1
|
Peters AM. The physiological basis of renal nuclear medicine. Nucl Med Commun 2024:00006231-990000000-00313. [PMID: 38903047 DOI: 10.1097/mnm.0000000000001872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Renal physiology underpins renal nuclear medicine, both academic and clinical. Clearance, an important concept in renal physiology, comprises tissue uptake rate of tracer (tissue clearance), disappearance rate from plasma (plasma clearance), appearance rate in urine (urinary clearance) and disappearance rate from tissue. In clinical research, steady-state plasma clearances of para-amino-hippurate and inulin have been widely used to measure renal blood flow (RBF) and glomerular filtration rate (GFR), respectively. Routinely, GFR is measured at non-steady state as plasma clearance of a filtration agent, such as technetium-99m diethylenetriaminepentaacetic acid. Scaled to three-dimensional whole body metrics rather than body surface area, GFR in women is higher than in men but declines faster with age. Age-related decline is predominantly from nephron loss. Tubular function determines parenchymal transit time, which is important in renography, and the route of uptake of technetium-99m dimercaptosuccinic acid, which is via filtration. Resistance to flow is defined according to the pressure-flow relationship but in renography, only transit time can be measured, which, being equal to urine flow divided by collecting system volume, introduces further uncertainty because the volume is also unmeasurable. Tubuloglomerular feedback governs RBF and GFR, is regulated by the macula densa, mediated by adenosine and renin, and can be manipulated with proximal tubular sodium-glucose cotransporter-2 inhibitors. Other determinants of renal haemodynamics include prostaglandins, nitric oxide and dopamine, while protein meal and amino acid infusion are used to measure renal functional reserve. In conclusion, for measuring renal responses to exogenous agents, steady-state para-amino-hippurate and inulin clearances should be replaced with rubidium-82 and gallium-68 EDTA for measuring RBF and GFR.
Collapse
|
2
|
Pușcașu C, Zanfirescu A, Negreș S, Șeremet OC. Exploring the Multifaceted Potential of Sildenafil in Medicine. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2190. [PMID: 38138293 PMCID: PMC10744870 DOI: 10.3390/medicina59122190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Phosphodiesterase type 5 (PDE5) is pivotal in cellular signalling, regulating cyclic guanosine monophosphate (cGMP) levels crucial for smooth muscle relaxation and vasodilation. By targeting cGMP for degradation, PDE5 inhibits sustained vasodilation. PDE5 operates in diverse anatomical regions, with its upregulation linked to various pathologies, including cancer and neurodegenerative diseases. Sildenafil, a selective PDE5 inhibitor, is prescribed for erectile dysfunction and pulmonary arterial hypertension. However, considering the extensive roles of PDE5, sildenafil might be useful in other pathologies. This review aims to comprehensively explore sildenafil's therapeutic potential across medicine, addressing a gap in the current literature. Recognising sildenafil's broader potential may unveil new treatment avenues, optimising existing approaches and broadening its clinical application.
Collapse
Affiliation(s)
| | - Anca Zanfirescu
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, 020956 Bucharest, Romania; (C.P.); (S.N.); (O.C.Ș.)
| | | | | |
Collapse
|
3
|
Chen HY, Wu YH, Wei CY, Liao ZY, Wu HT, Chen YC, Pang JHS. Incomplete Recovery from the Radiocontrast-Induced Dysregulated Cell Cycle, Adhesion, and Fibrogenesis in Renal Tubular Cells after Radiocontrast (Iohexol) Removal. Int J Mol Sci 2023; 24:10945. [PMID: 37446141 DOI: 10.3390/ijms241310945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Contrast-induced nephropathy (CIN) is one of the most common causes of acute kidney injury (AKI). However, management is still limited, and the cellular response to radiocontrast removal for CIN remains unclear. This study aimed to explore the latent effects of iohexol in cultured renal tubular cells with or without the removal of iohexol by medium replacement. HK2 renal tubular cells were subcultured 24 h before use in CIN experiments. Three treatment groups were established: the control, a radiocontrast (iohexol)-only group at 75 mg I/mL (I-75), and iohexol exposure for 24 h with culture medium replacement (I-75/M). Cell cycle arrest, fibrogenic mediator assays, cell viability, cell function, and cell-cycle-related protein expression were compared between groups. Iohexol induced numerous changes in HK2 renal tubular cells, such as enlarged cell shape, cell cycle arrest, increased apoptosis, and polyploidy. Iohexol inhibited the expression of cyclins, CDKs, ZO-1, and E-cadherin but conversely enhanced the expression of p21 and fibrosis-related genes, including TGF-β1, CTGF, collagen I, collagen III, and HIF-1α within 60 hr after the exposure. Except for the recovery from cell cycle arrest and cell cycle gene expression, notably, the removal of iohexol by medium replacement could not fully recover the renal tubular cells from the formation of polyploid cells, the adhesion or spreading, or the expression of fibrosis-related genes. The present study demonstrates, for the first time, that iohexol exerts latent cytotoxic effects on cultured renal tubular cells after its removal, suggesting that these irreversible cell changes may cause the insufficiency of radiocontrast reduction in CIN, which is worth investigating further.
