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Pavuluri KS, Pathi D, Dash SK, Das P, Panda SS. Microalbuminuria as a Predictor of Early Neurological Deterioration and Poor Functional Outcomes in Acute Ischemic Stroke. Cureus 2024; 16:e58311. [PMID: 38752035 PMCID: PMC11095285 DOI: 10.7759/cureus.58311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 05/18/2024] Open
Abstract
Background Ischemic stroke is a major health crisis with significant consequences. Microalbuminuria, a sign of endothelial dysfunction, has been linked to adverse outcomes in ischemic stroke. Early neurological deterioration (END) is a critical factor influencing the patient's prognosis. This study aimed to determine the prevalence of microalbuminuria, its predictive value in assessing END, and its prognostic implications in acute ischemic stroke (AIS). Methodology This study conducted at Pradyumna Bal Memorial Hospital, Kalinga Institute of Medical Sciences Bhubaneswar (November 2020-April 2022) included 114 AIS patients over 18 years who presented within 24 hours of stroke onset. Demographics, vascular risk factors, National Institutes of Health Stroke Scale (NIHSS) scores (admission and day three), modified Rankin scores (day 10), urinary albumin-to-creatinine ratios, and carotid artery Doppler studies were collected. Results The mean age of the patients was 61.87 years, with males constituting 72.8% of the population. Hypertension (50.9%) and diabetes mellitus (28.9%) were the most common comorbid conditions. The mean NIHSS stroke severity at presentation was 11.30. END occurred in 38.6% of patients. Overall, 43.9% of cases showed carotid stenosis, and the mean carotid intimal media thickness was 1.08 mm. Notably, the presence of microalbuminuria significantly increased the chances of both END (39.45 times higher risk) and worse functional outcomes (odds ratio = 19.147, p = 0.001). Conclusions Microalbuminuria emerges as a robust independent predictor of END and a poor prognosis in AIS. These findings highlight the importance of early microalbuminuria identification and intervention to reduce END risk and potentially improve outcomes in AIS patients.
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Affiliation(s)
| | - Debasis Pathi
- General Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
| | | | - Pragateshnu Das
- Neurology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
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Zhang S, Li X, Liu S, Zhang W, Li M, Qiao C. Research progress on the role of ET-1 in diabetic kidney disease. J Cell Physiol 2023; 238:1183-1192. [PMID: 37063089 DOI: 10.1002/jcp.31023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/16/2023] [Accepted: 04/03/2023] [Indexed: 04/18/2023]
Abstract
Diabetic kidney disease (DKD) is one of the common complications of diabetes mellitus, which usually progresses to end-stage renal disease and causes great damage to the health of patients. Endothelin-1 (ET-1), a molecule closely associated with the progression of DKD, has increased expression in response to high glucose stimulation and is involved in hemodynamic changes, inflammation, glomerular and tubular dysfunction in the kidney, causing an increase in proteinuria and a decrease in glomerular filtration function, ultimately leading to glomerulosclerosis and renal failure. This paper aims to review the molecular level changes, regulatory mechanisms, and mechanisms of action of ET-1 under DKD, clinical trials of ET-1 receptor antagonists in recent years and current problems, to provide basic information and new research directions and ideas for the treatment of DKD and ET-1-related research.
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Affiliation(s)
- Shenghao Zhang
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Xiaodan Li
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Siyu Liu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Wanting Zhang
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Meinuo Li
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Chen Qiao
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China
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Matheus ASDM, da Matta MDFB, Clemente ELS, Rodrigues MDLG, Valença DCT, Drummond KRG, Gomes MB. Biochemical and clinical markers of endothelial dysfunction do not outweigh traditional risk factors for the presence of diabetic retinopathy in patients with type 1 diabetes. Diabetol Metab Syndr 2022; 14:141. [PMID: 36167607 PMCID: PMC9516819 DOI: 10.1186/s13098-022-00912-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/14/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This study aimed to evaluate whether soluble vascular cytoadhesive molecule-1 (sVCAM-1), intracellular cytoadhesive molecule-1 (sICAM-1), and endothelial function as assessed by EndoPat outweighed traditional risk factors for the presence of diabetic retinopathy (DR) in patients with type 1 diabetes (T1D). METHODS Patients aged ≥ 12 years completed a clinical-epidemiological questionnaire. Fasting venous blood samples were obtained (lipid profile, glycemic control, and C-reactive protein levels). Vascular reactivity was assessed via peripheral arterial tonometry performed by supplying the reactive hyperemia index (RHI) through the EndoPAT device. sVCAM-1 and sICAM-1 levels were measured using multiplex assays. RESULTS Data were obtained from 187 patients (51.3% female), aged 32 ± 13 years with a disease duration of 14 (6-15) years and mean hemoglobin A1c (HbA1c) of 9.1% ± 2.1%. After adjustments were made, age, HbA1c, arterial blood pressure, and use of drugs that could interfere with endothelial function were found to be associated with DR. No association was noted with sVCAM-1 and sICAM-1 levels and RHI. CONCLUSIONS In our sample, sVCAM-1, sICAM and EndoPAT did not outweigh the traditional DR risk factors, such as age, high HbA1c, arterial blood pressure, and use of drugs that could interfere with endothelial function and are significantly associated with DR. Further prospective studies should evaluate if markers of endothelial dysfunction could predict diabetes-related micro and macrovascular complications in T1D.
