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Kędzierska-Kapuza K, Safranow K, Niewiński K, Niewiński G, Durlik M, Szczuko M. Indices of Nutrition Status of Kidney and Pancreas Transplant Candidates. Transplant Proc 2024; 56:813-821. [PMID: 38692964 DOI: 10.1016/j.transproceed.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 05/03/2024]
Abstract
Nutritional assessment is used to implement early nutritional interventions and reduce complications associated with malnutrition, which plays a crucial role in improving postoperative outcomes for patients undergoing pancreas and/or kidney transplantation. OBJECTIVE The aim of this study was to analyze the nutritional status (NS) in patients eligible for kidney transplantation (KTx) and simultaneous kidney-pancreas transplantation (SPKTx). METHODS We analyzed the database of hospitalized patients from 2020 to 2023 to identify preoperative parameters of NS in patients eligible for KTx and SPKTx. A total of 59 patients participated in the study, all of whom were candidates for KTx-23 or SPKTx-36. The study population consisted of 35 women (W) and 24 men (M), with an overall mean age of 44.8 ± 10.2 years (43.5 ± 10.2 years for W and 46.2 ± 10.9 years for M). Both groups included patients on hemodialysis (n = 34) and peritoneal dialysis (n = 12), and patients in the predialysis period (pre-emptive, n = 13). The examined parameters included Onodera's prognostic nutritional index (PNIO), the nutritional risk index (NRI), proper body mass calculated using the Lorenz formula, and the neutrophil-to-lymphocyte ratio (NLR). All patients were assessed according to the NRS 2002 scale. RESULTS Analysis of the obtained results revealed that the NLR was only one differentiating parameter between Ktx and SPKtx group. Multivariate analysis adjusted for patients' age and gender, comparing quantitative NS indicators was performed. Albumin serum concentration was not dependent on patients' group (KTx/SPKTx) neither age nor gender P = .382. BMI was dependent on patients' age and gender, but not a group (KTx/SPKTx) P = .008. PNIO, NRI, and NRL were not dependent on patients' group (KTx/SPKTx) neither age nor gender. CONCLUSIONS Additional effort should be devoted to the development of a proper nutrition plan for SPKTx a especially in peritoneal dialysis patients. Toward patients on the waiting list, the regular assessment of nutritional status should be performed which is not a rule in dialysis centers. SPKTx candidates in the perioperative period should receive proper nutrition taking into account their caloric and protein needs.
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Affiliation(s)
- Karolina Kędzierska-Kapuza
- Department of Gastroenterological Surgery and Transplantology, Centre of Postgraduate Medical Education, Warsaw, Poland.
| | - Krzysztof Safranow
- Independent Laboratory of Biostatistics, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Kacper Niewiński
- Department of Gastroenterological Surgery and Transplantology, National Medical Institute of the Ministry of Interior Affairs and Administration, Warsaw, Poland
| | - Grzegorz Niewiński
- Department of Gastroenterological Surgery and Transplantology, National Medical Institute of the Ministry of Interior Affairs and Administration, Warsaw, Poland
| | - Marek Durlik
- Department of Gastroenterological Surgery and Transplantology, National Medical Institute of the Ministry of Interior Affairs and Administration, Warsaw, Poland
| | - Małgorzata Szczuko
- Department of Human Nutrition and Metabolomic, Pomeranian Medical University in Szczecin, Szczecin, Poland.
