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Kong S, Ding K, Jiang H, Yang F, Zhang C, Han L, Ge Y, Chen L, Shi H, Zhou J. Association Between Glycemic Variability and Persistent Acute Kidney Injury After Noncardiac Major Surgery: A Multicenter Retrospective Cohort Study. Anesth Analg 2024:00000539-990000000-00945. [PMID: 39269909 DOI: 10.1213/ane.0000000000007131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
BACKGROUND While the relationship between glycemic variability (GV) and acute kidney injury (AKI) has been a subject of interest, the specific association of GV with persistent AKI beyond 48 hours postoperative after noncardiac surgery is not well-established. METHODS This retrospective cohort study aimed to describe the patterns of different GV metrics in the immediate 48 hours after noncardiac surgery, evaluate the association between GV indices and persistent AKI within the 7-day postoperative window, and compare the risk identification capabilities of various GV for persistent AKI. A total of 10,937 patients who underwent major noncardiac surgery across 3 medical centers in eastern China between January 2015 and September 2023 were enrolled. GV was characterized using the coefficient of variations (CV), mean amplitude of glycemic excursions (MAGE), and the blood glucose risk index (BGRI). Multivariable logistic regression was used to examine the relationship between GV and AKI. Optimal cutoff values for GV metrics were calculated through the risk identification models, and an independent cohort from the INformative Surgical Patient dataset for Innovative Research Environment (INSPIRE) database with 7714 eligible cases served to externally validate the risk identification capability. RESULTS Overall, 274 (2.5%) of the 10,937 patients undergoing major noncardiac surgery met the criteria of persistent AKI. Higher GV was associated with an increased risk of persistent AKI (CV: odds ratio [OR] = 1.26, 95% confidence interval [CI], 1.08-1.46; MAGE: OR = 1.31, 95% CI, 1.15-1.49; BGRI: OR = 1.18, 95% CI, 1.08-1.29). Compared to models that did not consider glycemic factors, MAGE and BGRI independently contributed to predicting persistent AKI (MAGE: areas under the curve [AUC] = 0.768, P = .011; BGRI: AUC = 0.764, P = .014), with cutoff points of 3.78 for MAGE, and 3.02 for BGRI. The classification of both the internal and external validation cohorts using cutoffs demonstrated good performance, achieving the best AUC values of 0.768 for MAGE in the internal cohort and 0.777 for MAGE in the external cohort. CONCLUSIONS GV measured within 48 hours postoperative period is an independent risk factor for persistent AKI in patients undergoing noncardiac surgery. Specific cutoff points can be used to stratify at-risk patients. These findings indicate that stabilizing GV may potentially mitigate adverse kidney outcomes after noncardiac surgery, highlighting the importance of glycemic control in the perioperative period.
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Affiliation(s)
- Siyu Kong
- From the School of International Business, China Pharmaceutical University, Jiangsu, China
| | - Ke Ding
- Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Huili Jiang
- Department of Anesthesiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Fan Yang
- From the School of International Business, China Pharmaceutical University, Jiangsu, China
| | - Chen Zhang
- Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Liu Han
- Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Yali Ge
- Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Lihai Chen
- Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Hongwei Shi
- Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Jifang Zhou
- From the School of International Business, China Pharmaceutical University, Jiangsu, China
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Verónica VO, Leticia NT, Saret DS, Dora Luz CQ, Estela CR, Margarita MG, Arturo OS, Francisco C, Jorge RA. Consumption of sucrose in maternal and postnatal stages leads to kidney affectation in adult male rats. Physiol Behav 2024; 283:114551. [PMID: 38621601 DOI: 10.1016/j.physbeh.2024.114551] [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: 01/29/2024] [Revised: 03/16/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
High sugar-sweetened beverage intake has been related to human kidney disease and metabolic alterations. We determine the impact of high sucrose intake from pregnancy until early postnatal days and post-weaning on kidneys from adult male offspring rats. Wistar female rats were mated and assigned into two groups: one control drinking tap water (CM) and another drinking 5 % sucrose diluted in water (SM). Two offspring per mother were randomly allocated into two experimental groups at weaning. One had free access to simple water (CO) and the other to 5 % sucrose (SO) for 14 weeks. After treatment, levels of relative aquaporin-2 (AQP2), glomerulosclerosis index (GI), collecting tube area, perirenal fat, blood creatinine, and blood ureic nitrogen concentration (BUN) were determined. Two-way ANOVA followed by Bonferroni post-hoc test was used, considering P ≤ 0.05 as a significant statistical difference. Sucrose consumption during gestation/lactation and interaction increased AQP2 expression in the renal cortex and BUN concentration. In contrast, gestation/lactation consumption increased collecting tube area, post-weaning consumption favored perirenal fat, and finally, gestation/lactation, post-weaning, and the interaction caused glomerulosclerosis. Our results suggest that the consumption of sucrose water during gestation/lactation or post-weaning or combination triggers pathological changes in the kidneys of adult rats.
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Affiliation(s)
- Velázquez-Orozco Verónica
- Doctorado en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, Mexico; Licenciatura en Química Clínica, Facultad de Ciencias de la Salud, Universidad Autónoma de Tlaxcala, Mexico
| | - Nicolás-Toledo Leticia
- Centro Tlaxcala Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico
| | - Dávila-Santacruz Saret
- Doctorado en Ciencias Biológicas, Universidad Autónoma de Tlaxcala, Mexico; Centro Tlaxcala Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico
| | | | - Cuevas-Romero Estela
- Centro Tlaxcala Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico
| | - Martínez-Gómez Margarita
- Centro Tlaxcala Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico; Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Unidad Foránea Tlaxcala, Universidad Nacional Autónoma de México, Tlaxcala, Mexico
| | - Ortega-Soto Arturo
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Castelán Francisco
- Centro Tlaxcala Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico; Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Unidad Foránea Tlaxcala, Universidad Nacional Autónoma de México, Tlaxcala, Mexico
| | - Rodríguez-Antolín Jorge
- Centro Tlaxcala Biología de la Conducta, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico.
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Wang B, Xiong Y, Deng X, Wang Y, Gong S, Yang S, Yang B, Yang Y, Leng Y, Li W, Li W. The role of intercellular communication in diabetic nephropathy. Front Immunol 2024; 15:1423784. [PMID: 39238645 PMCID: PMC11374600 DOI: 10.3389/fimmu.2024.1423784] [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: 04/26/2024] [Accepted: 08/01/2024] [Indexed: 09/07/2024] Open
Abstract
Diabetic nephropathy, a common and severe complication of diabetes, is the leading cause of end-stage renal disease, ultimately leading to renal failure and significantly affecting the prognosis and lives of diabetics worldwide. However, the complexity of its developmental mechanisms makes treating diabetic nephropathy a challenging task, necessitating the search for improved therapeutic targets. Intercellular communication underlies the direct and indirect influence and interaction among various cells within a tissue. Recently, studies have shown that beyond traditional communication methods, tunnel nanotubes, exosomes, filopodial tip vesicles, and the fibrogenic niche can influence pathophysiological changes in diabetic nephropathy by disrupting intercellular communication. Therefore, this paper aims to review the varied roles of intercellular communication in diabetic nephropathy, focusing on recent advances in this area.
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Affiliation(s)
- Bihan Wang
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yonghong Xiong
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xinqi Deng
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yunhao Wang
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Siyuan Gong
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Songyuan Yang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Baichuan Yang
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuhang Yang
- The First Clinical College of Wuhan University, Wuhan, China
| | - Yan Leng
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wenyuan Li
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Li
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
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Yang T, Qi F, Guo F, Shao M, Song Y, Ren G, Linlin Z, Qin G, Zhao Y. An update on chronic complications of diabetes mellitus: from molecular mechanisms to therapeutic strategies with a focus on metabolic memory. Mol Med 2024; 30:71. [PMID: 38797859 PMCID: PMC11128119 DOI: 10.1186/s10020-024-00824-9] [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: 01/25/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Diabetes mellitus, a chronic metabolic disease, often leads to numerous chronic complications, significantly contributing to global morbidity and mortality rates. High glucose levels trigger epigenetic modifications linked to pathophysiological processes like inflammation, immunity, oxidative stress, mitochondrial dysfunction, senescence and various kinds of cell death. Despite glycemic control, transient hyperglycemia can persistently harm organs, tissues, and cells, a latent effect termed "metabolic memory" that contributes to chronic diabetic complications. Understanding metabolic memory's mechanisms could offer a new approach to mitigating these complications. However, key molecules and networks underlying metabolic memory remain incompletely understood. This review traces the history of metabolic memory research, highlights its key features, discusses recent molecules involved in its mechanisms, and summarizes confirmed and potential therapeutic compounds. Additionally, we outline in vitro and in vivo models of metabolic memory. We hope this work will inform future research on metabolic memory's regulatory mechanisms and facilitate the development of effective therapeutic compounds to prevent diabetic complications.
