1
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Javaid MA, Zia KM, Iqbal A, Ahmad S, Akram N, Liu X, Nawaz H, Khosa MK, Awais M. Utilization of waxy corn starch as an efficient chain extender for the preparation of polyurethane elastomers. Int J Biol Macromol 2020; 148:415-423. [DOI: 10.1016/j.ijbiomac.2020.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/29/2019] [Accepted: 01/02/2020] [Indexed: 02/07/2023]
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2
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Mujais S, Nolph K, Gokal R, Blake P, Burkart J, Coles G, Kawaguchi Y, Kawanishi H, Korbet S, Krediet R, Lindholm B, Oreopoulos D, Rippe B, Selgas R. Evaluation and Management of Ultrafiltration Problems in Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080002004s02] [Citation(s) in RCA: 187] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Salim Mujais
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Karl Nolph
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Ram Gokal
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Peter Blake
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - John Burkart
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Gerald Coles
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Yoshindo Kawaguchi
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Hideki Kawanishi
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Stephen Korbet
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Raymond Krediet
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Bengt Lindholm
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Dimitrios Oreopoulos
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Bengt Rippe
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
| | - Rafael Selgas
- International Society for Peritoneal Dialysis Ad Hoc Committee on Ultrafiltration Management in Peritoneal Dialysis
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Biesen Van W, Devriese AS, Carlsson O, Landschoot Van M, Dheuvaert T, Lameire NH. Comparison of the Radioiodinated Serum Albumin (RISA) Dilution Technique with Direct Volumetric Measurements in Animal Models of Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080202200304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Rat models of peritoneal dialysis (PD) are useful for studying the physiology of peritoneal transport and evaluating new osmotic agents. Intraperitoneal (IP) solute concentrations and their evolution over time are easy to measure, but IP volume (IPV) is not. Direct volumetric measurements are the “gold standard,” but they are expensive and do not allow for repetitive measurements in the same animal. The indicator dilution technique is therefore used as an alternative. However, that technique is based on assumptions that are not always valid. The present study compares direct volume measurement with the indicator dilution technique [radioiodinated serum albumin (RISA)] to determine the IPV over time curves in a rat model of PD. Methods In series 1, 17 Sprague–Dawley rats were instilled IP with 25 mL 1.36% glucose dialysate through a Teflon catheter. In 9 animals, 0.35 mL dialysate was sampled and discarded at time points 0, 3, 15, 30, 60, 180, and 240 minutes. In the other 8 animals, no sampling was performed. At 240 minutes, all 12 animals were humanely killed, and direct volumetric measurements of IPV were performed. In series 2, rats were instilled IP with 25 mL 1.36% glucose dialysate containing 18.5 kBq 131I RISA. In 9 animals, dialysate was sampled at 0, 3, 15, 30, 60, 90, 120, 180, and 240 minutes for the construction of the RISA concentration-over-time curve, and to calculate the elimination constant Ke. At 30, 60, 180, and 240 minutes, dialysate was sampled in 6 different animals (total n = 24) to calculate IPV using the RISA dilution technique. Immediately afterward, the animals were humanely killed, and direct volumetric measurements of IPV were performed. Results In series 1, after 240 minutes’ dwell time, the IPV was lower in the sampled animals as compared with the non sampled animals (27.11 ± 1.85 mL vs 30.75 ± 0.59 mL, p = 0.001). In series 2, the evolution of RISA activity in the dialysate over time was described by piecewise linear regression, yielding 3288 – 8.2T counts (cts) for T < 52.72 minutes and 2973 – 1.99T counts for T > 52.72 minutes. The IPV was better predicted with a Ke that took into account the disappearance of RISA by sampling than with a Ke that took into account disappearance of RISA only by absorption. Conclusions If indicator dilution techniques are used to measure IPV, attention must be paid to the disappearance of the osmotic agent and the marker by multiple sampling. The best way to meet that goal is to use micropipettes to avoid large sample volumes.
