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Luo M, Cai J, Luo S, Hong X, Xu L, Lin H, Chen X, Fu W. Causal effects of gut microbiota on the risk of chronic kidney disease: a Mendelian randomization study. Front Cell Infect Microbiol 2023; 13:1142140. [PMID: 37065213 PMCID: PMC10102584 DOI: 10.3389/fcimb.2023.1142140] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundPrevious studies have reported that gut microbiota is associated with an increased risk of chronic kidney disease (CKD) progression. However, whether gut microbiota has a causal effect on the development of CKD has not been revealed. Thus, we aimed to analyze the potential causal effect of gut microbiota on the risk of CKD using mendelian randomization (MR) study.Materials and MethodsIndependent single nucleotide polymorphisms closely associated with 196 gut bacterial taxa (N = 18340) were identified as instrumental variables. Two-sample MR was performed to evaluate the causal effect of gut microbiota on CKD (N = 480698), including inverse-variance-weighted (IVW) method, weighted median method, MR-Egger, mode-based estimation and MR-PRESSO. The robustness of the estimation was tested by a series of sensitivity analyses including Cochran’s Q test, MR-Egger intercept analysis, leave-one-out analysis and funnel plot. Statistical powers were also calculated.ResultsThe genetically predicted higher abundance of order Desulfovibrionales was causally associated with an increased risk of CKD (odds ratio = 1.15, 95% confidence interval: 1.05-1.26; p = 0.0026). Besides, we also detected potential causalities between nine other taxa (Eubacterium eligens group, Desulfovibrionaceae, Ruminococcaceae UCG-002, Deltaproteobacteria, Lachnospiraceae UCG-010, Senegalimassilia, Peptostreptococcaceae, Alcaligenaceae and Ruminococcus torques group) and CKD (p < 0.05). No heterogeneity or pleiotropy was detected for significant estimates.ConclusionWe found that Desulfovibrionales and nine other taxa are associated with CKD, thus confirming that gut microbiota plays an important role in the pathogenesis of CKD. Our work also provides new potential indicators and targets for screening and prevention of CKD.
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Affiliation(s)
- Mingli Luo
- Department of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiahao Cai
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Shulu Luo
- Department of Prosthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Xiaosi Hong
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Lingxin Xu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Honghong Lin
- Department of Pediatric Orthopedics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Xiong Chen
- Department of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
- *Correspondence: Xiong Chen, ; Wen Fu,
| | - Wen Fu
- Department of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China
- *Correspondence: Xiong Chen, ; Wen Fu,
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Di-(2-ethylhexyl) Phthalate Limits the Lipid-Lowering Effects of Simvastatin by Promoting Protein Degradation of Low-Density Lipoprotein Receptor: Role of PPARγ-PCSK9 and LXRα-IDOL Signaling Pathways. Antioxidants (Basel) 2023; 12:antiox12020477. [PMID: 36830035 PMCID: PMC9952605 DOI: 10.3390/antiox12020477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
Dialysis prevents death from uremia in patients with end-stage renal disease (ESRD). Nevertheless, during hemodialysis, circulating levels of di-(2-ethylhexyl) phthalate (DEHP) are increased due to phthalates leaching from medical tubes. Statins are an effective therapy for reducing the risks associated with cardiovascular diseases in patients with chronic kidney disease; however, the mechanism by which statins fail to reduce cardiovascular events in hemodialysis ESRD patients remains unclear. In this study, we investigated whether DEHP and its metabolites interfere with the lipid-lowering effect of statins in hepatocytes. In Huh7 cells, treatment with DEHP and its metabolites abolished the simvastatin-conferred lipid-lowering effect. Mechanistically, DEHP down-regulated the expression of low-density lipoprotein receptor (LDLR) and led to a decrease in LDL binding, which was mediated by the activation of the PPARγ-PCSK9 and LXRα-IDOL signaling pathways. Additionally, the NOX-ROS-TRPA1 pathway is involved in the DEHP-mediated inhibition of LDLR expression and LDL binding activity. Blockage of this pathway abrogated the DEHP-mediated inhibition in the LDLR expression and LDL binding of simvastatin. Collectively, DEHP induces the activation of the NOX-ROS-TRPA1 pathway, which in turn activates PPARγ-PCSK9- and LXRα-IDOL-dependent signaling, and, ultimately, diminishes the statin-mediated lipid-lowering effect in hepatocytes.
