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Deo P, Fenech M, Dhillon VS. Association between glycation biomarkers, hyperglycemia, and micronucleus frequency: A meta -analysis. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2021; 787:108369. [PMID: 34083054 DOI: 10.1016/j.mrrev.2021.108369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 12/15/2022]
Abstract
Micronucleus assay has been used as a biomarker of DNA damage, chromosomal instability, cancer risk and accelerated aging. In this review, a meta-analysis was performed to assess the association between micronuclei (MNi) and diseases with increased advanced glycation end products (AGEs) and HbA1c. The review identified eight studies with 632 subjects with disease and 547 controls. The Mean Ratio (MRi) for AGE levels (MRi = 2.92, 95 %CI: 2.06-4.13, P < 0.00001) and HbA1c levels (MRi = 1.32, 95 %CI: 1.12-1.56, P = 0.001) were significantly higher in the disease group compared to healthy controls. The meta-analysis indicated that the overall estimates of MRi for MNi was 1.83 (95 %CI: 1.38-2.42, p < 0.0001) in subjects with disease compared to controls. Significant increases in MRi for MNi were also observed in the following sub-groups: subjects with disease for elevated AGEs (MRi = 1.62, 95 %CI: 1.12-2.35, P = 0.01), elevated HbA1c (MRi = 2.13, 95 %CI: 1.33-3.39, P = 0.002), lymphocytes MNi (MRi = 1.74, 95 %CI: 1.29-2.33, P = 0.0003), exfoliated buccal cells MNi (MRi = 2.86, 95 %CI: 1.19-6.87, P = 0.02), type 2 diabetes mellitus (T2DM) (MRi = 1.99, 95 %CI: 1.17-3.39, P = 0.01), chronic renal disease (MRi = 1.68, 95 %CI: 1.18-2.38, P = 0.004) and other disease groups (MRi = 2.52, 95 %CI: 1.28-4.96, P = 0.008). The results of this review suggest that MNi could be used as a biomarker of DNA damage and chromosomal instability in degenerative disease where increased AGEs and HbA1c are implicated. The lack of heterogeneity for MN frequency when considered either for all studies or subgroup strengthened the MRi of the meta-analysis. However, the lack of significant association between MRi for MNi and MRi for AGEs or HbA1c indicates that the case-control studies investigated may be confounded by other variables. Thus, larger studies with long term AGE exposure is warranted to further understand the role of MN formation in the initiation and progression of diseases caused by excessive glycation.
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Affiliation(s)
- Permal Deo
- Health and Biomedical Innovation, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, 5000, Australia.
| | - Michael Fenech
- Health and Biomedical Innovation, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, 5000, Australia; Genome Health Foundation, North Brighton, 5048, Australia; Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Varinderpal S Dhillon
- Health and Biomedical Innovation, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, 5000, Australia
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Deo P, McCullough CL, Almond T, Jaunay EL, Donnellan L, Dhillon VS, Fenech M. Dietary sugars and related endogenous advanced glycation end-products increase chromosomal DNA damage in WIL2-NS cells, measured using cytokinesis-block micronucleus cytome assay. Mutagenesis 2020; 35:169-177. [PMID: 31971590 DOI: 10.1093/mutage/geaa002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/07/2020] [Indexed: 01/11/2023] Open
Abstract
This study investigated the effect of glucose and fructose, and advanced glycation end-products (AGEs) on genome damage in WIL2-NS cells, measured using the cytokinesis-block micronucleus cytome (CBMN-Cyt) assay. The effect of AGEs was investigated using the bovine serum albumin (AGE-BSA) model system induced either with glucose (Glu-BSA) or with fructose (Fru-BSA). Liquid chromatography-mass spectrometry (LC-MS/MS) analysis showed higher Nε-carboxymethyllysine (CML; 26.76 ± 1.09 nmol/mg BSA) levels in the Glu-BSA model. Nε-Carboxyethyllysine (CEL; 7.87 ± 0.19 nmol/mg BSA) and methylglyoxal-derived hydroimidazolone-1 (MG-H1; 69.77 ± 3.74 nmol/mg BSA) levels were higher in the Fru-BSA model. Genotoxic effects were measured using CBMN-Cyt assay biomarkers [binucleated(BN) cells with micronuclei (MNi), BN with nucleoplasmic bridges (NPBs) and BN with nuclear buds (NBuds)] following 9 days of treatment with either glucose, fructose, Glu-BSA or Fru-BSA. Fructose treatment exerted a significant genotoxic dose-response effect including increases of BN with MNi (R2 = 0.7704; P = 0.0031), BN with NPBs (R2 = 0.9311; P < 0.0001) and BN with NBuds (R2 = 0.7118; P = 0.0091) on cells, whereas the DNA damaging effects of glucose were less evident. High concentrations of AGEs (400-600 µg/ml) induced DNA damage; however, there was no effect on cytotoxicity indices (necrosis and apoptosis). In conclusion, this study demonstrates a potential link between physiologically high concentrations of reducing sugars or AGEs with increased chromosomal damage which is an important emerging aspect of the pathology that may be induced by diabetes. Ultimately, loss of genome integrity could accelerate the rate of ageing and increase the risk of age-related diseases over the long term. These findings indicate the need for further research on the effects of glycation on chromosomal instability and to establish whether this effect is replicated in humans in vivo.
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Affiliation(s)
- Permal Deo
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Caitlin L McCullough
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | | | - Emma L Jaunay
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Leigh Donnellan
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Varinderpal S Dhillon
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Michael Fenech
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Genome Health Foundation, North Brighton, Australia
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Stopper H, Bankoglu EE, Marcos R, Pastor S. Micronucleus frequency in chronic kidney disease patients: A review. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2020; 786:108340. [PMID: 33339580 DOI: 10.1016/j.mrrev.2020.108340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/04/2020] [Accepted: 10/09/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) is defined as a gradual loss of renal function progressing from very mild damage, with no obvious symptoms in stage one, to complete kidney failure in stage five, which ultimately requires kidney replacement therapy by organ transplantation or dialysis. Cancer incidence and other health problems, mainly diabetes and hypertension, are elevated in CKD, ultimately leading to elevated mortality. METHODS A literature search on the induction of micronuclei (MN) as endpoint for genomic damage in white blood cells and buccal mucosa cells of CKD patients was conducted. Possible associations with disease stage, treatment modalities, and vitamin or antioxidant supplementations were analyzed. RESULTS In total, 26 studies were enclosed in the data analysis. Patient groups in the predialysis or hemodialysis state of the disease exhibit higher levels of genomic damage, measured as micronucleus frequency in peripheral blood lymphocytes and buccal mucosa cells, than healthy control groups. Genomic damage seems to increase with the disease stage during the predialysis phase. The association with dialysis regimens or with years on dialysis is less clear, but there are indications that efficient removal of uremic toxins is beneficial. Patients with CKD receive a variety of medications, some of which could modulate genomic damage levels and thus contribute to the observed heterogeneity. In addition, supplementation with vitamins or antioxidants may in some cases lower the genomic damage. Meta-Analysis confirmed the high and significant levels of genomic damage present in CKD patients compared to matched healthy controls. CONCLUSION Genomic damage, as measured by the MN frequency, is elevated in CKD patients. Different strategies, including supplementation with antioxidants and optimizing dialysis processes, can reduce the levels of genomic damage and the different associated pathologies. Whether MN frequency can in the future also be used to assist in certain therapeutic decisions in CKD will have to be investigated further in larger studies.