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Affiliation(s)
- Wim Biesen Van
- Department of Internal Medicine, Renal Division, University Hospital Gent, Gent
| | - An S. Devriese
- Department of Internal Medicine, Renal Division, University Hospital Gent, Gent
| | - Ola Carlsson
- Department of Nephrology and Physiology, University Lund, Lund, Belgium
| | - Mike Landschoot Van
- Department of Internal Medicine, Renal Division, University Hospital Gent, Gent
| | - Tomy Dheuvaert
- Department of Internal Medicine, Renal Division, University Hospital Gent, Gent
| | - Norbert H. Lameire
- Department of Internal Medicine, Renal Division, University Hospital Gent, Gent
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4
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Martikainen TA, Teppo AM, Grönhagen–Riska C, Ekstrand AV. Glucose-Free Dialysis Solutions: Inductors of Inflammation or Preservers of Peritoneal Membrane? Perit Dial Int 2020. [DOI: 10.1177/089686080502500509] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objectives Glucose and other bioincompatible factors of conventional peritoneal dialysis solutions may damage the peritoneal membrane. The aim of our study was to investigate whether replacement of glucose with icodextrin (ID) or amino acids (AA) affects inflammatory parameters or cancer antigen 125 (CA125). Design Either ID or AA was used, in random order, in one daily exchange during an 8-week period. After the first study period, the patients entered a washout period and then switched to the other study solution for an 8-week period. C-reactive protein (CRP) was measured in serum, and CA125, tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), and hyaluronan (HA) were measured in the overnight dwell dialysates at the beginning and end of the study periods. Setting A university hospital. Patients 22 patients with duration on peritoneal dialysis of 1.5 – 6.3 months. Main Outcome Measures Levels of serum CRP and dialysate CA125, IL-6, HA, and sICAM-1 during use of ID and AA were compared to levels during use of glucose-only-based solutions. Results CRP increased significantly during use of ID. CA125 increased significantly during 8 weeks’ use of AA, from 22.8 (5.4 – 89.0) to 42.9 (7.1 – 92.9) kU/L ( p = 0.007). IL-6 increased during 8 weeks’ use of AA, from 22.0 (9.0 – 108.0) to 36.5 (14.0 – 93.0) ng/L ( p = 0.002) and ID, from 25.5 (8.0 – 82.0) to 40.0 (12.0 – 118.0) ng/L ( p = 0.008). TNF-α also increased significantly during use of ID, but showed no significant changes during use of AA. Conclusions The use of glucose-free solutions, especially AA, may lead to preservation of mesothelial cell mass and host defense. However, activation of systemic and peritoneal inflammation may appear during the use of ID and to a lesser extent during use of AA.
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Affiliation(s)
- Terhi A. Martikainen
- Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - Anna-Maija Teppo
- Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - Carola Grönhagen–Riska
- Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - Agneta V. Ekstrand
- Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
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Pereira I, Fraga S, Maltez L, Requicha J, Guardão L, Oliveira J, Prada J, Alves H, Santos JD, Teixeira JP, Pereira JE, Soares R, Gama FM. In vivo systemic toxicity assessment of an oxidized dextrin-based hydrogel and its effectiveness as a carrier and stabilizer of granular synthetic bone substitutes. J Biomed Mater Res A 2019; 107:1678-1689. [PMID: 30920095 DOI: 10.1002/jbm.a.36683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/25/2019] [Accepted: 03/22/2019] [Indexed: 11/11/2022]
Abstract
The worldwide incidence of bone disorders is raising, mainly due to aging population. The lack of effective treatments is pushing the development of synthetic bone substitutes (SBSs). Most ceramic-based SBSs commercially available display limited handling properties. Attempting to solve these issues and achieve wider acceptance by the clinicians, granular ceramics have been associated with hydrogels (HGs) to produce injectable/moldable SBSs. Dextrin, a low-molecular-weight carbohydrate, was used to develop a fully resorbable and injectable HG. It was first oxidized with sodium periodate and then cross-linked with adipic acid dihydrazide. The in vivo biocompatibility and safety of the dextrin-based HG was assessed by subacute systemic toxicity and skin sensitization tests, using rodent models. The results showed that the HG did not induce any systemic toxic effect, skin reaction, or genotoxicity, neither impaired the bone repair/regeneration process. Then, the HG was successfully combined with granular bone substitute, registered as Bonelike (250-500 μm) to obtain a moldable/injectable SBS, which was implanted in tibial fractures in goats for 3 and 6 weeks. The obtained results showed that HG allowed the stabilization of the granules into the defect, ensuring effective handling, and molding properties of the formulation, as well as an efficient cohesion of the granules. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1678-1689, 2019.
