks of hemorrhagic colitis and, less commonly, a serious kidney-damaging sequela called the hemolytic uremic syndrome (HUS). Stx, the primary virulence factor expressed by STEC, is an AB5 toxin with two antigenically distinct forms, Stx1a and Stx2a. Although both toxins have similar biological activities, Stx2a is more frequently produced by STEC strains that cause HUS than is Stx1a. Here we asked whether Stx1a and Stx2a act differently when delivered orally by gavage. We found that Stx2a had a 50% lethal dose (LD50) of 2.9 μg, but no morbidity occurred after oral intoxication with up to 157 μg of Stx1a. We also compared several biochemical and histological parameters in mice intoxicated orally versus intraperitoneally with Stx2a. We discovered that both intoxication routes caused similar increases in serum creatinine and blood urea nitrogen, indicative of kidney damage, as well as electrolyte imbalances and weight loss in the animals. Furthermore, kidney sections from Stx2a-intoxicated mice revealed multifocal, acute tubular necrosis (ATN). Of particular note, we detected Stx2a in kidney sections from orally intoxicated mice in the same region as the epithelial cell type in which ATN was detected. Lastly, we showed reduced renal damage, as determined by renal biomarkers and histopathology, and full protection of orally intoxicated mice with monoclonal antibody (MAb) 11E10 directed against the toxin A subunit; conversely, an irrelevant MAb had no therapeutic effect. Orally intoxicated mice could be rescued by MAb 11E10 6 h but not 24 h after Stx2a delivery.
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