Collapse
Affiliation(s)
- Hsing-Yu Chen
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Yi-Hong Wu
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Cheng-Yu Wei
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Zhi-Yao Liao
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Hsiao-Ting Wu
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Yung-Chang Chen
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 33342, Taiwan
| | - Jong-Hwei S Pang
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan 33342, Taiwan
| |
Collapse
|
4
|
Renoprotective Effect of Vardenafil and Avanafil in Contrast-Induced Nephropathy: Emerging Evidence from an Animal Model. J Pers Med 2022; 12:jpm12050670. [PMID: 35629096 PMCID: PMC9144719 DOI: 10.3390/jpm12050670] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 02/04/2023] Open
Abstract
The potential renoprotective effects of vardenafil (VAR) have been evaluated in a very limited number of studies using acute kidney injury animal models other than contrast-induced nephropathy (CIN) with promising results, while avanafil (AVA) has not been evaluated in this respect before. The purpose of this study was to evaluate for the first time the potential renoprotective effect of VAR and AVA in a rat model of CIN. Twenty-five male Wistar rats were equally assigned into five groups: control, CIN, CIN+N-acetyl cysteine (NAC) (100 mg/kg/day) as a positive control, CIN+VAR (10 mg/kg/day) and CIN+AVA (50 mg/kg/day). CIN was induced by dehydration, inhibition of prostaglandin and nitric oxide synthesis as well as exposure to the contrast medium (CM). Serum Cr (sCr) levels were measured at 24 and 48 h after CIN induction. At 48 h of CM exposure, animals were sacrificed. Matrix metalloproteinase (MMP) 2 (MMP-2) and MMP-9, kidney injury molecule 1 (KIM-1) and cystatin-C (Cys-C) were measured on renal tissue. Histopathological findings were evaluated on kidney tissue. All treatment groups had close to normal kidney appearance. sCr levels subsided in all treatment groups compared to CIN group at 48 h following CIN induction. A significant decline in the levels of MMP-2, MMP-9, KIM-1 and Cys-C compared to CIN group was observed. These results provide emerging evidence that VAR and AVA may have the potential to prevent CIN.
Collapse
|
5
|
Fragkiadoulaki E, Tsatsakis A, Nikitovic D, Georgiadis G, Kalogeraki A, Kaloudis K, Alegkakis A, Karzi V, Mamoulakis C. Resveratrol and lycopene ameliorate contrast-induced nephropathy in a rabbit model. Hum Exp Toxicol 2022; 41:9603271221145355. [PMID: 36565226 DOI: 10.1177/09603271221145355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Oxidative stress appears to possess a central role in CIN pathophysiology. Resveratrol (Res) and lycopene (Lyc) are strong natural antioxidants evaluated in a limited number of CIN animal studies in vivo. The aim of the study was to evaluate the potential renoprotective effects of Res/Lyc in a CIN rabbit model. Twenty-four adult male New Zealand white rabbits were equally assigned into four groups: control (saline), CIN (intravenous iopromide; 7.5 g iodine/kg), Res + CIN (per os Res; 5 mg/kg), and Lyc + CIN (per os Lyc; 4 mg/kg). Serum Cr (sCr); symmetric/asymmetric dimethylarginine (SDMA/ADMA); oxidative stress biomarkers: malondialdehyde; total antioxidant capacity; catalase; glutathione) were evaluated in blood samples at three time points: right after (0 h); 24 h; 48 h after iopromide/saline administration. CD20+/CD3+ lymphocytes were determined (48 h). All animals were sacrificed at 48 h and both kidneys collected. Oxidative stress biomarkers were measured in renal tissue. sCr and SDMA/ADMA levels increased significantly in CIN compared to all groups. Oxidative stress secondary to CIN in blood/kidneys was suppressed by Res/Lyc. B and T lymphocytes decreased significantly in CIN compared to all groups. The present study provides emerging evidence that Res/Lyc ameliorate CIN by modulating oxidant/antioxidant balance in blood/renal tissue and by inhibiting vasoconstriction/blood cytotoxicity.
