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Oh GJ, Butani L. Nephrocalcinosis in Neonates. Neoreviews 2024; 25:e88-e98. [PMID: 38296790 DOI: 10.1542/neo.25-2-e88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Nephrocalcinosis occurs in as many as 40% of preterm neonates. Many causes and contributors predispose neonates to develop nephrocalcinosis, including metabolic, genetic, and iatrogenic factors. Because nephrocalcinosis can be a manifestation of an underlying genetic disorder, neonates with nephrocalcinosis must undergo an evaluation to identify and address contributors, to prevent further renal calcium deposition that can potentially lead to renal dysfunction. In this article, we review the epidemiology, pathogenesis, diagnosis, and evaluation of nephrocalcinosis in neonates. We also summarize the natural history of nephrocalcinosis of prematurity as well as the management of this condition.
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Affiliation(s)
- Gia J Oh
- Department of Pediatrics, Division of Pediatric Nephrology, University of California, Davis, Children's Hospital, Sacramento, CA
| | - Lavjay Butani
- Department of Pediatrics, Division of Pediatric Nephrology, University of California, Davis, Children's Hospital, Sacramento, CA
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Desmond HE, Lindner C, Troost JP, Held Z, Callaway A, Oh GJ, Lafayette R, O'Shaughnessy M, Elliott M, Adler SG, Kamil ES, Pesenson A, Selewski DT, Gipson PE, Carlozzi NE, Gipson DS, Massengill SF. Association between Psychiatric Disorders and Glomerular Disease. Glomerular Dis 2021; 1:118-128. [PMID: 36751494 PMCID: PMC9677713 DOI: 10.1159/000516359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/06/2021] [Indexed: 01/20/2023]
Abstract
Introduction Patients with chronic health conditions, particularly chronic kidney disease, are at heightened risk for psychiatric disorders; yet, there are limited data on those with primary glomerular disease. Methods This study included patients with glomerular disease enrolled in the kidney research network multisite patient registry. Registry data include encounter, diagnoses, medication, laboratory, and vital signs data extracted from participants' electronic health records. ICD-9/10 diagnosis codes were used to identify a subset of psychiatric disorders focused on anxiety, mood, and behavioral disorders. Time-varying Cox proportional hazard models were used to analyze time from the onset of kidney disease to diagnosis of psychiatric disorder. Adjusted models retained significant covariates from the full list of potential confounders, including age, sex, race, ethnicity, time-varying treatment, the estimated glomerular filtration rate, and proteinuria (urine protein-to-creatinine ratio [UPCR]). Analogous models examined diagnosis of psychiatric disorder as a predictor of time to end-stage kidney disease (ESKD). Results Data were available for 950 participants, with a median of 58 months of follow-up. 110 (12%) participants were diagnosed with psychiatric disorder during the follow-up. The estimated rate of psychiatric diagnosis after kidney disease was 14.7 cases per 1,000 person-years and was highest among those of adolescent age at the time of kidney disease diagnosis. Adjusted analyses found adolescent age (vs. adult, hazard ratio [HR] = 3.11, 95% confidence interval [CI] 1.87-5.17) and Asian race (vs. white, HR = 0.34, 95% CI 0.16-0.71) were associated with psychiatric diagnosis. A higher UPCR per 1 log unit (HR 1.13, 95% CI 1.01-1.27) and a higher total number of oral medications were associated with psychiatric disorder (p < 0.001). Psychiatric diagnosis was also associated with progression to ESKD (HR = 2.45, 95% CI 1.53-3.92) in adjusted models. Discussion/Conclusion Psychiatric disorders were documented in approximately one-eighth of patients with glomerular disease and correlated with clinical disease characteristics such as age, race, proteinuria, and oral medication burden. These findings suggest mental health screening is warranted in patients of all ages with glomerular disease.
