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Mao W, Ding X, Ding Y, Fu C, Zeng M, Zhou J. Does Bi-Exponential Fitting Perform Better than Mono-Exponential Fitting in IVIM-DWI? An Assessment of Renal Pathological Injury of IgA Nephropathy. Curr Med Imaging 2023:CMIR-EPUB-132699. [PMID: 37366355 DOI: 10.2174/1573405620666230627103919] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/09/2023] [Accepted: 05/01/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Chronic kidney disease has become one of the world's major public health problems, immunoglobulin A (IgA) nephropathy is a common pathological type of CKD. Delaying the progression of IgA nephropathy has currently become the main clinical treatment strategy, precise evaluation of renal pathological injury during follow-up of patients with IgA nephropathy is important. Therefore, it is imperative to develop an accurate and non-invasive imaging technique for effective follow-up of renal pathological injury in patients with IgA nephropathy. OBJECTIVE To investigate the clinical value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in assessing renal pathological injury in patients with immunoglobulin A (IgA) nephropathy compared with a mono-exponential model. METHODS Altogether, 80 patients with IgA nephropathy were divided into the mild (41 cases) andmoderate-severe (m-s) renal injury groups (39 cases) according to pathology scores, and 20 healthy volunteers were recruited as controls. All participants underwent IVIM-DWI of the kidneys, and renal parenchymal apparent diffusion coefficient (ADC), pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) values were measured. One-way analysis of variance, receiver operating characteristic (ROC) curve analysis, and Pearson correlation analysis were performed for all the DWI-derived parameters. RESULTS The DWI-derived parameters of the m-s renal injury group were significantly lower than those of the mild renal injury and control groups (P < 0.01). The ROC analysis revealed that f had the largest area under the ROC curve for differentiation between the m-s and mild renal injury groups and between the m-s renal injury and control groups. The f had the largest correlation coefficient with renal pathology scores (r=-0.81), followed by the D* (-0.69), ADC (-0.54), and D values (-0.53), respectively (all P<0.01). CONCLUSION IVIM-DWI demonstrated better diagnostic performance than the mono-exponential model in assessing renal pathological injury in patients with IgA nephropathy.
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Affiliation(s)
- Wei Mao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai 200032, People’s Republic of China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People’s Republic of China
| | - Yuqin Ding
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai 200032, People’s Republic of China
| | - Caixia Fu
- Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, People’s Republic of China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai 200032, People’s Republic of China
| | - Jianjun Zhou
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai 200032, People’s Republic of China
- Department of Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
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Abstract
In pediatric trauma, the kidney is the most commonly injured organ of the urinary tract. Renal trauma occurs in 10% to 20% of all pediatric blunt abdominal trauma cases. The vast majority of renal injuries can be treated conservatively. However, cases associated with hemodynamic instability require operative interventions. Injuries to the ureter, bladder or urethra are almost exclusively encountered in polytraumatized children. The aim of this article is to give an overview on traumatic injuries to the pediatric urinary system.
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Affiliation(s)
- Georg Singer
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.
| | - Christoph Arneitz
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Sebastian Tschauner
- Division of Paediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Christoph Castellani
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Holger Till
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
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Kong J, Han L, Su H, Hu Y, Huang X, Lou Y. Riligustilide Attenuated Renal Injury by the Blockade of Renin. Cell Physiol Biochem 2018; 50:654-667. [PMID: 30308499 DOI: 10.1159/000494186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 01/30/2018] [Accepted: 10/02/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Nephropathy related with renin can be alleviated with ACE-inhibitors or AT1R blockers, whereas they might be ineffective after long-term administration because of a feedback production of enhanced renin. Therefore, it is urgent to develop a new category of anti-nephropathy medicine directly targeting renin. Riligustilide (C20), originally isolated from the Chinese herb Ligusticumporteri, a rhizome, was confirmed effective against many diseases. METHODS The therapeutic effect of C20 on renal injury and its underlying mechanism were investigated in three different nephrotic models, which were spontaneously hypertension rats (SHR) model, diabetic nephropathy in BTBR ob/ob mice model and 5/6-nephrectomized (5/6NX) rats model. RESULTS The intensity of kidney fibrosis was extensively decreased in the C20-treated rats compared to the vehicle animals. C20 significantly alleviated renal injury much more in 5/6 NX rats than in vehicle group. The rats in 5/6 NX without administrated C20 developed albuminuria earlier with more severe symptoms. Additionally, our findings showed that C20 down-regulated the renin expression and relocation of CREB-CBP complex in vivo and in vitro. CONCLUSION C20 plays importantly reno-protective roles most likely through the relocation of CREB-CBP complex.
