Evaluation of Selected Markers in Kidneys of Cynomolgus Monkey (Macaca fascicularis) with Induced Diabetes during Renal Ischemia-reperfusion Injury

We previously reported that induced type 1 diabetes mellitus (DM) increases the susceptibility of acute kidney injury in- duced by ischemia-reperfusion injury (IRI) in cynomolgus monkeys. In this follow-up study, we compared the expression of selected markers in the renal tissues of monkeys subjected to bilateral renal IRI with and without diabetes. All tissues were obtained from the original study. Renal biopsies were obtained before and 24 and 48 h after ischemia and were examined for expression of KI-67 (tubular proliferation), Na+ /K+ ATPase (sodium-potassium pump), TNF-α(tumor necrosis factor-α, inflammation), CD31 (microvessels), CD3 (T-cells), 2 fibrotic markers (fibroblast specific protein-1, FSP-1;α-smooth muscle actin,α -SMA), and cleaved caspase 3 (apoptosis). Generally, the expression of these markers differed in monkeys with and without DM. As compared with non-DM monkeys, DM monkeys had more cells that expressed KI-67 during progression of acute kidney injury (AKI). Na+ /K+ ATPase expression was clearly present at baseline in the basolateral tubular areas only in the non-DM monkeys. At 48 h, its expression in the basolateral area was not visible in DM monkeys, but was still present in intercellular junctions of non-DM monkeys. The expression of TNF-αwas higher in DM before and 48 h after ischemia. Before and 24 h after ischemia, the number of CD31-positive capillaries was not different between 2 groups, although more collapsed vessels were found at in DM at 24 h. At 48 h, the number of capillaries was less in DM compared with those from non-DM animals. DM monkeys had more interstitial CD3-positive cells than did non-DM monkeys at 24 and 48 h after ischemia. Finally, FSP-1-stained cells were more abundant in DM than non-DM at 24 and 48 h. Our results show that DM aggravates the recovery of renal ischemia/reperfusion injury by affecting tubular proliferation, capillary density, T cell infil- tration and by altering protein and mRNA expression of various genes involved in ion channel, inflammation, and fibrotic change. The results from this observational study demonstrate that DM aggravates the recovery of renal ischemia/reperfusion injury by affecting multiple events including tubular necrosis, proliferation, function, inflammation and by inducing capillary rarefaction in cynomolgus monkeys.

Evaluation of Selected Markers in Kidneys of Cynomolgus Monkey (Macaca fascicularis) with Induced Diabetes during Renal Ischemia-reperfusion Injury

We previously reported that induced type 1 diabetes mellitus (DM) increases the susceptibility of acute kidney injury inducedby ischemia-reperfusion injury (IRI) in cynomolgus monkeys. In this follow-up study, we compared the expression ofselected markers in the renal tissues of monkeys subjected to bilateral renal IRI with and without diabetes. All tissues wereobtained from the original study. Renal biopsies were obtained before and 24 and 48 h after ischemia and were examinedfor expression of KI-67 (tubular proliferation), Na+/K+ ATPase (sodium-potassium pump), TNF-α (tumor necrosis factor-α,inflammation), CD31 (microvessels), CD3 (T-cells), 2 fibrotic markers (fibroblast specific protein-1, FSP-1; α-smooth muscleactin, α-SMA), and cleaved caspase 3 (apoptosis). Generally, the expression of these markers differed in monkeys with andwithout DM. As compared with non-DM monkeys, DM monkeys had more cells that expressed KI-67 during progressionof acute kidney injury (AKI). Na+/K+ ATPase expression was clearly present at baseline in the basolateral tubular areas onlyin the non-DM monkeys. At 48 h, its expression in the basolateral area was not visible in DM monkeys, but was still presentin intercellular junctions of non-DM monkeys. The expression of TNF-α was higher in DM before and 48 h after ischemia.Before and 24 h after ischemia, the number of CD31-positive capillaries was not different between 2 groups, although morecollapsed vessels were found at in DM at 24 h. At 48 h, the number of capillaries was less in DM compared with those fromnon-DM animals. DM monkeys had more interstitial CD3-positive cells than did non-DM monkeys at 24 and 48 h afterischemia. Finally, FSP-1-stained cells were more abundant in DM than non-DM at 24 and 48 h. Our results show that DMaggravates the recovery of renal ischemia/reperfusion injury by affecting tubular proliferation, capillary density, T cell infiltrationand by altering protein and mRNA expression of various genes involved in ion channel, inflammation, and fibroticchange. The results from this observational study demonstrate that DM aggravates the recovery of renal ischemia/reperfusioninjury by affecting multiple events including tubular necrosis, proliferation, function, inflammation and by inducingcapillary rarefaction in cynomolgus monkeys.

