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Nikitiuk BE, Rydzewska-Rosołowska A, Kakareko K, Głowińska I, Hryszko T. On Whether Ca-125 Is the Answer for Diagnosing Overhydration, Particularly in End-Stage Kidney Disease Patients-A Systematic Review. Int J Mol Sci 2024; 25:2192. [PMID: 38396869 PMCID: PMC10889175 DOI: 10.3390/ijms25042192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Overhydration (OH) is a prevalent medical problem that occurs in patients with kidney failure, but a specific marker has still not been found. Patients requiring kidney replacement therapy suffer from a water imbalance, which is correlated with mortality rates in this population. Currently, clinicians employ techniques such as bioimpedance spectroscopy (BIS) and ultrasound (USG) markers of overhydration or markers of heart and kidney function, namely NT-pro-BNP, GFR, or creatinine levels. New serum markers, including but not limited to Ca-125, galectin-3 (Gal-3), adrenomedullin (AMD), and urocortin-2 (UCN-2), are presently under research and have displayed promising results. Ca-125, which is a protein mainly used in ovarian cancer diagnoses, holds great potential to become an OH marker. It is currently being investigated by cardiologists as it corresponds to the volume status in heart failure (HF) and ventricular hypertrophy, which are also associated with OH. The need to ascertain a more precise marker of overhydration is urgent mainly because physical examinations are exceptionally inaccurate. The signs and symptoms of overhydration, such as edema or a gradual increase in body mass, are not always present, notably in patients with chronic kidney disease. Metabolic disruptions and cachexia can give a false picture of the hydration status. This review paper summarizes the existing knowledge on the assessment of a patient's hydration status, focusing specifically on kidney diseases and the role of Ca-125.
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Affiliation(s)
| | - Alicja Rydzewska-Rosołowska
- 2nd Department of Nephrology, Hypertension, and Internal Medicine with Dialysis Unit, Medical University of Bialystok, 15-276 Bialystok, Poland; (B.E.N.); (K.K.); (I.G.); (T.H.)
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Sumii K, Miyake H, Enatsu N, Chiba K, Fujisawa M. Characterization of urocortin as an anti-apoptotic protein in experimental ischemia-reperfusion model of the rat testis. Biochem Biophys Res Commun 2016; 479:387-392. [PMID: 27659706 DOI: 10.1016/j.bbrc.2016.09.091] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 09/19/2016] [Indexed: 12/26/2022]
Abstract
The objective of this study was to investigate the role of urocortin in testicular apoptosis using an experimental ischemia-reperfusion rat model. To evaluate the change in urocortin expression and apoptotic status in the testes following ischemia-reperfusion, the left testes of rats were rotated clockwise by 720° for 1 h, and were then harvested at 0, 1, 3, 6 and 24 h after detorsion (n = 5 in each group). A time-dependent increase in the expression levels of urocortin was noted until 6 h after reperfusion, but the expression of urocortin was markedly decreased 24 h after reperfusion. However, a TUNEL assay showed that the proportion of germ cells undergoing apoptosis significantly increased 24 h after reperfusion compared with that of 6 h after reperfusion. To clarify whether or not urocortin directly regulates the testicular apoptosis induced by ischemia-reperfusion, either astressin, an antagonist of urocortin, or normal saline was injected into the rat testes 15 min before detorsion, followed by the testicular torsion. The testes were then removed 3 h after detorsion (n = 5 in each group). The testicular injection of astressin significantly increased the proportion of TUNEL-positive germ cells, and significantly decreased expression of Bcl-2 and Bcl-xL. In addition, the level of phosphorylated ERK 1/2, but not that of phosphorylated Akt, was significantly reduced by the intratesticular administration of astressin. These findings suggest that urocortin may play a cytoprotective role in the germ cells in response to ischemia-reperfusion injury through the activation of major anti-apoptotic proteins, as well as by the mitogen-activated protein kinase signaling pathway activation.