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Affiliation(s)
| | | | - Eliete Leão Silva Clemente
- Diabetes Unit, State University of Rio de Janeiro, Boulevard 28 de Setembro, n. 77-Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | | | - Débora Cristina Torres Valença
- Clinical and Experimental Physiopathology of Hypertension Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Karla Rezende Guerra Drummond
- Diabetes Unit, State University of Rio de Janeiro, Boulevard 28 de Setembro, n. 77-Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | - Marília Brito Gomes
- Diabetes Unit, State University of Rio de Janeiro, Boulevard 28 de Setembro, n. 77-Vila Isabel, Rio de Janeiro, 20551-030, Brazil
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Cohen M, Yaseen H, Khamaisi M, Gendelman R, Zuckerman-Levin N, Shilo S, Ilivitzki A, Weiss R, Shehadeh N. Endothelin-1 levels are decreased in pediatric Type 1 diabetes and negatively correlate with the carotid intima media thickness. Pediatr Diabetes 2021; 22:916-923. [PMID: 34018289 DOI: 10.1111/pedi.13237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/24/2021] [Accepted: 05/05/2021] [Indexed: 12/17/2022] Open
Abstract
AIMS Better understanding of the timeline and risk factors for the appearance of complications in pediatric Type-1-diabetes is key for developing prevention strategies. We studied endothelial markers and their determinants in adolescents with Type-1-diabetes at different time points from diagnosis. METHODS A cross-sectional study of 58 adolescents, mean age 15.0 ± 2.4 years; 20 with recent-onset Type-1-diabetes, 20 with over 7 years of Type-1-diabetes and 18 controls. Clinical and biochemical data were collected. Fingertip arterial reactive hyperemia (EndoPAT) and carotid intima-media-thickness (cIMT) were measured to assess endothelial function and structure. RESULTS Compared to controls, individuals with prolonged Type-1-diabetes had higher mean cIMT (0.49 ± 0.07 mm vs. 0.43 ± 0.05 mm p = 0.021) and maximal cIMT (0.61 ± 0.08 mm 0.52 ± 0.08 mm, p = 0.025). Endothelin-1 levels were significantly lower in subjects with prolonged Type-1-diabetes (1.2 ± 1.0 pg/ml) compared to controls (3.0 ± 1.7, p = 0.008 pg/ml); they negatively correlated with the mean cIMT (c = - 0.291, p = 0.031) and mean 6 months hemoglobin A1c (c = - 0.301, p = 0.022) and positively correlated with mean c-peptide levels (c = 0.356, p = 0.006) and the weekly exercise time (c = 0.485, p < 0.001). Endothelin-1 levels did not correlate with EndoPAT results. CONCLUSIONS Our results suggest that the early years after the diagnosis of Type-1-diabetes are an important window for prevention of arterial damage in the pediatric population. The trajectories of relationships of Endothelin-1 with metabolic and vascular measures were opposite from the anticipated, yet consistent. Endothelin-1 related indirectly to adverse measures and directly to favorable measures. Decreased Endothelin-1 levels might reflect early stages in endothelial impairment in Type-1-diabetes, yet its' exact role in the development of complications is yet to be unraveled.
