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Central fibrous areas: changes in glomerular vascular pole lesions associated with age and disease. Int Urol Nephrol 2022; 54:2263-2273. [PMID: 35099688 PMCID: PMC9371997 DOI: 10.1007/s11255-022-03126-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 01/11/2022] [Indexed: 11/15/2022]
Abstract
Purpose Central fibrous areas (CFAs) are small, hyalinotic, monotonous nodular areas observed in glomerular vascular pole lesions. We attempted to clarify the relationship between CFA formation and age in healthy kidneys and in those affected by immunoglobulin A (IgA) nephropathy. Methods Zero-hour biopsy specimens from living renal donors (135 cases) and IgA nephropathy biopsy specimens (67 cases) were collected retrospectively. We observed each biopsy specimen and determined the total number of glomeruli, total level of glomerulosclerosis, number of observable glomerular vascular poles, number of glomeruli with CFAs, serum creatinine level, and estimated glomerular filtration rate (eGFR). Additionally, we calculated the glomerular sclerosis rate (GSR), vascular pole appearance rate (PAR), and CFA rate (CFAR) to evaluate the relationship between these factors and patient age. Results There was a significant negative correlation between patient age and eGFR for both the zero-hour (p < 0.0001 in Spearman, p = 0.0009 in multiple regression, the same hereafter) and IgA (p = 0.0022, p = 0.0001) groups. In the zero-hour group, we observed a significant positive correlation between patient age and GSR (p = 0.0001, p < 0.0001); however, there was no such correlation in the IgA group. In both groups, there was a significant positive correlation between patient age and CFAR (zero-hour group: p = 0.0003, p = 0.0091, IgA group; p < 0.0001, p = 0.0004). The slope of the regression line of the IgA group formula was also significantly higher than that of the zero-hour group formula (p < 0.01). Conclusion These findings indicate that CFA may be a useful indicator of kidney aging, especially in patients with kidney disease caused by IgA nephropathy.
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L-ergothioneine and its combination with metformin attenuates renal dysfunction in type-2 diabetic rat model by activating Nrf2 antioxidant pathway. Biomed Pharmacother 2021; 141:111921. [PMID: 34346315 DOI: 10.1016/j.biopha.2021.111921] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/02/2021] [Accepted: 07/12/2021] [Indexed: 12/20/2022] Open
Abstract
L-ergothioneine (L-egt) is a bioactive compound recently approved by the food and drug administration as a supplement. L-egt exerts potent cyto-protective, antioxidant and anti-inflammatory properties in tissues exposed to injury, while metformin is a first-line prescription in type-2 diabetes. Therefore, the present study investigated the protective effect of L-egt alone, or combined with metformin, on renal damage in a type-2 diabetic (T2D) rat model. T2D was induced in male Sprague-Dawley rats using the fructose-streptozotocin rat model. L-egt administration, alone or combined with metformin, began after confirming diabetes and was administered orally for seven weeks. After the experiment, all animals were euthanized by decapitation, blood samples were collected, and both kidneys were excised. Biochemical analysis, Enzyme-link Immunoassay (ELISA), Reverse transcriptase quantitative polymerase chain reaction (RT-qPCR), western blotting, and histological analyses were done to evaluate various biomarkers and structural changes associated with renal damage. Untreated diabetic rats showed loss of kidney functions characterized by increased serum creatinine, blood urea nitrogen, proteinuria, triglycerides, lipid peroxidation, inflammation, and decreased antioxidant enzymes. Histological evaluation showed evidence of fibrosis, mesangial expansion, and damaged basement membrane in the nephrons. However, L-egt alleviates these functional and structural derangements in the kidney, while co-administration with metformin reduced hyperglycemia and improves therapeutic outcomes. Furthermore, L-egt treatment significantly increased the expression of major antioxidant transcription factors, cytoprotective genes and decreased the expression of inflammatory genes in the kidney. Thus, combining L-egt and metformin may improve therapeutic efficacy and be used as an adjuvant therapy to alleviate renal damage in type-2 diabetes.