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Affiliation(s)
- Isabel Pereira
- CEB - Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Sónia Fraga
- Departamento de Saúde Ambiental, Instituto Nacional de Saúde Dr. Ricardo Jorge, 4000-053, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600, Porto, Portugal
| | - Luís Maltez
- CECAV - Animal and Veterinary Research Centre, University of Trás-os-Montes e Alto Douro, 5001-801, Vila Real, Portugal.,Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5001-801, Vila Real, Portugal
| | - João Requicha
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5001-801, Vila Real, Portugal
| | - Luísa Guardão
- Animal House Unit, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - Joana Oliveira
- Animal House Unit, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - Justina Prada
- CECAV - Animal and Veterinary Research Centre, University of Trás-os-Montes e Alto Douro, 5001-801, Vila Real, Portugal.,Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5001-801, Vila Real, Portugal
| | - Helena Alves
- Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, Instituto Nacional de Saúde Dr. Ricardo Jorge, 4000-053, Porto, Portugal
| | - José Domingos Santos
- REQUIMTE-LAQV, Departamento de Engenharia Metalúrgica e Materiais, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, Porto, 4200-465, Portugal
| | - João Paulo Teixeira
- Departamento de Saúde Ambiental, Instituto Nacional de Saúde Dr. Ricardo Jorge, 4000-053, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600, Porto, Portugal
| | - José Eduardo Pereira
- CECAV - Animal and Veterinary Research Centre, University of Trás-os-Montes e Alto Douro, 5001-801, Vila Real, Portugal.,Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5001-801, Vila Real, Portugal
| | - Raquel Soares
- Department of Biomedicine, Unit of Biochemistry, Faculty of Medicine, i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, 4200-319, Portugal
| | - Francisco Miguel Gama
- CEB - Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
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Pereira I, Fraga S, Silva S, Teixeira JP, Gama M. In vitro genotoxicity assessment of an oxidized dextrin-based hydrogel for biomedical applications. J Appl Toxicol 2018; 39:639-649. [PMID: 30485472 DOI: 10.1002/jat.3754] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/01/2018] [Accepted: 10/15/2018] [Indexed: 01/13/2023]
Abstract
Hydrogels are three-dimensional, crosslinked networks of hydrophilic polymers swollen with a large amount of water or biological fluids, without dissolving. Dextrin, a low-molecular-weight carbohydrate composed by glucose residues, has been used to develop an injectable hydrogel for biomedical applications. Dextrin was first oxidized to introduce aldehyde groups, which then reticulate with adipic acid dihydrazide, forming the dextrin-based hydrogel (HG). The HG and its components were tested for cyto- and genotoxicity according to the International Standard ISO 10993-3 on the biological evaluation of medical devices. To assess genotoxicity, a battery of in vitro genotoxicity tests employing both eukaryotic and prokaryotic models was performed: comet assay, cytokinesis-block micronucleus assay and Ames test. Our data revealed that the HG (IC50 = 2.8 mg/mL) and oxidized dextrin by itself (IC50 = 1.2 mg/mL) caused a concentration-dependent decrease in cellular viability of human lymphoblastoid TK6 cells after 24 hours of exposure to the test agents. However, these concentrations are unlikely to be reached in vivo. In addition, no significant increase in the DNA and chromosomal damage of TK6 cells exposed to non-cytotoxic concentrations of the HG and its isolated components was detected. Furthermore, neither the HG nor its metabolites exerted a mutagenic effect in different of Salmonella typhimurium strains and in an Escherichia coli mix. Our data demonstrated the genocompatibility of the HG (up to 3.5 mg/mL) for biomedical applications. To our best acknowledge, this is the first report with a detailed genotoxicity assessment of an aldehyde-modified polysaccharide/adipic acid dihydrazide hydrogel.
