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Bácsi A, Penyige A, Becs G, Benkő S, Kovács EG, Jenei C, Pócsi I, Balla J, Csernoch L, Balatoni I. Whole blood transcriptome characterization of young female triathlon athletes following an endurance exercise: a pilot study. Physiol Genomics 2022; 54:457-469. [PMID: 36250559 PMCID: PMC9762975 DOI: 10.1152/physiolgenomics.00090.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The vast majority of studies focusing on the effects of endurance exercise on hematological parameters and leukocyte gene expression were performed in adult men, so our aim was to investigate these changes in young females. Four young (age 15.3 ± 1.3 yr) elite female athletes completed an exercise session, in which they accomplished the cycling and running disciplines of a junior triathlon race. Blood samples were taken immediately before the exercise, right after the exercise, and then 1, 2, and 7 days later. Analysis of cell counts and routine biochemical parameters were complemented by RNA sequencing (RNA-seq) to whole blood samples. The applied exercise load did not trigger remarkable changes in either cardiovascular or biochemical parameters; however, it caused a significant increase in the percentage of neutrophils and a significant reduction in the ratio of lymphocytes immediately after exercise. Furthermore, endurance exercise induced a characteristic gene expression pattern change in the blood transcriptome. Gene set enrichment analysis (GSEA) using the Reactome database revealed that the expression of genes involved in immune processes and neutrophil granulocyte activation was upregulated, whereas the expression of genes important in translation and rRNA metabolism was downregulated. Comparison of a set of immune cell gene signatures (ImSig) and our transcriptomic data identified 15 overlapping genes related to T-cell functions and involved in podosome formation and adhesion to the vessel wall. Our results suggest that RNA-seq to whole blood together with ImSig analysis are useful tools for the investigation of systemic responses to endurance exercise.
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Affiliation(s)
- Attila Bácsi
- 1Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - András Penyige
- 2Department of Human Genetics, Faculty of Medicine, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
| | - Gergely Becs
- 3Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Szilvia Benkő
- 4Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Elek Gergő Kovács
- 4Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary,5Doctoral School of Molecular Cellular and Immune Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Csaba Jenei
- 6Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - István Pócsi
- 7Department of Molecular Biotechnology and Microbiology, Institute of Biotechnology, Faculty of Science and Technology, University of Debrecen, Debrecen, Hungary
| | - József Balla
- 8Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Csernoch
- 4Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Fülöp T, Tapolyai MB, Zsom L, Molnar MZ, Abdul Salim S, Újhelyi L, Becs G, Balla J, Hamrahian M. Successful Practice Transitioning Between Hemodialysis and Hemodiafiltration in Outpatient Units: Ten Key Issues for Physicians to Remember. Artif Organs 2018; 42:925-932. [PMID: 29682748 DOI: 10.1111/aor.13135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 12/17/2022]
Abstract
Hemodiafiltration (HDF) during chronic renal replacement therapy (RRT) is a relatively new practice phenomenon, emerging over the last two decades. While the technological platforms utilized during chronic RRT are in many cases similar or effectively identical to conventional hemodialysis (HD), significant differences may emerge in daily practice. Several authors of this review moved practice site between the United States and the European Union and transitioned from an HD-based practice to predominantly HDF-practicing networks. In doing so, we became keenly aware of the potential pitfalls nephrologists may be facing during such transitions. This brief review is intended to provide a succinct overview of several practical concerns and complications nephrologists may encounter in daily practice of end-stage renal disease care, including but not limited to management of electrolytes, renal anemia and treatment goals and settings during HDF.
