Alkaline phosphatase affects renal function in never-treated hypertensive patients: effect modification by age

Inflammatory atherosclerotic plaque identification by SPECT/CT imaging of LFA-1 using [111In] In-DANBIRT in a novel dyslipidemic rat model

INTRODUCTION

Atherosclerosis is prevalent globally, closely associated with dyslipidemia and other metabolic dysfunction. Early diagnosis of atherosclerosis is challenging due to limited diagnostic capabilities that need to be expanded with animal models with enhanced vascular biology like rats. Our previous research showed [111In] In-DANBIRT has potential as a diagnostic tool for detecting atherosclerosis in mice. The primary aim of the present study is to evaluate [111In] In-DANBIRT in a novel atherosclerotic rat with early- and late-stage atherosclerosis and metabolic disease.

METHODS

We characterized metabolic and body composition differences in these novel dyslipidemic rats under different diets using serum chemistry and dual-energy X-ray absorptiometry (DEXA) scan, respectively. We performed 1-h post-injection in vivo molecular imaging of ApoE knockout, lean Zucker (LZ) male rats at baseline and followed them into 10 weeks of either normal or high-fat/cholesterol diet implementation (22 weeks of age).

RESULTS

We identified significant differences in body composition and metabolic changes in ApoE knockout rats compared to ApoE wildtype rats. Our findings indicate an increased uptake of [111In] In-DANBIRT in ApoE knockout, lean Zucker (LZ) rats, particularly in the descending aorta, a location where early-stage atherosclerosis is commonly found. Our findings, however, also revealed that the ApoE knockout, Zucker diabetic fatty (ZDF) model has high mortality rate, which may be attributed to alterations of critical enzymes involved in regulating metabolism and liver function.

CONCLUSION

Our results are highly encouraging as they demonstrated the potential of [111In] In-DANBIRT to detect early-stage atherosclerosis in rats that might otherwise go unnoticed by other methods, showcasing the high sensitivity of [111In] In-DANBIRT. Our future studies will aim to establish a viable T2D atherosclerosis model in rats with more advanced stages of the disease to further demonstrate the reliability of [111In] In-DANBIRT as a diagnostic tool for patients in all stages of atherosclerosis.

Self-assembly of protein-DNA superstructures for alkaline phosphatase detection in blood

We designed a paper-based analytical device by integrating horseradish peroxidase (HRP)-encapsulated 3D DNA for visual detection of alkaline phosphatase (ALP). This device allows on-paper sample pre-treatment, target recognition and signal readout, enabling simple (without additional pre-treatment of blood samples) and rapid (within 23 min) determination of ALP in clinical samples.

Circulating liver function markers and the risk of COPD in the UK Biobank

OBJECTIVE

To investigate the associations of circulating liver function marker levels with the risk of chronic obstructive pulmonary disease (COPD).

METHODS

We leveraged the data of 372,056 participants from the UK Biobank between 2006 and 2010. The assessed circulating liver function markers included alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total bilirubin (TBIL), albumin (ALB), and total protein (TP). Incident COPD was identified through linkage to the National Health Service registries. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

During a median follow-up period of 12.3 (interquartile range:11.4-13.2) years, we documented 10,001 newly diagnosed COPD cases. Lower levels of ALT, TBIL, ALB, and TP and higher levels of GGT and ALP were nonlinearly associated with elevated COPD risk. The HR (95% CI) for decile 10 vs. 1 was 0.92 (0.84-1.01) for ALT, 0.82 (0.75-0.89) for TBIL, 0.74 (0.67-0.81) for ALB, 0.96 (0.88-1.04) for TP, 1.45 (1.31-1.62) for GGT, and 1.31 (1.19-1.45) for ALP. Restricted cubic spline analyses suggested a U-shaped relationship between AST levels and COPD risk (P for nonlinearity <0.05).

CONCLUSION

We observed that all seven circulating liver function markers were nonlinearly associated with the risk of COPD, indicating the importance of liver function in COPD.