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Soh JF, Bodenstein K, Yu OHY, Linnaranta O, Renaud S, Mahdanian A, Su CL, Mucsi I, Mulsant B, Herrmann N, Rajji T, Beaulieu S, Sekhon H, Rej S. Atorvastatin lowers serum calcium levels in lithium-users: results from a randomized controlled trial. BMC Endocr Disord 2022; 22:238. [PMID: 36153583 PMCID: PMC9508741 DOI: 10.1186/s12902-022-01145-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although lithium is considered the gold-standard treatment for bipolar disorder (BD), it is associated with a variety of major endocrine and metabolic side effects, including parathyroid hormone (PTH) dependent hypercalcemia. Aside from surgery and medication discontinuation, there are limited treatments for hypercalcemia. This paper will assess data from a randomized controlled trial (RCT). METHODS This is a secondary analysis of an RCT that explored the effects of atorvastatin (n = 27) versus placebo (n = 33) on lithium-induced nephrogenic diabetes insipidus (NDI) in patients with BD and major depressive disorder (MDD) using lithium (n = 60), over a 12-week period. This secondary analysis will explore serum calcium levels and thyroid stimulating hormone (TSH) measured at baseline, week 4, and week 12. RESULTS At 12-weeks follow-up while adjusting results for baseline, linear regression analyses found that corrected serum calcium levels were significantly lower in the treatment group (mean (M) = 2.30 mmol/L, standard deviation (SD) = 0.07) compared to the placebo group (M = 2.33 mmol/L, SD = 0.07) (β = - 0.03 (95% C.I.; - 0.0662, - 0.0035), p = 0.03) for lithium users. There were no significant changes in TSH. CONCLUSION In lithium users with relatively normal calcium levels, receiving atorvastatin was associated with a decrease in serum calcium levels. Although exciting, this is a preliminary finding that needs further investigation with hypercalcemic patients. Future RCTs could examine whether atorvastatin can treat PTH dependent hypercalcemia due to lithium and other causes.
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Affiliation(s)
- Jocelyn Fotso Soh
- GeriPARTy Research Group, Jewish General Hospital, Montreal, Canada
- Department of Psychology, Concordia University, Montreal, Canada
| | - Katie Bodenstein
- GeriPARTy Research Group, Jewish General Hospital, Montreal, Canada
- Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal, H3A 1A1, Canada
| | - Oriana Hoi Yun Yu
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Division of Endocrinology and Metabolism, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Outi Linnaranta
- Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal, H3A 1A1, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- National Institute for Health and Welfare, Helsinki, Finland
| | - Suzane Renaud
- Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal, H3A 1A1, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Artin Mahdanian
- Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal, H3A 1A1, Canada
- Department of Psychiatry, Jewish General Hospital, Montreal, Canada
| | - Chien-Lin Su
- Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Istvan Mucsi
- Multiorgan Transplant Program, University Health Network and Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Benoit Mulsant
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Psychiatry, Centre for Addictions and Mental Health, University of Toronto, Toronto, Canada
| | - Nathan Herrmann
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Tarek Rajji
- Department of Psychiatry, Centre for Addictions and Mental Health, University of Toronto, Toronto, Canada
| | - Serge Beaulieu
- Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal, H3A 1A1, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Harmehr Sekhon
- GeriPARTy Research Group, Jewish General Hospital, Montreal, Canada.