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Affiliation(s)
- Hailey E. Desmond
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA,*Hailey E. Desmond,
| | - Clare Lindner
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathan P. Troost
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Zack Held
- Division of Pediatric Nephrology, Department of Pediatrics, Levine Children's Hospital, Atrium Health, Charlotte, North Carolina, USA
| | | | - Gia J. Oh
- Department of Pediatric Nephrology, Randall Children's Hospital at Legacy Emanuel Medical Center, Legacy Health, Portland, Oregon, USA
| | - Richard Lafayette
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, California, USA
| | | | - Matthew Elliott
- Metrolina Nephrology Associates, Charlotte, North Carolina, USA
| | - Sharon G. Adler
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-University of California, Torrance, California, USA
| | - Elaine S. Kamil
- Division of Pediatric Nephrology, Department of Pediatrics, Cedars-Sinai Medical Center, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | | | - David T. Selewski
- Division of Nephrology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Patrick E. Gipson
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA,Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Noelle E. Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Debbie S. Gipson
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Susan F. Massengill
- Division of Pediatric Nephrology, Department of Pediatrics, Levine Children's Hospital, Atrium Health, Charlotte, North Carolina, USA
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Weaver DJ, Waldo A, Oh GJ, Kamil ES, Elliott M, Adler S, Pesenson A, Modes MM, Gipson P, Lafayette RA, Selewski DT, Attalla SE, Eikstadt R, Troost JP, Gipson DS, Massengill SF. Time to Initiation of Antihypertensive Therapy After Onset of Elevated Blood Pressure in Patients With Primary Proteinuric Kidney Disease. Kidney Med 2020; 2:131-138. [PMID: 32734234 PMCID: PMC7380443 DOI: 10.1016/j.xkme.2019.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 12/02/2022] Open
Abstract
Rationale & Objective The objective of the study was to estimate the prevalence of hypertension in patients with proteinuric kidney disease and evaluate blood pressure (BP) control. Study Design Retrospective cohort study. Setting & Participants Data from adults and children with proteinuric kidney disease enrolled in the multicenter Kidney Research Network Registry were used for this study. Exposure Proteinuric kidney disease. Outcomes Hypertension and BP control. Analytical Approach Patients with white-coat hypertension were excluded. Patients were censored at end-stage kidney disease onset. Patients were defined as hypertensive either by hypertension diagnosis code, having 2 or more encounters with elevated BPs, or treatment with antihypertensive therapy excluding renin-angiotensin-aldosterone system blockade. Elevated BP was defined as greater than 95th percentile for children and >140/90 mm Hg in adults. Sustained BP control was defined as 2 or more consecutive encounters with BPs lower than 95th percentile for children and <140/90 mm Hg for adults. Kaplan-Meier and Cox proportional hazards analyses were used to evaluate the time to initiation of antihypertensive therapy. Results 842 patients, 69% adults and 31% children, with a total observation period of 6,722 patient-years were included in the analysis. 644 (76%) had hypertension during observation. There was no difference in the prevalence of hypertension between children and adults (74% vs 78%; P = 0.3). Hypertension was most common among those of African American race compared with other races (90% vs 72%-75%; P = 0.003). 504 (78%) patients with hypertension achieved BP control but only 51% achieved control within 1 year. 140 (22%) patients with hypertension never achieved BP control during a median of 41 (IQR, 24-73) months of observation. Limitations Differing BP control goals that may lead to overestimation of the controlled patient population. Conclusions Hypertension affects most patients with proteinuric kidney disease regardless of age. Time to BP control exceeded 1 year in 50% of patients with hypertension and 22% did not demonstrate control. This study highlights the need to address hypertension early and completely in disease management of patients with proteinuric kidney disease.
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Affiliation(s)
- Donald J Weaver
- Division of Pediatric Nephrology, Levine Children's Hospital at Atrium Health, Charlotte, NC
| | - Anne Waldo
- Division of Nephrology, Department of Pediatrics & Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI
| | - Gia J Oh
- Division of Nephrology, Department of Pediatrics, Stanford University, Stanford, CA
| | | | | | - Sharon Adler
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA
| | | | | | - Patrick Gipson
- Division of Nephrology, Department of Pediatrics & Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.,Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, MI
| | | | - David T Selewski
- Division of Nephrology, Department of Pediatrics & Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI
| | - Samara E Attalla
- Division of Nephrology, Department of Pediatrics & Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI
| | - Richard Eikstadt
- Division of Nephrology, Department of Pediatrics & Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI
| | - Jonathan P Troost
- Division of Nephrology, Department of Pediatrics & Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI
| | - Debbie S Gipson
- Division of Nephrology, Department of Pediatrics & Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI
| | - Susan F Massengill
- Division of Pediatric Nephrology, Levine Children's Hospital at Atrium Health, Charlotte, NC