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Vidigal AC, de Lucena DD, Beyerstedt S, Rangel ÉB. A comprehensive update of the metabolic and toxicological considerations for immunosuppressive drugs used during pancreas transplantation. Expert Opin Drug Metab Toxicol 2023; 19:405-427. [PMID: 37542452 DOI: 10.1080/17425255.2023.2243808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/07/2023]
Abstract
INTRODUCTION Despite significant advancements in immunosuppressive regimens and surgical techniques, the prevalence of adverse events related to immunosuppression remains a major challenge affecting the long-term survival rates of pancreas and kidney allografts. AREAS COVERED This article presents a comprehensive review of the literature and knowledge (Jan/2012-Feb/2023) concerning glucose metabolism disorders and nephrotoxicity associated with tacrolimus and mammalian target of rapamycin inhibitors (mTORi). Novel signaling pathways potentially implicated in these adverse events are discussed. Furthermore, we extensively examine the findings from clinical trials evaluating the efficacy and safety of tacrolimus, mTORi, and steroid minimization. EXPERT OPINION Tacrolimus-based regimens continue to be the standard treatment following pancreas transplants. However, prolonged use of tacrolimus and mTORi may lead to hyperglycemia and nephrotoxicity. Understanding and interpreting experimental data, particularly concerning novel signaling pathways beyond calcineurin-NFAT and mTOR pathways, can offer valuable insights for therapeutic interventions to mitigate hyperglycemia and nephrotoxicity. Additionally, critically analyzing clinical trial results can identify opportunities for personalized safety-based approaches to minimize side effects. It is imperative to conduct randomized-controlled studies to assess the impact of mTORi use and steroid-free protocols on pancreatic allograft survival. Such studies will aid in tailoring treatment strategies for improved transplant outcomes.
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Affiliation(s)
- Ana Cláudia Vidigal
- Nephrology Division, Department of Medicine, Federal University of São Paulo, SP, Brazil
| | - Débora D de Lucena
- Nephrology Division, Department of Medicine, Federal University of São Paulo, SP, Brazil
| | - Stephany Beyerstedt
- Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, SP, São Paulo, Brazil
| | - Érika B Rangel
- Nephrology Division, Department of Medicine, Federal University of São Paulo, SP, Brazil
- Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, SP, São Paulo, Brazil
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Larina II, Severina AS, Maganeva IS, Ainetdinova AR, Eremkina AK, Gavrilova AO, Shamhalova MS, Dmitriev IV, Pinchuk AV, Shestakova MV. Advanced glycation end products and oxidative stress as a basis for metabolic abnormalities in patients with type 1 diabetes after successful simultaneous pancreas-kidney transplantation. TERAPEVT ARKH 2021; 93:1155-1163. [DOI: 10.26442/00403660.2021.10.201100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/03/2021] [Indexed: 11/22/2022]
Abstract
Aim. To compare advanced glycation end-products (AGE, RAGE) and 3-nitrotyrosine (3-HT) in patients with DM 1 after successful simultaneous pancreas-kidney transplantation (SPK) and kidney transplantation alone (KTA). To assess relationship between levels of AGE, RAGE, 3-HT and renal transplant (RT) function, carbohydrate and mineral metabolism.
Materials and methods. The study included 58 patients who received kidney transplantation in end-stage renal disease (ESRD). 36 patients received SPK. There were performed routine laboratory, examination of AGE, RAGE, 3-NT, parathyroid hormone (PTH), 25(OH)vitamin D, calcium, phosphorus, FGF23, osteoprotegerin (OPG), and fetuin-A levels.
Results. All patients after SPK reached normoglycemia (HbA1c 5.7 [5.3; 6.1] %; C-peptide 3.24 [2.29; 4.40] ng/ml) with the achievement of significant difference vs patients after KTA. Arterial hypertension (AH) was more frequent in recipients of SPK before transplantation than after (p=0.008). AH also persisted in greater number of cases in patients after KTA than after SPK. Patients after SPK had higher AGE (р=0.0003) and lower RAGE (р=0.000003) levels. OPG in patients after SPK was significantly higher (р=0.04). The correlation analysis revealed significant positive correlation between 3-HT and OPG (p0.05; r=0.30), RAGE and eGFR (r=-0.52), HbA1c (r=0.48), duration of AH (r=0.34), AGE with HbA1c (r=0.51).
Conclusion. The results of the "metabolic memory" markers analysis may indicate their contribution to the persistence of the metabolic consequences of CKD and DM 1 after achievement of normoglycemia and renal function restoration and their possible participation in development of recurrent nephropathy, vascular calcification, and bone disorders.