Collapse
Affiliation(s)
- Eirini Fragkiadoulaki
- Department of Urology, Medical School, University General Hospital of Heraklion, 37778University of Crete, Heraklion, Greece.,Department of Forensic Sciences and Toxicology, Medical School, 37778University of Crete, Heraklion, Greece
| | - Aristides Tsatsakis
- Department of Forensic Sciences and Toxicology, Medical School, 37778University of Crete, Heraklion, Greece
| | - Dragana Nikitovic
- Laboratory of Anatomy-Histology-Embryology, Medical School, 37778University of Crete, Heraklion, Greece
| | - Georgios Georgiadis
- Department of Urology, Medical School, University General Hospital of Heraklion, 37778University of Crete, Heraklion, Greece
| | - Alexandra Kalogeraki
- Laboratory of Cytopathology, Medical School, 37778University of Crete, Heraklion, Greece
| | - Konstantinos Kaloudis
- Department of Forensic Sciences and Toxicology, Medical School, 37778University of Crete, Heraklion, Greece
| | - Athanasios Alegkakis
- Department of Forensic Sciences and Toxicology, Medical School, 37778University of Crete, Heraklion, Greece
| | - Vasiliki Karzi
- Department of Forensic Sciences and Toxicology, Medical School, 37778University of Crete, Heraklion, Greece
| | - Charalampos Mamoulakis
- Department of Urology, Medical School, University General Hospital of Heraklion, 37778University of Crete, Heraklion, Greece
| |
Collapse
|
6
|
Coskuner ER, Ozkan B. Reno-protective effects of Phosphodiesterase 5 inhibitors. Clin Exp Nephrol 2021; 25:585-597. [PMID: 33754203 DOI: 10.1007/s10157-021-02051-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/09/2021] [Indexed: 12/20/2022]
Abstract
The kidneys are vital organs that play an important role in removing waste materials from the blood, electrolyte balance, blood pressure regulation, and red blood cell genesis. Kidney disease can be caused by various factors, including diabetes, ischemia/reperfusion injury, and nephrotoxic agents. Inflammation and oxidative stress play a key role in the progression and pathogenesis of kidney diseases. Acute kidney injury (AKI) and chronic kidney disease (CKD) are important health problems worldwide, as they are associated with a long-term hospital stay, and increased morbidity and mortality in high-risk patients. Current standard therapeutic options are not sufficient to delay or stop the loss of kidney function. Therefore, it is necessary to develop new therapeutic options. Phosphodiesterase 5 inhibitors (PDE5Is) are a currently available class of drugs that are used to treat erectile dysfunction and pulmonary hypertension in humans. However, recent evidence suggests that PDE5Is have beneficial renoprotective effects via a variety of mechanisms. In this review, the benefits of PDE5 inhibitors in clinical conditions associated with kidney disease, such as diabetic nephropathy, ischemia-reperfusion injury, and acute and chronic kidney injury, are summarized.
Collapse
Affiliation(s)
- Enis Rauf Coskuner
- Department of Urology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Acibadem Bakirkoy Hospital, Halit Ziya Usakligil Cad No:1, Bakirkoy, 34140, Istanbul, Turkey.
| | - Burak Ozkan
- Department of Urology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Acibadem Bakirkoy Hospital, Halit Ziya Usakligil Cad No:1, Bakirkoy, 34140, Istanbul, Turkey
| |
Collapse
|
7
|
Kusirisin P, Chattipakorn SC, Chattipakorn N. Contrast-induced nephropathy and oxidative stress: mechanistic insights for better interventional approaches. J Transl Med 2020; 18:400. [PMID: 33081797 PMCID: PMC7576747 DOI: 10.1186/s12967-020-02574-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/14/2020] [Indexed: 12/17/2022] Open
Abstract
Contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI) is an iatrogenic acute kidney injury observed after intravascular administration of contrast media for intravascular diagnostic procedures or therapeutic angiographic intervention. High risk patients including those with chronic kidney disease (CKD), diabetes mellitus with impaired renal function, congestive heart failure, intraarterial intervention, higher volume of contrast, volume depletion, old age, multiple myeloma, hypertension, and hyperuricemia had increased prevalence of CIN. Although CIN is reversible by itself, some patients suffer this condition without renal recovery leading to CKD or even end-stage renal disease which required long term renal replacement therapy. In addition, both CIN and CKD have been associated with increasing of mortality. Three pathophysiological mechanisms have been proposed including direct tubular toxicity, intrarenal vasoconstriction, and excessive production of reactive oxygen species (ROS), all of which lead to impaired renal function. Reports from basic and clinical studies showing potential preventive strategies for CIN pathophysiology including low- or iso-osmolar contrast media are summarized and discussed. In addition, reports on pharmacological interventions to reduce ROS and attenuate CIN are summarized, highlighting potential for use in clinical practice. Understanding this contributory mechanism could pave ways to improve therapeutic strategies in combating CIN.
Collapse
Affiliation(s)
- Prit Kusirisin
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand.