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Affiliation(s)
- Isabel Pereira
- CEB-Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Sónia Fraga
- Departamento de Saúde Ambiental, Instituto Nacional de Saúde Dr. Ricardo Jorge, 4000-055, Porto, Portugal.,EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600, Porto, Portugal
| | - Susana Silva
- Departamento de Saúde Ambiental, Instituto Nacional de Saúde Dr. Ricardo Jorge, 4000-055, Porto, Portugal.,EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600, Porto, Portugal
| | - João Paulo Teixeira
- Departamento de Saúde Ambiental, Instituto Nacional de Saúde Dr. Ricardo Jorge, 4000-055, Porto, Portugal.,EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600, Porto, Portugal
| | - Miguel Gama
- CEB-Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
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Pereira I, Simões J, Evtyugin DV, Rouif S, Coimbra MA, Domingues MRM, Gama M. Effects of gamma irradiation and periodate oxidation on the structure of dextrin assessed by mass spectrometry. Eur Polym J 2018. [DOI: 10.1016/j.eurpolymj.2018.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Hu X, Wang Y, Liu C, Jin Z, Tian Y. Dextrin-uricase conjugate: Preparation, characterization, and enzymatic properties. Int J Biol Macromol 2018; 111:28-32. [DOI: 10.1016/j.ijbiomac.2017.12.131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/18/2017] [Accepted: 12/25/2017] [Indexed: 01/13/2023]
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Rousso S, Banh TM, Ackerman S, Piva E, Licht C, Harvey EA. Impact of fill volume on ultrafiltration with icodextrin in children on chronic peritoneal dialysis. Pediatr Nephrol 2016; 31:1673-9. [PMID: 27178072 DOI: 10.1007/s00467-016-3398-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 04/22/2016] [Accepted: 04/22/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Icodextrin is a solution of glucose polymers developed to provide sustained ultrafiltration over an extended dwell. Our aim was to determine whether or not fill volume with icodextrin contributes to the ability to achieve ultrafiltration in children. METHODS The charts of all children on chronic peritoneal dialysis between January 2000 and July 2014 were screened for the use of an icodextrin day dwell. Data were extracted from the electronic chart and the HomeChoice™ Pro card and corrected for body surface area (BSA). RESULTS Fifty children had an icodextrin day dwell. A linear correlation was found between the daytime fill volume and net ultrafiltration (p < 0.001). More ultrafiltration was achieved with a fill volume above 550 ml/m(2) BSA (107 ± 75 ml/m(2) BSA) than with smaller fill volumes (-8 ± 99 ml; p = 0.004). Ultrafiltration was achieved in 88 % of children with a fill volume above 550 ml/m(2) BSA versus only 44 % of patients with a smaller fill volume (p = 0.001). Icodextrin was well tolerated. CONCLUSIONS Our observations reveal that the larger the fill volume the higher the likelihood of achieving ultrafiltration with icodextrin and suggest that a minimum day dwell volume of 550 ml/m(2) BSA seems to facilitate ultrafiltration in children. To our knowledge this is the largest study addressing ultrafiltration with icodextrin in children.
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Affiliation(s)
- Sharon Rousso
- Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. .,University of Toronto, Toronto, Ontario, Canada.
| | - Tonny M Banh
- University of Toronto, Toronto, Ontario, Canada.,Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Susan Ackerman
- Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Piva
- Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Christoph Licht
- Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.,University of Toronto, Toronto, Ontario, Canada.,Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elizabeth A Harvey
- Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.,University of Toronto, Toronto, Ontario, Canada
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Azzopardi E, Lloyd C, Teixeira SR, Conlan RS, Whitaker IS. Clinical applications of amylase: Novel perspectives. Surgery 2016; 160:26-37. [PMID: 27117578 DOI: 10.1016/j.surg.2016.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 12/20/2015] [Accepted: 01/08/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Amylase was the first enzyme to be characterized, and for the previous 200 years, its clinical role has been restricted to a diagnostic aid. Recent interface research has led to a substantial expansion of its role into novel, viable diagnostic, and therapeutic applications to cancer, infection, and wound healing. This review provides a concise "state-of-the-art" overview of the genetics, structure, distribution, and localization of amylase in humans. METHOD A first-generation literature search was performed with the MeSH search string "Amylase AND (diagnost∗ OR therapeut$)" on OVIDSP and PUBMED platforms. A second-generation search was then performed by forward and backward referencing on Web of Knowledge™ and manual indexing, limited to the English Language. RESULTS "State of the Art" in amylase genetics, structure, function distribution, localisation and detection of amylase in humans is provided. To the 4 classic patterns of hyperamylasemia (pancreatic, salivary, macroamylasemia, and combinations) a fifth, the localized targeting of amylase to specific foci of infection, is proposed. CONCLUSIONS The implications are directed at novel therapeutic and diagnostic clinical applications of amylase such as the novel therapeutic drug classes capable of targeted delivery and "smart release" in areas of clinical need. Future directions of research in areas of high clinical benefit are reported.