- Postdoctoral Research Fellow, Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
| | - Soham Rej
- GeriPARTy Research Group, Jewish General Hospital, Montreal, Canada
- Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal, H3A 1A1, Canada
- McGill Meditation and Mind-Body Medicine Research Clinic (MMMM-RC), Montreal, Canada
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Tsai MH, Su FY, Chang HY, Su PC, Chiu LY, Nowicki M, Kao CC, Lin YC. The Effect of Statin on Anemia in Patients with Chronic Kidney Disease and End-Stage Kidney Disease: A Systematic Review and Meta-Analysis. J Pers Med 2022; 12:jpm12071175. [PMID: 35887674 PMCID: PMC9317421 DOI: 10.3390/jpm12071175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 11/20/2022] Open
Abstract
Although erythropoietin-stimulating agents are effective in treating anemia in patients with end-stage kidney disease (ESKD) undergoing hemodialysis, some ESKD patients, especially those with inflammation, continue to suffer from anemia. Statin, an inhibitor of hydroxymethylglutaryl-CoA (HMG-CoA) reductase with lipid-lowering effects, may have a pleiotropic effect in reducing inflammation, and thus increase hemoglobin (Hb) level. We searched the PubMed, Embase, and Cochrane databases for relevant studies. The population of interest comprised advanced chronic kidney disease (CKD) patients and ESKD patients receiving hemodialysis with statin treatment. The included study designs were randomized control trial/cohort study/pre-post observational study, and outcomes of interest were Hb, erythropoietin resistance index (ERI) and ferritin. PRISMA 2020 guidelines were followed, and risk of bias (RoB) was assessed using the RoB 2.0 tool in randomized controlled trials, and the Newcastle-Ottawa scale (NOS) in cohort studies. We eventually included ten studies (5258 participants), comprising three randomized controlled trials and seven cohort studies. Overall, Hb increased by 0.84 g/dL (95% confidence interval [CI]: −0.02 to 1.70) in all groups using statins, including single-arm cohorts, and by 0.72 g/dL (95% CI: −0.02 to 1.46) in studies with placebo control. Hb levels were higher in the study group than in the control group, with a mean difference of 0.18 g/dL (95% CI: 0.04–0.32) at baseline and 1.0 g/dL (95% CI: 0.13–1.87) at the endpoint. Ferritin increased by 9.97 ng/mL (95% CI: −5.36 to 25.29) in the study group and decreased by 34.01 ng/mL (95% CI: −148.16 to 80.14) in the control group; ferritin fluctuation was higher in the control group. In conclusion, statin may improve renal anemia in ESKD patients receiving hemodialysis and regular erythropoietin-stimulating agents. Future studies with more rigorous methodology and larger sample size study should be performed to confirm this beneficial effect.
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Affiliation(s)
- Meng-Hsu Tsai
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250, Wu-xing St., Taipei 110, Taiwan; (M.-H.T.); (F.-Y.S.); (H.-Y.C.); (P.-C.S.); (L.-Y.C.); (C.-C.K.)
- Department of Medical Education, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Fu-You Su
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250, Wu-xing St., Taipei 110, Taiwan; (M.-H.T.); (F.-Y.S.); (H.-Y.C.); (P.-C.S.); (L.-Y.C.); (C.-C.K.)
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, 252, Wu-xing St., Taipei 110, Taiwan
| | - Hao-Yun Chang
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250, Wu-xing St., Taipei 110, Taiwan; (M.-H.T.); (F.-Y.S.); (H.-Y.C.); (P.-C.S.); (L.-Y.C.); (C.-C.K.)
- Department of Medical Education, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Po-Cheng Su
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250, Wu-xing St., Taipei 110, Taiwan; (M.-H.T.); (F.-Y.S.); (H.-Y.C.); (P.-C.S.); (L.-Y.C.); (C.-C.K.)
- Department of Medical Education, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Li-Yun Chiu
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250, Wu-xing St., Taipei 110, Taiwan; (M.-H.T.); (F.-Y.S.); (H.-Y.C.); (P.-C.S.); (L.-Y.C.); (C.-C.K.)
- Department of Medical Education, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Michal Nowicki
- Department of Nephrology, Hypertension and Kidney Transplantation, Central University Hospital, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Chih-Chin Kao
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250, Wu-xing St., Taipei 110, Taiwan; (M.-H.T.); (F.-Y.S.); (H.-Y.C.); (P.-C.S.); (L.-Y.C.); (C.-C.K.)
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, 252, Wu-xing St., Taipei 110, Taiwan
- TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei 110, Taiwan
| | - Yen-Chung Lin
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250, Wu-xing St., Taipei 110, Taiwan; (M.-H.T.); (F.-Y.S.); (H.-Y.C.); (P.-C.S.); (L.-Y.C.); (C.-C.K.)
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, 252, Wu-xing St., Taipei 110, Taiwan
- TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei 110, Taiwan
- Correspondence:
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Dewi PEN, Thavorncharoensap M. Statin Utilization among Patients with Acute Coronary Syndrome: Systematic Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The early use of statin with intensive regimen has been recommended by the recent guidelines as the prevention of acute coronary syndrome (ACS) related events among the high-risk patients. Meanwhile, the inconsistent statin utilization for targeted patient in current practice is still an issue.
AIM: This study aims to review the utilization rate of statin among patients with ACS.
METHODS: A systematic search of relevant studies published between inceptions to June 2020 was conducted in PubMed. Patients and intervention domains were used to build up the searching formula. A study was eligible for inclusion if it was an original study of patients with ACS and it examined the utilization of statin. The risk of bias was assessed using Axis and NOS checklist.