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| |
Collapse
|
8
|
Iordache AM, Buga AM, Albulescu D, Vasile RC, Mitrut R, Georgiadis G, Zisis IE, Mamoulakis C, Tsatsakis A, Docea AO, Calina D. Phosphodiesterase-5 inhibitors ameliorate structural kidney damage in a rat model of contrast-induced nephropathy. Food Chem Toxicol 2020; 143:111535. [PMID: 32622850 DOI: 10.1016/j.fct.2020.111535] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 12/11/2022]
Abstract
The aim of the study was to investigate the potential of sildenafil and tadalafil to ameliorate structural kidney damage in contrast-induced nephropathy (CIN). A rat model of CIN was developed by dehydration, administration of a nitric oxide inhibitor and a prostaglandin synthesis inhibitor (L-NAME/indomethacin) and contrast media exposure to iopromide. The effect of pre-treatment with sildenafil, tadalafil or N-acetyl cysteine (NAC) for 7 days prior to CIN induction was investigated. All animals were sacrificed at 24 h after CIN induction and both kidneys were collected. Histopathological examination was performed under light microscopy in serial tissue sections stained with hematoxylin and eosin. CIN group showed hydropic changes of the renal tubules (proximal and distal convoluted tubules and Henle's loop), an increased Bowman space with lobulated glomerulus and alteration of macula densa region of distal convolute tubules. The groups pretreated with sildenafil and tadalafil showed nearly normal histological aspects of renal tissue. The group pretreated with NAC showed similar but less intense histopathologic changes compared to CIN group. Sildenafil and tadalafil pre-treatment ameliorates CIN-related structural kidney damage and the protective potential of these agents is superior to NAC.
Collapse
Affiliation(s)
- Andrei Mihai Iordache
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Ana Maria Buga
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Dana Albulescu
- Department of Radiology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Ramona Constantina Vasile
- Department of Epidemiology and Primary Healthcare, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Radu Mitrut
- Department of Cardiology, University and Emergency Hospital, 050098, Bucharest, Romania.
| | - George Georgiadis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, Crete, 71003, Greece.
| | - Ioannis-Erineos Zisis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, Crete, 71003, Greece.
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece.
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, Crete, 71003, Greece.
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| |
Collapse
|
9
|
Georgiadis G, Zisis IE, Docea AO, Tsarouhas K, Fragkiadoulaki I, Mavridis C, Karavitakis M, Stratakis S, Stylianou K, Tsitsimpikou C, Calina D, Sofikitis N, Tsatsakis A, Mamoulakis C. Current Concepts on the Reno-Protective Effects of Phosphodiesterase 5 Inhibitors in Acute Kidney Injury: Systematic Search and Review. J Clin Med 2020; 9:jcm9051284. [PMID: 32365529 PMCID: PMC7287956 DOI: 10.3390/jcm9051284] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 12/11/2022] Open
Abstract
Acute kidney injury (AKI) is associated with increased morbidity, prolonged hospitalization, and mortality, especially in high risk patients. Phosphodiesterase 5 inhibitors (PDE5Is), currently available as first-line therapy of erectile dysfunction in humans, have shown a beneficial potential of reno-protection through various reno-protective mechanisms. The aim of this work is to provide a comprehensive overview of the available literature on the reno-protective properties of PDE5Is in the various forms of AKI. Medline was systematically searched from 1946 to November 2019 to detect all relevant animal and human studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. In total, 83 studies were included for qualitative synthesis. Sildenafil is the most widely investigated compound (42 studies), followed by tadalafil (20 studies), icariin (10 studies), vardenafil (7 studies), zaprinast (4 studies), and udenafil (2 studies). Even though data are limited, especially in humans with inconclusive or negative results of only two clinically relevant studies available at present, the results of animal studies are promising. The reno-protective action of PDE5Is was evident in the vast majority of studies, independently of the AKI type and the agent applied. PDE5Is appear to improve the renal functional/histopathological alternations of AKI through various mechanisms, mainly by affecting regional hemodynamics, cell expression, and mitochondrial response to oxidative stress and inflammation.
Collapse
Affiliation(s)
- Georgios Georgiadis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
| | - Ioannis-Erineos Zisis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, Crete 71003, Greece;
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | | | - Irene Fragkiadoulaki
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, Crete 71003, Greece;
| | - Charalampos Mavridis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
| | - Markos Karavitakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
| | - Stavros Stratakis
- Department of Nephrology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (S.S.); (K.S.)
| | - Kostas Stylianou
- Department of Nephrology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (S.S.); (K.S.)
| | - Christina Tsitsimpikou
- Department of Hazardous Substances, Mixtures and Articles, General Chemical State Laboratory of Greece, Ampelokipi, Athens, Greece;
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Nikolaos Sofikitis
- Department of Urology, School of Medicine, Ioannina University, Ioannina, Greece;
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, Crete 71003, Greece;
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece; (G.G.); (I.-E.Z.); (I.F.); (C.M.); (M.K.)
