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Kaysi S, Pacha B, Mesquita M, Collart F, Nortier J. Pulmonary congestion and systemic congestion in hemodialysis: dynamics and correlations. Front Nephrol 2024; 4:1336863. [PMID: 38463190 PMCID: PMC10921353 DOI: 10.3389/fneph.2024.1336863] [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] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/15/2024] [Indexed: 03/12/2024]
Abstract
Introduction Systemic congestion and pulmonary congestion (PC) are common in hemodialysis (HD) patients. However, the relationship between these two entities is not quite clear. We study this relationship and attempt to uncover the factors that may affect it considering different inter-dialytic intervals. Methods A prospective pilot observational and interventional study including 18 HD patients was conducted. The following were obtained: i) B-line score (BLS) by lung ultrasound (LUS) (reflecting significant pulmonary congestion if BLS > 5), ii) echocardiography, iii) bioelectrical impedance analysis (BIA) (reflecting global volume status), and iv) inferior vena cava (IVC) dynamics (reflecting systemic congestion) before and after the first two consecutive HD sessions of the week, with different inter-dialytic intervals (68 hours and 44 hours). Serum N-terminal pro-brain natriuretic peptide type B (NT-proBNP) levels were obtained before each session. Then, patients were randomized into two groups: the active group, where dry weight was reduced according to BLS + standard of care, and the control group, where dry weight was modified according to standard of care. All the measures were repeated on day 30. Results We found no correlation between pulmonary congestion represented by BLS and IVC dimensions and dynamics reflecting systemic congestion, independent of different inter-dialytic intervals. Pulmonary congestion was quite prevalent, as mean pre- and post-dialysis BLSs were quite elevated (16 ± 5.53 and 15.3 ± 6.63, respectively) in the first session compared with the second session (16.3 ± 5.26 and 13.6 ± 5.83, respectively). Systolic (left ventricular ejection fraction) and diastolic cardiac function (e/è ratio) parameters from one side and pulmonary congestion (BLS) from the other were not always correlated. BLS was correlated to e/è ratio before HD (session 1) (R 2 = 0.476, p = 0.002) and after HD (session 2) (R 2 = 0.193, p = 0.034). Pulmonary congestion reflected by BLS was correlated to the global volume state reflected by BIA only in the second HD session (HD2) (R 2 = 0.374, p = 0.007). NT-proBNP levels and BLS were correlated before both sessions (R 2 = 0.421, p = 0.004, and R 2 = 0.505, p = 0.001, respectively). Systemic congestion was quite prevalent, as mean pre- and post-dialysis IVC dimensions and dynamics were quite elevated in both sessions, with a higher level of systemic congestion in the first HD session (diameter and collapsibility of 2.1 cm and 23%, and 2.01 cm and 19%, respectively) compared with the second session (1.98 cm and 17.5%, and 1.9 cm and 22%, respectively) without reaching statistical significance. IVC dimensions and global volume status measured by BIA were correlated in the second dialysis session (R 2 = 0.260, p = 0.031). No correlation was found between IVC dimensions and diastolic cardiac function (e/è ratio) parameters or with NT-proBNP levels. On day 30, BLS was significantly reduced in the active group, whereas no difference was found in the control group. However, no real impact was observed on IVC dimensions and dynamics or in total volume status by BIA. Conclusion Pulmonary congestion is common in HD patients even after reaching their dry weight at the end of two consecutive sessions, and it is not correlated to systemic congestion, suggesting a complex multifactorial pathophysiology origin. Global volume status reflected by BIA and cardiac function are not always related to either systemic congestion represented by IVC dimensions or pulmonary congestion represented by BLS. Fluid redistribution anomalies may allow pulmonary congestion accumulation independently from systemic congestion and global volume status (non-cardiogenic pulmonary congestion). We recommend a personalised approach when managing HD patients by integrating systemic and pulmonary congestion parameters. Dry weight modification guided by repeat LUS may safely reduce pulmonary congestion. However, no impact was observed on systemic congestion or global volume status.