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Affiliation(s)
- Tibor Fülöp
- Department of Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, Hungary.,FMC Extracorporeal Life Support Center - Fresenius Medical Care Hungary
| | | | - Lajos Zsom
- Cegléd Hemodialysis Units, Fresenius Medical Care Hungary
| | - Miklos Z Molnar
- Division of Transplant Surgery, Methodist University Hospital Transplant Institute, Memphis, TN, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Sohail Abdul Salim
- Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, MS, USA
| | - László Újhelyi
- Department of Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, Hungary.,FMC Extracorporeal Life Support Center - Fresenius Medical Care Hungary
| | - Gergely Becs
- Department of Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, Hungary.,FMC Extracorporeal Life Support Center - Fresenius Medical Care Hungary
| | - József Balla
- Department of Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, Hungary.,FMC Extracorporeal Life Support Center - Fresenius Medical Care Hungary
| | - Mehrdad Hamrahian
- Department of Medicine, Division of Nephrology, Thomas Jefferson University, Philadelphia, PA, USA
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Becs G, Hudák R, Fejes Z, Debreceni IB, Bhattoa HP, Balla J, Kappelmayer J. Haemodiafiltration elicits less platelet activation compared to haemodialysis. BMC Nephrol 2016; 17:147. [PMID: 27737645 PMCID: PMC5064778 DOI: 10.1186/s12882-016-0364-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/11/2016] [Indexed: 11/20/2022] Open
Abstract
Background Mortality in patients with end-stage renal disorders is often a consequence of cardiovascular complications. Renal replacement therapies may contribute to this morbidity by promoting cellular activation. In renal failure patients peripheral blood samples were investigated for platelet and endothelial cell activation markers to compare the effects of haemodiafiltration (HDF) and haemodialysis (HD). Methods Overall 28 patients were included in the study. Platelet P-selectin and leukocyte - platelet heterotypic aggregates were studied by flow cytometry. Soluble P- and E-selectin values were determined by ELISA, while von Willebrand factor (vWF) antigen levels were measured by immunoturbidimetry. Statistical analysis was done by the SPSS v22 software. Results Platelet surface P-selectin was below 3.0 % in healthy controls, but it was higher during the dialysis after 4 h, 8 % and 14.3 % in HDF and HD, respectively. Monocyte-platelet heterotypic aggregates were significantly elevated after 4 h in both treatments, up to 69.2 % in HDF and to 82.9 % in HD. Soluble P-selectin levels were also significantly elevated by the end of both treatment procedures (p < 0.001), vWF antigen values, however, showed elevation only during HD treatment. Conclusions The attenuated platelet activating effects of HDF compared to HD may contribute to a less unfavourable vascular effect in this treatment modality. Electronic supplementary material The online version of this article (doi:10.1186/s12882-016-0364-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gergely Becs
- Department of Nephrology, University of Debrecen, Debrecen, Hungary
| | - Renáta Hudák
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, Hungary
| | - Zsolt Fejes
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, Hungary
| | - Ildikó Beke Debreceni
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, Hungary
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, Hungary
| | - József Balla
- Department of Nephrology, University of Debrecen, Debrecen, Hungary.,MTA-DE Vascular Biology, Thrombosis and Hemostasis Research Group, Hungarian Academy of Sciences, Debrecen, Hungary
| | - János Kappelmayer
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, Hungary.
