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Abstract
The kidney is a vital organ that demands an extraordinary amount of energy to actively maintain the body's metabolism, plasma hemodynamics, electrolytes and water homeostasis, nutrients reabsorption, and hormone secretion. Kidney is only second to the heart in mitochondrial count and oxygen consumption. As such, the health and status of the energy power house, the mitochondria, is pivotal to the health and proper function of the kidney. Mitochondria are heterogeneous and highly dynamic organelles and their functions are subject to complex regulations through modulation of its biogenesis, bioenergetics, dynamics and clearance within cell. Kidney diseases, either acute kidney injury (AKI) or chronic kidney disease (CKD), are important clinical issues and global public health concerns with high mortality rate and socioeconomic burden due to lack of effective therapeutic strategies to cure or retard the progression of the diseases. Mitochondria-targeted therapeutics has become a major focus for modern research with the belief that maintaining mitochondria homeostasis can prevent kidney pathogenesis and disease progression. A better understanding of the cellular and molecular events that govern mitochondria functions in health and disease will potentially lead to improved therapeutics development.
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Affiliation(s)
- Pu Duann
- Department of Surgery, Baylor College of Medicine, Houston, TX, 77030, USA.
| | - Pei-Hui Lin
- Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, 43210, USA.
- Department of Surgery, The Ohio State University, Columbus, OH, 43210, USA.
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102
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Won AJ, Kim S, Kim YG, Kim KB, Choi WS, Kacew S, Kim KS, Jung JH, Lee BM, Kim S, Kim HS. Discovery of urinary metabolomic biomarkers for early detection of acute kidney injury. MOLECULAR BIOSYSTEMS 2016; 12:133-44. [PMID: 26566257 DOI: 10.1039/c5mb00492f] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The discovery of new biomarkers for early detection of drug-induced acute kidney injury (AKI) is clinically important. In this study, sensitive metabolomic biomarkers identified in the urine of rats were used to detect cisplatin-induced AKI. Cisplatin (10 mg kg(-1), i.p.) was administered to Sprague-Dawley rats, which were subsequently euthanized after 1, 3 or 5 days. In cisplatin-treated rats, mild histopathological alterations were noted at day 1, and these changes were severe at days 3 and 5. Blood urea nitrogen (BUN) and serum creatinine (SCr) levels were significantly increased at days 3 and 5. The levels of new urinary protein-based biomarkers, including kidney injury molecule-1 (KIM-1), glutathione S-transferase-α (GST-α), tissue inhibitor of metalloproteinase-1 (TIMP-1), vascular endothelial growth factor (VEGF), calbindin, clusterin, neutrophil, neutrophil gelatinase-associated lipocalin (NGAL), and osteopontin, were significantly elevated at days 3 and 5. Among urinary metabolites, trigonelline and 3-indoxylsulfate (3-IS) levels were significantly decreased in urine collected from cisplatin-treated rats prior to histological kidney damage. However, carbon tetrachloride (CCl4), a hepatotoxicant, did not affect these urinary biomarkers. Trigonelline is closely associated with GSH depletion and results in insufficient antioxidant capacity against cisplatin-induced AKI. The predominant cisplatin-induced AKI marker appeared to be reduced in urinary 3-IS levels. Because 3-IS is predominantly excreted via active secretion in proximal tubules, a decrease is indicative of tubular damage. Further, urinary excretion of 3-IS levels was markedly reduced in patients with AKI compared to normal subjects. The area under the curve receiver operating characteristics (AUC-ROC) for 3-IS was higher than for SCr, BUN, lactate dehydrogenase (LDH), total protein, and glucose. Therefore, low urinary or high serum 3-IS levels may be more useful for early detection of AKI than conventional biomarkers.
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Affiliation(s)
- A Jin Won
- College of Pharmacy, Pusan National University, Busan, 609-735, Republic of Korea
| | - Siwon Kim
- Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan, 609-735, Republic of Korea
| | - Yoon Gyoon Kim
- College of Pharmacy, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam 330-714, Republic of Korea
| | - Kyu-Bong Kim
- College of Pharmacy, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam 330-714, Republic of Korea
| | - Wahn Soo Choi
- School of Medicine, Konkuk University, Chungju 380-701, Republic of Korea
| | - Sam Kacew
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario, Canada
| | - Kyeong Seok Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, 440-746, Republic of Korea.
| | - Jee H Jung
- College of Pharmacy, Pusan National University, Busan, 609-735, Republic of Korea
| | - Byung Mu Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, 440-746, Republic of Korea.
| | - Suhkmann Kim
- Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan, 609-735, Republic of Korea
| | - Hyung Sik Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, 440-746, Republic of Korea.
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103
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Andreucci M, Faga T, Riccio E, Sabbatini M, Pisani A, Michael A. The potential use of biomarkers in predicting contrast-induced acute kidney injury. Int J Nephrol Renovasc Dis 2016; 9:205-21. [PMID: 27672338 PMCID: PMC5024777 DOI: 10.2147/ijnrd.s105124] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Contrast-induced acute kidney injury (CI-AKI) is a problem associated with the use of iodinated contrast media, causing kidney dysfunction in patients with preexisting renal failure. It accounts for 12% of all hospital-acquired kidney failure and increases the length of hospitalization, a situation that is worsening with increasing numbers of patients with comorbidities, including those requiring cardiovascular interventional procedures. So far, its diagnosis has relied upon the rise in creatinine levels, which is a late marker of kidney damage and is believed to be inadequate. Therefore, there is an urgent need for biomarkers that can detect CI-AKI sooner and more reliably. In recent years, many new biomarkers have been characterized for AKI, and these are discussed particularly with their use in known CI-AKI models and studies and include neutrophil gelatinase-associated lipocalin, cystatin C (Cys-C), kidney injury molecule-1, interleukin-18, N-acetyl-β-d-glucosaminidase, and L-type fatty acid-binding protein (L-FABP). The potential of miRNA and metabolomic technology is also mentioned. Early detection of CI-AKI may lead to early intervention and therefore improve patient outcome, and in future any one or a combination of several of these markers together with development in technology for their analysis may prove effective in this respect.
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Affiliation(s)
- Michele Andreucci
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro
| | - Teresa Faga
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro
| | - Eleonora Riccio
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Massimo Sabbatini
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Antonio Pisani
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Ashour Michael
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro
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104
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Downes KJ, Dong M, Fukuda T, Clancy JP, Haffner C, Bennett MR, Vinks AA, Goldstein SL. Urinary kidney injury biomarkers and tobramycin clearance among children and young adults with cystic fibrosis: a population pharmacokinetic analysis. J Antimicrob Chemother 2016; 72:254-260. [PMID: 27585963 DOI: 10.1093/jac/dkw351] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 07/21/2016] [Accepted: 07/26/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Tobramycin is frequently used for treatment of bronchopneumonia in patients with cystic fibrosis (CF). Variability in tobramycin clearance (CL) is high in this population with few reliable approaches to guide dosing. OBJECTIVES We sought to evaluate the pharmacokinetics of once-daily intravenous tobramycin in patients with CF and test the influence of covariates on tobramycin CL, including serum creatinine (SCr) and urinary biomarkers: neutrophil gelatinase-associated lipocalin (NGAL), retinol-binding protein (RBP) and kidney injury molecule-1 (KIM-1). METHODS This was a prospective, observational cohort study of children/young adults with CF receiving once-daily intravenous tobramycin from October 2012 to May 2014 at Cincinnati Children's Hospital Medical Center. Therapeutic drug monitoring data were prospectively obtained. Population pharmacokinetic analyses were performed using non-linear mixed-effects modelling. RESULTS Thirty-seven patients (median age 15.3 years, IQR 12.7-19.5) received 62 tobramycin courses. A one-compartment model with allometrically scaled weight for tobramycin CL and volume of distribution (V) best described the data. Urinary NGAL was associated with tobramycin CL (P < 0.001), as was urinary RBP (P < 0.001). SCr, estimated glomerular filtration rate and urinary KIM-1 were not significant covariates. The population pharmacokinetic parameter estimates were CL = 8.60 L/h/70 kg (relative standard error 4.3%) and V = 31.3 L/70 kg (relative standard error 4.7%). CONCLUSIONS We describe urinary biomarkers as predictors of tobramycin CL using a population pharmacokinetic modelling approach. Our findings suggest that patient weight and urinary NGAL or RBP could be used to individualize tobramycin therapy in patients with CF.
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Affiliation(s)
- Kevin J Downes
- Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA .,Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Min Dong
- Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tsuyoshi Fukuda
- Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - John P Clancy
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Pulmonology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher Haffner
- Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Michael R Bennett
- Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Alexander A Vinks
- Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stuart L Goldstein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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105
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Lee EK, Shin YJ, Park EY, Kim ND, Moon A, Kwack SJ, Son JY, Kacew S, Lee BM, Bae ON, Kim HS. Selenium-binding protein 1: a sensitive urinary biomarker to detect heavy metal-induced nephrotoxicity. Arch Toxicol 2016; 91:1635-1648. [PMID: 27578022 DOI: 10.1007/s00204-016-1832-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/24/2016] [Indexed: 11/24/2022]
Abstract
Identifying novel biomarkers to detect nephrotoxicity is clinically important. Here, we attempted to identify new biomarkers for mercury-induced nephrotoxicity and compared their sensitivity to that of traditional biomarkers in animal models. Comparative proteomics analysis was performed in kidney tissues of Sprague-Dawley rats after oral treatment with HgCl2 (0.1, 1, or 5 mg/kg/day) for 21 days. Kidney cortex tissues were analyzed by two-dimensional gel electrophoresis/matrix-assisted laser desorption/ionization, and differentially expressed proteins were identified. The corresponding spots were quantitated by RT-PCR. Selenium-binding protein 1 (SBP1) was found to be the most markedly upregulated protein in the kidney cortex of rats after HgCl2 administration. However, blood urea nitrogen, serum creatinine, and glucose levels increased significantly only in the 1 or 5 mg/kg HgCl2-treated groups. A number of urinary excretion proteins, including kidney injury molecule-1, clusterin, monocyte chemoattractant protein-1, and β-microglobulin, increased dose-dependently. Histopathological examination revealed severe proximal tubular damage in high-dose (5 mg/kg) HgCl2-exposed groups. In addition, urinary excretion of SBP1 significantly increased in a dose-dependent manner. To confirm the critical role of SBP1 as a biomarker for nephrotoxicity, normal kidney proximal tubular cells were treated with HgCl2, CdCl2, or cisplatin for 24 h. SBP1 levels significantly increased in conditioned media exposed to nephrotoxicants, but decreased in cell lysates. Our investigations suggest that SBP1 may play a critical role in the pathological processes underlying chemical-induced nephrotoxicity. Thus, urinary excretion of SBP1 might be a sensitive and specific biomarker to detect early stages of kidney injury.
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Affiliation(s)
- Eui Kyung Lee
- College of Pharmacy, Pusan National University, Busan, 609-735, Republic of Korea
| | - Young-Jun Shin
- College of Pharmacy, Hanyang University, Ansan, 426-791, Republic of Korea
| | - Eun Young Park
- College of Pharmacy, Pusan National University, Busan, 609-735, Republic of Korea
| | - Nam Deuk Kim
- College of Pharmacy, Pusan National University, Busan, 609-735, Republic of Korea
| | - Aree Moon
- College of Pharmacy, Duksung Women's University, Seoul, 132-714, Republic of Korea
| | - Seung Jun Kwack
- Department of Biochemistry and Health Science, Changwon National University, Gyeongnam, 641-773, Republic of Korea
| | - Ji Yeon Son
- School of Pharmacy, Sungkyunkwan University, Suwon, 440-746, Republic of Korea
| | - Sam Kacew
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada
| | - Byung Mu Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, 440-746, Republic of Korea
| | - Ok-Nam Bae
- College of Pharmacy, Hanyang University, Ansan, 426-791, Republic of Korea.
| | - Hyung Sik Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, 440-746, Republic of Korea.