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Chudek J, Kolonko A, Ziaja J, Francuz T, Kamińska D, Owczarek AJ, Kuczera P, Kujawa-Szewieczek A, Kusztal M, Kowalik AP, Bożek-Pająk D, Kluz J, Choręza P, Król R, Krajewska M, Cierpka L, Więcek A. Beneficial Effect of Successful Simultaneous Pancreas-Kidney Transplantation on Plasma Profile of Metalloproteinases in Type 1 Diabetes Mellitus Patients. J Clin Med 2021; 10:jcm10173800. [PMID: 34501247 PMCID: PMC8432100 DOI: 10.3390/jcm10173800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/21/2021] [Accepted: 08/23/2021] [Indexed: 12/04/2022] Open
Abstract
It is not fully elucidated whether the restoring of normal glucose metabolism after successful simultaneous pancreas-kidney transplantation (SPK) improves vascular wall morphology and function in type 1 diabetic (T1D) patients. Therefore, we compared arterial stiffness, assessed by pulse wave velocity (PWV), carotid intima-media thickness (IMT), and biomarkers of arterial wall calcification in T1D patients after SPK or kidney transplantation alone (KTA). In 39 SPK and 39 KTA adult patients of similar age, PWV, IMT, circulating matrix metalloproteinases (MMPs) and calcification biomarkers were assessed at median 83 months post transplantation. Additionally, carotid plaques were visualized and semi-qualitatively classified. Although PWV and IMT values were similar, the occurrence of atherosclerotic plaques (51.3 vs. 70.3%, p < 0.01) and calcified lesions (35.9 vs. 64.9%, p < 0.05) was lower in SPK patients. There were significantly lower concentrations of MMP-1, MMP-2, MMP-3, and osteocalcin in SPK subjects. Among the analyzed biomarkers, only logMMP-1, logMMP-2, and logMMP-3 concentrations were associated with log HbA1c. Multivariate stepwise backward regression analysis revealed that MMP-1 and MMP-3 variability were explained only by log HbA1c. Normal glucose metabolism achieved by SPK is followed by the favorable profile of circulating matrix metalloproteinases, which may reflect the vasoprotective effect of pancreas transplantation.
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Affiliation(s)
- Jerzy Chudek
- Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, 40-027 Katowice, Poland;
| | - Aureliusz Kolonko
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, 40-027 Katowice, Poland; (P.K.); (A.K.-S.); (A.W.)
- Correspondence: ; Tel.: +48-32-259-1429
| | - Jacek Ziaja
- Department of General, Vascular and Transplant Surgery, Medical University of Silesia, 40-027 Katowice, Poland; (J.Z.); (A.P.K.); (D.B.-P.); (R.K.); (L.C.)
| | - Tomasz Francuz
- Department of Biochemistry, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Dorota Kamińska
- Department of Nephrology and Transplantation Medicine, Wrocław Medical University, 50-556 Wrocław, Poland; (D.K.); (M.K.); (M.K.)
| | - Aleksander J. Owczarek
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical University of Silesia, 40-752 Katowice, Poland; (A.J.O.); (P.C.)
| | - Piotr Kuczera
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, 40-027 Katowice, Poland; (P.K.); (A.K.-S.); (A.W.)
| | - Agata Kujawa-Szewieczek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, 40-027 Katowice, Poland; (P.K.); (A.K.-S.); (A.W.)
| | - Mariusz Kusztal
- Department of Nephrology and Transplantation Medicine, Wrocław Medical University, 50-556 Wrocław, Poland; (D.K.); (M.K.); (M.K.)
| | - Adrian P. Kowalik
- Department of General, Vascular and Transplant Surgery, Medical University of Silesia, 40-027 Katowice, Poland; (J.Z.); (A.P.K.); (D.B.-P.); (R.K.); (L.C.)
