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Sharma B, Schmidt L, Nguyen C, Kiernan S, Dexter-Meldrum J, Kuschner Z, Ellis S, Bhatia ND, Agriantonis G, Whittington J, Twelker K. The Effect of L-Carnitine on Critical Illnesses Such as Traumatic Brain Injury (TBI), Acute Kidney Injury (AKI), and Hyperammonemia (HA). Metabolites 2024; 14:363. [PMID: 39057686 PMCID: PMC11278892 DOI: 10.3390/metabo14070363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
L-carnitine (LC) through diet is highly beneficial for critical patients. Studies have found that acetyl-L-carnitine (ALC) can reduce cerebral edema and neurological complications in TBI patients. It significantly improves their neurobehavioral and neurocognitive functions. ALC has also been shown to have a neuroprotective effect in cases of global and focal cerebral ischemia. Moreover, it is an effective agent in reducing nephrotoxicity by suppressing downstream mitochondrial fragmentation. LC can reduce the severity of renal ischemia-reperfusion injury, renal cast formation, tubular necrosis, iron accumulation in the tubular epithelium, CK activity, urea levels, Cr levels, and MDA levels and restore the function of enzymes such as SOD, catalase, and GPx. LC can also be administered to patients with hyperammonemia (HA), as it can suppress ammonia levels. It is important to note, however, that LC levels are dysregulated in various conditions such as aging, cirrhosis, cardiomyopathy, malnutrition, sepsis, endocrine disorders, diabetes, trauma, starvation, obesity, and medication interactions. There is limited research on the effects of LC supplementation in critical illnesses such as TBI, AKI, and HA. This scarcity of studies highlights the need for further research in this area.
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Affiliation(s)
- Bharti Sharma
- Department of Surgery, NYC Health and Hospitals, Elmhurst, 79-01 Broadway, New York, NY 11373, USA; (C.N.); (Z.K.); (S.E.); (N.D.B.); (G.A.); (J.W.); (K.T.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
| | - Lee Schmidt
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
| | - Cecilia Nguyen
- Department of Surgery, NYC Health and Hospitals, Elmhurst, 79-01 Broadway, New York, NY 11373, USA; (C.N.); (Z.K.); (S.E.); (N.D.B.); (G.A.); (J.W.); (K.T.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
| | - Samantha Kiernan
- Touro College of Osteopathic Medicine–Harlem, New York, NY 10027, USA;
| | - Jacob Dexter-Meldrum
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
| | - Zachary Kuschner
- Department of Surgery, NYC Health and Hospitals, Elmhurst, 79-01 Broadway, New York, NY 11373, USA; (C.N.); (Z.K.); (S.E.); (N.D.B.); (G.A.); (J.W.); (K.T.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
| | - Scott Ellis
- Department of Surgery, NYC Health and Hospitals, Elmhurst, 79-01 Broadway, New York, NY 11373, USA; (C.N.); (Z.K.); (S.E.); (N.D.B.); (G.A.); (J.W.); (K.T.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
| | - Navin D. Bhatia
- Department of Surgery, NYC Health and Hospitals, Elmhurst, 79-01 Broadway, New York, NY 11373, USA; (C.N.); (Z.K.); (S.E.); (N.D.B.); (G.A.); (J.W.); (K.T.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
| | - George Agriantonis
- Department of Surgery, NYC Health and Hospitals, Elmhurst, 79-01 Broadway, New York, NY 11373, USA; (C.N.); (Z.K.); (S.E.); (N.D.B.); (G.A.); (J.W.); (K.T.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
| | - Jennifer Whittington
- Department of Surgery, NYC Health and Hospitals, Elmhurst, 79-01 Broadway, New York, NY 11373, USA; (C.N.); (Z.K.); (S.E.); (N.D.B.); (G.A.); (J.W.); (K.T.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
| | - Kate Twelker
- Department of Surgery, NYC Health and Hospitals, Elmhurst, 79-01 Broadway, New York, NY 11373, USA; (C.N.); (Z.K.); (S.E.); (N.D.B.); (G.A.); (J.W.); (K.T.)
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (L.S.); (J.D.-M.)
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Alhasaniah AH. l-carnitine: Nutrition, pathology, and health benefits. Saudi J Biol Sci 2023; 30:103555. [PMID: 36632072 PMCID: PMC9827390 DOI: 10.1016/j.sjbs.2022.103555] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/09/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Carnitine is a medically needful nutrient that contributes in the production of energy and the metabolism of fatty acids. Bioavailability is higher in vegetarians than in people who eat meat. Deficits in carnitine transporters occur as a result of genetic mutations or in combination with other illnesses such like hepatic or renal disease. Carnitine deficit can arise in diseases such endocrine maladies, cardiomyopathy, diabetes, malnutrition, aging, sepsis, and cirrhosis due to abnormalities in carnitine regulation. The exogenously provided molecule is obviously useful in people with primary carnitine deficits, which can be life-threatening, and also some secondary deficiencies, including such organic acidurias: by eradicating hypotonia, muscle weakness, motor skills, and wasting are all improved l-carnitine (LC) have reported to improve myocardial functionality and metabolism in ischemic heart disease patients, as well as athletic performance in individuals with angina pectoris. Furthermore, although some intriguing data indicates that LC could be useful in a variety of conditions, including carnitine deficiency caused by long-term total parenteral supplementation or chronic hemodialysis, hyperlipidemias, and the prevention of anthracyclines and valproate-induced toxicity, such findings must be viewed with caution.
