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Zou B, Yuan Q, Luo H, Wang M, Chen X, Gao Z, Wang J, Peng Y, Yang H, Dai F, Huang X. Combination of Fushengong decoction with Western medicine on patients with chronic renal failure: An observational study. Medicine (Baltimore) 2024; 103:e37473. [PMID: 38608120 PMCID: PMC11018180 DOI: 10.1097/md.0000000000037473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/12/2024] [Indexed: 04/14/2024] Open
Abstract
Chronic renal failure (CRF) causes a reduction in glomerular filtration rate and damage to renal parenchyma. Fushengong decoction (FSGD) showed improvement in renal function in CRF rats. This study aims to analyze the differentially expressed proteins in CRF patients treated with Western medicine alone or in combination with FSGD. Sixty patients with CRF recruited from Yongchuan Traditional Chinese Medicine Hospital affiliated to Chongqing Medical University were randomly assigned into control (treated with Western medicine alone) and observation groups (received additional FSGD treatment thrice daily for 8 weeks). The clinical efficacy and changes in serum Bun, serum creatinine, Cystatin C, and transforming growth factor beta 1 (TGF-β1) before and after treatment were observed. We employed isotope relative labeling absolute quantification labeling and liquid chromatography-mass spectrometry to identify differentially expressed proteins and carried out bioinformatics Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses. Patients in the observation group showed greater clinical improvement and lower levels of serum Bun, serum creatinine, Cyc-c, and TGF-β1 than the control group. We identified 32 differentially up-regulated and 52 down-regulated proteins in the observation group. These proteins are involved in the blood coagulation system, protein serine/threonine kinase activity, and TGF-β, which are closely related to the pathogenesis of CRF. Protein-protein-interaction network analysis indicated that candidate proteins fibronectin 1, fibrinogen alpha chain, vitronectin, and Serpin Family C Member 1 were in the key nodes. This study provided an experimental basis suggesting that FSGD combined with Western medicine could significantly improve renal function and renal fibrosis of CRF patients, which may be through the regulation of fibronectin 1, fibrinogen alpha chain, vitronectin, Serpin Family C Member 1, TGF-β, and the complement coagulation pathway (see Graphical abstract S1, Supplemental Digital Content, http://links.lww.com/MD/L947).
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Affiliation(s)
- Bo Zou
- Department of Nephrology, Yongchuan Traditional Chinese Medicine Affiliated to Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
| | - Qiaoqiao Yuan
- Department of Nephrology, Yongchuan Traditional Chinese Medicine Affiliated to Chongqing Medical University, Chongqing, China
| | - Hongyu Luo
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
| | - Munan Wang
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
| | - Xin Chen
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
| | - Zuling Gao
- Department of Nephrology, Yongchuan Traditional Chinese Medicine Affiliated to Chongqing Medical University, Chongqing, China
| | - Jianwei Wang
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
| | - Yongbo Peng
- Chongqing Key Laboratory for Pharmaceutical Metabolism Research, The Key Laboratory of Biochemistry and Molecular Pharmacology, College of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Haijun Yang
- Department of Nephrology, Yongchuan Traditional Chinese Medicine Affiliated to Chongqing Medical University, Chongqing, China
| | - Feng Dai
- Department of Nephrology, Yongchuan Traditional Chinese Medicine Affiliated to Chongqing Medical University, Chongqing, China
| | - Xuekuan Huang
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
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Abe T, Aoyama T, Takeuchi Y. Evaluating Risk Factors for Developing Allergic Reactions during Plasma Exchange Using Fresh-frozen Plasma: A Single-center Retrospective Study. Intern Med 2023; 62:2803-2811. [PMID: 36792201 PMCID: PMC10602830 DOI: 10.2169/internalmedicine.0507-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/10/2023] [Indexed: 02/16/2023] Open
Abstract