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Affiliation(s)
- Ernest Azzopardi
- Reconstructive Surgery and Regenerative Medicine Group, Swansea University, Swansea, United Kingdom; Centre for Nanohealth, Swansea University, Swansea, United Kingdom; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom; Swansea University Medical School, Swansea University, Swansea, United Kingdom.
| | - Catherine Lloyd
- Reconstructive Surgery and Regenerative Medicine Group, Swansea University, Swansea, United Kingdom; Centre for Nanohealth, Swansea University, Swansea, United Kingdom
| | | | - R Steven Conlan
- Centre for Nanohealth, Swansea University, Swansea, United Kingdom; Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Iain S Whitaker
- Reconstructive Surgery and Regenerative Medicine Group, Swansea University, Swansea, United Kingdom; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom; Swansea University Medical School, Swansea University, Swansea, United Kingdom
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Das D, Pal S. Modified biopolymer-dextrin based crosslinked hydrogels: application in controlled drug delivery. RSC Adv 2015. [DOI: 10.1039/c4ra16103c] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This review describes hydrogels and their classifications along with the synthesis and properties of biopolymer-dextrin based crosslinked hydrogels towards potential application in controlled drug delivery.
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Affiliation(s)
- Dipankar Das
- Polymer Chemistry Laboratory
- Department of Applied Chemistry
- Indian School of Mines
- Dhanbad-826004
- India
| | - Sagar Pal
- Polymer Chemistry Laboratory
- Department of Applied Chemistry
- Indian School of Mines
- Dhanbad-826004
- India
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12
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Silva DM, Nunes C, Pereira I, Moreira AS, Domingues MRM, Coimbra MA, Gama FM. Structural analysis of dextrins and characterization of dextrin-based biomedical hydrogels. Carbohydr Polym 2014; 114:458-466. [DOI: 10.1016/j.carbpol.2014.08.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 06/24/2014] [Accepted: 08/02/2014] [Indexed: 11/25/2022]
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14
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Hu X, Wei B, Zhang B, Xu X, Jin Z, Tian Y. Synthesis and characterization of dextrin monosuccinate. Carbohydr Polym 2013; 97:111-5. [DOI: 10.1016/j.carbpol.2013.04.054] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 04/10/2013] [Accepted: 04/13/2013] [Indexed: 01/13/2023]
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17
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Chaudhary K, Khanna R. Biocompatible Peritoneal Dialysis Solutions: Do We Have One?: Table 1. Clin J Am Soc Nephrol 2010; 5:723-32. [DOI: 10.2215/cjn.05720809] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Nakao A, Nakao K, Takatori Y, Kojo S, Inoue J, Akagi S, Sugiyama H, Wada J, Makino H. Effects of icodextrin peritoneal dialysis solution on the peritoneal membrane in the STZ-induced diabetic rat model with partial nephrectomy. Nephrol Dial Transplant 2009; 25:1479-88. [DOI: 10.1093/ndt/gfp479] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Raju I, Cressey DM. Icodextrin 7.5% dialysate solution for peritoneal dialysis and erroneous blood glucose measurement. Anaesthesia 2008; 63:1262-3. [DOI: 10.1111/j.1365-2044.2008.05721.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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The new peritoneal dialysis solutions: friends only, or foes in part? ACTA ACUST UNITED AC 2007; 3:604-12. [DOI: 10.1038/ncpneph0620] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2007] [Accepted: 06/29/2007] [Indexed: 11/08/2022]
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21
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Martikainen T, Ekstrand A, Honkanen E, Teppo AM, Grönhagen-Riska C. Do interleukin-6, hyaluronan, soluble intercellular adhesion molecule-1 and cancer antigen 125 in dialysate predict changes in peritoneal function? A 1-year follow-up study. ACTA ACUST UNITED AC 2006; 39:410-6. [PMID: 16257844 DOI: 10.1080/00365590500386809] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Diminishing ultrafiltration and dialysis adequacy may limit the long-term use of peritoneal dialysis (PD). Inflammation may play a role in changes in peritoneal function. This study was designed to evaluate alterations in peritoneal function and soluble factors in dialysate during a 