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Wang HHS, Cho PS, Zhi H, Kostel SA, DiMartino S, Dagher AM, Davis KH, Cabour LD, Shimmel A, Lee J, Froehlich JW, Zurakowski D, Moses MA, Lee RS. Association between urinary biomarkers MMP-7/TIMP-2 and reduced renal function in children with ureteropelvic junction obstruction. PLoS One 2022; 17:e0270018. [PMID: 35834547 PMCID: PMC9282603 DOI: 10.1371/journal.pone.0270018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022] Open
Abstract
IMPORTANCE Extracellular matrix proteins and enzymes involved in degradation have been found to be associated with tissue fibrosis and ureteropelvic junction obstruction (UPJO). In this study we developed a promising urinary biomarker model which can identify reduced renal function in UPJ obstruction patients. This can potentially serve as a non-invasive way to enhance surgical decision making for patients and urologists. OBJECTIVE We sought to develop a predictive model to identify UPJO patients at risk for reduced renal function. DESIGN Prospective cohort study. SETTING Pre-operative urine samples were collected in a prospectively enrolled UPJO biomarker registry at our institution. Urinary MMP-2, MMP-7, TIMP-2, and NGAL were measured as well as clinical characteristics including hydronephrosis grade, differential renal function, t1/2, and UPJO etiology. PARTICIPANTS Children who underwent pyeloplasty for UPJO. MAIN OUTCOME MEASUREMENT Primary outcome was reduced renal function defined as MAG3 function <40%. Multivariable logistic regression was applied to identify the independent predictive biomarkers in the original Training cohort. Model validation and generalizability were evaluated in a new UPJO Testing cohort. RESULTS We included 71 patients with UPJO in the original training cohort and 39 in the validation cohort. Median age was 3.3 years (70% male). By univariate analysis, reduced renal function was associated with higher MMP-2 (p = 0.064), MMP-7 (p = 0.047), NGAL (p = 0.001), and lower TIMP-2 (p = 0.033). Combining MMP-7 with TIMP-2, the multivariable logistic regression model predicted reduced renal function with good performance (AUC = 0.830; 95% CI: 0.722-0.938). The independent testing dataset validated the results with good predictive performance (AUC = 0.738). CONCLUSIONS AND RELEVANCE Combination of urinary MMP-7 and TIMP-2 can identify reduced renal function in UPJO patients. With the high sensitivity cutoffs, patients can be categorized into high risk (aggressive management) versus lower risk (observation).
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Affiliation(s)
- Hsin-Hsiao S. Wang
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Patricia S. Cho
- Department of Urology, University of Massachusetts, Worcester, MA, United States of America
| | - Hui Zhi
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Stephen A. Kostel
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Shannon DiMartino
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Adelle M. Dagher
- The Program in Vascular Biology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Kylie H. Davis
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Lily D. Cabour
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Ashley Shimmel
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - James Lee
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - John W. Froehlich
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - David Zurakowski
- Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Marsha A. Moses
- The Program in Vascular Biology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Department of Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Richard S. Lee
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
- * E-mail:
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Minuth WW. Concepts for a therapeutic prolongation of nephrogenesis in preterm and low-birth-weight babies must correspond to structural-functional properties in the nephrogenic zone. Mol Cell Pediatr 2017; 4:12. [PMID: 29218481 PMCID: PMC5721096 DOI: 10.1186/s40348-017-0078-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/20/2017] [Indexed: 12/30/2022] Open
Abstract
Numerous investigations are dealing with anlage of the mammalian kidney and primary development of nephrons. However, only few information is available about the last steps in kidney development leading at birth to a downregulation of morphogen activity in the nephrogenic zone and to a loss of stem cell niches aligned beyond the organ capsule. Surprisingly, these natural changes in the developmental program display similarities to processes occurring in the kidneys of preterm and low-birth-weight babies. Although those babies are born at a time with a principally intact nephrogenic zone and active niches, a high proportion of them suffers on impairment of nephrogenesis resulting in oligonephropathy, formation of atypical glomeruli, and immaturity of parenchyma. The setting points out that up to date not identified noxae in the nephrogenic zone hamper primary steps of parenchyma development. In this situation, a possible therapeutic aim is to prolong nephrogenesis by medications. However, actual data provide information that administration of drugs is problematic due to an unexpectedly complex microanatomy of the nephrogenic zone, in niches so far not considered textured extracellular matrix and peculiar contacts between mesenchymal cell projections and epithelial stem cells via tunneling nanotubes. Thus, it remains to be figured out whether disturbance of morphogen signaling altered synthesis of extracellular matrix, disturbed cell-to-cell contacts, or modified interstitial fluid impair nephrogenic activity. Due to most unanswered questions, search for eligible drugs prolonging nephrogenesis and their reliable administration is a special challenge for the future.
