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Kim K, Fazzone B, Cort TA, Kunz EM, Alvarez S, Moerschel J, Palzkill VR, Dong G, Anderson EM, O'Malley KA, Berceli SA, Ryan TE, Scali ST. Mitochondrial targeted catalase improves muscle strength following arteriovenous fistula creation in mice with chronic kidney disease. Sci Rep 2024; 14:8288. [PMID: 38594299 PMCID: PMC11004135 DOI: 10.1038/s41598-024-58805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/03/2024] [Indexed: 04/11/2024] Open
Abstract
Hand dysfunction is a common observation after arteriovenous fistula (AVF) creation for hemodialysis access and has a variable clinical phenotype; however, the underlying mechanism responsible is unclear. Grip strength changes are a common metric used to assess AVF-associated hand disability but has previously been found to poorly correlate with the hemodynamic perturbations post-AVF placement implicating other tissue-level factors as drivers of hand outcomes. In this study, we sought to test if expression of a mitochondrial targeted catalase (mCAT) in skeletal muscle could reduce AVF-related limb dysfunction in mice with chronic kidney disease (CKD). Male and female C57BL/6J mice were fed an adenine-supplemented diet to induce CKD prior to placement of an AVF in the iliac vascular bundle. Adeno-associated virus was used to drive expression of either a green fluorescent protein (control) or mCAT using the muscle-specific human skeletal actin (HSA) gene promoter prior to AVF creation. As expected, the muscle-specific AAV-HSA-mCAT treatment did not impact blood urea nitrogen levels (P = 0.72), body weight (P = 0.84), or central hemodynamics including infrarenal aorta and inferior vena cava diameters (P > 0.18) or velocities (P > 0.38). Hindlimb perfusion recovery and muscle capillary densities were also unaffected by AAV-HSA-mCAT treatment. In contrast to muscle mass and myofiber size which were not different between groups, both absolute and specific muscle contractile forces measured via a nerve-mediated in-situ preparation were significantly greater in AAV-HSA-mCAT treated mice (P = 0.0012 and P = 0.0002). Morphological analysis of the post-synaptic neuromuscular junction uncovered greater acetylcholine receptor cluster areas (P = 0.0094) and lower fragmentation (P = 0.0010) in AAV-HSA-mCAT treated mice. Muscle mitochondrial oxidative phosphorylation was not different between groups, but AAV-HSA-mCAT treated mice had lower succinate-fueled mitochondrial hydrogen peroxide emission compared to AAV-HSA-GFP mice (P < 0.001). In summary, muscle-specific scavenging of mitochondrial hydrogen peroxide significantly improves neuromotor function in mice with CKD following AVF creation.
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Affiliation(s)
- Kyoungrae Kim
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd, Gainesville, FL, 32611, USA
| | - Brian Fazzone
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, P.O. Box 100128, Gainesville, FL, 32610, USA
- Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA
| | - Tomas A Cort
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd, Gainesville, FL, 32611, USA
| | - Eric M Kunz
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd, Gainesville, FL, 32611, USA
| | - Samuel Alvarez
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd, Gainesville, FL, 32611, USA
| | - Jack Moerschel
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd, Gainesville, FL, 32611, USA
| | - Victoria R Palzkill
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd, Gainesville, FL, 32611, USA
| | - Gengfu Dong
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd, Gainesville, FL, 32611, USA
| | - Erik M Anderson
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, P.O. Box 100128, Gainesville, FL, 32610, USA
- Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA
| | - Kerri A O'Malley
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, P.O. Box 100128, Gainesville, FL, 32610, USA
- Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA
| | - Scott A Berceli
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, P.O. Box 100128, Gainesville, FL, 32610, USA
- Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA
| | - Terence E Ryan
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd, Gainesville, FL, 32611, USA.
- Center for Exercise Science, University of Florida, Gainesville, FL, USA.
| | - Salvatore T Scali
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, P.O. Box 100128, Gainesville, FL, 32610, USA.
- Malcom Randall Veteran Affairs Medical Center, Gainesville, FL, USA.
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Troutman AD, Arroyo E, Sheridan EM, D'Amico DJ, Brandt PR, Hinrichs R, Chen X, Lim K, Avin KG. Skeletal muscle atrophy in clinical and preclinical models of chronic kidney disease: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2024; 15:21-35. [PMID: 38062879 PMCID: PMC10834351 DOI: 10.1002/jcsm.13400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/12/2023] [Accepted: 11/02/2023] [Indexed: 02/03/2024] Open
Abstract
Patients with chronic kidney disease (CKD) are often regarded as experiencing wasting of muscle mass and declining muscle strength and function, collectively termed sarcopenia. The extent of skeletal muscle wasting in clinical and preclinical CKD populations is unclear. We evaluated skeletal muscle atrophy in preclinical and clinical models of CKD, with multiple sub-analyses for muscle mass assessment methods, CKD severity, sex and across the different preclinical models of CKD. We performed a systematic literature review of clinical and preclinical studies that measured muscle mass/size using the following databases: Ovid Medline, Embase and Scopus. A random effects meta-analysis was utilized to determine standard mean difference (SMD; Hedges' g) between healthy and CKD. Heterogeneity was evaluated using the I2 statistic. Preclinical study quality was assessed via the Systematic Review Centre for Laboratory Animal Experimentation and clinical studies quality was assessed via the Newcastle-Ottawa Scale. This study was registered in PROSPERO (CRD42020180737) prior to initiation of the search. A total of 111 studies were included in this analysis using the following subgroups: 106 studies in the primary CKD analysis, 18 studies that accounted for diabetes and 7 kidney transplant studies. Significant atrophy was demonstrated in 78% of the preclinical studies and 49% of the clinical studies. The random effects model demonstrated a medium overall SMD (SMD = 0.58, 95% CI = 0.52-0.64) when combining clinical and preclinical studies, a medium SMD for the clinical population (SMD = 0.48, 95% CI = 0.42-0.55; all stages) and a large SMD for preclinical CKD (SMD = 0.95, 95% CI = 0.76-1.14). Further sub-analyses were performed based upon assessment methods, disease status and animal model. Muscle atrophy was reported in 49% of the clinical studies, paired with small mean differences. Preclinical studies reported significant atrophy in 78% of studies, with large mean differences. Across multiple clinical sub-analyses such as severity of CKD, dialysis modality and diabetes, a medium mean difference was found. Sub-analyses in both clinical and preclinical studies found a large mean difference for males and medium for females suggesting sex-specific implications. Muscle atrophy differences varied based upon assessment method for clinical and preclinical studies. Limitations in study design prevented conclusions to be made about the extent of muscle loss with disease progression, or the impact of dialysis. Future work would benefit from the use of standardized measurement methods and consistent clinical staging to improve our understanding of atrophy changes in CKD progression, and analysis of biological sex differences.
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Affiliation(s)
- Ashley D Troutman
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University Purdue University, Indianapolis, Indiana, USA
| | - Eliott Arroyo
- Department of Medicine, Division of Nephrology & Hypertension, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Elizabeth M Sheridan
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University Purdue University, Indianapolis, Indiana, USA
| | - Duncan J D'Amico
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University Purdue University, Indianapolis, Indiana, USA
| | - Peyton R Brandt
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University Purdue University, Indianapolis, Indiana, USA
| | - Rachel Hinrichs
- University Library, Indiana University-Purdue University Indianapolis, Indiana, USA
| | - Xiwei Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Kenneth Lim
- Department of Medicine, Division of Nephrology & Hypertension, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Keith G Avin
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University Purdue University, Indianapolis, Indiana, USA
- Department of Medicine, Division of Nephrology & Hypertension, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Fusagawa H, Sato T, Yamada T, Ashida Y, Kimura I, Naito A, Tokuda N, Yamauchi N, Ichise N, Terashima Y, Ogon I, Teramoto A, Yamashita T, Tohse N. Skeletal muscle endurance declines with impaired mitochondrial respiration and inadequate supply of acetyl-CoA during muscle fatigue in 5/6 nephrectomized rats. J Appl Physiol (1985) 2023; 135:731-746. [PMID: 37560765 PMCID: PMC10642514 DOI: 10.1152/japplphysiol.00226.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 08/11/2023] Open
Abstract
Chronic kidney disease (CKD)-related cachexia increases the risks of reduced physical activity and mortality. However, the physiological phenotype of skeletal muscle fatigue and changes in intramuscular metabolites during muscle fatigue in CKD-related cachexia remain unclear. In the present study, we performed detailed muscle physiological evaluation, analysis of mitochondrial function, and comprehensive analysis of metabolic changes before and after muscle fatigue in a 5/6 nephrectomized rat model of CKD. Wistar rats were randomized to a sham-operation (Sham) group that served as a control group or a 5/6 nephrectomy (Nx) group. Eight weeks after the operation, in situ torque and force measurements in plantar flexor muscles in Nx rats using electrical stimulation revealed a significant decrease in muscle endurance during subacute phase related to mitochondrial function. Muscle mass was reduced without changes in the proportions of fiber type-specific myosin heavy chain isoforms in Nx rats. Pyruvate-malate-driven state 3 respiration in isolated mitochondria was impaired in Nx rats. Protein expression levels of mitochondrial respiratory chain complexes III and V were decreased in Nx rats. Metabolome analysis revealed that the increased supply of acetyl CoA in response to fatigue was blunted in Nx rats. These findings suggest that CKD deteriorates skeletal muscle endurance in association with mitochondrial dysfunction and inadequate supply of acetyl-CoA during muscle fatigue.NEW & NOTEWORTHY Mitochondrial dysfunction is associated with decreased skeletal muscle endurance in chronic kidney disease (CKD), but the muscle physiological phenotype and major changes in intramuscular metabolites during muscle fatigue in CKD-related cachexia remain unclear. By using a 5/6 nephrectomized CKD rat model, the present study revealed that CKD is associated with reduced tetanic force in response to repetitive stimuli in a subacute phase, impaired mitochondrial respiration, and inadequate supply of acetyl-CoA during muscle fatigue.