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Affiliation(s)
- Helga Stopper
- Institute of Pharmacology and Toxicology, University of Wuerzburg, Wuerzburg, Germany.
| | - Ezgi Eyluel Bankoglu
- Institute of Pharmacology and Toxicology, University of Wuerzburg, Wuerzburg, Germany
| | - Ricard Marcos
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Madrid, Spain
| | - Susana Pastor
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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Micronuclei and disease - Report of HUMN project workshop at Rennes 2019 EEMGS conference. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2020; 850-851:503133. [PMID: 32247551 DOI: 10.1016/j.mrgentox.2020.503133] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 12/05/2019] [Accepted: 01/07/2020] [Indexed: 02/07/2023]
Abstract
The "Micronuclei and Disease" workshop was organized by the HUMN Project consortium and hosted by the European Environmental Mutagen and Genomics Society at their annual meeting in Rennes, France, on 23 May 2019. The program of the workshop focused on addressing the emerging evidence linking micronucleus (MN) frequency to human disease. The first objective was to review what has been published and evaluate the level and quality of evidence for the connection between MN frequency and various diseases through all life stages. The second objective was to identify the knowledge gaps and what else needs to be done to determine the clinical utility of MN assays as predictors of disease risk and of prognosis when disease is active. Speakers at the workshop discussed the association of MN frequency with inflammation, infertility, pregnancy complications, obesity, diabetes, cardiovascular disease, kidney disease, cervical and bladder cancer, oral head and neck cancer, lung cancer, accelerated ageing syndromes, neurodegenerative diseases, and a road-map on how to utilise this knowledge was proposed. The outcomes of the workshop indicated that there are significant opportunities for translating the application of MN assays into clinical practice to improve disease prevention and risk management and to inform public health policy.
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Colombo G, Reggiani F, Astori E, Altomare A, Finazzi S, Garavaglia ML, Angelini C, Milzani A, Badalamenti S, Dalle-Donne I. Advanced oxidation protein products in nondiabetic end stage renal disease patients on maintenance haemodialysis. Free Radic Res 2019; 53:1114-1124. [PMID: 31755327 DOI: 10.1080/10715762.2019.1690651] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In chronic kidney disease (CKD), the impairment of the excretory function leads to elevation in the blood concentrations of urea, creatinine, and various protein metabolic products. Advanced oxidation protein products (AOPP), along with protein carbonyls, protein-bound di-tyrosines and S-thiolated proteins, are considered biomarkers of oxidative stress in end-stage renal disease (ESRD) patients on maintenance haemodialysis (HD). In this study, we evaluated the correlations between plasma levels of AOPP (measured by size exclusion/gel filtration high performance liquid chromatography) and those of protein-bound di-tyrosines, protein carbonyls, albumin and fibrinogen in 50 nondiabetic ESRD patients on maintenance HD. Considering that AOPP could represent the bridge between oxidative stress and inflammation, having been identified as proinflammatory mediators, we also evaluated the association between AOPP levels, C-reactive protein concentration and white blood cells count. Finally, we assessed the associations between plasma level of AOPP and serum concentrations of creatinine and urea, both of which showed a strong dependence on the chronological age of haemodialysed patients. Taken together, our results confirm the robust relationship between uraemia and oxidative stress, especially when measured as biomarkers of severe protein oxidative damage (e.g. plasma AOPP).
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Affiliation(s)
- Graziano Colombo
- Department of Biosciences (Department of Excellence 2018-2022), Università degli Studi di Milano, Milan, Italy
| | | | - Emanuela Astori
- Department of Biosciences (Department of Excellence 2018-2022), Università degli Studi di Milano, Milan, Italy
| | - Alessandra Altomare
- Department of Pharmaceutical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Silvia Finazzi
- Nephrology Unit, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Maria L Garavaglia
- Department of Biosciences (Department of Excellence 2018-2022), Università degli Studi di Milano, Milan, Italy
| | - Claudio Angelini
- Nephrology Unit, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Aldo Milzani
- Department of Biosciences (Department of Excellence 2018-2022), Università degli Studi di Milano, Milan, Italy
| | | | - Isabella Dalle-Donne
- Department of Biosciences (Department of Excellence 2018-2022), Università degli Studi di Milano, Milan, Italy
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Mamur S, Yuzbasioglu D, Altok K, Unal F, Deger SM. Determination of genotoxic effects in hemodialysis patients with chronic kidney disease and the role of diabetes mellitus and other biochemical parameters. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2019; 844:46-53. [DOI: 10.1016/j.mrgentox.2019.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/19/2019] [Accepted: 05/29/2019] [Indexed: 02/04/2023]
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Bonassi S, Fenech M. Micronuclei and Their Association with Infertility, Pregnancy Complications, Developmental Defects, Anaemias, Inflammation, Diabetes, Chronic Kidney Disease, Obesity, Cardiovascular Disease, Neurodegenerative Diseases and Cancer. THE MICRONUCLEUS ASSAY IN TOXICOLOGY 2019. [DOI: 10.1039/9781788013604-00038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Micronuclei (MN) are a strong cytogenetic indicator of a catastrophic change in the genetic structure and stability of a cell because they originate from either chromosome breaks or whole chromosomes that have been lost from the main nucleus during cell division. The resulting genetic abnormalities can to lead to cellular malfunction, altered gene expression and impaired regenerative capacity. Furthermore, MN are increased as a consequence of genetic defects in DNA repair, deficiency in micronutrients required for DNA replication and repair and exposure to genotoxic chemicals and ultraviolet or ionising radiation. For all of these reasons, the measurement of MN has become one of the best-established methods to measure DNA damage in humans at the cytogenetic level. This chapter is a narrative review of the current evidence for the association of increased MN frequency with developmental and degenerative diseases. In addition, important knowledge gaps are identified, and recommendations for future studies required to consolidate the evidence are provided. The great majority of published studies show a significant association of increased MN in lymphocytes and/or buccal cells with infertility, pregnancy complications, developmental defects, anaemias, inflammation, diabetes, cardiovascular disease, kidney disease, neurodegenerative diseases and cancer. However, the strongest evidence is from prospective studies showing that MN frequency in lymphocytes predicts cancer risk and cardiovascular disease mortality.