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Affiliation(s)
- Tongyue Yang
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Feng Qi
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Research Institute of Nephrology, Zhengzhou University, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People's Republic of China
| | - Feng Guo
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Mingwei Shao
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yi Song
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Gaofei Ren
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zhao Linlin
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Guijun Qin
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yanyan Zhao
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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Wang XX, Wang RJ, Ji HL, Liu XY, Zhang NY, Wang KM, Chen K, Liu PP, Meng N, Jiang CS. Design, synthesis, and evaluation of novel ferrostatin derivatives for the prevention of HG-induced VEC ferroptosis. RSC Med Chem 2024; 15:1198-1209. [PMID: 38665835 PMCID: PMC11042167 DOI: 10.1039/d4md00038b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/27/2024] [Indexed: 04/28/2024] Open
Abstract
Ferroptosis is a nonapoptotic, iron-catalyzed form of regulated cell death. It has been shown that high glucose (HG) could induce ferroptosis in vascular endothelial cells (VECs), consequently contributing to the development of various diseases. This study synthesized and evaluated a series of novel ferrostatin-1 (Fer-1) derivatives fused with a benzohydrazide moiety to prevent HG-induced VEC ferroptosis. Several promising compounds showed similar or improved inhibitory effects compared to positive control Fer-1. The most effective candidate 12 exhibited better protection against erastin-induced ferroptosis and high glucose-induced ferroptosis in VECs. Mechanistic studies revealed that compound 12 prevented mitochondrial damage, reduced intracellular ROS accumulation, upregulated the expression of GPX4, and decreased the amounts of ferrous ion, LPO and MDA in VECs. However, compound 12 still exhibited undesirable microsomal stability like Fer-1, suggesting the need for further optimization. Overall, the present findings highlight ferroptosis inhibitor 12 as a potential lead compound for treating ferroptosis-associated vascular diseases.
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Affiliation(s)
- Xin-Xin Wang
- School of Biological Science and Technology, University of Jinan Jinan 250022 China
| | - Run-Jie Wang
- Key Laboratory of Forest Plant Ecology, Ministry of Education, College of Chemistry, Chemical Engineering and Resource Utilization, Northeast Forestry University Harbin 150040 China
| | - Hua-Long Ji
- School of Biological Science and Technology, University of Jinan Jinan 250022 China
| | - Xiao-Yu Liu
- Evaluation Center of the New Drug, Shandong Academy of Pharmaceutical Sciences Jinan 250101 China
| | - Nai-Yu Zhang
- School of Biological Science and Technology, University of Jinan Jinan 250022 China
| | - Kai-Ming Wang
- School of Biological Science and Technology, University of Jinan Jinan 250022 China
| | - Kai Chen
- Evaluation Center of the New Drug, Shandong Academy of Pharmaceutical Sciences Jinan 250101 China
| | - Ping-Ping Liu
- Department of Gynaecology and Obstetrics, 960th Hospital of PLA Jinan 250000 China
| | - Ning Meng
- School of Biological Science and Technology, University of Jinan Jinan 250022 China
| | - Cheng-Shi Jiang
- School of Biological Science and Technology, University of Jinan Jinan 250022 China
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Di Leo V, Annese F, Papadia F, Russo MS, Giliberti M, Sallustio F, Gesualdo L. Refractory IgA Nephropathy: A Challenge for Future Nephrologists. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:274. [PMID: 38399561 PMCID: PMC10890070 DOI: 10.3390/medicina60020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
IgA nephropathy (IgAN) represents the most prevalent form of primary glomerulonephritis, and, on a global scale, it ranks among the leading culprits behind end-stage kidney disease (ESKD). Presently, the primary strategy for managing IgAN revolves around optimizing blood pressure and mitigating proteinuria. This is achieved through the utilization of renin-angiotensin system (RAS) inhibitors, namely, angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs). As outlined by the KDIGO guidelines, individuals who continue to show a persistent high risk of progressive ESKD, even with comprehensive supportive care, are candidates for glucocorticoid therapy. Despite these therapies, some patients have a disease refractory to treatment, defined as individuals that present a 24 h urinary protein persistently >1 g after at least two rounds of regular steroids (methylprednisolone or prednisone) and/or immunosuppressant therapy (e.g., mycophenolate mofetil), or who do not tolerate regular steroids and/or immunosuppressant therapy. The aim of this Systematic Review is to revise the current literature, using the biomedical database PubMed, to investigate possible therapeutic strategies, including SGLT2 inhibitors, endothelin receptor blockers, targeted-release budesonide, B cell proliferation and differentiation inhibitors, fecal microbiota transplantation, as well as blockade of complement components.
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Chen X, Dai W, Li H, Yan Z, Liu Z, He L. Targeted drug delivery strategy: a bridge to the therapy of diabetic kidney disease. Drug Deliv 2023; 30:2160518. [PMID: 36576203 PMCID: PMC9809356 DOI: 10.1080/10717544.2022.2160518] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Diabetic kidney disease (DKD) is the main complication in diabetes mellitus (DM) and the main cause of end-stage kidney disease worldwide. However, sodium glucose cotransporter 2 (SGLT2) inhibition, glucagon-like peptide-1 (GLP-1) receptor agonist, mineralocorticoid receptor antagonists and endothelin receptor A inhibition have yielded promising effects in DKD, a great part of patients inevitably continue to progress to uremia. Newly effective therapeutic options are urgently needed to postpone DKD progression. Recently, accumulating evidence suggests that targeted drug delivery strategies, such as macromolecular carriers, nanoparticles, liposomes and so on, can enhance the drug efficacy and reduce the undesired side effects, which will be a milestone treatment in the management of DKD. The aim of this article is to summarize the current knowledge of targeted drug delivery strategies and select the optimal renal targeting strategy to provide new therapies for DKD.
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Affiliation(s)
- Xian Chen
- Department of Nephrology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Wenni Dai
- Department of Nephrology, Hunan Key Lab of Kidney Disease and Blood Purification, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Hao Li
- Department of Nephrology, Hunan Key Lab of Kidney Disease and Blood Purification, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Zhe Yan
- Department of Nephrology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Zhiwen Liu
- Department of Nephrology, Hunan Key Lab of Kidney Disease and Blood Purification, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Liyu He
- Department of Nephrology, Hunan Key Lab of Kidney Disease and Blood Purification, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China,CONTACT Liyu He Department of Nephrology, Hunan Key Lab of Kidney Disease and Blood Purification, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, Hunan410011, People’s Republic of China
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Kim TM, Lee KW, Kim HD, Hong SO, Cho HJ, Yang JH, Kim SJ, Park JB. Evaluation of Selected Markers in Kidneys of Cynomolgus Monkey ( Macaca fascicularis) with Induced Diabetes during Renal Ischemia-reperfusion Injury. Comp Med 2023; 73:357-372. [PMID: 38087409 PMCID: PMC10702167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/26/2023] [Accepted: 05/04/2023] [Indexed: 12/18/2023]
Abstract
We previously reported that induced type 1 diabetes mellitus (DM) increases the susceptibility of acute kidney injury in- duced by ischemia-reperfusion injury (IRI) in cynomolgus monkeys. In this follow-up study, we compared the expression of selected markers in the renal tissues of monkeys subjected to bilateral renal IRI with and without diabetes. All tissues were obtained from the original study. Renal biopsies were obtained before and 24 and 48 h after ischemia and were examined for expression of KI-67 (tubular proliferation), Na+ /K+ ATPase (sodium-potassium pump), TNF-α(tumor necrosis factor-α, inflammation), CD31 (microvessels), CD3 (T-cells), 2 fibrotic markers (fibroblast specific protein-1, FSP-1;α-smooth muscle actin,α -SMA), and cleaved caspase 3 (apoptosis). Generally, the expression of these markers differed in monkeys with and without DM. As compared with non-DM monkeys, DM monkeys had more cells that expressed KI-67 during progression of acute kidney injury (AKI). Na+ /K+ ATPase expression was clearly present at baseline in the basolateral tubular areas only in the non-DM monkeys. At 48 h, its expression in the basolateral area was not visible in DM monkeys, but was still present in intercellular junctions of non-DM monkeys. The expression of TNF-αwas higher in DM before and 48 h after ischemia. Before and 24 h after ischemia, the number of CD31-positive capillaries was not different between 2 groups, although more collapsed vessels were found at in DM at 24 h. At 48 h, the number of capillaries was less in DM compared with those from non-DM animals. DM monkeys had more interstitial CD3-positive cells than did non-DM monkeys at 24 and 48 h after ischemia. Finally, FSP-1-stained cells were more abundant in DM than non-DM at 24 and 48 h. Our results show that DM aggravates the recovery of renal ischemia/reperfusion injury by affecting tubular proliferation, capillary density, T cell infil- tration and by altering protein and mRNA expression of various genes involved in ion channel, inflammation, and fibrotic change. The results from this observational study demonstrate that DM aggravates the recovery of renal ischemia/reperfusion injury by affecting multiple events including tubular necrosis, proliferation, function, inflammation and by inducing capillary rarefaction in cynomolgus monkeys.