| | - Dominika Bożek-Pająk
- Department of General, Vascular and Transplant Surgery, Medical University of Silesia, 40-027 Katowice, Poland; (J.Z.); (A.P.K.); (D.B.-P.); (R.K.); (L.C.)
| | - Joanna Kluz
- Department of Angiology, Hypertension and Diabetology, University Clinical Hospital, 50-556 Wrocław, Poland;
| | - Piotr Choręza
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical University of Silesia, 40-752 Katowice, Poland; (A.J.O.); (P.C.)
| | - Robert Król
- Department of General, Vascular and Transplant Surgery, Medical University of Silesia, 40-027 Katowice, Poland; (J.Z.); (A.P.K.); (D.B.-P.); (R.K.); (L.C.)
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wrocław Medical University, 50-556 Wrocław, Poland; (D.K.); (M.K.); (M.K.)
| | - Lech Cierpka
- Department of General, Vascular and Transplant Surgery, Medical University of Silesia, 40-027 Katowice, Poland; (J.Z.); (A.P.K.); (D.B.-P.); (R.K.); (L.C.)
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, 40-027 Katowice, Poland; (P.K.); (A.K.-S.); (A.W.)
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Gomes SV, Rodrigues V, Nunes-Dos-Santos DL, Pereira ALA, Peres MA. The relationship between periodontal status and hyperglycemia after kidney transplantation. Clin Oral Investig 2021; 26:397-406. [PMID: 34196853 DOI: 10.1007/s00784-021-04011-6] [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: 03/06/2021] [Accepted: 05/24/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Several factors have been associated with hyperglycemia after kidney transplantation (KTx), including systemic inflammation. This study aimed to investigate the relationship between periodontal status and hyperglycemia in KTx patients. MATERIALS AND METHODS Forty-four KTx patients were included in this cross-sectional study. Periodontitis severity was categorized into stage I to IV. Fasting blood glucose (FBG) was measured, and hyperglycemia was analyzed at different FBG cutoff points (100 mg/dL, 110 mg/dL, 120 mg/dL, 126 mg/dL, 140 mg/dL). Age, history of smoking, prior type 2 diabetes (T2D), and prior cardiovascular disease (CVD) were considered cofounders. Multivariable logistic regression modelling was performed with periodontitis as the exposure and hyperglycemia as the outcome. Pathway analysis was performed with FBG as a continuous outcome. RESULTS Periodontitis had increased odds of hyperglycemia from 120 mg/dL FBG cutoff, even after adjustment. In addition, periodontitis severity was positively associated with FBG level (β = 0.323, SE = 0.127, P = 0.011). CONCLUSION The findings suggest that periodontitis may be related to increase of hyperglycemia and FBG levels in KTx patients. CLINICAL RELEVANCE Periodontitis severity and cardiovascular disease were positively associated with FBG levels in KTx patients. Clinicians and patients should be aware of the potential benefit of periodontal care for better glycemic control management.
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Affiliation(s)
- Samira V Gomes
- Dentistry Graduate Program, Federal University of Maranhão, Avenida Dos Portugueses, São Luís, 196665080-805, Brazil
| | - Vandilson Rodrigues
- Dentistry Graduate Program, Federal University of Maranhão, Avenida Dos Portugueses, São Luís, 196665080-805, Brazil. .,School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia.