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Affiliation(s)
- Will W Minuth
- Institute of Anatomy, University of Regensburg, 93053, Regensburg, Germany.
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Chen Q, Cui Y, Ding G, Jia Z, Zhang Y, Zhang A, Huang S. PEA3 protects against gentamicin nephrotoxicity: role of mitochondrial dysfunction. Am J Transl Res 2017; 9:2153-2162. [PMID: 28559968 PMCID: PMC5446500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/10/2017] [Indexed: 06/07/2023]
Abstract
Toxin-induced nephrotoxicity is one of the major causes leading to the acute kidney injury (AKI). Among these nephrotoxic toxins, gentamicin can induce AKI with elusive mechanisms. Emerging evidence demonstrated that PEA3 (polyomavirus enhancer activator 3) contributed to the nephrogenesis, while its role in AKI remains unknown. Thus, this study was to investigate the role of PEA3 in gentamicin nephrotoxicity, as well as the underlying mechanisms. In rats, gentamicin treatment (200 mg/kg twice per day) for two days induced remarkable kidney injury with a peak damage on day 5 evaluated by the tubular injury score, proteinuria, and tubular injury markers of NGAL and KIM-1. In parallel with the tubular injury, PEA3 protein and mRNA expressions were significantly upregulated by gentamicin and peaked on day 5. To define the role of PEA3 in gentamicin nephrotoxicity, proximal tubule cells were transfected with PEA3 plasmid with or without gentamicin treatment (1 mg/ml). Notably, overexpression of PEA3 attenuated gentamicin-induced cell injury shown by the ameliorated cell apoptosis and NGAL and KIM-1 upregulation. Meantime, gentamicin caused severe mitochondrial dysfunction, which was largely normalized by PEA3 overexpression. In contrast, silencing PEA3 by a siRNA strategy further deteriorated gentamicin-induced cell apoptosis and mitochondrial dysfunction. In sum, PEA3 protected against gentamicin nephrotoxicity possibly via a mitochondrial mechanism.
