Ultra-Endurance Participation and Acute Kidney Injury: A Narrative Review

What is known about the health effects of non-steroidal anti-inflammatory drug (NSAID) use in marathon and ultraendurance running: a scoping review

This systematic scoping review aimed to understand the extent and scope of evidence on the health risks of non-steroidal anti-inflammatory drug (NSAID) use in marathon and ultraendurance running. NSAIDs are commonly consumed by runners to combat pain and inflammation; however, the health risks of consuming these drugs during marathon and ultrarunning events are currently not fully understood. Four databases (Cochrane Library, PubMed, MEDLINE and SPORTDiscus) were searched to identify articles focusing on running events of 26.2 miles or further, and they must have reported on the health risks of NSAID use. There was no restriction on the study design or the date of publication. Thirty studies were ultimately included: 4 randomised controlled trials, 1 cross-sectional study, 11 retrospective reviews, 4 case reports, 1 non-randomised control trial, and 9 prospective observational studies. The literature showed that potential health concerns of NSAID use could be split into five categories: electrolyte balance and hyponatraemia; acute kidney injury (AKI); gastrointestinal disturbances; oxidative stress, inflammation and muscle damage; other medical concerns. None of these sections had clear statistically significant links with NSAID use in ultraendurance running. However, potential links were shown, especially in AKI and electrolyte balance. This review suggests there is very limited evidence to show that NSAIDs have a negative impact on the health of ultrarunning athletes. Indications from a few non-randomised studies of a possible effect on kidney function need exploring with more high-quality research.

Thalamic Neuron Resilience during Osmotic Demyelination Syndrome (ODS) Is Revealed by Primary Cilium Outgrowth and ADP-ribosylation factor-like protein 13B Labeling in Axon Initial Segment

A murine osmotic demyelinating syndrome (ODS) model was developed through chronic hyponatremia, induced by desmopressin subcutaneous implants, followed by precipitous sodium restoration. The thalamic ventral posterolateral (VPL) and ventral posteromedial (VPM) relay nuclei were the most demyelinated regions where neuroglial damage could be evidenced without immune response. This report showed that following chronic hyponatremia, 12 h and 48 h time lapses after rebalancing osmolarity, amid the ODS-degraded outskirts, some resilient neuronal cell bodies built up primary cilium and axon hillock regions that extended into axon initial segments (AIS) where ADP-ribosylation factor-like protein 13B (ARL13B)-immunolabeled rod-like shape content was revealed. These AIS-labeled shaft lengths appeared proportional with the distance of neuronal cell bodies away from the ODS damaged epicenter and time lapses after correction of hyponatremia. Fine structure examination verified these neuron abundant transcriptions and translation regions marked by the ARL13B labeling associated with cell neurotubules and their complex cytoskeletal macromolecular architecture. This necessitated energetic transport to organize and restore those AIS away from the damaged ODS core demyelinated zone in the murine model. These labeled structures could substantiate how thalamic neuron resilience occurred as possible steps of a healing course out of ODS.

Ultrasensitive Silicon Nanowire Biosensor with Modulated Threshold Voltages and Ultra-Small Diameter for Early Kidney Failure Biomarker Cystatin C

Acute kidney injury (AKI) is a frequently occurring severe disease with high mortality. Cystatin C (Cys-C), as a biomarker of early kidney failure, can be used to detect and prevent acute renal injury. In this paper, a biosensor based on a silicon nanowire field-effect transistor (SiNW FET) was studied for the quantitative detection of Cys-C. Based on the spacer image transfer (SIT) processes and channel doping optimization for higher sensitivity, a wafer-scale, highly controllable SiNW FET was designed and fabricated with a 13.5 nm SiNW. In order to improve the specificity, Cys-C antibodies were modified on the oxide layer of the SiNW surface by oxygen plasma treatment and silanization. Furthermore, a polydimethylsiloxane (PDMS) microchannel was involved in improving the effectiveness and stability of detection. The experimental results show that the SiNW FET sensors realize the lower limit of detection (LOD) of 0.25 ag/mL and have a good linear correlation in the range of Cys-C concentration from 1 ag/mL to 10 pg/mL, exhibiting its great potential in the future real-time application.