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Choi SJ, Oh JS, Hong S, Lee CK, Yoo B, Hong B, Kim YG. Treatment Response to Idiopathic Retroperitoneal Fibrosis-associated Hydronephrosis With a Focus on IgG4/IgG3 Serum Concentration Ratio. JOURNAL OF RHEUMATIC DISEASES 2021; 28:38-44. [PMID: 37476393 PMCID: PMC10324956 DOI: 10.4078/jrd.2021.28.1.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/15/2020] [Accepted: 10/28/2020] [Indexed: 07/22/2023]
Abstract
OBJECTIVE Hydronephrosis, a common complication of idiopathic retroperitoneal fibrosis (iRPF), may lead to poor renal outcomes unless resolved in a timely manner IgG4-related diseases characterized by elevated serum IgG4 levels are responsible for a few iRPF cases However, the underlying immunologic features of most iRPF cases have not been clearly defined, and these cases exhibit varied responses to medical treatment Thus, we investigated the predictive factors for hydronephrosis-associated outcomes among iRPF patients. METHODS We retrospectively included 18 iRPF patients with hydronephrosis in a tertiary referral hospital from 2012 to 2019 Hydronephrosis improvement was assessed on images taken 6 months after diagnosis Categorical variables were compared using chi-square or Fisher's exact test Continuous variables were compared using Mann-Whitney U-test. RESULTS On follow-up images, 8 patients (444%) showed an improvement in hydronephrosis Patients with improvement more frequently had reverse serum IgG4/IgG3 ratio (875% vs 30%, p=0025), abdominal aorta involvement (875% vs 30%, p=0025) and glucocorticoid treatment administration (875% vs 30%, p=0025) than those without improvement The proportion of elevated serum IgG4 level did not differ between the two groups Even in the 14 cases with normal serum IgG4 levels, reverse serum IgG4/IgG3 ratio was more frequently observed in patients with improvement than in those without improvement (833% vs 125%, p=0026). CONCLUSION The reverse serum IgG4/IgG3 ratio was associated with hydronephrosis improvement in iRPF patients, suggesting it to be a suitable serologic marker for predicting favourable responses to glucocorticoid treatment.
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Affiliation(s)
- Su Jin Choi
- Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Seon Oh
- Department of Biomedical Informatics, Asan Medical Center, Seoul, Korea
| | - Seokchan Hong
- Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang-Keun Lee
- Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bin Yoo
- Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bumsik Hong
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong-Gil Kim
- Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Essam M, Barakat N, Elkashef A, Awadalla A, Behery AE, Abdel-Maboud M. Functional and molecular evaluation of using aliskiren during acute and chronic partial ureteral obstruction in rat solitary kidney. Life Sci 2020; 265:118811. [PMID: 33259867 DOI: 10.1016/j.lfs.2020.118811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/13/2020] [Accepted: 11/21/2020] [Indexed: 02/06/2023]
Abstract
AIMS To study the effect of direct renin inhibitor (aliskiren) on the renal function during acute and chronic partial ureteral obstruction (PUO) in rat solitary kidney. MAIN METHODS Sixty male Sprague-Dawley rats were randomly allocated into three groups (20 rats each); sham, PUO and aliskiren groups. Right nephrectomy was performed in all groups. Rats in PUO and aliskiren groups were subjected to left PUO and received no treatment and aliskiren (10 mg/kg, orally, once per day till sacrification), respectively. Blood samples were then collected for biochemical measurements. Ten rats from each group were sacrificed after two weeks, while the remaining rats were sacrificed after four weeks. Left kidneys were harvested for histopathological examination, BCL-2, interleukin (IL)-6, transforming growth factor (TGF)-β1, collagen I and fibronectin relative gene expression and assessment of glutathione (GSH), superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO) activity. KEY FINDINGS After two and four weeks of PUO, aliskiren significantly recompensed the rise of serum creatinine (Scr) and blood urea nitrogen (BUN). Aliskiren also revealed significantly better histopathological results regarding cortical and medullary necrosis, regeneration and inflammatory cell infiltration. Aliskiren group showed statistically significant up-regulation of BCL-2 and down-regulation of IL-6, TGF-β1, collagen I and fibronectin relative gene expression. Aliskiren significantly increased GSH and SOD activity and reduced MDA and NO activity. Moreover, aliskiren administration for four weeks after PUO significantly yielded more renoprotective effect compared to its administration for two weeks. SIGNIFICANCE Aliskiren ameliorates the deterioration of the renal function during acute and chronic PUO in a solitary kidney.