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Affiliation(s)
- Hiroyori Fusagawa
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tatsuya Sato
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takashi Yamada
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yuki Ashida
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Iori Kimura
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Azuma Naito
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Nao Tokuda
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Nao Yamauchi
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Nobutoshi Ichise
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoshinori Terashima
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Izaya Ogon
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsushi Teramoto
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshihiko Yamashita
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Noritsugu Tohse
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
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Kim K, Cort TA, Kunz EM, Moerschel J, Palzkill VR, Dong G, Moparthy CN, Anderson EM, Fazzone B, O'Malley KA, Robinson ST, Berceli SA, Ryan TE, Scali ST. N-acetylcysteine treatment attenuates hemodialysis access-related limb pathophysiology in mice with chronic kidney disease. Am J Physiol Renal Physiol 2023; 325:F271-F282. [PMID: 37439200 PMCID: PMC10511162 DOI: 10.1152/ajprenal.00083.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/20/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023] Open
Abstract
The objective of the present study was to determine if treatment with N-acetylcysteine (NAC) could reduce access-related limb dysfunction in mice. Male and female C57BL6J mice were fed an adenine-supplemented diet to induce chronic kidney disease (CKD) prior to the surgical creation of an arteriovenous fistula (AVF) in the iliac vascular bundle. AVF creation significantly increased peak aortic and infrarenal vena cava blood flow velocities, but NAC treatment had no significant impact, indicating that fistula maturation was not impacted by NAC treatment. Hindlimb muscle and paw perfusion recovery and muscle capillary density in the AVF limb were unaffected by NAC treatment. However, NAC treatment significantly increased the mass of the tibialis anterior (P = 0.0120) and soleus (P = 0.0452) muscles post-AVF. There was a significant main effect of NAC treatment on hindlimb grip strength at postoperative day 12 (POD 12) (P = 0.0003), driven by significantly higher grip strength in both male (P = 0.0273) and female (P = 0.0031) mice treated with NAC. There was also a significant main effect of NAC treatment on the walking speed at postoperative day 12 (P = 0.0447), and post hoc testing revealed an improvement in NAC-treated male mice (P = 0.0091). The area of postsynaptic acetylcholine receptors (P = 0.0263) and motor endplates (P = 0.0240) was also increased by NAC treatment. Interestingly, hindlimb skeletal muscle mitochondrial oxidative phosphorylation trended higher in NAC-treated female mice but was not statistically significant (P = 0.0973). Muscle glutathione levels and redox status were not significantly impacted by NAC treatment in either sex. In summary, NAC treatment attenuated some aspects of neuromotor pathology in mice with chronic kidney disease following AVF creation.NEW & NOTEWORTHY Hemodialysis via autogenous arteriovenous fistula (AVF) is the preferred first-line modality for renal replacement therapy in patients with end-stage kidney disease. However, patients undergoing AVF surgery frequently experience a spectrum of hand disability symptoms postsurgery including weakness and neuromotor dysfunction. Unfortunately, no treatment is currently available to prevent or mitigate these symptoms. Here, we provide evidence that daily N-acetylcysteine supplementation can attenuate some aspects of limb neuromotor function in a preclinical mouse model of AVF.
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Affiliation(s)
- Kyoungrae Kim
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
| | - Tomas A Cort
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
| | - Eric M Kunz
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
| | - Jack Moerschel
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
| | - Victoria R Palzkill
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
| | - Gengfu Dong
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
| | - Chatick N Moparthy
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
| | - Erik M Anderson
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, Florida, United States
- Malcom Randall Veteran Affairs Medical Center, University of Florida, Gainesville, Florida, United States
| | - Brian Fazzone
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, Florida, United States
- Malcom Randall Veteran Affairs Medical Center, University of Florida, Gainesville, Florida, United States
| | - Kerri A O'Malley
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, Florida, United States
- Malcom Randall Veteran Affairs Medical Center, University of Florida, Gainesville, Florida, United States
| | - Scott T Robinson
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, Florida, United States
- Malcom Randall Veteran Affairs Medical Center, University of Florida, Gainesville, Florida, United States
| | - Scott A Berceli
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, Florida, United States
- Malcom Randall Veteran Affairs Medical Center, University of Florida, Gainesville, Florida, United States
| | - Terence E Ryan
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
- Center for Exercise Science, University of Florida, Gainesville, Florida, United States
| | - Salvatore T Scali
- Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, Florida, United States
- Malcom Randall Veteran Affairs Medical Center, University of Florida, Gainesville, Florida, United States
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Zhang H, Qi G, Wang K, Yang J, Shen Y, Yang X, Chen X, Yao X, Gu X, Qi L, Zhou C, Sun H. Oxidative stress: roles in skeletal muscle atrophy. Biochem Pharmacol 2023:115664. [PMID: 37331636 DOI: 10.1016/j.bcp.2023.115664] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
Oxidative stress, inflammation, mitochondrial dysfunction, reduced protein synthesis, and increased proteolysis are all critical factors in the process of muscle atrophy. In particular, oxidative stress is the key factor that triggers skeletal muscle atrophy. It is activated in the early stages of muscle atrophy and can be regulated by various factors. The mechanisms of oxidative stress in the development of muscle atrophy have not been completely elucidated. This review provides an overview of the sources of oxidative stress in skeletal muscle and the correlation of oxidative stress with inflammation, mitochondrial dysfunction, autophagy, protein synthesis, proteolysis, and muscle regeneration in muscle atrophy. Additionally, the role of oxidative stress in skeletal muscle atrophy caused by several pathological conditions, including denervation, unloading, chronic inflammatory diseases (diabetes mellitus, chronic kidney disease, chronic heart failure, and chronic obstructive pulmonary disease), sarcopenia, hereditary neuromuscular diseases (spinal muscular atrophy, amyotrophic lateral sclerosis, and Duchenne muscular dystrophy), and cancer cachexia, have been discussed. Finally, this review proposes the alleviation oxidative stress using antioxidants, Chinese herbal extracts, stem cell and extracellular vesicles as a promising therapeutic strategy for muscle atrophy. This review will aid in the development of novel therapeutic strategies and drugs for muscle atrophy.
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Affiliation(s)
- Han Zhang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Medical College, Nantong University, Nantong, Jiangsu Province, 226001, PR China
| | - Guangdong Qi
- Department of Endocrinology, Binhai County People's Hospital, Yancheng, Jiangsu Province, 224500, PR China
| | - Kexin Wang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Medical College, Nantong University, Nantong, Jiangsu Province, 226001, PR China
| | - Jiawen Yang
- Department of Clinical Medicine, Medical College, Nantong University, Nantong 226001, China
| | - Yuntian Shen
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Medical College, Nantong University, Nantong, Jiangsu Province, 226001, PR China
| | - Xiaoming Yang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Medical College, Nantong University, Nantong, Jiangsu Province, 226001, PR China
| | - Xin Chen
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, 226001, PR China
| | - Xinlei Yao
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Medical College, Nantong University, Nantong, Jiangsu Province, 226001, PR China
| | - Xiaosong Gu
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Medical College, Nantong University, Nantong, Jiangsu Province, 226001, PR China
| | - Lei Qi
- Department of Emergency Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, 226001, PR China.
| | - Chun Zhou
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, 226001, PR China.
| | - Hualin Sun
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Medical College, Nantong University, Nantong, Jiangsu Province, 226001, PR China; Research and Development Center for E-Learning, Ministry of Education, Beijing 100816, PR China.