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Raval N, Jogi H, Gondaliya P, Kalia K, Tekade RK. Cyclo-RGD Truncated Polymeric Nanoconstruct with Dendrimeric Templates for Targeted HDAC4 Gene Silencing in a Diabetic Nephropathy Mouse Model. Mol Pharm 2020; 18:641-666. [PMID: 32453574 DOI: 10.1021/acs.molpharmaceut.0c00094] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Diabetic nephropathy (DN), a chronic progressive kidney disease, is a significant complication of diabetes mellitus. Dysregulation of the histone deacetylases (HDACs) gene has been implicated in the pathogenesis of DN. Hence, the HDAC-inhibitors have emerged as a critical class of therapeutic agents in DN; however, the currently available HDAC4-inhibitors are mostly nonselective in nature as well as inhibit multiple HDACs. RNA interference of HDAC4 (HDAC4 siRNA) has shown immense promise, but the clinical translation has been impeded due to lack of a targeted, specific, and in vivo applicable delivery modality. In the present investigation, we examined Cyclo(RGDfC) (cRGD) truncated polymeric nanoplex with dendrimeric templates for targeted HDAC4 Gene Silencing. The developed nanoplex exhibited enhanced encapsulation of siRNA and offered superior protection against serum RNase nucleases degradation. The nanoplex was tested on podocytes (in vitro), wherein it showed selective binding to the αvβ3 integrin receptor, active cellular uptake, and significant in vitro gene silencing. The in vivo experiments showed remarkable suppression of the HDAC4 and inhibition in the progression of renal fibrosis in the Streptozotocin (STZ) induced DN C57BL/6 mice model. Histopathological and toxicological studies revealed nonsignificant abnormality/toxicity with the nanoplex. Conclusively, nanoplex was found as a promising tactic for targeted therapy of podocytes and could be extended for other kidney-related ailments.
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Affiliation(s)
- Nidhi Raval
- National Institute of Pharmaceutical Education and Research (NIPER) - Ahmedabad, Palaj (An Institute of National Importance), Opposite Air Force Station, Gandhinagar 382355, Gujarat, India
| | - Hardi Jogi
- National Institute of Pharmaceutical Education and Research (NIPER) - Ahmedabad, Palaj (An Institute of National Importance), Opposite Air Force Station, Gandhinagar 382355, Gujarat, India
| | - Piyush Gondaliya
- National Institute of Pharmaceutical Education and Research (NIPER) - Ahmedabad, Palaj (An Institute of National Importance), Opposite Air Force Station, Gandhinagar 382355, Gujarat, India
| | - Kiran Kalia
- National Institute of Pharmaceutical Education and Research (NIPER) - Ahmedabad, Palaj (An Institute of National Importance), Opposite Air Force Station, Gandhinagar 382355, Gujarat, India
| | - Rakesh K Tekade
- National Institute of Pharmaceutical Education and Research (NIPER) - Ahmedabad, Palaj (An Institute of National Importance), Opposite Air Force Station, Gandhinagar 382355, Gujarat, India
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3D organoid-derived human glomeruli for personalised podocyte disease modelling and drug screening. Nat Commun 2018; 9:5167. [PMID: 30514835 PMCID: PMC6279764 DOI: 10.1038/s41467-018-07594-z] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 11/05/2018] [Indexed: 12/11/2022] Open
Abstract
The podocytes within the glomeruli of the kidney maintain the filtration barrier by forming interdigitating foot processes with intervening slit diaphragms, disruption in which results in proteinuria. Studies into human podocytopathies to date have employed primary or immortalised podocyte cell lines cultured in 2D. Here we compare 3D human glomeruli sieved from induced pluripotent stem cell-derived kidney organoids with conditionally immortalised human podocyte cell lines, revealing improved podocyte-specific gene expression, maintenance in vitro of polarised protein localisation and an improved glomerular basement membrane matrisome compared to 2D cultures. Organoid-derived glomeruli retain marker expression in culture for 96 h, proving amenable to toxicity screening. In addition, 3D organoid glomeruli from a congenital nephrotic syndrome patient with compound heterozygous NPHS1 mutations reveal reduced protein levels of both NEPHRIN and PODOCIN. Hence, human iPSC-derived organoid glomeruli represent an accessible approach to the in vitro modelling of human podocytopathies and screening for podocyte toxicity. Studies examining human podocytopathies have utilised 2D cultured primary or immortalised podocyte cell lines. Here, the authors demonstrate that 3D human glomeruli sieved from induced pluripotent stem cell-derived kidney organoids retain an improved podocyte identity in vitro facilitating disease modelling and toxicity testing.