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Affiliation(s)
- Michal Cohen
- Department of Pediatrics, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Diabetes, Endocrinology and Metabolism Institute, Rambam Health Care Campus, Haifa, Israel.,The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hiba Yaseen
- Rambam Hematology Research Center, The Clinical Research Institute, Rambam Health Care Campus, Haifa, Israel
| | - Mogher Khamaisi
- Diabetes, Endocrinology and Metabolism Institute, Rambam Health Care Campus, Haifa, Israel.,The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Rambam Hematology Research Center, The Clinical Research Institute, Rambam Health Care Campus, Haifa, Israel
| | - Raya Gendelman
- The Endocrinology Laboratory, Rambam Health Care Campus, Haifa, Israel
| | - Nehama Zuckerman-Levin
- Diabetes, Endocrinology and Metabolism Institute, Rambam Health Care Campus, Haifa, Israel.,The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Smadar Shilo
- Diabetes, Endocrinology and Metabolism Institute, Rambam Health Care Campus, Haifa, Israel
| | - Anat Ilivitzki
- The Pediatric Radiology Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Ram Weiss
- Department of Pediatrics, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Diabetes, Endocrinology and Metabolism Institute, Rambam Health Care Campus, Haifa, Israel.,The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Naim Shehadeh
- Diabetes, Endocrinology and Metabolism Institute, Rambam Health Care Campus, Haifa, Israel.,The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Navval-Esfahlan E, Rafraf M, Asghari S, Imani H, Asghari-Jafarabadi M, Karimi-Avval S. Effect of French maritime pine bark extract supplementation on metabolic status and serum vascular cell adhesion molecule-1 levels in patients with type 2 diabetes and microalbuminuria. Complement Ther Med 2021; 58:102689. [PMID: 33610726 DOI: 10.1016/j.ctim.2021.102689] [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: 08/04/2020] [Revised: 01/17/2021] [Accepted: 02/16/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES This study investigated the effect of French maritime pine bark extract (PBE) supplementation on metabolic parameters, vascular cell adhesion molecule 1 (VCAM-1), urinary albumin-to-creatinine ratio (UACR), and anthropometric indexes in patients with type 2 diabetes (T2DM) and microalbuminuria. DESIGN This randomized, double-blind, placebo-controlled clinical trial was conducted on 46 patients with T2DM and the evidence of microalbuminuria aged 30-65 years. SETTING Patients were recruited from the endocrinology clinic of Sina hospital (Tabriz, Iran) from March 2018 to April 2019. INTERVENTIONS The subjects were randomly assigned to receive two capsules/day each containing 50mg of PBE or placebo for eight weeks. MAIN OUTCOME MEASURES Glycemic parameters, serum VCAM-1 and lipid profile, UACR, and anthropometric indexes were measured for all patients at baseline and the end of the study. RESULTS PBE supplementation significantly reduced glycosylated hemoglobin, VCAM-1, total cholesterol, UACR, waist circumference, and waist-to-height ratio compared to the placebo group at the end of the study (all P < 0.05). Changes in fasting blood glucose, insulin, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were not significant between the two groups (all P > 0.05). CONCLUSIONS The study findings demonstrated some favorable effects of PBE supplementation on glycemic control, serum VCAM-1 and total cholesterol levels, and microalbuminuria, as well as abdominal obesity in patients with T2DM.
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Affiliation(s)
- Elham Navval-Esfahlan
- Students' Research Committee, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Rafraf
- Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Somayyeh Asghari
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sanaz Karimi-Avval
- Department of Endocrine and Metabolism, Sina Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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Serag H, El Wakeel L, Adly A. Coenzyme Q10 administration has no effect on sICAM-1 and metabolic parameters of pediatrics with type 1 diabetes mellitus. INT J VITAM NUTR RES 2020; 91:315-324. [PMID: 31942840 DOI: 10.1024/0300-9831/a000636] [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] [Indexed: 01/06/2023]
Abstract
Background: Endothelial dysfunction (ED) plays a key role in the development and progression of microvascular and macrovascular complications in pediatrics with type 1 diabetes mellitus (T1DM). Coenzyme Q10 (CoQ10) is a nutraceutical with a known anti-inflammatory and anti-oxidant activity. This study was conducted to evaluate the potential effect of CoQ10 on ED and various metabolic parameters. Methods: This prospective randomized open-label pilot study was conducted on 49 T1DM pediatric patients. Seven healthy non-diabetic pediatric subjects who didn't receive treatment were included as a control group. Eligible patients were randomly allocated into either group I (n = 25); received 100 mg of CoQ10 in addition to standard treatment or group II (n = 24); received standard treatment only. The levels of; soluble intracellular adhesion molecule-1 (sICAM-1), glycated hemoglobin (HbA1c), fasting blood glucose (FBG), lipid profile, serum creatinine and liver function tests were assessed for both groups at baseline and after 3 months of treatment. Results: At baseline, compared to an age-matched healthy control group sICAM-1 levels were significantly elevated in group II diabetic patients (276.5 (231.6-320.66) vs 221.8 (177.9-267.1 ng/ml), p = 0.042. After 3 months of treatment no significant difference was observed in sICAM-1, HbA1c, FBG, lipid profile, serum creatinine and liver function tests between the two study groups. A positive correlation was found between sICAM-1 and HbA1c throughout the study (r = 0.308, p = 0.0054). Conclusion: Administration of CoQ10 for 3 months in T1DM pediatric patients was well tolerated but had no favorable effect on ED or metabolic parameters.