RESULTS: Among the 49 eligible studies, 38 were cohort studies while the others were cross-sectional studies. The utilization rate of statin at hospital admission ranged from 16% to 61% while 25% to 75% during the hospitalization. Of the total studies, 35 studies reported the statin rate at discharge ranging from 58% to 99%. Almost all studies revealed the reduction of statin utilization rate along the follow-up period. The number of statins prescribed was found to be lower among female and elderly patients.
CONCLUSION: Despite the established benefits of statin among patients with ACS, our study revealed that statin was underutilized for secondary prevention after ACS. To improve patients’ clinical outcomes with ACS, efforts should be made to increase optimal treatment and compliance with a statin.
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Fotso Soh J, Beaulieu S, Trepiccione F, Linnaranta O, Torres-Platas G, Platt RW, Renaud S, Su CL, Mucsi I, D'Apolito L, Mulsant BH, Levinson A, Saury S, Müller D, Schaffer A, Dols A, Low N, Cervantes P, Christensen BM, Herrmann N, Rajji T, Rej S. A double-blind, randomized, placebo-controlled pilot trial of atorvastatin for nephrogenic diabetes insipidus in lithium users. Bipolar Disord 2021; 23:66-75. [PMID: 32621644 DOI: 10.1111/bdi.12973] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 06/17/2020] [Accepted: 06/24/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Lithium remains an important treatment for mood disorders but is associated with kidney disease. Nephrogenic diabetes insipidus (NDI) is associated with up to 3-fold risk of incident chronic kidney disease among lithium users. There are limited randomized controlled trials (RCT) for treatments of lithium-induced NDI, and existing therapies can be poorly tolerated. Therefore, novel treatments are needed for lithium-induced NDI. METHOD We conducted a 12-week double-blind pilot RCT to assess the feasibility and efficacy of 20 mg/d atorvastatin vs placebo in the treatment of NDI in chronic lithium users. Patients, recruited between September 2017 and October 2018, were aged 18 to 85, currently on a stable dose of lithium, and determined to have NDI. RESULTS Urinary osmolality (UOsm) at 12 weeks adjusted for baseline was not statistically different between groups (+39.6 mOsm/kg [95% CI, -35.3, 114.5] in atorvastatin compared to placebo groups). Secondary outcomes of fluid intake and aquaporin-2 excretions at 12 weeks adjusted for baseline were -0.13 L [95% CI, -0.54, 0.28] and 98.68 [95% CI, -190.34, 387.70], respectively. A moderate effect size was observed for improvements in baseline UOsm by ≥100 mOsm/kg at 12 weeks in patients who received atorvastatin compared to placebo (38.45% (10/26) vs 22.58% (7/31); Cohen's d = 0.66). CONCLUSION Among lithium users with NDI, atorvastatin 20 mg/d did not significantly improve urinary osmolality compared to placebo over a 12-week period. Larger confirmatory trials with longer follow-up periods may help to further assess the effects of statins on NDI, especially within patients with more severe NDI.
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Affiliation(s)
- Jocelyn Fotso Soh
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Serge Beaulieu
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | | | - Outi Linnaranta
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | | | - Robert W Platt
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Health Centre, Montreal, QC, Canada
| | - Suzane Renaud
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Chien-Lin Su
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Health Centre, Montreal, QC, Canada
| | - Istvan Mucsi
- Division of Nephrology, University Health Network, University of Toronto (UofT), Toronto, ON, Canada
| | - Luciano D'Apolito
- Biogem S.c.a.r.l., Istituto di Ricerche Genetiche "Gaetano Salvatore", Ariano Irpino, Italy
| | - Benoit H Mulsant
- Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Andrea Levinson
- Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sybille Saury
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Daniel Müller
- Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Annemiek Dols
- Amsterdam UMC, Department of Psychiatry, GGZinGeest, Neuroscience, Amsterdam, The Netherlands
| | - Nancy Low
- Department of Psychiatry, McGill University Health Centre, Montreal, QC, Canada
| | - Pablo Cervantes
- Department of Psychiatry, McGill University Health Centre, Montreal, QC, Canada
| | | | - Nathan Herrmann
- Department of Psychiatry, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Tarek Rajji
- Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Soham Rej
- Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada
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Bazyluk A, Malyszko J, Hryszko T, Zbroch E. State of the art - sirtuin 1 in kidney pathology - clinical relevance. Adv Med Sci 2019; 64:356-364. [PMID: 31125865 DOI: 10.1016/j.advms.2019.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/17/2018] [Accepted: 04/19/2019] [Indexed: 01/19/2023]
Abstract
Sirtuins represent a group of nicotinamide adenine dinucleotide dependent histone deacetylases, which regulates various biological pathways by promoting chromatin silencing and transcriptional repression. Therefore, they are linked to cellular energy metabolism, mitochondrial biogenesis, stress response, apoptosis, inflammation and fibrosis. Since sirtuin 1 became a promising candidate for targeted therapies of numerous conditions, researchers have been investigating its activator. As for now, natural agents and antidiabetic drug - metformin, have been found to activate sirtuin 1. Sirtuin 1 is able to improve kidney outcomes by direct impact on kidney cells, regulation of non-specific processes generally involved in pathogenesis of age-dependent and metabolic disorders and improvement of the comorbid diseases. This review discusses the state of the art knowledge on the role of sirtuin 1 on kidney pathology.