Correlation of Biomarkers in Severe COVID-19 Patients Cross-sectional Study

BACKGROUND: In patients with coronavirus disease-19 (COVID-19), serious biomarkers (liver function tests and renal functions tests) (urea, creatinine, GOT, GPT, and LDH) are determined immediate to assess in prognosis of the severity of disease. AIM: The aim of the study was to determine correlation between biomarkers (liver function tests and renal functions tests) (urea, creatinine, GOT, GPT, and LDH) among COVID-19 patients. METHODS: A cross-sectional study, a total of 90 COVID-19 patients who attending in the Al-Hussein Medical City in Karbala, Iraq, participated in the present study within a month’s time in late December 2021 to early January of 2022. All COVID-19 patients with positive SARS-COV-2 real-time RT-PCR results were reviewed. The patients were classifying according SPO2 into three groups (mild, moderate, and severe groups). The demographic data (sex, age, and SPO2) were collected while the biomarkers (liver function tests and renal functions tests) for all patients were done by bio-base instrument (ACCENT-200 ALAT KIT). RESULTS: The white blood cell “WBC” and neutrophil in moderate and severe groups had substantially greater counts (p = 0.005) when compared with mild group while lymphocytes were considerably decreased in the severe and moderate groups (p = 0.005). In the moderate group, there was positive significant correlation among neutrophils and serum LDH (r = 0.451*, p = 0.014). There was no significant correlation between neutrophils and liver function tests. Furthermore, in the moderate patient group, a strong positively correlating notably among lymphocytes and serum LDH. Moreover, the concentration of serum GOT, GPT, and LDH (p = 0.05, p = 0.08, and p = 0.5) was higher levels in severe group when compared to moderate and mild groups, on the other hand, the renal function tests (urea and creatinine) were high serum levels in severe group than mild and moderate groups. CONCLUSION: The serum concentration of urea, creatinine, GOPT, GPT, and LDH was high in severe COVID-19 patients group, although there was no statistically significant in ALP, GPT, and urea among COVID-19 patient’s groups (mild, moderate, and severe group). The present study found no significant correlation between biomarkers (liver function tests and renal function test).

An evaluation of liver function tests in severe acute respiratory syndrome - Corona virus 2 (SARS-CoV-2) infection in the backdrop of chronic kidney disease

Background:

The SARS-CoV-2 pandemic has emerged as the most challenging global health problem of this century. The concomitant presence of co-morbidities like chronic kidney disease (CKD), diabetes, CHD, further complicates the problem.

Aim:

To assess the patterns of LFT abnormalities in patients of SARS-CoV-2 infection with and without CKD and evaluate the probable outcomes.

Materials and Methods:

A cross-sectional retrospective observational study done on 600 patient samples (Group 1: SARS-CoV-2 without CKD, Group 2: SARS-CoV-2 with CKD and Group 3: CKD uninfected with SARS-CoV-2) which were processed for LFT and KFT.

Results:

AST and ALT were significantly higher in all SARS-CoV-2 infected; Group 1 mean ± 2SD, (63.63 ± 42.89U/L & 50.25 ± 46.53U/L), group 2 (90.59 ± 62.51U/L & 72.09 ± 67.24 U/L) as compared to Group 3 (25.24 ± 7.47U/L & 24.93 ± 11.44U/L). A statistically significant elevation is seen in these two parameters in Group 2 as compared to Group 1. There was a negative significant correlation between eGFR and AST/ALT levels in Group 1 (p < 0.05). In Group 2, a weak positive correlation was seen with ALT. Group 3, eGFR’s showed strong correlations with AST and ALT levels; reduction in kidney function correlated well with increase in serum ALP levels.

Conclusions:

This study establishes that SARS-CoV-2 infected, with CKD, show higher elevations in serum aminotransferase levels in comparison to those without CKD. In contrast, the CKD group not infected, shows a decline in serum aminotransferase levels. Serum ALT values in SARS-CoV-2 show significant correlation with eGFR. Also, elevated ALP values in CKD patients may be used as an indicator of declining kidney function.