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106
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Wang X, Wang Y, Feng L, Tong Y, Chen Z, Ying S, Chen T, Li T, Xia H, Jiang Z, Shang Q, Lou X, Lou J. Application of the Benchmark Dose (BMD) Method to Identify Thresholds of Cadmium-Induced Renal Effects in Non-Polluted Areas in China. PLoS One 2016; 11:e0161240. [PMID: 27537182 PMCID: PMC4990304 DOI: 10.1371/journal.pone.0161240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/02/2016] [Indexed: 11/18/2022] Open
Abstract
The benchmark dose (BMD) method has been increasingly used to assess the health risks of cadmium (Cd) in epidemiological studies. The aim of our study was to estimate the threshold levels of urinary Cd (UCd) using the BMD method in a general population of Jiangshan City, Zhejiang Province of China. In our study, a total of 934 people (469 men, 465 women) were recruited and morning urine samples were collected from all the participants. Levels of Cd, creatinine, and renal dysfunction indicators such as retinol binding protein (RBP), β2-microglobulin (β2-MG), and N-acetyl-b-glucosaminidase (NAG) in urine were detected for analysis of BMD and BMD low (BMDL) of UCd. RBP, β2-MG, and NAG in urine all correlated significantly (P < 0.001) with UCd except of age (P = 0.767). When the benchmark response (BMR) was 5%, the BMD/BMDL of UCd for RBP, β2-MG, and NAG was 1.69/ 0.89, 1.24/0.62, 0.85/0.49 μg/g Cr in men and 1.70/0.76, 1.35/0.64, 1.36/0.65 μg/g Cr in women, respectively. If the BMR was set at 10%, the BMD/BMDL of UCd for RBP, β2-MG, and NAG was 2.44/1.59, 2.09/1.30, 1.80/1.04 μg/g Cr in men and 2.43/1.53, 2.10/1.34, 2.31/1.37 μg/g Cr in women, respectively. Our results provided evidence for Cd-induced tubular effects in cadmium non-polluted areas in China. Both β2-MG and NAG were more sensitive than RBP in response to Cd exposure. But β2-MG was the most sensitive indicator in women, and NAG was the most sensitive one in men.
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Affiliation(s)
- Xiaofeng Wang
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, P.R. China
| | - Yu Wang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Lingfang Feng
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Yan Tong
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Zhijian Chen
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Shibo Ying
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Tianhui Chen
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Tao Li
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Hailing Xia
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Zhaoqiang Jiang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Qi Shang
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing 100050, P.R. China
| | - Xiaoming Lou
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, P.R. China
- * E-mail: (JL); (XL)
| | - Jianlin Lou
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
- * E-mail: (JL); (XL)
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107
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Abd El-Twab SM, Hozayen WG, Hussein OE, Mahmoud AM. 18β-Glycyrrhetinic acid protects against methotrexate-induced kidney injury by up-regulating the Nrf2/ARE/HO-1 pathway and endogenous antioxidants. Ren Fail 2016; 38:1516-1527. [DOI: 10.1080/0886022x.2016.1216722] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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108
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Herrera-Pérez Z, Gretz N, Dweep H. A Comprehensive Review on the Genetic Regulation of Cisplatin-induced Nephrotoxicity. Curr Genomics 2016; 17:279-93. [PMID: 27252593 PMCID: PMC4869013 DOI: 10.2174/1389202917666160202220555] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 09/10/2015] [Accepted: 09/28/2015] [Indexed: 12/16/2022] Open
Abstract
Cisplatin (CDDP) is a well-known antineoplastic drug which has been extensively utilized over the last decades in the treatment of numerous kinds of tumors. However, CDDP induces a wide range of toxicities in a dose-dependent manner, among which nephrotoxicity is of particular importance. Still, the mechanism of CDDP-induced renal damage is not completely understood; moreover, the knowledge about the role of microRNAs (miRNAs) in the nephrotoxic response is still unknown. miRNAs are known to interact with the representative members of a diverse range of regulatory pathways (including postnatal development, proliferation, inflammation and fibrosis) and pathological conditions, including kidney diseases: polycystic kidney diseases (PKDs), diabetic nephropathy (DN), kidney cancer, and drug-induced kidney injury. In this review, we shed light on the following important aspects: (i) information on genes/proteins and their interactions with previously known pathways engaged with CDDP-induced nephrotoxicity, (ii) information on newly discovered biomarkers, especially, miRNAs for detecting CDDP-induced nephrotoxicity and (iii) information to improve our understanding on CDDP. This information will not only help the researchers belonging to nephrotoxicity field, but also supply an indisputable help for oncologists to better understand and manage the side effects induced by CDDP during cancer treatment. Moreover, we provide up-to-date information about different in vivo and in vitro models that have been utilized over the last decades to study CDDP-induced renal injury. Taken together, this review offers a comprehensive network on genes, miRNAs, pathways and animal models which will serve as a useful resource to understand the molecular mechanism of CDDP-induced nephrotoxicity.
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Affiliation(s)
- Zeneida Herrera-Pérez
- Medical Research Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Norbert Gretz
- Medical Research Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Harsh Dweep
- Medical Research Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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109
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Lee YH, Kim D, Lee MJ, Kim MJ, Jang HS, Park SH, Lee JM, Lee HY, Park CB, Han BS, Son WC, Kang JS, Kang JK. Subchronic toxicity of Acorus gramineus rhizoma in rats. JOURNAL OF ETHNOPHARMACOLOGY 2016; 183:46-53. [PMID: 26924566 DOI: 10.1016/j.jep.2016.02.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 01/29/2016] [Accepted: 02/25/2016] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Acorus gramineus rhizoma (AGR) is the dry rhizome of Acorus gramineus Solander from the family Araceae that has been used as sedative, analgesic, diuretic, digestive and antifungal agent. AIM OF THE STUDY To evaluate the no-observed-adverse-effect level (NOAEL) and the toxicity of AGR, following repeated oral administration to rats for 13 weeks. MATERIALS AND METHODS AGR was administered by oral gavage to groups of rats (10 per group, each sex) at doses of 0 (control), 25, 74, 222, 667, or 2,000mg/kg/day, 5 times per week for 13 weeks. Mortality, clinical signs, body weights, food consumption, hematology, serum chemistry, urinalysis, vaginal cytology, sperm motility, sperm morphology, organ weights, gross and histopathological findings were compared between control and AGR groups. RESULTS No mortality or remarkable clinical signs were observed during this 13-week study. No adverse effects on body weight, food consumption, urinalysis, hematology, serum chemistry, organ weights, gross lesion, histopathology, vaginal cytology, sperm motility or deformity were observed in any of the male or female rats treated with AGR. CONCLUSIONS On the basis of these results, the NOAEL of AGR is determined to be 2,000mg/kg/day for male and female rats.
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Affiliation(s)
- Yong-Hoon Lee
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea; Pathology Department, Chronic Inhalation Toxicity Research Center, Chemicals Toxicity Research Bureau, Occupational Safety and Health Research Institute, KOSHA, 339-30 Expo-ro, Yuseong-gu, Daejeon 305-380, Republic of Korea
| | - Duyeol Kim
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea
| | - Mi Ju Lee
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea
| | - Myoung Jun Kim
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea
| | - Ho-Song Jang
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea
| | - Sun Hee Park
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea
| | - Jung-Min Lee
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea; Department of Biomedical Laboratory Science, Namseoul University, 91 Daehak-ro, Seonghwan-eup, Sebuk-gu, Cheonan, Chungnam 331-707, Republic of Korea
| | - Hye-Yeong Lee
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea
| | - Cheol-Beom Park
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea
| | - Beom Seok Han
- Division of Toxicopathology, Hoseo Toxicology Research Center, Hoseo University, 79 Hoseo-ro, BaeBang-Myeon, Asan, Chungnam 336-795, Republic of Korea
| | - Woo-Chan Son
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Jin Seok Kang
- Department of Biomedical Laboratory Science, Namseoul University, 91 Daehak-ro, Seonghwan-eup, Sebuk-gu, Cheonan, Chungnam 331-707, Republic of Korea.
| | - Jong-Koo Kang
- Pathology Team, Biotoxtech Co., Ltd., 53 Yeongudanji-ro, Ochang-eup, Cheongwon-gu, Cheongju, Chungbuk 363-883, Republic of Korea; Department of Laboratory Animal medicine, College of Veterinary medicine, Chungbuk National University, 52 Naesudong-ro, Seowon-gu, Cheongju, Chungbuk 361-763, Republic of Korea.
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110
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Gautier JC, Zhou X, Yang Y, Gury T, Qu Z, Palazzi X, Léonard JF, Slaoui M, Veeranagouda Y, Guizon I, Boitier E, Filali-Ansary A, van den Berg BHJ, Poetz O, Joos T, Zhang T, Wang J, Detilleux P, Li B. Evaluation of novel biomarkers of nephrotoxicity in Cynomolgus monkeys treated with gentamicin. Toxicol Appl Pharmacol 2016; 303:1-10. [PMID: 27105553 DOI: 10.1016/j.taap.2016.04.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/11/2016] [Accepted: 04/15/2016] [Indexed: 11/16/2022]
Abstract
Most studies to evaluate kidney safety biomarkers have been performed in rats. This study was conducted in Cynomolgus monkeys in order to evaluate the potential usefulness of novel biomarkers of nephrotoxicity in this species. Groups of 3 males were given daily intramuscular injections of gentamicin, a nephrotoxic agent known to produce lesions in proximal tubules, at dose-levels of 10, 25, or 50mg/kg/day for 10days. Blood and 16-h urine samples were collected on Days -7, -3, 2, 4, 7, and at the end of the dosing period. Several novel kidney safety biomarkers were evaluated, with single- and multiplex immunoassays and in immunoprecipitation-LC/MS assays, in parallel to histopathology and conventional clinical pathology parameters. Treatment with gentamicin induced a dose-dependent increase in kidney tubular cell degeneration/necrosis, ranging from minimal to mild severity at 10mg/kg/day, moderate at 25mg/kg/day, and to severe at 50mg/kg/day. The results showed that the novel urinary biomarkers, microalbumin, α1-microglobulin, clusterin, and osteopontin, together with the more traditional clinical pathology parameters, urinary total protein and N-acetyl-β-D-glucosaminidase (NAG), were more sensitive than blood urea nitrogen (BUN) and serum creatinine (sCr) to detect kidney injury in the monkeys given 10mg/kg/day gentamicin for 10days, a dose leading to an exposure which is slightly higher than the desired therapeutic exposure in clinics. Therefore, these urinary biomarkers represent non-invasive biomarkers of proximal tubule injury in Cynomolgus monkeys which may be potentially useful in humans.
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Affiliation(s)
| | - Xiaobing Zhou
- National Center for Safety Evaluation of Drugs (NCSED), National Institutes for Food and Drug Control, Beijing, China
| | - Yi Yang
- Sanofi R&D, Bridgewater, USA
| | | | - Zhe Qu
- National Center for Safety Evaluation of Drugs (NCSED), National Institutes for Food and Drug Control, Beijing, China
| | | | | | | | | | | | | | | | | | - Oliver Poetz
- Natural and Medical Sciences Institute at the University Tübingen, Germany
| | - Thomas Joos
- Natural and Medical Sciences Institute at the University Tübingen, Germany
| | | | - Jufeng Wang
- National Center for Safety Evaluation of Drugs (NCSED), National Institutes for Food and Drug Control, Beijing, China
| | | | - Bo Li
- National Center for Safety Evaluation of Drugs (NCSED), National Institutes for Food and Drug Control, Beijing, China.
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111
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A proteomics-based identification of putative biomarkers for disease in bovine milk. Vet Immunol Immunopathol 2016; 174:11-8. [PMID: 27185258 DOI: 10.1016/j.vetimm.2016.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/01/2016] [Accepted: 04/04/2016] [Indexed: 10/22/2022]
Abstract
The objective of this study was to identify and characterize potential biomarkers for disease resistance in bovine milk that can be used to indicate dairy cows at risk to develop future health problems. We selected high- and low-resistant cows i.e. cows that were less or more prone to develop diseases according to farmers' experience and notifications in the disease registration data. The protein composition of milk serum samples of these high- and low-resistant cows were compared using NanoLC-MS/MS. In total 78 proteins were identified and quantified of which 13 were significantly more abundant in low-resistant cows than high-resistant cows. Quantification of one of these proteins, lactoferrin (LF), by ELISA in a new and much larger set of full fat milk samples confirmed higher LF levels in low- versus high-resistant cows. These high- and low-resistant cows were selected based on comprehensive disease registration and milk recording data, and absence of disease for at least 4 weeks. Relating the experienced diseases to LF levels in milk showed that lameness was associated with higher LF levels in milk. Analysis of the prognostic value of LF showed that low-resistant cows with higher LF levels in milk had a higher risk of being culled within one year after testing than high-resistant cows. In conclusion, LF in milk are higher in low-resistant cows, are associated with lameness and may be a prognostic marker for risk of premature culling.