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Huang M, Yan Y, Deng Z, Zhou L, She M, Yang Y, Zhang M, Wang D. Saikosaponin A and D attenuate skeletal muscle atrophy in chronic kidney disease by reducing oxidative stress through activation of PI3K/AKT/Nrf2 pathway. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 114:154766. [PMID: 37002971 DOI: 10.1016/j.phymed.2023.154766] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/22/2023] [Accepted: 03/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Skeletal muscle atrophy in chronic kidney disease (CKD) leads to a decline in quality of life and increased risk of morbidity and mortality. We have obtained evidence that oxidative stress is essential in the progression of CKD-related muscle atrophy. Whether Saikosaponin A and D, two emerging antioxidants extracted from Bupleurum chinense DC, alleviate muscle atrophy remains to be further studied. The purpose of this study was to investigate the effects and mechanisms of these two components on CKD complicated with muscle atrophy. METHODS In this research, muscle dystrophy model was established using 5/6 nephrectomized mice in vivo and in vitro with Dexamethasone (Dex)-managed C2C12 myotubes. RESULTS The results of RNA-sequencing showed that exposure to Dex affected the antioxidant activity, catalytic activity and enzyme regulator activity of C2C12 cells. According to KEGG analysis, the largest numbers of differentially expressed genes detected were enriched in the PI3K/AKT pathway. In vivo, Saikosaponin A and D remain renal function, cross-section size, fiber-type composition and anti-inflammatory ability. These two components suppressed the expression of MuRF-1 and enhanced the expression of MyoD and Dystrophin. In addition, Saikosaponin A and D maintained redox balance by increasing the activities of antioxidant enzymes while inhibiting the excessive accumulation of reactive oxygen species. Furthermore, Saikosaponin A and D stimulated PI3K/AKT and its downstream Nrf2 pathway in CKD mice. The effects of Saikosaponin A and D on increasing the inner diameter of C2C12 myotube, reducing oxidative stress and enhancing expression of p-AKT, p-mTOR, p70S6K, Nrf2 and HO-1 proteins were observed in vitro. Importantly, we verified that these protective effects could be significantly reversed by inhibiting PI3K and knocking out Nrf2. CONCLUSIONS In summary, Saikosaponin A and D improve CKD-induced muscle atrophy by reducing oxidative stress through the PI3K/AKT/Nrf2 pathway.
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Affiliation(s)
- Minna Huang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, 518000, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510000, China
| | - Yan Yan
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, 518000, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510000, China
| | - Zihao Deng
- The First Clinical Medical College, Southern Medical University, Guangzhou, 510000, China
| | - Lingli Zhou
- The First Clinical Medical College, Southern Medical University, Guangzhou, 510000, China
| | - Meiling She
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, 518000, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510000, China
| | - Yajun Yang
- Department of Pharmacology, Guangdong Key Laboratory for R&D of Natural Drug, Guangdong Medical University, Zhanjiang,524000, China
| | - Meng Zhang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, 518000, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510000, China
| | - Dongtao Wang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, 518000, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510000, China.
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Zhang Y, Gu L, Wang L, Rong S, Yuan W. Low protein diet supplemented with ketoacids on muscle wasting in chronic kidney disease: A clinical trial. Front Med (Lausanne) 2022; 9:949108. [PMID: 36186800 PMCID: PMC9516635 DOI: 10.3389/fmed.2022.949108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
Aim Nutrition is an important part of the care of patients with chronic kidney disease (CKD). However, there is limited clinical research on the skeletal muscle nutrition of patients with CKD. We carried out this study to find out whether a low-protein diet supplemented with ketoacids (LPD + KA) could improve muscle wasting in patients with CKD. Methods Patients were enrolled in this non-blind, parallel-group, randomized trial assessing the nutritional status of CKD, randomly assigned to either the LPD + KA group or conventional LPD group. Blood samples such as Hemoglobin, Cystatin C, Creatinine, BUN, Albumin, Pre- Albumin, Glycerin Trilaurate, and Cholesterol were measured at baseline and every 3 months. The parameters of skeletal muscle and other body composition were assessed before and after dietary intervention for 12 months. Results A total of 58 patients with CKD completed the study and were available for further analysis. The hemoglobin and albumin were observed to be markedly improved in the LPD + KA group during the follow-up as compared to baseline. Body mass index and total body water index of both groups were increased upon follow-up but the increase in the LPD + KA group was comparatively higher. Moreover, an increase in body fat%, skeletal muscle mass index, and appendicular skeletal muscle mass index was observed in both groups between baseline and follow-up, but it was statistically insignificant. Conclusion This study did not find a significant improvement of KAs on muscle wasting, and a long time or more indices study may need to find the effects of the LPD + KA diets. Clinical trial registration [www.ClinicalTrials.gov], identifier [NCT02568020].
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Kundu S, Hossain KS, Moni A, Zahan MS, Rahman MM, Uddin MJ. Potentials of ketogenic diet against chronic kidney diseases: pharmacological insights and therapeutic prospects. Mol Biol Rep 2022; 49:9749-9758. [PMID: 35441940 DOI: 10.1007/s11033-022-07460-8] [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: 11/08/2021] [Accepted: 04/06/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) is a worldwide public health concern. Nutritional interventions become a primary concern in managing various diseases, including CKD. Ketogenic diets (KD) are a popular diet and an increasingly used diet for weight loss. MAIN BODY With the increasing cases of CKD, KD has been proposed as a treatment by many scientists. Several studies have shown that KD can slow down the progression rate of renal abnormalities. Also, this diet is regarded as a safe route for managing CKD. CKD is generally associated with increased inflammation, oxidative stress, fibrosis, autophagy dysfunction, and mitochondrial dysfunction, while all of these can be attenuated by KD. The protective effect of KD is mainly mediated through inhibition of ROS, NF-κB, and p62 signaling. CONCLUSIONS It is suggested that KD could be considered a new strategy for managing and treating CKD more carefully. This review explores the potential of KD on CKD and the mechanism involved in KD-mediated kidney protection.
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Affiliation(s)
- Sushmita Kundu
- ABEx Bio-Research Center, East Azampur, Dhaka, 1230, Bangladesh
| | | | - Akhi Moni
- ABEx Bio-Research Center, East Azampur, Dhaka, 1230, Bangladesh
| | - Md Sarwar Zahan
- ABEx Bio-Research Center, East Azampur, Dhaka, 1230, Bangladesh
| | - Md Masudur Rahman
- Department of Pathology, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, 3100, Bangladesh
| | - Md Jamal Uddin
- ABEx Bio-Research Center, East Azampur, Dhaka, 1230, Bangladesh. .,Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul, 03760, Republic of Korea.
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9
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Sasaki Y, Kojima-Yuasa A, Tadano H, Mizuno A, Kon A, Norikura T. Ursolic acid improves the indoxyl sulfate-induced impairment of mitochondrial biogenesis in C2C12 cells. Nutr Res Pract 2022; 16:147-160. [PMID: 35392531 PMCID: PMC8971825 DOI: 10.4162/nrp.2022.16.2.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/29/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND/OBJECTIVES Patients with chronic kidney disease (CKD) have a high concentration of uremic toxins in their blood and often experience muscle atrophy. Indoxyl sulfate (IS) is a uremic toxin produced by tryptophan metabolism. Although an elevated IS level may induce muscle dysfunction, the effect of IS on physiological concentration has not been elucidated. Additionally, the effects of ursolic acid (UA) on muscle hypertrophy have been reported in healthy models; however, it is unclear whether UA ameliorates muscle dysfunction associated with chronic diseases, such as CKD. Thus, this study aimed to investigate whether UA can improve the IS-induced impairment of mitochondrial biogenesis. MATERIALS/METHODS C2C12 cells were incubated with or without IS (0.1 mM) and UA (1 or 2 µM) to elucidate the physiological effect of UA on CKD-related mitochondrial dysfunction and its related mechanisms using real-time reverse transcription-polymerase chain reaction, western blotting and enzyme-linked immunosorbent assay. RESULTS IS suppressed the expression of differentiation marker genes without decreasing cell viability. IS decreased the mitochondrial DNA copy number and ATP levels by downregulating the genes pertaining to mitochondrial biogenesis (Ppargc1a, Nrf1, Tfam, Sirt1, and Mef2c), fusion (Mfn1 and Mfn2), oxidative phosphorylation (Cycs and Atp5b), and fatty acid oxidation (Pdk4, Acadm, Cpt1b, and Cd36). Furthermore, IS increased the intracellular mRNA and secretory protein levels of interleukin (IL)-6. Finally, UA ameliorated the IS-induced impairment in C2C12 cells. CONCLUSIONS Our results indicated that UA improves the IS-induced impairment of mitochondrial biogenesis by affecting differentiation, ATP levels, and IL-6 secretion in C2C12 cells. Therefore, UA could be a novel therapeutic agent for CKD-induced muscle dysfunction.
