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An TF, Zhang ZP, Xue JT, Luo WM, Li Y, Fang ZZ, Zong GW. Interpretable machine learning identifies metabolites associated with glomerular filtration rate in type 2 diabetes patients. Front Endocrinol (Lausanne) 2024; 15:1279034. [PMID: 38915893 PMCID: PMC11194401 DOI: 10.3389/fendo.2024.1279034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/17/2024] [Indexed: 06/26/2024] Open
Abstract
Objective The co-occurrence of kidney disease in patients with type 2 diabetes (T2D) is a major public health challenge. Although early detection and intervention can prevent or slow down the progression, the commonly used estimated glomerular filtration rate (eGFR) based on serum creatinine may be influenced by factors unrelated to kidney function. Therefore, there is a need to identify novel biomarkers that can more accurately assess renal function in T2D patients. In this study, we employed an interpretable machine-learning framework to identify plasma metabolomic features associated with GFR in T2D patients. Methods We retrieved 1626 patients with type 2 diabetes (T2D) in Liaoning Medical University First Affiliated Hospital (LMUFAH) as a development cohort and 716 T2D patients in Second Affiliated Hospital of Dalian Medical University (SAHDMU) as an external validation cohort. The metabolite features were screened by the orthogonal partial least squares discriminant analysis (OPLS-DA). We compared machine learning prediction methods, including logistic regression (LR), support vector machine (SVM), random forest (RF), and eXtreme Gradient Boosting (XGBoost). The Shapley Additive exPlanations (SHAP) were used to explain the optimal model. Results For T2D patients, compared with the normal or elevated eGFR group, glutarylcarnitine (C5DC) and decanoylcarnitine (C10) were significantly elevated in GFR mild reduction group, and citrulline and 9 acylcarnitines were also elevated significantly (FDR<0.05, FC > 1.2 and VIP > 1) in moderate or severe reduction group. The XGBoost model with metabolites had the best performance: in the internal validate dataset (AUROC=0.90, AUPRC=0.65, BS=0.064) and external validate cohort (AUROC=0.970, AUPRC=0.857, BS=0.046). Through the SHAP method, we found that C5DC higher than 0.1μmol/L, Cit higher than 26 μmol/L, triglyceride higher than 2 mmol/L, age greater than 65 years old, and duration of T2D more than 10 years were associated with reduced GFR. Conclusion Elevated plasma levels of citrulline and a panel of acylcarnitines were associated with reduced GFR in T2D patients, independent of other conventional risk factors.
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Affiliation(s)
- Tian-Feng An
- Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhi-Peng Zhang
- Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jun-Tang Xue
- Department of Surgery, Peking University Third Hospital, Beijing, China
| | - Wei-Ming Luo
- Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yang Li
- Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhong-Ze Fang
- Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Guo-Wei Zong
- Department of Mathematics, School of Public Health, Tianjin Medical University, Tianjin, China
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Biernat K, Kuciel N, Mazurek J, Hap K. Is It Possible to Train the Endothelium?-A Narrative Literature Review. Life (Basel) 2024; 14:616. [PMID: 38792637 PMCID: PMC11121998 DOI: 10.3390/life14050616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 05/26/2024] Open
Abstract
This review provides an overview of current knowledge regarding the adaptive effects of physical training on the endothelium. The endothelium plays a crucial role in maintaining the health of vessel walls and regulating vascular tone, structure, and homeostasis. Regular exercise, known for its promotion of cardiovascular health, can enhance endothelial function through various mechanisms. The specific health benefits derived from exercise are contingent upon the type and intensity of physical training. The review examines current clinical evidence supporting exercise's protective effects on the vascular endothelium and identifies potential therapeutic targets for endothelial dysfunction. There is an urgent need to develop preventive strategies and gain a deeper understanding of the distinct impacts of exercise on the endothelium.
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Affiliation(s)
| | - Natalia Kuciel
- University Rehabilitation Centre, Wroclaw Medical University, 50-367 Wroclaw, Poland; (K.B.); (J.M.); (K.H.)
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Au AYM, Mantik K, Bahadory F, Stathakis P, Guiney H, Erlich J, Walker R, Poulton R, Horvath AR, Endre ZH. Plasma arginine metabolites in health and chronic kidney disease. Nephrol Dial Transplant 2023; 38:2767-2775. [PMID: 37230955 DOI: 10.1093/ndt/gfad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Elevated plasma asymmetric and symmetric dimethylarginine (ADMA and SDMA) are risk factors for chronic kidney disease (CKD) and cardiovascular disease. Using plasma cystatin C (pCYSC)-based estimated glomerular filtration rate (eGFR) trajectories, we identified a cohort at high risk of poor kidney-related health outcomes amongst members of the Dunedin Multidisciplinary Health and Development Study (DMHDS). We therefore examined associations between methylarginine metabolites and kidney function in this cohort. METHODS ADMA, SDMA, L-arginine and L-citrulline were measured in plasma samples from 45-year-olds in the DMHDS cohort by liquid chromatography-tandem mass spectrometry. RESULTS In a healthy DMHDS subset (n = 376), mean concentrations were: ADMA (0.40 ± 0.06 µmol/L), SDMA (0.42 ± 0.06 µmol/L), L-arginine (93.5 ± 23.1 µmol/L) and L-citrulline (24.0 ± 5.4 µmol/L). In the total cohort (n = 857), SDMA correlated positively with serum creatinine (Pearson's r = 0.55) and pCYSC (r = 0.55), and negatively with eGFR (r = 0.52). A separate cohort of 38 patients with stage 3-4 CKD (eGFR 15-60 mL/min/1.73 m2) confirmed significantly higher mean ADMA (0.61 ± 0.11 µmol/L), SDMA (0.65 ± 0.25 µmol/L) and L-citrulline (42.7 ± 11.8 µmol/L) concentrations. DMHDS members classified as high-risk of poor kidney health outcomes had significantly higher mean concentrations of all four metabolites compared with individuals not at risk. ADMA and SDMA individually predicted high-risk of poor kidney health outcomes with areas under the ROC curves (AUCs) of 0.83 and 0.84, and together with an AUC of 0.90. CONCLUSIONS Plasma methylarginine concentrations facilitate stratification for risk of CKD progression.
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Affiliation(s)
- Amy Y M Au
- Department of Nephrology, Prince of Wales Hospital, Sydney, NSW, Australia
- Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Kevin Mantik
- Department of Chemical Pathology, New South Wales Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Forough Bahadory
- Department of Chemical Pathology, New South Wales Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Paul Stathakis
- Department of Chemical Pathology, New South Wales Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Hayley Guiney
- Department of Psychology, Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Jonathan Erlich
- Department of Nephrology, Prince of Wales Hospital, Sydney, NSW, Australia
- Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Robert Walker
- Department of Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Department of Psychology, Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
| | - Andrea Rita Horvath
- Department of Chemical Pathology, New South Wales Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Zoltan H Endre
- Department of Nephrology, Prince of Wales Hospital, Sydney, NSW, Australia
- Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
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Baach F, Meyer B, Oh J, Lezius S, Böger R, Schwedhelm E, Choe CU, Neu A. Developmental dynamics of homoarginine, ADMA and SDMA plasma levels from birth to adolescence. Amino Acids 2023; 55:1381-1388. [PMID: 37648945 PMCID: PMC10689515 DOI: 10.1007/s00726-023-03318-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 08/15/2023] [Indexed: 09/01/2023]
Abstract
Guanidino compounds such as dimethylarginines (SDMA, ADMA) and L-homoarginine ((L-)hArg) can interfere with bioavailability and function of the main NO-donor L-arginine (L-Arg). High ADMA and SDMA but low L-hArg concentrations have been associated with cardio- and cerebrovascular events and mortality in adults. The role of guanidino compounds in paediatric patients remains less clear. We, therefore, compared guanidino compound levels in plasma samples of 57 individuals with chronic kidney disease (CKD) and 141 individuals without CKD from the age of 0 to 17 years, including patients with different comorbidities by correlation and regression analyses. We found highest hArg, SDMA and ADMA concentrations in neonates (Kruskal-Wallis, p < 0.001 for all). From the age of 1 year on, hArg levels increased, whereas SDMA und ADMA levels further decreased in children. SDMA and ADMA are higher in children with CKD independent of GFR (mean factor 1.92 and 1.38, respectively, p < 0.001 for both), and SDMA is strongly correlated with creatinine concentration in children with CKD (Spearman's rho 0.74, p < 0.001). We provide guanidino compound levels in a large sample covering all paediatric age groups for the first time. Our data can be used to assess the role of guanidino compounds such as hArg in disease states, i.e. cerebro- and cardiovascular disorders in childhood and adolescence.
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Affiliation(s)
- Florence Baach
- Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Boglarka Meyer
- Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Jun Oh
- Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Susanne Lezius
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rainer Böger
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK E.V.), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Chi-Un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Neurology, Klinikum Itzehoe, Robert-Koch-Strasse 2, 25524, Itzehoe, Germany
| | - Axel Neu
- Department of Paediatrics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
- VAMED Klinik Geesthacht, Johannes-Ritter-Strasse 100, 21502, Geesthacht, Germany.
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Sarwar MS, Cheng D, Peter RM, Shannar A, Chou P, Wang L, Wu R, Sargsyan D, Goedken M, Wang Y, Su X, Hart RP, Kong AN. Metabolic rewiring and epigenetic reprogramming in leptin receptor-deficient db/db diabetic nephropathy mice. Eur J Pharmacol 2023:175866. [PMID: 37331680 DOI: 10.1016/j.ejphar.2023.175866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Diabetic nephropathy (DN) is the leading cause of end-stage renal disease in the United States. Emerging evidence suggests that mitochondrial metabolism and epigenetics play an important role in the development and progression of DN and its complications. For the first time, we investigated the regulation of cellular metabolism, DNA methylation, and transcriptome status by high glucose (HG) in the kidney of leptin receptor-deficient db/db mice using multi-omics approaches. METHODS The metabolomics was performed by liquid-chromatography-mass spectrometry (LC-MS), while epigenomic CpG methylation coupled with transcriptomic gene expression was analyzed by next-generation sequencing. RESULTS LC-MS analysis of glomerular and cortex tissue samples of db/db mice showed that HG regulated several cellular metabolites and metabolism-related signaling pathways, including S-adenosylmethionine, S-adenosylhomocysteine, methionine, glutamine, and glutamate. Gene expression study by RNA-seq analysis suggests transforming growth factor beta 1 (TGFβ1) and pro-inflammatory pathways play important roles in early DN. Epigenomic CpG methyl-seq showed HG revoked a list of differentially methylated regions in the promoter region of the genes. Integrated analysis of DNA methylation in the promoter regions of genes and gene expression changes across time points identified several genes persistently altered in DNA methylation and gene expression. Cyp2d22, Slc1a4, and Ddah1 are some identified genes that could reflect dysregulated genes involved in renal function and DN. CONCLUSION Our results suggest that leptin receptor deficiency leading to HG regulates metabolic rewiring, including SAM potentially driving DNA methylation and transcriptomic signaling that could be involved in the progression of DN.
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Affiliation(s)
- Md Shahid Sarwar
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - David Cheng
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA; Graduate Program in Pharmaceutical Sciences, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Rebecca Mary Peter
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA; Graduate Program in Pharmaceutical Sciences, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Ahmad Shannar
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA; Graduate Program in Pharmaceutical Sciences, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Pochung Chou
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA; Graduate Program in Pharmaceutical Sciences, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Lujing Wang
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA; Graduate Program in Pharmaceutical Sciences, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Renyi Wu
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Davit Sargsyan
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA; Graduate Program in Pharmaceutical Sciences, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Michael Goedken
- Office of Translational Science, Research Pathology Services, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Yujue Wang
- Metabolomics Shared Resource, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA
| | - Xiaoyang Su
- Metabolomics Shared Resource, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA
| | - Ronald P Hart
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA
| | - Ah-Ng Kong
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, 08854, USA.
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Mandel IA, Podoksenov YK, Mikheev SL, Suhodolo IV, Svirko YS, Shipulin VM, Ivanova AV, Yavorovskiy AG, Yaroshetskiy AI. Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial. Biomedicines 2023; 11:biomedicines11041044. [PMID: 37189663 DOI: 10.3390/biomedicines11041044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
A hypoxic–hyperoxic preconditioning (HHP) may be associated with cardioprotection by reducing endothelial damage and a beneficial effect on postoperative outcome in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Patients (n = 120) were randomly assigned to an HHP and a control group. A safe, inhaled oxygen fraction for the hypoxic preconditioning phase (10–14% oxygen for 10 min) was determined by measuring the anaerobic threshold. At the hyperoxic phase, a 75–80% oxygen fraction was used for 30 min. The cumulative frequency of postoperative complications was 14 (23.3%) in the HHP vs. 23 (41.1%), p = 0.041. The nitrate decreased after surgery by up to 20% in the HHP group and up to 38% in the control group. Endothelin-1 and nitric oxide metabolites were stable in HHP but remained low for more than 24 h in the control group. The endothelial damage markers appeared to be predictors of postoperative complications. The HHP with individual parameters based on the anaerobic threshold is a safe procedure, and it can reduce the frequency of postoperative complications. The endothelial damage markers appeared to be predictors of postoperative complications.