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112
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Mosa OF, Skitek M, Kalisnik JM, Jerin A. Evaluation of serum cysteine-rich protein 61 and cystatin C levels for assessment of acute kidney injury after cardiac surgery. Ren Fail 2016; 38:699-705. [DOI: 10.3109/0886022x.2016.1157747] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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113
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Severin MJ, Trebucobich MS, Buszniez P, Brandoni A, Torres AM. The urinary excretion of an organic anion transporter as an early biomarker of methotrexate-induced kidney injury. Toxicol Res (Camb) 2016; 5:530-538. [PMID: 30090367 PMCID: PMC6062349 DOI: 10.1039/c5tx00436e] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 01/06/2016] [Indexed: 11/21/2022] Open
Abstract
Methotrexate (MTX) belongs to a group of medicines known as antimetabolites. It is commonly used in the treatment of malignant diseases and is prescribed in autoimmune and chronic inflammatory disorders. Along with its effective therapeutic power, MTX has adverse effects on several organs, including the kidney. The organic anion transporter 5 (Oat5) is exclusively localized in the renal apical membrane. Oat5 urinary excretion was proposed as an early biomarker in ischemic and nephrotoxic-induced kidney injury and in renal damage due to vascular calcification in preclinical models. The aim of this study was to evaluate Oat5 renal expression and urinary excretion in rats 48 h after the exposure to different doses of MTX, in comparison with traditional markers of renal injury, such as creatinine and urea plasma levels, protein urinary levels, urinary alkaline phosphatase (AP) activity, fractional excretion of water (FEWater) and renal histology. Male Wistar rats were treated with a single intraperitoneal injection of MTX at different dosages: 40-80-120-180-360 mg per kg b.w. (M40, M80, M120, M180, M360, n = 4, respectively) and experiments were carried out 48 h after MTX administration. Oat5 renal expression was evaluated by western blotting and immunohistochemistry. Traditional parameters were only modified at the higher MTX dose (M360). Conversely, Oat5 urinary excretion was elevated at the middle dose of 80 mg per kg b.w. Oat5 renal expression was modified at the highest dose as well, both in homogenates and in apical membranes. These results suggest that Oat5 urinary excretion might serve as an early biomarker of MTX-induced kidney injury.
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Affiliation(s)
- María J Severin
- Área Farmacología , Facultad de Ciencias Bioquímicas y Farmacéuticas. Universidad Nacional de Rosario. CONICET , Argentina . ; Tel: +0054/341/4393400
| | - Mara S Trebucobich
- Área Farmacología , Facultad de Ciencias Bioquímicas y Farmacéuticas. Universidad Nacional de Rosario. CONICET , Argentina . ; Tel: +0054/341/4393400
| | - Patricia Buszniez
- Área Farmacología , Facultad de Ciencias Bioquímicas y Farmacéuticas. Universidad Nacional de Rosario. CONICET , Argentina . ; Tel: +0054/341/4393400
| | - Anabel Brandoni
- Área Farmacología , Facultad de Ciencias Bioquímicas y Farmacéuticas. Universidad Nacional de Rosario. CONICET , Argentina . ; Tel: +0054/341/4393400
| | - Adriana M Torres
- Área Farmacología , Facultad de Ciencias Bioquímicas y Farmacéuticas. Universidad Nacional de Rosario. CONICET , Argentina . ; Tel: +0054/341/4393400
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114
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Kidney Injury Molecule-1 and Cardiovascular Diseases: From Basic Science to Clinical Practice. BIOMED RESEARCH INTERNATIONAL 2015; 2015:854070. [PMID: 26697493 PMCID: PMC4677159 DOI: 10.1155/2015/854070] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/27/2015] [Accepted: 11/04/2015] [Indexed: 01/09/2023]
Abstract
Despite the recent findings concerning pathogenesis and novel therapeutic strategies, cardiovascular disease (CVD) still stays the leading cause of morbidity and mortality in patients with renal dysfunction, especially acute kidney injury (AKI). Early detection of patients with impaired renal function with cardiovascular risk may help ensure more aggressive treatment and improve clinical outcome. Kidney injury molecule-1 (KIM-1) is a new, promising marker of kidney damage which is currently the focus of countless studies worldwide. Some recent animal and human studies established KIM-1 as an important marker of acute tubular necrosis (ATN) and reliable predictor of development and prognosis of AKI. Food and Drug Administration (FDA) in USA acclaimed KIM-1 as an AKI biomarker for preclinical drug development. Recent data suggest the importance of monitoring of KIM-1 for early diagnosis and clinical course not only in patients with various forms of AKI and other renal diseases but also in patients with cardiorenal syndrome, heart failure, cardiopulmonary bypass, cardiothoracic surgical interventions in the pediatric emergency setting, and so forth. The aim of this review article is to summarize the literature data concerning KIM-1 as a potential novel marker in the early diagnosis and prediction of clinical outcome of certain cardiovascular diseases.
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115
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Kuwata K, Nakamura I, Ide M, Sato H, Nishikawa S, Tanaka M. Comparison of changes in urinary and blood levels of biomarkers associated with proximal tubular injury in rat models. J Toxicol Pathol 2015. [PMID: 26441477 DOI: 10.1293/tox.2014-0039.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To investigate useful biomarkers associated with proximal tubular injury, we assessed changes in levels of a focused set of biomarkers in urine and blood. Male rats administered a single dose or four doses of gentamicin (GM, 240 mg/kg/day) or a single dose of cisplatin (CDDP, 5 mg/kg) were euthanized on days 2 (the day after initial dosing) 5, or 12. At each time point, histopathological examination of the kidney and immunohistochemistry for biomarkers, kidney injury molecule-1 (Kim-1), lipocalin (NGAL), clusterin (CLU), cystatin C (CysC) and β2-microglobulin (β2M) were performed. Biomarker levels were measured in urine and blood. In both treatment groups, degenerated/necrotic proximal tubules and regenerated tubules were mainly observed on days 5 and 12, respectively. At the same time as these tubular injuries, urinary Kim-1, CysC and β2M levels were increased. Moreover, urinary levels of CysC and β2M in GM-treated animals and Kim-1 in CDDP-treated animals increased (on day 2) prior to tubular injury on day 5. This was considered to reflect the characteristics of drug toxicity. Although almost all of the biomarkers in blood were not sufficiently sensitive to detect proximal tubular injury, urinary and plasma β2M levels simultaneously increased. Therefore, in addition to urinary Kim-1, CysC and β2M levels, plasma β2M levels were also considered useful for detecting proximal tubular injury.
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Affiliation(s)
- Kazunori Kuwata
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 1-1-1 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Itsuko Nakamura
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 2-2-50 Kawagishi, Toda, Saitama 335-8505, Japan
| | - Mika Ide
- Research Strategy & Planning Department, Research Division, Mitsubishi Tanabe Pharma Corporation, 2-2-50 Kawagishi, Toda, Saitama 335-8505, Japan
| | - Hiroko Sato
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 1-1-1 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Satomi Nishikawa
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 1-1-1 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Masaharu Tanaka
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 1-1-1 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
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116
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Xie L, Layton AT, Wang N, Larson PEZ, Zhang JL, Lee VS, Liu C, Johnson GA. Dynamic contrast-enhanced quantitative susceptibility mapping with ultrashort echo time MRI for evaluating renal function. Am J Physiol Renal Physiol 2015; 310:F174-82. [PMID: 26447222 DOI: 10.1152/ajprenal.00351.2015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/06/2015] [Indexed: 12/30/2022] Open
Abstract
Dynamic contrast-enhanced (DCE) MRI can provide key insight into renal function. DCE MRI is typically achieved through an injection of a gadolinium (Gd)-based contrast agent, which has desirable T1 quenching and tracer kinetics. However, significant T2* blooming effects and signal voids can arise when Gd becomes very concentrated, especially in the renal medulla and pelvis. One MRI sequence designed to alleviate T2* effects is the ultrashort echo time (UTE) sequence. In the present study, we observed T2* blooming in the inner medulla of the mouse kidney, despite using UTE at an echo time of 20 microseconds and a low dose of 0.03 mmol/kg Gd. We applied quantitative susceptibility mapping (QSM) and resolved the signal void into a positive susceptibility signal. The susceptibility values [in parts per million (ppm)] were converted into molar concentrations of Gd using a calibration curve. We determined the concentrating mechanism (referred to as the concentrating index) as a ratio of maximum Gd concentration in the inner medulla to the renal artery. The concentrating index was assessed longitudinally over a 17-wk course (3, 5, 7, 9, 13, 17 wk of age). We conclude that the UTE-based DCE method is limited in resolving extreme T2* content caused by the kidney's strong concentrating mechanism. QSM was able to resolve and confirm the source of the blooming effect to be the large positive susceptibility of concentrated Gd. UTE with QSM can complement traditional magnitude UTE and offer a powerful tool to study renal pathophysiology.
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Affiliation(s)
- Luke Xie
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina; Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, Utah
| | - Anita T Layton
- Department of Mathematics, Duke University, Durham, North Carolina
| | - Nian Wang
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, North Carolina
| | - Peder E Z Larson
- Department of Radiology and Biomedical Engineering, University of California, San Francisco, California; and
| | - Jeff L Zhang
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, Utah
| | - Vivian S Lee
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, Utah
| | - Chunlei Liu
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina; Brain Imaging and Analysis Center, Duke University Medical Center, Durham, North Carolina
| | - G Allan Johnson
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina
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117
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Gobe GC, Coombes JS, Fassett RG, Endre ZH. Biomarkers of drug-induced acute kidney injury in the adult. Expert Opin Drug Metab Toxicol 2015; 11:1683-94. [PMID: 26548752 DOI: 10.1517/17425255.2015.1083011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION This article addresses general biomarkers of drug-induced acute kidney injury (AKI) and their application in development and progression of AKI in the adult. It also highlights some clinical benefits, but also uncertainties, of biomarker use. AREAS COVERED Drug-induced AKI is traditionally diagnosed by monitoring serum creatinine (SCr), blood urea nitrogen and albuminuria. The sensitivity of these measures is, however, limited to well-established AKI. Application of selected biomarkers for early diagnosis of drug-induced AKI may inform on progression of AKI and alert clinicians to adopt renoprotective strategies at the earliest times. Novel biomarkers, accepted for early detection of drug-induced AKI (kidney injury molecule-1, neutrophil gelatinase-associated lipocalin and N-acetyl-β-d-glucosaminidase), may be useful additions in panels of biomarkers. Clinical biomarkers of cell cycle arrest, tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein 7 show promise but need further validation in clinical trials. EXPERT OPINION Traditional parameters, such as SCr, provide some guidance for functional decline in drug-induced AKI but early, more sensitive, affordable, clinically acceptable, biomarkers of kidney dysfunction are needed. Basic biological understanding of AKI will improve with high-throughput methodologies such as proteomics and metabolomics, and this should lead to identification and usage of novel biomarkers. Ultimately, a combination of biomarkers indicating kidney dysfunction and damage is likely to be required.