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Pastor S, Rodríguez-Ribera L, Corredor Z, da Silva Filho MI, Hemminki K, Coll E, Försti A, Marcos R. Levels of DNA damage (Micronuclei) in patients suffering from chronic kidney disease. Role of GST polymorphisms. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2018; 836:41-46. [DOI: 10.1016/j.mrgentox.2018.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/09/2018] [Accepted: 05/07/2018] [Indexed: 12/08/2022]
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Gandhi G, Mehta T, Contractor P, Tung G. Genotoxic damage in end-stage renal disease. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2018; 835:1-10. [DOI: 10.1016/j.mrgentox.2018.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 08/11/2018] [Accepted: 08/12/2018] [Indexed: 01/24/2023]
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Systemic Redox Imbalance in Chronic Kidney Disease: A Systematic Review. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:8598253. [PMID: 27563376 PMCID: PMC4987477 DOI: 10.1155/2016/8598253] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/31/2016] [Accepted: 06/07/2016] [Indexed: 01/01/2023]
Abstract
Patients with chronic kidney disease (CKD) experience imbalance between oxygen reactive species (ROS) production and antioxidant defenses leading to cell and tissue damage. However, it remains unclear at which stage of renal insufficiency the redox imbalance becomes more profound. The aim of this systematic review was to provide an update on recent advances in our understanding of how the redox status changes in the progression of renal disease from predialysis stages 1 to 4 to end stage 5 and whether the various treatments and dialysis modalities influence the redox balance. A systematic review was conducted searching PubMed and Scopus by using the Cochrane and PRISMA guidelines. In total, thirty-nine studies met the inclusion criteria and were reviewed. Even from an early stage, imbalance in redox status is evident and as the kidney function worsens it becomes more profound. Hemodialysis therapy per se seems to negatively influence the redox status by the elevation of lipid peroxidation markers, protein carbonylation, and impairing erythrocyte antioxidant defense. However, other dialysis modalities do not so far appear to confer advantages. Supplementation with antioxidants might assist and should be considered as an early intervention to halt premature atherogenesis development at an early stage of CKD.
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Corredor Z, Rodríguez-Ribera L, Silva I, Díaz JM, Ballarín J, Marcos R, Coll E, Pastor S. Levels of DNA damage in peripheral blood lymphocytes of patients undergoing standard hemodialysis vs on-line hemodiafiltration: A comet assay investigation. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2016; 808:1-7. [PMID: 27637480 DOI: 10.1016/j.mrgentox.2016.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/22/2016] [Accepted: 07/28/2016] [Indexed: 12/19/2022]
Abstract
Chronic kidney disease (CKD) patients exhibit high levels of genetic damage. Part of this genetic damage is supposed to be caused by the hemodialysis (HD) therapy. Different and more efficient HD procedures could reduce the genetic damage and improve health status of CKD patients. In the present study, we analyzed if changing to online hemodiafiltration (OL-HDF) has a beneficial effect on the levels of genetic damage. The levels of genetic damage (DNA breaks and oxidatively damaged DNA) were analyzed in peripheral blood lymphocytes by using the comet assay. Forty-nine patients submitted to HD, 34 of them changing to OL-HDF and 15 patients continuing in low-flux HD, were included in the study. Plasma antioxidant capacity was also determined. Second sampling period was established after 6 months on the new or traditional HD protocol. A slight decrease in the levels of DNA damage was observed in patients who switched to OL-HDF (P=0.048) in relation to the reference group. This reduction is indicative that OL-HDF shows greater efficiency than low-flux HD in the reduction of basal levels of genetic damage.
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Affiliation(s)
- Zuray Corredor
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici C, Universitat Autònoma de Barcelona, 08193 Bellaterra, Cerdanyola del Vallès, Spain
| | - Lara Rodríguez-Ribera
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici C, Universitat Autònoma de Barcelona, 08193 Bellaterra, Cerdanyola del Vallès, Spain
| | | | | | | | - Ricard Marcos
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici C, Universitat Autònoma de Barcelona, 08193 Bellaterra, Cerdanyola del Vallès, Spain; CIBER Epidemiología y Salud Pública, ISCIII, Madrid, Spain
| | | | - Susana Pastor
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici C, Universitat Autònoma de Barcelona, 08193 Bellaterra, Cerdanyola del Vallès, Spain; CIBER Epidemiología y Salud Pública, ISCIII, Madrid, Spain.
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DNA Damage in Chronic Kidney Disease: Evaluation of Clinical Biomarkers. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:3592042. [PMID: 27313827 PMCID: PMC4897719 DOI: 10.1155/2016/3592042] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/03/2016] [Indexed: 12/11/2022]
Abstract
Patients with chronic kidney disease (CKD) exhibit an increased cancer risk compared to a healthy control population. To be able to estimate the cancer risk of the patients and to assess the impact of interventional therapies thereon, it is of particular interest to measure the patients' burden of genomic damage. Chromosomal abnormalities, reduced DNA repair, and DNA lesions were found indeed in cells of patients with CKD. Biomarkers for DNA damage measurable in easily accessible cells like peripheral blood lymphocytes are chromosomal aberrations, structural DNA lesions, and oxidatively modified DNA bases. In this review the most common methods quantifying the three parameters mentioned above, the cytokinesis-block micronucleus assay, the comet assay, and the quantification of 8-oxo-7,8-dihydro-2′-deoxyguanosine, are evaluated concerning the feasibility of the analysis and regarding the marker's potential to predict clinical outcomes.