| | - Danila L Nunes-Dos-Santos
- Dentistry Graduate Program, Federal University of Maranhão, Avenida Dos Portugueses, São Luís, 196665080-805, Brazil
| | - Antonio L A Pereira
- Dentistry Graduate Program, Federal University of Maranhão, Avenida Dos Portugueses, São Luís, 196665080-805, Brazil
| | - Marco A Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia.,National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
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Musiał M, Wiench R, Kolonko A, Choręza P, Niedzielski D, Machorowska-Pieniążek A, Skaba D, Więcek A, Owczarek A, Niedzielska I, Król R, Ziaja J. Simultaneously Transplanted Pancreas Improves Salivation and Reduces Oral Fungal Infections Incidence in Type 1 Diabetic Renal Transplant Recipients. Transplant Proc 2020; 52:2067-2073. [PMID: 32305203 DOI: 10.1016/j.transproceed.2020.01.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/22/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Long-lasting diabetes mellitus may lead to numerous pathologies in the oral cavity. The aim of the study was to assess the condition of the oral cavity, caries intensity, salivary parameters, and incidence of oral fungal infections in patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD) after kidney transplantation (KTx) or simultaneous kidney and pancreas transplantation (SPK). METHODS Twenty-one patients after SPK, 18 T1D patients after KTx, and 14 kidney recipients without diabetes (control group) were included in the study. Donor sources complied with Helsinki Congress and the Declaration of Istanbul. RESULTS Approximal plague index in SPK (80% [68%-90%]) was comparable to KTx (80% [37.5%-92.5%]) but higher than in control group (46% [35%-50%]). All 3 groups did not differ in terms of decayed-missing-filled tooth index: 22.3 ± 4.8 vs 22.5 ± 4.5 vs 19.1 ± 4.9, respectively. Normal saliva resting secretion and consistency were more common in SPK (71.4% and 52%, respectively) than in KTx (27.8% and 50.0%, respectively). Stimulated saliva volume in the SPK, KTx and controls, pH value, and buffering capacity were comparable. In KTx higher incidence of Candida albicans infection (55.6%) compared with SPK (23.8%) and controls (no infection) was observed. CONCLUSIONS Simultaneously transplanted pancreas improves salivation and reduces the incidence of oral fungal infections in T1D kidney recipients. The severity of caries is higher and oral hygiene is worse in T1D kidney recipients compared with patients after KTx without diabetes.
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Affiliation(s)
- Mikołaj Musiał
- Department of Orthodontics, Medical University of Silesia, Katowice, Poland.
| | - Rafał Wiench
- Department of Periodontal Diseases and Oral Mucosa, Medical University of Silesia, Katowice, Poland
| | - Aureliusz Kolonko
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Piotr Choręza
- Department of Statistics, Department of Instrumental Analysis, Faculty of Pharmaceutical Sciences, Medical University of Silesia, Katowice, Poland
| | - Damian Niedzielski
- Department of Craniomaxillofacial Surgery, Medical University of Silesia, Katowice, Poland
| | | | - Dariusz Skaba
- Department of Periodontal Diseases and Oral Mucosa, Medical University of Silesia, Katowice, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Aleksander Owczarek
- Department of Statistics, Department of Instrumental Analysis, Faculty of Pharmaceutical Sciences, Medical University of Silesia, Katowice, Poland
| | - Iwona Niedzielska
- Department of Craniomaxillofacial Surgery, Medical University of Silesia, Katowice, Poland
| | - Robert Król
- Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland
| | - Jacek Ziaja
- Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland
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Raghunathan R, Sethi MK, Klein JA, Zaia J. Proteomics, Glycomics, and Glycoproteomics of Matrisome Molecules. Mol Cell Proteomics 2019; 18:2138-2148. [PMID: 31471497 PMCID: PMC6823855 DOI: 10.1074/mcp.r119.001543] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/26/2019] [Indexed: 12/21/2022] Open
Abstract
The most straightforward applications of proteomics database searching involve intracellular proteins. Although intracellular gene products number in the thousands, their well-defined post-translational modifications (PTMs) makes database searching practical. By contrast, cell surface and extracellular matrisome proteins pass through the secretory pathway where many become glycosylated, modulating their physicochemical properties, adhesive interactions, and diversifying their functions. Although matrisome proteins number only a few hundred, their high degree of complex glycosylation multiplies the number of theoretical proteoforms by orders of magnitude. Given that extracellular networks that mediate cell-cell and cell-pathogen interactions in physiology depend on glycosylation, it is important to characterize the proteomes, glycomes, and glycoproteomes of matrisome molecules that exist in a given biological context. In this review, we summarize proteomics approaches for characterizing matrisome molecules, with an emphasis on applications to brain diseases. We demonstrate the availability of methods that should greatly increase the availability of information on matrisome molecular structure associated with health and disease.