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Affiliation(s)
- Glenda C Gobe
- a 1 The University of Queensland, Translational Research Institute, School of Medicine, Centre for Kidney Disease Research , Woolloongabba 4102, Australia +61 7 34 43 80 11 ; +61 7 34 43 77 79 ;
| | - Jeff S Coombes
- b 2 The University of Queensland, School of Human Movement Studies, Exercise and Oxidative Stress Group , St Lucia, Brisbane 4072, Australia
| | - Robert G Fassett
- b 2 The University of Queensland, School of Human Movement Studies, Exercise and Oxidative Stress Group , St Lucia, Brisbane 4072, Australia.,c 3 The University of Queensland, School of Medicine , Herston, Brisbane 4067, Australia.,d 4 Royal Brisbane and Women's Hospital, Renal Medicine , Brisbane 4029, Australia
| | - Zoltan H Endre
- e 5 Prince of Wales Hospital, Prince of Wales Clinical School, Department of Nephrology , Randwick 2031, Australia
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118
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Mohamed F, Buckley NA, Jayamanne S, Pickering JW, Peake P, Palangasinghe C, Wijerathna T, Ratnayake I, Shihana F, Endre ZH. Kidney damage biomarkers detect acute kidney injury but only functional markers predict mortality after paraquat ingestion. Toxicol Lett 2015; 237:140-50. [DOI: 10.1016/j.toxlet.2015.06.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/02/2015] [Accepted: 06/07/2015] [Indexed: 11/25/2022]
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119
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Kim SY, Lee HM, Kim KS, Kim HS, Moon A. Noninvasive Biomarker Candidates for Cadmium-Induced Nephrotoxicity by 2DE/MALDI-TOF-MS and SILAC/LC-MS Proteomic Analyses. Toxicol Sci 2015; 148:167-82. [DOI: 10.1093/toxsci/kfv172] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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120
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Bulacio RP, Anzai N, Ouchi M, Torres AM. Organic Anion Transporter 5 (Oat5) Urinary Excretion Is a Specific Biomarker of Kidney Injury: Evaluation of Urinary Excretion of Exosomal Oat5 after N-Acetylcysteine Prevention of Cisplatin Induced Nephrotoxicity. Chem Res Toxicol 2015; 28:1595-602. [PMID: 26230185 DOI: 10.1021/acs.chemrestox.5b00176] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cisplatin is a commonly used chemotherapeutic agent. Its main side-effect is nephrotoxicity. It was reported that the organic anion transporter 5 (Oat5) urinary excretion is elevated, implying renal perturbation, when no modifications of traditional markers of renal damage are still observed in cisplatin-induced acute kidney injury (AKI). It was also demonstrated that Oat5 is excreted in urine by the exosomal pathway. This study was designated to demonstrate the specific response of the urinary excretion of exosomal Oat5 to kidney injury independently of other cisplatin toxic effects, in order to strengthen Oat5 urinary levels as a specific biomarker of AKI. To accomplish that aim, we evaluated if urinary excretion of exosomal Oat5 returns to its basal levels when cisplatin renal damage is prevented by the coadministration of the renoprotective compound N-acetylcysteine. Four days after cisplatin administration, AKI was induced in cisplatin-treated male Wistar rats (Cis group), as it was corroborated by increased urea and creatinine plasma levels. Tubular damage was also observed. In cotreated animals (Cis + NAC group), plasma urea and creatinine concentrations tended to return to their basal values, and tubular damage was improved. Urinary excretion of exosomal Oat5 was notably increased in the Cis group, but when renal injury was ameliorated by N-acetylcysteine coadministration, that increase was undetected. So, in this work we observed that urinary excretion of exosomal Oat5 was only increased if renal insult is produced, demonstrating its specificity as a renal injury biomarker.
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Affiliation(s)
- Romina Paula Bulacio
- †Area Farmacología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, CONICET, Rosario 2000, Argentina
| | - Naohiko Anzai
- ‡Department of Pharmacology and Toxicology, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan
| | - Motoshi Ouchi
- ‡Department of Pharmacology and Toxicology, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan
| | - Adriana Mónica Torres
- †Area Farmacología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, CONICET, Rosario 2000, Argentina
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121
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Kuwata K, Nakamura I, Ide M, Sato H, Nishikawa S, Tanaka M. Comparison of changes in urinary and blood levels of biomarkers associated with proximal tubular injury in rat models. J Toxicol Pathol 2015; 28:151-64. [PMID: 26441477 PMCID: PMC4588209 DOI: 10.1293/tox.2014-0039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 05/05/2015] [Indexed: 11/19/2022] Open
Abstract
To investigate useful biomarkers associated with proximal tubular injury, we assessed
changes in levels of a focused set of biomarkers in urine and blood. Male rats
administered a single dose or four doses of gentamicin (GM, 240 mg/kg/day) or a single
dose of cisplatin (CDDP, 5 mg/kg) were euthanized on days 2 (the day after initial dosing)
5, or 12. At each time point, histopathological examination of the kidney and
immunohistochemistry for biomarkers, kidney injury molecule-1 (Kim-1), lipocalin (NGAL),
clusterin (CLU), cystatin C (CysC) and β2-microglobulin (β2M) were performed. Biomarker
levels were measured in urine and blood. In both treatment groups, degenerated/necrotic
proximal tubules and regenerated tubules were mainly observed on days 5 and 12,
respectively. At the same time as these tubular injuries, urinary Kim-1, CysC and β2M
levels were increased. Moreover, urinary levels of CysC and β2M in GM-treated animals and
Kim-1 in CDDP-treated animals increased (on day 2) prior to tubular injury on day 5. This
was considered to reflect the characteristics of drug toxicity. Although almost all of the
biomarkers in blood were not sufficiently sensitive to detect proximal tubular injury,
urinary and plasma β2M levels simultaneously increased. Therefore, in addition to urinary
Kim-1, CysC and β2M levels, plasma β2M levels were also considered useful for detecting
proximal tubular injury.
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Affiliation(s)
- Kazunori Kuwata
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 1-1-1 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Itsuko Nakamura
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 2-2-50 Kawagishi, Toda, Saitama 335-8505, Japan
| | - Mika Ide
- Research Strategy & Planning Department, Research Division, Mitsubishi Tanabe Pharma Corporation, 2-2-50 Kawagishi, Toda, Saitama 335-8505, Japan
| | - Hiroko Sato
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 1-1-1 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Satomi Nishikawa
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 1-1-1 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Masaharu Tanaka
- Safety Research Laboratories, Research Division, Mitsubishi Tanabe Pharma Corporation, 1-1-1 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
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122
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Mohamed F, Endre ZH, Buckley NA. Role of biomarkers of nephrotoxic acute kidney injury in deliberate poisoning and envenomation in less developed countries. Br J Clin Pharmacol 2015; 80:3-19. [PMID: 26099916 DOI: 10.1111/bcp.12601] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/17/2014] [Accepted: 01/29/2015] [Indexed: 12/20/2022] Open
Abstract
Acute kidney injury (AKI) has diverse causes and is associated with increased mortality and morbidity. In less developed countries (LDC), nephrotoxic AKI (ToxAKI) is common and mainly due to deliberate ingestion of nephrotoxic pesticides, toxic plants or to snake envenomation. ToxAKI shares some pathophysiological pathways with the much more intensively studied ischaemic AKI, but in contrast to ischaemic AKI, most victims are young, previously healthy adults. Diagnosis of AKI is currently based on a rise in serum creatinine. However this may delay diagnosis because of the kinetics of creatinine. Baseline creatinine values are also rarely available in LDC. Novel renal injury biomarkers offer a way forward because they usually increase more rapidly in AKI and are normally regarded as absent or very low in concentration, thereby reducing the need for a baseline estimate. This should increase sensitivity and speed of diagnosis. Specificity should also be increased for urine biomarkers since many originate from the renal tubular epithelium. Earlier diagnosis of ToxAKI should allow earlier initiation of appropriate therapy. However, translation of novel biomarkers of ToxAKI into clinical practice requires better understanding of non-renal factors in poisoning that alter biomarkers and the influence of dose of nephrotoxin on biomarker performance. Further issues are establishing LDC population-based normal ranges and assessing sampling and analytical parameters for low resource settings. The potential role of renal biomarkers in exploring ToxAKI aetiologies for chronic kidney disease of unknown origin (CKDu) is a high research priority in LDC. Therefore, developing more sensitive biomarkers for early diagnosis of nephrotoxicity is a critical step to making progress against AKI and CKDu in the developing world.
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Affiliation(s)
- Fahim Mohamed
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka.,Clinical Pharmacology and Toxicology Group, Professorial Medicine Unit, The Prince of Wales Clinical School, University of New South Wales, NSW, Australia.,Department of Pharmacy, Faculty of Allied Health Science, University of Peradeniya, Sri Lanka
| | - Zoltan H Endre
- Department of Nephrology, Prince Of Wales Hospital and Clinical School, University of New South Wales, Sydney, Australia
| | - Nicholas A Buckley
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka.,Clinical Pharmacology and Toxicology Group, Professorial Medicine Unit, The Prince of Wales Clinical School, University of New South Wales, NSW, Australia.,Pharmacology, SOMS, Sydney Medical School, University of Sydney, NSW, Australia
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123
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Xie L, Qi Y, Subashi E, Liao G, Miller DeGraff L, Jetten AM, Johnson GA. 4D MRI of polycystic kidneys from rapamycin-treated Glis3-deficient mice. NMR IN BIOMEDICINE 2015; 28:546-54. [PMID: 25810360 PMCID: PMC4400264 DOI: 10.1002/nbm.3281] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 01/29/2015] [Accepted: 02/03/2015] [Indexed: 05/23/2023]
Abstract
Polycystic kidney disease (PKD) is a life-threatening disease that leads to a grotesque enlargement of the kidney and significant loss of function. Several imaging studies with MRI have demonstrated that cyst size in polycystic kidneys can determine disease severity and progression. In the present study, we found that, although kidney volume and cyst volume decreased with drug treatment, renal function did not improve with treatment. Here, we applied dynamic contrast-enhanced MRI to study PKD in a Glis3 (GLI-similar 3)-deficient mouse model. Cysts from this model have a wide range of sizes and develop at an early age. To capture this crucial stage and assess cysts in detail, we imaged during early development (3-17 weeks) and applied high spatiotemporal resolution MRI (125 × 125 × 125 cubic microns every 7.7 s). A drug treatment with rapamycin (also known as sirolimus) was applied to determine whether disease progression could be halted. The effect and synergy (interaction) of aging and treatment were evaluated using an analysis of variance (ANOVA). Structural measurements, including kidney volume, cyst volume and cyst-to-kidney volume ratio, changed significantly with age. Drug treatment significantly decreased these metrics. Functional measurements of time-to-peak (TTP) mean and TTP variance were determined. TTP mean did not change with age, whereas TTP variance increased with age. Treatment with rapamycin generally did not affect these functional metrics. Synergistic effects of treatment and age were not found for any measurements. Together, the size and volume ratio of cysts decreased with drug treatment, whereas renal function remained the same. The quantification of renal structure and function with MRI can comprehensively assess the pathophysiology of PKD and response to treatment.
