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Choubey AP, Rady EW, Koizumi N, Siddique AB, Wiederhold P, Ortiz J. Disparate Formulations for Machine Perfusion: A Survey of Organ Procurement Organizations' Medication Additives and Outcome Analyses. EXP CLIN TRANSPLANT 2021; 19:1124-1132. [PMID: 34812703 DOI: 10.6002/ect.2021.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Machine perfusionfor kidney preservation is a common practice. There is no consensus on the best formula for perfusion solutions. We aimed to discern the additives that organ procurement organizations in the United States include in their perfusate and the impact of these additives on transplant outcomes. MATERIALS AND METHODS A telephone survey of all 58 organ procurement organizations in the United States regarding additives to their perfusion solutions was conducted. The survey data were merged with transplant recipient outcome data from the United Network for Organ Sharing database.The final analysis included perfused kidneys between January 2014 and March 2019. Logistic regressions were performed to investigate whether a particular perfusion formula was associated with delayed graft function, primary nonfunction, or early graft failure. RESULTS Additives correlated with decreased rates of graft failure were mannitol in all kidneys and kidneys of lower quality (P < .01) and penicillin/ampicillin in all kidneys (P < .05). Additives associated with increased graft failure regardless of type included verapamil in all kidneys (P < .05) and kidneys of lower quality (P < .01) and arginine with glutathione in all kidneys and low-quality kidneys alone (P < .01). CONCLUSIONS Further outcomes research and standardized guidelines for additives in machine perfusion of kidneys across all organ procurement organizations are needed.
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Affiliation(s)
- Ankur P Choubey
- From the Department of Surgery, Rutgers Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
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Gonzalez-Vicente A, Saez F, Monzon CM, Asirwatham J, Garvin JL. Thick Ascending Limb Sodium Transport in the Pathogenesis of Hypertension. Physiol Rev 2019; 99:235-309. [PMID: 30354966 DOI: 10.1152/physrev.00055.2017] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The thick ascending limb plays a key role in maintaining water and electrolyte balance. The importance of this segment in regulating blood pressure is evidenced by the effect of loop diuretics or local genetic defects on this parameter. Hormones and factors produced by thick ascending limbs have both autocrine and paracrine effects, which can extend prohypertensive signaling to other structures of the nephron. In this review, we discuss the role of the thick ascending limb in the development of hypertension, not as a sole participant, but one that works within the rich biological context of the renal medulla. We first provide an overview of the basic physiology of the segment and the anatomical considerations necessary to understand its relationship with other renal structures. We explore the physiopathological changes in thick ascending limbs occurring in both genetic and induced animal models of hypertension. We then discuss the racial differences and genetic defects that affect blood pressure in humans through changes in thick ascending limb transport rates. Throughout the text, we scrutinize methodologies and discuss the limitations of research techniques that, when overlooked, can lead investigators to make erroneous conclusions. Thus, in addition to advancing an understanding of the basic mechanisms of physiology, the ultimate goal of this work is to understand our research tools, to make better use of them, and to contextualize research data. Future advances in renal hypertension research will require not only collection of new experimental data, but also integration of our current knowledge.
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Affiliation(s)
| | - Fara Saez
- Department of Physiology and Biophysics, Case Western Reserve University , Cleveland, Ohio
| | - Casandra M Monzon
- Department of Physiology and Biophysics, Case Western Reserve University , Cleveland, Ohio
| | - Jessica Asirwatham
- Department of Physiology and Biophysics, Case Western Reserve University , Cleveland, Ohio
| | - Jeffrey L Garvin
- Department of Physiology and Biophysics, Case Western Reserve University , Cleveland, Ohio
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Trejo-Moreno C, Méndez-Martínez M, Zamilpa A, Jiménez-Ferrer E, Perez-Garcia MD, Medina-Campos ON, Pedraza-Chaverri J, Santana MA, Esquivel-Guadarrama FR, Castillo A, Cervantes-Torres J, Fragoso G, Rosas-Salgado G. Cucumis sativus Aqueous Fraction Inhibits Angiotensin II-Induced Inflammation and Oxidative Stress In Vitro. Nutrients 2018; 10:nu10030276. [PMID: 29495578 PMCID: PMC5872694 DOI: 10.3390/nu10030276] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 02/15/2018] [Accepted: 02/25/2018] [Indexed: 01/05/2023] Open
Abstract
Inflammation and oxidative stress play major roles in endothelial dysfunction, and are key factors in the progression of cardiovascular diseases. The aim of this study was to evaluate in vitro the effect of three subfractions (SFs) from the Cucumis sativus aqueous fraction to reduce inflammatory factors and oxidative stress induced by angiotensin II (Ang II) in human microvascular endothelial cells-1 (HMEC-1) cells. The cells were cultured with different concentrations of Ang II and 0.08 or 10 μg/mL of SF1, SF2, or SF3, or 10 μmol of losartan as a control. IL-6 (Interleukin 6) concentration was quantified. To identify the most effective SF combinations, HMEC-1 cells were cultured as described above in the presence of four combinations of SF1 and SF3. Then, the effects of the most effective combination on the expression of adhesion molecules, the production of reactive oxygen species (ROS), and the bioavailability of nitric oxide (NO) were evaluated. Finally, a mass spectrometry analysis was performed. Both SF1 and SF3 subfractions decreased the induction of IL-6 by Ang II, and C4 (SF1 and SF3, 10 μg/mL each) was the most effective combination to inhibit the production of IL-6. Additionally, C4 prevented the expression of adhesion molecules, reduced the production of ROS, and increased the bioavailability of NO. Glycine, arginine, asparagine, lysine, and aspartic acid were the main components of both subfractions. These results demonstrate that C4 has anti-inflammatory and antioxidant effects.