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Affiliation(s)
- Mohamed Essam
- Department of General Surgery, Faculty of Veterinary Medicine, Zagazig University, Egypt
| | - Nashwa Barakat
- Department of Urology, Urology and Nephrology Center, Mansoura University, Egypt
| | - Ahmed Elkashef
- Department of Urology, Urology and Nephrology Center, Mansoura University, Egypt.
| | - Amira Awadalla
- Center of Excellence for Genome and Cancer Research, Urology and Nephrology Center, Mansoura University, Egypt
| | - A E Behery
- Department of General Surgery, Faculty of Veterinary Medicine, Zagazig University, Egypt
| | - Mahmoud Abdel-Maboud
- Department of General Surgery, Faculty of Veterinary Medicine, Zagazig University, Egypt
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Elkappany S, Hashem A, Elkarta A, Sheashaa H, Osman Y, Shokeir AA. Effect of losartan on the recoverability of renal function in anuric and oliguric patients with a solitary obstructed kidney: a double‐blind randomized placebo‐controlled trial. BJU Int 2020; 126:715-721. [DOI: 10.1111/bju.15168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Sherif Elkappany
- Urology Department Urology and Nephrology Center Mansoura University Mansoura Egypt
| | - Abdelwahab Hashem
- Urology Department Urology and Nephrology Center Mansoura University Mansoura Egypt
| | - Ahmed Elkarta
- Urology Department Urology and Nephrology Center Mansoura University Mansoura Egypt
| | - Hussein Sheashaa
- Urology Department Urology and Nephrology Center Mansoura University Mansoura Egypt
| | - Yasser Osman
- Urology Department Urology and Nephrology Center Mansoura University Mansoura Egypt
| | - Ahmed A. Shokeir
- Urology Department Urology and Nephrology Center Mansoura University Mansoura Egypt
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Hu S, Xie H, Luo R, Feng P, Liu Q, Han M, Kong Y, Zou X, Wang W, Li C. Inhibition of IL-1β by Aliskiren Improved Renal AQP2 Expression and Urinary Concentration Defect in Ureteral Obstruction and Release. Front Physiol 2019; 10:1157. [PMID: 31572210 PMCID: PMC6753185 DOI: 10.3389/fphys.2019.01157] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 08/28/2019] [Indexed: 12/19/2022] Open
Abstract
We previously demonstrated that ureteral obstruction is associated with a urinary concentrating defect and reduced expression of renal aquaporins (AQPs), in which the renin–angiotensin system (RAS) may play an important role. The aims of the present study were to examine whether the renin inhibitor aliskiren could prevent the reduction in AQP expression and improve the urinary concentrating capacity in mice with bilateral ureteral obstruction (BUO) and BUO release. BUO was performed for 24 h, and BUO release was performed for 1 (B-R1D) or 3 days (B-R3D) with or without aliskiren treatment. Aliskiren prevented polyuria and decreased urine osmolality induced by B-R3D. In mice with BUO and BUO release, aliskiren attenuated the reduction in AQP2 protein and mRNA expression in the obstructed kidneys. B-R3D increased the protein expression of NLRP3 inflammasome components ASC, caspase-1, and interleukin-1β in the obstructed kidneys, which was markedly prevented by aliskiren. Moreover, the NF-κB inhibitor Bay 11-7082 blocked NLRP3 inflammasome activation and attenuated the decrease in AQP2 protein expression in primary cultured rat inner medullary collecting duct cells treated with angiotensin II. These results indicate that the renin inhibitor aliskiren increases water channel AQP2 expression at least partially by suppressing NLRP3 inflammasome activation in the obstructed kidneys of mice with BUO and BUO release.
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Affiliation(s)
- Shan Hu
- Institute of Hypertension, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Haixia Xie
- Institute of Hypertension, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Renfei Luo
- Institute of Hypertension, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Pinning Feng
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiaojuan Liu
- Institute of Hypertension, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Mengke Han
- Institute of Hypertension, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yonglun Kong
- Institute of Hypertension, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Xuenong Zou
- Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weidong Wang
- Institute of Hypertension, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,Department of Nephrology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Chunling Li
- Institute of Hypertension, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
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Zahran MH, Barakat N, Khater S, Awadalla A, Mosbah A, Nabeeh A, Hussein AM, Shokeir AA. Renoprotective effect of local sildenafil administration in renal ischaemia-reperfusion injury: A randomised controlled canine study. Arab J Urol 2019; 17:150-159. [PMID: 31285928 PMCID: PMC6600067 DOI: 10.1080/2090598x.2019.1600995] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2018] [Indexed: 12/22/2022] Open
Abstract
Objectives: To design a new canine model to assess the renoprotective effect of local sildenafil administration, as the renoprotective effect of systemic sildenafil administration in renal ischaemia-reperfusion (IR) injury in animal models has been shown but its local effects have not been established to date. Materials and methods: In all, 120 dogs were assigned to five groups: sham, oral control (OC) group (right nephrectomy + left renal ischaemia for 60 min), oral sildenafil (OS) group (oral sildenafil 1 mg/kg, 60 min before ischaemia), local control (LC) group (local renal perfusion with saline and heparin for 5 min) and local sildenafil (LS) group (perfusion with sildenafil 0.5 mg/kg). Renal functions, histopathological changes, expression of caspase-3, nuclear factor erythroid 2-related factor 2 (Nrf2), inflammatory cytokines (intracellular adhesion molecule 1, tumour necrosis factor α and interleukin 1β) and endothelial nitric oxide synthase (eNOS) in renal tissues were assessed in all groups at 1, 3, 7 and 14 days. Results: There were significant improvements in renal functions and cortical and medullary damage scores in the sildenafil-treated groups compared to their control groups (P < 0.05). Also, the LS group showed significantly better improvement of renal functions and cortical and medullary damage scores than the OS group (P < 0.05). Moreover, sildenafil significantly decreased the expression of caspase-3 and inflammatory cytokines and increased the expression of Nrf2 and eNOS in renal tissue, which were statistically significant in the LS group. Conclusion: LS has a greater renoprotective effect against renal IR injury than systemic administration via anti-inflammatory, antioxidant and anti-apoptotic pathways. Abbreviations: BUN: blood urea nitrogen; Ct: cycle threshold; eNOS: endothelial nitric oxide synthase; GAPDH: glyceraldehyde 3-phosphate dehydrogenase; H&E: haematoxylin and eosin; IL-1β: interleukin 1β; NO: nitric oxide; Nrf2: nuclear factor erythroid 2-related factor 2; OC: oral control; OS: oral sildenafil; LC: local control; LS: local sildenafil.