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Tran CL, Selewski DT, Oh GJ, Troost JP, Massengill SF, Al-Akash SI, Mahesh S, Amin R, Ashoor IF, Chanchlani R, Kallash M, Woroniecki RP, Gipson DS. Pediatric Immunization Practices in Nephrotic Syndrome: An Assessment of Provider and Parental Knowledge. Front Pediatr 2020; 8:619548. [PMID: 33634053 PMCID: PMC7901920 DOI: 10.3389/fped.2020.619548] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/24/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Children with nephrotic syndrome (NS) are at high risk for vaccine-preventable infections due to the immunological effects from the disease and concurrent treatment with immunosuppressive medications. Immunizations in these patients may be deferred due to their immunosuppressive treatment which may increase the risk for vaccine-preventable infections. Immunization practices in children with NS continue to vary among pediatric nephrologists. This raises the question of whether children with NS are receiving the recommended vaccinations at appropriate times. Therefore, it is critical to understand the practices and patient education provided by physicians to patients on the topic of vaccinations. Methods: After informed consent, parents/guardians of 153 pediatric patients (<18 years old) diagnosed with NS from 2005 to 2018 and 50 pediatric nephrologists from 11 participating centers completed anonymous surveys to evaluate immunization practices among pediatric nephrologists, assess the vaccine education provided to families of children with NS, assess the parental knowledge of immunization recommendations, and assess predictors of polysaccharide pneumococcal vaccine adherence. The Advisory Committee on Immunization Practices (ACIP) Immunization 2019 Guideline for those with altered immunocompetence was used to determine accuracy of vaccine knowledge and practices. Results: Forty-four percent of providers self-reported adherence to the ACIP guidelines for inactive vaccines and 22% to the guidelines for live vaccines. Thirty-two percent of parents/guardians reported knowledge that aligned with the ACIP guidelines for inactive vaccines and 1% for live vaccines. Subjects residing in the Midwest and provider recommendations for vaccines were positive predictors of vaccine adherence (p < 0.001 and p 0.02, respectively). Conclusions: Vaccine recommendation by medical providers is paramount in vaccine adherence among pediatric patients with NS. This study identifies potential educational opportunities for medical subspecialty providers and family caregivers about immunization recommendations for immunosuppressed patients.
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Affiliation(s)
- Cheryl L Tran
- Division of Pediatric Nephrology, Department of Pediatrics, Mayo Clinic, Rochester, MN, United States
| | - David T Selewski
- Division of Pediatric Nephrology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Gia J Oh
- Division of Nephrology, Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - Jonathan P Troost
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI, United States
| | - Susan F Massengill
- Levine Children's Hospital at Atrium Health, Charlotte, NC, United States
| | | | - Shefali Mahesh
- Division of Nephrology and Dialysis, Akron Children's Hospital, Akron, OH, United States
| | - Rasheda Amin
- Pediatric Specialists of Virginia, Fairfax, VA, United States.,Department of Pediatrics, George Washington University, Washington, DC, United States
| | - Isa F Ashoor
- Division of Nephrology, Department of Pediatrics, Louisiana State University, New Orleans, LA, United States
| | - Rahul Chanchlani
- Division of Pediatric Nephrology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Mahmoud Kallash
- Division of Nephrology, Nationwide Children's Hospital, Columbus, OH, United States
| | - Robert P Woroniecki
- Division of Pediatric Nephrology and Hypertension, Stony Brook Children's Hospital and Renaissance School of Medicine, Stony Brook, NY, United States
| | - Debbie S Gipson
- Division of Pediatric Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
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Oh GJ, Waldo A, Paez-Cruz F, Gipson PE, Pesenson A, Selewski DT, Kamil ES, Massengill SF, Lafayette RA, Modes M, Adler SG, Desmond H, Eikstadt R, Attalla S, Modi ZJ, Troost JP, Gipson DS. Steroid-Associated Side Effects in Patients With Primary Proteinuric Kidney Disease. Kidney Int Rep 2019; 4:1608-1616. [PMID: 31891002 PMCID: PMC6933464 DOI: 10.1016/j.ekir.2019.08.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 08/02/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 12/28/2022] Open
Abstract
Introduction The goal of this study was to assess the occurrence of steroid-associated adverse events (SAAE) in patients with primary proteinuric kidney disease. Methods The Kidney Research Network Registry consists of children and adults with primary proteinuric kidney disease. SAAEs of interest were hypertension, hyperglycemia and diabetes, overweight and obesity, short stature, ophthalmologic complications, bone disorders, infections, and psychosis. Events were identified using International Classification of Diseases, Ninth Revision/Tenth Revision codes, blood pressures, growth parameters, laboratory values, and medications. Poisson generalized estimating equations tested the association between steroid onset and dose on SAAE risk. Results A total of 884 participants were included in the analysis; 534 (60%) were treated with steroids. Of these, 62% had at least one SAAE. The frequency of any SAAE after initiation of steroids was 293 per 1000 person-years. The most common SAAEs were hypertension (173.7 per 1000 person-years), diabetes (78.7 per 1000 person-years), obesity (66.8 per 1000 person-years), and infections (46.1 per 1000 person-years). After adjustment for demographics, duration of kidney disease, estimated glomerular filtration rate (eGFR), proteinuria, and other therapies, steroid exposure was associated with a 40% increase in risk of any SAAE (Relative risk [RR]: 1.4; 95% confidence interval [CI]: 1.3–1.6). A 1-mg/kg per day increase in steroid dose was associated with a 2.5-fold increase in risk of any SAAE. Conclusion Most patients with primary proteinuric kidney disease treated with steroids experienced at least one SAAE. Steroid therapy increased risk of hypertension, diabetes, weight gain, short stature, fractures, and infections after adjusting for disease-related factors. This study highlights the importance of surveillance and management of SAAE and provides rationale for the development of steroid minimization protocols.