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Affiliation(s)
- Yutaro Sasaki
- Department of Nutrition, Faculty of Health Science, Aomori University of Health and Welfare, Aomori 030-8505, Japan
| | - Akiko Kojima-Yuasa
- Department of Food and Human Health Sciences, Graduate School of Human Life & Science, Osaka City University, Osaka 558-8585, Japan
| | - Hinako Tadano
- Department of Nutrition, Faculty of Health Science, Aomori University of Health and Welfare, Aomori 030-8505, Japan
| | - Ayaka Mizuno
- Department of Nutrition, Faculty of Health Science, Aomori University of Health and Welfare, Aomori 030-8505, Japan
| | - Atsushi Kon
- Department of Nutrition, Faculty of Health Science, Aomori University of Health and Welfare, Aomori 030-8505, Japan
| | - Toshio Norikura
- Department of Nutrition, Faculty of Health Science, Aomori University of Health and Welfare, Aomori 030-8505, Japan
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10
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Thome T, Coleman MD, Ryan TE. Mitochondrial Bioenergetic and Proteomic Phenotyping Reveals Organ-Specific Consequences of Chronic Kidney Disease in Mice. Cells 2021; 10:3282. [PMID: 34943790 PMCID: PMC8699079 DOI: 10.3390/cells10123282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 12/17/2022] Open
Abstract
Chronic kidney disease (CKD) results in reduced kidney function, uremia, and accumulation of uremic metabolites. Mitochondrial alterations have been suggested to play a role in the disease pathology within various tissues. The purpose of this study was to perform a comprehensive bioenergetic and proteomic phenotyping of mitochondria from skeletal muscle (SkM), cardiac muscle (CM), and renal tissue from mice with CKD. The 5-month-old C57BL/6J male mice were fed a casein control or adenine-supplemented diet for 6 months. CKD was confirmed by blood urea nitrogen. A mitochondrial diagnostic workflow was employed to examine respiratory function, membrane and redox potential, reactive oxygen species production, and maximal activities of matrix dehydrogenases and electron transport system (ETS) protein complexes. Additionally, tandem-mass-tag-assisted proteomic analyses were performed to uncover possible differences in mitochondrial protein abundance. CKD negatively impacted mitochondrial energy transduction (all p < 0.05) in SkM, CM, and renal mitochondria, when assessed at physiologically relevant cellular energy demands (ΔGATP) and revealed the tissue-specific impact of CKD on mitochondrial health. Proteomic analyses indicated significant abundance changes in CM and renal mitochondria (115 and 164 proteins, p < 0.05), but no differences in SkM. Taken together, these findings reveal the tissue-specific impact of chronic renal insufficiency on mitochondrial health.
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Affiliation(s)
- Trace Thome
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA; (T.T.); (M.D.C.)
| | - Madeline D. Coleman
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA; (T.T.); (M.D.C.)
| | - Terence E. Ryan
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA; (T.T.); (M.D.C.)
- Center for Exercise Science, University of Florida, Gainesville, FL 32611, USA
- Myology Institute, University of Florida, Gainesville, FL 32611, USA
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11
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Mann G, Mora S, Madu G, Adegoke OAJ. Branched-chain Amino Acids: Catabolism in Skeletal Muscle and Implications for Muscle and Whole-body Metabolism. Front Physiol 2021; 12:702826. [PMID: 34354601 PMCID: PMC8329528 DOI: 10.3389/fphys.2021.702826] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/24/2021] [Indexed: 12/20/2022] Open
Abstract
Branched-chain amino acids (BCAAs) are critical for skeletal muscle and whole-body anabolism and energy homeostasis. They also serve as signaling molecules, for example, being able to activate mammalian/mechanistic target of rapamycin complex 1 (mTORC1). This has implication for macronutrient metabolism. However, elevated circulating levels of BCAAs and of their ketoacids as well as impaired catabolism of these amino acids (AAs) are implicated in the development of insulin resistance and its sequelae, including type 2 diabetes, cardiovascular disease, and of some cancers, although other studies indicate supplements of these AAs may help in the management of some chronic diseases. Here, we first reviewed the catabolism of these AAs especially in skeletal muscle as this tissue contributes the most to whole body disposal of the BCAA. We then reviewed emerging mechanisms of control of enzymes involved in regulating BCAA catabolism. Such mechanisms include regulation of their abundance by microRNA and by post translational modifications such as phosphorylation, acetylation, and ubiquitination. We also reviewed implications of impaired metabolism of BCAA for muscle and whole-body metabolism. We comment on outstanding questions in the regulation of catabolism of these AAs, including regulation of the abundance and post-transcriptional/post-translational modification of enzymes that regulate BCAA catabolism, as well the impact of circadian rhythm, age and mTORC1 on these enzymes. Answers to such questions may facilitate emergence of treatment/management options that can help patients suffering from chronic diseases linked to impaired metabolism of the BCAAs.
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Affiliation(s)
| | | | | | - Olasunkanmi A. J. Adegoke
- Muscle Health Research Centre, School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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12
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Lin YL, Hou JS, Wang CH, Su CY, Liou HH, Hsu BG. Effects of ketoanalogues on skeletal muscle mass in patients with advanced chronic kidney disease: real-world evidence. Nutrition 2021; 91-92:111384. [PMID: 34273683 DOI: 10.1016/j.nut.2021.111384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/11/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Ketoanalogue (KA) supplementation in patients with chronic kidney disease (CKD) on a restricted protein diet has been shown to maintain their nutritional status in clinical trials. However, a gap existed between the findings of the clinical trials and the real-world practice. The aim of this prospective observational study was to evaluate the KA effect on skeletal muscle mass in patients with stage 4-5 CKD. METHODS Among 170 patients with CKD screened, 148 were recruited. Patients were defined as KA or non-KA users. During a 12-mo follow-up, skeletal muscle and body fat mass were measured via bioelectrical impedance analysis at baseline, 6 mo (n = 108), and 12 mo (n = 85). RESULTS Among the patients (mean age, 66.5 ± 12.9 y), KA users tended to maintain skeletal muscle and body fat mass, whereas non-KA users had a significantly reduced muscle mass (P = 0.011) and body fat gain (P = 0.004). Stratified by median age, in patients ≥68 y of age, non-KA users yielded the most significant muscle mass reduction and fat mass gain, whereas KA users revealed no changes in skeletal muscle and fat mass. CONCLUSION In real-world practice, we concluded that KA supplementation favorably prevents skeletal muscle mass loss and fat mass gain in elderly patients with stage 4-5 CKD.
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Affiliation(s)
- Yu-Li Lin
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Jia-Sian Hou
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chih-Hsien Wang
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chen-Ying Su
- Division of Dietetics and Nutrition, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Hung-Hsiang Liou
- Division of Nephrology, Department of Internal Medicine, Hsin-Jen Hospital, New Taipei City, Taiwan.
| | - Bang-Gee Hsu
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
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13
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Takahashi Y, Shimizu T, Kato S, Nara M, Suganuma Y, Sato T, Morii T, Yamada Y, Fujita H. Reduction of Superoxide Dismutase 1 Delays Regeneration of Cardiotoxin-Injured Skeletal Muscle in KK/Ta- Ins2Akita Mice with Progressive Diabetic Nephropathy. Int J Mol Sci 2021; 22:5491. [PMID: 34071003 PMCID: PMC8197123 DOI: 10.3390/ijms22115491] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/24/2022] Open
Abstract
Superoxide dismutase (SOD) is a major antioxidant enzyme for superoxide removal, and cytoplasmic SOD (SOD1) is expressed as a predominant isoform in all cells. We previously reported that renal SOD1 deficiency accelerates the progression of diabetic nephropathy (DN) via increasing renal oxidative stress. To evaluate whether the degree of SOD1 expression determines regeneration capacity and sarcopenic phenotypes of skeletal muscles under incipient and advanced DN conditions, we investigated the alterations of SOD1 expression, oxidative stress marker, inflammation, fibrosis, and regeneration capacity in cardiotoxin (CTX)-injured tibialis anterior (TA) muscles of two Akita diabetic mouse models with different susceptibility to DN, DN-resistant C57BL/6-Ins2Akita and DN-prone KK/Ta-Ins2Akita mice. Here, we report that KK/Ta-Ins2Akita mice, but not C57BL/6-Ins2Akita mice, exhibit delayed muscle regeneration after CTX injection, as demonstrated by the finding indicating significantly smaller average cross-sectional areas of regenerating TA muscle myofibers relative to KK/Ta-wild-type mice. Furthermore, we observed markedly reduced SOD1 expression in CTX-injected TA muscles of KK/Ta-Ins2Akita mice, but not C57BL/6-Ins2Akita mice, along with increased inflammatory cell infiltration, prominent fibrosis and superoxide overproduction. Our study provides the first evidence that SOD1 reduction and the following superoxide overproduction delay skeletal muscle regeneration through induction of overt inflammation and fibrosis in a mouse model of progressive DN.