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Rodríguez-Ribera L, Pastor S, Corredor Z, Silva I, Diaz JM, Ballarin J, Marcos R, Coll E. Genetic damage in patients moving from hemodialysis to online hemodiafiltration. Mutagenesis 2015; 31:131-5. [DOI: 10.1093/mutage/gev063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Corredor Z, Stoyanova E, Rodríguez-Ribera L, Coll E, Silva I, Diaz JM, Ballarin J, Marcos R, Pastor S. Genomic damage as a biomarker of chronic kidney disease status. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2015; 56:301-312. [PMID: 25234591 DOI: 10.1002/em.21911] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 09/03/2014] [Accepted: 09/04/2014] [Indexed: 06/03/2023]
Abstract
Patients suffering from chronic kidney disease (CKD) exhibit a high incidence of cancer and cardiovascular diseases, as well as high levels of genomic damage. To confirm the association of CKD with genomic damage we have carried out the largest study to date addressing this issue, using a total of 602 subjects (187 controls, 206 pre-dialysis CKD patients and 209 CKD patients in hemodialysis). DNA oxidative damage was measured in all individuals using the comet assay. Our results indicate that CKD patients have significantly higher levels of DNA damage than controls, but no significant differences were observed between pre-hemodialysis (pre-HD) and hemodialysis (HD) patients. When oxidative damage was measured, no differences were observed between patients and controls, although HD patients showed significantly higher levels of oxidative damage than pre-HD patients. In addition, a positive relationship was demonstrated between genomic damage and all-cause mortality. Our study confirms that genomic damage can be predictive of prognosis in CKD patients, with high levels of DNA damage indicating a poor prognosis in HD patients.
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Affiliation(s)
- Zuray Corredor
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici C, Universitat Autònoma de Barcelona, 08193, Bellaterra, Cerdanyola del Vallès, Spain
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Rodríguez-Ribera L, Corredor Z, Sandoval SB, Coll E, Silva I, Diaz JM, Ballarin J, Marcos R, Pastor S. Radiosensitivity in patients suffering from chronic kidney disease. Int J Radiat Biol 2014; 91:172-8. [PMID: 25219678 DOI: 10.3109/09553002.2015.959670] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Patients suffering from chronic kidney disease (CKD) exhibit a high incidence of cancer, as well as high levels of genetic damage. We hypothesized that these patients show genomic instability detected as an increased chromosomal radiosensitivity in front of the genetic damage induced by ionizing radiation. MATERIAL AND METHODS The background levels of genetic damage and the net genetic damage after in vitro irradiation with 0.5 Gy were analyzed using the micronucleus (MN) assay in peripheral blood lymphocytes. A total number of 552 individuals (179 controls and 373 CKD patients) were included in the study. RESULTS The net radiation-induced genetic damage was significantly higher in CKD patients than in controls; but no differences between those patients submitted to hemodialysis and those in pre-dialytic stages were detected. A positive correlation was observed between basal and net micronucleus frequencies in CKD patients what would indicate an underlying genetic background modulating DNA damage levels. CONCLUSIONS Our results indicate that CKD patients present genomic instability, measured as an increased chromosomal radiosensitivity in front of ionizing radiation.
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Affiliation(s)
- Lara Rodríguez-Ribera
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici Cn, Universitat Autònoma de Barcelona , Bellaterra, Cerdanyola del Vallès , Spain
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Rodríguez-Ribera L, Stoyanova E, Corredor Z, Coll E, Silva I, Diaz JM, Ballarin J, Marcos R, Pastor S. Time in hemodialysis modulates the levels of genetic damage in hemodialysis patients. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2014; 55:363-368. [PMID: 24436196 DOI: 10.1002/em.21849] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 12/17/2013] [Accepted: 12/19/2013] [Indexed: 06/03/2023]
Abstract
It is assumed that hemodialysis treatment can diminish the levels of genetic damage in circulating lymphocytes by cleaning the blood of uremic toxins that cause oxidative stress. However, the hemodialysis process by itself may also induce genomic damage by producing reactive oxygen species (ROS). We conducted a follow-up study in a group of 70 hemodialysis patients followed for a mean time of 15 months. We investigated the effect of exposure time in hemodialysis on the levels of genetic damage in peripheral blood lymphocytes using the micronucleus assay. In addition, genetic damage after in vitro irradiation with 0.5 Gy was also analyzed to evaluate changes in radiosensitivity. Our results showed that, at the end of the study, there was a decrease in both the basal levels of genetic damage (9.9 ± 1.0 vs. 7.6 ± 0.7) and radiosensitivity values (38.5 ± 3.0 vs. 27.6 ± 2.4). We conclude that hemodialysis procedures may act as an ameliorating factor reducing the genetic damage present in chronic kidney disease patients.
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Affiliation(s)
- Lara Rodríguez-Ribera
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici C, Universitat Autònoma de Barcelona, 08193, Bellaterra, Cerdanyola del Vallès, Spain
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Rangel-López A, Paniagua-Medina ME, Urbán-Reyes M, Cortes-Arredondo M, Alvarez-Aguilar C, López-Meza J, Ochoa-Zarzosa A, Lindholm B, García-López E, Paniagua JR. Genetic damage in patients with chronic kidney disease, peritoneal dialysis and haemodialysis: a comparative study. Mutagenesis 2013; 28:219-25. [PMID: 23408844 PMCID: PMC3570793 DOI: 10.1093/mutage/ges075] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Patients with chronic kidney disease (CKD) have signs of genomic instability and, as a consequence, extensive genetic damage, possibly due to accumulation of uraemic toxins, oxidative stress mediators and other endogenous substances with genotoxic properties. We explored factors associated with the presence and background levels of genetic damage in CKD. A cross-sectional study was performed in 91 CKD patients including pre-dialysis (CKD patients; n = 23) and patients undergoing peritoneal dialysis (PD; n = 33) or haemodialysis (HD; n = 35) and with 61 healthy subjects, divided into two subgroups with the older group being in the age range of the patients, serving as controls. Alkaline comet assay and cytokinesis-block micronucleus assay in peripheral blood lymphocytes were used to determine DNA and chromosome damage, respectively, present in CKD. Markers of oxidative stress [malondialdehyde (MDA), advanced glycation end products (AGEs), thiols, advanced oxidation protein products and 8-hydroxy-2'-deoxyguanosine] and markers of inflammation (C-reactive protein, interleukin-6 and tumour necrosis factor alpha) were also measured. Micronucleus (MN) frequency was significantly higher (P < 0.05) in the CKD group (46±4‰) when compared with the older control (oC) group (27.7±14). A significant increase in MN frequency (P < 0.05) was also seen in PD patients (41.9±14‰) versus the oC group. There was no statistically significant difference for the HD group (29.7±15.6‰; P = NS) versus the oC group. Comet assay data showed a significant increase (P < 0.001) of tail DNA intensity in cells of patients with CKD (15.6±7%) with respect to the total control (TC) group (11±1%). PD patients (14.8±7%) also have a significant increase (P < 0.001) versus the TC group. Again, there was no statistically significant difference for the HD group (12.5±3%) compared with the TC group. Patients with MN values in the upper quartile had increased cholesterol, triglycerides, AGEs and MDA levels and lower albumin levels. Multiple logistic regression analysis showed that male gender, diabetes and treatment modality were independently associated with higher levels of DNA damage. Our results suggest that oxidative stress, diabetes, gender and dialysis modality in CKD patients increased DNA and chromosome damage. To confirm these data, prospective clinical trials need to be performed.