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Affiliation(s)
- Saleh Kaysi
- Nephrology Department, Brugmann University Hospital, Université libre de Bruxelles, Brussels, Belgium
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
| | - Bakhtar Pacha
- Nephrology Department, Brugmann University Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Maria Mesquita
- Nephrology Department, Brugmann University Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Frédéric Collart
- Nephrology Department, Brugmann University Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Joëlle Nortier
- Nephrology Department, Brugmann University Hospital, Université libre de Bruxelles, Brussels, Belgium
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
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Taghavi M, Jabrane A, Jacobs L, Mesquita MDCF, Demulder A, Nortier J. Antiphospholipid Antibodies Associated with Native Arteriovenous Fistula Complications in Hemodialysis Patients: A Comprehensive Review of the Literature. Antibodies (Basel) 2024; 13:1. [PMID: 38247565 PMCID: PMC10801604 DOI: 10.3390/antib13010001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Antiphospholipid antibody (aPL)-persistent positivity is frequent in hemodialysis (HD) patients. Native arteriovenous fistula (AVF) complications such as stenosis and thrombosis are among the most important causes of morbidity and mortality in hemodialysis patients. The association between aPL positivity and AVF thrombosis seems to now be well established. However, whether aPL positivity is associated with other AVF complications, such as maturation failure or stenosis, is not well known. Given the significant impact of AVF failure on patient's prognosis, it is of interest to further investigate this particular point in order to improve prevention, surveillance and treatment, and, ultimately, the patient's outcome. This literature review aims to report the recent literature on aPL-associated native AVF complications.
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Affiliation(s)
- Maxime Taghavi
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium; (A.J.); (L.J.); (M.D.C.F.M.); (J.N.)
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
| | - Abla Jabrane
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium; (A.J.); (L.J.); (M.D.C.F.M.); (J.N.)
| | - Lucas Jacobs
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium; (A.J.); (L.J.); (M.D.C.F.M.); (J.N.)
| | - Maria Do Carmo Filomena Mesquita
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium; (A.J.); (L.J.); (M.D.C.F.M.); (J.N.)
| | - Anne Demulder
- Laboratory of Hematology and Haemostasis LHUB-ULB, Brugmann University Hospital, Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium;
| | - Joëlle Nortier
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), 1020 Brussels, Belgium; (A.J.); (L.J.); (M.D.C.F.M.); (J.N.)
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
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Lablad Y, Vanhomwegen C, De Prez E, Antoine MH, Hasan S, Baudoux T, Nortier J. Longitudinal Follow-Up of Serum and Urine Biomarkers Indicative of COVID-19-Associated Acute Kidney Injury: Diagnostic and Prognostic Impacts. Int J Mol Sci 2023; 24:16495. [PMID: 38003685 PMCID: PMC10671700 DOI: 10.3390/ijms242216495] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
In patients hospitalized for severe COVID-19, the incidence of acute kidney injury (AKI) is approximately 40%. To predict and understand the implications of this complication, various blood and urine biomarkers have been proposed, including neutrophil gelatinase-associated lipocalin (NGAL), chemokine (C-C motif) ligand 14 (CCL14), cystatin C, leucine aminopeptidase (LAP), and soluble urokinase plasminogen activator (suPAR). This study, conducted between mid-January and early May 2021, aimed to assess the diagnostic and prognostic capabilities of these biomarkers in a cohort of COVID-19 patients monitored during the initial two weeks of hospitalization. Among the 116 patients included in this study, 48 developed AKI within the first three days of hospitalization (41%), with 29 requiring intensive care unit (ICU) admission, and the overall mortality rate was 18%. AKI patients exhibited a statistically significant increase in urinary LAP levels, indicating acute tubular injury as a potential mechanism underlying COVID-19-related renal damage. Conversely, urinary NGAL and CCL-14 excretion rates did not differ significantly between the AKI and non-AKI groups. Importantly, elevated plasma suPAR and cystatin C levels upon admission persisted throughout the first week of hospitalization and were associated with unfavorable outcomes, such as prolonged ICU stays and increased mortality, irrespective of AKI development. In conclusion, this study underscores the early predictive value of urinary LAP levels in identifying acute tubular injury in COVID-19-induced AKI. Moreover, elevated plasma suPAR and cystatin C levels serve as valuable prognostic markers, offering insights into the short-term morbidity and mortality risks among COVID-19 patients, regardless of AKI occurrence. These findings shed light on the complex interplay between COVID-19, renal injury, and biomarkers with diagnostic and prognostic potential.