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Páll A, Czifra Á, Sebestyén V, Becs G, Kun C, Balla J, Paragh G, Lőrincz I, Páll D, Padra TJ, Agarwal A, Zarjou A, Szabó Z. Hemodiafiltration and hemodialysis differently affect P wave duration and dispersion on the surface electrocardiogram. Int Urol Nephrol 2015; 48:271-7. [PMID: 26560477 DOI: 10.1007/s11255-015-1144-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/19/2015] [Indexed: 11/27/2022]
Abstract
AIM The incidence of atrial fibrillation is increased during hemodialysis (HD); however, the effects of hemodiafiltration (HDF) on atrial arrhythmias have not been evaluated. The prolongation of the P wave and P dispersion (Pd) can predict atrial arrhythmias. METHODS Data from 30 patients receiving HDF over a period of 3 months were collected; the same group of patients was then evaluated during treatment with conventional HD for at least another 3 months. Electrolyte values were obtained, and surface electrocardiograms (ECG), echocardiography, and Holter ECGs were performed. RESULTS The duration of the P wave and Pd increased significantly during HD. The left atrial diameter decreased significantly only during HDF. During HDF, the left atrial cross diameter measured at the beginning of the session was positively correlated with the incidence of supraventricular premature beats (p = 0.011, r = 0.4556). The decrease in left atrial diameter during HDF was negatively correlated with the incidence of supraventricular premature beats (p = 0.016, r = -0.43). During HDF, the changes in sodium and Pd were significantly positively correlated (p < 0.05, r = 0.478). During HD, the changes in ionized calcium levels and Pd were positively correlated (p < 0.05, r = 0.377). CONCLUSION Our results suggest that HDF has a more beneficial effect on P wave duration and Pd than HD. The alterations in the ECG markers may be the result of the simultaneous occurrence of certain electrolyte imbalances and renal replacement methods.
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Affiliation(s)
- Alida Páll
- Division of Emergency Medicine, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Nagyerdei krt. 98, P.O. Box 19, 4032, Debrecen, Hungary
| | - Árpád Czifra
- Division of Emergency Medicine, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Nagyerdei krt. 98, P.O. Box 19, 4032, Debrecen, Hungary
| | - Veronika Sebestyén
- Division of Emergency Medicine, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Nagyerdei krt. 98, P.O. Box 19, 4032, Debrecen, Hungary
| | - Gergely Becs
- Division of Nephrology, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Debrecen, Hungary
| | - Csaba Kun
- Faculty of Medicine, Clinical Center, Institute of Cardiology, University of Debrecen, Debrecen, Hungary
| | - József Balla
- Division of Nephrology, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Debrecen, Hungary
| | - György Paragh
- Division of Emergency Medicine, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Nagyerdei krt. 98, P.O. Box 19, 4032, Debrecen, Hungary
| | - István Lőrincz
- Division of Emergency Medicine, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Nagyerdei krt. 98, P.O. Box 19, 4032, Debrecen, Hungary
| | - Dénes Páll
- Division of Nephrology, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamás János Padra
- Division of Nephrology, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Debrecen, Hungary
| | - Anupam Agarwal
- Department of Medicine, Nephrology Research and Training Center and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Abolfazl Zarjou
- Department of Medicine, Nephrology Research and Training Center and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Zoltán Szabó
- Division of Emergency Medicine, Faculty of Medicine, Clinical Center, Institute of Medicine, University of Debrecen, Nagyerdei krt. 98, P.O. Box 19, 4032, Debrecen, Hungary.
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Becs G, Zarjou A, Agarwal A, Kovács KÉ, Becs Á, Nyitrai M, Balogh E, Bányai E, Eaton JW, Arosio P, Poli M, Jeney V, Balla J, Balla G. Pharmacological induction of ferritin prevents osteoblastic transformation of smooth muscle cells. J Cell Mol Med 2015; 20:217-30. [PMID: 26499096 PMCID: PMC4727553 DOI: 10.1111/jcmm.12682] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 08/14/2015] [Indexed: 12/31/2022] Open
Abstract
Vascular calcification is a frequent complication of atherosclerosis, diabetes and chronic kidney disease. In the latter group of patients, calcification is commonly seen in tunica media where smooth muscle cells (SMC) undergo osteoblastic transformation. Risk factors such as elevated phosphorus levels and vitamin D3 analogues have been identified. In the light of earlier observations by our group and others, we sought to inhibit SMC calcification via induction of ferritin. Human aortic SMC were cultured using β-glycerophosphate with activated vitamin D3 , or inorganic phosphate with calcium, and induction of alkaline phosphatase (ALP) and osteocalcin as well as accumulation of calcium were used to monitor osteoblastic transformation. In addition, to examine the role of vitamin D3 analogues, plasma samples from patients on haemodialysis who had received calcitriol or paricalcitol were tested for their tendency to induce calcification of SMC. Addition of exogenous ferritin mitigates the transformation of SMC into osteoblast-like cells. Importantly, pharmacological induction of heavy chain ferritin by 3H-1,2-Dithiole-3-thione was able to inhibit the SMC transition into osteoblast-like cells and calcification of extracellular matrix. Plasma samples collected from patients after the administration of activated vitamin D3 caused significantly increased ALP activity in SMC compared to the samples drawn prior to activated vitamin D3 and here, again induction of ferritin diminished the osteoblastic transformation. Our data suggests that pharmacological induction of ferritin prevents osteoblastic transformation of SMC. Hence, utilization of such agents that will cause enhanced ferritin synthesis may have important clinical applications in prevention of vascular calcification.