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Affiliation(s)
- Heba Serag
- Department of Clinical Pharmacy, Faculty of Pharmacy Ain Shams University, Cairo, Egypt
| | - Lamia El Wakeel
- Department of Clinical Pharmacy, Faculty of Pharmacy Ain Shams University, Cairo, Egypt
| | - Amira Adly
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Smani T, Gallardo-Castillo I, Ávila-Médina J, Jimenez-Navarro MF, Ordoñez A, Hmadcha A. Impact of Diabetes on Cardiac and Vascular Disease: Role of Calcium Signaling. Curr Med Chem 2019; 26:4166-4177. [DOI: 10.2174/0929867324666170523140925] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 02/14/2017] [Accepted: 05/04/2017] [Indexed: 12/12/2022]
Abstract
The pathophysiology linking diabetes and cardiovascular disease (CVD) is
complex and multifactorial. The specific type of cardiomyopathy associated with diabetes,
known as diabetic cardiomyopathy (DCM), is recognized as asymptomatic progression
of structural and functional remodeling in the heart of diabetic patients in the absence
of coronary atherosclerosis and hypertension. In other words, the presence of heart disease
specifically in diabetic patients is also known as diabetic heart disease. This article
reviews the impact of diabetes in heart and vascular beds focusing on molecular mechanisms
involving the oxidative stress, the inflammation, the endothelium dysfunction and
the alteration of the homeostasis of calcium, among others mechanisms. Understanding
these mechanisms will help identify and treat CVD in patients with diabetes, as well as to
plan efficient strategies to mitigate DCM impact in those patients.
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Affiliation(s)
- Tarik Smani
- Group of Cardiovascular Physiopathology, Institute of Biomedicine of Seville-IBiS, HUVR/University of Seville/CSIC, Seville, Spain
| | | | - Javier Ávila-Médina
- Group of Cardiovascular Physiopathology, Institute of Biomedicine of Seville-IBiS, HUVR/University of Seville/CSIC, Seville, Spain
| | - Manuel F. Jimenez-Navarro
- UGC del Corazon, Instituto de Biomedicina de Malaga (IBIMA), Hospital Clínico Universitario Virgen de la Victoria, Universidad de Malaga, Malaga, Spain
| | - Antonio Ordoñez
- Group of Cardiovascular Physiopathology, Institute of Biomedicine of Seville-IBiS, HUVR/University of Seville/CSIC, Seville, Spain
| | - Abdelkrim Hmadcha
- Department of Regeneration and Cell Therapy, Andalusian Center for Molecular Biology and Regenerative Medicine (CABIMER), Unversity of Pablo de Olavide- University of Seville-CSIC, Seville, Spain
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8
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Liu SX, Zheng F, Xie KL, Xie MR, Jiang LJ, Cai Y. Exercise Reduces Insulin Resistance in Type 2 Diabetes Mellitus via Mediating the lncRNA MALAT1/MicroRNA-382-3p/Resistin Axis. MOLECULAR THERAPY-NUCLEIC ACIDS 2019; 18:34-44. [PMID: 31479923 PMCID: PMC6726922 DOI: 10.1016/j.omtn.2019.08.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/24/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022]
Abstract
Insulin resistance (IR) is the primary pathological mechanism underlying type 2 diabetes mellitus (T2DM). Here, the study aimed to ascertain whether and how exercise mediates IR in T2DM. An in vivo mouse model of high-fat diet-induced IR and an in vitro high-glucose-induced IR model were constructed. High long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) expression was detected in T2MD and was positively correlated with HOMA-IR and resistin levels. Then, short hairpin RNA targeting MALAT1 (sh-MALAT1) or pcDNA-MALAT1 was delivered into human umbilical vein endothelial cells (HUVECs) to knock down or upregulate its expression, respectively. Silencing of MALAT1 resulted in reduced levels of resistin, Ang II, tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), endothelin-1 (ET-1), and p-insulin receptor substrate-1 (p-IRS)/ISR-1, and decreased cell migration, as well as enhanced glucose uptake and levels of nitric oxide (NO) and p-Akt/Akt. In the IR mouse model, exercise was observed to downregulate MALAT1 to reduce resistin, whereby exercise reduced homeostatic model assessment-insulin resistance (HOMA-IR). Besides, exercise also elevated microRNA-382-3p (miR-382-3p) expression in the serum of IR mice. Dual-luciferase reporter and RNA binding protein immunoprecipitation (RIP) assays identified that MALAT1 could bind to miR-382-3p to upregulate resistin. Collectively, the key observations of the study provide evidence that inhibition of MALAT1 elevates miR-382-3p to repress resistin, which consequently underlies the mechanism of exercise protecting against IR, highlighting a direction for T2DM therapy development.