1-year follow-up period. MATERIAL AND METHODS A personal dialysis capacity test was performed at the start of the study and after 6 and 12 months in 20 patients in order to determine dialysis adequacy and membrane characteristics. Dialysate was collected during the test days for analyses of interleukin-6 (IL-6), soluble intercellular adhesion molecule-1, hyaluronan and cancer antigen 125 (CA125). RESULTS There were no significant changes in dialysis adequacy or membrane characteristics during the 1-year follow-up period. The appearance rate of IL-6 in dialysate increased significantly (419.8+/-63.3 at the start, 784.1+/-136.4 after 6 months and 1149.3+/-252.2 ng/24 h after 12 months; p=0.006) during follow-up. Furthermore, the appearance rate of CA125 increased throughout the study in patients using icodextrin, but decreased slightly in patients using only conventional dialysis solutions. CONCLUSIONS There were no major changes in dialysis adequacy or membrane characteristics during the follow-up period, but increased IL-6 in dialysate may reflect peritoneal inflammation, which may lead to long-term alterations in the peritoneal membrane. Icodextrin may have a preventive effect on the longevity of the peritoneal membrane.
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Affiliation(s)
- Terhi Martikainen
- Department of Medicine, Division of Nephrology, Helsinki University Central Hospital, Helsinki, Finland
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22
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Martikainen T, Teppo AM, Gronhagen-Riska C, Ekstrand A. Benefit of Glucose-Free Dialysis Solutions on Glucose and Lipid Metabolism in Peritoneal Dialysis Patients. Blood Purif 2005; 23:303-10. [PMID: 15980620 DOI: 10.1159/000086553] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2004] [Accepted: 03/21/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Glucose absorbed from conventional peritoneal dialysis (PD) solutions contributes to unfavorable metabolic effects. Its replacement with a glucose-free osmotic agent such as icodextrin (ID) or amino acids (AA) may have some benefit on glucose and lipid metabolism. METHODS Serum lipids, insulin sensitivity and substrate oxidation (calorimetry) were measured before and after 8 weeks use of ID or AA in 22 patients. Calorimetry and blood tests (HbA1c, lipids) were also performed after 8 weeks of simultaneous use of ID and AA in 8 patients. RESULTS Cholesterol declined during the use of AA (4.8 +/- 0.3-4.5 +/- 0.3 mmol/l, p = 0.045). Triglycerides decreased during the use of both ID (2.2 +/- 0.2-1.9 +/- 0.1 mmol/l, p = 0.019) and AA (1.9 +/- 0.2-1.6 +/- 0.1 mmol/l, p = 0.024). Free fatty acids declined during the use of AA. There were no significant changes in insulin sensitivity. Glucose oxidation decreased and lipid oxidation increased during the use of ID, the changes in substrate oxidation were accentuated during the simultaneous use of ID and AA. CONCLUSION Replacement of glucose with ID or AA had a benefit on glucose and lipid metabolism.
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Affiliation(s)
- Terhi Martikainen
- Department of Medicine, Division of Nephrology, Helsinki University Central Hospital, Helsinki, Finland
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Dart A, Feber J, Wong H, Filler G. Icodextrin re-absorption varies with age in children on automated peritoneal dialysis. Pediatr Nephrol 2005; 20:683-5. [PMID: 15719251 DOI: 10.1007/s00467-004-1783-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2004] [Revised: 11/12/2004] [Accepted: 11/12/2004] [Indexed: 11/24/2022]
Abstract
Information on the use of Icodextrin in children remains scarce; however, it is believed that the characteristics are similar across all ages. We report the use of Icodextrin in a cohort of pediatric automated peritoneal dialysis (APD) patients younger than those previously reported (n=8, median age of 2.8, range 0.02-17.1 years). Net Icodextrin daytime dwell ultrafiltration was calculated in each patient for every day on therapy as ml/h/m2. Half of the patients showed re-absorption even when reducing Icodextrin dwells from a median of 10 to 6 h. All four patients who re-absorbed the Icodextrin (ranging from -23.7+/-7.5 to -2.5+/-6.0 ml/h/m2) were treated with cyclic nocturnal APD, and three of these four patients were high transporters on the peritoneal equilibration test (PET). Icodextrin fluid removal correlated significantly with age (Spearman rank r=0.8571, P=0.0107). The data suggest that Icodextrin behaves differently in young children.