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MESH Headings
- Animals
- Cardiotoxins/toxicity
- Collagen Type I/biosynthesis
- Collagen Type I/genetics
- Collagen Type I, alpha 1 Chain
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/genetics
- Diabetic Nephropathies/complications
- Diabetic Nephropathies/enzymology
- Diabetic Nephropathies/genetics
- Diabetic Nephropathies/pathology
- Disease Progression
- Enzyme Induction/drug effects
- Fibrosis
- Gene Expression Regulation, Enzymologic
- Genetic Predisposition to Disease
- Glomerular Mesangium/pathology
- Inflammation
- Insulin/deficiency
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Mutant Strains
- Muscle, Skeletal/drug effects
- Muscle, Skeletal/enzymology
- Muscle, Skeletal/pathology
- Muscle, Skeletal/physiology
- Nerve Regeneration/drug effects
- Oxidative Stress/drug effects
- Sarcopenia/etiology
- Superoxide Dismutase-1/biosynthesis
- Superoxide Dismutase-1/drug effects
- Superoxide Dismutase-1/genetics
- Superoxide Dismutase-1/physiology
- Superoxides/metabolism
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Affiliation(s)
- Yuya Takahashi
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; (Y.T.); (T.S.); (S.K.); (M.N.); (Y.S.); (T.S.); (T.M.); (Y.Y.)
| | - Tatsunori Shimizu
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; (Y.T.); (T.S.); (S.K.); (M.N.); (Y.S.); (T.S.); (T.M.); (Y.Y.)
| | - Shunsuke Kato
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; (Y.T.); (T.S.); (S.K.); (M.N.); (Y.S.); (T.S.); (T.M.); (Y.Y.)
| | - Mitsuhiko Nara
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; (Y.T.); (T.S.); (S.K.); (M.N.); (Y.S.); (T.S.); (T.M.); (Y.Y.)
| | - Yumi Suganuma
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; (Y.T.); (T.S.); (S.K.); (M.N.); (Y.S.); (T.S.); (T.M.); (Y.Y.)
| | - Takehiro Sato
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; (Y.T.); (T.S.); (S.K.); (M.N.); (Y.S.); (T.S.); (T.M.); (Y.Y.)
| | - Tsukasa Morii
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; (Y.T.); (T.S.); (S.K.); (M.N.); (Y.S.); (T.S.); (T.M.); (Y.Y.)
| | - Yuichiro Yamada
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; (Y.T.); (T.S.); (S.K.); (M.N.); (Y.S.); (T.S.); (T.M.); (Y.Y.)
- Kansai Electric Power Medical Research Institute, 2-1-7 Fukushima-ku, Osaka 553-0003, Japan
| | - Hiroki Fujita
- Department of Metabolism and Endocrinology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; (Y.T.); (T.S.); (S.K.); (M.N.); (Y.S.); (T.S.); (T.M.); (Y.Y.)
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14
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Zhou F, Zou X, Zhang J, Wang Z, Yang Y, Wang D. Jian-Pi-Yi-Shen Formula Ameliorates Oxidative Stress, Inflammation, and Apoptosis by Activating the Nrf2 Signaling in 5/6 Nephrectomized Rats. Front Pharmacol 2021; 12:630210. [PMID: 33841151 PMCID: PMC8027107 DOI: 10.3389/fphar.2021.630210] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/01/2021] [Indexed: 12/30/2022] Open
Abstract
Chronic kidney disease (CKD) is an increasing global public health problem, with high morbidity and mortality. Jian-Pi-Yi-Shen (JPYS) formula is a representative traditional Chinese medicine formula in the treatment of CKD, which is widely used in clinical practice in China. However, the underlying mechanism has not been well elucidated. In the present study, we measured the markers of apoptosis, inflammation, oxidative stress, and nuclear factor erythroid 2–related factor 2 (Nrf2) signaling to investigate the effects of JPYS formula on renal function and fibrosis and its molecular mechanism in an established animal model of 5/6 nephrectomized (5/6Nx) rats. The results demonstrated that the JPYS formula exerted a significant preventive effect on renal dysfunction and fibrosis, based on analysis of correlative parameters such as urinary protein, SCr, BUN, glomerular sclerosis index, and tubulointerstitial fibrosis score and renal histopathology and ultrastructural pathology of CKD rats. JPYS formula also induced downregulation of gene expression associated with fibrosis, such as TGF-β and type I, III, and IV collagen. Moreover, the JPYS formula showed a significant protective effect in suppressing cell apoptosis according to the results of apoptotic indexes, including increased gene expression of Bcl-2, decreased gene expression of Bax, caspase 3, caspase 9, and the number of TUNEL-positive cells. JPYS formula also ameliorated the activation of the NF-κB-mediated inflammatory pathway, as manifested by the downregulation of gene expression of TNF-α, IL-1β, IκBα, NF-κB p65, MCP-1, CXCL1, COX-2, and iNOS in the kidney. Our evidence also suggested that the JPYS formula ameliorates oxidative stress by promoting antioxidant function according to antioxidant index indicators as an indicator of GSH, SOD, CAT, and GPx and abating excessive accumulation of the reactive oxygen species biomarkers, including ROS, TBARS, 8-oxo-dG, and MDA. The data also suggested that the JPYS formula reversed the downregulation of HO-1 and Nrf2 level and upregulation of Keap1 expression. Together, our data highlighted that the JPYS formula relieved renal oxidative injury mediated by activation of Nrf2 signaling by inhibiting inflammation and apoptosis in CKD rats.
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Affiliation(s)
- Fanyuan Zhou
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Xiaohu Zou
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Jing Zhang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Ziwei Wang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Yajun Yang
- Department of Pharmacology, Guangdong Key Laboratory for R&D of Natural Drug, Guangdong Medical University, Zhanjiang, China
| | - Dongtao Wang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China.,School of Chinese Medicine, Southern Medical University, Shenzhen, China.,Department of the Ministry of Science and Technology, Guangxi International Zhuang Medicine Hospital, Nanning, China.,Department of Nephrology, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Traditional Chinese Medicine, Shenzhen, China
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15
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Wang D, Yang Y, Zou X, Zhang J, Zheng Z, Wang Z. Antioxidant Apigenin Relieves Age-Related Muscle Atrophy by Inhibiting Oxidative Stress and Hyperactive Mitophagy and Apoptosis in Skeletal Muscle of Mice. J Gerontol A Biol Sci Med Sci 2021; 75:2081-2088. [PMID: 32857105 PMCID: PMC7566467 DOI: 10.1093/gerona/glaa214] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Indexed: 12/22/2022] Open
Abstract
Skeletal muscle atrophy in the aged causes loss in muscle mass and functions. Naturally occurring antioxidant flavonoid apigenin is able to ameliorate obesity- and denervation-induced muscle atrophies, but its effects on age-related muscle atrophy remain unknown. We hypothesized that apigenin can relieve muscle atrophy in aged mice, probably through special effects on reactive oxygen species and enzymes with antioxidant functions. For the male mice of the study, apigenin showed significant dose-dependent effects in relieving aging-related muscle atrophy according to results of frailty index as indicator of frailty associated with aging, grip strength, and running distance. Apigenin also improved myofiber size and morphological features and increased mitochondria number and volume, as manifested by succinate dehydrogenase staining and transmission electron microscopy. Our tests also suggested that apigenin promoted activities of enzymes such as superoxide dismutase and glutathione peroxidase for antioxidation and those for aerobic respiration such as mitochondrial respiratory enzyme complexes I, II, and IV, increased ATP, and enhanced expression of genes such as peroxisome proliferator-activated receptor-γ coactivator 1α, mitochondrial transcription factor A, nuclear respiratory factor-1, and ATP5B involved in mitochondrial biogenesis. The data also suggested that apigenin inhibited Bcl-2/adenovirus E1B 19kD-interacting protein 3 and DNA fragmentation as indicators of mitophagy and apoptosis in aged mice with skeletal muscle atrophy. Together, the results suggest that apigenin relieves age-related skeletal muscle atrophy through reducing oxidative stress and inhibiting hyperactive autophagy and apoptosis.