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Affiliation(s)
- Tae M Kim
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang, Gangwon-do 25354, South Korea
- Institutes of Green-Bio Science and Technology, Seoul National University, Pyeongchang, Gangwon-do 25354, South Korea
| | - Kyo W Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea
| | - Hong D Kim
- Institutes of Green-Bio Science and Technology, Seoul National University, Pyeongchang, Gangwon-do 25354, South Korea
| | - Sung O Hong
- Institutes of Green-Bio Science and Technology, Seoul National University, Pyeongchang, Gangwon-do 25354, South Korea
| | - Hye J Cho
- Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang, Gangwon-do 25354, South Korea
| | - Je H Yang
- Laboratory Animal Research Center, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea
| | - Sung J Kim
- GenNBio Inc., 80 Deurimsandan 2-ro, Cheongbuk-myeon, Pyeongtaek-si, Gyeonggi-do 17796, South Korea
| | - Jae B Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea
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Gong D, Chen X, Yang L, Zhang Y, Zhong Q, Liu J, Yan C, Cai Y, Yang W, Wang J. From normal population to prediabetes and diabetes: study of influencing factors and prediction models. Front Endocrinol (Lausanne) 2023; 14:1225696. [PMID: 37964953 PMCID: PMC10640999 DOI: 10.3389/fendo.2023.1225696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/29/2023] [Indexed: 11/09/2023] Open
Abstract
Objective The purpose of this study is to investigate the independent influencing factors of the transition from normal population to prediabetes, and from prediabetes to diabetes, and to further construct clinical prediction models to provide a basis for the prevention and management of prediabetes and diabetes. Materials and methods The data for this study were based on clinical information of participants from the Health Management Center of Peking University Shenzhen Hospital. Participants were classified into normal group, prediabetes group, and diabetes group according to their functional status of glucose metabolism. Spearman's correlation coefficients were calculated for the variables, and a matrix diagram was plotted. Further, univariate and multivariate logistic regression analysis were conducted to explore the independent influencing factors. The independent influencing factors were used as predictors to construct the full-variable prediction model (Full.model) and simplified prediction model (Simplified.model). Results This study included a total of 5310 subjects and 22 variables, among which there were 1593(30%) in the normal group, 3150(59.3%) in the prediabetes group, and 567(10.7%) in the diabetes group. The results of the multivariable logistic regression analysis showed that there were significant differences in 9 variables between the normal group and the prediabetes group, including age(Age), body mass index(BMI), systolic blood pressure(SBP), urinary glucose(U.GLU), urinary protein(PRO), total protein(TP), globulin(GLB), alanine aminotransferase(ALT), and high-density lipoprotein cholesterol(HDL-C). There were significant differences in 7 variables between the prediabetes group and the diabetes group, including Age, BMI, SBP, U.GLU, PRO, triglycerides(TG), and HDL.C. The Full.model and Simplified.model constructed based on the above influencing factors had moderate discriminative power in both the training set and the test set. Conclusion Age, BMI, SBP, U.GLU, PRO, TP, and ALT are independent risk factors, while GLB and HDL.C are independent protective factors for the development of prediabetes in the normal population. Age, BMI, SBP, U.GLU, PRO, and TG are independent risk factors, while HDL.C is an independent protective factor for the progression from prediabetes to diabetes. The Full.model and Simplified.model developed based on these influencing factors have moderate discriminative power.
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Affiliation(s)
- Di Gong
- Shenzhen Eye Hospital, Jinan University, Shenzhen, Guangdong, China
- The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, Guangdong, China
| | - Xiaohong Chen
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lin Yang
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Yongjian Zhang
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Qianqian Zhong
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Jing Liu
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Chen Yan
- Shenzhen Eye Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Yongjiang Cai
- Center of Health Management, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Weihua Yang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Finch NC, Neal CR, Welsh GI, Foster RR, Satchell SC. The unique structural and functional characteristics of glomerular endothelial cell fenestrations and their potential as a therapeutic target in kidney disease. Am J Physiol Renal Physiol 2023; 325:F465-F478. [PMID: 37471420 PMCID: PMC10639027 DOI: 10.1152/ajprenal.00036.2023] [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: 02/21/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023] Open
Abstract
Glomerular endothelial cell (GEnC) fenestrations are a critical component of the glomerular filtration barrier. Their unique nondiaphragmed structure is key to their function in glomerular hydraulic permeability, and their aberration in disease can contribute to loss of glomerular filtration function. This review provides a comprehensive update of current understanding of the regulation and biogenesis of fenestrae. We consider diseases in which GEnC fenestration loss is recognized or may play a role and discuss methods with potential to facilitate the study of these critical structures. Literature is drawn from GEnCs as well as other fenestrated cell types such as liver sinusoidal endothelial cells that most closely parallel GEnCs.
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Affiliation(s)
- Natalie C Finch
- Bristol Renal, University of Bristol, United Kingdom
- Langford Vets, University of Bristol, United Kingdom
| | - Chris R Neal
- Bristol Renal, University of Bristol, United Kingdom
| | - Gavin I Welsh
- Bristol Renal, University of Bristol, United Kingdom
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11
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Gomchok D, Ge RL, Wuren T. Platelets in Renal Disease. Int J Mol Sci 2023; 24:14724. [PMID: 37834171 PMCID: PMC10572297 DOI: 10.3390/ijms241914724] [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: 08/31/2023] [Revised: 09/18/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Kidney disease is a major global health concern, affecting millions of people. Nephrologists have shown interest in platelets because of coagulation disorders caused by renal diseases. With a better understanding of platelets, it has been found that these anucleate and abundant blood cells not only play a role in hemostasis, but also have important functions in inflammation and immunity. Platelets are not only affected by kidney disease, but may also contribute to kidney disease progression by mediating inflammation and immune effects. This review summarizes the current evidence regarding platelet abnormalities in renal disease, and the multiple effects of platelets on kidney disease progression. The relationship between platelets and kidney disease is still being explored, and further research can provide mechanistic insights into the relationship between thrombosis, bleeding, and inflammation related to kidney disease, and elucidate targeted therapies for patients with kidney disease.
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Affiliation(s)
- Drolma Gomchok
- Research Center for High Altitude Medicine, School of Medicine, Qinghai University, Xining 810001, China; (D.G.); (R.-L.G.)
| | - Ri-Li Ge
- Research Center for High Altitude Medicine, School of Medicine, Qinghai University, Xining 810001, China; (D.G.); (R.-L.G.)
- Key Laboratory for Application for High Altitude Medicine, Qinghai University, Xining 810001, China
| | - Tana Wuren
- Research Center for High Altitude Medicine, School of Medicine, Qinghai University, Xining 810001, China; (D.G.); (R.-L.G.)
- Key Laboratory for Application for High Altitude Medicine, Qinghai University, Xining 810001, China
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12
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Naaman SC, Bakris GL. Diabetic Nephropathy: Update on Pillars of Therapy Slowing Progression. Diabetes Care 2023; 46:1574-1586. [PMID: 37625003 PMCID: PMC10547606 DOI: 10.2337/dci23-0030] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/16/2023] [Indexed: 08/27/2023]
Abstract
Management of diabetic kidney disease (DKD) has evolved in parallel with our growing understanding of the multiple interrelated pathophysiological mechanisms that involve hemodynamic, metabolic, and inflammatory pathways. These pathways and others play a vital role in the initiation and progression of DKD. Since its initial discovery, the blockade of the renin-angiotensin system has remained a cornerstone of DKD management, leaving a large component of residual risk to be dealt with. The advent of sodium-glucose cotransporter 2 inhibitors followed by nonsteroidal mineralocorticoid receptor antagonists and, to some extent, glucagon-like peptide 1 receptor agonists (GLP-1 RAs) has ushered in a resounding paradigm shift that supports a pillared approach in maximizing treatment to reduce outcomes. This pillared approach is like that derived from the approach to heart failure treatment. The approach mandates that all agents that have been shown in clinical trials to reduce cardiovascular outcomes and/or mortality to a greater extent than a single drug class alone should be used in combination. In this way, each drug class focuses on a specific aspect of the disease's pathophysiology. Thus, in heart failure, β-blockers, sacubitril/valsartan, a mineralocorticoid receptor antagonist, and a diuretic are used together. In this article, we review the evolution of the pillar concept of therapy as it applies to DKD and discuss how it should be used based on the outcome evidence. We also discuss the exciting possibility that GLP-1 RAs may be an additional pillar in the quest to further slow kidney disease progression in diabetes.