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Affiliation(s)
- Celeste Trejo-Moreno
- Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, Cuernavaca, Morelos CP 62209, Mexico.
- Facultad de Medicina, Universidad Autónoma del Estado de Morelos, Leñeros S/N, Cuernavaca, Morelos CP 62350, Mexico.
| | - Marisol Méndez-Martínez
- Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, Cuernavaca, Morelos CP 62209, Mexico.
- Facultad de Medicina, Universidad Autónoma del Estado de Morelos, Leñeros S/N, Cuernavaca, Morelos CP 62350, Mexico.
| | - Alejandro Zamilpa
- Laboratorio de Farmacología, Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Republica de Argentina 1, Xochitepec, Morelos CP 62790, Mexico.
| | - Enrique Jiménez-Ferrer
- Laboratorio de Farmacología, Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Republica de Argentina 1, Xochitepec, Morelos CP 62790, Mexico.
| | - Maria Dolores Perez-Garcia
- Laboratorio de Farmacología, Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Republica de Argentina 1, Xochitepec, Morelos CP 62790, Mexico.
| | - Omar N Medina-Campos
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Coyoacán, Mexico City CP 04510, Mexico.
| | - José Pedraza-Chaverri
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Coyoacán, Mexico City CP 04510, Mexico.
| | - María Angélica Santana
- Centro de Investigación en Dinámica Celular (IICBA), Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, Cuernavaca, Morelos CP 62209, Mexico.
| | | | - Aida Castillo
- Departamento de Fisiología Biofísica y Neurociencias del Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV del IPN), Mexico City CP 07360, Mexico.
| | - Jacquelynne Cervantes-Torres
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Coyoacán, Mexico City CP 04510, Mexico.
| | - Gladis Fragoso
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Coyoacán, Mexico City CP 04510, Mexico.
| | - Gabriela Rosas-Salgado
- Facultad de Medicina, Universidad Autónoma del Estado de Morelos, Leñeros S/N, Cuernavaca, Morelos CP 62350, Mexico.
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Vögeli A, Ottiger M, Meier MA, Steuer C, Bernasconi L, Kulkarni P, Huber A, Christ-Crain M, Henzen C, Hoess C, Thomann R, Zimmerli W, Mueller B, Schuetz P. Admission levels of asymmetric and symmetric dimethylarginine predict long-term outcome in patients with community-acquired pneumonia. Respir Res 2017; 18:25. [PMID: 28114935 PMCID: PMC5259979 DOI: 10.1186/s12931-017-0502-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 12/28/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND During infection, there is an activation of the L-arginine-nitric-oxide pathway, with a shift from nitric oxide synthesis to a degradation of L-arginine to its metabolites, asymmetric and symmetric dimethylarginine (ADMA and SDMA). However, the prognostic implications for short-term or long-term survival remains unclear. We investigated the association of L-arginine, ADMA, and SDMA with adverse clinical outcomes in a well-defined cohort of patients with community-acquired pneumonia (CAP). METHODS We measured L-arginine, ADMA, and SDMA in 268 CAP patients from a Swiss multicenter trial by mass spectrometry and used Cox regression models to investigate associations between blood marker levels and disease severity as well as mortality over a period of 6 years. RESULTS Six-year mortality was 44.8%. Admission levels of ADMA and SDMA (μmol/L) were correlated with CAP severity as assessed by the pneumonia severity index (r = 0.32, p < 0.001 and r = 0.56, p < 0.001 for ADMA and SDMA, respectively) and higher in 6-year non-survivors versus survivors (median 0.62 vs. 0.48; p < 0.001 and 1.01 vs. 0.85; p < 0.001 for ADMA and SDMA, respectively). Both ADMA and SDMA were significantly associated with long-term mortality (hazard ratios [HR] 4.44 [95% confidence intervals (CI) 1.84 to 10.74] and 2.81 [95% CI 1.45 to 5.48], respectively). The effects were no longer significant after multivariate adjustment for age and comorbidities. No association of L-arginine with severity and outcome was found. CONCLUSIONS Both ADMA and SDMA show a severity-dependent increase in patients with CAP and are strongly associated with mortality. This association is mainly explained by age and comorbidities. TRIAL REGISTRATION ISRCTN95122877 . Registered 31 July 2006.