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Affiliation(s)
- Gergely Becs
- Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | - Abolfazl Zarjou
- Division of Nephrology, Department of Medicine, Nephrology Research and Training Center and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anupam Agarwal
- Division of Nephrology, Department of Medicine, Nephrology Research and Training Center and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Katalin Éva Kovács
- Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | - Ádám Becs
- Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | - Mónika Nyitrai
- Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | - Enikő Balogh
- Faculty of Medicine, Division of Neonatology, Department of Pediatrics, University of Debrecen, Debrecen, Hungary
| | - Emese Bányai
- Faculty of Medicine, Division of Neonatology, Department of Pediatrics, University of Debrecen, Debrecen, Hungary
| | - John W Eaton
- Molecular Targets Program, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Paolo Arosio
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Maura Poli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Viktória Jeney
- Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary.,MTA-DE Vascular Biology, Thrombosis and Hemostasis Research Group, Hungarian Academy of Sciences, Debrecen, Hungary
| | - József Balla
- Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary.,MTA-DE Vascular Biology, Thrombosis and Hemostasis Research Group, Hungarian Academy of Sciences, Debrecen, Hungary
| | - György Balla
- Faculty of Medicine, Division of Neonatology, Department of Pediatrics, University of Debrecen, Debrecen, Hungary
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Páll A, Becs G, Erdei A, Sira L, Czifra A, Barna S, Kovács P, Páll D, Pfliegler G, Paragh G, Szabó Z. Pseudopheochromocytoma induced by anxiolytic withdrawal. Eur J Med Res 2014; 19:53. [PMID: 25288254 PMCID: PMC4196012 DOI: 10.1186/s40001-014-0053-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/22/2014] [Indexed: 11/30/2022] Open
Abstract
Background Symptomatic paroxysmal hypertension without significantly elevated catecholamine concentrations and with no evidence of an underlying adrenal tumor is known as pseudopheochromocytoma. Methods We describe the case of a female patient with paroxysmal hypertensive crises accompanied by headache, vertigo, tachycardia, nausea and altered mental status. Previously, she was treated for a longer period with alprazolam due to panic disorder. Causes of secondary hypertension were excluded. Neurological triggers (intracranial tumor, cerebral vascular lesions, hemorrhage, and epilepsy) could not be detected. Results Setting of the diagnosis of pseudopheochromocytoma treatment was initiated with alpha- and beta-blockers resulting in reduced frequency of symptoms. Alprazolam was restarted at a daily dose of 1 mg. The patient’s clinical condition improved rapidly and the dosage of alpha- and beta-blockers could be decreased. Conclusions We conclude that the withdrawal of an anxiolytic therapeutic regimen may generate sympathetic overdrive resulting in life-threatening paroxysmal malignant hypertension and secondary encephalopathy. We emphasize that pseudopheochromocytoma can be diagnosed only after exclusion of the secondary causes of hypertension. We highlight the importance of a psychopharmacological approach to this clinical entity.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Zoltán Szabó
- Division of Emergency Medicine, Institute of Internal Medicine, University of Debrecen Medical Center, Nagyerdei krt, 98, Debrecen, 4032, Hungary.
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