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Affiliation(s)
- Dongtao Wang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Guangdong, China.,Department of the Ministry of Science and Technology, Guangxi International Zhuang Medicine Hospital, Nanning, China
| | - Yajun Yang
- Department of Pharmacology, Guangdong Key Laboratory for R&D of Natural Drug, Guangdong Medical University, Zhanjiang, China
| | - Xiaohu Zou
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Guangdong, China
| | - Jing Zhang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Guangdong, China
| | - Zena Zheng
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Guangdong, China
| | - Ziwei Wang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Guangdong, China
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16
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Noce A, Marrone G, Ottaviani E, Guerriero C, Di Daniele F, Pietroboni Zaitseva A, Di Daniele N. Uremic Sarcopenia and Its Possible Nutritional Approach. Nutrients 2021; 13:nu13010147. [PMID: 33406683 PMCID: PMC7824031 DOI: 10.3390/nu13010147] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/21/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022] Open
Abstract
Uremic sarcopenia is a frequent condition present in chronic kidney disease (CKD) patients and is characterized by reduced muscle mass, muscle strength and physical performance. Uremic sarcopenia is related to an increased risk of hospitalization and all-causes mortality. This pathological condition is caused not only by advanced age but also by others factors typical of CKD patients such as metabolic acidosis, hemodialysis therapy, low-grade inflammatory status and inadequate protein-energy intake. Currently, treatments available to ameliorate uremic sarcopenia include nutritional therapy (oral nutritional supplement, inter/intradialytic parenteral nutrition, enteral nutrition, high protein and fiber diet and percutaneous endoscopic gastrectomy) and a personalized program of physical activity. The aim of this review is to analyze the possible benefits induced by nutritional therapy alone or in combination with a personalized program of physical activity, on onset and/or progression of uremic sarcopenia.
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Affiliation(s)
- Annalisa Noce
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
- Correspondence: (A.N.); (G.M.); Tel.: +39-06-2090-2194 (A.N.); +39-06-2090-2191 (G.M.)
| | - Giulia Marrone
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
- PhD School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- Correspondence: (A.N.); (G.M.); Tel.: +39-06-2090-2194 (A.N.); +39-06-2090-2191 (G.M.)
| | - Eleonora Ottaviani
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
| | - Cristina Guerriero
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
| | - Francesca Di Daniele
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
- PhD School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Anna Pietroboni Zaitseva
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
| | - Nicola Di Daniele
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
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17
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Garibotto G, Saio M, Aimasso F, Russo E, Picciotto D, Viazzi F, Verzola D, Laudon A, Esposito P, Brunori G. How to Overcome Anabolic Resistance in Dialysis-Treated Patients? Front Nutr 2021; 8:701386. [PMID: 34458305 PMCID: PMC8387577 DOI: 10.3389/fnut.2021.701386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/12/2021] [Indexed: 02/05/2023] Open
Abstract
A current hypothesis is that dialysis-treated patients are "anabolic resistant" i. e., their muscle protein synthesis (MPS) response to anabolic stimuli is blunted, an effect which leads to muscle wasting and poor physical performance in aging and in several chronic diseases. The importance of maintaining muscle mass and MPS is often neglected in dialysis-treated patients; better than to describe mechanisms leading to energy-protein wasting, the aim of this narrative review is to suggest possible strategies to overcome anabolic resistance in this patient's category. Food intake, in particular dietary protein, and physical activity, are the two major anabolic stimuli. Unfortunately, dialysis patients are often aged and have a sedentary behavior, all conditions which per se may induce a state of "anabolic resistance." In addition, patients on dialysis are exposed to amino acid or protein deprivation during the dialysis sessions. Unfortunately, the optimal amount and formula of protein/amino acid composition in supplements to maximixe MPS is still unknown in dialysis patients. In young healthy subjects, 20 g whey protein maximally stimulate MPS. However, recent observations suggest that dialysis patients need greater amounts of proteins than healthy subjects to maximally stimulate MPS. Since unneccesary amounts of amino acids could stimulate ureagenesis, toxins and acid production, it is urgent to obtain information on the optimal dose of proteins or amino acids/ketoacids to maximize MPS in this patients' population. In the meantime, the issue of maintaining muscle mass and function in dialysis-treated CKD patients needs not to be overlooked by the kidney community.
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Affiliation(s)
- Giacomo Garibotto
- Department of Internal Medicine, University of Genoa, Genova, Italy
- *Correspondence: Giacomo Garibotto
| | - Michela Saio
- Department of Internal Medicine, University of Genoa, Genova, Italy
| | - Francesca Aimasso
- Clinical Nutrition Unit, Istituto di Ricerca a Carattere Scientifico Ospedale Policlinico San Martino, Genova, Italy
| | - Elisa Russo
- Department of Internal Medicine, University of Genoa, Genova, Italy
- Clinica Nefrologica, Dialisi e Trapianto, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Daniela Picciotto
- Department of Internal Medicine, University of Genoa, Genova, Italy
- Clinica Nefrologica, Dialisi e Trapianto, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Francesca Viazzi
- Department of Internal Medicine, University of Genoa, Genova, Italy
- Clinica Nefrologica, Dialisi e Trapianto, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Daniela Verzola
- Department of Internal Medicine, University of Genoa, Genova, Italy
| | - Alessandro Laudon
- Division of Nephrology and Dialysis, Ospedale Santa Chiara, Trento, Italy
| | - Pasquale Esposito
- Department of Internal Medicine, University of Genoa, Genova, Italy
- Clinica Nefrologica, Dialisi e Trapianto, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Giuliano Brunori
- Division of Nephrology and Dialysis, Ospedale Santa Chiara, Trento, Italy
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18
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Thome T, Kumar RA, Burke SK, Khattri RB, Salyers ZR, Kelley RC, Coleman MD, Christou DD, Hepple RT, Scali ST, Ferreira LF, Ryan TE. Impaired muscle mitochondrial energetics is associated with uremic metabolite accumulation in chronic kidney disease. JCI Insight 2020; 6:139826. [PMID: 33290279 PMCID: PMC7821598 DOI: 10.1172/jci.insight.139826] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 11/25/2020] [Indexed: 01/01/2023] Open
Abstract
Chronic kidney disease (CKD) causes progressive skeletal myopathy involving atrophy, weakness, and fatigue. Mitochondria have been thought to contribute to skeletal myopathy; however, the molecular mechanisms underlying muscle metabolism changes in CKD are unknown. We employed a comprehensive mitochondrial phenotyping platform to elucidate the mechanisms of skeletal muscle mitochondrial impairment in mice with adenine-induced CKD. CKD mice displayed significant reductions in mitochondrial oxidative phosphorylation (OXPHOS), which was strongly correlated with glomerular filtration rate, suggesting a link between kidney function and muscle mitochondrial health. Biochemical assays uncovered that OXPHOS dysfunction was driven by reduced activity of matrix dehydrogenases. Untargeted metabolomics analyses in skeletal muscle revealed a distinct metabolite profile in CKD muscle including accumulation of uremic toxins that strongly associated with the degree of mitochondrial impairment. Additional muscle phenotyping found CKD mice experienced muscle atrophy and increased muscle protein degradation, but only male CKD mice had lower maximal contractile force. CKD mice had morphological changes indicative of destabilization in the neuromuscular junction. This study provides the first comprehensive evaluation of mitochondrial health in murine CKD muscle to our knowledge and uncovers several unknown uremic metabolites that strongly associate with the degree of mitochondrial impairment.