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Affiliation(s)
- Sandra C. Naaman
- Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, and American Heart Association Comprehensive Hypertension Center, University of Chicago Medicine, Chicago, IL
| | - George L. Bakris
- Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, and American Heart Association Comprehensive Hypertension Center, University of Chicago Medicine, Chicago, IL
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13
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Hammad N, Hassanein M, Rahman M. Diabetic Kidney Care Redefined with a New Way into Remission. Endocrinol Metab Clin North Am 2023; 52:101-118. [PMID: 36754487 DOI: 10.1016/j.ecl.2022.08.002] [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] [Indexed: 12/12/2022]
Abstract
Diabetic kidney disease has been a leading cause for end-stage kidney disease. Traditional methods to slow progression include tight glycemic control, blood pressure control, and use of renin-angiotensin axis inhibitors. Finerenone and sodium glucose co-transporters have shown proven benefit in diabetic kidney disease regression recently. Other potential targets for slowing the decline in diabetic kidney disease are transforming growth factor beta, endothelin antagonist, protein kinase C inhibitors, advanced glycation end product inhibition, Janus kinase-signal transducer and activator of transcription pathway inhibition, phosphodiesterase 3 or 5 inhibitors, and Rho kinase inhibitor. These targets are at various trial phases and so far, show promising results.
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Affiliation(s)
- Nour Hammad
- Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA. https://twitter.com/nourhammad92
| | - Mohamed Hassanein
- Division of Nephrology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. https://twitter.com/kidneymo
| | - Mahboob Rahman
- Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA; Louis Stokes Cleveland VA Medical Center, 10701 East Boulevard, Cleveland, OH 44106, USA; Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
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14
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Zhang L, Jin G, Zhang W, Wang X, Li Z, Dong Q. Silencing circ_0080425 alleviates high-glucose-induced endothelial cell dysfunction in diabetic nephropathy by targeting miR-140-3p/FN1 axis. Clin Exp Nephrol 2023; 27:12-23. [PMID: 36083527 DOI: 10.1007/s10157-022-02273-2] [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: 06/23/2022] [Accepted: 08/25/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hsa_circ_0080425 (circ_0080425) is newly identified to correlate with the progression of diabetic nephropathy (DN). However, its role and mechanism in DN process is not very clear. METHODS Cell counting kit-8 assay, flow cytometry, scratch wound assay, and western blotting were performed to measure endothelial cell dysfunction. Expression of circ_0080425, microRNA (miR)-140-3p and fibronectin 1 (FN1) were determined by quantitative real-time PCR and western blotting. The direct interaction was confirmed by dual-luciferase reporter assay. RESULTS High-glucose (HG) treatment could induce inhibition of cell proliferation, cell cycle entrance and wound healing rate in human umbilical vein endothelial cells (HRGEC), and enhancement of apoptosis rate. Circ_0080425 expression was upregulated by HG, and exhausting circ_0080425 could attenuate HG-induced above effects in HRGEC. MiR-140-3p was sponged by circ_0080425, and its inhibitor reversed the regulation of circ_0080425 knockdown on HG-induced HRGEC injury. FN1 was targeted by miR-140-3p, and its overexpression also restored the inhibitory effect of miR-140-3p on HC-induced HRGEC injury. CONCLUSION Circ_0080425 expression might contribute to HG-induced endothelial cell injury, and circ_0080425/miR-140-3p/FN1 axis was a potential therapeutic approach to interfere DN process.
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Affiliation(s)
- Linping Zhang
- Kidney Disease and Dialysis Center, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Beilin District, Xi'an, 710068, Shaanxi, China
| | - Gang Jin
- Kidney Disease and Dialysis Center, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Beilin District, Xi'an, 710068, Shaanxi, China
| | - Wei Zhang
- Kidney Disease and Dialysis Center, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Beilin District, Xi'an, 710068, Shaanxi, China
| | - Xiaoming Wang
- Kidney Disease and Dialysis Center, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Beilin District, Xi'an, 710068, Shaanxi, China
| | - Zhenjiang Li
- Kidney Disease and Dialysis Center, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Beilin District, Xi'an, 710068, Shaanxi, China
| | - Qianlan Dong
- Kidney Disease and Dialysis Center, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Beilin District, Xi'an, 710068, Shaanxi, China.
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15
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Zhang X, Zhang Y, Hu Y. Knowledge domain and emerging trends in empagliflozin for heart failure: A bibliometric and visualized analysis. Front Cardiovasc Med 2022; 9:1039348. [DOI: 10.3389/fcvm.2022.1039348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
ObjectiveEmpagliflozin (EMPA), a sodium-glucose cotransporter 2 inhibitor (SGLT2i), is recommended for all patients with Heart failure (HF) to reduce the risk of Cardiovascular death, hospitalization, and HF exacerbation. Qualitative and quantitative evaluation was conducted by searching relevant literatures of EMPA for Heart Failure from 2013 to 2022, and visual analysis in this field was conducted.MethodsThe data were from the Web of Science Core Collection database (WOSCC). The bibliometric tools, CiteSpace and VOSviewer, were used for econometric analysis to probe the evolvement of disciplines and research hotspots in the field of EMPA for Heart Failure.ResultsA total of 1461 literatures with 43861 references about EMPA for Heart Failure in the decade were extracted from WOSCC, and the number of manuscripts were on a rise. In the terms of co-authorship, USA leads the field in research maturity and exerts a crucial role in the field of EMPA for Heart Failure. Multidisciplinary research is conducive to future development. With regards to literatures, we obtained 9 hot paper, 93 highly cited literatures, and 10 co-cited references. The current research focuses on the following three aspects: EMPA improves left ventricular remodeling, exert renal protection, and increases heart rate variability.ConclusionBased on methods such as bibliometrics, citation analysis and knowledge graph, this study analyzed the current situation and trend of EMPA for Heart Failure, sorted out the knowledge context in this field, and provided reference for current and future prevention and scientific research.
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16
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Pastukhova Y, Luzza F, Shevel S, Savchuk O, Ostapchenko L, Falalyeyeva T, Molochek N, Kuryk O, Korotkyi O, Kobyliak N. Changes in Metabolic Parameters in Patients with Diabetic Kidney Disease Depending on the Status of D3. Rev Recent Clin Trials 2022; 17:280-290. [PMID: 35319388 DOI: 10.2174/1574887117666220321152855] [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: 11/05/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Type 2 diabetes is a metabolic disease characterized by hyperglycemia as a result of insulin resistance and decreased insulin secretion. A relatively large number of patients with this type of diabetes have abdominal obesity, which also affects insulin resistance development. Chronic hyperglycemia can lead to damage and dysfunction of various organs, and a striking example is diabetic nephropathy. Diabetic nephropathy is a specific kind of kidney damage that occurs due to complications of diabetes and is accompanied by the formation of diffuse or nodular glomerulosclerosis, which can lead to terminal renal failure and requires immediate substitution through renal therapy or renal transplantation. Diabetic nephropathy is diagnosed with albuminuria and a decrease in the rate of glomerular filtration. METHODS This review was based on a literature search for the most important evidence of vitamin D as a possible method of prevention for obesity, type 2 diabetes, and diabetic nephropathy. Collected published articles were summarized according to their overall themes. RESULTS In this review, we considered vitamin D as a possible method of treatment for type 2 diabetes, as well as its complications, including diabetic nephropathy. CONCLUSION Studies show that vitamin D inhibits the renin-angiotensin-aldosterone system, resulting in improved renal function in diabetic nephropathy. Vitamin D also has antiinflammatory, antiproliferative, and anti-metastatic effects, which improve endothelial function.
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Affiliation(s)
| | | | | | | | | | | | | | - Olena Kuryk
- Bogomolets National Medical University, Kyiv, Ukraine
| | | | - Nazarii Kobyliak
- Bogomolets National Medical University, Kyiv, Ukraine.,Medical Laboratory CSD, Kyiv, Ukraine
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17
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Hofherr A, Williams J, Gan LM, Söderberg M, Hansen PBL, Woollard KJ. Targeting inflammation for the treatment of Diabetic Kidney Disease: a five-compartment mechanistic model. BMC Nephrol 2022; 23:208. [PMID: 35698028 PMCID: PMC9190142 DOI: 10.1186/s12882-022-02794-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 04/20/2022] [Indexed: 12/25/2022] Open
Abstract
Diabetic kidney disease (DKD) is the leading cause of kidney failure worldwide. Mortality and morbidity associated with DKD are increasing with the global prevalence of type 2 diabetes. Chronic, sub-clinical, non-resolving inflammation contributes to the pathophysiology of renal and cardiovascular disease associated with diabetes. Inflammatory biomarkers correlate with poor renal outcomes and mortality in patients with DKD. Targeting chronic inflammation may therefore offer a route to novel therapeutics for DKD. However, the DKD patient population is highly heterogeneous, with varying etiology, presentation and disease progression. This heterogeneity is a challenge for clinical trials of novel anti-inflammatory therapies. Here, we present a conceptual model of how chronic inflammation affects kidney function in five compartments: immune cell recruitment and activation; filtration; resorption and secretion; extracellular matrix regulation; and perfusion. We believe that the rigorous alignment of pathophysiological insights, appropriate animal models and pathology-specific biomarkers may facilitate a mechanism-based shift from recruiting ‘all comers’ with DKD to stratification of patients based on the principal compartments of inflammatory disease activity.