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Zhang W, Zheng J, Zhang J, Li N, Yang X, Fang ZZ, Zhang Q. Associations of serum amino acids related to urea cycle with risk of chronic kidney disease in Chinese with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1117308. [PMID: 36936143 PMCID: PMC10018121 DOI: 10.3389/fendo.2023.1117308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
OBJECTIVE Serum levels of amino acids related to urea cycle are associated with risk of type 2 diabetes mellitus (T2DM). Our study aimed to explore whether serum levels of amino acids related to urea cycle, i.e., arginine, citrulline, and ornithine, are also associated with increased risk of chronic kidney disease (CKD) in T2DM. METHODS We extracted medical records of 1032 consecutive patients with T2DM from the Electronic Administrative System of Liaoning Medical University First Affiliated Hospital (LMUFAH) system from May 2015 to August 2016. Of them, 855 patients with completed data available were used in the analysis. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Serum amino acids were measured by mass spectrometry (MS) technology. Binary logistic regression was performed to obtain odds ratios (ORs) and their 95% confidence intervals (CIs). RESULTS 52.3% of the 855 T2DM patients were male, and 143 had CKD. In univariable analysis, high serum citrulline, high ratio of arginine to ornithine, and low ratio of ornithine to citrulline were associated with markedly increased risk of CKD (OR of top vs. bottom tertile: 2.87, 95%CI, 1.79-4.62 & 1.98, 95%CI,1.25-3.14 & 2.56, 95%CI, 1.61-4.07, respectively). In multivariable analysis, the ORs of citrulline and ornithine/citrulline ratio for CKD remained significant (OR of top vs. bottom tertile: 2.22, 95%CI, 1.29-3.82 & 2.24, 1.29-3.87, respectively). CONCLUSIONS In Chinese patients with T2DM, high citrulline and low ornithine/citrulline ratio were associated with increased risk of CKD.
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Affiliation(s)
- Wei Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jun Zheng
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin, China
| | - Jikun Zhang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ninghua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhong-Ze Fang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
- *Correspondence: Qiang Zhang, ; Zhong-Ze Fang,
| | - Qiang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin, China
- *Correspondence: Qiang Zhang, ; Zhong-Ze Fang,
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Nitric-oxide precursors and dimethylarginines as risk markers for accelerated measured GFR decline in the general population. Kidney Int Rep 2023; 8:818-826. [PMID: 37069987 PMCID: PMC10105054 DOI: 10.1016/j.ekir.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/02/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023] Open
Abstract
Introduction Nitric oxide (NO) deficiency is associated with endothelial dysfunction, hypertension, atherosclerosis, and chronic kidney disease (CKD). Reduced NO bioavailability is hypothesized to play a vital role in kidney function impairment and CKD. We investigated the association of serum levels of endogenous inhibitors of NO, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), and precursors of NO, arginine, citrulline, and ornithine, with a decline in glomerular filtration rate (GFR) and new-onset CKD. Methods In a prospective cohort study of 1407 healthy, middle-aged participants of Northern European origin in the Renal Iohexol Clearance Survey (RENIS), GFR was measured repeatedly with iohexol clearance during a median follow-up time of 11 years. GFR decline rates were analyzed using a linear mixed model, new-onset CKD (GFR < 60 ml/min per 1.73 m2) was analyzed with interval-censored Cox regression, and accelerated GFR decline (the 10% with the steepest GFR decline) was analyzed with logistic regression. Results Higher SDMA was associated with slower annual GFR decline. Higher levels of citrulline and ornithine were associated with accelerated GFR decline (odds ratio [OR], 1.43; 95% confidence interval [CI] 1.16-1.76 per SD higher citrulline and OR 1.23; 95% CI 1.01 to 1.49 per SD higher ornithine). Higher citrulline was associated with new-onset CKD, with a hazard ratio of 1.33 (95% CI 1.07-1.66) per SD higher citrulline. Conclusions Associations between NO precursors and the outcomes suggest that NO metabolism plays a significant role in the pathogenesis of age-related GFR decline and the development of CKD in middle-aged people.
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Thompson LE, Joy MS. Endogenous markers of kidney function and renal drug clearance processes of filtration, secretion, and reabsorption. CURRENT OPINION IN TOXICOLOGY 2022; 31:100344. [PMID: 36777447 PMCID: PMC9910221 DOI: 10.1016/j.cotox.2022.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The kidneys are responsible for maintaining physiologic homeostasis. The kidneys clear a variety of drugs and other substances through passive (filtration) and active processes that utilize transport proteins. Renal clearance is comprised of the processes of glomerular filtration, tubular secretion, and tubular reabsorption. Endogenous biomarkers, such as creatinine and cystatin C, are routinely used to estimate renal clearance. Understanding the contributing components of renal function and clearance, through the use of biomarkers, is necessary in elucidating the renal pharmacology of drugs and other substances. While exogenous markers of kidney function have been known for decades, several complexities have limited their usage. Several endogenous markers are being evaluated and hold promise to elucidate the individual components of kidney function that represent filtration, secretion, and reabsorption.
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Affiliation(s)
- Lauren E. Thompson
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Melanie S. Joy
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA,Division of Renal Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Symmetric Dimethylarginine is a Promising Biomarker for the Early Detection of Age-Related Kidney Dysfunction in Zoo Felids. ACTA VET-BEOGRAD 2022. [DOI: 10.2478/acve-2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Chronic renal failure is one of the leading causes of death in African lions, cheetahs, and tigers. Conventional methods to measure renal dysfunction include measuring serum creatinine and blood urea nitrogen (BUN). Symmetric dimethylarginine (SDMA) measurement is a reliable predictor of renal dysfunction in the domestic cat because SDMA serum levels increase early when the kidneys are damaged. Serum SDMA levels were assessed and correlated with creatinine as well as BUN from healthy captive Bengal tigers and lions at the Everland Zoo in Korea. Serum SDMA concentrations were increasingly associated with increased age in lions. However, SDMA concentrations were higher in some young Bengal tigers than in older ones, which may allow for earlier renal dysfunction detection in these young cats than would be BUN and creatinine alone. In Bengal tigers, the correlation between the SDMA and BUN was slightly higher than that between SDMA and creatinine. In lions, SDMA correlated better with creatinine than with BUN concentration. These results show that serum SDMA concentration can be used as a biomarker for age-associated renal dysfunction. SDMA measurement may be an essential preventive management method in zoos.
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Yu L, Lacorcia L, Johnstone T. Hyperthyroid cats and their kidneys: a literature review. Aust Vet J 2022; 100:415-432. [PMID: 35711100 PMCID: PMC9543258 DOI: 10.1111/avj.13179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 11/28/2022]
Abstract
Hyperthyroidism and chronic kidney disease (CKD) are common diseases of geriatric cats, and often occur concurrently. Thus, a thorough understanding of the influence of thyroid function on renal function is of significant value for all feline practitioners. Among other effects, hyperthyroidism causes protein catabolism and increases renal blood flow and glomerular filtration rate (GFR). These effects render traditional renal markers insensitive for the detection of CKD in cats with uncontrolled hyperthyroidism. Furthermore, the development of iatrogenic hypothyroidism with over treatment of hyperthyroidism can be detrimental to renal function and may negatively affect long-term survival. This review discusses important diagnostic considerations of feline hyperthyroidism, as well as key treatment modalities, with an emphasis on the use of radioiodine and the importance of post treatment monitoring of thyroid and renal parameters. In Australia, a common curative treatment for cats with benign hyperthyroidism (i.e. thyroid hyperplasia or adenoma) is a fixed dose of orally administered radioiodine, regardless of the serum total thyroxine concentration at the time of diagnosis. This review discusses the long term outcomes of this standard of care in comparison with current, relevant research literature from around the world. Finally, this review explores the use of symmetric dimethylarginine (SDMA) in assessing renal function before and after treatment in hyperthyroid cats. SDMA correlates well with GFR and creatinine in non-hyperthyroid cats, but our understanding of its performance in hyperthyroid cats remains in its infancy.
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Affiliation(s)
- L Yu
- Veterinary Referral HospitalDandenongVictoriaAustralia
| | - L Lacorcia
- Veterinary Referral HospitalDandenongVictoriaAustralia
| | - T Johnstone
- Animal Referral Hospital, Essendon Fields72 Hargrave AvenueEssendon FieldsVictoria3041Australia
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Grelová S, Karasová M, Tóthová C, Kisková T, Baranová D, Lukáč B, Fialkovičová M, Micháľová A, Kunay L, Svoboda M. Relationship between FGF 23, SDMA, Urea, Creatinine and Phosphate in Relation to Feline Chronic Kidney Disease. Animals (Basel) 2022; 12:2247. [PMID: 36077967 PMCID: PMC9454452 DOI: 10.3390/ani12172247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic kidney disease (CKD) is a common diagnosis in older cats, and its prevalence increases with age. Conventional indirect biomarkers of glomerular filtration rate (GFR) have their limitations, and are not efficient in detecting early decreases in glomerular filtration rate. Recently, symmetric dimethylarginine (SDMA) concentrations have been proposed as a novel biomarker of GFR for the early detection of CKD. This study discusses the relationship between SDMA, FGF 23 and previously used indicators of kidney function, mainly creatinine, urea and phosphate. Ninety-nine cats were included in this study. Based on their SDMA values, 48 cats had CKD and the remaining 51 cats were used as a healthy control group. Serum of these cats was assayed for creatinine, urea and phosphate concentrations as well as FGF 23 values, and correlations between them were evaluated. Cats with CKD had higher FGF 23 concentrations than healthy cats, and no correlation was found between FGF 23 and SDMA, nor between FGF 23 and phosphate. On the other hand, phosphate strongly correlated with SDMA, urea and creatinine, making it a possible independent factor of CKD progression.
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Affiliation(s)
- Simona Grelová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Martina Karasová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Csilla Tóthová
- Clinic of Ruminants, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Terézia Kisková
- Faculty of Science, University of Pavol Jozef Šafárik, 04154 Košice, Slovakia
| | - Darina Baranová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Branislav Lukáč
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Mária Fialkovičová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Alena Micháľová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Lukáš Kunay
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Miroslav Svoboda
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
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13
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Singh J, Lee Y, Kellum JA. A new perspective on NO pathway in sepsis and ADMA lowering as a potential therapeutic approach. Crit Care 2022; 26:246. [PMID: 35962414 PMCID: PMC9373887 DOI: 10.1186/s13054-022-04075-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Abstract
The nitric oxide pathway plays a critical role in vascular homeostasis. Increased levels of systemic nitric oxide (NO) are observed in preclinical models of sepsis and endotoxemia. This has led to the postulation that vasodilation by inducible nitric oxide synthase (iNOS) generated NO may be a mechanism of hypotension in sepsis. However, contrary to the expected pharmacological action of a nitric oxide synthase (NOS) inhibitor, clinical studies with L-NAME produced adverse cardiac and pulmonary events, and higher mortality in sepsis patients. Thus, the potential adverse effects of NO in human sepsis and shock have not been fully established. In recent years, the emerging new understanding of the NO pathway has shown that an endogenously produced inhibitor of NOS, asymmetric dimethylarginine (ADMA), a host response to infection, may play an important role in the pathophysiology of sepsis as well as organ damage during ischemia–reperfusion. ADMA induces microvascular dysfunction, proinflammatory and prothrombotic state in endothelium, release of inflammatory cytokines, oxidative stress and mitochondrial dysfunction. High levels of ADMA exist in sepsis patients, which may produce adverse effects like those observed with L-NAME. Several studies have demonstrated the association of plasma ADMA levels with mortality in sepsis patients. Preclinical studies in sepsis and ischemia–reperfusion animal models have shown that lowering of ADMA reduced organ damage and improved survival. The clinical finding with L-NAME and the preclinical research on ADMA “bed to bench” suggest that ADMA lowering could be a potential therapeutic approach to attenuate progressive organ damage and mortality in sepsis. Testing of this approach is now feasible by using the pharmacological molecules that specifically lower ADMA.