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Affiliation(s)
- Sui-Xin Liu
- Cardiac Rehabilitation Center, Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha 410008, P.R. China
| | - Fan Zheng
- Cardiac Rehabilitation Center, Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha 410008, P.R. China
| | - Kang-Ling Xie
- Cardiac Rehabilitation Center, Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha 410008, P.R. China
| | - Mu-Rong Xie
- Cardiac Rehabilitation Center, Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha 410008, P.R. China
| | - Ling-Jun Jiang
- Cardiac Rehabilitation Center, Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha 410008, P.R. China
| | - Ying Cai
- Cardiac Rehabilitation Center, Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha 410008, P.R. China.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to examine the proposed role of immune modulation in the development and progression of diabetic kidney disease (DKD). RECENT FINDINGS Diabetic kidney disease has not historically been considered an immune-mediated disease; however, increasing evidence is emerging in support of an immune role in its pathophysiology. Both systemic and local renal inflammation have been associated with DKD. Infiltration of immune cells, predominantly macrophages, into the kidney has been reported in a number of both experimental and clinical studies. In addition, increased levels of circulating pro-inflammatory cytokines have been linked to disease progression. Consequently, a variety of therapeutic strategies involving modulation of the immune response are currently being investigated in diabetic kidney disease. Although no current therapies for DKD are directly based on immune modulation many of the therapies in clinical use have anti-inflammatory effects along with their primary actions. Macrophages emerge as the most likely beneficial immune cell target and compounds which reduce macrophage infiltration to the kidney have shown potential in both animal models and clinical trials.
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Affiliation(s)
- Fionnuala B Hickey
- Department of Clinical Medicine, Trinity College Dublin, Tallaght Hospital, Dublin, Dublin 24, Ireland
| | - Finian Martin
- School of Biomolecular & Biomedical Science, UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland.
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10
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Ziaja J, Kowalik AP, Kolonko A, Kamińska D, Owczarek AJ, Kujawa-Szewieczek A, Kusztal MA, Badura J, Bożek-Pająk D, Choręza P, Zakrzewska A, Król R, Chłopicki S, Klinger M, Więcek A, Chudek J, Cierpka L. Type 1 diabetic patients have better endothelial function after simultaneous pancreas-kidney transplantation than after kidney transplantation with continued insulin therapy. Diab Vasc Dis Res 2018; 15:122-130. [PMID: 29233018 DOI: 10.1177/1479164117744423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to analyse the influence of simultaneous pancreas-kidney or kidney transplantation on endothelial function and systemic inflammation in type 1 diabetic patients with end-stage renal disease. In 39 simultaneous pancreas-kidney, 39 type 1 diabetic kidney and 52 non-diabetic kidney recipients, flow-mediated dilatation was measured. Additionally, blood glycated haemoglobin, serum creatinine and lipids, plasma nitrites [Formula: see text] and nitrates, asymmetric dimethylarginine, soluble vascular cell adhesion molecule-1, intercellular adhesion molecule-1, and E-selectin, high-sensitivity C-reactive protein, tumour necrosis factor-α, interleukin 1β and interleukin 6 concentrations were assessed. During 58 ± 31 months follow-up period, flow-mediated dilatation and [Formula: see text] were greater in simultaneous pancreas-kidney than in type 1 diabetic kidney recipients [10.4% ± 4.7% vs 7.7% ± 4.2%, p < 0.05 and 0.94 (0.74-1.34) vs 0.24 (0.20-0.43) μmol/L, p < 0.01, respectively]. In type 1 diabetic patients after simultaneous pancreas-kidney or kidney transplantation, [Formula: see text] correlated with flow-mediated dilatation (r = 0.306, p < 0.05) and with blood glycated haemoglobin (r = -0.570, p < 0.001). The difference in [Formula: see text] was linked to blood glycated haemoglobin and estimated glomerular filtration rate, whereas the difference in flow-mediated dilatation was linked to [Formula: see text]. The levels of inflammatory markers (except soluble vascular cell adhesion molecule-1) were similar in simultaneous pancreas-kidney and type 1 diabetic kidney recipients. Improved endothelial function in type 1 diabetic patients with end-stage renal disease after simultaneous pancreas-kidney compared to kidney transplantation is associated with normalisation of glucose metabolism but not with improvement in plasma pro-inflammatory cytokines.