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Affiliation(s)
- Alexis Hofherr
- Research and Early Clinical Development, Cardiovascular, Renal and Metabolism, AstraZeneca, BioPharmaceuticals R&D, Gothenburg, Sweden. .,Renal Division, Department of Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Julie Williams
- Bioscience Renal, Research and Early Development, Cardiovascular, Renal and Metabolic, AstraZeneca, BioPharmaceuticals R&D, Gothenburg, UK
| | - Li-Ming Gan
- Research and Early Clinical Development, Cardiovascular, Renal and Metabolism, AstraZeneca, BioPharmaceuticals R&D, Gothenburg, Sweden.,Department of Molecular and Clinical Medicine, Department of Cardiology, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Magnus Söderberg
- Cardiovascular, Renal and Metabolic Safety, Clinical Pharmacology and Safety Sciences, AstraZeneca, BioPharmaceuticals R&D, Gothenburg, Sweden
| | - Pernille B L Hansen
- Bioscience Renal, Research and Early Development, Cardiovascular, Renal and Metabolic, AstraZeneca, BioPharmaceuticals R&D, Gothenburg, UK.,Wallenberg Center for Molecular and Translational Medicine, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kevin J Woollard
- Bioscience Renal, Research and Early Development, Cardiovascular, Renal and Metabolic, AstraZeneca, BioPharmaceuticals R&D, Gothenburg, UK. .,Centre for Inflammatory Disease, Imperial College London, London, UK.
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18
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Hu M, Ma Q, Liu B, Wang Q, Zhang T, Huang T, Lv Z. Long Non-Coding RNAs in the Pathogenesis of Diabetic Kidney Disease. Front Cell Dev Biol 2022; 10:845371. [PMID: 35517509 PMCID: PMC9065414 DOI: 10.3389/fcell.2022.845371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/08/2022] [Indexed: 01/09/2023] Open
Abstract
Diabetic kidney disease (DKD) is one of the major microvascular complications of diabetes mellitus, with relatively high morbidity and mortality globally but still in short therapeutic options. Over the decades, a large body of data has demonstrated that oxidative stress, inflammatory responses, and hemodynamic disorders might exert critical influence in the initiation and development of DKD, whereas the delicate pathogenesis of DKD remains profoundly elusive. Recently, long non-coding RNAs (lncRNAs), extensively studied in the field of cancer, are attracting increasing attentions on the development of diabetes mellitus and its complications including DKD, diabetic retinopathy, and diabetic cardiomyopathy. In this review, we chiefly focused on abnormal expression and function of lncRNAs in major resident cells (mesangial cell, endothelial cell, podocyte, and tubular epithelial cell) in the kidney, summarized the critical roles of lncRNAs in the pathogenesis of DKD, and elaborated their potential therapeutic significance, in order to advance our knowledge in this field, which might help in future research and clinical treatment for the disease.
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Affiliation(s)
- Mengsi Hu
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Nephrology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qiqi Ma
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Bing Liu
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Nephrology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qianhui Wang
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Tingwei Zhang
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Tongtong Huang
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zhimei Lv
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Nephrology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Zhimei Lv,
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19
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Li B, Li H, Dai L, Liu C, Wang L, Li Q, Gu C. NIK-SIX1 signalling axis regulates high glucose-induced endothelial cell dysfunction and inflammation. Autoimmunity 2022; 55:86-94. [PMID: 34894925 DOI: 10.1080/08916934.2021.2015579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/05/2021] [Accepted: 12/04/2021] [Indexed: 12/12/2022]
Abstract
Endothelial dysfunction and inflammation are the main manifestations of diabetes-associated atherosclerosis. This paper studied the roles of NF-κB-inducing kinase (NIK) and sine oculis homeobox homolog 1 (SIX1) in regulating high glucose-induced endothelial dysfunction and inflammation. The expression of NIK and SIX1 in human umbilical vein endothelial cells (HUVECs) was silenced by transfection with the specific shRNAs. HUVECs exposed to high glucose were considered as a cell model of endothelial dysfunction. Expression of NIK and SIX1 following transfection was measured by qRT-PCR and western blotting analysis. The proliferation, migration, and inflammation of HUVECs were evaluated by EdU staining, scratch test, ELISA, and western blotting. High glucose (30 mM) significantly decreased the proliferation and migration of HUVECs. High glucose-induced the expression of adhesion molecules VCAM-1 and ICAM-1. Moreover, high glucose increased the release of IL-1β, IL-6, TNF-α, and MCP-1. Transfection of cells with NIK shRNA significantly reversed the toxic effects of high glucose on HUVECs. Of contrast, SIX1 shRNA accelerated the effects of high glucose on HUVECs. NIK shRNA inhibited the accumulation of RelA, RelB, and p52. Meanwhile, NIK shRNA led to SIX1 downregulation which further induced the activation of the NF-κB pathway. NIK-SIX1 signalling axis was suggested to be critical in the regulation of high glucose-induced endothelial dysfunction and inflammation. SIX1 may function as an immunological gatekeeper to control the excessive inflammation mediated by NIK in diabetes-associated atherosclerosis.
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Affiliation(s)
- Bo Li
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Haiming Li
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Longsheng Dai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Changcheng Liu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Liangshan Wang
- Department of Cardiac Surgery Intensive Care Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qin Li
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Chengxiong Gu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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20
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Wang T, Li C, Shi M, Zhou S, Chen J, Wang F. Circular RNA circZNF532 facilitates angiogenesis and inflammation in diabetic retinopathy via regulating miR-1243/CARM1 axis. Diabetol Metab Syndr 2022; 14:14. [PMID: 35063035 PMCID: PMC8780307 DOI: 10.1186/s13098-022-00787-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/06/2022] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is a serious complication of diabetes. Numerous reports have validated that circular RNAs (circRNAs) participate in DR progression. This study aimed to elucidate the role and potential mechanism of circRNA zinc finger protein 532 (circZNF532) in DR. METHODS The levels of circZNF532, miR-1243, and coactivator associated arginine methyltransferase 1 (CARM1) in DR patients and human retinal microvascular endothelial cells (hRMECs) were determined by quantitative real-time PCR and western blot. Colony formation assay, transwell assay, tube formation assay and enzyme-linked immunosorbent assay were used to assess the biological function of hRMECs. The binding relationship between miR-1243 and circZNF532/CARM1 was verified by dual-luciferase reporter and RNA immunoprecipitation assays. RESULTS circZNF532 and CARM1 levels were increased, while miR-1243 level was reduced in DR patients and high glucose (HG)-stimulated hRMECs. In terms of mechanism, miR-1243 competitively bound to circZNF532 and CARM1. Down-regulation of circZNF532 restrained HG-induced hRMECs proliferation, migration, invasion, angiogenesis and inflammation via regulating miR-1243. In addition, miR-1243 inhibited HG-triggered hRMECs progression via targeting CARM1. CONCLUSION circZNF532 facilitated HG-induced angiogenesis and inflammation in hRMECs via modulating the miR-1243/CARM1 pathway, suggesting that circZNF532 might be a potential biomarker for DR treatment.
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Affiliation(s)
- Ting Wang
- Department of Ophthalmology, The Affiliated Huaian No.1 People's Hospital, Nanjing Medical University, Huai'an, 223300, China
| | - Chaopeng Li
- Department of Ophthalmology, The Affiliated Huaian No.1 People's Hospital, Nanjing Medical University, Huai'an, 223300, China
| | - Min Shi
- Department of Endocrinology, The Affiliated Huaian No.1 People's Hospital, Nanjing Medical University, Huai'an, 223300, China
| | - Shi Zhou
- Department of Ophthalmology, The Affiliated Huaian No.1 People's Hospital, Nanjing Medical University, Huai'an, 223300, China
| | - Jiajing Chen
- Department of Ophthalmology, The Affiliated Huaian No.1 People's Hospital, Nanjing Medical University, Huai'an, 223300, China
| | - Fang Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, 301 Yan'an Zhong Lu, Jing'an District, Shanghai, 200071, China.