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Affiliation(s)
- Angélica Rangel-López
- Medical Research Unit on Nephrological Diseases, Specialties Hospital, National Medical Centre, Century XXI, Mexican Institute for Social Security (IMSS), Mexico City, Mexico.
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18
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Tucker PS, Dalbo VJ, Han T, Kingsley MI. Clinical and research markers of oxidative stress in chronic kidney disease. Biomarkers 2013; 18:103-15. [PMID: 23339563 DOI: 10.3109/1354750x.2012.749302] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
CONTEXT Kidney-related pathologies have increasing prevalence rates, produce a considerable financial burden, and are characterized by elevated levels of oxidative stress (OS). OBJECTIVE This review examines relationships between chronic kidney disease (CKD) and markers of OS and antioxidant status (AS). METHODS A systematic review of MEDLINE-indexed clinical trials, randomized controlled trials and comparative studies that examined OS and AS was performed. RESULTS AND CONCLUSION Several markers emerged as well-suited indicators of OS and AS in CKD: malondialdehyde, F2-isoprostanes, lipid hydroperoxides, asymmetric dimethylarginine, 8-oxo-7,8-dihydro-2'-deoxyguanosine, protein carbonyls, advanced oxidation protein products and glutathione-related activity.
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Affiliation(s)
- Patrick Steven Tucker
- Clinical Biochemistry Laboratory, Institute for Health and Social Science Research, Central Queensland University, Rockhampton, QLD, Australia
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19
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Ersson C, Odar‐Cederlöf I, Fehrman‐Ekholm I, Möller L. The effects of hemodialysis treatment on the level of
DNA
strand breaks and oxidative
DNA
lesions measured by the comet assay. Hemodial Int 2012; 17:366-73. [DOI: 10.1111/hdi.12008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Clara Ersson
- Department of Biosciences and NutritionKarolinska Institutet Huddinge Sweden
| | | | | | - Lennart Möller
- Department of Biosciences and NutritionKarolinska Institutet Huddinge Sweden
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20
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Sandoval SB, Pastor S, Stoyanova E, Rodríguez-Ribera L, García-Quispes WA, Coll E, Reyes J, Andrés E, Ballarin J, Marcos R. Genomic instability in chronic renal failure patients. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2012; 53:343-349. [PMID: 22467378 DOI: 10.1002/em.21694] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 02/08/2012] [Accepted: 03/07/2012] [Indexed: 05/31/2023]
Abstract
Patients suffering chronic renal failure (CRF) exhibit a high incidence of cancer, as well as high levels of genetic damage. We hypothesized that these patients show genomic instability as measured by increased radiosensitivity to the induction of genetic damage. The background levels of genetic damage and the net genetic damage after in vitro irradiation with 0.5 Gy were analyzed using the micronucleus assay in peripheral blood lymphocytes of 174 CRF patients and 53 controls. The net radiation-induced genetic damage was significantly higher in CRF patients with respect to controls. Among CRF patients, the levels of genetic damage were higher in those with prior incidence of cancer than in those without cancer; in addition, those CRF patients undergoing hemodialysis presented with higher levels of genetic damage than those in the advanced Stages (4-5) of the pathology. A positive association was observed between basal and net micronucleus frequency among CFR patients. However, no association was found between net genetic damage and parameters linked to the different stages of the pathology, such as urine creatinine levels and glomerular filtration rate. Our results indicate that CRF patients show increased radiosensitivity and that the degree of radiosensitivity is associated with the progression of the pathological stage of the disease.
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Affiliation(s)
- Silvia B Sandoval
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici Cn, Universitat Autònoma de Barcelona, 08193 Bellaterra, Cerdanyola del Vallès, Spain
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21
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Duranton F, Cohen G, De Smet R, Rodriguez M, Jankowski J, Vanholder R, Argiles A. Normal and pathologic concentrations of uremic toxins. J Am Soc Nephrol 2012; 23:1258-70. [PMID: 22626821 DOI: 10.1681/asn.2011121175] [Citation(s) in RCA: 703] [Impact Index Per Article: 58.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
An updated review of the existing knowledge regarding uremic toxins facilitates the design of experimental studies. We performed a literature search and found 621 articles about uremic toxicity published after a 2003 review of this topic. Eighty-seven records provided serum or blood measurements of one or more solutes in patients with CKD. These records described 32 previously known uremic toxins and 56 newly reported solutes. The articles most frequently reported concentrations of β2-microglobulin, indoxyl sulfate, homocysteine, uric acid, and parathyroid hormone. We found most solutes (59%) in only one report. Compared with previous results, more recent articles reported higher uremic concentrations of many solutes, including carboxymethyllysine, cystatin C, and parathyroid hormone. However, five solutes had uremic concentrations less than 10% of the originally reported values. Furthermore, the uremic concentrations of four solutes did not exceed their respective normal concentrations, although they had been previously described as uremic retention solutes. In summary, this review extends the classification of uremic retention solutes and their normal and uremic concentrations, and it should aid the design of experiments to study the biologic effects of these solutes in CKD.