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Affiliation(s)
- Gia J Oh
- Division of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Anne Waldo
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Francisco Paez-Cruz
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Patrick E Gipson
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | - David T Selewski
- Division of Nephrology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Elaine S Kamil
- Division of Pediatric Nephrology, Department of Pediatrics, Cedars-Sinai Medical Center, David Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | - Susan F Massengill
- Division of Pediatric Nephrology, Department of Pediatrics, Levine Children's Hospital, Charlotte, North Carolina, USA
| | - Richard A Lafayette
- Division of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | | | - Sharon G Adler
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, California, USA
| | - Hailey Desmond
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Richard Eikstadt
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Samara Attalla
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Zubin J Modi
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathan P Troost
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Debbie S Gipson
- Division of Nephrology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Gomez-Ospina N, Scott AI, Oh GJ, Potter D, Goel VV, Destino L, Baugh N, Enns GM, Niemi AK, Cowan TM. Expanding the phenotype of hawkinsinuria: new insights from response to N-acetyl-L-cysteine. J Inherit Metab Dis 2016; 39:821-829. [PMID: 27488560 DOI: 10.1007/s10545-016-9963-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 06/19/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
Hawkinsinuria is a rare disorder of tyrosine metabolism that can manifest with metabolic acidosis and growth arrest around the time of weaning off breast milk, typically followed by spontaneous resolution of symptoms around 1 year of age. The urinary metabolites hawkinsin, quinolacetic acid, and pyroglutamic acid can aid in identifying this condition, although their relationship to the clinical manifestations is not known. Herein we describe clinical and laboratory findings in two fraternal twins with hawkinsinuria who presented with failure to thrive and metabolic acidosis. Close clinical follow-up and laboratory testing revealed previously unrecognized hypoglycemia, hypophosphatemia, combined hyperlipidemia, and anemia, along with the characteristic urinary metabolites, including massive pyroglutamic aciduria. Treatment with N-acetyl-L-cysteine (NAC) restored normal growth and normalized or improved most biochemical parameters. The dramatic response to NAC therapy supports the idea that glutathione depletion plays a key role in the pathogenesis of hawkinsinuria.
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Affiliation(s)
- Natalia Gomez-Ospina
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, H 315, Stanford, CA, 94305-5208, USA.