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Affiliation(s)
- Trace Thome
- Department of Applied Physiology and Kinesiology, College of Health & Human Performance
| | - Ravi A Kumar
- Department of Applied Physiology and Kinesiology, College of Health & Human Performance
| | - Sarah K Burke
- Department of Physical Therapy, College of Public Health and Health Professions
| | - Ram B Khattri
- Department of Applied Physiology and Kinesiology, College of Health & Human Performance
| | - Zachary R Salyers
- Department of Applied Physiology and Kinesiology, College of Health & Human Performance
| | - Rachel C Kelley
- Department of Applied Physiology and Kinesiology, College of Health & Human Performance
| | - Madeline D Coleman
- Department of Applied Physiology and Kinesiology, College of Health & Human Performance
| | - Demetra D Christou
- Department of Applied Physiology and Kinesiology, College of Health & Human Performance.,Center for Exercise Science, College of Health & Human Performance, and
| | - Russell T Hepple
- Department of Physical Therapy, College of Public Health and Health Professions
| | - Salvatore T Scali
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA.,Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida, USA
| | - Leonardo F Ferreira
- Department of Applied Physiology and Kinesiology, College of Health & Human Performance.,Center for Exercise Science, College of Health & Human Performance, and
| | - Terence E Ryan
- Department of Applied Physiology and Kinesiology, College of Health & Human Performance.,Center for Exercise Science, College of Health & Human Performance, and
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19
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Hu R, Wang MQ, Liu LY, You HY, Wu XH, Liu YY, Wang YJ, Lu L, Xiao W, Wei LB. Calycosin inhibited autophagy and oxidative stress in chronic kidney disease skeletal muscle atrophy by regulating AMPK/SKP2/CARM1 signalling pathway. J Cell Mol Med 2020; 24:11084-11099. [PMID: 32910538 PMCID: PMC7576237 DOI: 10.1111/jcmm.15514] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/26/2020] [Accepted: 05/30/2020] [Indexed: 02/06/2023] Open
Abstract
Skeletal muscle atrophy is a common and serious complication of chronic kidney disease (CKD). Oxidative stress and autophagy are the primary molecular mechanisms involved in muscle atrophy. Calycosin, a major component of Radix astragali, exerts anti‐inflammatory, anti‐oxidative stress and anti‐autophagy effects. We investigated the effects and mechanisms of calycosin on skeletal muscle atrophy in vivo and in vitro. 5/6 nephrectomy (5/6 Nx) rats were used as a model of CKD. We evaluated bodyweight and levels of serum creatinine (SCr), blood urea nitrogen (BUN) and serum albumin (Alb). H&E staining, cell apoptosis, oxidative stress biomarkers, autophagosome and LC3A/B levels were performed and evaluated in skeletal muscle of CKD rat. Calycosin treatment improved bodyweight and renal function, alleviated muscle atrophy (decreased the levels of MuRF1 and MAFbx), increased superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH‐Px) activity and reduced malondialdehyde (MDA) levels in skeletal muscle of CKD rats. Importantly, calycosin reduced autophagosome formation, down‐regulated the expression of LC3A/B and ATG7 through inhibition of AMPK and FOXO3a, and increased SKP2, which resulted in decreased expression of CARM1, H3R17me2a. Similar results were observed in C2C12 cells treated with TNF‐α and calycosin. Our findings showed that calycosin inhibited oxidative stress and autophagy in CKD induced skeletal muscle atrophy and in TNF‐α‐induced C2C12 myotube atrophy, partially by regulating the AMPK/SKP2/CARM1 signalling pathway.
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Affiliation(s)
- Rong Hu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Ming-Qing Wang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Ling-Yu Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Hai-Yan You
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Xiao-Hui Wu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Yang-Yang Liu
- Zhongshan Huangpu People's Hospital, Zhongshan, China
| | - Yan-Jing Wang
- Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Lu Lu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Xiao
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Lian-Bo Wei
- Shenzhen Hospital, Southern Medical University, Shenzhen, China
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20
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Liu Y, Perumal E, Bi X, Wang Y, Ding W. Potential mechanisms of uremic muscle wasting and the protective role of the mitochondria-targeted antioxidant Mito-TEMPO. Int Urol Nephrol 2020; 52:1551-1561. [PMID: 32488756 DOI: 10.1007/s11255-020-02508-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 05/12/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Muscle wasting is common in patients with chronic kidney disease (CKD). Many studies report that mitochondrial dysfunction and endoplasmic reticulum (ER) stress are involved in the development of muscle wasting. However, treatment approaches to protect against muscle wasting are limited. In this study, we investigated the benefits and potential mechanism of Mito-TEMPO, a mitochondria-targeted antioxidant on uremic-induced muscle wasting. METHODS Mice were randomly divided into four groups as follows: control group, CKD group, CKD + Mito-TEMPO group, and Mito-TEMPO group. Renal injury was assessed by measurement of serum creatinine and BUN along with PAS and Masson's staining. Bodyweight, gastrocnemius muscle mass, grip strength, and myofiber cross-sectional areas were investigated to evaluate muscle atrophy. Muscle protein synthesis and proteolysis were evaluated by Western blot and real-time PCR. Inflammatory cytokines including TNF-α, IL-6, IL-1β, and MCP-1 were measured by ELISA kits. Oxidative stress markers such as SOD2 activity and MDA level in gastrocnemius muscle tissue were measured by colorimetric assay. Mitochondrial dysfunction was evaluated by transmission electron microscopy and real-time PCR. ER stress was evaluated by Western blot. RESULTS Impaired renal function was significantly restored by Mito-TEMPO treatment. Severe muscle atrophy was observed in muscle tissues of CKD mice along with increased inflammatory factors, oxidative stress markers, mitochondrial dysfunction, and ER stress. However, these effects were significantly attenuated with Mito-TEMPO treatment. CONCLUSIONS Mito-TEMPO improved muscle wasting in CKD mice possibly through alleviating mitochondrial dysfunction and endoplasmic reticulum stress, providing a potential new therapeutic approach for preventing muscle wasting in chronic kidney disease.
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Affiliation(s)
- Yuqing Liu
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, 639 zhizaoju Road, Shanghai, 200011, China
| | - Elangovan Perumal
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, 639 zhizaoju Road, Shanghai, 200011, China
| | - Xiao Bi
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, 639 zhizaoju Road, Shanghai, 200011, China
| | - Yingdeng Wang
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, 639 zhizaoju Road, Shanghai, 200011, China.
| | - Wei Ding
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, 639 zhizaoju Road, Shanghai, 200011, China.
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21
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Wang D, Yang Y, Zou X, Zheng Z, Zhang J. Curcumin ameliorates CKD-induced mitochondrial dysfunction and oxidative stress through inhibiting GSK-3β activity. J Nutr Biochem 2020; 83:108404. [PMID: 32531667 DOI: 10.1016/j.jnutbio.2020.108404] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 12/21/2022]
Abstract
Curcumin has been reported to attenuate muscle atrophy. However, the underling mechanism remains unclear. The aim of this study was to investigate whether curcumin could improve chronic kidney disease (CKD)-induced muscle atrophy and mitochondrial dysfunction by inhibiting glycogen synthase kinase-3β (GSK-3β) activity. The sham and CKD mice were fed either a control diet or an identical diet containing 0.04% curcumin for 12 weeks. The C2C12 myotubes were treated with H2O2 in the presence or absence of curcumin. In addition, wild-type and muscle-specific GSK-3β knockout (KO) CKD model mice were made by 5/6 nephrectomy, and the sham was regarded as control. Curcumin could exert beneficial effects, including weight maintenance and improved muscle function, increased mitochondrial biogenesis, alleviated mitochondrial dysfunction by increasing adenosine triphosphate levels, activities of mitochondrial electron transport chain complexes and basal mitochondrial respiration and suppressing mitochondrial membrane potential. In addition, curcumin modulated redox homeostasis by increasing antioxidant activity and suppressed mitochondrial oxidative stress. Moreover, the protective effects of curcumin had been found to be mediated via inhibiting GSK-3β activity in vitro and in vivo. Importantly, GSK-3β KO contributed to improved mitochondrial function, attenuated mitochondrial oxidative damage and augmented mitochondrial biogenesis in muscle of CKD. Overall, this study suggested that curcumin alleviated CKD-induced mitochondrial oxidative damage and mitochondrial dysfunction via inhibiting GSK-3β activity in skeletal muscle.