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Affiliation(s)
- Allison Dart
- Department of Pediatrics, Division of Nephrology, Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada
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24
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Johnson DW, Agar J, Collins J, Disney A, Harris DCH, Ibels L, Irish A, Saltissi D, Suranyi M. Recommendations for the use of icodextrin in peritoneal dialysis patients. Nephrology (Carlton) 2004; 8:1-7. [PMID: 15012742 DOI: 10.1046/j.1440-1797.2003.00117.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Icodextrin is a starch-derived, high molecular weight glucose polymer, which has been shown to promote sustained ultrafiltration equivalent to that achieved with hypertonic (3.86%/4.25%) glucose exchanges during prolonged intraperitoneal dwells (up to 16 h). Patients with impaired ultrafiltration, particularly in the settings of acute peritonitis, high transporter status and diabetes mellitus, appear to derive the greatest benefit from icodextrin with respect to augmentation of dialytic fluid removal, amelioration of symptomatic fluid retention and possible prolongation of technique survival. Glycaemic control is also improved by substituting icodextrin for hypertonic glucose exchanges in diabetic patients. Preliminary in vitro and ex vivo studies suggest that icodextrin demonstrates greater peritoneal membrane biocompatibility than glucose-based dialysates, but these findings need to be confirmed by long-term clinical studies. This paper reviews the available clinical evidence pertaining to the safety and efficacy of icodextrin and makes recommendations for its use in peritonal dialysis.
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Affiliation(s)
- David W Johnson
- Princess Alexandra Hospital, Brisbane, Queensland, Australia.
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25
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Abstract
UNLABELLED Icodextrin (Extraneal) is a high molecular weight glucose polymer developed specifically for use as an alternative osmotic agent to dextrose during the once-daily long-dwell exchange in peritoneal dialysis (PD). Isosmotic 7.5% icodextrin solution induces transcapillary ultrafiltration (UF) by a mechanism resembling 'colloid' osmosis (unlike hyper-osmolar dextrose-based solutions, which induce UF by crystalline osmosis). In addition, absorption of icodextrin from the peritoneal cavity is relatively slow compared with that of dextrose; this results not only in UF of longer duration, but also a lower carbohydrate load compared with medium (2.5%) and strong (4.25%) dextrose exchanges. In randomised clinical trials of up to 2 years in duration, administration of icodextrin for the long (8- to 16-hour) overnight exchange in continuous ambulatory peritoneal dialysis (CAPD) or daytime exchange in automated peritoneal dialysis (APD) produced net UF which exceeded that with 1.5% and 2.5% dextrose solutions (thereby improving fluid balance), and was equivalent to that with 4.25% dextrose solution. Icodextrin also increased peritoneal clearances of creatinine and urea nitrogen compared with 2.5% dextrose solution. The increase in UF volume with icodextrin was enhanced in CAPD patients with high peritoneal membrane permeability (i.e. high and high-average transporters), maintained in the small number of patients followed-up for 2 years and sustained during episodes of peritonitis. Icodextrin reduced the percentage of patients with net negative UF in contrast to 1.5% and 2.5% dextrose and, in noncomparative studies, extended PD technique survival in patients who had failed dextrose-based dialysis. The use of icodextrin was also associated with some symptomatic improvements and health-related quality of life advantages, and no adverse effect on patient survival, compared with dextrose, although confirmation of these findings is ideally required in appropriately designed studies. The tolerability of icodextrin was generally similar to that of dextrose-based solutions in controlled clinical trials, although there was an approximate three-fold increase in the risk of new skin rash (5.5% vs 1.7%). However, reports of severe cutaneous hypersensitivity reactions remain rare; this possibility should not preclude the use of the polymer. CONCLUSION 7.5% icodextrin solution offers the first feasible alternative to conventional dextrose solutions for the once-daily long-dwell exchange in PD. It is effective, generally well tolerated and appears to be most useful in situations of reduced or inadequate UF with dextrose, including in high and high-average transporters, during episodes of peritonitis and patients who have failed dextrose-based dialysis.