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Affiliation(s)
- Luke Xie
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, 27708
| | - Yi Qi
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710
| | - Ergys Subashi
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710
- Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina, 27710
| | - Grace Liao
- Cell Biology Section, Immunity, Inflammation and Disease Laboratory, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, 27709
| | - Laura Miller DeGraff
- Cell Biology Section, Immunity, Inflammation and Disease Laboratory, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, 27709
| | - Anton M. Jetten
- Cell Biology Section, Immunity, Inflammation and Disease Laboratory, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, 27709
| | - G. Allan Johnson
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, 27708
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Benjamin A, Gallacher DJ, Greiter-Wilke A, Guillon JM, Kasai C, Ledieu D, Levesque P, Prelle K, Ratcliffe S, Sannajust F, Valentin JP. Renal studies in safety pharmacology and toxicology: A survey conducted in the top 15 pharmaceutical companies. J Pharmacol Toxicol Methods 2015; 75:101-10. [PMID: 25637943 DOI: 10.1016/j.vascn.2015.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 01/08/2015] [Accepted: 01/14/2015] [Indexed: 12/11/2022]
Abstract
INTRODUCTION With the recent development of more sensitive biomarkers to assess kidney injury preclinically, a survey was designed i) to investigate what strategies are used to investigate renal toxicity in both ICH S7A compliant Safety Pharmacology (SP) studies after a single dose of a compound and within repeat-dose toxicity studies by large pharmaceutical companies today; ii) to understand whether renal SP studies have impact or utility in drug development and/or if it may be more appropriate to assess renal effects after multiple doses of compounds; iii) to ascertain how much mechanistic work is performed by the top 15 largest pharmaceutical companies (as determined by R&D revenue size); iv) to gain an insight into the impact of the validation of DIKI biomarkers and their introduction in the safety evaluation paradigm; and v) to understand the impact of renal/urinary safety study data on progression of projects. METHODS Two short anonymous surveys were submitted to SP leaders of the top 15 pharmaceutical companies, as defined by 2012 R&D portfolio size. Fourteen multiple choice questions were designed to explore the strategies used to investigate renal effects in both ICH S7A compliant SP studies and within toxicology studies. RESULTS A 67% and 60% response rate was obtained in the first and second surveys, respectively. Nine out of ten respondent companies conduct renal excretory measurements (eg. urine analysis) in toxicology studies whereas only five out of ten conduct specific renal SP studies; and all of those 5 also conduct the renal excretory measurements in toxicology studies. These companies measure and/or calculate a variety of parameters as part of these studies, and also on a case by case basis include regulatory qualified and non-qualified DIKI biomarkers. Finally, only one company has used renal/urinary functional data alone to stop a project, whereas the majority of respondents combine renal data with other target organ assessments to form an integrated decision-making set. CONCLUSION These short surveys highlighted areas of similarity: a) urinary measurements are most commonly taken on repeat-dose toxicity studies, and b) renal SP studies are less often utilised. The two major differences are a) lack of consistent use of DIKI biomarkers in urinary safety studies and b) the way large pharmaceutical companies assess renal function. Finally, suggestions were made to improve the safety assessment methods for determining the safety of compounds with potential renal liability.
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Affiliation(s)
- Amanda Benjamin
- Safety Pharmacology Centre of Excellence, Drug Safety and Metabolism, AstraZeneca R&D Alderley Park, Macclesfield, Cheshire SK10 4TG, United Kingdom.
| | - David J Gallacher
- Center of Excellence for Cardiovascular Safety Research & Mechanistic Pharmacology Janssen, Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium
| | | | - Jean-Michel Guillon
- Sanofi R&D, Preclinical Safety, Safety Pharmacology, 13 quai Jules Guesde, 94400 Vitry sur Seine, France
| | - Cheiko Kasai
- Drug Safety Research Labs, Astellas Pharma Inc., 2-1-6, Kashima, Yodogawa-ku, Osaka 532-8514, Japan
| | - David Ledieu
- Novartis Pharma AG, Preclinical Safety, Basel, Switzerland
| | | | - Katja Prelle
- Safety Pharmacology, Bayer HealthCare, Wuppertal, Germany
| | - Sian Ratcliffe
- Drug Safety Research and Development, Pfizer, Eastern Point Road, Groton, CT 0634, USA
| | - Frederick Sannajust
- Safety & Exploratory Pharmacology, Merck Research Laboratories, SALAR Division, 770 Sumneytown Pike, P.O. Box 4, West-Point, PA 19486-0004, USA
| | - Jean-Pierre Valentin
- Safety Pharmacology Centre of Excellence, Drug Safety and Metabolism, AstraZeneca R&D Alderley Park, Macclesfield, Cheshire SK10 4TG, United Kingdom
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Abstract
The kidney is a complex excretory organ playing a crucial role in various physiological processes such as fluid and electrolyte balance, control of blood pressure, removal of waste products, and drug disposition. Drug-induced kidney injury (DIKI) remains a significant cause of candidate drug attrition during drug development. However, the incidence of renal toxicities in preclinical studies is low, and the mechanisms by which drugs induce kidney injury are still poorly understood. Although some in vitro investigational tools have been developed, the in vivo assessment of renal function remains the most widely used methodology to identify DIKI. Stand-alone safety pharmacology studies usually include assessment of glomerular and hemodynamic function, coupled with urine and plasma analyses. However, as renal function is not part of the ICH S7A core battery, such studies are not routinely conducted by pharmaceutical companies. The most common approach consists in integrating renal/urinary measurements in repeat-dose toxicity studies. In addition to the standard analyses and histopathological examination of kidneys, novel promising urinary biomarkers have emerged over the last decade, offering greater sensitivity and specificity than traditional renal parameters. Seven of these biomarkers have been qualified by regulatory agencies for use in rat toxicity studies.
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Tsuchimoto A, Shinke H, Uesugi M, Kikuchi M, Hashimoto E, Sato T, Ogura Y, Hata K, Fujimoto Y, Kaido T, Kishimoto J, Yanagita M, Matsubara K, Uemoto S, Masuda S. Urinary neutrophil gelatinase-associated lipocalin: a useful biomarker for tacrolimus-induced acute kidney injury in liver transplant patients. PLoS One 2014; 9:e110527. [PMID: 25329716 PMCID: PMC4203804 DOI: 10.1371/journal.pone.0110527] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 09/23/2014] [Indexed: 12/17/2022] Open
Abstract
Tacrolimus is widely used as an immunosuppressant in liver transplantation, and tacrolimus-induced acute kidney injury (AKI) is a serious complication of liver transplantation. For early detection of AKI, various urinary biomarkers such as monocyte chemotactic protein-1, liver-type fatty acid-binding protein, interleukin-18, osteopontin, cystatin C, clusterin and neutrophil gelatinase-associated lipocalin (NGAL) have been identified. Here, we attempt to identify urinary biomarkers for the early detection of tacrolimus-induced AKI in liver transplant patients. Urine samples were collected from 31 patients after living-donor liver transplantation (LDLT). Twenty recipients developed tacrolimus-induced AKI. After the initiation of tacrolimus therapy, urine samples were collected on postoperative days 7, 14, and 21. In patients who experienced AKI during postoperative day 21, additional spot urine samples were collected on postoperative days 28, 35, 42, 49, and 58. The 8 healthy volunteers, whose renal and liver functions were normal, were asked to collect their blood and spot urine samples. The urinary levels of NGAL, monocyte chemotactic protein-1 and liver-type fatty acid-binding protein were significantly higher in patients with AKI than in those without, while those of interleukin-18, osteopontin, cystatin C and clusterin did not differ between the 2 groups. The area under the receiver operating characteristics curve of urinary NGAL was 0.876 (95% confidence interval, 0.800–0.951; P<0.0001), which was better than those of the other six urinary biomarkers. In addition, the urinary levels of NGAL at postoperative day 1 (p = 0.0446) and day 7 (p = 0.0006) can be a good predictive marker for tacrolimus-induced AKI within next 6 days, respectively. In conclusion, urinary NGAL is a sensitive biomarker for tacrolimus-induced AKI, and may help predict renal event caused by tacrolimus therapy in liver transplant patients.
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Affiliation(s)
- Ayami Tsuchimoto
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
| | - Haruka Shinke
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
| | - Miwa Uesugi
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
| | - Mio Kikuchi
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
- Department of Pharmacy, Kagawa University Hospital, Kagawa, Japan
| | - Emina Hashimoto
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
| | - Tomoko Sato
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
| | - Yasuhiro Ogura
- Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koichiro Hata
- Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuhiro Fujimoto
- Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshimi Kaido
- Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Junji Kishimoto
- Department of Research and Development of Next Generation Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Motoko Yanagita
- Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuo Matsubara
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Uemoto
- Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satohiro Masuda
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
- * E-mail:
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Aptamer-functionalized porous phospholipid nanoshells for direct measurement of Hg(2+) in urine. Anal Bioanal Chem 2014; 407:953-60. [PMID: 25326888 DOI: 10.1007/s00216-014-8246-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 09/08/2014] [Accepted: 10/07/2014] [Indexed: 10/24/2022]
Abstract
A porous phospholipid nanoshell (PPN) sensor functionalized with a specific aptamer sensor agent was prepared for rapid detection of Hg(2+) in human urine with minimal sample preparation. Aptamer sensors provide an important class of optical transducers that can be readily and reproducibly synthesized. A key limitation of aptamer sensors, and many other optical sensors, is the potential of biofouling or biodegradation when used in complex biological matrices such as serum or urine, particularly when high levels of nucleases are present. We prepared Hg(2+)-responsive, PPN-encapsulated aptamer sensors that overcome these limitations. PPNs provide a protective barrier to encapsulate the aptamer sensor in an aqueous environment free of diffusional restrictions encountered with many polymer nanomaterials. The unique porous properties of the PPN membrane enable ready and rapid transfer of small molecular weight ions and molecules into the sensor interior while minimizing the macromolecular interactions between the transducer and degradants or interferents in the exterior milieu. Using Hg(2+)-responsive, PPN-encapsulated aptamer sensors, we were able to detect sub-100 ppb (chronic threshold limit from urine test) Hg(2+) in human urine with no sample preparation, whereas free aptamer sensors yielded inaccurate results due to interferences from the matrix. The PPN architecture provides a new platform for construction of aptamer-functionalized sensors that target low molecular weight species in complex matrices, beyond the Hg(2+) demonstrated here.
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Xie L, Subashi E, Qi Y, Knepper MA, Johnson GA. Four-dimensional MRI of renal function in the developing mouse. NMR IN BIOMEDICINE 2014; 27:1094-102. [PMID: 25066408 PMCID: PMC4134394 DOI: 10.1002/nbm.3162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/13/2014] [Accepted: 06/22/2014] [Indexed: 05/02/2023]
Abstract
The major roles of filtration, metabolism and high blood flow make the kidney highly vulnerable to drug-induced toxicity and other renal injuries. A method to follow kidney function is essential for the early screening of toxicity and malformations. In this study, we acquired high spatiotemporal resolution (four dimensional) datasets of normal mice to follow changes in kidney structure and function during development. The data were acquired with dynamic contrast-enhanced MRI (via keyhole imaging) and a cryogenic surface coil, allowing us to obtain a full three-dimensional image (isotropic resolution, 125 microns) every 7.7 s over a 50-min scan. This time course permitted the demonstration of both contrast enhancement and clearance. Functional changes were measured over a 17-week course (at 3, 5, 7, 9, 13 and 17 weeks). The time dimension of the MRI dataset was processed to produce unique image contrasts to segment the four regions of the kidney: cortex (CO), outer stripe (OS) of the outer medulla (OM), inner stripe (IS) of the OM and inner medulla (IM). Local volumes, time-to-peak (TTP) values and decay constants (DC) were measured in each renal region. These metrics increased significantly with age, with the exception of DC values in the IS and OS. These data will serve as a foundation for studies of normal renal physiology and future studies of renal diseases that require early detection and intervention.
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Affiliation(s)
- Luke Xie
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, 27708
| | - Ergys Subashi
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710
- Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina, 27710
| | - Yi Qi
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710
| | - Mark A. Knepper
- Epithelial Systems Biology Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, 20892-1603
| | - G. Allan Johnson
- Center for In Vivo Microscopy, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, 27708
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Zirak MR, Rahimian R, Ghazi-Khansari M, Abbasi A, Razmi A, Ejtemaei Mehr S, Mousavizadeh K, Dehpour AR. Tropisetron attenuates cisplatin-induced nephrotoxicity in mice. Eur J Pharmacol 2014; 738:222-9. [DOI: 10.1016/j.ejphar.2014.05.050] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 05/26/2014] [Accepted: 05/26/2014] [Indexed: 12/12/2022]
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Bulacio RP, Torres AM. Time course of organic anion transporter 5 (Oat5) urinary excretion in rats treated with cisplatin: a novel urinary biomarker for early detection of drug-induced nephrotoxicity. Arch Toxicol 2014; 89:1359-69. [PMID: 25164828 DOI: 10.1007/s00204-014-1345-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 08/14/2014] [Indexed: 01/08/2023]
Abstract
Cisplatin is a widely used citostatic drug employed in the treatment of many solid tumors. Its principal side-effect is nephrotoxicity. The organic anion transporter 5 (Oat5) is exclusively expressed in the kidneys. The aim of this study was to evaluate the time course of Oat5 urinary excretion and changes in conventional biomarkers, such as creatinine and urea plasma levels (Urp and Crp), and protein and glucose urinary levels (Pu and Gluu), between others, and compared them to the onset and progression of histological changes after cisplatin treatment. Male Wistar rats were treated with cisplatin with 5 mg/kg b.w., i.p., and experiments were carried out after 2, 4, 7 and 14 days of treatment. Two days after cisplatin administration, only Oat5 urinary excretion was found markedly modified. On day 4, Urp, Crp, PU and GluU were increased. By the seventh day, a severe impairment in tubular architecture was observed, and from this point and thereon, Oat5 urinary excretion and PU showed a tendency to return to their basal values. Meanwhile, Urp, Crp and GluU tended to return to their basal values by the day 14 of treatment, when kidney morphology showed an important recovery. So Oat5 urinary abundance was elevated 2 days after cisplatin treatment, when no modifications of traditional markers of renal injury were still observed. Therefore, the results showed in this work, in addition to previous data obtained by our group, propose that Oat5 urinary excretion might potentially serve as a noninvasive early biomarker of cisplatin-induced nephrotoxicity.