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21
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Jiang L, Zhou J, Zhang L, Du Y, Jiang M, Xie L, Ma Z, Chen F. The association between serum interleukin-1 beta and heparin sulphate in diabetic nephropathy patients. Glycoconj J 2022; 38:697-707. [PMID: 34997893 PMCID: PMC8821487 DOI: 10.1007/s10719-021-10035-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/02/2021] [Accepted: 12/17/2021] [Indexed: 12/15/2022]
Abstract
Inflammation is considered an important mechanism in the development of diabetes mellitus (DM) and persists for a long time before the occurrence of diabetic nephropathy (DN). Many studies have demonstrated that a decrease in the endothelial glycocalyx (EG) is negatively correlated with proteinuria. To elucidate whether EG damage induced by inflammasomes in DM patients leads to the occurrence of microalbuminuria (MA) and accelerates the progression of DN, this study screened 300 diagnosed DM patients. Finally, 70 type 2 diabetes patients were invited to participate in this study and were divided into two groups: the T2DM group (patients with normal MA and without diabetic retinopathy, n = 35) and the T2DN group (patients with increased MA and diabetic retinopathy, n = 35). Circulating heparin sulphate (HS, EG biomarkers) and interleukin-1 beta (IL-1β, inflammasome biomarkers) of the patients were measured by ELISA. Laboratory data were measured using routine laboratory methods. Patients in the T2DN group had increased serum HS, increased IL-1β, increased CRP, decreased haemoglobin, and increased neutrophils compared to patients in the T2DM group (all P < 0.05). Increased HS and decreased haemoglobin were independently associated with T2DN patients. ROC curves showed that the AUC of HS for the prediction of T2DN was 0.67 (P < 0.05). The combination of HS and haemoglobin yielded a significant increasement in the AUC (0.75, P < 0.001) with optimal sensitivity (71.2%) and specificity (79%). Furthermore, serum IL-1β was positively correlated with HS and was an independent associated factor of HS in the T2DN group. The relationship between HS and IL-1β was not significant in the T2DM group. Our findings surgessed the inflammasome may be associated with and promote damage to the EG during the disease course of DN that manifests as increased MA.
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Affiliation(s)
- Liqiong Jiang
- Department of Nephrology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
| | - Jianying Zhou
- Department of Endocrinology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Li Zhang
- Clinical Lab, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Yufeng Du
- Department of Nephrology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Mingming Jiang
- Department of Nephrology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Liqian Xie
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhenni Ma
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fengling Chen
- Department of Hemodialysis Center, the First Affiliated Hospital of Soochow University, Suzhou, China.
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22
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Wen L, Li Y, Li S, Hu X, Wei Q, Dong Z. Glucose Metabolism in Acute Kidney Injury and Kidney Repair. Front Med (Lausanne) 2021; 8:744122. [PMID: 34912819 PMCID: PMC8666949 DOI: 10.3389/fmed.2021.744122] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/19/2021] [Indexed: 12/13/2022] Open
Abstract
The kidneys play an indispensable role in glucose homeostasis via glucose reabsorption, production, and utilization. Conversely, aberrant glucose metabolism is involved in the onset, progression, and prognosis of kidney diseases, including acute kidney injury (AKI). In this review, we describe the regulation of glucose homeostasis and related molecular factors in kidneys under normal physiological conditions. Furthermore, we summarize recent investigations about the relationship between glucose metabolism and different types of AKI. We also analyze the involvement of glucose metabolism in kidney repair after injury, including renal fibrosis. Further research on glucose metabolism in kidney injury and repair may lead to the identification of novel therapeutic targets for the prevention and treatment of kidney diseases.
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Affiliation(s)
- Lu Wen
- Hunan Key Laboratory of Kidney Disease and Blood Purification, Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, GA, United States.,Research Department, Charlie Norwood VA Medical Center, Augusta, GA, United States
| | - Ying Li
- Hunan Key Laboratory of Kidney Disease and Blood Purification, Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Siyao Li
- Hunan Key Laboratory of Kidney Disease and Blood Purification, Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, GA, United States.,Research Department, Charlie Norwood VA Medical Center, Augusta, GA, United States
| | - Xiaoru Hu
- Hunan Key Laboratory of Kidney Disease and Blood Purification, Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, GA, United States.,Research Department, Charlie Norwood VA Medical Center, Augusta, GA, United States
| | - Qingqing Wei
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, GA, United States.,Research Department, Charlie Norwood VA Medical Center, Augusta, GA, United States
| | - Zheng Dong
- Hunan Key Laboratory of Kidney Disease and Blood Purification, Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, GA, United States.,Research Department, Charlie Norwood VA Medical Center, Augusta, GA, United States
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23
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Chen X, Chen J, Li X, Yu Z. Activation of mTOR mediates hyperglycemia-induced renal glomerular endothelial hyperpermeability via the RhoA/ROCK/pMLC signaling pathway. Diabetol Metab Syndr 2021; 13:105. [PMID: 34627341 PMCID: PMC8501565 DOI: 10.1186/s13098-021-00723-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Hyperglycemia is associated with albuminuria and renal glomerular endothelial dysfunction in patients with diabetic nephropathy. The mTOR and RhoA/ROCK signaling pathways are involved in glomerular filtration barrier (GFB) regulation, but their role in high glucose (HG)-induced GFB dysfunction in human renal glomerular endothelial cells (HRGECs) has not been investigated. This study aimed to investigate the mechanisms of HG-induced GFB dysfunction in vitro. MATERIALS AND METHODS HRGECs were cultured in vitro and exposed to HG. The horseradish peroxidase-albumin leakage and transendothelial electrical resistance of the endothelial monolayer were measured after HG treatment with or without rapamycin preincubation. A fluorescence probe was used to study the distribution of F-actin reorganization. The phosphorylation levels of myosin light chain (MLC) and mTOR were measured via western blotting. RhoA activity was evaluated via GTPase activation assay. The effects of blocking mTOR or the RhoA/ROCK pathway on endothelial permeability and MLC phosphorylation under HG conditions were observed. RESULTS HG exposure induced F-actin reorganization and increased MLC phosphorylation, leading to EC barrier disruption. This effect was attenuated by treatment with rapamycin or Y-27632. Phospho-MLC (pMLC) activation in HRGECs was mediated by RhoA/ROCK signaling. mTOR and RhoA/ROCK inhibition or knockdown attenuated pMLC activation, F-actin reorganization and barrier disruption that occurred in response to HG exposure. CONCLUSIONS Our results revealed that HG stimulation upregulated RhoA expression and activity through an mTOR-dependent pathway, leading to MLC-mediated endothelial cell cytoskeleton rearrangement and glomerular endothelial barrier dysfunction.
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Affiliation(s)
- Xiaolin Chen
- Department of Clinical Laboratory, Pingxiang People's Hospital, Pingxiang, 337000, Jiangxi, China.
- Department of Clinical Laboratory, The Sixth Clinical College of Gannan Medical University, Pingxiang, Jiangxi, China.
| | - Jianhui Chen
- Department of Clinical Laboratory, Pingxiang People's Hospital, Pingxiang, 337000, Jiangxi, China
| | - Xianfan Li
- Department of Clinical Laboratory, Pingxiang People's Hospital, Pingxiang, 337000, Jiangxi, China
| | - Zengpu Yu
- Department of Clinical Laboratory, Pingxiang People's Hospital, Pingxiang, 337000, Jiangxi, China
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24
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Wang J, Xiang H, Lu Y, Wu T, Ji G. New progress in drugs treatment of diabetic kidney disease. Biomed Pharmacother 2021; 141:111918. [PMID: 34328095 DOI: 10.1016/j.biopha.2021.111918] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 02/08/2023] Open
Abstract
Diabetic kidney disease (DKD) is not only one of the main complications of diabetes, but also the leading cause of the end-stage renal disease (ESRD). The occurrence and development of DKD have always been a serious clinical problem that leads to the increase of morbidity and mortality and the severe damage to the quality of life of human beings. Controlling blood glucose, blood pressure, blood lipids, and improving lifestyle can help slow the progress of DKD. In recent years, with the extensive research on the pathological mechanism and molecular mechanism of DKD, there are more and more new drugs based on this, such as new hypoglycemic drugs sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors with good efficacy in clinical treatment. Besides, there are some newly developed drugs, including protein kinase C (PKC) inhibitors, advanced glycation end product (AGE) inhibitors, aldosterone receptor inhibitors, endothelin receptor (ETR) inhibitors, transforming growth factor-β (TGF-β) inhibitors, Rho kinase (ROCK) inhibitors and so on, which show positive effects in animal or clinical trials and bring hope for the treatment of DKD. In this review, we sort out the progress in the treatment of DKD in recent years, the research status of some emerging drugs, and the potential drugs for the treatment of DKD in the future, hoping to provide some directions for clinical treatment of DKD.