- Correspondence:
| |
Collapse
|
10
|
Iordache AM, Docea AO, Buga AM, Zlatian O, Ciurea ME, Rogoveanu OC, Burada F, Sosoi S, Mitrut R, Mamoulakis C, Albulescu D, Vasile RC, Tsatsakis A, Calina D. Sildenafil and tadalafil reduce the risk of contrast-induced nephropathy by modulating the oxidant/antioxidant balance in a murine model. Food Chem Toxicol 2019; 135:111038. [PMID: 31825855 DOI: 10.1016/j.fct.2019.111038] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 12/26/2022]
Abstract
The aim of the study was to evaluate the potential protective role of sildenafil and tadalafil in contrast-induced nephropathy (CIN) by modulating oxidative stress. Thirty Wistar male rats were equally assigned into five groups: sham, CIN, CIN + sildenafil (10 mg/kg bw/day), CIN + tadalafil (5 mg/kg bw/day) and CIN + N-Acetyl Cysteine (NAC) (100 mg/kg bw/day) as a positive control. CIN was induced by 12 h dehydration and administration of indomethacin (10 mg/kg bw), N-ω- nitro-L-arginine methyl ester (10 mg/kg bw), and iopromide (3 g/kg bw iodine). Blood was drawn prior to and 24 h after CIN induction for evaluating renal function and oxidative stress. In the CIN group, total antioxidant capacity (TAC), reduced glutathione (GSH) and catalase (CAT) levels were significantly decreased; and protein carbonyl (PROTC) and thiobarbituric reactive species (TBARS) were significantly increased compared to the sham group. Pre- Sildenafil and tadalafil pre-treatment reduced CIN risk and reversed oxidative stress almost to the sham group levels. These results suggest that PDE5Is can be good candidates for preventing CIN based on their ability to modulate the oxidant/antioxidant balance.
Collapse
Affiliation(s)
- Andrei Mihai Iordache
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Ana Maria Buga
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Ovidiu Zlatian
- Department of Microbiology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Marius Eugen Ciurea
- Department of Plastic Surgery, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Otilia Constantina Rogoveanu
- Department of Physical and Rehabilitation Medicine Department, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Florin Burada
- Department of Human Genomics Laboratory, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Simona Sosoi
- Department of Human Genomics Laboratory, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Radu Mitrut
- Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania; Department of Cardiology, University and Emergency Hospital, 050098, Bucharest, Romania.
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece.
| | - Dana Albulescu
- Department of Radiology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Ramona Constantina Vasile
- Department of Epidemiology and Primary Healthcare, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Aristides Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion, 71003, Greece.
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| |
Collapse
|
11
|
Kalogirou TE, Meditskou S, Davidopoulou S, Savvas I, Pitoulias AG, Pitoulias GA. Investigating the Possible Protective Role of Direct Intra-arterial Administration of Mannitol and N-Acetylcysteine and Per Os Administration of Simvastatin Against Contrast-Induced Nephropathy: An Experimental Study in a Rabbit Model. Cardiovasc Intervent Radiol 2019; 42:1777-1785. [PMID: 31392490 DOI: 10.1007/s00270-019-02304-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/30/2019] [Accepted: 07/30/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Contrast-induced nephropathy (CIN) is one of the leading causes of hospital-acquired acute kidney injury due to the use of iodinated contrast media in various interventional procedures like endovascular aneurysm repair. Its pathophysiology remains mostly unclear. The purpose of the present study was to comparatively study the possible protective role of direct intra-arterial administration of mannitol and acetylcysteine and per os administration of simvastatin in a histopathological level. MATERIALS AND METHODS In the present study, we administered iopromide directly in the infrarenal aorta of 24 New Zealand white rabbits after laparotomy. Animals were divided in four groups of six: G1 received iopromide with no protection, G2 iopromide with mannitol, G3 iopromide with acetylcysteine, and G4 iopromide with simvastatin. Renal function blood parameters were assessed prior to the administration, and in 48 h; histopathological evaluation of the kidneys was performed. RESULTS CIN was evident only in the no protection group G1. Moreover, G1 demonstrated significantly more severe lesions than groups G2, G3, and G4 regarding histopathological findings in glomeruli, vacuolization of tubular epithelial cells, tubular proteinaceous casts, and tubular necrosis. According to our results, intra-arterial administration of mannitol seems to be effective in protection against tubular necrosis. CONCLUSION In general, all three agents demonstrated a protective role in preventing the development of CIN, although it seems that there are various pathways that remain to be investigated further.