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A higher ratio of refined grain to whole grain is associated with a greater likelihood of chronic kidney disease: a population-based study. Br J Nutr 2018; 121:1294-1302. [PMID: 30375292 DOI: 10.1017/s0007114518003124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A growing number of studies suggest that diet and renal function are related. However, little is known about the link between both whole grain (WG) and refined grain (RG) consumption and kidney function parameters. Thus, we investigated the association of WG and RG with urinary albumin to creatinine ratio (ACR) and prevalent chronic kidney disease (CKD). Data from participants of the National Health and Nutrition Examination Surveys (NHANES) from 2005 to 2010 were collected. Estimated glomerular filtration rate (eGFR) was calculated by the CKD Epidemiology Collaboration equation. Survey design and sample weights were taken into consideration for statistical analyses. Finally, we included 16 325 participants from NHANES, 6·9 % of whom had prevalent CKD. In models adjusted for age, sex, race, fasting blood glucose, blood pressure, adiposity, hypertension and diabetes status, mean eGFR significantly increased across increasing quartiles of WG (Q1: 88·2 v. Q4: 95·4 ml/min per 1·73 m2, P<0·001), whereas it significantly decreased across increasing quartiles of RG (Q1: 97·2 v. Q4: 88·4 ml/min per 1·73 m2, P<0·001). Furthermore, serum uric acid levels and ACR significantly decreased across quartiles of WG (both P<0·001). In multivariable-adjusted logistic regression models, the likelihood of prevalent CKD was 21 % lower in the highest WG quartile compared with the lowest one. In conclusion, our results shed light on the beneficial impact of WG on kidney function and CKD, whereas RG is adversely associated with eGFR.
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Comparative Effectiveness of Inclisiran 100, 300, and 500 mg in a Population with Hyperlipidemia: A Network Meta-Analysis of Randomized Controlled Trials. Am J Cardiovasc Drugs 2018. [PMID: 29516321 DOI: 10.1007/s40256-018-0270-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND To our knowledge, inclisiran was the first agent composed of small interfering RNAs (siRNAs) to be preliminarily used to reduce proatherogenic lipoprotein cholesterol levels. Inclisiran was evaluated in large clinical trials but did not receive government approval. The ability of inclisiran to reduce low-density lipoprotein cholesterol (LDL-C) greatly improved its chances of becoming a novel therapeutic option for patients with hyperlipidemia. OBJECTIVE Our goal was to summarize the preliminary effectiveness and safety data for inclisiran. METHODS We conducted a comprehensive search of PubMed, Scopus, Web of Science, the OVID EMB Reviews database, and Clinical Trials with the keyword "inclisiran" to find all related randomized controlled trials (RCTs). Five recently published RCTs involving 583 adults aged 18-65 years with hyperlipidemia were included in the analysis. RESULTS Subgroup analysis suggested that inclisiran 100 mg (standard mean difference [SMD] - 2.09; 95% confidence interval [CI] - 2.51 to - 1.66; p < 0.05), 300 mg (SMD - 2.74; 95% CI - 3.61 to - 1.87; p < 0.05), and 500 mg (SMD - 2.21; 95% CI - 2.62 to - 1.80; p < 0.05) significantly (p < 0.05) reduced LDL-C and total cholesterol even though pooled analysis showed no LDL-C-lowering effect (SMD 0.15; 95% CI - 0.34 to 0.04; p = 0.116). Compared with patients receiving placebo, pooled and subgroup analysis of patients receiving inclisiran showed no favorable changes in triglycerides or high-density lipoprotein cholesterol (p > 0.05). The most commonly reported adverse events were musculoskeletal pain, nasopharyngitis, headache, and elevated C-reactive protein (CRP), none of which were significant (p > 0.05). CONCLUSIONS To date, inclisiran has been effective in treating hyperlipidemia. Major adverse events were not identified, although other possible adverse events may be discovered with more RCTs and extensive long-term follow-up.