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Affiliation(s)
- Jacek Ziaja
- 1 Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland
| | - Adrian P Kowalik
- 1 Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland
| | - Aureliusz Kolonko
- 2 Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Dorota Kamińska
- 3 Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Aleksander J Owczarek
- 4 Department of Statistics, Department of Instrumental Analysis, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Agata Kujawa-Szewieczek
- 2 Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Mariusz A Kusztal
- 3 Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Joanna Badura
- 1 Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland
| | - Dominika Bożek-Pająk
- 1 Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland
| | - Piotr Choręza
- 4 Department of Statistics, Department of Instrumental Analysis, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Zakrzewska
- 5 Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
| | - Robert Król
- 1 Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland
| | - Stefan Chłopicki
- 5 Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
- 6 Chair of Pharmacology, Jagiellonian University Medical College, Kraków, Poland
| | - Marian Klinger
- 3 Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Andrzej Więcek
- 2 Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Jerzy Chudek
- 7 Department of Pathophysiology, Medical University of Silesia, Katowice, Poland
- 8 Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, Katowice, Poland
| | - Lech Cierpka
- 1 Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland
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11
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Pourfarjam Y, Rezagholizadeh L, Nowrouzi A, Meysamie A, Ghaseminejad S, Ziamajidi N, Norouzi D. Effect of Cichorium intybus L. seed extract on renal parameters in experimentally induced early and late diabetes type 2 in rats. Ren Fail 2017; 39:211-221. [PMID: 27846769 PMCID: PMC6014526 DOI: 10.1080/0886022x.2016.1256317] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/11/2016] [Accepted: 10/27/2016] [Indexed: 01/04/2023] Open
Abstract
Blood and urine biochemistry screening tests are important for initial detection of diabetes, determination of severity of its complications, and monitoring of therapy. We evaluated the effects of aqueous chicory seed extract (CSE), on renal biochemical parameters, histology, and Na+/glucose cotansporters, SGLT1 and SGLT2 expression levels using metformin, and aspirin as controls. Late stage type 2 diabetes (LT2D; FBS, >300 mg/dl) and early stage type 2 diabetes (ET2D; FBS, 140-220 mg/dl) were induced in rats by streptozotocin (STZ group) and a combination of STZ and niacinamide (NIA/STZ group), respectively. A non-diabetic group was included as control. Treatment included daily intraperitoneal injections of either CSE (125 mg/kg b.w.) or metformin (100 mg/kg b.w.) and oral aspirin (120 mg/kg b.w.) for 21 days. At the end, blood and 24 h urine samples were collected; and kidneys were saved at -80 ˚C. CSE reduced urinary α1-microgobulin excretion in ET2D (p = .043), and serum uric acid (p = .045), and glomerular diameter (p < .01) in LT2D. Metformin appeared to be more effective in LT2D with respect to serum uric acid, urea, and BUN (< .05). Both CSE and metformin improved histology. Aspirin improved several blood and urine variables, but appeared to aggravate morphological damages to the kidney tissue. The absolute values of albumin, α1-microglobulin or total protein in urine rather than their creatinine ratios seemed more useful in the detection of early kidney damage; CSE was able to repair the kidney damage and α1-microglobulin was sensitive enough to allow monitoring of the improvements caused by the treatment.
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Affiliation(s)
- Yasin Pourfarjam
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Lotfollah Rezagholizadeh
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nowrouzi
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Alipasha Meysamie
- Department of Community & Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarah Ghaseminejad
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Ziamajidi
- Department of Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Davood Norouzi
- Department of Public Relations, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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12
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Atay AE, Esen B, Akbas H, Gokmen ES, Pilten S, Guler H, Yavuz DG. Serum ICAM-1 level and ICAM-1 gene 1462A>G (K469E) polimorphism on microalbuminuria in nondiabetic, nonhypertensive and normolipidemic obese patients: Genetical background of microalbuminuria in obesity. Nefrologia 2017; 37:381-388. [PMID: 28576439 DOI: 10.1016/j.nefro.2016.11.025] [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: 04/14/2016] [Revised: 08/29/2016] [Accepted: 11/17/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND A growing body of evidence suggest that obese individuals are under risk of renal parenchymal disorders when compared to nonobese counterparts. Microalbuminuria is the early marker of renal involvement. Although most of obese patients carries multiple risk factors for microalbuminuria, some obese individuals without risk factor may progress to microalbuminuria. The present study was performed to examine the role of ICAM-1 gene 1462A>G (K469E) polymorphism on microalbuminuria in obese subjects without diabetes mellitus, hypertension, hiperlipidemia and older age. METHODS Ninety eight obese and 96 nonobese individuals without a comorbidity enrolled into the study. Serum ICAM-1 level was measured by enzyme linked immunoabsorbent assay (ELISA) method. ICAM-1 gene 1462A>G (K469E) polymorphism was examined by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). Nepholometric method was used to examine urinary albumin loss, and microalbuminuria was measured by albumin to creatinine ratio. RESULTS Obese individuals had significantly higher microalbuminuria and proteinuria level compared to nonobese subjects (p: 0.043 and p: 0.011; respectively). GG genotype of ICAM-1 carriers have significantly higher microalbuminuria compared to individuals with AA or AG genotype carriers (p: 0.042). Serum ICAM-1 level was significantly correlated with creatinine and microalbuminuria (p: 0.002 and p: 0.03; respectively). Logistic regression analysis indicated a 7.39 fold increased risk of microalbuminuria in individuals with GG genotype of ICAM-1 gene 1462A>G (K469E) polymorphism. CONCLUSIONS GG genotype of ICAM-1 gene K469E polymorphism is associated with increased microalbuminuria in obese individuals without another metabolic risk factor.