Objective Allergic reactions are a severe complication of plasma exchange (PEx). Few reports have analyzed allergic reactions during PEx using fresh-frozen plasma (FFP) as a replacement solution. We therefore clarified the relationship between risk and exacerbation factors that lead to the onset of PEx-related allergic reactions, particularly PEx, using FFP, and examined whether or not allergic reactions were predictable. Methods This retrospective study included 88 consecutive patients who underwent PEx with FFP as a replacement solution at Kitasato University Hospital. The patients were grouped according to the presence of allergic reactions and compared. Data were analyzed using the χ2 test, Mann-Whitney U test, and a binomial logistic analysis. Statistical analyses were performed using EZR software program, version 1.54, with p<0.05 considered statistically significant. Results There were 44 allergic reaction cases. The average time to the onset of an allergic reactions was 63.5 (45-93) minutes. The allergic reaction-onset group had significantly higher average albumin (Alb) levels than did the non-allergic reaction-onset group. The binomial logistic analysis identified Alb levels as independent risk factors for allergic reactions. The receiver operating characteristic analysis identified an Alb level ≥3.4 g/dL as a risk factor for allergic reactions (area under the curve: 0.731; 95% confidence interval: 0.622-0.84). Conclusion Allergic reaction onset occurred approximately one hour after PEx initiation in the critical period. A serum Alb level ≥3.4 g/dL was identified as a risk factor for predicting allergic reactions. Patients with Alb levels ≥3.4 g/dL at the first PEx should be monitored for allergic reaction symptoms.
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Affiliation(s)
- Tetsuya Abe
- Department of Nephrology, Kitasato University School of Medicine, Japan
| | - Togo Aoyama
- Department of Nephrology, Kitasato University School of Medicine, Japan
| | - Yasuo Takeuchi
- Department of Nephrology, Kitasato University School of Medicine, Japan
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Iwami D, Matsumoto T, Ono K, Hotta K, Ota M, Chiba Y, Sasaki H, Hirose T, Higuchi H, Takada Y, Iwahara N, Murai S, Shinohara N. Novel double-filtration plasmapheresis preserves fibrinogen while removing immunoglobulin-G antibodies before ABO blood type-incompatible kidney transplantation. RENAL REPLACEMENT THERAPY 2021. [DOI: 10.1186/s41100-021-00379-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Abstract
Background
Removal of anti-blood group antibodies is important for successful ABO-incompatible kidney transplantation (ABOi-KTx). Double-filtration plasmapheresis (DFPP) using albumin solution removes antibodies effectively. However, fibrinogen is largely removed resulting in hemostatic failure. Herein, we designed an altered combination of plasma membranes in DFPP (novel DFPP, nDFPP) to retain more fibrinogen while removing IgG, and assessed its efficacy and safety compared with conventional DFPP (cDFPP).
Methods
Consecutive ABOi-KTx recipients (from 2015 to 2018) were enrolled. For the first membrane, we used Cascadeflo EC-50W in nDFPP and Plasmaflo OP-08W in cDFPP, and Cascadeflo EC-20W as the second membrane in both modalities. Removal rates (RR) of IgG, IgM and fibrinogen per DFPP session, and adverse events were compared with historical control patients who underwent cDFPP before ABOi-KTx, between 2006 and 2015.
Results
nDFPP and cDFPP groups included 12 and 23 cases, respectively. nDFPP was inferior to cDFPP in RR of IgG and IgM. nDFPP was also inferior to cDFPP in the decline in anti-blood group IgG and IgM antibody titers. However, fibrinogen was more preserved in nDFPP compared with cDFPP, indicating that nDFPP has more selective removal properties (median RR of IgG, IgM, and fibrinogen: 62.1%, 15.7% and 37.6%, respectively, in nDFPP; and 74.5%, 85.0% and 76.6%, respectively, in cDFPP). In the comparison of hemostatic function among the patients who had arteriovenous fistula for hemodialysis, prolonged hemostasis (> 20 min) at the cannulation site was significantly less frequently observed in nDFPP group (1 in 9 cases, 9.1%) than in cDFPP group (all 18 cases, 10%, p < 0.0001).
Conclusions
nDFPP preserves fibrinogen while removing anti-blood type IgG antibodies before ABOi-KTx.
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