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Fotso Soh J, Torres-Platas SG, Beaulieu S, Mantere O, Platt R, Mucsi I, Saury S, Renaud S, Levinson A, Andreazza AC, Mulsant BH, Müller D, Schaffer A, Dols A, Cervantes P, Low NCP, Herrmann N, Christensen BM, Trepiccione F, Rajji T, Rej S. Atorvastatin in the treatment of Lithium-induced nephrogenic diabetes insipidus: the protocol of a randomized controlled trial. BMC Psychiatry 2018; 18:227. [PMID: 30012135 PMCID: PMC6048831 DOI: 10.1186/s12888-018-1793-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 06/14/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Lithium is the gold-standard treatment for bipolar disorder, is highly effective in treating major depressive disorder, and has anti-suicidal properties. However, clinicians are increasingly avoiding lithium largely due to fears of renal toxicity. Nephrogenic Diabetes Insipidus (NDI) occurs in 15-20% of lithium users and predicts a 2-3 times increased risk of chronic kidney disease (CKD). We recently found that use of statins is associated with lower NDI risk in a cross-sectional study. In this current paper, we describe the methodology of a randomized controlled trial (RCT) to treat lithium-induced NDI using atorvastatin. METHODS We will conduct a 12-week, double-blind placebo-controlled RCT of atorvastatin for lithium-induced NDI at McGill University, Montreal, Canada. We will recruit 60 current lithium users, aged 18-85, who have indicators of NDI, which we defined as urine osmolality (UOsm) < 600 mOsm/kg after 10-h fluid restriction. We will randomize patients to atorvastatin (20 mg/day) or placebo for 12 weeks. We will examine whether this improves measures of NDI: UOsm and aquaporin (AQP2) excretion at 12-week follow-up, adjusted for baseline. RESULTS Not applicable. CONCLUSION The aim of this clinical trial is to provide preliminary data about the efficacy of atorvastatin in treating NDI. If successful, lithium could theoretically be used more safely in patients with a reduced subsequent risk of CKD, hypernatremia, and acute kidney injury (AKI). If future definitive trials confirm this, this could potentially allow more patients to benefit from lithium, while minimizing renal risk. TRIAL REGISTRATION ClinicalTrials.gov NCT02967653 . Registered in February 2017.
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Affiliation(s)
- Jocelyn Fotso Soh
- Geri-PARTy Research Group, Jewish General Hospital/Lady Davis Institute, McGill University, 4333 Cote Ste-Catherine, Montreal, QC, H3T, 1E4, Montreal, Canada.
| | - Susana G. Torres-Platas
- 0000 0004 1936 8649grid.14709.3bGeri-PARTy Research Group, Jewish General Hospital/Lady Davis Institute, McGill University, 4333 Cote Ste-Catherine, Montreal, QC, H3T, 1E4, Montreal, Canada
| | - Serge Beaulieu
- 0000 0004 1936 8649grid.14709.3bDouglas Mental Health University Institute and Department of Psychiatry, McGill University, Montreal, Canada
| | - Outi Mantere
- 0000 0004 1936 8649grid.14709.3bDouglas Mental Health University Institute and Department of Psychiatry, McGill University, Montreal, Canada
| | - Robert Platt
- 0000 0000 9064 4811grid.63984.30Department of Epidemiology, Biostatistics and Occupational Health, McGill University Health Centre, Montreal, Canada
| | - Istvan Mucsi
- 0000 0001 2157 2938grid.17063.33Division of Nephrology, University Health Network, University of Toronto (UofT), Toronto, Canada
| | - Sybille Saury
- 0000 0004 1936 8649grid.14709.3bDouglas Mental Health University Institute and Department of Psychiatry, McGill University, Montreal, Canada
| | - Suzane Renaud
- 0000 0004 1936 8649grid.14709.3bDouglas Mental Health University Institute and Department of Psychiatry, McGill University, Montreal, Canada
| | - Andrea Levinson
- 0000 0001 2157 2938grid.17063.33Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Ana C. Andreazza
- 0000 0001 2157 2938grid.17063.33Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Benoit H. Mulsant
- 0000 0001 2157 2938grid.17063.33Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Daniel Müller
- 0000 0001 2157 2938grid.17063.33Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Ayal Schaffer
- 0000 0001 2157 2938grid.17063.33Department of Psychiatry, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Annemiek Dols
- Department of Psychiatry, GGZ, Geest, Amsterdam, the Netherlands
| | - Pablo Cervantes
- 0000 0000 9064 4811grid.63984.30Department of Psychiatry, McGill University Health Centre, Montreal, Canada
| | - Nancy CP Low
- 0000 0000 9064 4811grid.63984.30Department of Psychiatry, McGill University Health Centre, Montreal, Canada
| | - Nathan Herrmann
- 0000 0001 2157 2938grid.17063.33Department of Psychiatry, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Birgitte M. Christensen
- 0000 0001 1956 2722grid.7048.bDepartment of Biomedicine, University of Aarhus, Aarhus, Denmark
