Effect of low-osmolar contrast medium iopromide and iso-osmolar iodixanol on DNA fragmentation in renal tubular cell culture

SiO2@Au nanoshell-assisted laser desorption/ionization mass spectrometry for coronary heart disease diagnosis

Cardiovascular diseases have threatened human health, amongst which coronary heart disease (CHD) is the third most common cause of death. CHD is considered to be a metabolic disease; however, there is little research on the CHD metabolism. Matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) has enabled the development of a suitable nanomaterial that can be used to obtain considerable high-quality metabolic information without complex pretreatment of biological fluid samples. This study combines SiO₂@Au nanoshells with minute plasma to obtain metabolic fingerprints of CHD. The thickness of the SiO₂@Au shell was also optimized to maximize the laser desorption/ionization effect. The results demonstrated 84% sensitivity at 85% specificity for distinguishing CHD patients from controls in the validation cohort.

Acute kidney injury in patients with acute coronary syndrome after percutaneous coronary intervention: pathophysiologies, risk factors and preventive measures

Background: Percutaneous coronary intervention (PCI) has been an effective treatment for acute coronary syndrome (ACS) patients. Acute kidney injury (AKI) is one of the common complications after PCI, which seriously affects the living quality and survival time of patients. The approach followed for the patient with AKI after PCI depends on the clinical context and may vary by resource availability. Summary: This review focuses on the pathophysiologies, influencing factors, and preventive measures of AKI in patients with ACS after PCI. The knowledge may better serve the patients and improve their outcomes. Key Messages: Many studies have been carried out for the definition and standard of AKI in the past few years. Etiologies of AKI after PCI included renal damage of contrast medium and atherosclerotic embolism, cardiac insufficiency and surgical factors on renal function. Basic conditions, treatment modalities, and perioperative changes are major risk factors of AKI. Studies have reported that the prevention of contrast-induced nephropathy, modulating the volume overload, some pharmaceuticals and blood purification treatment are helpful to prevent the occurrence of AKI.

Zinc Preconditioning Provides Cytoprotection following Iodinated Contrast Media Exposure in In Vitro Models

Methods

Normal human proximal renal kidney cells (HK-2) were preconditioned with either increasing doses of ZnCl₂ or control. Following this preconditioning, cells were exposed to increasing concentrations of Iohexol 300 mg I₂/ml for four hours. Key outcome measures included cell survival (MTT colorimetric assay) and ROS generation (H₂DCFDA fluorescence assay).

Results

Contrast media induced a dose-dependent reduction in survival of HK-2 cells. Compared to control, contrast media at 150, 225, and 300 mg I₂/ml resulted in 69.5% (SD 8.8%), 37.3% (SD 4.8%), and 4.8% (SD 6.6%) cell survival, respectively (p < 0.001). Preconditioning with 37.5 μM and 50 μM ZnCl₂ increased cell survival by 173% (SD 27.8%) (p < 0.001) and 219% (SD 32.2%) (p < 0.001), respectively, compared to control preconditioning. Zinc preconditioning resulted in a reduction of ROS generation. Zinc pre-conditioning with 37.5 μM μM ZnCl₂ reduced ROS generation by 46% (p < 0.001) compared to control pre-conditioning.

Conclusions

Zinc preconditioning reduces oxidative stress following exposure to radiographic contrast media which in turn results in increased survival of renal cells. Translation of this in vitro finding in animal models will lay the foundation for future use of zinc preconditioning against contrast induced nephropathy.

Nephrotoxicity: Topical issue

Drug-induced kidney injury is one of the most significant adverse events and dose limiting factor in chemotherapy as well a major cause of prospective drug attrition during pharmaceutical development. Moreover, kidney injury can also occur as a consequence of exposures to environmental xenobiotics such as heavy metals, fungal toxins and nanomaterials. The lack of adequate in vitro human kidney models that mimic more realistically the in vivo conditions and the absence of suitable and robust, cost-effective and predictive cell-based in vitro assays contribute to an underestimation of the kidney toxic potential of new drugs and xenobiotics. Therefore, a rapid screening system capable to detect potential nephrotoxicity at early stages of drug discovery is an urgent need. Here we provide an overview of human cell lines currently used as a surrogate in vitro kidney models in nephrotoxicity studies, including their advantages and limitations. In addition, the capacity of the single cell gel electrophoresis (SCGE)/comet assay as a potential tool in kidney toxicants screening is discussed. Despite a limited number of studies using the comet assay to evaluate the drug-induced kidney damage potential, a considerable variability in SCGE methodology (e.g. lysis, unwinding, and electrophoresis conditions) has been observed. Before the comet assay can be included in nephrotoxicity testing, a basic guideline has to be developed. To test its feasibility, additional in vitro experiments including inter-laboratory validation studies based on this guideline have to be performed.

Radiographic contrast-media-induced acute kidney injury: pathophysiology and prophylactic strategies

Contrast-induced acute kidney injury (CI-AKI) is one of the most widely discussed and debated topics in cardiovascular medicine. With increasing number of contrast-media- (CM-) enhanced imaging studies being performed and growing octogenarian population with significant comorbidities, incidence of CI-AKI remains high. In this review, pathophysiology of CI-AKI, its relationship with different types of CM, role of serum and urinary biomarkers for diagnosing CI-AKI, and various prophylactic strategies used for nephroprotection against CI-AKI are discussed in detail.