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Affiliation(s)
- Qiuxia Chen
- Department of Nephrology, Children’s Hospital of Nanjing Medical UniversityNanjing 210008, Jiangsu Province, P. R. China
- Jiangsu Key Laboratory of PediatricsNanjing 210029, Jiangsu Province, P. R. China
| | - Yiyun Cui
- Department of Nephrology, Children’s Hospital of Nanjing Medical UniversityNanjing 210008, Jiangsu Province, P. R. China
- Jiangsu Key Laboratory of PediatricsNanjing 210029, Jiangsu Province, P. R. China
| | - Guixia Ding
- Department of Nephrology, Children’s Hospital of Nanjing Medical UniversityNanjing 210008, Jiangsu Province, P. R. China
- Jiangsu Key Laboratory of PediatricsNanjing 210029, Jiangsu Province, P. R. China
| | - Zhanjun Jia
- Department of Nephrology, Children’s Hospital of Nanjing Medical UniversityNanjing 210008, Jiangsu Province, P. R. China
- Jiangsu Key Laboratory of PediatricsNanjing 210029, Jiangsu Province, P. R. China
| | - Yue Zhang
- Jiangsu Key Laboratory of PediatricsNanjing 210029, Jiangsu Province, P. R. China
| | - Aihua Zhang
- Department of Nephrology, Children’s Hospital of Nanjing Medical UniversityNanjing 210008, Jiangsu Province, P. R. China
- Jiangsu Key Laboratory of PediatricsNanjing 210029, Jiangsu Province, P. R. China
| | - Songming Huang
- Department of Nephrology, Children’s Hospital of Nanjing Medical UniversityNanjing 210008, Jiangsu Province, P. R. China
- Jiangsu Key Laboratory of PediatricsNanjing 210029, Jiangsu Province, P. R. China
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Moalem S, Brouillard P, Kuypers D, Legius E, Harvey E, Taylor G, Francois M, Vikkula M, Chitayat D. Hypotrichosis-lymphedema-telangiectasia-renal defect associated with a truncating mutation in the SOX18 gene. Clin Genet 2014; 87:378-82. [DOI: 10.1111/cge.12388] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 03/18/2014] [Accepted: 03/20/2014] [Indexed: 11/29/2022]
Affiliation(s)
- S. Moalem
- Department of Pediatrics, Division of Clinical and Metabolic Genetics; The Hospital for Sick Children
| | | | - D. Kuypers
- Department of Nephrology and Renal Transplantation; University Hospital Gasthuisberg; Leuven Belgium
| | - E. Legius
- Department of Human Genetics, KU Leuven; University Hospitals Leuven; Leuven Belgium
| | - E. Harvey
- Department of Pediatrics, Division of Nephrology; The Hospital for Sick Children, University of Toronto
| | - G. Taylor
- Department of Pediatrics; Division of Pathology and laboratory Medicine; The Hospital for Sick Children
| | - M. Francois
- The University of Queensland; St Lucia Campus; Brisbane Australia
| | - M. Vikkula
- Laboratory of Human Molecular Genetics
- Walloon Excellence in Life Sciences and Biotechnology (WELBIO); de Duve Institute Université catholique de Louvain; Brussels Belgium
| | - D. Chitayat
- Department of Pediatrics, Division of Clinical and Metabolic Genetics; The Hospital for Sick Children
- Department of Obstetrics and Gynecology, The Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital; University of Toronto; Toronto Ontario Canada
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Rims CR, McGuire JK. Matrilysin (MMP-7) catalytic activity regulates β-catenin localization and signaling activation in lung epithelial cells. Exp Lung Res 2014; 40:126-36. [PMID: 24624896 DOI: 10.3109/01902148.2014.890681] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Matrix metalloproteinase-7 (matrilysin, MMP-7) expression is increased in epithelium by bacterial infection, inflammation, fibrosis, and in a myriad of carcinomas. It functions to degrade extracellular matrix and other pericellular substrates including the adherens junction protein E-cadherin to promote wound healing and tissue remodeling. β-catenin functions as both a structural component of adherens junctions and as an intracellular signaling molecule. To assess if matrilysin-mediated disassembly of adherens junctions regulates β-catenin function, we assessed effects of matrilysin catalytic activity on β-catenin localization and signaling activity in A549 cells and in bleomycin-induced lung injury in mice. We determined that matrilysin activity releases β-catenin from the cell membrane after which it is degraded in the cytosol. However, in the presence of a β-catenin stabilizing Wnt signal, β-catenin accumulated in the cytosol and activated a β-catenin luciferase promoter. Furthermore, β-catenin nuclear translocation and activation was impaired in matrilysin-null mice when compared to wild-type mice after bleomycin-induced lung injury. These results show identify matrilysin as a regulator of β-catenin function in injured lung epithelium and may link extracellular proteolytic activity to cell junction disassembly and intracellular signaling.
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Affiliation(s)
- Cliff R Rims
- Department of Pediatrics and Center for Lung Biology, University of Washington , Seattle, Washington , USA
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