| | - Francesco Trepiccione
- 0000 0001 0790 385Xgrid.4691.aDivision of Nephrology, University of Naples, Naples, Italy
| | - Tarek Rajji
- 0000 0001 2157 2938grid.17063.33Department of Psychiatry, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Soham Rej
- 0000 0004 1936 8649grid.14709.3bGeri-PARTy Research Group, Jewish General Hospital/Lady Davis Institute, McGill University, 4333 Cote Ste-Catherine, Montreal, QC, H3T, 1E4, Montreal, Canada ,0000 0004 1936 8649grid.14709.3bDouglas Mental Health University Institute and Department of Psychiatry, McGill University, Montreal, Canada
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11
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Lau TW, Tan KEK, Choo JCJ, Ng TG, Tavintharan S, Chan JCN. Regional evidence and international recommendations to guide lipid management in Asian patients with type 2 diabetes with special reference to renal dysfunction. J Diabetes 2018; 10:200-212. [PMID: 28960806 DOI: 10.1111/1753-0407.12610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 08/30/2017] [Accepted: 09/23/2017] [Indexed: 12/22/2022] Open
Abstract
The anticipated increase in the prevalence and incidence of type 2 diabetes in Asia, and its associated cardiovascular-renal complications, will place a significant burden on patients, caregivers, and society. Despite the proven effectiveness of lipid management in reducing these complications, there are major treatment gaps, especially in Asian patients with young-onset diabetes and chronic kidney disease (CKD). Recent international guidelines recommended the adoption of absolute risk estimation of atherosclerosis and cardiovascular disease to guide treatment intensity. These recommendations replaced the previous strategy of using low-density lipoprotein cholesterol targets to guide initiation and intensification of lipid lowering, albeit still widely practiced in Asia. The latest guidelines also highlight the high risk of atherosclerosis and cardiovascular disease (ASCVD) for people with diabetes, who should be protected with statins, except for young patients without other risk factors, who will need yearly monitoring of blood lipid levels. Given the propensity of Asian patients with diabetes to develop CKD and the amplifying effect of CKD on ASCVD, the use of statins in Asian patients is particularly important. Due to interethnic differences in drug metabolism, rosuvastatin, which is largely cleared by the kidney, should be prescribed in low dosages (5-10 mg daily) in Asian populations. Conversely, epidemiological and experimental data confirm pleotropic and organ-protective effects of atorvastatin, with proven safety in Asian populations within a daily dose range of 10-40 mg. Thus, there is a need for Asian countries to review and align their lipid-lowering treatment guidelines to reduce the substantial burden of diabetes in the Asian region.
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Affiliation(s)
- Titus Wl Lau
- Division of Nephrology, National University Health System, National University Hospital, Singapore
| | - Kevin E K Tan
- Mount Elizabeth Medical Centre, Singapore
- Mt Alvernia Medical Centre Block A, Singapore
| | - Jason C J Choo
- Department of Renal Medicine, Singapore General Hospital, Singapore
| | - Tsun-Gun Ng
- TG Ng Kidney & Medical Centre, Gleneagles Medical Centre, Singapore
| | | | - Juliana C N Chan
- Department of Medicine and Therapeutics and Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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12
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Kim DG, Bae GS, Jo IJ, Choi SB, Kim MJ, Jeong JH, Kang DG, Lee HS, Song HJ, Park SJ. Guggulsterone Attenuated Lipopolysaccharide-Induced Inflammatory Responses in Mouse Inner Medullary Collecting Duct-3 Cells. Inflammation 2016; 39:87-95. [PMID: 26260258 DOI: 10.1007/s10753-015-0226-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Guggulsterone (GS) is a phytosterol that has been used to treat inflammatory diseases such as colitis, obesity, and thrombosis. Although many previous studies have examined activities of GS, the effect of GS on lipopolysaccharide (LPS)-induced inflammatory responses in mouse inner medullary collecting duct-3 (mIMCD-3) cells have not been examined. Therefore, here, we investigated the anti-inflammatory action of GS on mIMCD-3 cells exposed to LPS. LPS treatment on mIMCD-3 cells produced pro-inflammatory molecules such as inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) significantly; however, GS treatment significantly inhibited the production of pro-inflammatory molecules. In addition, GS inhibited the degradation of Iκ-Bα and translocation of NF-κB on mIMCD-3 cells. These results suggest that GS could inhibit inflammatory responses in collecting duct cells which could contribute to kidney injury during systemic infection.