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Nakuluri K, Mukhi D, Nishad R, Saleem MA, Mungamuri SK, Menon RK, Pasupulati AK. Hypoxia induces ZEB2 in podocytes: Implications in the pathogenesis of proteinuria. J Cell Physiol 2018; 234:6503-6518. [DOI: 10.1002/jcp.27387] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 08/17/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Krishnamurthy Nakuluri
- Department of Biochemistry School of Life Sciences, University of Hyderabad Hyderabad India
| | - Dhanunjay Mukhi
- Department of Biochemistry School of Life Sciences, University of Hyderabad Hyderabad India
| | - Rajkishor Nishad
- Department of Biochemistry School of Life Sciences, University of Hyderabad Hyderabad India
| | | | - Sathish Kumar Mungamuri
- Institute of Basic Sciences and Translational Research, Asian Health Care Foundation, Asian Institute of Gastroenterology Hyderabad India
| | - Ram K. Menon
- Department of Pediatrics University of Michigan Ann Arbor Michigan
- Department of Molecular and Integrative Physiology University of Michigan Ann Arbor Michigan
| | - Anil Kumar Pasupulati
- Department of Biochemistry School of Life Sciences, University of Hyderabad Hyderabad India
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Muthukrishnan SD, Ryzhov S, Karolak M, Oxburgh L. Nephron progenitor cell death elicits a limited compensatory response associated with interstitial expansion in the neonatal kidney. Dis Model Mech 2018; 11:dmm.030544. [PMID: 29196442 PMCID: PMC5818074 DOI: 10.1242/dmm.030544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 11/23/2017] [Indexed: 12/11/2022] Open
Abstract
The final nephron number in an adult kidney is regulated by nephron progenitor cell availability and collecting duct branching in the fetal period. Fetal environmental perturbations that cause reductions in cell numbers in these two compartments result in low nephron endowment. Previous work has shown that maternal dietary factors influence nephron progenitor cell availability, with both caloric restriction and protein deprivation leading to reduced cell numbers through apoptosis. In this study, we evaluate the consequences of inducing nephron progenitor cell death on progenitor niche dynamics and on nephron endowment. Depletion of approximately 40% of nephron progenitor cells by expression of diphtheria toxin A at embryonic day 15 in the mouse results in 10-20% nephron reduction in the neonatal period. Analysis of cell numbers within the progenitor cell pool following induction of apoptosis reveals a compensatory response in which surviving progenitor cells increase their proliferation and replenish the niche. The proliferative response is temporally associated with infiltration of macrophages into the nephrogenic zone. Colony stimulating factor 1 (CSF1) has a mitogenic effect on nephron progenitor cells, providing a potential explanation for the compensatory proliferation. However, CSF1 also promotes interstitial cell proliferation, and the compensatory response is associated with interstitial expansion in recovering kidneys which can be pharmacologically inhibited by treatment with clodronate liposomes. Our findings suggest that the fetal kidney employs a macrophage-dependent compensatory regenerative mechanism to respond to acute injury caused by death of nephron progenitor cells, but that this regenerative response is associated with neonatal interstitial expansion. Editor's choice: Formation of the kidney relies on maintaining progenitor cells throughout development. The authors find that apoptotic loss of nephron progenitor cells provokes compensatory proliferation mediated by trophic factors released by phagocytes.