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Affiliation(s)
- Rekha Raghunathan
- Molecular and Translational Medicine Program, Boston University, Boston, MA 02218; Department of Biochemistry, Boston University, Boston, MA 02218
| | - Manveen K Sethi
- Department of Biochemistry, Boston University, Boston, MA 02218
| | - Joshua A Klein
- Bioinformatics Program, Boston University, Boston, MA 02218
| | - Joseph Zaia
- Molecular and Translational Medicine Program, Boston University, Boston, MA 02218; Department of Biochemistry, Boston University, Boston, MA 02218; Bioinformatics Program, Boston University, Boston, MA 02218.
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Acute exercise increases syndecan-1 and -4 serum concentrations. Glycoconj J 2019; 36:113-125. [DOI: 10.1007/s10719-019-09869-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/15/2019] [Accepted: 03/26/2019] [Indexed: 12/21/2022]
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Reine TM, Lanzalaco F, Kristiansen O, Enget AR, Satchell S, Jenssen TG, Kolset SO. Matrix metalloproteinase-9 mediated shedding of syndecan-4 in glomerular endothelial cells. Microcirculation 2019; 26:e12534. [PMID: 30703289 DOI: 10.1111/micc.12534] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 01/17/2019] [Accepted: 01/25/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Diabetic nephropathy is the most common cause of end-stage renal failure in the western world and Asia. The mechanisms are not fully elucidated, but disruption of glomerular endothelial glycocalyx and shedding of its components including syndecans has been implicated. AIMS We hypothesize that reduced glomerular filtration in diabetes is caused by disruption of endothelial glycocalyx in glomeruli, including increased shedding of syndecan-4. The aim of this study was to determine the effects of experimental diabetic conditions by means of hyperglycemia and IL-1β exposure on syndecan-4 shedding in GEnC, and to investigate regulation of shedding by sheddases. RESULTS We found that in GEnC the expression of syndecan-4 is higher than that of the other syndecans. In polarized GEnC, apical shedding of syndecan-4 and syndecan-4 gene expression was increased by 60% after IL-1β-stimulation, but not affected by hyperglycemic conditions. This was accompanied by a 50% increase in MMP9 gene expression in IL-1β-stimulated cells but not hyperglycemia. MMP9 knockdown reduced syndecan-4 shedding by 50%. CONCLUSION IL-1β but not hyperglycemia increases the shedding of syndecan-4 from GEnC in an MMP9-dependent manner. This provides a potential mechanism of GEnC damage in diabetes and other inflammatory conditions.
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Affiliation(s)
- Trine M Reine
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Section of Renal Diseases, Department of Organ transplantation, OUS, Oslo, Norway
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
| | - Francesca Lanzalaco
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Sciences and Technology, University of Milan, Milan, Italy
| | - Oddrun Kristiansen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Anne Randi Enget
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | - Trond G Jenssen
- Section of Renal Diseases, Department of Organ transplantation, OUS, Oslo, Norway
- Metabolic and Renal Research Group, UiT The Artic University of Norway, Tromsø, Norway
| | - Svein O Kolset
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Solbu MD, Kolset SO, Jenssen TG, Wilsgaard T, Løchen ML, Mathiesen EB, Melsom T, Eriksen BO, Reine TM. Gender differences in the association of syndecan-4 with myocardial infarction: The population-based Tromsø Study. Atherosclerosis 2018; 278:166-173. [DOI: 10.1016/j.atherosclerosis.2018.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/27/2018] [Accepted: 08/15/2018] [Indexed: 01/23/2023]