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Affiliation(s)
- Juan Kong
- Department of Clinical Nutrition, Shengjing Hospital of China Medical University, Shenyang, China
| | - Li Han
- Institute of Microbial Pharmaceuticals College of Life and Health Sciences, Northeastern University, Shenyang, China
| | - Han Su
- Department of Clinical Nutrition, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yihan Hu
- Department of Pharmaceuticals, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xueshi Huang
- Institute of Microbial Pharmaceuticals College of Life and Health Sciences, Northeastern University, Shenyang, China
| | - Yan Lou
- Department of Computer Application, China Medical University, Shenyang, China
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Kramer R, Karpa K. Drug-Induced Acute Kidney Injury: A Standardized Patient Case for Clerkship Students. MedEdPORTAL 2017; 13:10553. [PMID: 30800755 PMCID: PMC6342158 DOI: 10.15766/mep_2374-8265.10553] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 02/16/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Drug-induced nephrotoxicity is a common yet preventable cause of acute renal failure. With the upward trend of prescription and over-the-counter medication use, it has become increasingly important for health care professionals to not only be able to identify acute renal failure precipitated by medications, but also to recognize medications that are eliminated by the kidneys and adjust dosages accordingly to prevent further damage. METHODS In this activity, third-year clerkship medical students are presented with a standardized patient portraying an acute medical problem in which students must ascertain the underlying cause of the problem and draw from their knowledge of pharmacology, pharmacokinetic principles, and clinical therapeutics to develop a plan to address the patient's medical concerns. RESULTS We found that few students were able to identify the underlying cause of the patient's acute condition, and none were successful at applying pharmacokinetic principles appropriately. DISCUSSION Implementing this case with third-year medical students has identified the need to revisit pharmacokinetic principles in an applied setting. As a result, this topic is being added to a course that highlights the relevance of basic sciences in clinical contexts for clerkship students.
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Affiliation(s)
| | - Kelly Karpa
- Associate Professor, Department of Pharmacology, Pennsylvania State University College of Medicine
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Arif E, Rathore YS, Kumari B, Ashish F, Wong HN, Holzman LB, Nihalani D. Slit diaphragm protein Neph1 and its signaling: a novel therapeutic target for protection of podocytes against glomerular injury. J Biol Chem 2014; 289:9502-18. [PMID: 24554715 DOI: 10.1074/jbc.m113.505743] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Podocytes are specialized epithelial cells that are critical components of the glomerular filtration barrier, and their dysfunction leads to proteinuria and renal failure. Therefore, preserving podocyte function is therapeutically significant. In this study, we identified Neph1 signaling as a therapeutic target that upon inhibition prevented podocyte damage from a glomerular injury-inducing agent puromycin aminonucleoside (PAN). To specifically inhibit Neph1 signaling, we used a protein transduction approach, where the cytoplasmic domain of Neph1 (Neph1CD) tagged with a protein transduction domain trans-activator of transcription was transduced in cultured podocytes prior to treatment with PAN. The PAN-induced Neph1 phosphorylation was significantly reduced in Neph1CD-transduced cells; in addition, these cells were resistant to PAN-induced cytoskeletal damage. The biochemical analysis using subfractionation studies showed that unlike control cells Neph1 was retained in the lipid raft fractions in the transduced cells following treatment with PAN, indicating that transduction of Neph1CD in podocytes prevented PAN-induced mislocalization of Neph1. In accordance, the immunofluorescence analysis further suggested that Neph1CD-transduced cells had increased ability to retain endogenous Neph1 at the membrane in response to PAN-induced injury. Similar results were obtained when angiotensin was used as an injury-inducing agent. Consistent with these observations, maintaining high levels of Neph1 at the membrane using a podocyte cell line overexpressing chimeric Neph1 increased the ability of podocytes to resist PAN-induced injury and PAN-induced albumin leakage. Using a zebrafish in vivo PAN and adriamycin injury models, we further demonstrated the ability of transduced Neph1CD to preserve glomerular function. Collectively, these results support the conclusion that inhibiting Neph1 signaling is therapeutically significant in preventing podocyte damage from glomerular injury.