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Affiliation(s)
- Sree Deepthi Muthukrishnan
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME 04074, USA.,Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME 04469, USA
| | - Sergey Ryzhov
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME 04074, USA
| | - Michele Karolak
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME 04074, USA
| | - Leif Oxburgh
- Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME 04074, USA
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Sekta S, Ziaja J, Kolonko A, Lekstan A, Świder R, Klimunt J, Wilk J, Król R, Durlik M, Więcek A, Cierpka L. Donation and Transplantation of Kidneys Harvested From Deceased Donors Over the Age of 60 Years in the Upper Silesia Region. Transplant Proc 2017; 48:1466-71. [PMID: 27496429 DOI: 10.1016/j.transproceed.2015.11.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 11/11/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Population aging and shortage of organs for transplantation result in increasing numbers of kidneys retrieved from elderly donors. The aim of this study was to analyze donation of kidneys from donors after brain death (DBD) over the age of 60 years (≥60), comorbidities that affect decisions on retrieval, and early results of kidney transplantation. METHODS Ninety-six potential DBD ≥60 and 309 aged 40-59 years (40-59) reported in Upper Silesia, Poland, from 2004 to 2013 were enrolled in the study. RESULTS DBD >60 presented a higher rate of coexisting hypertension (53% vs 34%), limb ischemia (10% vs 1%), and past stroke (6% vs 1%) compared with DBD 40-59 (P < .05), but no differences were observed in serum creatinine concentration (85 vs 84 μmol/L), coexisting coronary disease (14% vs 6%), or diabetes (10% vs 4%). The decision of withdrawal from retrieval was more frequent in DBD ≥60 (16% vs 7%; P < .05). Twelve months after kidney transplantation, serum creatinine concentration was higher in recipients of kidneys from DBD ≥60 compared with DBD 40-59 (169 vs 138 μmol/L; P < .001). The survivals of recipients (93% vs 95%) and kidney grafts (90% vs 93%) as well as rates of proteinuria >1.0 g/24 h (6% vs 2%) did not differ between the groups. CONCLUSIONS A higher rate of comorbidities in potential kidney DBD ≥60 results in a lower retrieval rate in these donors. The function of kidneys harvested from DBD ≥60 12 months after transplantation is worse than those from DBD 40-59, but still acceptable.
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Affiliation(s)
- S Sekta
- Polish Transplant Coordinating Center "Poltransplant", Warsaw, Poland
| | - J Ziaja
- Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Poland.
| | - A Kolonko
- Department of Nephrology, Transplantation, and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - A Lekstan
- Department of Digestive Tract Surgery, Medical University of Silesia, Katowice, Poland
| | - R Świder
- Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Poland
| | - J Klimunt
- Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Poland
| | - J Wilk
- Chair of Anesthesiology, Intensive Therapy, and Emergency Medicine, Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - R Król
- Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Poland
| | - M Durlik
- Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Poland
| | - A Więcek
- Department of Nephrology, Transplantation, and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - L Cierpka
- Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Poland
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Roeder SS, Stefanska A, Eng DG, Kaverina N, Sunseri MW, McNicholas BA, Rabinovitch P, Engel FB, Daniel C, Amann K, Lichtnekert J, Pippin JW, Shankland SJ. Changes in glomerular parietal epithelial cells in mouse kidneys with advanced age. Am J Physiol Renal Physiol 2015; 309:F164-78. [PMID: 26017974 DOI: 10.1152/ajprenal.00144.2015] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 05/26/2015] [Indexed: 02/08/2023] Open
Abstract
Kidney aging is accompanied by characteristic changes in the glomerulus, but little is known about the effect of aging on glomerular parietal epithelial cells (PECs), nor if the characteristic glomerular changes in humans and rats also occur in very old mice. Accordingly, a descriptive analysis was undertaken in 27-mo-old C57B6 mice, considered advanced age. PEC density was significantly lower in older mice compared with young mice (aged 3 mo), and the decrease was more pronounced in juxtamedullary glomeruli compared with outer cortical glomeruli. In addition to segmental and global glomerulosclerosis in older mice, staining for matrix proteins collagen type IV and heparan sulfate proteoglycan were markedly increased in Bowman's capsules of older mouse glomeruli, consistent with increased extracellular matrix production by PECs. De novo staining for CD44, a marker of activated and profibrotic PECs, was significantly increased in aged glomeruli. CD44 staining was more pronounced in the juxtamedullary region and colocalized with phosphorylated ERK. Additionally, a subset of aged PECs de novo expressed the epithelial-to-mesenchymal transition markers α-smooth muscle and vimentin, with no changes in epithelial-to-mesenchymal transition markers E-cadherin and β-catenin. The mural cell markers neural/glial antigen 2, PDGF receptor-β, and CD146 as well as Notch 3 were also substantially increased in aged PECs. These data show that mice can be used to better understand the aging kidney and that PECs undergo substantial changes, especially in juxtamedullary glomeruli, that may participate in the overall decline in glomerular structure and function with advancing age.