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Affiliation(s)
- Alaadin Vögeli
- Kantonsspital Aarau, University Department of Internal Medicine, Tellstrasse, CH-5001 Aarau, Switzerland
| | - Manuel Ottiger
- Kantonsspital Aarau, University Department of Internal Medicine, Tellstrasse, CH-5001 Aarau, Switzerland
| | - Marc A. Meier
- Kantonsspital Aarau, University Department of Internal Medicine, Tellstrasse, CH-5001 Aarau, Switzerland
| | - Christian Steuer
- Institute of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Luca Bernasconi
- Institute of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | | | - Andreas Huber
- Institute of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Mirjam Christ-Crain
- Endocrinology, Diabetology, and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Christoph Henzen
- Department of Internal Medicine, Kantonsspital Luzern, Luzern, Switzerland
| | - Claus Hoess
- Department of Internal Medicine, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
| | - Robert Thomann
- Department of Internal Medicine, Bürgerspital Solothurn, Solothurn, Switzerland
| | - Werner Zimmerli
- Kantonsspital Baselland, University Department of Internal Medicine, Liestal, Switzerland
| | - Beat Mueller
- Kantonsspital Aarau, University Department of Internal Medicine, Tellstrasse, CH-5001 Aarau, Switzerland
| | - Philipp Schuetz
- Kantonsspital Aarau, University Department of Internal Medicine, Tellstrasse, CH-5001 Aarau, Switzerland
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Massa NML, Silva AS, Toscano LT, Silva JDGR, Persuhn DC, Gonçalves MDCR. Watermelon extract reduces blood pressure but does not change sympathovagal balance in prehypertensive and hypertensive subjects. Blood Press 2016; 25:244-8. [DOI: 10.3109/08037051.2016.1150561] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
| | - Alexandre Sérgio Silva
- Departments of Physical Education, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | | | | | - Darlene Camati Persuhn
- Departments of Molecular Biology, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
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Abstract
A large number of investigations have demonstrated the participation of the immune system in the pathogenesis of hypertension. Studies focusing on macrophages and Toll-like receptors have documented involvement of the innate immunity. The requirements of antigen presentation and co-stimulation, the critical importance of T cell-driven inflammation, and the demonstration, in specific conditions, of agonistic antibodies directed to angiotensin II type 1 receptors and adrenergic receptors support the role of acquired immunity. Experimental findings support the concept that the balance between T cell-induced inflammation and T cell suppressor responses is critical for the regulation of blood pressure levels. Expression of neoantigens in response to inflammation, as well as surfacing of intracellular immunogenic proteins, such as heat shock proteins, could be responsible for autoimmune reactivity in the kidney, arteries, and central nervous system. Persisting, low-grade inflammation in these target organs may lead to impaired pressure natriuresis, an increase in sympathetic activity, and vascular endothelial dysfunction that may be the cause of chronic elevation of blood pressure in essential hypertension.
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Affiliation(s)
- Bernardo Rodríguez-Iturbe
- Hospital Universitario y Universidad del Zulia, Maracaibo, Venezuela; Instituto Venezolano de Investigaciones Científicas-Zulia, Maracaibo, Venezuela;
| | - Héctor Pons
- Hospital Universitario y Universidad del Zulia, Maracaibo, Venezuela
| | - Yasmir Quiroz
- Instituto Venezolano de Investigaciones Científicas-Zulia, Maracaibo, Venezuela
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado, Denver, Colorado
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