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Affiliation(s)
- Ehtesham Arif
- From the Renal Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, Pennsylvania 19104 and
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Whitney JL, Bilkan CM, Sandberg K, Myers AK, Mulroney SE. Growth hormone exacerbates diabetic renal damage in male but not female rats. Biol Sex Differ 2013; 4:12. [PMID: 23805912 PMCID: PMC3698039 DOI: 10.1186/2042-6410-4-12] [Citation(s) in RCA: 11] [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: 03/21/2013] [Accepted: 06/18/2013] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Human and animal studies support the idea that there are sex differences in the development of diabetic renal disease. Our lab and others have determined that in addition to Ang II (through the AT1R), growth hormone (GH) contributes to renal damage in models of renal failure; however, the impact of sex and GH on the mechanisms initiating diabetic renal disease is not known. This study examined the effect of sex and GH on parameters of renal damage in early, uncontrolled streptozotocin (STZ)-induced diabetes. METHODS Adult male and female Sprague-Dawley rats were injected with vehicle (control), STZ, or STZ + GH and euthanized after 8 weeks. RESULTS Mild but significant glomerulosclerosis (GS) and tubulointerstitial fibrosis (TIF) was observed in both kidneys from male and female diabetic rats, with GH significantly increasing GS and TIF by 30% and 25% in male rats, but not in female rats. STZ increased TGF-β expression in both kidneys from male and female rats; however, while GH had no further effect on TGF-β protein in diabetic females, GH increased TGF-β protein in the male rat's kidneys by an additional 30%. This sex-specific increase in renal injury following GH treatment was marked by increased MCP-1 and CD-68+ cell density. STZ also reduced renal MMP-2 and MMP-9 protein expression in both kidneys from male and female rats, but additional decreases were only observed in GH-treated diabetic male rats. The sex differences were independent of AT1R activity. CONCLUSIONS These studies indicate that GH affects renal injury in diabetes in a sex-specific manner and is associated with an increase in pro-inflammatory mediators.
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Affiliation(s)
- Jennifer L Whitney
- Department of Physiology and Biophysics, Georgetown University Medical Center, Washington, DC 20057-1640, USA
| | - Christine Maric Bilkan
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kathryn Sandberg
- Department of Physiology and Biophysics, Georgetown University Medical Center, Washington, DC 20057-1640, USA
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
- Center for the Study of Sex Differences in Health, Aging and Disease, Georgetown University Medical Center, Washington, DC, USA
| | - Adam K Myers
- Department of Physiology and Biophysics, Georgetown University Medical Center, Washington, DC 20057-1640, USA
- Center for the Study of Sex Differences in Health, Aging and Disease, Georgetown University Medical Center, Washington, DC, USA
| | - Susan E Mulroney
- Department of Physiology and Biophysics, Georgetown University Medical Center, Washington, DC 20057-1640, USA
- Center for the Study of Sex Differences in Health, Aging and Disease, Georgetown University Medical Center, Washington, DC, USA
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