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Affiliation(s)
- Sebastian S Roeder
- Division of Nephrology, University of Washington, Seattle, Washington; Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ania Stefanska
- Division of Nephrology, University of Washington, Seattle, Washington
| | - Diana G Eng
- Division of Nephrology, University of Washington, Seattle, Washington
| | - Natalya Kaverina
- Division of Nephrology, University of Washington, Seattle, Washington
| | - Maria W Sunseri
- Division of Nephrology, University of Washington, Seattle, Washington
| | | | - Peter Rabinovitch
- Department of Pathology, University of Washington, Seattle, Washington
| | - Felix B Engel
- Department of Nephropathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; and
| | - Christoph Daniel
- Department of Nephropathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; and
| | - Kerstin Amann
- Department of Nephropathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; and
| | - Julia Lichtnekert
- Division of Nephrology, University of Washington, Seattle, Washington
| | - Jeffrey W Pippin
- Division of Nephrology, University of Washington, Seattle, Washington
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Kita Y, Takamura T, Misu H, Ota T, Kurita S, Takeshita Y, Uno M, Matsuzawa-Nagata N, Kato KI, Ando H, Fujimura A, Hayashi K, Kimura T, Ni Y, Otoda T, Miyamoto KI, Zen Y, Nakanuma Y, Kaneko S. Metformin prevents and reverses inflammation in a non-diabetic mouse model of nonalcoholic steatohepatitis. PLoS One 2012; 7:e43056. [PMID: 23028442 PMCID: PMC3445596 DOI: 10.1371/journal.pone.0043056] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 07/17/2012] [Indexed: 02/06/2023] Open
Abstract
Background Optimal treatment for nonalcoholic steatohepatitis (NASH) has not yet been established, particularly for individuals without diabetes. We examined the effects of metformin, commonly used to treat patients with type 2 diabetes, on liver pathology in a non-diabetic NASH mouse model. Methodology/Principal Findings Eight-week-old C57BL/6 mice were fed a methionine- and choline-deficient plus high fat (MCD+HF) diet with or without 0.1% metformin for 8 weeks. Co-administration of metformin significantly decreased fasting plasma glucose levels, but did not affect glucose tolerance or peripheral insulin sensitivity. Metformin ameliorated MCD+HF diet-induced hepatic steatosis, inflammation, and fibrosis. Furthermore, metformin significantly reversed hepatic steatosis and inflammation when administered after the development of experimental NASH. Conclusions/Significance These histological changes were accompanied by reduced hepatic triglyceride content, suppressed hepatic stellate cell activation, and the downregulation of genes involved in fatty acid metabolism, inflammation, and fibrogenesis. Metformin prevented and reversed steatosis and inflammation of NASH in an experimental non-diabetic model without affecting peripheral insulin resistance.
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Affiliation(s)
- Yuki Kita
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Toshinari Takamura
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
- * E-mail:
| | - Hirofumi Misu
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Tsuguhito Ota
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Seiichiro Kurita
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Yumie Takeshita
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Masafumi Uno
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Naoto Matsuzawa-Nagata
- Department of Hospital Pharmacy, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Ken-ichiro Kato
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Hitoshi Ando
- Division of Clinical Pharmacology, Department of Pharmacology, School of Medicine, Jichi Medical University, Tochigi, Japan
| | - Akio Fujimura
- Division of Clinical Pharmacology, Department of Pharmacology, School of Medicine, Jichi Medical University, Tochigi, Japan
| | - Koji Hayashi
- Genomic Science Laboratories, Dainippon Sumitomo Pharma Co. Ltd., Osaka, Japan
| | - Toru Kimura
- Genomic Science Laboratories, Dainippon Sumitomo Pharma Co. Ltd., Osaka, Japan
| | - Yinhua Ni
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Toshiki Otoda
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Ken-ichi Miyamoto
- Department of Hospital Pharmacy, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Yoh Zen
- Department of Human Pathology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Yasuni Nakanuma
- Department of Human Pathology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Shuichi Kaneko
- Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
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