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Affiliation(s)
- Kenta Sumii
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan
| | - Noritoshi Enatsu
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Koji Chiba
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Masato Fujisawa
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
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Liu X, Liu C, Li J, Zhang X, Song F, Xu J. Urocortin attenuates myocardial fibrosis in diabetic rats via the Akt/GSK-3β signaling pathway. Endocr Res 2016; 41:148-57. [PMID: 26934363 DOI: 10.3109/07435800.2015.1094489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Urocortin, a novel identified corticotropin-releasing factor-related endocrinal peptide, has been shown to play an essential role in cardioprotection. Until recently, whether urocortin can protect the heart against diabetic cardiomyopathy (DCM) remained unclear. Herein, we evaluated the cardioprotective effect of urocortin on cardiac dysfunction, inflammation, and fibrosis and demonstrated the potential mechanism in a diabetic rat model. METHODS Diabetic rats were randomly divided into 4 groups: diabetic control group, urocortin, urocortin + astressin (a selective CRF receptor 2 antagonist) and urocortin + triciribine (an Akt pathway blocker). Cardiac catheterization was performed to evaluate cardiac function. The levels of creatine phosphokinase isoenzyme (CK-MB), plasma brain natriuretic peptide (BNP), myocardial collagen volume fraction (CVF) and left ventricular mass index (LVWI) were measured. Inflammatory factors (transforming growth factor beta 1, TGF-β1; connective tissue growth factor, CTGF) and activation of signaling proteins (Akt, GSK-3β) were also detected using western blot. RESULTS DCM was successfully induced by the injection of streptozotocin (STZ) as evidenced by abnormal heart mass and cardiac function as well as the imbalance of extracellular matrix homeostasis. Rats in the DCM group showed increased mRNA and protein levels of LVWI, BNP, CK-MB, CVF, TGF-β1 and CTGF compared to the control group, which were accompanied with diminished phosphorylation of Akt and GSK-3β. Interestingly, myocardial dysfunction, cardiac fibrosis, and inflammation were suppressed by urocortin in the heart of diabetic rats. Moreover, inhibition of phosphorylation of Akt and GSK-3β was also reversed by urocortin. These effects of urocortin were suppressed by astressin. In addition, triciribine partially reduced the effects of urocortin on myocardial dysfunction, inflammation, and cardiac fibrosis. CONCLUSIONS These results suggest that urocortin exhibits a therapeutic benefit in the treatment of DCM by attenuating fibrosis and inflammation. Furthermore, inhibition of the Akt/GSK-3β signaling pathway may be partially responsible for these effects.
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Affiliation(s)
- Xinyu Liu
- a The First Affiliated Hospital of Liaoning Medical University , Jinzhou , China
- b Department of Endocrinology , Provincial Hospital Affiliated to Shandong University , Jinan , China
| | - Chunna Liu
- c Department of Pharmacology , Liaoning Medical University , Jinzhou , China
| | - Jian Li
- a The First Affiliated Hospital of Liaoning Medical University , Jinzhou , China
| | - Xiaoyan Zhang
- a The First Affiliated Hospital of Liaoning Medical University , Jinzhou , China
| | - Feiran Song
- a The First Affiliated Hospital of Liaoning Medical University , Jinzhou , China
| | - Jin Xu
- b Department of Endocrinology , Provincial Hospital Affiliated to Shandong University , Jinan , China
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Lemm H, Dietz S, Janusch M, Buerke M. [Modern drug therapy in cardiovascular intensive care medicine]. Internist (Berl) 2016; 56:702, 704-8, 710-2. [PMID: 26054838 DOI: 10.1007/s00108-015-3717-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Vasoactive drugs and inotropes are important in the hemodynamic management of patients with cardiogenic shock despite modest volume administration. Currently, the concept of cardiac relief is pursued in the treatment of acute heart failure. In this article we present the use of different drugs in the intensive care unit for acute heart failure and cardiogenic shock. In acute heart failure catecholamines are only used during the transition from heart failure to cardiogenic shock. Here, the therapeutic concept of ventricular unloading is more sought after. This can be achieved by the use of diuretics, nitrates, levosimendan (inodilatator), or in the future serelaxin. The hemodynamic management in cardiogenic shock occurs after moderate volume administration with dobutamine to increase inotropy. If no adequate perfusion pressures are achieved, norepinephrine can be administered as a vasopressor. If there is still no sufficient increase in cardiac output, the inodilatator levosimendan can be used. Levosimendan instead of phosphodiesterase inhibitors in this case is preferable. The maxim of hemodynamic management in cardiogenic shock is the transient use of inotropes and vasopressors in the lowest dose possible and only for as long as necessary. This means that one should continuously check whether the dose can be reduced. There are no mortality data demonstrating the utility of hemodynamic monitoring based on objective criteria—but it makes sense to use inotropes and vasopressors sparingly.