Collapse
Affiliation(s)
- Thomas E Kalogirou
- Department of Vascular Surgery, 2nd Surgical Department, General Hospital of Thessaloniki "G.Gennimatas", Aristotle University of Thessaloniki, Eth. Aminis 41, 546 35, Thessaloniki, Greece.
| | - Soultana Meditskou
- Laboratory of Histology- Embryology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sotiria Davidopoulou
- Department of Vascular Surgery, 2nd Surgical Department, General Hospital of Thessaloniki "G.Gennimatas", Aristotle University of Thessaloniki, Eth. Aminis 41, 546 35, Thessaloniki, Greece
| | - Ioannis Savvas
- Veterinary Anaesthesia, Analgesia, and Intensive Care Unit of Anaesthesiology, and Intensive Care Companion Animal Clinic, Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos G Pitoulias
- Department of Vascular Surgery, 2nd Surgical Department, General Hospital of Thessaloniki "G.Gennimatas", Aristotle University of Thessaloniki, Eth. Aminis 41, 546 35, Thessaloniki, Greece
| | - Georgios A Pitoulias
- Department of Vascular Surgery, 2nd Surgical Department, General Hospital of Thessaloniki "G.Gennimatas", Aristotle University of Thessaloniki, Eth. Aminis 41, 546 35, Thessaloniki, Greece
| |
Collapse
|
12
|
de Souza Santos V, Peters B, Côco LZ, Alves GM, de Assis ALEM, Nogueira BV, Meyrelles SS, Porto ML, Vasquez EC, Campagnaro BP, Pereira TMC. Silymarin protects against radiocontrast-induced nephropathy in mice. Life Sci 2019; 228:305-315. [PMID: 31047898 DOI: 10.1016/j.lfs.2019.04.061] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Silymarin, an extract from Silybum marianum (milk thistle) containing a standardized mixture of flavonolignans that ameliorates some types of liver disease and, more recently, kidney damage, could be used for the ROS-scavenging effect of these antioxidants. Furthermore, contrast-induced nephropathy (CIN) is an iatrogenic impairment of renal function in patients subjected to angiographic procedures for which there is not yet a successful preventative treatment. Recent evidence has shown that this event is related to tubular/vascular injury activated mainly by oxidative stress. However, whether this bioavailable and pharmacologically safe extract protects against CIN is not clear. We proposed to evaluate the possible protective role of the antioxidant silymarin in an experimental model of CIN. Adult male Swiss mice were separated into 6 groups and pretreated orally with silymarin (50, 200 and 300 mg/kg), N-acetylcysteine (200 mg/kg) or vehicle for 5 days before the CIN and control groups. Renal function was analyzed by plasma creatinine, urea and cystatin C levels. Additionally, blood reactive oxygen species (ROS) were evaluated using ROS bioavailability, protein oxidation and DNA damage. Renal oxidative damage was evaluated using apoptosis/cell viability assays and histological analysis. We showed that silymarin preserved renal function and decreased systemic and renal oxidative damage (antigenotoxic and antiapoptotic properties, respectively) in a dose-dependent manner and was superior to conventional treatment with N-acetylcysteine. Histologically, silymarin treatment also had beneficial effects on renal glomerular and tubular injuries. Therefore, silymarin prophylaxis may be an interesting strategy for the prevention of CIN.
Collapse
Affiliation(s)
| | - Beatriz Peters
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | - Larissa Zambom Côco
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | - Gisele Maziero Alves
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | | | - Breno Valentim Nogueira
- Department of Morphology, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Silvana Santos Meyrelles
- Laboratory of Translational Physiology, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | - Marcella Leite Porto
- Federal Institute of Education, Science and Technology (IFES), Vila Velha, ES, Brazil
| | - Elisardo Corral Vasquez
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil; Laboratory of Translational Physiology, Health Sciences Center, Federal University of Espirito Santo, Vitoria, Brazil
| | | | - Thiago Melo Costa Pereira
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil; Federal Institute of Education, Science and Technology (IFES), Vila Velha, ES, Brazil.