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Gunasekaran M, Vachharajani N, Gaut JP, Maw TT, Delos Santos R, Shenoy S, Chapman WC, Wellen J, Mohanakumar T. Development of immune response to tissue-restricted self-antigens in simultaneous kidney-pancreas transplant recipients with acute rejection. Clin Transplant 2017. [PMID: 28639386 DOI: 10.1111/ctr.13009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Simultaneous kidney-pancreas transplantation (SKP Tx) is a treatment for end-stage kidney disease secondary to diabetes mellitus. We investigated the role of immune responses to donor human leukocyte antigens (HLA) and tissue-restricted kidney and pancreas self-antigens (KSAgs and PSAgs, respectively) in SKP Tx recipients (SKP TxRs). Sera collected from 39 SKP TxRs were used to determine de novo Abs specific for KSAgs (collagen-IV, Col-IV; fibronectin, FN) and PSAgs (insulin, islet cells, glutamic acid decarboxylase, and pancreas-associated protein-1) by ELISA. KSAg-specific IFN-γ, IL-17, and IL-10 cytokines were enumerated by ELISpot. Abs to donor HLA classes I and II were determined by Luminex assay. Abs to KSAgs and PSAgs were detectable in recipients with rejection compared with stable recipients (P<.05). Kidney-only rejection recipients had increased Abs against KSAgs compared with stable (P<.05), with no increase in Abs against PSAgs. Pancreas-only rejection recipients showed increased Abs against PSAgs compared to stable (P<.05), with no Abs against KSAgs. SKP TxRs with rejection showed increased frequencies of KSAg-specific IFN-γ and IL-17 with reduction in IL-10-secreting cells. SKP TxRs with rejection developed Abs to KSAgs and PSAgs demonstrated increased frequencies of kidney or pancreas SAg-specific IFN-γ and IL-17-secreting cells with reduced IL-10, suggesting loss of peripheral tolerance to SAgs.
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Affiliation(s)
| | - Neeta Vachharajani
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Joseph P Gaut
- Department of Anatomic and Molecular Pathology, Washington University School of Medicine, St. Louis, MO, USA
| | - Thin Thin Maw
- Department of Medicine, Nephrology, University of Southern California, Los Angeles, CA, USA
| | - Rowena Delos Santos
- Division of Nephrology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Surendra Shenoy
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - William C Chapman
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Jason Wellen
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
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12
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Kolseth IBM, Reine TM, Parker K, Sudworth A, Witczak BJ, Jenssen TG, Kolset SO. Increased levels of inflammatory mediators and proinflammatory monocytes in patients with type I diabetes mellitus and nephropathy. J Diabetes Complications 2017; 31:245-252. [PMID: 27452162 DOI: 10.1016/j.jdiacomp.2016.06.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/20/2016] [Accepted: 06/28/2016] [Indexed: 12/31/2022]
Abstract
AIMS To investigate and describe the relationship between diabetic nephropathy and systemic inflammation in patients with type 1 diabetes mellitus (T1DM). METHODS Patients with T1DM, with or without reduced renal function due to diabetic nephropathy, were included. Differences in inflammatory mediators, adhesion molecules, markers of endothelial dysfunction and subsets of monocytes were studied in patients with mean disease duration of 31years. RESULTS Patients with T1DM with and without renal failure were compared. Patients with nephropathy had increased plasma levels of proinflammatory monocytes, as well as circulatory PAI-1, syndecan-1, VEGF, IL-1β, IL-1Ra and CCL4. Peripheral blood mononuclear cells from patients with nephropathy numerically increased soluble ICAM and PAI-1 in co-culture with primary endothelial cells compared to cells from patients without nephropathy. CONCLUSIONS T1DM patients with kidney failure have higher levels of proinflammatory monocytes and circulatory inflammatory mediators compared to patients with T1DM alone. The results highlight the importance of inflammation and endothelial dysfunction in diabetic nephropathy with reduced GFR.