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Key Words
- AD, Alzheimer's disease
- AIF, Apoptosis-inducing factor
- Anti-wasting effect
- BBB, Blood–brain barrier
- CC, Cancer cachexia
- CHF, Chronic heart failure
- COPD, Chronic obstructive pulmonary disease
- ESRD, End-stage renal disease
- GOT, Glutamic oxaloacetic transaminase
- HCC, Hepatocellular carcinoma
- HFD, High-Fat Diet
- HOI, Highest observed intake
- Health benefits
- LC, l-carnitine
- MI, myocardial infarction
- MTX, Methotrexate
- NF-kB, Nuclear factor-kB
- Nutrition
- OSL, Observed safe level
- PCD, Primary carnitine deficiency
- Pathology
- ROS, Reactive oxygen species
- SCD, Secondary carnitine deficiency
- TLE, Temporal lobe epilepsy
- VD, Vascular dementia
- l-carnitine
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Affiliation(s)
- Abdulaziz Hassan Alhasaniah
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, P.O. Box 1988, Najran 61441, Saudi Arabia
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Zheng C, Wu D, Shi S, Wang L. miR-34b-5p promotes renal cell inflammation and apoptosis by inhibiting aquaporin-2 in sepsis-induced acute kidney injury. Ren Fail 2021; 43:291-301. [PMID: 33494641 PMCID: PMC7850462 DOI: 10.1080/0886022x.2021.1871922] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE This study was designed to uncover the mechanism of miR-34b-5p-mediated aquaporin-2 (AQP2) in sepsis-induced injury using human renal tubular epithelial cells (HK-2). METHODS Serum levels of miR-34b-5p, TNF-α, IL-1β, IL-6, serum creatinine (SCr), and blood urea nitrogen (BUN) in septic patients with acute kidney injury (AKI) and healthy controls were detected. Lipopolysaccharide (LPS) was used to induce sepsis in HK-2 cells. LPS-induced HK-2 cells were transfected with miR-34b-5p inhibitor, miR-34b-5p mimic, pcDNA3.1-AQP2, si-AQP2, miR-34b-5p inhibitor + si-NC, or miR-34b-5p inhibitor + si-AQP2. The expressions of miR-34b-5p, AQP2, Bax, Bcl-2, cleaved caspase-3, TNF-α, IL-1β, and IL-6 in HK-2 cells were detected. TUNEL staining revealed the apoptosis of HK-2 cells. Dual-luciferase reporter assay verified the binding between miR-34b-5p and AQP2. RESULTS The expression of miR-34b-5p and the inflammatory responses were augmented in septic AKI patients. miR-34b-5p was up-regulated and AQP2 was down-regulated in LPS-induced HK-2 cells. miR-34b-5p inhibition or AQP2 overexpression ameliorated apoptosis and inflammation in LPS-induced HK-2 cells. In contrast, overexpressing miR-34b-5p deteriorated LPS-induced injury in HK-2 cells. AQP2 was a downstream target of miR-34b-5p. AQP2 silencing abolished the suppressive effects of miR-34b-5p inhibition on LPS-induced apoptosis and inflammatory response in HK-2 cells. CONCLUSION miR-34b-5p inhibits AQP2 to promote LPS-induced injury in HK-2 cells.
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Affiliation(s)
- Caifa Zheng
- Department of Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, P.R. China
| | - Dansen Wu
- Department of Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, P.R. China
| | - Songjing Shi
- Department of Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, P.R. China
- School of Clinical Medicine, Fujian Medical University, Fuzhou, P.R. China
| | - Liming Wang
- Department of Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, P.R. China
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Fernández SN, Santiago MJ, González R, López J, Solana MJ, Urbano J, López-Herce J. Changes in hemodynamics, renal blood flow and urine output during continuous renal replacement therapies. Sci Rep 2020; 10:20797. [PMID: 33247145 PMCID: PMC7695709 DOI: 10.1038/s41598-020-77435-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 11/09/2020] [Indexed: 11/09/2022] Open
Abstract
Continuous renal replacement therapies (CRRT) affect hemodynamics and urine output. Some theories suggest a reduced renal blood flow as the cause of the decreased urine output, but the exact mechanisms remain unclear. A prospective experimental study was carried out in 32 piglets (2–3 months old) in order to compare the impact of CRRT on hemodynamics, renal perfusion, urine output and renal function in healthy animals and in those with non-oliguric acute kidney injury (AKI). CRRT was started according to our clinical protocol, with an initial blood flow of 20 ml/min, with 10 ml/min increases every minute until a goal flow of 5 ml/kg/min. Heart rate, blood pressure, central venous pressure, cardiac output, renal blood flow and urine output were registered at baseline and during the first 6 h of CRRT. Blood and urine samples were drawn at baseline and after 2 and 6 h of therapy. Blood pressure, cardiac index and urine output significantly decreased after starting CRRT in all piglets. Renal blood flow, however, steadily increased throughout the study. Cisplatin piglets had lower cardiac index, higher vascular resistance, lower renal blood flow and lower urine output than control piglets. Plasma levels of ADH and urine levels of aquaporin-2 were lower, whereas kidney injury biomarkers were higher in the cisplatin group of piglets. According to our findings, a reduced renal blood flow doesn’t seem to be the cause of the decrease in urine output after starting CRRT.