| |
Collapse
|
13
|
Antioxidant effect of sildenafil: Potential hepatoprotection via differential expression of mitochondrial proteins in apolipoprotein E knockout mice. Pharmacol Rep 2019; 71:422-429. [PMID: 31003152 DOI: 10.1016/j.pharep.2019.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/12/2018] [Accepted: 01/04/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND High plasma cholesterol levels are able to trigger several pathophysiological events, including inflammation, cell damage and especially oxidative stress. Previously, studies have shown that sildenafil exhibited antioxidant effects in several experimental models. Here we evaluate the role of sildenafil in liver redox equilibrium of apolipoprotein E knockout (apoE-KO) mice. METHODS ApoE-KO mice were divided in two groups: one group received the PDE5 inhibitor sildenafil (40 mg/kg/day) for 3 weeks (apoE-KO + Sil) and was compared to a second group of apoE-KO mice, which received only the vehicle (water) for 3 weeks (apoE-KO). Control group (C57 mice) received only a standard chow diet. At the age of 18 weeks, mice livers were collected for the measurement of intracellular ROS levels and apoptotic cells by flow cytometry analysis, and mitochondria isolation for proteomic analysis. RESULTS Compared to the control group, liver cells from apoE-KO presented some typical redox imbalance features: higher levels of intracellular ROS (global oxidative stress ˜60%, superoxide anion ˜82%, and peroxynitrite/hydroxyl radical ˜53%), higher amounts of apoptotic cells (up to ˜19%) and higher mitochondrial intensity of catalase (+339%) and transferrin spots (+914%). After treatment with sildenafil, apoE-KO presented ROS levels and the number of apoptotic cells similar to those observed in C57. In addition, when compared to apoE-KO, apoE-KO + Sil showed lower spots volumes of catalase (-23%) and transferrin (-71%) and up-regulation of urate oxidase (+94%). CONCLUSION The treatment with sildenafil is able to induce beneficial changes in liver mitochondrial protein dynamics, which restores the redox homeostasis contributing to a potential hepatoprotection.
Collapse
|
14
|
Serum and Tissue HIF-2 Alpha Expression in CIN, N-Acetyl Cysteine, and Sildenafil-Treated Rat Models: An Experimental Study. ACTA ACUST UNITED AC 2018; 54:medicina54040054. [PMID: 30344285 PMCID: PMC6174349 DOI: 10.3390/medicina54040054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 12/21/2022]
Abstract
Background and Objectives: Contrast-induced nephropathy (CIN), is acute renal damage due to contrast agents. This study is conducted to evaluate serum and renal heterodimeric nuclear transcription factor (HIF)-2 alpha levels and its tissue expression in contrast-induced nephropathy, and in N-acetyl cysteine (NAC)-and Sildenafil-treated rat models. Materials/Methods: This randomized, controlled, interventional animal study was conducted on Wistar rats. Rats (n = 36) were randomly assigned to four groups: control (n = 9), CIN group (n = 9), CIN + NAC group (n = 9), and sildenafil (n = 9). The rat model was used to form iohexol-originated CIN. During the modeling, prophylactic treatment was performed at the 24th and 48th h. After 48 h of modeling, blood, urine, and tissue samples were obtained for biochemical analyses. HIF-2-α levels were measured in renal tissue, serum, and urine samples. Renal sections were also performed for histopathologic and immunohistochemical evaluations of renal injury and HIF-2-α expression. Results: In the CIN model, HIF-2α levels and other biochemical parameters were significantly increased (p < 0.01). Both sildenafil and NAC efficiently decreased renal damage due to contrast agents, as shown in histopathologic examinations (p < 0.05). Similarly, after treatment with sildenafil and NAC, HIF-2α levels were significantly decreased (p < 0.05). Conclusions: The current study shows that serum and tissue HIF-2α levels decrease in CIN. Besides, the levels and tissue expression of HIF-2α decrease with both NAC and sildenafil treatments. With further studies, HIF-2α can be investigated as a biomarker of CIN and can be used in the follow-up of patients with CIN.
Collapse
|
15
|
Tsamouri MM, Rapti M, Kouka P, Nepka C, Tsarouhas K, Soumelidis A, Koukoulis G, Tsatsakis A, Kouretas D, Tsitsimpikou C. Histopathological evaluation and redox assessment in blood and kidney tissues in a rabbit contrast-induced nephrotoxicity model. Food Chem Toxicol 2017; 108:186-193. [DOI: 10.1016/j.fct.2017.07.058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 01/14/2023]
|
16
|
El-Naa MM, Othman M, Younes S. Sildenafil potentiates the antitumor activity of cisplatin by induction of apoptosis and inhibition of proliferation and angiogenesis. DRUG DESIGN DEVELOPMENT AND THERAPY 2016; 10:3661-3672. [PMID: 27895461 PMCID: PMC5117873 DOI: 10.2147/dddt.s107490] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Sildenafil is the first phosphodiesterase-5 inhibitor used for the treatment of erectile dysfunction. However, recent studies have been suggesting an antitumor effect of sildenafil. The current study assessed the aforementioned activity of sildenafil in vivo and in vitro in solid-tumor-bearing mice and in a human cell line MCF-7, respectively. Moreover, we investigated the impact of sildenafil on cisplatin antitumor activity. The solid tumor was induced by inoculation of Ehrlich ascites carcinoma cells in female mice. The tumor-bearing mice were assigned randomly to control (saline), sildenafil (sildenafil 5 mg/kg/d, PO daily for 15 days), cisplatin (cisplatin 7.5 mg/kg, IP once on the 12th day of Ehrlich ascites carcinoma inoculation), and combination therapy (cisplatin and sildenafil) groups. The tumor volume was measured at the end of the treatment period along with the following parameters: angiogenin, vascular endothelial growth factor, tumor necrosis factor-α, Ki-67, caspase-3, DNA-flow cytometry analysis, and histopathological examination. The study results showed that sildenafil has significantly decreased the tumor volume by 30.4%, angiogenin and tumor necrosis factor-α contents, as well as vascular endothelial growth factor expression. Additionally, caspase-3 level significantly increased with sildenafil treatment, whereas Ki-67 expression failed to show any significant changes. Furthermore, the cell cycle analysis revealed that sildenafil was capable of improving the category of tumor activity from moderate to low proliferative. Sildenafil induced necrosis in the tumor. Moreover, the drug of interest showed cytotoxic activity against MCF-7 in vitro as well as potentiated cisplatin antitumor activity in vivo and in vitro. These findings shed light on the antitumor activity of sildenafil and its possible impact on potentiating the antitumor effect of conventional chemotherapeutic agents such as cisplatin. These effects might be related to antiangiogenic, antiproliferative, and apoptotic activities of sildenafil.