Upper airway stimulation as an alternative to maxillomandibular advancement for obstructive sleep apnoea in a patient with dentofacial deformity: case report with literature review

Obstructive sleep apnoea (OSA) is characterized by repeated upper airway collapse leading to oxygen desaturation resulting in cardiovascular and neurocognitive sequelae. Upper airway surgeries such as palatopharyngoplasty, tongue base surgery, and maxillomandibular advancement can improve patient tolerance of continuous positive airway pressure, quality of life, and the severity of OSA. Upper airway stimulation (UAS) of the hypoglossal nerve is a contemporary US Food and Drug Administration-approved treatment modality for OSA with a fundamentally different mechanism. We report the case of a 65-year-old male with a high body mass index, hypertension, diabetes, dentofacial deformity, and severe OSA. He presented with a respiratory distress index (RDI) of 89.1 events per hour, apnoea-hypopnoea index (AHI) of 82.7 events per hour, and minimum oxygen saturation of 75%. He chose to undergo UAS. Initially, complete concentric collapse of the velum was found during drug-induced sedation endoscopy, which was converted by palatopharyngoplasty to meet inclusion criteria for UAS. The patient achieved surgical cure with postoperative RDI and AHI of 2 events per hour with minimum oxygen saturation of 83%, and resolution of daytime somnolence. UAS is an effective surgical option to broaden the surgeon's ability to treat OSA, especially if facial skeletal surgery is contraindicated or declined by the patient with dentofacial deformity.

Machine learning methods applied to pharmacokinetic modelling of remifentanil in healthy volunteers: a multi-method comparison

This study compared the blood concentrations of remifentanil obtained in a previous clinical investigation with the predicted remifentanil concentrations produced by different pharmacokinetic models: a non-linear mixed effects model created by the software NONMEM; an artificial neural network (ANN) model; a support vector machine (SVM) model; and multi-method ensembles. The ensemble created from the mean of the ANN and the non-linear mixed effects model predictions achieved the smallest error and the highest correlation coefficient. The SVM model produced the highest error and the lowest correlation coefficient. Paired t-tests indicated that there was insufficient evidence that the predicted values of the ANN, SVM and two multi-method ensembles differed from the actual measured values at alpha = 0.05. The ensemble method combining the ANN and non-linear mixed effects model predictions outperformed either method alone. These results indicated a potential advantage of ensembles in improving the accuracy and reducing the variance of pharmacokinetic models.

Tissue-specific expression of the subunits of chick 20S proteasomes

The subunit patterns of the proteasomes, that were purified from muscle, liver and brain, were found to be significantly different from one another. Furthermore, the proteasomes from adult and embryonic tissues of the same types also differed from each other in their subunit patterns. In addition, the specific activities of the purified proteasomes for peptide-cleavage, but not for casein-hydrolysis, appeared to be varied among the enzymes isolated from the different tissues. Thus, expression of a large number of proteasome subunits appears to be tissue-specific and under developmental control, although its relation with the multicatalytic activities of the proteasomes remains unclear.

Developmental regulation of proteolytic activities and subunit pattern of 20 S proteasome in chick embryonic muscle

The proteolytic activities of the 20 S proteasome were found to change in their levels during the development of chick embryonic muscle. The peptide-cleaving activities against N-succinyl-Leu-Leu-Val-Tyr-7-amido-4-methylcoumarin and N-benzyloxycarbonyl-Ala-Arg-Arg-4-methoxy-beta-naphthylamide gradually decreased with the time of development. On the other hand, the casein-degrading activity in the presence of poly-L-lysine markedly increased from embryonic day 11 and reached a maximal level by day 17. These changes appeared to be tissue-specific because little or no change in any of the proteolytic activities was observed with developing embryonic brain, while dramatic alterations occurred in the extents of the peptide hydrolyses in liver. Furthermore, a number, but not all, of the proteasome subunits in embryonic muscle were changed in their amounts during the development. These results suggest that the alterations in the proteasome activities and subunit pattern are developmentally regulated and may be correlated.

Effects of leucine on in vitro protein synthesis and degradation in rat skeletal muscles

Weanling rats were used to examine the role of leucine in in vitro protein turnover in skeletal muscles. In three experiments, rats were subjected to 24 or 72 hours of food deprivation or 5 days of consuming a protein-free diet or injection of streptozotocin. The soleus and extensor digitorum longus muscles were removed and utilized for measures of protein synthesis or degradation by using the isolated, incubated muscle technique of Li et al. These experiments demonstrate that supplementation of the incubation media with 0.5 mM leucine stimulates protein synthesis in these catabolic muscles and that during total starvation the stimulation decreases as the severity of the condition increases. Leucine supplementation failed to affect protein degradation in these skeletal muscles. This study demonstrates that the branched-chain amino acid leucine has the potential to stimulate protein synthesis in skeletal muscles, at least under specific catabolic conditions, but does not affect protein degradation in skeletal muscles under the conditions studied.