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Affiliation(s)
- Junmin Wang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Hongjiao Xiang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yifei Lu
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Tao Wu
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Guang Ji
- Institute of Digestive Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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25
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Dou L, Burtey S. Reversing endothelial dysfunction with empagliflozin to improve cardiomyocyte function in cardiorenal syndrome. Kidney Int 2021; 99:1062-1064. [PMID: 33892855 DOI: 10.1016/j.kint.2021.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 12/26/2022]
Abstract
Sodium-glucose cotransporter 2 inhibitors offer cardiovascular and renal benefits in patients with chronic kidney disease through not yet clearly defined mechanisms. Juni et al. showed that sodium-glucose cotransporter 2 inhibitor empagliflozin exposure in vitro can restore cardiomyocyte function by counteracting harmful effects of uremic serum on the endothelium-cardiomyocyte crosstalk between endothelial cells and cardiomyocytes. The author's findings improved our understanding of cardiovascular impairment in chronic kidney disease and provided new perspectives for the beneficial effects of sodium-glucose cotransporter 2 inhibitor therapy.
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Affiliation(s)
- Laetitia Dou
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France.
| | - Stéphane Burtey
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France; Centre de Néphrologie et Transplantation Rénale, AP-HM, Hôpital de la Conception, Marseille, France
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26
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Yang YY, Deng RR, Chen Z, Yao LY, Yang XD, Xiang DX. Piperazine ferulate attenuates high glucose‑induced mesangial cell injury via the regulation of p66 Shc. Mol Med Rep 2021; 23:374. [PMID: 33760157 PMCID: PMC7985999 DOI: 10.3892/mmr.2021.12013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/22/2021] [Indexed: 12/26/2022] Open
Abstract
Diabetic nephropathy (DN) is a severe microvascular complication of diabetes. Hyperglycemia-induced glomerular mesangial cells injury is associated with microvascular damage, which is an important step in the development of DN. Piperazine ferulate (PF) has been reported to exert protective effects against the progression of DN. However, whether PF prevents high glucose (HG)-induced mesangial cell injury remains unknown. The aim of the present study was to investigate the effects of PF on HG-induced mesangial cell injury and to elucidate the underlying mechanisms. Protein and mRNA expression levels were determined via western blot analysis and reverse transcription-quantitative PCR, respectively. IL-6 and TNF-α levels were measured using ELISA. Reactive oxygen species levels and NF-κB p65 nuclear translation were determined via immunofluorescence analysis. Apoptosis was assessed by measuring lactate dehydrogenase (LDH) release, as well as using MTT and flow cytometric assays. The mitochondrial membrane potential of mesangial cells was determined using the JC-1 kit. The results revealed that LDH release were increased; however, cell viability and mitochondrial membrane potential were decreased in the HG group compared with the control group. These changes were inhibited after the mesangial cells were treated with PF. Moreover, PF significantly inhibited the HG-induced production of inflammatory cytokines and the activation of NF-κB in mesangial cells. PF also attenuated the HG-induced upregulation of the expression levels of fibronectin and collagen 4A1. Furthermore, the overexpression of p66Src homology/collagen (Shc) abolished the protective effect of PF on HG-induced mesangial cell injury. In vivo experiments revealed that PF inhibited the activation of inflammatory signaling pathways, glomerular cell apoptosis and mesangial matrix expansion in diabetic mice. Collectively, the present findings demonstrated that PF attenuated HG-induced mesangial cells injury by inhibiting p66Shc.
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Affiliation(s)
- Yong-Yu Yang
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
| | - Rong-Rong Deng
- School of Traditional Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, Guangdong 510006, P.R. China
| | - Zhuo Chen
- Department of Geriatrics, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Liang-Yuan Yao
- Hunan Provincial Engineering Research Central of Translational Medical and Innovative Drug, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
| | - Xi-Ding Yang
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
| | - Da-Xiong Xiang
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
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27
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Juni RP, Al-Shama R, Kuster DWD, van der Velden J, Hamer HM, Vervloet MG, Eringa EC, Koolwijk P, van Hinsbergh VWM. Empagliflozin restores chronic kidney disease-induced impairment of endothelial regulation of cardiomyocyte relaxation and contraction. Kidney Int 2020; 99:1088-1101. [PMID: 33359500 DOI: 10.1016/j.kint.2020.12.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/10/2020] [Accepted: 12/07/2020] [Indexed: 12/11/2022]
Abstract
Chronic kidney disease (CKD) promotes development of cardiac abnormalities and is highly prevalent in patients with heart failure, particularly in those with preserved ejection fraction. CKD is associated with endothelial dysfunction, however, whether CKD can induce impairment of endothelium-to-cardiomyocyte crosstalk leading to impairment of cardiomyocyte function is not known. The sodium-glucose co-transporter 2 inhibitor, empagliflozin, reduced cardiovascular events in diabetic patients with or without CKD, suggesting its potential as a new treatment for heart failure with preserved ejection fraction. We hypothesized that uremic serum from patients with CKD would impair endothelial control of cardiomyocyte relaxation and contraction, and that empagliflozin would protect against this effect. Using a co-culture system of human cardiac microvascular endothelial cells with adult rat ventricular cardiomyocytes to measure cardiomyocyte relaxation and contraction, we showed that serum from patients with CKD impaired endothelial enhancement of cardiomyocyte function which was rescued by empagliflozin. Exposure to uremic serum reduced human cardiac microvascular endothelial cell nitric oxide bioavailability, and increased mitochondrial reactive oxygen species and 3-nitrotyrosine levels, indicating nitric oxide scavenging by reactive oxygen species. Empagliflozin attenuated uremic serum-induced generation of endothelial mitochondrial reactive oxygen species, leading to restoration of nitric oxide production and endothelium-mediated enhancement of nitric oxide levels in cardiomyocytes, an effect largely independent of sodium-hydrogen exchanger-1. Thus, empagliflozin restores the beneficial effect of cardiac microvascular endothelial cells on cardiomyocyte function by reducing mitochondrial oxidative damage, leading to reduced reactive oxygen species accumulation and increased endothelial nitric oxide bioavailability.
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Affiliation(s)
- Rio P Juni
- Department of Physiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Rushd Al-Shama
- Department of Physiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Diederik W D Kuster
- Department of Physiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jolanda van der Velden
- Department of Physiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Henrike M Hamer
- Department of Clinical Chemistry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Marc G Vervloet
- Department of Nephrology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Etto C Eringa
- Department of Physiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands; Department of Physiology, Maastricht University, Maastricht, The Netherlands
| | - Pieter Koolwijk
- Department of Physiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Victor W M van Hinsbergh
- Department of Physiology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.
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28
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Srivastava B, Sen S, Sen K. Free serum sorbitol and its interaction with caffeine: A suggestive approach for plausible remediation of diabetic neuropathy. Biotechnol Appl Biochem 2020; 69:77-91. [PMID: 33264452 DOI: 10.1002/bab.2083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022]
Abstract
The measure of sorbitol in serum can act as a good indicator in the monitoring of the diabetic complications. To analyze the sorbitol level in serum medium, fluorometric enzymatic assay was performed. To remove the excess sorbitol from the body, proposed binding of sorbitol with caffeine was investigated. Their interaction in serum medium was studied and established by UV-Vis, fluorescence spectrophotometry, and time-correlated single photon counting (TCSPC). The linear calibration of sorbitol (in the range 10-50 mM) was done using UV-Vis spectrophotometry. Time scan experiments furnished the reaction rate of sorbitol assayed solution as well as sorbitol-caffeine complex as 0.021 min-1 and 0.018 min-1 , respectively. A sudden drop was observed in the fluorescence lifetime of reduced nicotinamide adenine dinucleotide (NADH) present in sorbitol assayed solution upon complexation with caffeine, that is, from 1.774 × 10-09 to 1.23 × 10-10 Sec, which indicates the hindrance in the formation of NADH and the probable formation of some other species. Isothermal titration calorimetric experiments clearly indicate the number of binding sites (i.e., 3.89, 1.40, and 2.07) that exist between sorbitol and caffeine at the complexation ratio of 1:1.2, 1:1.5, and 1:3. The present method can be helpful in pharmacological and therapeutic studies of sorbitol using caffeine for treating diabetic neuropathy.