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Affiliation(s)
- Ahmet Engin Atay
- Division of Nephrology, Department of Internal Medicine, Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Bennur Esen
- Division of Nephrology, Department of Internal Medicine, Acıbadem University School of Medicine, Istanbul, Turkey.
| | - Halit Akbas
- Department of Medical Biology and Genetics, Medical School of Harran University, Sanlıurfa, Turkey
| | - Emel Saglam Gokmen
- Division of Nephrology, Department of Internal Medicine, Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Saadet Pilten
- Department of Biochemistry, Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Hale Guler
- Department of Medical Biology and Genetics, Medical School of Harran University, Sanlıurfa, Turkey
| | - Dilek Gogas Yavuz
- Department of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey
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13
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Tseng YH, Chiou SS, Zeng YS, Tsai SP, Chen CS, Liao YM, Lin PC. Soluble vascular cell adhesion molecular-1 is a potential biological indicator of hemophilic arthropathy. Medicine (Baltimore) 2016; 95:e5384. [PMID: 27861372 PMCID: PMC5120929 DOI: 10.1097/md.0000000000005384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Hemophilic arthropathy is the most common chronic complication in patients with hemophilia. The pathogenesis of hemophilic arthropathy involves the inflammatory processes associated with rheumatoid arthritis (RA). Determining the severity and/or progression of joint damage is crucial when evaluating the effect of treatment modalities. Identifying reliable biomarkers in the peripheral blood of patients with hemophilic arthropathy may be beneficial in clinical practice. Circulating soluble vascular cell adhesion molecule-1 (sVCAM-1), E-selectin, and P-selectin levels are elevated in patients with RA. Our study investigated whether these soluble adhesion molecules can be used as biological indicators in the course of joint damage in patients with hemophilia A.Patients with hemophilia A (mild, moderate, and severe) were enrolled. The plasma levels of sVCAM-1, E-selectin, and P-selectin in patients with hemophilia A and control were measured using specific enzyme-linked immunosorbent assay kits. Joint damages were evaluated using Pettersson scores.No statistically significant differences were observed in E-selectin and P-selectin levels between patients and controls. The sVCAM-1 level was significantly higher in patients with hemophilia A than in controls. The differences remained significant in patients with severe hemophilia A but not in patients with mild or moderate hemophilia A. The degree of hemophilic arthropathy was evaluated using Pettersson scores, and a score higher than 5 indicated marked arthropathy. Patients with more than 1 joint with marked arthropathy showed significantly higher sVCAM-1 levels.sVCAM-1 levels in patients with hemophilia A are associated with the severity of hemophilic arthropathy.