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14
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Nitric Oxide Synthesis Metabolites-As Potential Markers in Chronic Kidney Disease in Children. Curr Issues Mol Biol 2022; 44:3518-3532. [PMID: 36005138 PMCID: PMC9406431 DOI: 10.3390/cimb44080242] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Nitric oxide (NO) is an important signaling molecule for many physiological and pathological processes. Diseases associated with abnormal NO synthesis include cardiovascular diseases, insulin-dependent diabetes, or chronic kidney disease (CKD). The aim of the paper was to evaluate NO synthesis metabolites, i.e., asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), dimethylamine (DMA), arginine, citrulline in plasma of patients with different severity of CKD and to seek possible links between these parameters and the development of this disease. Forty-eight CKD children and thirty-three age-matched controls were examined. Patients were divided into groups depending on the CKD stages (Group II-stage II, Group III-stage III, Group IV-stage IV, and Group RRT children on dialysis). To determine the concentrations of the above-mentioned metabolites in plasma liquid chromatography-mass spectrometry was used. There were significant differences observed in levels of ADMA, SDMA, DMA, and citrulline between control vis CKD groups (p values ranging from <0.001 to 0.029). Plasma arginine concentration was also higher in CKD patients compared to the control group but statistically insignificant. ADMA levels in CKD children were statistically significantly higher in relation to particular stages of CKD (RRT vis II stage of CKD: p = 0.01; RRT vis III-IV stages of CKD: p < 0.046). Citrulline levels in CKD children were statistically significantly higher in RRT group vis control (p < 0.001). Children with CKD develop disturbances in most metabolites of NO synthesis. Dialysis children treated show the greatest disturbances of plasma ADMA and citrulline levels. ADMA seems to be a good indicator of the gradual progression of the CKD, which is proved by the negative correlation with eGFR.
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15
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Schwedhelm E, Tiedt S, Lezius S, Wölfer TA, Jensen M, Schulz R, Böger R, Gerloff C, Thomalla G, Choe CU. Effective high-density lipoprotein cholesterol is associated with carotid intima-media thickness and vascular events after acute ischemic stroke. Atherosclerosis 2022; 357:9-13. [DOI: 10.1016/j.atherosclerosis.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/08/2022] [Accepted: 08/02/2022] [Indexed: 11/28/2022]
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16
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Ateya AM, El Hakim I, Shahin SM, El Borolossy R, Kreutz R, Sabri NA. Effects of Ramipril on Biomarkers of Endothelial Dysfunction and Inflammation in Hypertensive Children on Maintenance Hemodialysis: the SEARCH Randomized Placebo-Controlled Trial. Hypertension 2022; 79:1856-1865. [PMID: 35686561 DOI: 10.1161/hypertensionaha.122.19312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hypertension, endothelial dysfunction, and inflammation are associated with increased cardiovascular mortality in end-stage kidney disease. We evaluated the effects of ACE (angiotensin-converting enzyme) inhibition on biomarkers of endothelial dysfunction and inflammation in hypertensive children with end-stage kidney disease on maintenance hemodialysis. METHODS In a randomized, double-blind, placebo-controlled trial, 135 (72 males/63 females) children and adolescents (age 7-15 years) were randomly assigned to treatment with either 2.5 mg once daily ramipril (n=68) or placebo (n=67) for 16 weeks. Primary outcome were the serum concentrations of asymmetrical dimethylarginine, a marker of endothelial dysfunction and hs-CRP (high-sensitivity C-reactive protein), a marker of inflammation. Changes in IL-6 (interleukin-6), TNF-α (tumor necrosis factor-alpha), systolic (S), and diastolic (D) blood pressure were secondary outcomes. Change in potassium levels and incidence of hyperkalemia were among the safety parameters. RESULTS Ramipril, but not placebo, significantly reduced serum levels of asymmetrical dimethylarginine (-79.6%; P<0.001), hs-CRP (-46.5%; P<0.001), IL-6 (-27.1%; P<0.001), and TNF-α (-51.7%; P<0.001). Systolic blood pressure and diastolic blood pressure were significantly lowered in both groups with a greater reduction in children receiving ramipril (median between-group differences -12.0 [95% CI -18.0 to -9.5] and -9.0 [95% CI -12.0 to -4.5]; P<0.001, respectively). Changes in asymmetrical dimethylarginine, hs-CRP, IL-6, or TNF-α in the ramipril group did not significantly correlate with blood pressure reductions. No severe cases of hyperkalemia or other serious treatment-associated adverse events were observed. CONCLUSIONS Ramipril improves biomarkers of endothelial dysfunction and inflammation in hypertensive children on maintenance hemodialysis in addition to its efficacious and safe potential to lower blood pressure. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT04582097.
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Affiliation(s)
- Areej Mohamed Ateya
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt (A.M.A., S.M.S., R.E.B., N.A.S.).,Charité - Universitätsmedizin Berlin, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany (A.M.A., R.K.)
| | - Ihab El Hakim
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt (I.E.H.)
| | - Sara Mahmoud Shahin
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt (A.M.A., S.M.S., R.E.B., N.A.S.)
| | - Radwa El Borolossy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt (A.M.A., S.M.S., R.E.B., N.A.S.)
| | - Reinhold Kreutz
- Charité - Universitätsmedizin Berlin, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany (A.M.A., R.K.)
| | - Nagwa Ali Sabri
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt (A.M.A., S.M.S., R.E.B., N.A.S.)
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Lundberg JO, Weitzberg E. Nitric oxide signaling in health and disease. Cell 2022; 185:2853-2878. [DOI: 10.1016/j.cell.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 10/16/2022]
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18
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Chen KH, Chou LF, Hung CC, Tang HY, Cheng ML, Yang HY, Hsu HH, Tian YC, Yang CW. Integrated Metabolomic and Transcriptomic Analysis of Acute Kidney Injury Caused by Leptospira Infection. Pathogens 2022; 11:pathogens11070764. [PMID: 35890009 PMCID: PMC9316537 DOI: 10.3390/pathogens11070764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/06/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022] Open
Abstract
Renal leptospirosis caused by leptospiral infection is characterised by tubulointerstitial nephritis and tubular dysfunction, resulting in acute and chronic kidney injury. Metabolomic and transcriptomic data from a murine model of Leptospira infection were analysed to determine whether metabolomic data from urine were associated with transcriptome changes relevant to kidney injury caused by Leptospira infection. Our findings revealed that 37 metabolites from the urine of L. interrogans-infected mice had significantly different concentrations than L. biflexa-infected and non-infected control mice. Of these, urinary L-carnitine and acetyl-L-carnitine levels were remarkably elevated in L. interrogans-infected mice. Using an integrated pathway analysis, we found that L-carnitine and acetyl-L-carnitine were involved in metabolic pathways such as fatty acid activation, the mitochondrial L-carnitine shuttle pathway, and triacylglycerol biosynthesis that were enriched in the renal tissues of the L. interrogans-infected mice. This study highlights that L-carnitine and acetyl-L-carnitine are implicated in leptospiral infection-induced kidney injury, suggesting their potential as metabolic modulators.
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Affiliation(s)
- Kuan-Hsing Chen
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
- Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan; (H.-Y.T.); (M.-L.C.)
- Metabolomics Core Laboratory, Chang Gung University, Taoyuan 333, Taiwan
| | - Li-Fang Chou
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Cheng-Chieh Hung
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Hsiang-Yu Tang
- Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan; (H.-Y.T.); (M.-L.C.)
- Metabolomics Core Laboratory, Chang Gung University, Taoyuan 333, Taiwan
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Clinical Phenome Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Mei-Ling Cheng
- Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan; (H.-Y.T.); (M.-L.C.)
- Metabolomics Core Laboratory, Chang Gung University, Taoyuan 333, Taiwan
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Clinical Phenome Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Huang-Yu Yang
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Hsiang-Hao Hsu
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Ya-Chung Tian
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
| | - Chih-Wei Yang
- Kidney Research Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-H.C.); (L.-F.C.); (C.-C.H.); (H.-Y.Y.); (H.-H.H.); (Y.-C.T.)
- Correspondence:
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19
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Yuan X, Cai L, Hu F, Xie L, Chen X, Wu J, Li Q. Evaluation of the predictive values of elevated serum L-homoarginine and dimethylarginines in preeclampsia. Amino Acids 2022; 54:1215-1227. [PMID: 35752997 PMCID: PMC9365731 DOI: 10.1007/s00726-022-03177-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/28/2022] [Indexed: 01/14/2023]
Abstract
L-homoarginine (hARG) is involved in nitric oxide biosynthesis, but its role and concentration in preeclampsia (PE) have not been fully revealed. The purpose of this study was to develop and validate a feasible clinical assay to quantify serum hARG, arginine (ARG), asymmetric (ADMA) and symmetric dimethylarginines (SDMA) levels by LC-MS/MS and investigate their differences at different stages of pregnancy with or without preeclampsia. Serum samples were collected from 84 pregnant women without complications (controls), 84 with mild preeclampsia (MPE), and 81 with severe preeclampsia (SPE) at various gestation stages (before the 20th week, during the 20th-28th week or after the 28th week of gestation). No significant difference in ARG levels was observed between PE and controls at any stage (P > 0.05). The serum hARG levels and hARG/ADMA ratios of MPE before the 20th week were higher than those of controls (P < 0.001). ADMA levels of MPE were higher than those of controls during the 20th-28th week (P < 0.01). SDMA levels of SPE were higher than those of MPE (P < 0.01) and controls (P < 0.05) after the 28th week. Elevated serum hARG before the 20th week was identified as an independent predictor for PE (OR = 1.478, 95% CI 1.120-1.950). ROC curve analysis showed serum hARG before the 20th week had a good potential to predict MPE (AUC = 0.875, 95% CI 0.759-0.948). In conclusion, our study indicated that elevated serum hARG and dimethylarginine levels detected by LC-MS/MS might serve as potential biomarkers for the early prediction of PE.
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Affiliation(s)
- Xiangmei Yuan
- Department of Laboratory Medicine, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Leiming Cai
- Department of Laboratory Medicine, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Fengmei Hu
- Shanghai AB Sciex Analytical Instrument Trading Co., Ltd., Shanghai, 200050, China
| | - Li Xie
- Department of Laboratory Medicine, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Xiong Chen
- Department of Gynecology and Obstetrics, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Jingjing Wu
- Department of Gynecology and Obstetrics, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Qian Li
- Department of Laboratory Medicine, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China.
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20
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Coyne MJ, Drake C, McCrann DJ, Kincaid D. The association between symmetric dimethylarginine concentrations and various neoplasms in dogs and cats. Vet Comp Oncol 2022; 20:846-853. [PMID: 35718995 DOI: 10.1111/vco.12845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Abstract
Following the introduction of the symmetric dimethylarginine (SDMA) immunoassay, cases were reported where the SDMA concentration was markedly increased above the reference interval (RI) with neither concurrent increases in serum creatinine (Cr) concentrations nor clinical signs of kidney disease. Many of these animals were also concurrently diagnosed with cancer, most commonly lymphoma. The purpose of the study was to evaluate the association of increased SDMA in dogs and cats with lymphoma and other cancers as compared with age- and breed-matched non-tumour controls. In this retrospective case-control study, serum chemistry results from 1804 tumour cases, and age- and breed-matched non-tumour control animals were used. Matched-pair odds ratios between animals diagnosed with neoplasms and non-tumour controls for dichotomized SDMA values were determined by tumour type. SDMA concentrations were significantly higher in dogs and cats with lymphoma (p < .0001) compared with non-tumour controls. The odds ratio for increased SDMA concentrations in dogs with lymphoma was 10.0 (95% CI, 5.98-16.72) and for cats with lymphoma was 3.04 (95% CI 1.95-4.73). A significant number of canine and feline lymphoma cases had an increased SDMA concentration not associated with an increased Cr concentration (p < .001). Canine and feline lymphoma patients have an increased odds of having a SDMA concentration above the RI at diagnosis. Further characterization and evaluation of dogs and cats with lymphoma is required to help understand the mechanism(s) and the clinical significance of these alterations.
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Affiliation(s)
- Michael J Coyne
- IDEXX Laboratories, Inc., One IDEXX Drive, Westbrook, Maine, USA
| | - Corie Drake
- IDEXX Laboratories, Inc., One IDEXX Drive, Westbrook, Maine, USA
| | - Donald J McCrann
- IDEXX Laboratories, Inc., One IDEXX Drive, Westbrook, Maine, USA
| | - David Kincaid
- IDEXX Laboratories, Inc., One IDEXX Drive, Westbrook, Maine, USA
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21
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Overexpression of alanine-glyoxylate aminotransferase 2 protects from asymmetric dimethylarginine-induced endothelial dysfunction and aortic remodeling. Sci Rep 2022; 12:9381. [PMID: 35672381 PMCID: PMC9174227 DOI: 10.1038/s41598-022-13169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/20/2022] [Indexed: 12/03/2022] Open
Abstract
Elevated plasma concentrations of asymmetric dimethylarginine (ADMA) are associated with an increased risk of mortality and adverse cardiovascular outcomes. ADMA can be metabolized by dimethylarginine dimethylaminohydrolases (DDAHs) and by alanine-glyoxylate aminotransferase 2 (AGXT2). Deletion of DDAH1 in mice leads to elevation of ADMA in plasma and increase in blood pressure, while overexpression of human DDAH1 is associated with a lower plasma ADMA concentration and protective cardiovascular effects. The possible role of alternative metabolism of ADMA by AGXT2 remains to be elucidated. The goal of the current study was to test the hypothesis that transgenic overexpression of AGXT2 leads to lowering of plasma levels of ADMA and protection from vascular damage in the setting of DDAH1 deficiency. We generated transgenic mice (TG) with ubiquitous overexpression of AGXT2. qPCR and Western Blot confirmed the expression of the transgene. Systemic ADMA levels were decreased by 15% in TG mice. In comparison with wild type animals plasma levels of asymmetric dimethylguanidino valeric acid (ADGV), the AGXT2 associated metabolite of ADMA, were six times higher. We crossed AGXT2 TG mice with DDAH1 knockout mice and observed that upregulation of AGXT2 lowers plasma ADMA and pulse pressure and protects the mice from endothelial dysfunction and adverse aortic remodeling. Upregulation of AGXT2 led to lowering of ADMA levels and protection from ADMA-induced vascular damage in the setting of DDAH1 deficiency. This is especially important, because all the efforts to develop pharmacological ADMA-lowering interventions by means of upregulation of DDAHs have been unsuccessful.