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22
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Aykanat B, Demircigil GC, Fidan K, Buyan N, Gulleroglu K, Baskin E, Bayrakci US, Sepici A, Buyukkaragoz B, Karakayali H, Haberal M, Burgaz S. Basal damage and oxidative DNA damage in children with chronic kidney disease measured by use of the comet assay. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2011; 725:22-8. [DOI: 10.1016/j.mrgentox.2011.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 05/21/2011] [Accepted: 06/22/2011] [Indexed: 11/17/2022]
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23
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Ersson C, Thorman R, Rodhe Y, Möller L, Hylander B. DNA damage in salivary gland tissue in patients with chronic kidney disease, measured by the comet assay. ACTA ACUST UNITED AC 2011; 112:209-15. [DOI: 10.1016/j.tripleo.2011.03.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 02/24/2011] [Accepted: 03/13/2011] [Indexed: 10/18/2022]
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24
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Piroddi M, Palazzetti I, Quintaliani G, Pilolli F, Montaldi M, Valentina V, Libetta C, Galli F. Circulating Levels and Dietary Intake of the Advanced Glycation End-product Marker Carboxymethyl Lysine in Chronic Kidney Disease Patients on Conservative Predialysis Therapy: A Pilot Study. J Ren Nutr 2011; 21:329-39. [DOI: 10.1053/j.jrn.2010.06.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 06/14/2010] [Accepted: 06/29/2010] [Indexed: 11/11/2022] Open
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25
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Cakmak Demircigil G, Aykanat B, Fidan K, Gulleroglu K, Bayrakci US, Sepici A, Buyukkaragoz B, Karakayali H, Haberal M, Baskin E, Buyan N, Burgaz S. Micronucleus frequencies in peripheral blood lymphocytes of children with chronic kidney disease. Mutagenesis 2011; 26:643-50. [DOI: 10.1093/mutage/ger027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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26
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Schupp N, Rutkowski P, Sebeková K, Klassen A, Bahner U, Grupp C, Heidland A, Stopper H. AT1 receptor antagonist candesartan attenuates genomic damage in peripheral blood lymphocytes of patients on maintenance hemodialysis treatment. Kidney Blood Press Res 2011; 34:167-72. [PMID: 21474964 DOI: 10.1159/000326805] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 02/25/2011] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Angiotensin II (ANG II) and advanced glycation end products (AGEs) exert genotoxic effects in vitro which were prevented by the ANG II type 1 (AT1) receptor blocker, candesartan. In end-stage renal disease (ESRD) the incidence of genomic damage is increased. A stimulation of the renin-angiotensin system and accumulation of AGEs could be involved. METHODS We tested whether oral co-administration of candesartan modulates enhanced DNA damage in ESRD patients. Fifteen maintenance hemodialysis (MHD) patients with mild hypertension were treated with candesartan for 4.5 months. Fourteen MHD patients served as conventionally treated uremic controls. DNA damage was measured as micronucleus frequency (MNF) in peripheral blood lymphocytes and evaluated three times before candesartan therapy and afterwards every 6 weeks. RESULTS Compared to 14 healthy controls, MNF at baseline was significantly elevated in MHD patients. While in the conventionally treated MHD patients the enhanced DNA damage persisted, the co-administration of candesartan ameliorated the genomic damage significantly and independently of blood pressure changes. CONCLUSION Blockade of AT1 receptors with candesartan can reduce DNA damage in MHD patients. Long-term studies in larger patient groups are needed to investigate whether the improved genomic damage lowers atherosclerotic complications and cancer development.
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Affiliation(s)
- Nicole Schupp
- Institute of Pharmacology and Toxicology, University of Würzburg, Versbacher Strasse 9, Würzburg, Germany.
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27
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Schupp N, Heidland A, Stopper H. Genomic damage in endstage renal disease-contribution of uremic toxins. Toxins (Basel) 2010; 2:2340-58. [PMID: 22069557 PMCID: PMC3153169 DOI: 10.3390/toxins2102340] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 09/23/2010] [Accepted: 09/26/2010] [Indexed: 12/16/2022] Open
Abstract
Patients with end-stage renal disease (ESRD), whether on conservative, peritoneal or hemodialysis therapy, have elevated genomic damage in peripheral blood lymphocytes and an increased cancer incidence, especially of the kidney. The damage is possibly due to accumulation of uremic toxins like advanced glycation endproducts or homocysteine. However, other endogenous substances with genotoxic properties, which are increased in ESRD, could be involved, such as the blood pressure regulating hormones angiotensin II and aldosterone or the inflammatory cytokine TNF-α. This review provides an overview of genomic damage observed in ESRD patients, focuses on possible underlying causes and shows modulations of the damage by modern dialysis strategies and vitamin supplementation.
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Affiliation(s)
- Nicole Schupp
- Institute of Pharmacology and Toxicology, University of Würzburg, Versbacher Straße 9, 97078 Würzburg, Germany;
- Author to whom correspondence should be addressed; ; Tel.: +49-931-20148722; Fax: +49-931-20148446
| | - August Heidland
- Department of Internal Medicine, University of Würzburg, Josef-Schneider-Straße 2, 97080 Würzburg, Germany;
| | - Helga Stopper
- Institute of Pharmacology and Toxicology, University of Würzburg, Versbacher Straße 9, 97078 Würzburg, Germany;
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28
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Sandoval SB, Stoyanova E, Coll E, Pastor S, Reyes J, Andrés E, Ballarin J, Xamena N, Marcos R. Genetic damage in chronic renal failure patients is associated with the glomerular filtration rate index. Mutagenesis 2010; 25:603-8. [PMID: 20884684 DOI: 10.1093/mutage/geq047] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Chronic renal failure (CRF) patients are considered to present genomic instability and, as a consequence, elevated levels of genetic damage. An open question is whether this damage is related to the stage of the pathology. To determine the background levels of genetic damage, a large population of 258 Caucasian adults (201 CRF patients and 57 controls) was analysed using the micronucleus (MN) assay. The frequency of MN in CRF patients was significantly higher than in controls and correlated with the progression of the disease, according to the glomerular filtration rate. In addition, a significant association was observed between genetic damage and serum creatinine levels. Genetic damage, measured as frequency of MN, increases when renal function decreases. The fact that an increased level of MN is already observed in patients' Stage 2 seems to indicate a genetic predisposition on these patients. Nevertheless, part of the observed damage can be attributed to the uraemic state itself.