Collapse
Affiliation(s)
- Mona Mohamed El-Naa
- Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), 6 October City, Egypt
| | - Mohamed Othman
- Preparatory Year College, University of Hail, Hail, Kingdom of Saudi Arabia; Faculty of Biotechnology, October University for Modern Science and Arts (MSA), 6 October City, Egypt
| | - Sheren Younes
- Pathology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt; College of Medicine, Princess Nora Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
17
|
Pereira TMC, Pimenta FS, Porto ML, Baldo MP, Campagnaro BP, Gava AL, Meyrelles SS, Vasquez EC. Coadjuvants in the Diabetic Complications: Nutraceuticals and Drugs with Pleiotropic Effects. Int J Mol Sci 2016; 17:ijms17081273. [PMID: 27527163 PMCID: PMC5000671 DOI: 10.3390/ijms17081273] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 07/27/2016] [Accepted: 07/29/2016] [Indexed: 12/19/2022] Open
Abstract
Because diabetes mellitus (DM) is a multifactorial metabolic disease, its prevention and treatment has been a constant challenge for basic and clinical investigators focused on translating their discoveries into clinical treatment of this complex disorder. In this review, we highlight recent experimental and clinical evidences of potential coadjuvants in the management of DM, such as polyphenols (quercetin, resveratrol and silymarin), cultured probiotic microorganisms and drugs acting through direct/indirect or pleiotropic effects on glycemic control in DM. Among several options, we highlight new promising therapeutic coadjuvants, including chemical scavengers, the probiotic kefir and the phosphodiesterase 5 inhibitors, which besides the reduction of hyperglycemia and ameliorate insulin resistance, they reduce oxidative stress and improve endothelial dysfunction in the systemic vascular circulation. In the near future, experimental studies are expected to clear the intracellular pathways involving coadjuvants. The design of clinical trials may also contribute to new strategies with coadjuvants against the harmful effects of diabetic complications.
Collapse
Affiliation(s)
- Thiago Melo Costa Pereira
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Av. Comissario Jose Dantas Melo 21, Boa Vista, 29102-920 Vila Velha, Brazil.
- Federal Institute of Education, Science and Technology (IFES), 29106-010 Vila Velha, Brazil.
| | - Fabio Silva Pimenta
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Av. Comissario Jose Dantas Melo 21, Boa Vista, 29102-920 Vila Velha, Brazil.
- Burn Treatment Center, Children State Hospital, 29056-030 Vitoria, Brazil.
| | - Marcella Lima Porto
- Federal Institute of Education, Science and Technology (IFES), 29106-010 Vila Velha, Brazil.
| | - Marcelo Perim Baldo
- Department of Pathophysiology, Montes Claros State University, 39401-089, Montes Claros, Brazil.
| | - Bianca Prandi Campagnaro
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Av. Comissario Jose Dantas Melo 21, Boa Vista, 29102-920 Vila Velha, Brazil.
| | - Agata Lages Gava
- Laboratory of Translational Physiology, Federal University of Espirito Santo (Ufes), 29047-100 Vitoria, Brazil.
- Division of Nephrology, McMaster University, Hamilton, ON L8N 4A6, Canada.
| | - Silvana Santos Meyrelles
- Laboratory of Translational Physiology, Federal University of Espirito Santo (Ufes), 29047-100 Vitoria, Brazil.
| | - Elisardo Corral Vasquez
- Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Av. Comissario Jose Dantas Melo 21, Boa Vista, 29102-920 Vila Velha, Brazil.
- Laboratory of Translational Physiology, Federal University of Espirito Santo (Ufes), 29047-100 Vitoria, Brazil.
| |
Collapse
|