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22
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Maassen H, Said MY, Frenay ARS, Koning A, Post A, Riphagen IJ, Heiner-Fokkema MR, Drabert K, Fernandez BO, Gans ROB, van den Berg E, Navis G, Tsikas D, Feelisch M, Bakker SJL, van Goor H. Nitric oxide and long-term outcomes after kidney transplantation: Results of the TransplantLines cohort study. Nitric Oxide 2022; 125-126:1-11. [PMID: 35660109 DOI: 10.1016/j.niox.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/22/2022] [Accepted: 05/31/2022] [Indexed: 11/12/2022]
Abstract
Impaired endogenous nitric oxide (NO) production may contribute to graft failure and premature mortality in kidney transplant recipients (KTR). We investigated potential associations of 24-h urinary NOx (NO3- + NO2-) excretion (uNOx) with long-term outcomes. uNOx was determined by HPLC and GC-MS in 698 KTR and in 132 kidney donors before and after donation. Additionally, we measured urinary nitroso species (RXNO) by gas-phase chemiluminescence. Median uNOx was lower in KTR compared to kidney donors (688 [393-1076] vs. 1301 [868-1863] before donation and 1312 [982-1853] μmol/24h after donation, P < 0.001). During median follow-up of 5.4 [4.8-6.1] years, 150 KTR died (61 due to cardiovascular disease) and 83 experienced graft failure. uNOx was inversely associated with all-cause mortality (HR per doubling of uNOx: 0.84 [95% CI 0.75-0.93], P < 0.001) and cardiovascular mortality (HR 0.78 [95% CI 0.67-0.92], P = 0.002). The association of uNOx with graft failure was lost when adjusted for renal function (HR per doubling of uNOx: 0.89 [95% CI 0.76-1.05], P = 0.17). There were no significant associations of urinary RXNO with outcomes. Our study suggests that KTR have lower NO production than healthy subjects and that lower uNOx is associated with a higher risk of all-cause and cardiovascular mortality.
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Affiliation(s)
- Hanno Maassen
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, the Netherlands
| | - M Yusof Said
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Anne-Roos S Frenay
- Department of Gynecology and Obstetrics, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
| | - Anne Koning
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Adrian Post
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Ineke J Riphagen
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - M Rebecca Heiner-Fokkema
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Kathrin Drabert
- Institute of Toxicology, Core Unit Proteomics, Hannover Medical School, Hannover, Germany
| | - Bernadette O Fernandez
- Clinical & Experimental Sciences, Faculty of Medicine and NIHR Southampton Biomedical Research Centre, Southampton General Hospital, United Kingdom
| | - Reinold O B Gans
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Else van den Berg
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Gerjan Navis
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Dimitrios Tsikas
- Institute of Toxicology, Core Unit Proteomics, Hannover Medical School, Hannover, Germany
| | - Martin Feelisch
- Clinical & Experimental Sciences, Faculty of Medicine and NIHR Southampton Biomedical Research Centre, Southampton General Hospital, United Kingdom
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Harry van Goor
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, the Netherlands.
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Bonnitcha P, Sullivan D, Fitzpatrick M, Ireland A, Nguyen VL, Koay YC, O'Sullivan J. Design and validation of an LC-MS/MS method for simultaneous quantification of asymmetric dimethylguanidino valeric acid, asymmetric dimethylarginine and symmetric dimethylarginine in human plasma. Pathology 2022; 54:591-598. [DOI: 10.1016/j.pathol.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/11/2022] [Accepted: 01/20/2022] [Indexed: 10/18/2022]
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Lee Y, Singh J, Scott SR, Ellis B, Zorlutuna P, Wang M. A Recombinant Dimethylarginine Dimethylaminohydrolase-1-Based Biotherapeutics to Pharmacologically Lower Asymmetric Dimethyl Arginine, thus Improving Postischemic Cardiac Function and Cardiomyocyte Mitochondrial Activity. Mol Pharmacol 2022; 101:226-235. [PMID: 35042831 PMCID: PMC11033929 DOI: 10.1124/molpharm.121.000394] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/16/2022] [Indexed: 11/22/2022] Open
Abstract
High serum levels of asymmetric dimethyl arginine (ADMA) are associated with cardiovascular disease and mortality. Pharmacological agents to specifically lower ADMA and their potential impact on cardiovascular complications are not known. In this study, we aimed to investigate the effect of specific lowering of ADMA on myocardial response to ischemia-reperfusion injury (I/R) and direct effects on cardiomyocyte function. Effects of recombinant dimethylarginine dimethylaminohydrolase (rDDAH)-1 on I/R injury were determined using isolated mouse heart preparation. Respiration capacity and mitochondrial reactive oxygen species (ROS) generation were determined on mouse cardiomyocytes. Our results show that lowering ADMA by rDDAH-1 treatment resulted in improved recovery of cardiac function and reduction in myocardial infarct size in mouse heart response to I/R injury (control 22.24 ±4.60% versus rDDAH-1 15.90 ±4.23%, P < 0.01). In mouse cardiomyocytes, rDDAH-1 treatment improved ADMA-induced dysregulation of respiration capacity and decreased mitochondrial ROS. Furthermore, in human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes with impaired contractility under hypoxia and high ADMA, rDDAH-1 treatment improved recovery and beating frequency (P < 0.05). rDDAH-1 treatment selectively modified I/R-induced myocardial cytokine expression, resulting in reduction in proinflammatory cytokine IL-17A (P < 0.001) and increased expression of anti-inflammatory cytokines IL-10 and IL-13 (P < 0.01). Further in vitro studies showed that IL-17A was the predominant and common cytokine modulated by ADMA-DDAH pathway in heart, cardiomyocytes, and endothelial cells. These studies show that lowering ADMA by pharmacological treatment with rDDAH-1 reduced I/R injury, improved cardiac function, and ameliorated cardiomyocyte bioenergetics and beating activity. These effects may be attributable to ADMA lowering in cardiomyocytes and preservation of cardiomyocyte mitochondrial function. SIGNIFICANCE STATEMENT: The pathological role of asymmetric dimethyl arginine (ADMA) has been demonstrated by its association with cardiovascular disease and mortality. Currently, pharmacological drugs to specifically lower ADMA are not available. The present study provides the first evidence that lowering of ADMA by recombinant recombinant dimethylarginine dimethylaminohydrolase (rDDAH)-1 improved postischemic cardiac function and cardiomyocyte bioenergetics and beating activity. Our studies suggest that lowering of ADMA by pharmacologic treatment offers opportunity to develop new therapies for the treatment of cardiovascular and renal disease.
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Affiliation(s)
- Young Lee
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (J.S.); Department of Surgery, Indiana University, School of Medicine, Indianapolis, Indiana (S.R.S., M.W.); Bioengineering Graduate Program (B.E., P.Z.) and Aerospace and Mechanical Engineering Department (P.Z.), University of Notre Dame, Notre Dame, Indiana; and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Jaipal Singh
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (J.S.); Department of Surgery, Indiana University, School of Medicine, Indianapolis, Indiana (S.R.S., M.W.); Bioengineering Graduate Program (B.E., P.Z.) and Aerospace and Mechanical Engineering Department (P.Z.), University of Notre Dame, Notre Dame, Indiana; and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Susan R Scott
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (J.S.); Department of Surgery, Indiana University, School of Medicine, Indianapolis, Indiana (S.R.S., M.W.); Bioengineering Graduate Program (B.E., P.Z.) and Aerospace and Mechanical Engineering Department (P.Z.), University of Notre Dame, Notre Dame, Indiana; and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Bradley Ellis
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (J.S.); Department of Surgery, Indiana University, School of Medicine, Indianapolis, Indiana (S.R.S., M.W.); Bioengineering Graduate Program (B.E., P.Z.) and Aerospace and Mechanical Engineering Department (P.Z.), University of Notre Dame, Notre Dame, Indiana; and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Pinar Zorlutuna
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (J.S.); Department of Surgery, Indiana University, School of Medicine, Indianapolis, Indiana (S.R.S., M.W.); Bioengineering Graduate Program (B.E., P.Z.) and Aerospace and Mechanical Engineering Department (P.Z.), University of Notre Dame, Notre Dame, Indiana; and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Meijing Wang
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (J.S.); Department of Surgery, Indiana University, School of Medicine, Indianapolis, Indiana (S.R.S., M.W.); Bioengineering Graduate Program (B.E., P.Z.) and Aerospace and Mechanical Engineering Department (P.Z.), University of Notre Dame, Notre Dame, Indiana; and Vasculonics LLC, Indianapolis, Indiana (J.S.)
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Michael H, Szlosek D, Clements C, Mack R. Symmetrical Dimethylarginine: Evaluating Chronic Kidney Disease in the Era of Multiple Kidney Biomarkers. Vet Clin North Am Small Anim Pract 2022; 52:609-629. [DOI: 10.1016/j.cvsm.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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METHOD COMPARISON FOR MEASUREMENT OF SYMMETRIC DIMETHYLARGININE IN TIGERS (PANTHERA TIGRIS). J Zoo Wildl Med 2022; 53:200-203. [DOI: 10.1638/2021-0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2021] [Indexed: 11/21/2022] Open
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Lee Y, Steinbach SML, Basile D, Singh J. A Therapeutic Extracorporeal Device for Specific Removal of Pathologic Asymmetric Dimethylarginine from the Blood. Blood Purif 2022; 51:889-898. [PMID: 35249015 PMCID: PMC9440949 DOI: 10.1159/000522294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/25/2022] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Blood levels of uremic toxin, asymmetric dimethylarginine (ADMA), are strongly associated with mortality in sepsis, renal failure, and cardiovascular and renal disease patients. METHODS An extracorporeal approach to reduce pathological ADMA was developed. The dimethylarginine dimethylaminohydrolase (DDAH) was immobilized on agarose beads to prepare a cartridge. The efficacy of cartridge for ADMA lowering in blood was investigated. RESULTS The DDAH beads and cartridge reduced ADMA from solution or plasma. The magnitude of ADMA removal was dependent on the quantity of DDAH linked to the beads and the flow rate. When tested in association with plasmapheresis, the DDAH-cartridge was highly effective in ADMA removal from the blood and improved the arginine/ADMA ratio in a pig model. CONCLUSION A new, safe, and effective extracorporeal approach to lower ADMA was developed which may have application in improving outcomes in patients with vascular complications and risk of mortality associated with high ADMA.
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Affiliation(s)
- Young Lee
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana, USA,
| | - Sarah ML Steinbach
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, USA
| | - David Basile
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jaipal Singh
- Indiana Center for Biomedical Innovation, Indianapolis, IN, USA,Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA,Vasculonics Inc, Indianapolis, IN, USA
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Endothelial Dysfunction and 6-Year Risk of Mortality in Kidney Transplant Recipients. Transplant Direct 2021; 8:e1262. [PMID: 34912949 PMCID: PMC8670577 DOI: 10.1097/txd.0000000000001262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/04/2021] [Accepted: 10/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background Endothelial dysfunction is an early and potentially reversible stage in the atherosclerotic process. We assessed endothelial dysfunction noninvasively in kidney transplant recipients (KTRs) and evaluated the association with mortality and graft outcomes. Methods Flow-mediated dilation (FMD) was measured in arteria brachialis by ultrasound, with baseline diameters obtained at rest and maximal diameters obtained during reactive hyperemia occurring after 5 min of forearm occlusion. FMD% is the percentage difference of flow-mediated dilation relative to baseline. Endpoints on mortality and graft outcomes were collected from The Norwegian Renal Registry. The distribution of risk according to FMD levels was assessed in Cox regression using a restricted cubic spline function. FMD was dichotomized using receiver operating characteristic analysis to identify optimal cut points at maximal sensitivity and specificity. Results From a total of 269 KTRs in 2012, 152 (56.5%) were eligible and examined 10 wk after transplantation, and 145 had successful FMD measurements. During a mean follow-up of 6.5 y, 26 patients died, 11 lost their graft, and 34 experienced either graft loss or death. Mortality increased with lower FMD levels until about 5% dilation and did not change with further reduction in FMD% (P for nonlinearity <0.01). An optimal cut point of FMD ≤5.36% defined impaired endothelial function and FMD% below this level, was associated with fatal outcome, hazard ratio (HR), 9.80 (1.29-74.62), P = 0.03, uncensored graft loss, HR, 7.80 (1.83-33.30), P = 0.01, but an association with death-censored graft loss was lost after adjusting for pulse pressure, HR, 4.58 (0.55-37.92), P = 0.16. Conclusions We found that impaired FMD is strongly associated with mortality in KTRs.