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Affiliation(s)
- H Lemm
- Medizinische Klinik II - Kardiologie, Angiologie, Internistische Intensivmedizin, St. Marienkrankenhaus Siegen, Kampenstr. 51, 57072, Siegen, Deutschland
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Abstract
Although the period from 1953 to 2001 resulted in the approval of more than 30 medications currently used to treat heart failure (HF), few novel drugs have been approved in the last decade. However, the investigational pipeline for HF medications once again appears promising. In patients with chronic heart failure with reduced ejection fraction (HFrEF), ivabradine and valsartan/sucubitril (LCZ696) were recently approved by the US Food and Drug Administration. Both agents have been shown to reduce the risk of cardiovascular death and HF hospitalization. In the treatment of acute HF, serelaxin and ularitide are the farthest along in development. Both agents have demonstrated favorable effects on surrogate end points and preliminary data suggest a possible mortality benefit with serelaxin. Consequently, phase 3 trials are ongoing to evaluate the effect of serelaxin and ularitide on clinical outcomes. Given the poor history of recent investigational acute HF drugs that have advanced to phase 3/4 studies, enthusiasm for both serelaxin and ularitide must be tempered until these trials are completed.
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Affiliation(s)
- Sarah Hanigan
- Department of Pharmacy, University of Michigan Health System, Ann Arbor, MI, USA
| | - Robert J. DiDomenico
- Department of Pharmacy Practice, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
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Chouridou E, Lambropoulou M, Koureta M, Zarouchlioti C, Balgouranidou I, Nena E, Papadopoulos N, Chatzaki E. Corticotropin-releasing factor (CRF) system localization in human fetal heart. Hormones (Athens) 2016; 15:54-64. [PMID: 30091054 DOI: 10.1007/bf03401403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 12/22/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The corticotropin-releasing factor (CRF) family consists of the neuropeptides CRF, Ucn I, II and III and the binding sites CRFR1, CRFR2 and CRF-BP. It regulates stress response and the homeostasis of an organism. In this study, we examined the presence of the CRF system in the human hearts of normal and pathological fetuses. DESIGN Heart tissues from 40 archival human fetuses were divided into Group A (without pathology, 'normal'), Group B (with chromosomal abnormalities) and Group C (with congenital disorders). Immunohistochemistry was used to localize the CRF system. Results correlated to gestational trimester and pathology. RESULTS Immunoreactivity for all antigens was found in cardiac myocytes of all groups, in almost all samples, except Ucn III which was present in almost half of the fetuses of Groups B and C and was not detected at all in Group A. Ucn III was more often present during the earlier stage of development (<21 weeks) and in fetuses with congenital disorders. In a fetus diagnosed with heart pathology, all but Ucn III antigens were also present. CONCLUSIONS We localized a complete CRF system in the human fetal heart and correlated the presence of Ucn III to development and pathology. More studies are needed to verify and clarify the exact role of the CRF system in the human fetal heart.
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Affiliation(s)
- Efterpi Chouridou
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, P.C. 68100, Greece
| | - Maria Lambropoulou
- Laboratory of Histology-Embryology, Faculty of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, Greece
| | - Maria Koureta
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, P.C. 68100, Greece
| | - Christina Zarouchlioti
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, P.C. 68100, Greece
| | - Ioanna Balgouranidou
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, P.C. 68100, Greece
| | - Evangelia Nena
- Laboratory of Hygiene and Environmental Protection, Faculty of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, Greece
| | - Nikolaos Papadopoulos
- Laboratory of Histology-Embryology, Faculty of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, Greece
| | - Ekaterini Chatzaki
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, P.C. 68100, Greece.
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