Burden of chronic kidney disease and rapid decline in renal function among adults attending a hospital-based diabetes center in Northern Europe

Introduction

This study aimed to determine the prevalence of diabetic kidney disease (DKD) and rapid renal function decline and to identify indices associated with this decline among adults attending a diabetes center in Northern Europe.

Research design and methods

This is a retrospective cohort study of 4606 patients who attended a diabetes center in Ireland between June 2012 and December 2016. Definition/staging of chronic kidney disease used the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 classification based on data from the most recently attended appointment. Relevant longitudinal trends and variabilities were derived from serial records prior to index visit. Rapid renal function decline was defined based on per cent and absolute rates of estimated glomerular filtration rate (eGFR) change. Multiple linear regression was used to explore the relationships between explanatory variables and per cent eGFR change.

Results

42.0% (total), 23.4% (type 1 diabetes), 47.9% (type 2 diabetes) and 32.6% (other diabetes) had DKD. Rapid decline based on per cent change was more frequent in type 2 than in type 1 diabetes (32.8% vs 14.0%, p<0.001). Indices independently associated with rapid eGFR decline included older age, greater number of antihypertensives, higher log-normalized urine albumin to creatinine ratio (LNuACR), serum alkaline phosphatase, thyroid stimulating hormone, variability in systolic blood pressure and variability in LNuACR, lower glycated hemoglobin, high-density lipoprotein cholesterol and diastolic blood pressure, and lack of ACE inhibitor/angiotensin receptor blocker prescription.

Conclusions

DKD (using the KDIGO 2012 classification) and rapid eGFR decline were highly prevalent among adults attending a hospital-based diabetes clinic in a predominantly Caucasian Northern European country. The burden was greater for adults with type 2 diabetes. Expected as well as potentially novel clinical predictors were identified.

Alkaline Phosphatase Activity Is a Key Determinant of Vascular Responsiveness to Norepinephrine

Here, we tested the hypothesis that TNAP (tissue nonspecific alkaline phosphatase) modulates vascular responsiveness to norepinephrine. In the isolated, Tyrode's-perfused rat mesentery, 50 µmol/L of L-p-bromotetramisole (L-p-BT; selective TNAP inhibitor, Ki=56 µmol/L) significantly reduced TNAP activity and caused a significant 9.0-fold rightward-shift in the norepinephrine concentration versus vasoconstriction relationship. At 100 µmol/L, L-p-BT further reduced mesenteric TNAP activity and caused an additional significant right-shift of the norepinephrine concentration versus vasoconstriction relationship. A higher concentration (200 µmol/L) of L-p-BT had no further effect on either mesenteric TNAP activity or norepinephrine-induced vasoconstriction. L-p-BT did not alter vascular responses to vasopressin, thus ruling-out nonspecific suppression of vascular reactivity. Since in the rat mesenteric vasculature α1-adrenoceptors mediate norepinephrine-induced vasoconstriction, these finding indicate that TNAP inhibition selectively interferes with α1-adrenoceptor signaling. Additional experiments showed that the effects of TNAP inhibition on norepinephrine-induced vasoconstriction were not mediated by accumulation of pyrophosphate or ATP (TNAP substrates) nor by reduced adenosine levels (TNAP product). TNAP inhibition significantly reduced the Hillslope of the norepinephrine concentration versus vasoconstriction relationship from 1.8±0.2 (consistent with positive cooperativity of α1-adrenoceptor signaling) to 1.0±0.1 (no cooperativity). Selective activation of A1-adenosine receptors, which are known to participate in coincident signaling with α1-adrenoceptors, reversed the suppressive effects of L-p-BT on norepinephrine-induced vasoconstriction. In vivo, L-p-BT administration achieved plasma levels of ≈60 µmol/L and inhibited mesenteric vascular responses to exogenous norepinephrine and sympathetic nerve stimulation. TNAP modulates vascular responses to norepinephrine likely by affecting positive cooperativity of α1-adrenoceptor signaling via a mechanism involving A1 receptor signaling.