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Hamlin DM, Schultze AE, Coyne MJ, McCrann DJ, Mack R, Drake C, Murphy RE, Cross J, Strong-Townsend M, Yerramilli M, Leissinger MK. Evaluation of Renal Biomarkers, Including Symmetric Dimethylarginine, following Gentamicin-Induced Proximal Tubular Injury in the Rat. KIDNEY360 2021; 3:341-356. [PMID: 35373128 PMCID: PMC8967625 DOI: 10.34067/kid.0006542020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/03/2021] [Indexed: 01/10/2023]
Abstract
Symmetric dimethylarginine (SDMA) is an excretory renal function biomarker shown to correlate well with glomerular filtration rate in dogs, cats, humans, and rats. The objectives of this study were to determine utility of serum SDMA as a renal biomarker in a rat model of gentamicin-induced renal injury and to provide validation of a commercially available SDMA immunoassay for rat serum. Rats were randomly assigned to one of three dose levels of gentamicin (20, 50, or 100 mg/kg) or a vehicle control group and dosed once daily by subcutaneous injection for either four or ten days. Serum and urine renal biomarker evaluation, including serum SDMA, hematologic and serum biochemical analysis, urinalysis, and histologic examination of kidney, were performed. Before biologic validation, analytic validation of the SDMA immunoassay for rat serum was performed, including assessment of assay accuracy, precision, analytical sensitivity, linearity, analyte stability, and interference testing. Among markers of excretory renal function, SDMA and serum creatinine increased earliest and at the lowest gentamicin concentrations and were significantly increased in both the 50- and 100- mg/kg dose levels in the four- and ten-dose treatment groups compared with controls. Time- and dose-dependent increases were noted for all urinary biomarkers investigated in this study, with microalbumin being most responsive and osteopontin least responsive for detection of gentamicin-induced injury across dose levels and schedules investigated. The SDMA immunoassay met all set quality requirements assessed in analytical validation. This study is the first to investigate performance of serum SDMA compared with other excretory renal function markers in a rat gentamicin acute toxicity model. In this study, serum SDMA was an earlier biomarker for detection of gentamicin-induced toxicity than serum cystatin C, BUN, and creatinine clearance. The SDMA immunoassay provides a reliable commercially available assay for future renal investigations in rat models.
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Affiliation(s)
- Diane M. Hamlin
- Pathology Department, Toxicology Division, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana
| | - A. Eric Schultze
- Pathology Department, Toxicology Division, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana
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Marrouche NF, Dagher L, Wazni O, Akoum N, Mansour M, El Hajjar AH, Bhatnagar A, Hua H. Effect of DrOnedarone on atrial fibrosis progression and atrial fibrillation recurrence postablation: Design of the EDORA randomized clinical trial. J Cardiovasc Electrophysiol 2021; 32:3203-3210. [PMID: 34664772 PMCID: PMC9298087 DOI: 10.1111/jce.15274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/16/2021] [Accepted: 09/29/2021] [Indexed: 01/08/2023]
Abstract
Background Atrial fibrillation (AF) recurrence after catheter ablation is associated with worse outcomes and quality of life. Left atrial (LA) structural remodeling provides the essential substrate for AF perpetuation. Baseline extent and the progression of LA fibrosis after ablation are strong predictors of postprocedural AF recurrence. Dronedarone is an antiarrhythmic drug proven to efficiently maintain sinus rhythm. Objective We sought to investigate the effect of the antiarrhythmic drug Dronedarone in decreasing LA fibrosis progression and AF recurrence after ablation of AF patients. Methods EDORA (NCT04704050) is a multicenter, prospective, randomized controlled clinical trial. Patients with persistent or paroxysmal AF undergoing AF ablation will be randomized into Dronedarone versus placebo/standard of care. The co‐primary outcomes are the recurrence of atrial arrhythmias (AA) within 13 months of follow‐up after ablation and the progression of left atrial fibrosis postablation. All patients will receive a late‐gadolinium enhancement magnetic resonance imaging at baseline, 3‐ and 12‐month follow‐up for the quantification of LA fibrosis and ablation‐related scarring. AA recurrence and burden will be assessed using a 30‐day ECG patch every 3 months with daily ECG recordings in between. Quality of life improvement is assessed using the AFEQT and AFSS questionnaires. Conclusion EDORA will be the first trial to assess the progression of LA structural remodeling after ablation and its association with Dronedarone treatment and ablation success in a randomized controlled fashion. The trial will provide insight into the pathophysiology of AF recurrence after ablation and may provide potential therapeutic targets to optimize procedural outcomes.
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Affiliation(s)
- Nassir F Marrouche
- Department of Cardiology, Tulane University School of Medicine, New Orleans, Los Angeles, USA
| | - Lilas Dagher
- Department of Cardiology, Tulane University School of Medicine, New Orleans, Los Angeles, USA
| | - Oussama Wazni
- Department of Cardiac Electrophysiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Nazem Akoum
- Department of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
| | - Moussa Mansour
- Department of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Abdel Hadi El Hajjar
- Department of Cardiology, Tulane University School of Medicine, New Orleans, Los Angeles, USA
| | - Arezu Bhatnagar
- Department of Cardiology, Tulane University School of Medicine, New Orleans, Los Angeles, USA
| | - He Hua
- Department of Epidemiology, Tulane University School of Public Health, New Orleans, Los Angeles, USA
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Valente C, Guglielmini C, Baron Toaldo M, Romito G, Artusi C, Brugnolo L, Contiero B, Poser H. Plasmatic Dimethylarginines in Dogs With Myxomatous Mitral Valve Disease. Front Vet Sci 2021; 8:738898. [PMID: 34604374 PMCID: PMC8481685 DOI: 10.3389/fvets.2021.738898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
Plasmatic dimethylarginines, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) are considered biomarkers of endothelial and renal dysfunction, respectively, in humans. We hypothesize that plasmatic concentration of dimethylarginines in dogs with myxomatous mitral valve disease (MMVD) is influenced by heart disease stage. Eighty-five client-owned dogs with MMVD, including 39, 19, and 27 dogs in ACVIM stages B1, B2, and C+D, respectively, and a control group of 11 clinically healthy dogs were enrolled. A prospective, multicentric, case-control study was performed. Each dog underwent a complete clinical examination, arterial blood pressure measurement, thoracic radiography, six-lead standard electrocardiogram, transthoracic echocardiography, CBC, biochemical profile, and urinalysis. Plasmatic concentration of dimethylarginines was determined through high-performance liquid chromatography coupled with tandem mass spectrometry. Median ADMA was significantly increased in dogs of group C+D (2.5 μmol/L [2.1–3.0]) compared to those of group B1 (1.8 μmol/L [1.6–2.3]; p < 0.001) and healthy dogs (1.9 μmol/L [1.7–2.3]; p = 0.02). Median SDMA was significantly increased in dogs of group C+D (0.7 μmol/L [0.5–0.9]) compared to those of groups B1 (0.4 μmol/L [0.3–0.5]; p < 0.001), B2 (0.4 μmol/L [0.3–0.6]; p < 0.01), and the control group (0.4 μmol/L [0.35–0.45]; p = 0.001). In the final multivariable analysis, ADMA and SDMA were significantly associated with left atrium to aorta ratio (p < 0.001), and creatinine (p < 0.001), respectively. Increased plasmatic concentrations of dimethylarginines suggest a possible role as biomarkers of disease severity in dogs with decompensated MMVD.
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Affiliation(s)
- Carlotta Valente
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Carlo Guglielmini
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Marco Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Giovanni Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Carlo Artusi
- Department of Laboratory Medicine, University-Hospital of Padua, Padua, Italy
| | - Laura Brugnolo
- Department of Laboratory Medicine, University-Hospital of Padua, Padua, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Helen Poser
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
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COMPARISON OF BLOOD SYMMETRIC DIMETHYLARGININE AND CREATININE AS ENDOGENOUS MARKERS OF KIDNEY FUNCTION IN CAPTIVE TIGERS ( PANTHERA TIGRIS). J Zoo Wildl Med 2021; 52:628-637. [PMID: 34130406 DOI: 10.1638/2020-0032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 11/21/2022] Open
Abstract
Chronic kidney disease (CKD) is a common cause of morbidity and mortality in captive tigers (Panthera tigris). Blood creatinine (Cr) and blood urea nitrogen measurements are inexpensive and common biomarkers used to evaluate renal function. However, several limitations have been reported regarding their sensitivity and interindividual variability. Symmetric dimethylarginine (SDMA) has been suggested to be a more sensitive biomarker that is less affected by extrarenal factors and has a strong correlation with glomerular filtration rate and blood Cr in several species. This project aimed to identify the usefulness of SDMA as an endogenous marker of kidney function in captive tigers. The hypothesis of this study is that increased circulating SDMA is positively associated with increased blood Cr. SDMA and Cr were measured in 65 banked samples (serum and plasma) from 30 individual captive tigers. The samples were collected over a 38-y period and stored at -21°C. SDMA and Cr concentrations were determined using the commercially available SDMA test and enzymatic colorimetric methods, respectively. SDMA had a significant positive association with Cr (for every 1 unit increase of log SDMA, Cr increased by 82%, P = 0.0002). Age and subspecies influenced Cr but not SDMA concentrations. In one animal, blood SDMA increased above the ZIMS reported range. approximately 3.6 mo before Cr increased. SDMA is currently indicated for the diagnosis of CKD in domestic felids and seems also promising in nondomestic felids. Further prospective studies might improve the understanding of the performance of this biomarker.
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Lo HC, Winter JC, Merle R, Gehlen H. Symmetric dimethylarginine and renal function analysis in horses with dehydration. Equine Vet J 2021; 54:670-678. [PMID: 34110650 DOI: 10.1111/evj.13484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acute dehydration caused by a variety of diseases in horses can lead to acute kidney injury. However, current renal biomarkers usually indicate renal damage late in the course of the disease. A novel biomarker would be helpful to diagnose renal disease earlier. OBJECTIVES (1) To estimate the correlation of serum symmetric dimethylarginine (SDMA) concentrations with the degree of dehydration, traditional renal biomarkers and renal function analysis, and (2) to determine the value of SDMA as a prognostic and early biomarker of renal injury in horses. STUDY DESIGN Prospective cohort. METHODS Serum SDMA, creatinine and urea concentrations and renal function analysis were measured in 41 horses with dehydration at 4 time points until 48 h after admission. Horses were grouped according to their dehydration level into mildly, moderately and severely dehydrated groups. RESULTS Serum SDMA concentrations at admission correlated with creatinine concentrations (r = .412, P < .001). Differences in SDMA concentrations at admission were detected among dehydration levels but not between survivors and nonsurvivors. Significant correlations of SDMA concentrations with other markers of renal function analysis and short-term outcome were not observed. MAIN LIMITATIONS Besides the small sample size and low statistical power, missing urine samples at specific time points were also 1 of the main limitations. Only 1 of the horses developed acute kidney injury, which made the evaluation of the predictive value of SDMA difficult. CONCLUSIONS SDMA concentrations correlated significantly with creatinine concentrations in dehydrated horses. Further research is needed to reveal the application of SDMA in horse.