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Affiliation(s)
- Romina Paula Bulacio
- Area Farmacología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, CONICET, Suipacha 531, 2000, Rosario, Argentina
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131
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Pathophysiology of cisplatin-induced acute kidney injury. BIOMED RESEARCH INTERNATIONAL 2014; 2014:967826. [PMID: 25165721 PMCID: PMC4140112 DOI: 10.1155/2014/967826] [Citation(s) in RCA: 450] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/18/2014] [Accepted: 07/19/2014] [Indexed: 02/06/2023]
Abstract
Cisplatin and other platinum derivatives are the most widely used chemotherapeutic agents to treat solid tumors including ovarian, head and neck, and testicular germ cell tumors. A known complication of cisplatin administration is acute kidney injury (AKI). The nephrotoxic effect of cisplatin is cumulative and dose-dependent and often necessitates dose reduction or withdrawal. Recurrent episodes of AKI may result in chronic kidney disease. The pathophysiology of cisplatin-induced AKI involves proximal tubular injury, oxidative stress, inflammation, and vascular injury in the kidney. There is predominantly acute tubular necrosis and also apoptosis in the proximal tubules. There is activation of multiple proinflammatory cytokines and infiltration of inflammatory cells in the kidney. Inhibition of the proinflammatory cytokines TNF-α or IL-33 or depletion of CD4+ T cells or mast cells protects against cisplatin-induced AKI. Cisplatin also causes endothelial cell injury. An understanding of the pathogenesis of cisplatin-induced AKI is important for the development of adjunctive therapies to prevent AKI, to lessen the need for dose decrease or drug withdrawal, and to lessen patient morbidity and mortality.
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132
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Kim SY, Moon A. Drug-induced nephrotoxicity and its biomarkers. Biomol Ther (Seoul) 2014; 20:268-72. [PMID: 24130922 PMCID: PMC3794522 DOI: 10.4062/biomolther.2012.20.3.268] [Citation(s) in RCA: 141] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 11/09/2011] [Accepted: 11/09/2011] [Indexed: 12/28/2022] Open
Abstract
Nephrotoxicity occurs when kidney-specific detoxification and excretion do not work properly due to the damage or destruction of kidney function by exogenous or endogenous toxicants. Exposure to drugs often results in toxicity in kidney which represents the major control system maintaining homeostasis of body and thus is especially susceptible to xenobiotics. Understanding the toxic mechanisms for nephrotoxicity provides useful information on the development of drugs with therapeutic benefi ts with reduced side effects. Mechanisms for drug-induced nephrotoxicity include changes in glomerular hemodynamics, tubular cell toxicity, inflammation, crystal nephropathy, rhabdomyolysis, and thrombotic microangiopathy. Biomarkers have been identifi ed for the assessment of nephrotoxicity. The discovery and development of novel biomarkers that can diagnose kidney damage earlier and more accurately are needed for effective prevention of drug-induced nephrotoxicity. Although some of them fail to confer specificity and sensitivity, several promising candidates of biomarkers were recently proved for assessment of nephrotoxicity. In this review, we summarize mechanisms of drug-induced nephrotoxicity and present the list of drugs that cause nephrotoxicity and biomarkers that can be used for early assessment of nephrotoxicity.
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Affiliation(s)
- Sun Young Kim
- College of Pharmacy, Duksung Women's University, Seoul 132-714, Republic of Korea
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Kashiwagi E, Tonomura Y, Kondo C, Masuno K, Fujisawa K, Tsuchiya N, Matsushima S, Torii M, Takasu N, Izawa T, Kuwamura M, Yamate J. Involvement of neutrophil gelatinase-associated lipocalin and osteopontin in renal tubular regeneration and interstitial fibrosis after cisplatin-induced renal failure. ACTA ACUST UNITED AC 2014; 66:301-11. [PMID: 24912749 DOI: 10.1016/j.etp.2014.04.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/14/2014] [Accepted: 04/29/2014] [Indexed: 01/21/2023]
Abstract
The kidney has a capacity to recover from ischemic or toxic insults that result in cell death, and timely tissue repair of affected renal tubules may arrest progression of injury, leading to regression of injury and paving the way for recovery. To investigate the roles of neutrophil gelatinase-associated lipocalin (NGAL/lcn2) and osteopontin (OPN/spp1) during renal regeneration, the expression patterns of NGAL and OPN in the cisplatin-induced rat renal failure model were examined. NGAL expression was increased from day 1 after injection; it was seen mainly in the completely regenerating proximal tubules of the cortico-medullary junction on days 3-35; however, the expression was not seen in abnormally dilated or atrophied renal tubules surrounded by fibrotic lesions. On the other hand, OPN expression was increased from day 5 and the increased expression developed exclusively in the abnormal renal tubules. NGAL expression level well correlated with the proliferating activity in the regenerating renal epithelial cells, whereas OPN significantly correlated with the α-smooth muscle actin-positive myofibroblast appearance, expression of transforming growth factor (TGF)-β1, and the number of CD68-positive macrophages. Interestingly, rat renal epithelial cell line (NRK-52E) treated with TGF-β1 decreased NGAL expression, but increased OPN expression in a dose-dependent manner. Because increases of TGF-β1, myofibroblasts and macrophages contribute to progressive interstitial renal fibrosis, OPN may be involved in the pathogenesis of fibrosis; on the contrary, NGAL may play a role in tubular regeneration after injury. Expression analysis of NGAL and OPN would be useful to investigate the tubule damage in renal-toxicity.
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Affiliation(s)
- Emi Kashiwagi
- Developmental Research Laboratories, Shionogi & Co., Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan; Laboratories of Veterinary Pathology, Life and Environmental Sciences, Osaka Prefecture University, Rinkuu Ourai Kita 1-58, Izumisano-shi, Osaka 598-8531, Japan
| | - Yutaka Tonomura
- Developmental Research Laboratories, Shionogi & Co., Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Chiaki Kondo
- Developmental Research Laboratories, Shionogi & Co., Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Koichi Masuno
- Developmental Research Laboratories, Shionogi & Co., Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Kae Fujisawa
- Developmental Research Laboratories, Shionogi & Co., Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Noriko Tsuchiya
- Developmental Research Laboratories, Shionogi & Co., Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Shuuichi Matsushima
- Developmental Research Laboratories, Shionogi & Co., Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Mikinori Torii
- Developmental Research Laboratories, Shionogi & Co., Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Nobuo Takasu
- Developmental Research Laboratories, Shionogi & Co., Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Takeshi Izawa
- Laboratories of Veterinary Pathology, Life and Environmental Sciences, Osaka Prefecture University, Rinkuu Ourai Kita 1-58, Izumisano-shi, Osaka 598-8531, Japan
| | - Mitsuru Kuwamura
- Laboratories of Veterinary Pathology, Life and Environmental Sciences, Osaka Prefecture University, Rinkuu Ourai Kita 1-58, Izumisano-shi, Osaka 598-8531, Japan
| | - Jyoji Yamate
- Laboratories of Veterinary Pathology, Life and Environmental Sciences, Osaka Prefecture University, Rinkuu Ourai Kita 1-58, Izumisano-shi, Osaka 598-8531, Japan.
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Shin YJ, Kim TH, Won AJ, Jung JY, Kwack SJ, Kacew S, Chung KH, Lee BM, Kim HS. Age-related differences in kidney injury biomarkers induced by cisplatin. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2014; 37:1028-1039. [PMID: 24751685 DOI: 10.1016/j.etap.2014.03.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/13/2014] [Accepted: 03/18/2014] [Indexed: 06/03/2023]
Abstract
Acute kidney injury (AKI) occurs in a half of cisplatin (CDDP)-treated patients. Traditional biomarkers including blood urea nitrogen (BUN) and serum creatinine (SCr) are still used for detection of CDDP-induced AKI, but these biomarkers are not specific or sensitive. The aim of this study was to identify the specific and sensitive biomarkers against CDDP-induced renal injury between young (3-week-old) and old (20-week-old) rats. All animals were intraperitoneally injected once with CDDP (6 mg/kg). After 3 days, all animals were sacrificed and serum, urine, and kidney tissues were collected. Urinary and serum biomarkers as well as histological changes were measured. CDDP-induced proximal tubular damage was apparent from histopathological examination, being more severe in 3-week-old rats accompanied by increased number of TUNEL-positive apoptotic cells. This was associated with elevated urinary kidney injury molecule-1 (KIM-1), glutathione-S-transferase alpha (GST-α), vascular endothelial growth factor (VEGF), and tissue inhibitor of metalloproteinases-1 (TIMP-1). In contrast, the levels of neutrophil gelatinase-associated lipocalin (NGAL) and osteopontin were significantly increased in 20-week-old rats after CDDP treatment. These results indicate that the use of age-specific urinary biomarkers is necessary to diagnosis of CDDP-induced AKI. Especially, urinary KIM-1, GST-α, TIMP-1, and VEGF levels may help in the early diagnosis of young patients with CDDP-induced AKI.
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Affiliation(s)
- Yu Jin Shin
- MRC Center, College of Pharmacy, Pusan National University, San 30, Jangjeon-dong, Geumjeung-gu, Busan 609-735, South Korea
| | - Tae Hyung Kim
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do 440-746, South Korea
| | - A Jin Won
- MRC Center, College of Pharmacy, Pusan National University, San 30, Jangjeon-dong, Geumjeung-gu, Busan 609-735, South Korea
| | - Ja Young Jung
- National Institute of Food and Drug Safety Evaluation, Korea Food and Drug Administration, Oh-song, South Korea
| | - Seung Jun Kwack
- Department of Biochemistry and Health Science, Changwon National University, Gyeongnam 641-773, South Korea
| | - Sam Kacew
- Department of Pharmacology, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Kyu Hyuck Chung
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do 440-746, South Korea
| | - Byung Mu Lee
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do 440-746, South Korea
| | - Hyung Sik Kim
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do 440-746, South Korea.
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135
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Gu L, Wang X, Zhang Y, Jiang Y, Lu H, Bi K, Chen X. Determination of 12 potential nephrotoxicity biomarkers in rat serum and urine by liquid chromatography with mass spectrometry and its application to renal failure induced by Semen Strychni. J Sep Sci 2014; 37:1058-66. [PMID: 24610835 DOI: 10.1002/jssc.201400053] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 02/22/2014] [Accepted: 02/25/2014] [Indexed: 01/20/2023]
Abstract
In previous nephrotoxicity metabonomic studies, several potential biomarkers were found and evaluated. To investigate the relationship between the nephrotoxicity biomarkers and the therapeutic role of Radix Glycyrrhizae extract on Semen Strychni-induced renal failure, 12 typical biomarkers are selected and a simple LC-MS method has been developed and validated. Citric acid, guanidinosuccinic acid, taurine, guanidinoacetic acid, uric acid, creatinine, hippuric acid, xanthurenic acid, kynurenic acid, 3-indoxyl sulfate, indole-3-acetic acid, and phenaceturic acid were separated by a Phenomenex Luna C18 column and a methanol/water (5 mM ammonium acetate) gradient program with a runtime of 20 min. The prepared calibration curves showed good linearity with regression coefficients all above 0.9913. The absolute recoveries of analytes from serum and urine were all more than 70.4%. With the developed method, analytes were successfully determined in serum and urine samples within 52 days. Results showed that guanidinosuccinic acid, guanidinoacetic acid, 3-indoxyl sulfate, and indole-3-acetic acid (only in urine) were more sensitive than the conventional renal function markers in evaluating the therapeutic role of Radix Glycyrrhizae extract on Semen Strychni-induced renal failure. The method could be further used in predicting and monitoring renal failure cause by other reasons in the following researches.