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Affiliation(s)
- James E Frampton
- Adis International Limited, Mairangi Bay, Auckland, New Zealand.
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Hreczuk-Hirst D, Chicco D, German L, Duncan R. Dextrins as potential carriers for drug targeting: tailored rates of dextrin degradation by introduction of pendant groups. Int J Pharm 2001; 230:57-66. [PMID: 11672956 DOI: 10.1016/s0378-5173(01)00859-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There is a recognised need to identify new biodegradable polymers suitable for development as targetable drug carriers. The aim of this study was to determine the rate of degradation of two dextrin fractions (Mw 15.5 and 51 KDa) by alpha-amylase and liver lysosomal enzymes (tritosomes). Also experiments were conducted to discover whether backbone modification by succinolyation (1-34 mol%) or pendant group incorporation (e.g. doxorubicin) could be used to tailor the rate of polymer degradation. Dextrin (alpha-1,4 polyglucose) is a natural polymer used clinically as a peritoneal dialysis solution and as a controlled drug delivery formulation. Size exclusion chromatography (SEC) showed that dextrin was degraded rapidly (within 20 min) by rat plasma and porcine pancreatic alpha-amylase. In contrast over 48 h no degradation was observed in the presence of tritosomes. The rate of alpha-amylase degradation of succinoylated dextrins (Mw approximately 51 KDa) was dependant on the degree of modification (dextrin >1>5>15>34 mol% succinoylation). Dextrin-doxorubicin conjugates were prepared from the 15 and 34 mol% succinoylated intermediates to have a doxorubicin loading of 8 and 12 wt.%, respectively. These doxorubicin conjugates were more stable than their parent intermediates, and SEC showed an apparently higher molecular weight. The drug conjugates did however degrade slowly over 7 days to release oligosaccharide-doxorubicin species. This fundamental study demonstrates the possibility of controlling the rate of dextrin enzymolysis by backbone modification and thus affords the potential to rationally design dextrin-drug conjugates for specific applications as targetable carriers.
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Affiliation(s)
- D Hreczuk-Hirst
- Centre for Polymer Therapeutics, The School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX, UK
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Hosie K, Gilbert JA, Kerr D, Brown CB, Peers EM. Fluid dynamics in man of an intraperitoneal drug delivery solution: 4% icodextrin. Drug Deliv 2001; 8:9-12. [PMID: 11280443 DOI: 10.1080/107175401300002694] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Interest in targeting drugs into the peritoneal cavity for intra-abdominal cancers or infections is undergoing a revival as recent clinical trials have demonstrated, not only a regional advantage in concentration of the active agent, but also improved long-term outcomes. Solutions currently used for intraperitoneal (IP) drug delivery have short residence times, however, which can limit the exposure of all areas of the peritoneum to the active agent. Icodextrin 4% solution was compared with saline and a glucose-based peritoneal dialysis solution in a clinical study of IP residence time. The study was carried out during the fortnightly rest phase in 9 patients undergoing 5-fluorouracil (5-Fu) IP treatment for colorectal cancer. The volume remaining in the peritoneal cavity was measured at 0, 12, 24, 48, 72, and 96 hr after an instillation of 2 liters of each fluid. Saline (n = 3 dwells) and glucose (n = 3 dwells) peritoneal dialysis solutions were almost fully absorbed by 24 hr, and the patients experienced discomfort when using these solutions. In contrast, icodextrin 4% solution (n = 188 dwells) maintained its instilled volume for up to 48 hr, and half the instilled volume remained after 72 and 96 hr. This result would allow extensive and prolonged coverage of the peritoneal surface. Icodextrin 4% solution may be an effective vehicle to deliver therapeutic agents into the peritoneal cavity.
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Affiliation(s)
- K Hosie
- Northern General Hospital, Sheffield, United Kingdom
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