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Affiliation(s)
- Hsiao-Chien Lo
- Equine Clinic: Surgery and Radiology, Free University of Berlin, Berlin, Germany
| | - Judith C Winter
- Equine Clinic: Surgery and Radiology, Free University of Berlin, Berlin, Germany
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Free University of Berlin, Berlin, Germany
| | - Heidrun Gehlen
- Equine Clinic: Surgery and Radiology, Free University of Berlin, Berlin, Germany
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Wang M, Ke Y, Li Y, Shan Z, Mi W, Cao Y, Feng W, Zheng X. The nephroprotective effects and mechanisms of rehmapicrogenin include ROS inhibition via an oestrogen-like pathway both in vivo and in vitro. Biomed Pharmacother 2021; 138:111305. [PMID: 33820633 DOI: 10.1016/j.biopha.2021.111305] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 01/12/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The root of Rehmannia glutinosa (R. glutinosa) is commonly used in various traditional Chinese herbal formulae to ameliorate nephropathy; however, little is known about its active component(s) and mechanisms. AIM In the present study, we examined the protective effect and potential mechanism of rehmapicrogenin, a monomeric compound extracted from R. glutinosa, against Adriamycin (ADR)-induced nephropathy (AN) in vivo and in vitro. METHODS In this study, an ADR-induced kidney injury model was employed to investigate the nephroprotective effects of rehmapicrogenin in mice. In vivo, ELISA kits, flow cytometry, haematoxylin-eosin staining, immunofluorescence techniques, and western blotting were used to evaluate the effect of rehmapicrogenin on kidney injury in mice. In vitro, the effects of rehmapicrogenin on NRK-52E cellular damage induced by ADR were determined using the 3-(4,5-dimethylthiazolyl-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method. The mechanism was investigated using ELISA kits, flow cytometry and In-Cell Western™ blotting. RESULTS In vivo, rehmapicrogenin treatment significantly attenuated the pathological changes in the kidney induced by ADR; rescued weight, serum creatinine (Scr), blood urea nitrogen (BUN) and urine albumin (U-ALB) levels; reduced reactive oxygen species (ROS) accumulation; and decreased oxidative stress, the apoptosis rate, and cell survival in ADR-treated mice. Importantly, both in vivo and in vitro experimental results demonstrated that rehmapicrogenin regulates the Nrf2/ARE signalling pathway, the most important pathway for oxidative stress. Rehmapicrogenin attenuated ADR-induced kidney damage by reducing oxidative stress through the oestrogen receptor pathway. Moreover, after treatment with ICI 182780 (the oestrogen receptor-nonspecific antagonist Faslodex), the improvement induced by rehmapicrogenin was significantly reversed. CONCLUSIONS In conclusion, rehmapicrogenin attenuates kidney damage by reducing inflammatory factor release through the oestrogen signalling pathway.
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Affiliation(s)
- Mengmeng Wang
- Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Yingying Ke
- Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Yage Li
- Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Zengfu Shan
- Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Wangyang Mi
- Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Yangang Cao
- Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Weisheng Feng
- Henan University of Chinese Medicine, Zhengzhou 450046, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou 450046, China.
| | - Xiaoke Zheng
- Henan University of Chinese Medicine, Zhengzhou 450046, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou 450046, China.
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Pérez-López L, Boronat M, Melián C, Brito-Casillas Y, Wägner AM. Kidney function and glucose metabolism in overweight and obese cats. Vet Q 2021; 40:132-139. [PMID: 32315583 PMCID: PMC7241541 DOI: 10.1080/01652176.2020.1759844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: In people, obesity and prediabetes mellitus might predispose to chronic kidney disease (CKD).Aims: To assess the association of overweight [Body condition score (BCS) >5] and glucose metabolism alterations, with established or potential markers of CKD. In addition, fructosamine and fasted blood glucose were compared as predictors of early abnormal glucose metabolism.Methods: 54 clinically healthy cats were included in a cross-sectional study comprising 25 neutered males and 29 (28 neutered) females aged 7.2 (5.5-9.4) years. Two potential markers of CKD, namely urinary free active transforming growth factor-β1-creatinine ratio and urinary retinol binding protein-creatinine ratio were measured along with other parameters to assess CKD. A receiver operating curve was used to identify the best sensitivity and specificity of fructosamine to identify cats with fasting glucose >6.5 mmol/L.Results: No association was found between BCS and markers of CKD. Fructosamine was greater in cats with fasting glucose >6.5 mmol/L compared to those with fasting glucose ≤6.5 mmol/L. A fructosamine concentration ≥250 µmol/L was able to detect cats with hyperglycemia with a sensitivity of 77% and a specificity of 65%. Furthermore, fructosamine was more strongly correlated with fasting glucose than albumin-corrected fructosamine (r = 0.43, p = 0.002 vs r = 0.32, p = 0.026). Cats with higher fructosamine had lower serum symmetric dimethylarginine concentrations.Conclusion: The present study does not suggest an effect of obesity on renal function in domestic cats.Clinical relevance: Fructosamine might be of value for the diagnosis of prediabetes mellitus in cats.
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Affiliation(s)
- L Pérez-López
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas, Spain
| | - M Boronat
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas, Spain.,Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
| | - C Melián
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas, Spain.,Veterinary Faculty, Department of Animal Pathology, University of Las Palmas de Gran Canaria, Arucas, Las Palmas, Spain
| | - Y Brito-Casillas
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas, Spain
| | - A M Wägner
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas, Spain.,Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
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Arginine Metabolites as Biomarkers of Myocardial Ischaemia, Assessed with Cardiac Magnetic Resonance Imaging in Chronic Kidney Disease. Biomolecules 2021; 11:biom11030416. [PMID: 33799818 PMCID: PMC8002086 DOI: 10.3390/biom11030416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/24/2021] [Accepted: 03/06/2021] [Indexed: 12/28/2022] Open
Abstract
(1) Background: Cardiovascular disease (CVD) is the major cause of morbidity and mortality in patients with chronic kidney disease (CKD). Myocardial oxygenation and perfusion response to stress, using oxygen-sensitive cardiovascular magnetic resonance (OS-CMR) and stress T1 mapping respectively, are impaired in CKD patients with and without known coronary artery disease (CAD). Endothelial dysfunction, assessed by circulating levels of asymmetric dimethylarginine (ADMA) and homoarginine (HMA), promotes atherosclerosis. We hypothesized that in CKD patients, worsening endothelial dysfunction is associated with worsening myocardial oxygenation and perfusion as assessed by change in OS-CMR signal intensity (Δ OS-CMR SI) and stress T1 (ΔT1) values. (2) Methods: 38 patients with advanced CKD underwent cardiovascular magnetic resonance (CMR) scanning at 3 Tesla. OS-CMR and T1 mapping images were acquired both at rest and after adenosine stress and analyzed semi-quantitatively. Serum ADMA and HMA concentrations were assessed using mass spectrometry. (3) Results: There was no significant correlation between Δ OS-CMR SI and ADMA or HMA. Interestingly, there was a significant negative correlation seen between Δ T1 and ADMA (r = -0.419, p = 0.037, n = 30) but not between Δ T1 and HMA. (4) Conclusions: Stress T1 response is impaired in CKD patients and is independently associated with higher circulating ADMA concentrations.
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Metabolomic characterisation of progression and spontaneous regression of melanoma in the melanoma-bearing Libechov minipig model. Melanoma Res 2021; 31:140-151. [PMID: 33625100 DOI: 10.1097/cmr.0000000000000722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Melanoma-bearing Libechov minipig (MeLiM) represents a large animal model for melanoma research. This model shows a high incidence of complete spontaneous regression of melanoma - a phenomenon uncommon in humans. Here, we present the first metabolomic characterisation of the MeLiM model comparing animals with progressing and spontaneously regressing melanomas. Plasma samples of 19 minipigs with progression and 27 minipigs with evidence of regression were analysed by a targeted metabolomic assay based on mass spectrometry detection. Differences in plasma metabolomics patterns were investigated by univariate and multivariate statistical analyses. Overall, 185 metabolites were quantified in each plasma sample. Significantly altered metabolomic profile was found, and 42 features were differentially regulated in plasma. Besides, the machine learning approach was used to create a predictive model utilising Arg/Orn and Arg/ADMA ratios to discriminate minipigs with progressive disease development from minipigs with regression evidence. Our results suggest that progression of melanoma in the MeLiM model is associated with alteration of arginine, glycerophospholipid and acylcarnitines metabolism. Moreover, this study provides targeted metabolomics characterisation of an animal model of melanoma with progression and spontaneous regression of tumours.
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Hillaert A, Liu DJX, Daminet S, Broeckx BJG, Stock E, Paepe D, Hesta M, Vanderperren K. Serum symmetric dimethylarginine shows a relatively consistent long-term concentration in healthy dogs with a significant effect of increased body fat percentage. PLoS One 2021; 16:e0247049. [PMID: 33596230 PMCID: PMC7888620 DOI: 10.1371/journal.pone.0247049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/31/2021] [Indexed: 11/19/2022] Open
Abstract
Symmetric dimethylarginine (SDMA) is a promising renal marker that correlates well with the glomerular filtration rate and could allow earlier detection of impaired renal function. The main objectives of this study were to assess the long-term variability of SDMA in healthy dogs and examine the influence of an increased body fat percentage on the level of SDMA. Sixteen lean Beagles were randomly assigned to the control group or weight-change group in age- and gender-matched pairs. The energy intake of the control group (n = 8) was strictly regulated to maintain an ideal body weight for 83 weeks, while the weight-change group (n = 8) was fed to induce weight gain (week 0–47), to maintain stable excessive body weight (week 47–56) and to lose weight (week 56–83), consecutively. At 8 specified time points, the body condition score, body composition, glomerular filtration rate, serum concentration of SDMA and creatinine were analyzed. In the control group, the within-subject coefficient of variation, between-subject coefficient of variation, reference change value (type I error = 5%) and index of individuality were 0.16, 0.22, 0.43 and 0.73, respectively. The control group and weight-change group did not differ significantly in SDMA concentration. SDMA showed a significant negative association (coefficient = -0.07) with body fat percentage (p<0.01) in the weight-change group and a significant positive association (coefficient = 7.79) with serum creatinine (p<0.01) in the entire study population. In conclusion, SDMA concentration has high long-term stability in healthy adult dogs. For the evaluation of SDMA concentrations, subject-specific reference values are preferred over a population-based reference value seen their higher sensitivity. Moreover, an increased body fat percentage does seem to affect the serum SDMA concentration of otherwise healthy dogs, but its clinical relevance has to be clarified in further research.
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Affiliation(s)
- Amber Hillaert
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Daisy J. X. Liu
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sylvie Daminet
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Bart J. G. Broeckx
- Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Emmelie Stock
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Dominique Paepe
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Myriam Hesta
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Katrien Vanderperren
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
- * E-mail:
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Obert LA, Elmore SA, Ennulat D, Frazier KS. A Review of Specific Biomarkers of Chronic Renal Injury and Their Potential Application in Nonclinical Safety Assessment Studies. Toxicol Pathol 2021; 49:996-1023. [PMID: 33576319 DOI: 10.1177/0192623320985045] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A host of novel renal biomarkers have been developed over the past few decades which have enhanced monitoring of renal disease and drug-induced kidney injury in both preclinical studies and in humans. Since chronic kidney disease (CKD) and acute kidney injury (AKI) share similar underlying mechanisms and the tubulointerstitial compartment has a functional role in the progression of CKD, urinary biomarkers of AKI may provide predictive information in chronic renal disease. Numerous studies have explored whether the recent AKI biomarkers could improve upon the standard clinical biomarkers, estimated glomerular filtration rate (eGFR), and urinary albumin to creatinine ratio, for predicting outcomes in CKD patients. This review is an introduction to alternative assays that can be utilized in chronic (>3 months duration) nonclinical safety studies to provide information on renal dysfunction and to demonstrate specific situations where these assays could be utilized in nonclinical drug development. Novel biomarkers such as symmetrical dimethyl arginine, dickkopf homolog 3, and cystatin C predict chronic renal injury in animals, act as surrogates for GFR, and may predict changes in GFR in patients over time, ultimately providing a bridge from preclinical to clinical renal monitoring.
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Affiliation(s)
- Leslie A Obert
- 549350GlaxoSmithKline (GSK), Nonclinical Safety, Collegeville, PA, USA
| | - Susan A Elmore
- Cellular and Molecular Pathology Branch, National Toxicology Program (NTP), 6857National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Daniela Ennulat
- 549350GlaxoSmithKline (GSK), Nonclinical Safety, Collegeville, PA, USA
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Vivarelli S, Falzone L, Basile MS, Candido S, Libra M. Nitric Oxide in Hematological Cancers: Partner or Rival? Antioxid Redox Signal 2021; 34:383-401. [PMID: 32027171 DOI: 10.1089/ars.2019.7958] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Significance: Hematological malignancies represent the fourth most diagnosed cancer. Relapse and acquired resistance to anticancer therapy constitute two actual issues that need to be overcome. Nitric oxide (NO) plays a pivotal role in regulating cancer progression. At present, many studies are attempting to uncover the potentials of modulating NO levels to improve the efficacy of currently available treatments against lymphoma, leukemia, and myeloma. Recent Advances: It is becoming progressively clear that NO modulation may help hematological cancer management, either by targeting directly tumor cells or by driving the immune system to eliminate cancer cells. Critical Issues: NO is a dual molecule that can have a tumor-protecting or stimulating effect, depending on its local concentration. Moreover, NO is able to target a wide range of molecules involved in both cancer genesis and evolution. In this review, an overview of the recent findings regarding the pivotal role played by NO and nitric oxide synthase in cancer progression and anticancer therapy is presented, with particular focus on hematological malignancies. Future Directions: It is critical to establish the cancer-specific function of NO and critically drive its modulation to improve cancer management toward a personalized approach. This has a special importance in hematological tumors, where the urgency of finding eradicative therapies is constant. Antioxid. Redox Signal. 34, 383-401.