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Affiliation(s)
- Dongtao Wang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 5181000, Guangdong, China; School of Chinese Medicine, Southern Medical University, Shenzhen 510515, Guangdong, China; Department of the Ministry of Science and Technology, Guangxi International Zhuang Medicine Hospital, Nanning 530201, Guangxi , China; Department of Nephrology, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Traditional Chinese Medicine, Shenzhen 518033, Guangdong, China.
| | - Yajun Yang
- Department of Pharmacology, Guangdong Key Laboratory for R&D of Natural Drug, Guangdong Medical University, Zhanjiang 524023, Guangdong , China
| | - Xiaohu Zou
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 5181000, Guangdong, China
| | - Zena Zheng
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 5181000, Guangdong, China
| | - Jing Zhang
- Department of Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 5181000, Guangdong, China
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22
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Ketoacid Analogues Supplementation in Chronic Kidney Disease and Future Perspectives. Nutrients 2019; 11:nu11092071. [PMID: 31484354 PMCID: PMC6770434 DOI: 10.3390/nu11092071] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 12/14/2022] Open
Abstract
Diet is a key component of care during chronic kidney disease (CKD). Nutritional interventions, and, specifically, a restricted protein diet has been under debate for decades. In order to reduce the risk of nutritional disorders in very-low protein diets (VLDP), supplementation by nitrogen-free ketoacid analogues (KAs) have been proposed. The aim of this review is to summarize the potential effects of this dietary therapy on renal function, uremic toxins levels, and nutritional and metabolic parameters and propose future directions. The purpose of this paper is also to select all experimental and randomized clinical studies (RCTs) that have compared VLDP + KA to normal diet or/and low protein diet (LPD). We reviewed the SCOPUS, WEB of SCIENCES, CENTRAL, and PUBMED databases from their inception to 1 January, 2019. Following duplicate removal and application of exclusion criteria, 23 RCTs and 12 experimental studies were included. LPD/VLPD + KAs appear nutritionally safe even if how muscle protein metabolism adapts to an LPD/VLPD + KAs is still largely unknown. VLPD + KAs seem to reduce uremic toxins production but the impact on intestinal microbiota remains unexplored. All studies observed a reduction of acidosis, phosphorus, and possibly sodium intake, while still providing adequate calcium intake. The impact of this diet on carbohydrate and bone parameters are only preliminary and need to be confirmed with RCTs. The Modification of Diet in Renal Disease study, the largest RCTs, failed to demonstrate a benefit in the primary outcome of the decline rate for the glomerular filtration rate. However, the design of this study was challenged and data were subsequently reanalyzed. However, when adherent patients were selected, with a rapid rate of progression and a long-term follow up, more recent meta-analysis and RCTs suggest that these diets can reduce the loss of the glomerular filtration rate in addition to the beneficial effects of renin-angiotensin-aldosterone system (RAAS) inhibitors. The current evidence suggests that KAs supplemented LPD diets should be included as part of the clinical recommendations for both the nutritional prevention and metabolic management of CKD. More research is needed to examine the effectiveness of KAs especially on uremic toxins. A reflection about the dose and composition of the KAs supplement, the cost-effective features, and their indication to reduce the frequency of dialysis needs to be completed.
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23
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Wang M, Xu H, Chong Lee Shin OLS, Li L, Gao H, Zhao Z, Zhu F, Zhu H, Liang W, Qian K, Zhang C, Zeng R, Zhou H, Yao Y. Compound α-keto acid tablet supplementation alleviates chronic kidney disease progression via inhibition of the NF-kB and MAPK pathways. J Transl Med 2019; 17:122. [PMID: 30975176 PMCID: PMC6458753 DOI: 10.1186/s12967-019-1856-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/25/2019] [Indexed: 12/29/2022] Open
Abstract
Background Keto-analogues administration plays an important role in clinical chronic kidney disease (CKD) adjunctive therapy, however previous studies on their reno-protective effect mainly focused on kidney pathological changes induced by nephrectomy. This study was designed to explore the currently understudied alternative mechanisms by which compound α-ketoacid tablets (KA) influenced ischemia–reperfusion (IR) induced murine renal injury, and to probe the current status of KA administration on staving CKD progression in Chinese CKD patients at different stages. Methods In animal experiment, IR surgery was performed to mimic progressive chronic kidney injury, while KA was administrated orally. For clinical research, a retrospective cohort study was conducted to delineate the usage and effects of KA on attenuating CKD exacerbation. End-point CKD event was defined as 50% reduction of initial estimated glomerular filtration rate (eGFR). Kaplan–Meier analysis and COX proportional hazard regression model were adopted to calculate the cumulative probability to reach the end-point and hazard ratio of renal function deterioration. Results In animal study, KA presented a protective effect on IR induced renal injury and fibrosis by attenuating inflammatory infiltration and apoptosis via inhibition of nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways. In clinical research, after adjusting basic demographic factors, patients at stages 4 and 5 in KA group presented a much delayed and slower incidence of eGFR decrease compared to those in No-KA group (hazard ratio (HR) = 0.115, 95% confidence interval (CI) 0.021–0.639, p = 0.0134), demonstrating a positive effect of KA on staving CKD progression. Conclusion KA improved IR induced chronic renal injury and fibrosis, and seemed to be a prospective protective factor in end stage renal disease.
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Affiliation(s)
- Meng Wang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Huzi Xu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Octavia Li-Sien Chong Lee Shin
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Li Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Hui Gao
- Department of Nutrition, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Zhi Zhao
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Fan Zhu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Han Zhu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Wangqun Liang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Kun Qian
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Chunxiu Zhang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Rui Zeng
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Hanjing Zhou
- Department of Nephrology, Jinhua Hospital of Zhejiang University, 365 Renmin East Ave, Jinhua, 321000, Zhejiang, China.
| | - Ying Yao
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China. .,Department of Nutrition, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China.
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24
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Attini R, Montersino B, Leone F, Minelli F, Fassio F, Rossetti MM, Colla L, Masturzo B, Barreca A, Menato G, Piccoli GB. Dialysis or a Plant-Based Diet in Advanced CKD in Pregnancy? A Case Report and Critical Appraisal of the Literature. J Clin Med 2019; 8:jcm8010123. [PMID: 30669543 PMCID: PMC6352283 DOI: 10.3390/jcm8010123] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 02/07/2023] Open
Abstract
Pregnancy is increasingly reported in chronic kidney disease (CKD), reflecting higher awareness, improvements in materno-foetal care, and a more flexible attitude towards “allowing” pregnancy in the advanced stages of CKD. Success is not devoid of problems and an important grey area regards the indications for starting dialysis (by urea level, clinical picture, and residual glomerular filtration rate) and for dietary management. The present case may highlight the role of plant-based diets in dietary management in pregnant CKD women, aimed at retarding dialysis needs. The case. A 28-year-old woman, affected by glomerulocystic disease and unilateral renal agenesis, in stage-4 CKD, was referred at the 6th week of amenorrhea: she weighed 40 kg (BMI 16.3), was normotensive, had no sign of oedema, her serum creatinine was 2.73 mg/dL, blood urea nitrogen (BUN) 35 mg/dL, and proteinuria 200 mg/24 h. She had been on a moderately protein-restricted diet (about 0.8 g/kg/real body weight, 0.6 per ideal body weight) since childhood. Low-dose acetylsalicylate was added, and a first attempt to switch to a protein-restricted supplemented plant-based diet was made and soon stopped, as she did not tolerate ketoacid and aminoacid supplementation. At 22 weeks of pregnancy, creatinine was increased (3.17 mg/dL, BUN 42 mg/dL), dietary management was re-discussed and a plant-based non-supplemented diet was started. The diet was associated with a rapid decrease in serum urea and creatinine; this favourable effect was maintained up to the 33rd gestational week when a new rise in urea and creatinine was observed, together with signs of cholestasis. After induction, at 33 weeks + 6 days, she delivered a healthy female baby, adequate for gestational age (39th centile). Urea levels decreased after delivery, but increased again when the mother resumed her usual mixed-protein diet. At the child’s most recent follow-up visit (age 4 months), development was normal, with normal weight and height (50th–75th centile). In summary, the present case confirms that a moderate protein-restricted diet can be prescribed in pregnancies in advanced CKD without negatively influencing foetal growth, supporting the importance of choosing a plant-based protein source, and suggests focusing on the diet’s effects on microcirculation to explain these favourable results.
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Affiliation(s)
- Rossella Attini
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Benedetta Montersino
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Filomena Leone
- Department of Surgery, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Fosca Minelli
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Federica Fassio
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Maura Maria Rossetti
- SCDU Nephrology, Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy.
| | - Loredana Colla
- SCDU Nephrology, Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy.
| | - Bianca Masturzo
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Antonella Barreca
- Department of Medical Sciences, University of Torino, 10100 Torino, Italy.
| | - Guido Menato
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Giorgina Barbara Piccoli
- Department of Biological and Clinical Sciences, University of Torino, 10100 Torino, Italy.
- Nephrology, Centre Hospitalier Le Mans, 72000 Le Mans, France.
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