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Affiliation(s)
- Mohamed H Zahran
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Nashwa Barakat
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Shery Khater
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Amira Awadalla
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ahmed Mosbah
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Adel Nabeeh
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Abdelaziz M Hussein
- Medical Physiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed A Shokeir
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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Shokeir AA, Hussein AAM, Soliman SA, Kamal MM, Abdel-Aziz A, Awadalla A, Rahim MA, Barakat N. Recoverability of renal functions after relief of partial ureteric obstruction of solitary kidney: impact of ferulic acid. BJU Int 2012; 110:904-11. [DOI: 10.1111/j.1464-410x.2011.10848.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Khalil KI, Shokeir AA, Wafa EW, Gad GEMA, Helmy SA, Nour EM, Sarhan M. Renoprotection against complete unilateral ureteric obstruction: Is there an ultimate choice? Arab J Urol 2012; 10:199-206. [PMID: 26558026 PMCID: PMC4442888 DOI: 10.1016/j.aju.2011.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 11/17/2011] [Accepted: 11/17/2011] [Indexed: 12/02/2022] Open
Abstract
Objectives To evaluate and compare the relative contribution of different therapeutic agents for renoprotection against complete unilateral ureteric obstruction (UUO), using a rabbit model sampled at different times. Materials and methods Eighty-four male New Zealand White rabbits were divided into seven groups of 12 rabbits; a sham group, a control (left UUO + no medication) or left UUO and treated with either enalapril, losartan, verapamil, l-arginine or antioxidant (vitamin E and selenium mixture). Rabbits in the control and treated groups were subjected to 3, 10 and 21 days of complete ureteric ligation and then killed humanely. The control and treated groups were evaluated at baseline and at the end of the experiment, by measuring split effective renal plasma flow (ERPF) using diuretic renography, and the split glomerular filtration rate (GFR) using selective creatinine clearance. Renal histopathology was evaluated using a tubulo-interstitial damage score. Results In the sham group there was no significant effect on any of the evaluated variables. For split ERPF, losartan showed the highest renoprotective effect, saving 44% and 77% of ERPF at 3 and 21 days after UUO, respectively. Losartan was also the best renoprotective agent for GFR. For renal histopathology, enalapril showed the earliest and greatest improvement as assessed by the damage score, reaching 60% at 21 days after UUO. l-Arginine was the next best effect to blockade the renin-angiotensin system for renoprotection. Conclusion We suggest that blockade of the renin-angiotensin system provides the best renoprotection against the effects of complete UUO.
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Key Words
- (U)UO, (unilateral) ureteric obstruction
- ACE inhibitors
- ACE, angiotensin-converting enzyme
- AT, angiotensin II
- Angiotensin receptor blocker
- Antioxidants
- Ccr, creatinine clearance
- ERPF, effective renal plasma flow
- ESRD, end-stage renal disease
- NF, nuclear factor
- NO, nitric oxide
- RAS, renin-angiotensin system
- RB, receptor blocker
- Renoprotection
- Unilateral ureteric obstruction
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Affiliation(s)
- Khaled I. Khalil
- Department of Physiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Corresponding author. Tel.: +20 50 2341603.
| | - Ahmed A. Shokeir
- Department of Urology, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ehab W. Wafa
- Department of Urology, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Gad El-Mawla A. Gad
- Department of Physiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Soheir A. Helmy
- Department of Physiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Eman M. Nour
- Department of Urology, Urology & Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Mohamed Sarhan
- Department of Physiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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