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Affiliation(s)
- Silvia Vivarelli
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori "Fondazione G. Pascale", Napoli, Italy
| | - Maria Sofia Basile
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Saverio Candido
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.,Research Centre for Prevention, Diagnosis and Treatment of Cancer, University of Catania, Catania, Italy
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.,Research Centre for Prevention, Diagnosis and Treatment of Cancer, University of Catania, Catania, Italy
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Siwinska N, Zak A, Paslawska U. Detecting acute kidney injury in horses by measuring the concentration of symmetric dimethylarginine in serum. Acta Vet Scand 2021; 63:3. [PMID: 33446216 PMCID: PMC7809759 DOI: 10.1186/s13028-021-00568-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 01/07/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Acute kidney injury (AKI) in horses may develop as a complication of a primary disease or following the administration of nephrotoxic drugs, and may pose a diagnostic challenge. Hence, the main objective of this study was to evaluate the concentrations and diagnostic significance of serum symmetric dimethylarginine (SDMA) and conventional renal dysfunction biomarkers in healthy horses, horses at risk of developing AKI, and horses with clinically evident AKI. A second aim was to assess how gastrointestinal disease and exposure to potentially nephrotoxic drugs affected SDMA levels. Thirty healthy horses, 30 horses with gastrointestinal disease and/or receiving phenylbutazone or gentamicin (risk group) and 11 horses with AKI were included in the study. Serum SDMA levels were measured using commercially available enzyme immunoassay tests. RESULTS SDMA levels in healthy horses, horses at risk of AKI and horses with AKI were 12 µg/dL (11-14), 12 µg/dL (11-13) and 20 µg/dL (20-37), respectively (all results presented as a median (quartile 1-quartile 3)). There was a significant difference in SDMA concentration between the healthy horses and those with AKI, whereas the SDMA levels in healthy horses and those at risk of AKI were comparable. A SDMA cut-off value of 19 µg/dL was established. Horses from the risk group had higher urine protein concentration and urine protein to creatinine ratio compared with healthy horses. Furthermore, horses with colic from the risk group presented with elevated urine γ-glutamyl transpeptidase to creatinine ratio. CONCLUSION The SDMA cut-off value established in healthy horses was higher than previously reported. The SDMA level correlated with the azotaemia levels. Horses from the AKI risk group had normal SDMA levels but single urine parameters was abnormal indicating their higher sensitivity in assessing subclinical kidney dysfunction.
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Affiliation(s)
- Natalia Siwinska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Agnieszka Zak
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
- Department of Immunology, Pathophysiology and Veterinary Preventive Medicine, University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Urszula Paslawska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
- Veterinary Institute, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, Torun ul. Gagarina 7, 87-100 Torun, Poland
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Echocardiography to Screen for Pulmonary Hypertension in CKD. Kidney Int Rep 2020; 5:2275-2283. [PMID: 33305121 PMCID: PMC7710815 DOI: 10.1016/j.ekir.2020.09.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/31/2020] [Accepted: 09/15/2020] [Indexed: 02/02/2023] Open
Abstract
Introduction Pulmonary hypertension (PH) is a common yet incompletely understood complication of chronic kidney disease (CKD). Although transthoracic echocardiogram is commonly used to noninvasively estimate PH, it has not been validated in a CKD population. We investigated the utility of this diagnostic tool for CKD-associated PH in a large right heart catheterization (RHC) cohort. Methods We reviewed RHC and echocardiography data in 4036 patients (1714 with CKD) obtained between 2011 and 2014 at a single center. We used multivariate regression to determine the associations of echocardiography measurements with PH, and evaluated whether estimated glomerular filtration rate (eGFR) modified these associations. Using internal validation, we sequentially added measurements to predictive models and analyzed the incremental predictive performance using the change in the area under the receiver operating characteristic curve (ΔAUC) and net reclassification improvement. Results The echocardiography measurements most strongly associated with the diagnosis of PH included tricuspid regurgitant velocity (TRV), tricuspid annular plane systolic excursion (TAPSE), right atrial pressure, diastolic dysfunction, and right ventricular function. Among these measurements, eGFR significantly modified the associations of TAPSE and diastolic dysfunction with the diagnosis of PH. The model consisting of a combination of TRV, right atrial pressure, and TAPSE most accurately predicted the diagnosis of PH in a CKD population (AUC 0.82). Conclusions The optimal model to predict PH diagnosis included TRV, right atrial pressure, and TAPSE. Since TAPSE more strongly associated with PH in the CKD population, these findings support a CKD-specific approach to the development of noninvasive screening algorithms for PH.
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Arginine and Arginine/ADMA Ratio Predict 90-Day Mortality in Patients with Out-of-Hospital Cardiac Arrest-Results from the Prospective, Observational COMMUNICATE Trial. J Clin Med 2020; 9:jcm9123815. [PMID: 33255752 PMCID: PMC7760544 DOI: 10.3390/jcm9123815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/08/2020] [Accepted: 11/19/2020] [Indexed: 02/07/2023] Open
Abstract
(1) Background: In patients with shock, the L-arginine nitric oxide pathway is activated, causing an elevation of nitric oxide, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels. Whether these metabolites provide prognostic information in patients after out-of-hospital cardiac arrest (OHCA) remains unclear. (2) Methods: We prospectively included OHCA patients, recorded clinical parameters and measured plasma ADMA, SDMA and Arginine levels by liquid chromatography tandem mass spectrometry (LC-MS). The primary endpoint was 90-day mortality. (3) Results: Of 263 patients, 130 (49.4%) died within 90 days after OHCA. Compared to survivors, non-survivors had significantly higher levels of ADMA and lower Arginine and Arginine/ADMA ratios in univariable regression analyses. Arginine levels and Arginine/ADMA ratio were significantly associated with 90-day mortality (OR 0.51 (95%CI 0.34 to 0.76), p < 0.01 and OR 0.40 (95%CI 0.26 to 0.61), p < 0.001, respectively). These associations remained significant in several multivariable models. Arginine/ADMA ratio had the highest predictive value with an area under the curve (AUC) of 0.67 for 90-day mortality. Results for secondary outcomes were similar with significant associations with in-hospital mortality and neurological outcome. (4) Conclusion: Arginine and Arginine/ADMA ratio were independently associated with 90-day mortality and other adverse outcomes in patients after OHCA. Whether therapeutic modification of the L-arginine-nitric oxide pathway has the potential to improve outcome should be evaluated.
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Ertelt A, Stumpff F, Merle R, Kuban S, Bollinger L, Liertz S, Gehlen H. Asymmetric dimethylarginine-A potential cardiac biomarker in horses. J Vet Cardiol 2020; 33:43-51. [PMID: 33360109 DOI: 10.1016/j.jvc.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 11/06/2020] [Accepted: 11/17/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION/OBJECTIVES Asymmetric dimethylarginine (ADMA) is a cardiac biomarker in humans, symmetric dimethylarginine (SDMA) a renal biomarker in humans, cats, and dogs. The purpose of this prospective study was to investigate if measuring serum ADMA and SDMA concentrations via ELISA allows detection of cardiac disease in horses in a routine laboratory setting. In this context, reference values in horses were established. ANIMALS, MATERIALS, AND METHODS Seventy-eight horses with no known medical history were compared to 23 horses with confirmed structural cardiac disease with/or without arrhythmias. Horses underwent physical examination, electrocardiography, echocardiography and venous blood sampling and were staged based on the severity of cardiac disease from 0 to II. Asymmetric dimethylarginine and SDMA were measured via ELISA and crosschecked using liquid chromatograph triple quadrupole mass spectrometry. Reference intervals with 90th percent confidence intervals were evaluated and standard software was used to test for significant differences in ADMA, SDMA, and the l-arginine/ADMA ratio between groups. RESULTS The reference ranges were 1.7-3.8 μmol/L and 0.3-0.8 μmol/L for ADMA and SDMA, respectively. Serum ADMA was higher in horses with heart disease compared to healthy horses (p < 0.01) and highest in horses with stage II heart disease (p = 0.02). The l-Arginine/ADMA ratio was significantly higher in healthy animals than those with cardiac disease (p = 0.001). CONCLUSIONS Reference values for serum ADMA and SDMA using ELISA methods are presented in horses. This study confirms the association between heart disease and increased serum ADMA concentration as well as a decreased l-Arginine/ADMA ratio in horses.
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Affiliation(s)
- A Ertelt
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany.
| | - F Stumpff
- Institute of Veterinary Physiology, Freie Universitaet Berlin, Oertzenweg 19b, 14163, Berlin, Germany
| | - R Merle
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universitaet Berlin, Koenigsweg 67, 14163, Berlin, Germany
| | - S Kuban
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany
| | - L Bollinger
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany
| | - S Liertz
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany
| | - H Gehlen
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany
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Lee Y, Mehrotra P, Basile D, Ullah M, Singh A, Skill N, Younes ST, Sasser J, Shekhar A, Singh J. Specific Lowering of Asymmetric Dimethylarginine by Pharmacological Dimethylarginine Dimethylaminohydrolase Improves Endothelial Function, Reduces Blood Pressure and Ischemia-Reperfusion Injury. J Pharmacol Exp Ther 2020; 376:181-189. [PMID: 33214214 DOI: 10.1124/jpet.120.000212] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/13/2020] [Indexed: 12/18/2022] Open
Abstract
Multiple clinical and preclinical studies have demonstrated that plasma levels of asymmetric dimethylarginine (ADMA) are strongly associated with hypertension, diabetes, and cardiovascular and renal disease. Genetic studies in rodents have provided evidence that ADMA metabolizing dimethylarginine dimethylaminohydrolase (DDAH)-1 plays a role in hypertension and cardiovascular disease. However, it remains to be established whether ADMA is a bystander, biomarker, or sufficient contributor to the pathogenesis of hypertension and cardiovascular and renal disease. The goal of the present investigation was to develop a pharmacological molecule to specifically lower ADMA and determine the physiologic consequences of ADMA lowering in animal models. Further, we sought to determine whether ADMA lowering will produce therapeutic benefits in vascular disease in which high ADMA levels are produced. A novel long-acting recombinant DDAH (M-DDAH) was produced by post-translational modification, which effectively lowered ADMA in vitro and in vivo. Treatment with M-DDAH improved endothelial function as measured by increase in cGMP and in vitro angiogenesis. In a rat model of hypertension, M-DDAH significantly reduced blood pressure (vehicle: 187 ± 19 mm Hg vs. M-DDAH: 157 ± 23 mm Hg; P < 0.05). Similarly, in a rat model of ischemia-reperfusion injury, M-DDAH significantly improved renal function as measured by reduction in serum creatinine (vehicle: 3.14 ± 0.74 mg/dl vs. M-DDAH: 1.1 ± 0.75 mg/dl; P < 0.01), inflammation, and injured tubules (vehicle: 73.1 ± 11.1% vs. M-DDAH: 22.1 ± 18.4%; P < 0.001). These pharmacological studies have provided direct evidence for a pathologic role of ADMA and the therapeutic benefits of ADMA lowering in preclinical models of endothelial dysfunction, hypertension, and ischemia-reperfusion injury. SIGNIFICANCE STATEMENT: High levels of ADMA occur in patients with cardiovascular and renal disease. A novel modified dimethylarginine dimethylaminohydrolase by PEGylation effectively lowers ADMA, improves endothelial function, reduces blood pressure and protects from ischemia-reperfusion renal injury.
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Affiliation(s)
- Young Lee
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Purvi Mehrotra
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - David Basile
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Mahbub Ullah
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Arshnoor Singh
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Nicholas Skill
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Subhi Talal Younes
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Jennifer Sasser
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Anantha Shekhar
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
| | - Jaipal Singh
- Indiana Center for Biomedical Innovation, Indianapolis, Indiana (Y.L., Ar.S., J.S.); Indiana University School of Medicine, Indianapolis, Indiana (P.M., D.B., M.U., N.S., Ar.S., J.S.); University of Mississippi Medical Center, Jackson, Mississippi (S.T.Y., Je.S.); and Vasculonics LLC, Indianapolis, Indiana (J.S.)
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Sargent HJ, Elliott J, Jepson RE. The new age of renal biomarkers: does SDMA solve all of our problems? J Small Anim Pract 2020; 62:71-81. [PMID: 33184865 DOI: 10.1111/jsap.13236] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 05/15/2020] [Accepted: 09/15/2020] [Indexed: 12/28/2022]
Abstract
Within clinical small animal practice, diagnosis of both chronic kidney disease and acute kidney injury is common. To assess renal function, measurement of glomerular filtration rate is considered the gold standard. Currently, routine tests of kidney function include surrogate markers of glomerular filtration rate such as serum creatinine, and urea, each with their own limitations, whilst urine protein to creatinine ratio gives an indication of glomerular and tubular handling of protein, and urine specific gravity information about urine concentrating ability by the kidney. These parameters are used together with historical and physical examination data to give a diagnosis of kidney disease following which creatinine, proteinuria and blood pressure are used to stage chronic kidney disease and, together with urine output, grade acute kidney injury according to the International Renal Interest Society. However, there has been much concern that creatinine is insensitive when used to indicate early decline in renal function and this has highlighted the need for additional methods of diagnosing and monitoring these patients, with the potential to allow earlier therapeutic intervention. Symmetric dimethylarginine is a novel biomarker, which has been shown to perform as a surrogate marker of glomerular filtration rate in small animals. This article will review current research on symmetric dimethylarginine and the ways in which it may be utilised in small animal practice; current research supports the use of symmetric dimethylarginine as a screening test for detection of early chronic kidney disease according to International Renal Interest Society guidelines, but further research is required in to the usefulness of symmetric dimethylarginine as a tool for monitoring disease and the effect of non-renal influences.