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Affiliation(s)
- Dong-Goo Kim
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Department of Herbology, School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea
| | - Gi-Sang Bae
- Department of Herbology, School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Hanbang Body Fluid Research Center, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea
| | - Il-Joo Jo
- Department of Herbology, School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Hanbang Body Fluid Research Center, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea
| | - Sun-Bok Choi
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea
| | - Myoung-Jin Kim
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Department of Herbology, School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea
| | - Jun-Hyeok Jeong
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Department of Herbology, School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea
| | - Dae-Gil Kang
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Hanbang Body Fluid Research Center, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Professional Graduate School of Oriental Medicine and College of Oriental Medicine, Wonkwang University, Shinyong-dong, Iksan, Jeonbuk, 570-749, South Korea
| | - Ho-Sub Lee
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Hanbang Body Fluid Research Center, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Professional Graduate School of Oriental Medicine and College of Oriental Medicine, Wonkwang University, Shinyong-dong, Iksan, Jeonbuk, 570-749, South Korea
| | - Ho-Joon Song
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.,Department of Herbology, School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea
| | - Sung-Joo Park
- BK21 Plus Team, Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea. .,Department of Herbology, School of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea. .,Hanbang Body Fluid Research Center, Wonkwang University, Iksan, Jeonbuk, 540-749, South Korea.
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13
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Yan YL, Qiu B, Wang J, Deng SB, Wu L, Jing XD, Du JL, Liu YJ, She Q. High-intensity statin therapy in patients with chronic kidney disease: a systematic review and meta-analysis. BMJ Open 2015; 5:e006886. [PMID: 25979868 PMCID: PMC4442158 DOI: 10.1136/bmjopen-2014-006886] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of high-intensity statin therapy in patients with chronic kidney disease (CKD). DESIGN A systematic review and meta-analysis. DATA SOURCES Randomised controlled trials (RCTs) comparing high-intensity statin therapy (atorvastatin 80 mg or rosuvastatin 20/40 mg) with moderate/mild statin treatment or placebo were derived from the databases (PubMed, Embase, Ovid, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, and ISI Web of Knowledge). OUTCOME MEASURE Primary end points: clinical events (all-cause mortality, stroke, myocardial infarction and heart failure); secondary end points: serum lipid, renal function changes and adverse events. RESULTS A total of six RCTs with 10,993 adult patients with CKD were included. A significant decrease in stroke was observed in the high-intensity statin therapy group (RR 0.69, 95% CI 0.56 to 0.85). However, the roles of high-intensity statin in decreasing all-cause mortality (RR 0.85, 95% CI 0.67 to 1.09), myocardial infarction (RR 0.69, 95% CI 0.40 to 1.18) and heart failure (RR 0.73, 95% CI 0.48 to 1.13) remain unclear with low evidence. High-intensity statin also had obvious effects on lowering the LDL-C level but no clear effects on renal protection. Although pooled results showed no significant difference between the intervention and control groups in adverse event occurrences, it was still insufficient to put off the doubts that high-intensity statin might increase adverse events because of limited data sources and low quality evidences. CONCLUSIONS High-intensity statin therapy could effectively reduce the risk of stroke in patients with CKD. However, its effects on all-cause mortality, myocardial infarction, heart failure and renal protection remain unclear. Moreover, it is hard to draw conclusions on the safety assessment of intensive statin treatment in this particular population. More studies are needed to credibly evaluate the effects of high-intensity statin therapy in patients with CKD.
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Affiliation(s)
- Yu-Ling Yan
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bo Qiu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Wang
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Song-Bai Deng
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ling Wu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Dong Jing
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jian-Lin Du
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ya-Jie Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang She
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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