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Affiliation(s)
- Liqiang Gu
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
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136
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Abstract
In-utero the placenta is the primary organ responsible for neonatal homeostasis of fluid and electrolyte balance. With birth, this responsibility now transitions to the neonatal kidney. For successful transition to extrauterine renal physiology to occur maturation of neonatal glomerular filtration must occur, which is dependent on the development of renal blood flow. While these functions are decreased at birth, the term infant's kidneys are still able to manage homeostasis and are sufficient for growth and development. However, stressors can limit the adaptive properties of the neonatal kidney. This is especially important for those infants born before 34 weeks' gestation, when nephrogenesis is not yet complete. Knowledge of the changes in renal physiology is essential in caring for the neonate during transition. This article describes those changes.
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137
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Lee YH, Kim D, Lee MJ, Kim MJ, Jang HS, Park SH, Lee JM, Lee HY, Han BS, Son WC, Seok JH, Lee JK, Jeong J, Kang JS, Kang JK. Subchronic toxicity study of Coptidis rhizoma in rats. JOURNAL OF ETHNOPHARMACOLOGY 2014; 152:457-463. [PMID: 24486210 DOI: 10.1016/j.jep.2014.01.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 12/26/2013] [Accepted: 01/14/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Coptidis Rhizoma (CR) is a medical herb from the family Ranunculacease that has been used to treat gastroenteritis, dysentery, diabetes mellitus, and severe skin diseases. AIM OF THE STUDY To evaluate the no-observed-adverse-effect level (NOAEL) and the toxicity of CR, following repeat oral administration to rats for 13 weeks. MATERIALS AND METHODS CR was administered by oral gavage to groups of rats (n=10/group, each sex) at dose levels of 0 (control), 25, 74, 222, 667 or 2000 mg/kg/day 5 times per week for 13 weeks. Mortality, clinical signs, body weights, food consumption, hematology, serum chemistry, urinalysis, vaginal cytology and sperm morphology, organ weights, gross and histopathological findings were compared between control and CR groups. RESULTS Urinalysis showed a significant increase in N-acety1-β-glucosaminidase in males in the 2000 mg/kg/day group (P<0.01). However, no mortality or remarkable clinical signs were observed during this 13-week study. No adverse effects on body weight, food consumption, hematology, serum chemistry, organ weights, gross lesion, histopathology, vaginal cytology, sperm motility, or deformity were observed in the males or female rats treated with CR. CONCLUSIONS On the basis of these results, the NOAEL of CR is determined to be 667 mg/kg/day for males and 2000 mg/kg/day for females.
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Affiliation(s)
- Yong-Hoon Lee
- Department of Pathology, Biotoxtech Co., Ltd, 686-2 Yangcheong-ri, Ochang-eup, Cheongwon-gun 363-883, Chungbuk, Republic of Korea
| | - Duyeol Kim
- Department of Pathology, Biotoxtech Co., Ltd, 686-2 Yangcheong-ri, Ochang-eup, Cheongwon-gun 363-883, Chungbuk, Republic of Korea
| | - Mi Ju Lee
- Department of Pathology, Biotoxtech Co., Ltd, 686-2 Yangcheong-ri, Ochang-eup, Cheongwon-gun 363-883, Chungbuk, Republic of Korea
| | - Myoung Jun Kim
- Department of Pathology, Biotoxtech Co., Ltd, 686-2 Yangcheong-ri, Ochang-eup, Cheongwon-gun 363-883, Chungbuk, Republic of Korea
| | - Ho-Song Jang
- Department of Pathology, Biotoxtech Co., Ltd, 686-2 Yangcheong-ri, Ochang-eup, Cheongwon-gun 363-883, Chungbuk, Republic of Korea
| | - Sun Hee Park
- Department of Pathology, Biotoxtech Co., Ltd, 686-2 Yangcheong-ri, Ochang-eup, Cheongwon-gun 363-883, Chungbuk, Republic of Korea
| | - Jung-Min Lee
- Department of Pathology, Biotoxtech Co., Ltd, 686-2 Yangcheong-ri, Ochang-eup, Cheongwon-gun 363-883, Chungbuk, Republic of Korea; Department of Biomedical Laboratory Science, Namseoul University, 21 Maeju-ri, Seonghwan-eup, Cheonan 331-707, Chungnam, Republic of Korea
| | - Hye-Yeong Lee
- Department of Pathology, Biotoxtech Co., Ltd, 686-2 Yangcheong-ri, Ochang-eup, Cheongwon-gun 363-883, Chungbuk, Republic of Korea
| | - Beom Seok Han
- Division of Toxicopathology, Hoseo Toxicology Research Center, Hoseo University, 79 Hoseo-ro, BaeBang-Myeon, Asan 336-795, Chungnam, Republic of Korea
| | - Woo-Chan Son
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea
| | - Ji Hyeon Seok
- Toxicological Research Divison, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Osong Health Technology Administration Complex, 187 Osongsaengmyeong2-ro, Osong, Cheongwon 363-700, Chungbuk, Republic of Korea
| | - Jong Kwon Lee
- Toxicological Research Divison, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Osong Health Technology Administration Complex, 187 Osongsaengmyeong2-ro, Osong, Cheongwon 363-700, Chungbuk, Republic of Korea
| | - Jayoung Jeong
- Toxicological Research Divison, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Osong Health Technology Administration Complex, 187 Osongsaengmyeong2-ro, Osong, Cheongwon 363-700, Chungbuk, Republic of Korea
| | - Jin Seok Kang
- Department of Biomedical Laboratory Science, Namseoul University, 21 Maeju-ri, Seonghwan-eup, Cheonan 331-707, Chungnam, Republic of Korea.
| | - Jong-Koo Kang
- Department of Pathology, Biotoxtech Co., Ltd, 686-2 Yangcheong-ri, Ochang-eup, Cheongwon-gun 363-883, Chungbuk, Republic of Korea; Department of Laboratory Animal Medicine, College of Veterinary Medicine, Chungbuk National University, 410 Naesudong-ro, Heungdeok-gu, Cheongju 361-763, Chungbuk, Republic of Korea.
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138
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Kidney biomarkers in MCPA-induced acute kidney injury in rats: Reduced clearance enhances early biomarker performance. Toxicol Lett 2014; 225:467-78. [DOI: 10.1016/j.toxlet.2014.01.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 01/16/2014] [Accepted: 01/17/2014] [Indexed: 11/22/2022]
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139
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Wunnapuk K, Gobe G, Endre Z, Peake P, Grice JE, Roberts MS, Buckley NA, Liu X. Use of a glyphosate-based herbicide-induced nephrotoxicity model to investigate a panel of kidney injury biomarkers. Toxicol Lett 2014; 225:192-200. [PMID: 24361898 DOI: 10.1016/j.toxlet.2013.12.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 12/08/2013] [Accepted: 12/10/2013] [Indexed: 11/28/2022]
Abstract
Accidental or intentional ingestion of glyphosate surfactant-based herbicides, like Roundup(®), leads to nephrotoxicity as well as death. In this study, a panel of kidney injury biomarkers was evaluated in terms of suitability to detect acute kidney injury and dysfunction. The Roundup(®) intoxication model involved oral administration of glyphosate to rats at dose levels of 250, 500, 1200 and 2500 mg/kg. Urinary and plasma biomarker patterns were investigated at 8, 24 and 48 h after dosing. Biomarkers were quantified by absolute concentration; by normalising to urine creatinine; and by calculating the excretion rate. The diagnostic performances of each method in predicting of acute kidney injury were compared. By Receiver Operating Characteristic (ROC) analysis of the selected biomarkers, only urinary kidney injury molecule-1 (KIM-1) best predicted histological changes at 8h (best cut-off point>0.00029 μg/ml). Plasma creatinine performed better than other biomarkers at 24 h (best cut-off point>0.21 mg/dl). Urinary KIM-1 was the best early biomarker of kidney injury in this glyphosate-induced nephrotoxicity model.
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Affiliation(s)
- Klintean Wunnapuk
- Therapeutics Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Glenda Gobe
- Centre for Kidney Disease Research, School of Medicine, The University of Queensland, Brisbane, Australia
| | - Zoltan Endre
- Centre for Kidney Disease Research, School of Medicine, The University of Queensland, Brisbane, Australia; Department of Nephrology, Prince of Wales Clinical School and Prince of Wales Hospital, Randwick, NSW, Australia
| | - Philip Peake
- Department of Nephrology, Prince of Wales Clinical School and Prince of Wales Hospital, Randwick, NSW, Australia
| | - Jeffrey E Grice
- Therapeutics Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Michael S Roberts
- Therapeutics Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia; School of Pharmacy & Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Nicholas A Buckley
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Sri Lanka; Professorial Medicine Unit, University of New South Wales, NSW, Australia
| | - Xin Liu
- Therapeutics Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
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140
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Charlton JR, Portilla D, Okusa MD. A basic science view of acute kidney injury biomarkers. Nephrol Dial Transplant 2014; 29:1301-11. [PMID: 24385545 DOI: 10.1093/ndt/gft510] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Over the last decade, significant progress has been made in the identification and validation of novel biomarkers as well as refinements in the use of serum creatinine as a marker of kidney function. These advances have taken advantage of laboratory investigations, which have identified these novel molecules that serve important biological functions in the pathogenesis of acute kidney injury (AKI). As we advance and validate these markers for clinical studies in AKI, we recognize that they serve not only to improve our understanding of AKI, but they could also serve as potential targets for the treatment of AKI. This review will underscore the biological basis of specific biomarkers that will contribute to the advancement in the treatment and outcomes of AKI.
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Affiliation(s)
- Jennifer R Charlton
- Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA Division of Nephrology, University of Virginia Health System, Charlottesville, VA, USA
| | - Didier Portilla
- Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mark D Okusa
- Division of Nephrology, University of Virginia Health System, Charlottesville, VA, USA Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA
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141
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Elyasi S, Khalili H, Dashti-Khavidaki S, Emadi-Koochak H, Mohammadpour A, Abdollahi A. Elevated Vancomycin Trough Concentration: Increased Efficacy and/or Toxicity? IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2014; 13:1241-7. [PMID: 25587313 PMCID: PMC4232790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Vancomycin susceptibility of methicillin-resistant Staphylococcus aureus has been changed over time and its average minimum inhibitory concentration increased from 1.5 to 1.75 mg/L.A recently published guideline by the American Society of Health Pharmacist recommended a daily dose of 15-20 mg/Kg every 8 to 12 hours of vancomycin to achieve a trough concentration between 15-20 mg/L for treatment of severe infections. Medical records of 69 patients from infectious ward of Imam Khomeini hospital, with suspected or confirmed gram-positive infection who had at least one trough level of vancomycin, were evaluated regarding vancomycin therapeutic goal; efficacy and renal safety. Most of patients (60.6%) with severe infections did not achieve the recommended vancomycin trough level during treatment course. Time to normalization of the signs and symptoms of infection did not correlate with the patients' serum vancomycin trough levels. At the end of treatment course, there was no significant correlation between patients' creatinine clearance and vancomycin trough levels (P=0.32). However, patients'cratinine clearance showed a negatively significant correlation with trough level of vancomycin (P=0.01). Vancomycin induced nephrotoxicity was detected in 4.3% of the patients. These data showed that vancomycin trough level may not necessarily assure treatment success, and also it would not essentially predict the risk of vancomycin induced nephrotoxicity. However, more well designed studies with larger sample size needed for better clinical and practical judgment.