| | - Anna I Scott
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Gia J Oh
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, H 315, Stanford, CA, 94305-5208, USA
| | - Donald Potter
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, H 315, Stanford, CA, 94305-5208, USA
| | - Veena V Goel
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, H 315, Stanford, CA, 94305-5208, USA
| | - Lauren Destino
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, H 315, Stanford, CA, 94305-5208, USA
| | - Nancy Baugh
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, H 315, Stanford, CA, 94305-5208, USA
| | - Gregory M Enns
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, H 315, Stanford, CA, 94305-5208, USA
| | - Anna-Kaisa Niemi
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, H 315, Stanford, CA, 94305-5208, USA
| | - Tina M Cowan
- Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur Drive, H 315, Stanford, CA, 94305-5208, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
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Lee JM, Park SB, Oh GJ, Lee YH, Lee S, Kim NH, Kang SK. Prevalence, Awareness, Treatment and Control of Hypertension in Korea. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt124.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hwang WJ, Park EJ, Jang CH, Han SW, Oh GJ, Kim NS, Kim HM. Inhibitory effect of immunoglobulin E production by jin-deuk-chal (Siegesbeckia orientalis). Immunopharmacol Immunotoxicol 2001; 23:555-63. [PMID: 11792014 DOI: 10.1081/iph-100108601] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Elevated levels of immunoglobulin (Ig) E are associated with immediate-type allergic reactions. Jin-deuk-chal is the whole plant of Siegesbeckia orientalis (SO) sL Immunization of mice with small amounts of protein antigens on alum results in several fold increases in total plasma IgE, much of it specific for the immunizing antigen. In the present study, we investigated the effect of Siegesbeckia orientalis (SO) on IgE production. SO inhibited the plasma levels of IgE induced by antigens. The effects of SO on the interleukin (IL)-4-dependent IgE response by mouse whole spleen cells were studied. IL-4 dependent IgE production of lipopolysaccharide (LPS)-stimulated whole spleen cells was inhibited by SO. In addition, using U266B I human IgE-bearing B cells, we found that SO inhibited the production of IgE activated by LPS plus IL-4. These results suggest that SO have antiallergic activity by inhibition of IgE production from B cells.
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Affiliation(s)
- W J Hwang
- Professional Graduate School of Oriental Medicine, College of Pharmacy, Wonkwang University, Iksan, Chonbuk, Republic of Korea
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Kim HM, Yim HG, Yoon HS, Park ST, Jeung JY, Lee KN, Baek SH, Song YS, Oh GJ, Kim NS, An NH. Phosphatidylinositol 3-kinase regulates proliferation of RAW 264.7 macrophages. Immunopharmacol Immunotoxicol 2001; 23:355-65. [PMID: 11694027 DOI: 10.1081/iph-100107336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Phosphatidylinositol 3-kinase (P13-kinase) is an enzyme that acts as a direct biochemical link between a novel phosphatidylinositol pathway and a number of proteins containing intrinsic or associated kinase activities. Here we demonstrate that wortmannin, P13-kinase inhibitor, decreases the proliferation of RAW 264.7 macrophages and that another structurally unrelated inhibitor of P13-kinase, LY294002. also inhibits the proliferation. These results indicate a possible involvement of P13-kinase in RAW 264.7 macrophages growth regulation. Wortmannin stimulation of RAW 264.7 macrophages is followed by sustained expression of the mRNA of c-fos and a transient expression of the mRNA of c-jun. We also show that the wortmannin and LY294002 induce a cell cycle arrest in asynchronously growing cells leading to an inhibition of cell proliferation after 12 h of treatment. In addition, wortmannin or LY294002 inhibited the phorbol 12-myristate 13-acetate-induced macrophages proliferation potently. These results suggest that P13-kinase plays an important role in growth regulation of RAW 264.7 macrophages and that protein kinase C is a down stream effector of P13-kinase.
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Affiliation(s)
- H M Kim
- College of Pharmacy, Korea Institute of Oriental Pharmacy, Wonkwang University School of Medicine, Iksan, Chonbuk, Republic of Korea.
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Min KR, Hwang BY, Lim HS, Kang BS, Oh GJ, Lee J, Kang SH, Lee KS, Ro JS, Kim Y. (-)-Epiafzelechin: cyclooxygenase-1 inhibitor and anti-inflammatory agent from aerial parts of Celastrus orbiculatus. Planta Med 1999; 65:460-462. [PMID: 10418338 DOI: 10.1055/s-2006-960813] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
An inhibitor of cyclooxygenase (COX)-1 activity of prostaglandin H2 synthase was isolated from aerial parts of Celastrus orbiculatus Thunb. (Celastraceae), an oriental folk medicine for rheumatoid arthritis by activity-guided column chromatographic methods. The COX inhibitor was identified as (-)-epiafzelechin, a member of flavan-3-ols by the structural analysis with HR-EI-mass, 1H-NMR and 13C-NMR spectral data. The compound exhibited a dose-dependent inhibition on the COX activity with an IC50 value of 15 microM. (-)-Epiafzelechin exhibited about 3-fold weaker inhibitory potency on the enzyme activity than indomethacin as a positive control. (-)-Epiafzelechin exhibited significant anti-inflammatory activity on carrageenin-induced mouse paw edema when the compound (100 mg/kg) was orally administrated at 1 h before carrageenin treatment.
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