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Affiliation(s)
- H J Sargent
- Royal Veterinary College, North Mymms, Herts, AL9 7TA, UK
| | - J Elliott
- Royal Veterinary College, North Mymms, Herts, AL9 7TA, UK
| | - R E Jepson
- Royal Veterinary College, North Mymms, Herts, AL9 7TA, UK
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Siwinska N, Zak A, Slowikowska M, Niedzwiedz A, Paslawska U. Serum symmetric dimethylarginine concentration in healthy horses and horses with acute kidney injury. BMC Vet Res 2020; 16:396. [PMID: 33081772 PMCID: PMC7576750 DOI: 10.1186/s12917-020-02621-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 10/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There are limited options to diagnose acute kidney injury (AKI) in horses. Symmetric dimethylarginine (SDMA) is routinely used in human and small animal medicine. The aim of this study was to assess serum SDMA concentrations in healthy horses and horses with AKI. The objective of this study was to evaluate the association of: 1) age, 2) sex, 3) body weight and 4) serum creatinine and urea levels on serum SDMA concentrations. Fifty-three healthy horses, including 17 foals (2-6 months of age) and 36 adult horses (3-29 years of age), and 23 horses with AKI were included in the study based on history, physical examination, blood analysis, urinalysis and an ultrasonographic examination of the urinary tract. Serum SDMA concentrations were measured using a non-species specific commercial ELISA test. RESULTS In healthy adult horses, the value of SDMA was 0.53 ± 0.14 μmol/L. The value was higher in foals (1.5 ± 0.4 μmol/L, P < 0.001). Horses with AKI had significantly higher concentrations of SDMA compared to healthy horses (1.76 ± 1.05 μmol/L, P < 0.001). In the healthy adult horses, there was no association of sex, age or body weight on SDMA. However, a significant positive relationship was found between serum creatinine and SDMA concentrations. CONCLUSIONS Healthy adult horses had SDMA values similar to those of other species. Foals had higher SDMA values. Therefore, different reference values should be created for them. The study confirmed an increased SDMA in horses with AKI. This, as well as the low influence of extrarenal factors on the SDMA values, may confirm its usefulness in the diagnosis of kidney dysfunction. Higher SDMA values may also indicate a more advanced degree of kidney dysfunction. Further research is required to determine whether SDMA could be used to detect kidney dysfunction in the asymptomatic stage of AKI.
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Affiliation(s)
- Natalia Siwinska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Agnieszka Zak
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Malwina Slowikowska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Artur Niedzwiedz
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Urszula Paslawska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
- Veterinary Institute, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University Torun ul, Gagarina 7, 87-100 Torun, Torun, Poland
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Di Paola A, Carotenuto G, Dondi F, Corsini A, Corradini S, Fracassi F. Symmetric dimethylarginine concentrations in dogs with hypothyroidism before and after treatement with levothyroxine. J Small Anim Pract 2020; 62:89-96. [PMID: 32926428 DOI: 10.1111/jsap.13212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the serum symmetric dimethylarginine (SDMA) and serum creatinine concentrations in a population of hypothyroid dogs at the time of diagnosis and after treatment. MATERIALS AND METHODS Serum SDMA and serum creatinine were measured in serum samples of 24 healthy dogs and 24 hypothyroid dogs, at the time of diagnosis (T0) and after supplementation with levothyroxine (T1). RESULTS The mean SDMA concentrations (reference intervals [RI] <18 μg/dL and <14 μg/dL depending on the source) were 11.7 ± 3.5 μg/dL, 13.8 ± 3.1 μg/dL and 11.83 ± 2.87 μg/dL in healthy dogs, and in the hypothyroid dogs at T0 and T1, respectively. The SDMA concentrations were higher in the hypothyroid dogs at T0 in comparison with the healthy dogs. Of the hypothyroid dogs, 1 out of 24 had an SDMA concentration above 18 μg/dL and 12 out of 24 above 14 μg/dL at T0. At T1, none of the hypothyroid dogs had SDMA concentrations above 18 μg/dL and two of them had SDMA concentrations above 14 μg/dL. The serum creatinine concentration was higher in the hypothyroid dogs at T0 as compared to the healthy dogs. At T0, 8 out of 24 hypothyroid dogs had serum creatinine concentrations above the RI (>1.4 mg/dL). In all but one dog, serum creatinine normalised after treatment. CLINICAL SIGNIFICANCE The SDMA and serum creatinine concentrations were higher in hypothyroid dogs at diagnosis as compared to healthy dogs. Serum creatinine concentrations were increased in one-third of the hypothyroid dogs and in the majority of cases normalised after levothyroxine supplementation. SDMA concentrations were rarely above the upper limit of the RI when the higest (<18 μg/dL) cut-off was employed. The diagnostic accuracy of SDMA in dogs with thyroid dysfunction requires additional evaluation.
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Affiliation(s)
- A Di Paola
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - G Carotenuto
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - F Dondi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - A Corsini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - S Corradini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - F Fracassi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
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Verratti V, Ferrante C, Soranna D, Zambon A, Bhandari S, Orlando G, Brunetti L, Parati G. Effect of high-altitude trekking on blood pressure and on asymmetric dimethylarginine and isoprostane production: Results from a Mount Ararat expedition. J Clin Hypertens (Greenwich) 2020; 22:1494-1503. [PMID: 32762147 DOI: 10.1111/jch.13961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/30/2020] [Accepted: 05/10/2020] [Indexed: 12/18/2022]
Abstract
The study aimed at exploring the mechanisms behind blood pressure and heart rate changes upon acute altitude exposure utilizing urinary excretion of biochemical factors involved in cardiovascular regulation. The study was conducted on 12 lowlander native male mountain climbers, living at sea level, exposed to altitudes ranging from 1800 to 5147 m above sea level over 4 days, during their ascent to Mount Ararat (Turkey). Blood pressure (measured by oscillometric method), heart rate, and blood oxygen saturation (SpO2 ) were recorded at rest (on awakening before food intake), in hypoxic conditions at 4200 m and at sea level before and after the altitude expedition. In the same study conditions (ie before-during-after the expedition), first-voided urinary samples were collected and assayed for 8-iso-prostaglandin F2α (8-iso-PGF2α ) and asymmetric dimethylarginine (ADMA) determination. Heart rate, and systolic and diastolic blood pressures were higher (P < .05) at high altitude than at the sea level. Furthermore, both urinary 8-iso-PGF2α and ADMA were significantly elevated (P < .01) at high altitude and returned to normal levels soon after returning to sea level. A 4-day exposure to high-altitude hypoxia induced a temporary increase in blood pressure and heart rate, confirming previous findings. Blood pressure increase at high altitude was associated with significantly enhanced production of biochemical mediators such as 8-iso-PGF2α, catecholamines, and ADMA, although we could not demonstrate a direct link between these parallel significant changes probably due to the forcefully limited sample size of our study, carried out in challenging environmental conditions at very high altitude.
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Affiliation(s)
- Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Claudio Ferrante
- Department of Pharmacy, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - Davide Soranna
- Department of Cardiovascular Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Antonella Zambon
- Department of statistic and quantitative method, University of Milano-Bicocca, Milan, Italy
| | - Suwas Bhandari
- Department of Critical Care and Internal Medicine, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Giustino Orlando
- Department of Pharmacy, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - Luigi Brunetti
- Department of Pharmacy, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - Gianfranco Parati
- Department of Cardiovascular Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Mandel IA, Podoksenov YK, Suhodolo IV, An DA, Mikheev SL, Podoksenov AY, Svirko YS, Gusakova AM, Shipulin VM, Yavorovskiy AG. Influence of Hypoxic and Hyperoxic Preconditioning on Endothelial Function in a Model of Myocardial Ischemia-Reperfusion Injury with Cardiopulmonary Bypass (Experimental Study). Int J Mol Sci 2020; 21:ijms21155336. [PMID: 32727110 PMCID: PMC7432780 DOI: 10.3390/ijms21155336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/17/2020] [Accepted: 07/22/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of the experiment was to evaluate the effect of preconditioning based on changes in inspiratory oxygen fraction on endothelial function in the model of ischemia-reperfusion injury of the myocardium in the condition of cardiopulmonary bypass. The prospective randomized study included 32 rabbits divided into four groups: hypoxic preconditioning, hyperoxic preconditioning, hypoxic-hyperoxic preconditioning, and control group. All animals were anesthetized and mechanically ventilated. We provided preconditioning, then started cardiopulmonary bypass, followed by induced acute myocardial infarction (ischemia 45 min, reperfusion 120 min). We investigated endothelin-1, nitric oxide metabolites, asymmetric dimethylarginine during cardiopulmonary bypass: before ischemia, after ischemia, and after reperfusion. We performed light microscopy of myocardium, kidney, lungs, and gut mucosa. The endothelin-1 level was much higher in the control group than in all preconditioning groups after ischemia. The endothelin-1 even further increased after reperfusion. The total concentration of nitric oxide metabolites was significantly higher after all types of preconditioning compared with the control group. The light microscopy of the myocardium and other organs revealed a diminished damage extent in the hypoxic-hyperoxic preconditioning group as compared to the control group. Hypoxic-hyperoxic preconditioning helps to maintain the balance of nitric oxide metabolites, reduces endothelin-1 hyperproduction, and enforces organ protection.
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Affiliation(s)
- Irina A. Mandel
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 111a Kievskaya Str., Tomsk 634012, Russia; (Y.K.P.); (S.L.M.); (A.Y.P.); (Y.S.S.); (A.M.G.); (V.M.S.)
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia;
- Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia, 28 Orekhoviy Blvd., Moscow 115682, Russia
- Correspondence: ; Tel.: +790-3952-8337
| | - Yuri K. Podoksenov
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 111a Kievskaya Str., Tomsk 634012, Russia; (Y.K.P.); (S.L.M.); (A.Y.P.); (Y.S.S.); (A.M.G.); (V.M.S.)
- Siberian State Medical University of the Ministry of Health of the Russian Federation, 2 Moskovskiy Tract Str., Tomsk 634050, Russia; (I.V.S.); (D.A.A.)
| | - Irina V. Suhodolo
- Siberian State Medical University of the Ministry of Health of the Russian Federation, 2 Moskovskiy Tract Str., Tomsk 634050, Russia; (I.V.S.); (D.A.A.)
| | - Darya A. An
- Siberian State Medical University of the Ministry of Health of the Russian Federation, 2 Moskovskiy Tract Str., Tomsk 634050, Russia; (I.V.S.); (D.A.A.)
| | - Sergey L. Mikheev
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 111a Kievskaya Str., Tomsk 634012, Russia; (Y.K.P.); (S.L.M.); (A.Y.P.); (Y.S.S.); (A.M.G.); (V.M.S.)
- Siberian State Medical University of the Ministry of Health of the Russian Federation, 2 Moskovskiy Tract Str., Tomsk 634050, Russia; (I.V.S.); (D.A.A.)
- Swiss Medica XXI C.A., 21/1 Annenskaya str., Moscow 127521, Russia
| | - Andrey Yu. Podoksenov
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 111a Kievskaya Str., Tomsk 634012, Russia; (Y.K.P.); (S.L.M.); (A.Y.P.); (Y.S.S.); (A.M.G.); (V.M.S.)
| | - Yulia S. Svirko
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 111a Kievskaya Str., Tomsk 634012, Russia; (Y.K.P.); (S.L.M.); (A.Y.P.); (Y.S.S.); (A.M.G.); (V.M.S.)
- Siberian State Medical University of the Ministry of Health of the Russian Federation, 2 Moskovskiy Tract Str., Tomsk 634050, Russia; (I.V.S.); (D.A.A.)
| | - Anna M. Gusakova
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 111a Kievskaya Str., Tomsk 634012, Russia; (Y.K.P.); (S.L.M.); (A.Y.P.); (Y.S.S.); (A.M.G.); (V.M.S.)
| | - Vladimir M. Shipulin
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 111a Kievskaya Str., Tomsk 634012, Russia; (Y.K.P.); (S.L.M.); (A.Y.P.); (Y.S.S.); (A.M.G.); (V.M.S.)
- Siberian State Medical University of the Ministry of Health of the Russian Federation, 2 Moskovskiy Tract Str., Tomsk 634050, Russia; (I.V.S.); (D.A.A.)
| | - Andrey G. Yavorovskiy
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia;
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