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Affiliation(s)
- Sepideh Elyasi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hossein Khalili
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Simin Dashti-Khavidaki
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hamid Emadi-Koochak
- Department of Infectious Diseases, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amirhooshang Mohammadpour
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Alireza Abdollahi
- Department of Pathology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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142
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Togashi Y, Imura N, Miyamoto Y. Urinary cystatin C as a renal biomarker and its immunohistochemical localization in anti-GBM glomerulonephritis rats. ACTA ACUST UNITED AC 2013; 65:1137-43. [DOI: 10.1016/j.etp.2013.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 04/09/2013] [Accepted: 05/14/2013] [Indexed: 01/18/2023]
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143
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Ruangyuttikarn W, Panyamoon A, Nambunmee K, Honda R, Swaddiwudhipong W, Nishijo M. Use of the kidney injury molecule-1 as a biomarker for early detection of renal tubular dysfunction in a population chronically exposed to cadmium in the environment. SPRINGERPLUS 2013; 2:533. [PMID: 24255836 PMCID: PMC3824703 DOI: 10.1186/2193-1801-2-533] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 10/09/2013] [Indexed: 11/10/2022]
Abstract
Cadmium (Cd) has been found as an environmental pollutant in Mae Sot district, Tak province, Thailand. Prolong exposure to high levels of Cd of the resident increases high risk of Cd toxicity especially to kidney which is the primary target of Cd. In order to investigate the early effect of Cd induced renal dysfunction, a kidney injury molecule-1 (KIM-1), a novel biomarker of renal tubular dysfunction, was measured using an enzyme linked immunosorbent assay (ELISA). The method was validated and used to quantify the KIM-1 concentrations in the urine of 700 subjects (260 men, 440 women) who lived in the Cd contaminated area. The KIM-1 concentrations were compared to the concentrations of two conventional renal tubular dysfunction biomarkers, N-acetyl-β-D-glucosaminidase (NAG) and β2-microglobulin (β2-MG). Urinary KIM-1 was correlated with urinary and blood Cd as well as NAG. After adjustment of age and smoking, urinary KIM-1 was correlated with blood Cd more than urinary NAG did. Clear dose response relationships of urinary KIM-1 with urinary Cd were shown in both men and women. These results indicate that the urinary KIM-1 might be more sensitive biomarker than urinary NAG and β2-MG for an early detection of renal tubular dysfunction. It is useful as a tool to detect renal effect of toxicity due to chronic Cd exposure at high level.
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Affiliation(s)
- Werawan Ruangyuttikarn
- Division of Toxicology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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144
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Organic anion transporter 5 renal expression and urinary excretion in rats with vascular calcification. BIOMED RESEARCH INTERNATIONAL 2013; 2013:283429. [PMID: 24199190 PMCID: PMC3807842 DOI: 10.1155/2013/283429] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 07/25/2013] [Accepted: 08/29/2013] [Indexed: 01/22/2023]
Abstract
It has been described renal damage in rats with vascular calcification. The organic anion transporter 5 (Oat5) is only expressed in kidney, and its urinary excretion was proposed as potential early biomarker of renal injury. The aim of this study was to evaluate the Oat5 renal expression and its urinary excretion in an experimental model of vascular calcification in comparison with traditional markers of renal injury. Vascular calcification was obtained by the administration of an overdose of vitamin D3 (300,000 IU/kg, b.w., i.m.) to male Wistar rats. Oat5 urinary abundance was evaluated by Western blotting. Traditional markers of renal injury, such as creatinine and urea plasma levels, urinary protein levels, and urinary alkaline phosphatase (AP) activity, were determined using commercial kits. Histology was assessed by hematoxylin/eosin staining. Oat5 renal expression was evaluated by Western blotting and by immunohistochemistry. An increased expression of Oat5 in renal homogenates, in apical membranes, and in its urinary excretion was observed in rats with vascular calcification. The traditional parameters used to evaluate renal function were not modified, with the exception of histology. It is possible to postulate the urinary excretion of Oat5 as a potential noninvasive biomarker of renal injury associated with vascular calcification.
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145
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Wunnapuk K, Liu X, Peake P, Gobe G, Endre Z, Grice JE, Roberts MS, Buckley NA. Renal biomarkers predict nephrotoxicity after paraquat. Toxicol Lett 2013; 222:280-8. [PMID: 23954200 DOI: 10.1016/j.toxlet.2013.08.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/31/2013] [Accepted: 08/06/2013] [Indexed: 12/11/2022]
Abstract
Paraquat is a widely used herbicide which has been involved in many accidental and intentional deaths. Nephrotoxicity is common in severe acute paraquat poisoning. We examined seven renal injury biomarkers, including cystatin-C, kidney injury molecule-1, β2-microglobulin, clusterin, albumin, neutrophil gelatinase-associated lipocalin and osteopontin, to develop a non-invasive method to detect early renal damage and dysfunction and to compare with the conventional endogenous marker creatinine. Male Wistar rats were dosed orally with four different doses of paraquat, and the biomarker patterns in urine and plasma were investigated at 8, 24 and 48h after paraquat exposure. By Receiver Operating Characteristic analysis, urinary kidney injury molecule-1 was the best marker at predicting histological changes, with areas under the Receiver Operating Characteristic curve of 0.81 and 0.98 at 8 and 24h (best cut-off value>0.000326μg/ml), respectively. Urinary kidney injury molecule-1, urinary albumin and urinary Cystatin-C elevations correlated with the degree of renal damage and injury development. Further study is required to compare biomarkers changes in rats with those seen in human poisoning.
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Affiliation(s)
- Klintean Wunnapuk
- Therapeutics Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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146
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Fuchs TC, Mally A, Wool A, Beiman M, Hewitt P. An Exploratory Evaluation of the Utility of Transcriptional and Urinary Kidney Injury Biomarkers for the Prediction of Aristolochic Acid–Induced Renal Injury in Male Rats. Vet Pathol 2013; 51:680-94. [DOI: 10.1177/0300985813498779] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The predictive value of different urinary and transcriptional biomarkers was evaluated in a proof-of-principle toxicology study in rats using aristolochic acid (AA), a known nephrotoxic agent. Male Wistar rats were orally dosed with 0.1, 1, or 10 mg/kg for 12 days. Urine was collected on days 1, 5, and 12 over 24 hours. Gene expression analysis was also conducted using quantitative real-time polymerase chain reaction and Illumina whole-genome chips. Protein biomarkers (Kim-1, Timp-1, vascular endothelial growth factor, osteopontin, clusterin, cystatin C, calbindin D-28K, β2-microglobulin, α–glutathione S-transferase, GSTY1b, RPA-1, and neutrophil gelatinase-associated lipocalin) were measured in these urine samples. Treatment with AA resulted in a slight dose- and/or time-dependent increase in urinary β2-microglobulin, lipocalin 2, and osteopontin before an increase in serum creatinine or serum urea nitrogen was observed. A strong decrease in urinary calbindin D-28K was also detected. The Compugen Ltd. prediction model scored both the 1- and 10-mg/kg AA dose groups as positive for nephrotoxicity despite the absence of renal histopathological changes. In addition, several previously described transcriptional biomarkers were identified as early predictors of renal toxicity as they were detected before morphological alterations had occurred. Altogether, these findings demonstrated the predictive values of renal biomarkers approved by the Food and Drug Administration, European Medicines Agency, and Pharmaceuticals & Medical Devices Agency in AA-induced renal injury in rats and confirmed the utility of renal transcriptional biomarkers for detecting progression of compound-induced renal injury in rats. In addition, several transcriptional biomarkers identified in this exploratory study could present early predictors of renal tubular epithelium injury in rats.
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Affiliation(s)
- T. C. Fuchs
- Merck Serono, Non-Clinical Safety, Darmstadt, Germany
| | - A. Mally
- Department of Toxicology, University of Wuerzburg, Wuerzburg, Germany
| | - A. Wool
- Compugen Ltd., Tel Aviv, Israel
| | | | - P. Hewitt
- Merck Serono, Non-Clinical Safety, Darmstadt, Germany
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147
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Ghlissi Z, Hakim A, Mnif H, Ayadi FM, Zeghal K, Rebai T, Sahnoun Z. Evaluation of colistin nephrotoxicity administered at different doses in the rat model. Ren Fail 2013; 35:1130-5. [PMID: 23879363 DOI: 10.3109/0886022x.2013.815091] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study evaluated the usefulness of plasma Cystatin C (pCysC) along with urinary neutrophil gelatinase-associated lipocalin (NGAL), γ-glutamyltransferase (GGT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), aspartate (AST) and alanine (ALT) aminotransferase to monitor colistin nephrotoxicity. METHOD Male rats were given intramuscular (i.m.) injections of colistin in doses of 150,000 (G1), 300,000 (G2) and 450,000 IU/kg/day (G3) or normal saline (Control), every 12 h for 7 days. After the 14th injection, animals were placed in metabolic cages and urine samples were collected in the next 12 h. Thereafter, animals were euthanized, blood samples were collected and kidneys were removed for histological assessment. RESULTS Nephrotoxicity was completely dose-dependent according to pathologic findings. The major insults were acute tubular necrosis in the tubules of G3. No significant change in pCr was observed in all treated groups, but pCysC increased in the G3 compared to the control. In urinary markers, uNGAL level showed a dose dependant increase with significant change in the G2 and G3 groups compared to the control. However, there was no significant change in the AST, ALT, LDH or ALP activities but only GGT increased in the G3 compared to the control. CONCLUSION Based on colistin doses used in our experimental study on rat model, histopathologic assessment remains the most accurate way to diagnose colistin nephrotoxicity. pCysC appears to be more reliable than pCr, and uNGAL seems to be the most sensitive factor of colistin nephrotoxicity.
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Affiliation(s)
- Zohra Ghlissi
- Laboratory of Pharmacology, Faculty of Medicine, University of Sfax, Tunisia.
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148
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Togashi Y, Miyamoto Y. Urinary cystatin C as a biomarker for diabetic nephropathy and its immunohistochemical localization in kidney in Zucker diabetic fatty (ZDF) rats. ACTA ACUST UNITED AC 2013; 65:615-22. [DOI: 10.1016/j.etp.2012.06.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 05/18/2012] [Accepted: 06/20/2012] [Indexed: 11/29/2022]
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149
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Fan W, Chen K, Zheng G, Wang W, Teng A, Liu A, Ming D, Yan P. Role of liver fatty acid binding protein in hepatocellular injury: Effect of CrPic treatment. J Inorg Biochem 2013; 124:46-53. [DOI: 10.1016/j.jinorgbio.2013.03.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 03/21/2013] [Accepted: 03/22/2013] [Indexed: 01/02/2023]
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150
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Hambach R, Lison D, D'Haese PC, Weyler J, De Graef E, De Schryver A, Lamberts LV, van Sprundel M. Co-exposure to lead increases the renal response to low levels of cadmium in metallurgy workers. Toxicol Lett 2013; 222:233-8. [PMID: 23806787 DOI: 10.1016/j.toxlet.2013.06.218] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Research on the effect of co-exposure to Cd and Pb on the kidney is scarce. The objective of the present study was to assess the effect of co-exposure to these metals on biomarkers of early renal effect. METHODS Cd in blood (Cd-B), Cd in urine (Cd-U), Pb in blood (Pb-B) and urinary renal biomarkers, i.e., microalbumin (μ-Alb), beta-2-microglobulin (β₂-MG), retinol binding protein (RBP), N-acetyl-β-d-glucosaminidase (NAG), intestinal alkaline phosphatase (IAP) were measured in 122 metallurgic refinery workers examined in a cross-sectional survey. RESULTS AND CONCLUSIONS The median Cd-B, Cd-U, Pb-B were: 0.8 μg/l (IQR = 0.5, 1.2), 0.5 μg/g creatinine (IQR = 0.3, 0.8) and 158.5 μg/l (IQR = 111.0, 219.3), respectively. The impact of Cd-B on the urinary excretion of NAG and IAP was only evident among workers with Pb-B concentrations ≥ 75th percentile. The association between Cd-U and the renal markers NAG and RBP was also evidenced when Pb-B ≥ 75th percentile. No statistically significant interaction terms were observed for the associations between Cd-B or Cd-U and the other renal markers under study (i.e., μ-Alb and β2-MG). Our findings indicate that Pb increases the impact of Cd exposure on early renal biomarkers.
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Affiliation(s)
- R Hambach
- Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
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