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Affiliation(s)
- S N Fernández
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain. .,Department of Pediatrics. School of Medicine, Complutense University of Madrid, Madrid, Spain. .,Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain.
| | - M J Santiago
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain.,Department of Pediatrics. School of Medicine, Complutense University of Madrid, Madrid, Spain.,Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
| | - R González
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain.,Department of Pediatrics. School of Medicine, Complutense University of Madrid, Madrid, Spain.,Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
| | - J López
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain.,Department of Pediatrics. School of Medicine, Complutense University of Madrid, Madrid, Spain.,Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
| | - M J Solana
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain.,Department of Pediatrics. School of Medicine, Complutense University of Madrid, Madrid, Spain.,Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
| | - J Urbano
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain.,Department of Pediatrics. School of Medicine, Complutense University of Madrid, Madrid, Spain.,Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
| | - J López-Herce
- Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain.,Department of Pediatrics. School of Medicine, Complutense University of Madrid, Madrid, Spain.,Health Research Institute of the Gregorio Marañón Hospital, Madrid, Spain
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Afjal MA, Goswami P, Ahmad S, Dabeer S, Akhter J, Salman M, Mangla A, Raisuddin S. Tempol (4-hydroxy tempo) protects mice from cisplatin-induced acute kidney injury via modulation of expression of aquaporins and kidney injury molecule-1. Drug Chem Toxicol 2020; 45:1355-1363. [PMID: 33078650 DOI: 10.1080/01480545.2020.1831011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Tempol (4-hydroxy tempo), a pleiotropic antioxidant is reported to afford protection against cisplatin (CP)-induced nephrotoxicity. However, molecular mechanisms of action of tempol in improving the renal function in CP-induced nephrotoxicity are not fully understood. We investigated the attenuating effect of tempol against CP-induced alterations in kidney injury molecule-1 (KIM-1) and aquaporins (AQPs) in mice. Tempol (100 mg/kg, po) pretreatment with CP (20 mg/kg ip) showed restoration in renal function markers including electrolytes. CP treatment upregulated mRNA expression of KIM-1 and downregulated AQP and arginine vasopressin (AVP) expression which was attenuated by tempol. Immunoblotting analysis revealed that CP-induced alterations in KIM-1 and AQP expression were restored by tempol. Immunofluorocense study also showed restorative effect of tempol on the expression of AQP2 in CP-treated mice. In conclusion, this study provides experimental evidence that tempol resolved urinary concentration defect by the restoration of AQP, AVP and KIM-1 levels indicating a potential use of tempol in ameliorating the AKI in cancer patients under the treatment with CP.
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Affiliation(s)
- Mohd Amir Afjal
- Molecular Toxicology Laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Poonam Goswami
- Molecular Toxicology Laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Shahzad Ahmad
- Molecular Toxicology Laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Sadaf Dabeer
- Molecular Toxicology Laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Juheb Akhter
- Molecular Toxicology Laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Mohd Salman
- Molecular Neurobiology Laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Anuradha Mangla
- Molecular Toxicology Laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Sheikh Raisuddin
- Molecular Toxicology Laboratory, Department of Medical Elementology and Toxicology, Jamia Hamdard (Hamdard University), New Delhi, India
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Aquaporins in Renal Diseases. Int J Mol Sci 2019; 20:ijms20020366. [PMID: 30654539 PMCID: PMC6359174 DOI: 10.3390/ijms20020366] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 12/16/2022] Open
Abstract
Aquaporins (AQPs) are a family of highly selective transmembrane channels that mainly transport water across the cell and some facilitate low-molecular-weight solutes. Eight AQPs, including AQP1, AQP2, AQP3, AQP4, AQP5, AQP6, AQP7, and AQP11, are expressed in different segments and various cells in the kidney to maintain normal urine concentration function. AQP2 is critical in regulating urine concentrating ability. The expression and function of AQP2 are regulated by a series of transcriptional factors and post-transcriptional phosphorylation, ubiquitination, and glycosylation. Mutation or functional deficiency of AQP2 leads to severe nephrogenic diabetes insipidus. Studies with animal models show AQPs are related to acute kidney injury and various chronic kidney diseases, such as diabetic nephropathy, polycystic kidney disease, and renal cell carcinoma. Experimental data suggest ideal prospects for AQPs as biomarkers and therapeutic targets in clinic. This review article mainly focuses on recent advances in studying AQPs in renal diseases.
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