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MESH Headings
- Biomarkers/blood
- Cells, Cultured
- Diabetes Mellitus, Type 1/complications
- Diabetic Angiopathies/blood
- Diabetic Angiopathies/immunology
- Diabetic Angiopathies/metabolism
- Diabetic Angiopathies/pathology
- Diabetic Nephropathies/blood
- Diabetic Nephropathies/immunology
- Diabetic Nephropathies/metabolism
- Diabetic Nephropathies/pathology
- Disease Progression
- Endothelium, Vascular/immunology
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/pathology
- Female
- Human Umbilical Vein Endothelial Cells/cytology
- Human Umbilical Vein Endothelial Cells/immunology
- Human Umbilical Vein Endothelial Cells/metabolism
- Humans
- Inflammation Mediators/blood
- Inflammation Mediators/metabolism
- Intercellular Adhesion Molecule-1/blood
- Intercellular Adhesion Molecule-1/metabolism
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/immunology
- Kidney Failure, Chronic/metabolism
- Kidney Failure, Chronic/pathology
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/metabolism
- Leukocytes, Mononuclear/pathology
- Male
- Middle Aged
- Monocytes/immunology
- Monocytes/metabolism
- Monocytes/pathology
- Plasminogen Activator Inhibitor 1/blood
- Plasminogen Activator Inhibitor 1/metabolism
- Renal Insufficiency/complications
- Renal Insufficiency/immunology
- Renal Insufficiency/metabolism
- Renal Insufficiency/pathology
- Renal Insufficiency, Chronic/complications
- Renal Insufficiency, Chronic/immunology
- Renal Insufficiency, Chronic/metabolism
- Renal Insufficiency, Chronic/pathology
- Severity of Illness Index
- Up-Regulation
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Affiliation(s)
| | - Trine Marita Reine
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Krystina Parker
- Department of Nephrology, Akershus University Hospital, Norway
| | - Amanda Sudworth
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Bartlomiej J Witczak
- Department of Nephrology, Akershus University Hospital, Norway; Department of Nephrology, Oslo University Hospital, Ullevaal, Oslo, Norway
| | - Trond Geir Jenssen
- Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; The Metabolic and Renal Research Group, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Svein Olav Kolset
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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13
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Zhang J, Hu X, Wang S, Zhang Y, Yang H. Protective effects of low-dose rapamycin combined with valsartan on podocytes of diabetic rats. Int J Clin Exp Med 2015; 8:13275-13281. [PMID: 26550253 PMCID: PMC4612938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/04/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study was to study the impacts and the mechanisms of low-dose rapamycin combined with valsartan on the renal functions of diabetic nephropathy (DN) rats. 50 SD rats were randomly divided into the normal control group (group A, n=10) and the DN model group (n=40), the DN model group was intraperitoneally injected streptozocin (STZ) for the modeling, which were then equally divided into the DN group (group B), the rapamycin group (group C, orally administrated rapamycin 1 mg/kg/d), the valsartan group (group D, orally administrated valsartan 30 mg/kg/d) and the combined therapy group (group E, orally administrated rapamycin 1 mg/kg/d + valsartan 30 mg/kg/d). Group A and group B were orally administrated the same amount of 0.5% carboxymethylcellulose. After 8-week treatment, the rats of each group were killed for the renal functional and pathological detection, as well as the expression detection of nephrin and podocin of kidney tissues. Compared with group A, the renal functions of the DN model groups were all decreased, and the pathological changes were significant. Meanwhile, the expressions of nephrin/podocin were reduced (P<0.05); among which group B exhibited the most serious changes, while the situations of group E were improved after the combined treatment, the expressions of nephrin/podocin were increased. Low-dose rapamycin and valsartan could enhance the expressions of nephrin and podocin, reduce kidney damages, thus achieving the protective effects towards the kidneys, and the effects of the combined therapy were superior to those of monotherapy.
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Affiliation(s)
- Jin Zhang
- Department of Nephrology, The Fifth Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan, China
| | - Xiaozhou Hu
- Department of Nephrology, The Fifth Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan, China
| | - Shaoting Wang
- Department of Nephrology, The Fifth Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan, China
| | - Yan Zhang
- Department of Nephrology, The Fifth Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan, China
| | - Hong Yang
- Department of Nephrology, The Fifth Affiliated Hospital of Zhengzhou University Zhengzhou 450052, Henan, China
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