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Affiliation(s)
| | - Shyh-Shin Chiou
- Department of Pediatrics
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital
- Department of Pediatrics, School of Medicine, College of Medicine
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Sheng Zeng
- Department of Pediatrics
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Pien Tsai
- Department of Nursing
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Shih Chen
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Mei Liao
- Department of Pediatrics
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pei-Chin Lin
- Department of Pediatrics
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital
- Department of Pediatrics, School of Medicine, College of Medicine
- Graduate Institute of Clinical Medicine, Kaohsiung Medical University
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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14
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Rodríguez-Pérez JM, Blachman-Braun R, Pomerantz A, Vargas-Alarcón G, Posadas-Sánchez R, Pérez-Hernández N. Possible role of intronic polymorphisms in the PHACTR1 gene on the development of cardiovascular disease. Med Hypotheses 2016; 97:64-70. [PMID: 27876132 DOI: 10.1016/j.mehy.2016.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 10/19/2016] [Indexed: 11/24/2022]
Abstract
Cardiovascular disease (CVD) is a complex multifactorial and polygenetic disease in which the interaction of numerous genes, genetic variants, and environmental factors plays a major role in its development. In an attempt to demonstrate the association between certain genetic variants and CVD, researchers have run large genomic wild association studies (GWAS) in recent decades. These studies have correlated several genomic variants with the presence of CVD. Recently, certain polymorphisms in the phosphatase and actin regulator 1 (PHACTR1) gene have been shown to be associated with CVD (i.e., coronary artery disease, coronary artery calcification, early onset myocardial infarction, cervical artery dissection and hypertension) in different ethnic groups. It is important to state that all of the described PHACTR1 genetic variants associated with CVD are located in non-translating gene regions known as introns. Thus, the purpose of this article is to hypothesize the effect of certain intronic polymorphisms in the PHACTR1 gene on pathological processes in the cardiovascular system. In addition, we present compelling evidence that supports this hypothesis as well as a methodology that could be used to assess the allelic effect using in vitro and in vivo models, which will ultimately demonstrate the pathophysiological contribution of PHACTR1 intronic polymorphisms to the development of CVD.
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Affiliation(s)
- José Manuel Rodríguez-Pérez
- Department of Molecular Biology, National Institute of Cardiology "Ignacio Chávez", Mexico City 14080, Mexico
| | - Ruben Blachman-Braun
- Department of Molecular Biology, National Institute of Cardiology "Ignacio Chávez", Mexico City 14080, Mexico
| | - Alan Pomerantz
- Department of Oncology and Hematology, National Institute of Medical Sciences and Nutrition "Salvador Zubirán", Mexico City 14080, Mexico
| | - Gilberto Vargas-Alarcón
- Department of Molecular Biology, National Institute of Cardiology "Ignacio Chávez", Mexico City 14080, Mexico
| | - Rosalinda Posadas-Sánchez
- Department of Endocrinology, National Institute of Cardiology "Ignacio Chávez", Mexico City 14080, Mexico
| | - Nonanzit Pérez-Hernández
- Department of Molecular Biology, National Institute of Cardiology "Ignacio Chávez", Mexico City 14080, Mexico.
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15
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Shi PA, Choi E, Chintagari NR, Nguyen J, Guo X, Yazdanbakhsh K, Mohandas N, Alayash AI, Manci EA, Belcher JD, Vercellotti GM. Sustained treatment of sickle cell mice with haptoglobin increases HO-1 and H-ferritin expression and decreases iron deposition in the kidney without improvement in kidney function. Br J Haematol 2016; 175:714-723. [PMID: 27507623 DOI: 10.1111/bjh.14280] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/06/2016] [Indexed: 12/21/2022]
Abstract
There is growing evidence that extracellular haemoglobin and haem mediate inflammatory and oxidative damage in sickle cell disease. Haptoglobin (Hp), the scavenger for free haemoglobin, is depleted in most patients with sickle cell disease due to chronic haemolysis. Although single infusions of Hp can ameliorate vaso-occlusion in mouse models of sickle cell disease, prior studies have not examined the therapeutic benefits of more chronic Hp dosing on sickle cell disease manifestations. In the present study, we explored the effect of Hp treatment over a 3-month period in sickle mice at two dosing regimens: the first at a moderate dose of 200 mg/kg thrice weekly and the second at a higher dose of 400 mg/kg thrice weekly. We found that only the higher dosing regimen resulted in increased haem-oxygenase-1 and heavy chain ferritin (H-ferritin) expression and decreased iron deposition in the kidney. Despite the decreased kidney iron deposition following Hp treatment, there was no significant improvement in kidney function. However, there was a nearly significant trend towards decreased liver infarction.
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Affiliation(s)
- Patricia A Shi
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Erika Choi
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | | | - Julia Nguyen
- Department of Hematology, Oncology, and Transplantation, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Xinhua Guo
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Karina Yazdanbakhsh
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Narla Mohandas
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
| | - Abdu I Alayash
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Elizabeth A Manci
- Department of Pathology, University of South Alabama School of Medicine, Birmingham, AL, USA
| | - John D Belcher
- Department of Hematology, Oncology, and Transplantation, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Gregory M Vercellotti
- Department of Hematology, Oncology, and Transplantation, University of Minnesota Medical School, Minneapolis, MN, USA
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16
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Titan S. Biomarkers in diabetic kidney disease: good use and pitfalls. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 60:92-94. [PMID: 27191045 DOI: 10.1590/2359-3997000000167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 03/28/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Silvia Titan
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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