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Affiliation(s)
- Silvia Berenice Sandoval
- Grup de Mutagènesi, Departament de Genètica i de Microbiologia, Edifici Cn, Universitat Autònoma de Barcelona, 08193 Bellaterra, Cerdanyola del Vallès, Spain
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29
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Fenech MF. Dietary reference values of individual micronutrients and nutriomes for genome damage prevention: current status and a road map to the future. Am J Clin Nutr 2010; 91:1438S-1454S. [PMID: 20219957 DOI: 10.3945/ajcn.2010.28674d] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Damage to the genome is recognized as a fundamental cause of developmental and degenerative diseases. Several micronutrients play an important role in protecting against DNA damage events generated through endogenous and exogenous factors by acting as cofactors or substrates for enzymes that detoxify genotoxins as well as enzymes involved in DNA repair, methylation, and synthesis. In addition, it is evident that either micronutrient deficiency or micronutrient excess can modify genome stability and that these effects may also depend on nutrient-nutrient and nutrient-gene interaction, which is affected by genotype. These observations have led to the emerging science of genome health nutrigenomics, which is based on the principle that DNA damage is a fundamental cause of disease that can be diagnosed and nutritionally prevented on an individual, genetic subgroup, or population basis. In this article, the following topics are discussed: 1) biomarkers used to study genome damage in humans and their validation, 2) evidence for the association of genome damage with developmental and degenerative disease, 3) current knowledge of micronutrients required for the maintenance of genome stability in humans, 4) the effect of nutrient-nutrient and nutrient-genotype interaction on DNA damage, and 5) strategies to determine dietary reference values of single micronutrients and micronutrient combinations (nutriomes) on the basis of DNA damage prevention. This article also identifies important knowledge gaps and future research directions required to shed light on these issues. The ultimate goal is to match the nutriome to the genome to optimize genome maintenance and to prevent pathologic amounts of DNA damage.
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Affiliation(s)
- Michael F Fenech
- Commonwealth Scientific and Industrial Research Organisation Food and Nutritional Sciences, Adelaide BC SA 5000, Australia.
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30
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Diabetic threesome (hyperglycaemia, renal function and nutrition) and advanced glycation end products: evidence for the multiple-hit agent? Proc Nutr Soc 2008; 67:60-74. [PMID: 18234133 DOI: 10.1017/s0029665108006034] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Complex chemical processes termed non-enzymic glycation that operate in vivo and similar chemical interactions between sugars and proteins that occur during thermal processing of food (known as the Maillard reaction) are one of the interesting examples of a potentially-harmful interaction between nutrition and disease. Non-enzymic glycation comprises a series of reactions between sugars, alpha-oxoaldehydes and other sugar derivatives and amino groups of amino acids, peptides and proteins leading to the formation of heterogeneous moieties collectively termed advanced glycation end products (AGE). AGE possess a wide range of chemical and biological properties and play a role in diabetes-related pathology as well as in several other diseases. Diabetes is, nevertheless, of particular interest for several reasons: (1) chronic hyperglycaemia provides the substrates for extracellular glycation as well as intracellular glycation; (2) hyperglycaemia-induced oxidative stress accelerates AGE formation in the process of glycoxidation; (3) AGE-modified proteins are subject to rapid intracellular proteolytic degradation releasing free AGE adducts into the circulation where they can bind to several pro-inflammatory receptors, especially receptor of AGE; (4) kidneys, which are principally involved in the excretion of free AGE adducts, might be damaged by diabetic nephropathy, which further enhances AGE toxicity because of diminished AGE clearance. Increased dietary intake of AGE in highly-processed foods may represent an additional exogenous metabolic burden in addition to AGE already present endogenously in subjects with diabetes. Finally, inter-individual genetic and functional variability in genes encoding enzymes and receptors involved in either the formation or the degradation of AGE could have important pathogenic, nutrigenomic and nutrigenetic consequences.
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31
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Stopper H, Treutlein AT, Bahner U, Schupp N, Schmid U, Brink A, Perna A, Heidland A. Reduction of the genomic damage level in haemodialysis patients by folic acid and vitamin B12 supplementation. Nephrol Dial Transplant 2008; 23:3272-9. [DOI: 10.1093/ndt/gfn254] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Schupp N, Dette EM, Schmid U, Bahner U, Winkler M, Heidland A, Stopper H. Benfotiamine reduces genomic damage in peripheral lymphocytes of hemodialysis patients. Naunyn Schmiedebergs Arch Pharmacol 2008; 378:283-91. [PMID: 18509620 DOI: 10.1007/s00210-008-0310-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Accepted: 04/30/2008] [Indexed: 12/28/2022]
Abstract
Hemodialysis patients have an elevated genomic damage in peripheral blood lymphocytes (PBLs) and an increased cancer incidence, possibly due to accumulation of uremic toxins like advanced glycation end products (AGEs). Because the vitamin B1 prodrug benfotiamine reduces AGE levels in experimental diabetes, and dialysis patients often suffer from vitamin B1 deficiency, we conducted two consecutive studies supplementing hemodialysis patients with benfotiamine. In both studies, genomic damage was measured as micronucleus frequency of PBLs before and at three time-points after initiation of benfotiamine supplementation. AGE-associated fluorescence in plasma, and in the second study additionally, the antioxidative capacity of plasma was analyzed. Benfotiamine significantly lowered the genomic damage of PBLs in hemodialysis patients of both studies independent of changes in plasma AGE levels. The second study gave a hint to the mechanism, as the antioxidative capacity of the plasma of the treated patients clearly increased, which might ameliorate the DNA damage.
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Affiliation(s)
- Nicole Schupp
- Department of Pharmacology and Toxicology, University of Würzburg, Würzburg, Germany.
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33
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Anderstam B, Ann-Christin BH, Valli A, Stenvinkel P, Lindholm B, Suliman ME. Modification of the oxidative stress biomarker AOPP assay: application in uremic samples. Clin Chim Acta 2008; 393:114-8. [PMID: 18423381 DOI: 10.1016/j.cca.2008.03.029] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 03/19/2008] [Accepted: 03/19/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND The levels of advanced oxidation protein products (AOPP), a plasma protein biomarker used to assess oxidative stress, are elevated in patients with chronic kidney disease (CKD). However, this apparent elevation is to a large extent due to assay interference (mostly by triglycerides which are usually markedly elevated in CKD). We therefore developed and tested a modified version of the AOPP assay to minimize the impact of this interference. METHODS Plasma levels of AOPP, lipids, proteins and various biomarkers of inflammation and oxidative stress were analyzed in 218 prevalent hemodialysis patients and 13 healthy controls using the established original (oAOPP) assay and following precipitation of plasma lipids using dextran sulphate (modified assay, mAOPP). The modified results were validated against a lipid extraction procedure using ether/butanol. RESULTS The modified assay decreased the levels of triglycerides and AOPP by 87% and 38%, respectively. Whereas oAOPP values correlated strongly with triglycerides, no such correlation was seen with mAOPP. The mAOPP levels correlated significantly with the oxidative stress markers 8-oxo-dG and pentosidine, whereas no such correlations were found for oAOPP. CONCLUSIONS The oAOPP concentration is largely overestimated in plasma samples due to lipid interferences. Precipitation of triglycerides before analysis yields markedly lower mAOPP values which more accurately reflect oxidative stress. Based on these results we propose that AOPP should be analyzed using the modified assay, which is a cheap, simple and fast method.