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Affiliation(s)
- Bhavya Srivastava
- Department of Chemistry, University of Calcutta, 92, APC Road, Kolkata, West Bengal, 700009, India
| | - Souvik Sen
- KPC Medical College & Hospital, 1F, Raja Subodh Chandra Mullick Road, Jadavpur, Kolkata, West Bengal, 700032, India
| | - Kamalika Sen
- Department of Chemistry, University of Calcutta, 92, APC Road, Kolkata, West Bengal, 700009, India
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29
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Abstract
BACKGROUND Insulin shares a limited physiological concentration range with other endocrine hormones. Not only too low, but also too high systemic insulin levels are detrimental for body functions. MAIN BODY The physiological function and clinical relevance of insulin are usually seen in association with its role in maintaining glucose homeostasis. However, insulin is an anabolic hormone which stimulates a large number of cellular responses. Not only too low, but also excess insulin concentrations are detrimental to the physiological balance. Although the glucoregulatory activity of insulin is mitigated during hyperinsulinemia by dampening the efficiency of insulin signaling ("insulin resistance"), this is not the case for most other hormonal actions of insulin, including the promotion of protein synthesis, de novo lipogenesis, and cell proliferation; the inhibition of lipolysis, of autophagy-dependent cellular turnover, and of nuclear factor E2-related factor-2 (Nrf2)-dependent antioxidative; and other defense mechanisms. Hence, there is no general insulin resistance but selective impairment of insulin signaling which causes less glucose uptake from the blood and reduced activation of endothelial NO synthase (eNOS). Because of the largely unrestricted insulin signaling, hyperinsulinemia increases the risk of obesity, type 2 diabetes, and cardiovascular disease and decreases health span and life expectancy. In epidemiological studies, high-dose insulin therapy is associated with an increased risk of cardiovascular disease. Randomized controlled trials of insulin treatment did not observe any effect on disease risk, but these trials only studied low insulin doses up to 40 IU/day. Proof for a causal link between elevated insulin levels and cardiovascular disease risk comes from Mendelian randomization studies comparing individuals with genetically controlled low or high insulin production. CONCLUSIONS The detrimental actions of prolonged high insulin concentrations, seen also in cell culture, argue in favor of a lifestyle that limits circadian insulin levels. The health risks associated with hyperinsulinemia may have implications for treatment regimens used in type 2 diabetes.
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30
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Varikasuvu SR, Sulekar H, Aloori S, Thangappazham B. The association of non-invasive skin autofluorescence measurements with cardiovascular and all-cause mortality in hemodialysis patients: a meta-analysis. Int Urol Nephrol 2020; 52:1757-1769. [PMID: 32661621 DOI: 10.1007/s11255-020-02543-6] [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: 03/05/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND This systematic review and meta-analysis were aimed to study the association of tissue accumulation of advanced glycation end products (AGEs) measured as skin autofluorescence (SAF) with cardiovascular disease (CVD), cardiovascular mortality (CVM) and all-cause mortality (ACM) in hemodialysis (HD) patients. METHODS All major databases were searched for relevant studies reporting SAF in dialysis patients. Data for meta-analyses were extracted in the form of odds ratios (OR) and/or hazard ratios (HR) and the pooled overall outcomes were computed for the association of SAF with CVD, CVM, ACM in HD patients using either fixed or random effects meta-analysis based on the between-study heterogeneity. The sensitivity and meta-regression analyses were performed. RESULTS We included nine studies in this meta-analysis. The SAF levels were associated with higher risk for cardiovascular morbidity (pooled OR = 2.59, Z = 2.30, P = 0.02), cardiovascular (pooled HR = 3.03, Z = 3.13, P = 0.002) and overall mortalities (pooled HR = 2.23, Z = 6.30, P < 0.001) in HD patients. CONCLUSION In HD patients, the novel and non-invasive measurement of tissue AGEs as SAF levels could be useful for risk estimating the cardiovascular and all-cause mortalities.
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Affiliation(s)
- Seshadri Reddy Varikasuvu
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, 814152, India.
| | - Harish Sulekar
- Department of Urology, M. Ch Resident, Vijayanagara Institute of Medical Sciences, Ballary, Karnataka, 583104, India
| | - Sowjanya Aloori
- Department of Health Education, Telangana State Residential School and College, Choutuppal, Telangana, 508252, India
| | - Balachandar Thangappazham
- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Bibinagar, Telangana, 508126, India
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31
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Varikasuvu SR, Aloori S, Bhongir AV. Higher skin autofluorescence detection using AGE-Reader™ technology as a measure of increased tissue accumulation of advanced glycation end products in dialysis patients with diabetes: a meta-analysis. J Artif Organs 2020; 24:44-57. [PMID: 32613473 DOI: 10.1007/s10047-020-01189-6] [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: 10/31/2019] [Accepted: 06/23/2020] [Indexed: 12/18/2022]
Abstract
This meta-analysis was conducted to compare skin autofluorescence (SAF) levels as a measure of advanced glycation end products (AGEs) accumulation between diabetic and non-diabetic dialysis patients. Relevant studies were identified primarily by searching PubMed/MEDLINE and other online databases and manual searching of cross-references. Random-effects model was used to obtain standardized mean differences (SMD) as a summary statistic. Heterogeneity was tested with meta-regression and sub-group analyses. Publication bias and robustness of this meta-analysis were tested using funnel plot and sensitivity analyses. A total of 11 reports comparing SAF between diabetic and non-diabetic dialysis patients were finally included in this meta-analysis. Dialysis patients with diabetes showed significantly higher circulatory SAF levels than their non-diabetic counterparts (SMD = 0.39; P < 0.0001). The difference was more evident in hemodialysis modality (SMD = 0.40; P < 0.0001). A one-study leave-out sensitivity analysis validated the robustness of this meta-analysis. The presence of diabetes in dialysis patients is associated with increased AGEs accumulation reflected through SAF measurements using a novel and non-invasive AGE-Reader™ technology. Our findings are in support of considering anti-AGE therapeutic strategies in addition to standard glycemic management in dialysis patients with diabetes.
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Affiliation(s)
- Seshadri Reddy Varikasuvu
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, 814152, India.
| | - Sowjanya Aloori
- Department of Health Education, Telangana State Residential School and College, Choutuppal, Telangana, 508252, India
| | - Aparna Varma Bhongir
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Bibinagar, Telangana, 508126, India
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32
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Barrera-Chimal J, Jaisser F. Pathophysiologic mechanisms in diabetic kidney disease: A focus on current and future therapeutic targets. Diabetes Obes Metab 2020; 22 Suppl 1:16-31. [PMID: 32267077 DOI: 10.1111/dom.13969] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/07/2020] [Accepted: 01/13/2020] [Indexed: 12/22/2022]
Abstract
Diabetic kidney disease (DKD) is the primary cause of chronic kidney disease around the globe and is one of the main complications in patients with type 1 and 2 diabetes. The standard treatment for DKD is drugs controlling hyperglycemia and high blood pressure. Renin angiotensin aldosterone system blockade and sodium glucose cotransporter 2 (SGLT2) inhibition have yielded promising results in DKD, but many diabetic patients on such treatments nevertheless continue to develop DKD, leading to kidney failure and cardiovascular comorbidities. New therapeutic options are urgently required. We review here the promising therapeutic avenues based on insights into the mechanisms of DKD that have recently emerged, including mineralocorticoid receptor antagonists, SGLT2 inhibitors, glucagon-like peptide-1 receptor agonist, endothelin receptor A inhibition, anti-inflammatory agents, autophagy activators and epigenetic remodelling. The involvement of several molecular mechanisms in DKD pathogenesis, together with the genetic and epigenetic variability of this condition, makes it difficult to target this heterogeneous patient population with a single drug. Personalized medicine, taking into account the genetic and mechanistic variability, may therefore improve renal and cardiovascular protection in diabetic patients with DKD.
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Affiliation(s)
- Jonatan Barrera-Chimal
- Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación en Medicina Traslacional, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México and Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Frédéric Jaisser
- INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Sorbonne University, Paris Descartes University, Paris, France
- INSERM U1116, Clinical Investigation Centre, Lorraine University, Vandoeuvre-lès-Nancy, France
- INI-CRCT (Cardiovascular and Renal Clinical Trialists) F-CRIN Network, Nancy, France
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33
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Yu B, Wu Y, Li Z. KLF4/Ch25h axis activated by metformin suppresses EndoMT in human umbilical vein endothelial cells. Biochem Biophys Res Commun 2019; 522:838-844. [PMID: 31801667 DOI: 10.1016/j.bbrc.2019.11.181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 11/26/2019] [Indexed: 01/29/2023]
Abstract
Metformin, an anti-hyperglycemia drug, protected endothelial cells (ECs) from dysfunction while high glucose (HG) caused endothelial dysfunction. Previously, we found that metformin suppressed endothelial-to-mesenchymal transition (EndoMT), a cellular process that promoted endothelial dysfunction. However, the involved mechanism is still unclear. In this study, we found that metformin increased the expression of krüppel-like factor 4 (KLF4) and cholesterol-25-hydroxylase (Ch25h) while HG decreased the expression of KLF4 and Ch25h. In addition, HG promoted EndoMT indicting by the decrease of endothelial maker genes and increase of mesenchymal maker genes. Furthermore, RNA sequence (RNA-seq) data showed that KLF4 suppressed EndoMT. Moreover, we proved that metformin increased Ch25h expression through not only KLF4 but also epigenetic modification including DNA methylation and active histone modification. Lastly, we proved that Ch25h/25 hydroxycholesterol (25 HC)/Liver X receptor α (LXRα) suppressed EndoMT. Altogether, our study demonstrated that KLF4/Ch25h/axis activated by metformin suppressed EndoMT. Therefore, KLF4/Ch25h/axis may be a new potential therapeutic target for endothelial dysfunction diseases.
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Affiliation(s)
- Beixin Yu
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Yingying Wu
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Zhao Li
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
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