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Affiliation(s)
- Björn Anderstam
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
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34
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Schupp N, Schmid U, Heidland A, Stopper H. New Approaches for the Treatment of Genomic Damage in End-Stage Renal Disease. J Ren Nutr 2008; 18:127-33. [DOI: 10.1053/j.jrn.2007.10.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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35
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Sebeková K, Wagner Z, Schupp N, Boor P. Genomic Damage and Malignancy in End-Stage Renal Failure: Do Advanced Glycation End Products Contribute? Kidney Blood Press Res 2006; 30:56-66. [PMID: 17261927 DOI: 10.1159/000099029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Indexed: 01/28/2023] Open
Abstract
In end-stage renal disease (ESRD) there is not only excessive morbidity and mortality due to cardiovascular disease but also an enhanced occurrence of various types of cancer. Both are characterized by oxidative stress and inflammation as two of the central underlying causes of the disease states. In cancer, genomic damage has been demonstrated to be of high pathogenetic relevance. DNA lesions may induce mutations of oncogenes and tumor-suppressor genes which, in the long-run, may lead to malignancies if mutagenicity is not mitigated by repair mechanisms. A high incidence of genomic damage in ESRD patients has been validated by various biomarkers of DNA lesions. We reviewed the mechanisms of DNA damage, focusing in particular on the role of advanced glycation end products (AGEs) which accumulate markedly in renal insufficiency. Considering the in vitro and in vivo findings to date, one has to assume a significant role of AGEs in DNA damage and the potential development of cancer.
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Affiliation(s)
- Katarína Sebeková
- Department of Experimental and Clinical Pharmacotherapy, Research Base of Slovak Medical University, Bratislava, Slovakia.
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36
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Rutkowski P, Malgorzewicz S, Slominska E, Renke M, Lysiak-Szydlowska W, Swierczynski J, Rutkowski B. Interrelationship between uremic toxicity and oxidative stress. J Ren Nutr 2006; 16:190-3. [PMID: 16825017 DOI: 10.1053/j.jrn.2006.04.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Uremic syndrome is associated with several metabolic disturbances. Oxidative stress is an important factor involved in the pathologic mechanism of these changes. The goal of this study was to understand the relationship between oxidative stress markers and two compounds included among uremic toxins. Two independent studies were performed, one with 29 peritoneal dialysis patients and the other with 43 predialysis subjects. In both groups of patients, known oxidative stress markers, malonyldialdehyde (MDA) and carbonyl groups (CG) formation were measured. Additionally, in the predialysis group, glutathione in erythrocytes (GSH) was estimated. In peritoneal dialysis patients, the concentration of advanced glycation end products (AGEs) was found to be significantly increased and correlated with both markers of oxidative stress. In predialysis patients, the increment of newly described uremic toxin purine nucleotide end products (Me2PY and Me4PY) were found and significant correlation was observed between both compounds versus MDA (positive) and GSH (negative). This relationship was visible especially in patients with more advanced renal failure. CG concentration was within the normal values and did not show any correlation with estimated toxin concentrations. In summary, results of both studies suggest that the interrelationship between uremic toxicity and oxidative stress is an important component of uremic syndrome. Nevertheless, further complex studies are needed to elucidate closer pathogenic links.
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Affiliation(s)
- Przemysław Rutkowski
- Department of Nephrology, Transplantology, and Internal Diseases, Medical University of Gdansk, Gdansk, Poland.
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37
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Abstract
Oxidative processes are inherent to life. Basic requirements such as energy production and defending the self imply free radical generation, exposing both sides of cell membranes to their potential toxic actions. Initially, the term oxidative stress was coined to describe mostly the biochemical imbalance between the generation of oxidants and the antioxidant defense. In contrast, the current definition underlines the importance of tissue damage resulting from the imbalance between an excessive generation of oxidant compounds and antioxidant defense mechanisms. Although more and more sophisticated markers of oxidative stress were described, there are relatively few studies investigating the relationships among these markers and outcome. The review of these studies suggests that oxidative stress, inflammation, and malnutrition are in various proportions strong predictors of outcome, especially from a cardiovascular point of view, in chronic kidney disease patients. The precise contribution of each factor is difficult to ascertain for the moment, but oxidative stress could safely be added to inflammation and malnutrition as an accomplice to uremic toxicity. The "immune connection" seems to offer a new explanation for the association between oxidative stress, inflammation, and outcome in chronic kidney disease patients.
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Affiliation(s)
- Gabriel Mircescu
- Dr. Carol Davila Teaching Hospital of Nephrology, Bucharest, Romania.
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Nascimento MM, Suliman ME, Murayama Y, Nihi M, Hayashi SY, Stenvinkel P, Riella MC, Lindholm B. Effect of High-Dose Thiamine and Pyridoxine on Advanced Glycation End Products and Other Oxidative Stress Markers in Hemodialysis Patients: A Randomized Placebo-Controlled Study. J Ren Nutr 2006; 16:119-24. [PMID: 16567267 DOI: 10.1053/j.jrn.2006.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2005] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To study the effect of high doses of thiamine (250 mg/day) and pyridoxine (200 mg/day) supplementation on plasma levels of advanced glycation end products and other oxidative stress markers in hemodialysis patients. DESIGN An interventional survey. SETTING This study was conducted at an outpatient nephrology clinic. INTERVENTION AND PATIENTS: We performed a randomized placebo-controlled study over 8 weeks in 50 patients (53% men, age 52.9 +/- 3.4 years) on regular hemodialysis. MAIN OUTCOME MEASURES The patients were divided into 2 groups of 25 patients in each arm. Before starting the study, the patients in both groups were matched by age, gender, inflammatory profile (plasma interleukin [IL]-6 and high-sensitivity C-reactive protein [hsCRP]), and nutritional status (subjective global assessment and protein nitrogen appearance). RESULTS In all, 40 of 50 patients completed the study (19 patients in the vitamin group and 21 in the placebo group). Serum albumin, plasma hsCRP, IL-6, advanced oxidation protein products, pentosidine and 8-hydroxy-2'-deoxyguanosine were measured before and after treatment in each group. In both groups, over 8 weeks of follow-up, no significant differences could be observed in oxidative stress, inflammatory, or nutritional markers. CONCLUSIONS There was no evidence showing that high doses of thiamine and pyridoxine affects oxidative stress in hemodialysis patients.
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