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Affiliation(s)
- Yahya Lablad
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, 1070 Brussels, Belgium; (C.V.); (E.D.P.); (M.-H.A.); (S.H.); (T.B.)
| | - Charlotte Vanhomwegen
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, 1070 Brussels, Belgium; (C.V.); (E.D.P.); (M.-H.A.); (S.H.); (T.B.)
| | - Eric De Prez
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, 1070 Brussels, Belgium; (C.V.); (E.D.P.); (M.-H.A.); (S.H.); (T.B.)
| | - Marie-Hélène Antoine
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, 1070 Brussels, Belgium; (C.V.); (E.D.P.); (M.-H.A.); (S.H.); (T.B.)
| | - Sania Hasan
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, 1070 Brussels, Belgium; (C.V.); (E.D.P.); (M.-H.A.); (S.H.); (T.B.)
| | - Thomas Baudoux
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, 1070 Brussels, Belgium; (C.V.); (E.D.P.); (M.-H.A.); (S.H.); (T.B.)
- Department of Nephrology, Dialysis and Renal Transplantation, Erasme University Hospital, Erasme Campus, 1070 Brussels, Belgium
| | - Joëlle Nortier
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, 1070 Brussels, Belgium; (C.V.); (E.D.P.); (M.-H.A.); (S.H.); (T.B.)
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Dogahe D, Cubilier E, Taghavi M, Kaysi S, Nortier J, Mesquita MDCF. Evaluation of Transplant Suitability in a Patient with Previous Colorectal Cancer and Subsequent Radiation Cystitis: Insights from a Complicated Case. Case Rep Nephrol 2023; 2023:7839441. [PMID: 37790841 PMCID: PMC10545455 DOI: 10.1155/2023/7839441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/07/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Abstract
Assessing transplant suitability can be a meticulous process, involving multiple investigations and various specialties. This process is well described in the latest KDIGO guidelines. We recently asked ourselves if those guidelines are still relevant to current clinical practice given the rapid evolution of modern medicine, especially in the field of oncology. We present the complicated case of a 60-year-old woman with ESKD (end-stage kidney disease) and a prior history of cancer, with secondary urological complications, to illustrate different interesting considerations for KT (kidney transplant). Our patient was diagnosed with rectal cancer at the age of 46, for which she was treated with surgery and radiotherapy before developing chronic radiation cystitis. This was followed by repeated urinary tract infections and secondary nephrolithiasis, ultimately leading to severe bilateral hydronephrosis and obstructive ESKD. We know that the type of cancer and its characteristics should be evaluated in detail, and we should offer patient-tailored recommendations after a multidisciplinary evaluation. In our case, the prior rectal cancer is not to be feared because curative treatment has been achieved and the patient has been cancer-free for 14 years, knowing that this type of cancer is not at high risk of recurrence after transplantation. The frail urological anatomy, however, represents a bigger challenge. Not only does it complicate the technical feasibility of KT but it also increases the risk of complications and graft failure. It is difficult to clearly determine KT possibility when considering it in such patients. What is clear on the other hand is that such a decision should be taken considering the choice of the patient and the involved physicians. We should also consider the potential benefits and risks of KT in order to make an informed decision.
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Affiliation(s)
- David Dogahe
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Edouard Cubilier
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Maxime Taghavi
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Saleh Kaysi
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Joëlle Nortier
- Nephrology and Dialysis Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Abu Ayyach A, Le Moine A, Kaci L, Royer-Chardon C, Ghisdal L, Marangoni M, Smits G, Nortier J. Salt-losing tubulopathy worsening the prognosis of renal sarcoidosis. J Nephrol 2023; 36:627-630. [PMID: 36645652 PMCID: PMC10089998 DOI: 10.1007/s40620-022-01538-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/20/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Anis Abu Ayyach
- Department of Nephrology, Dialysis and Transplantation, CUB Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium.
- Department of Nephrology-Dialysis, CHU Brugmann, Université Libre de Bruxelle (ULB), Place Van Gehuchten 4, 1020, Brussels, Belgium.
| | - Alain Le Moine
- Department of Nephrology, Dialysis and Transplantation, CUB Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Louiza Kaci
- Human Pathology Laboratory, Algiers, Algeria
| | | | - Lidia Ghisdal
- Department of Nephrology, Dialysis and Transplantation, CUB Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Department of Genetics, CUB Erasme, ULB, Brussels, Belgium
| | | | | | - Joëlle Nortier
- Department of Nephrology-Dialysis, CHU Brugmann, Université Libre de Bruxelle (ULB), Place Van Gehuchten 4, 1020, Brussels, Belgium
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Poivre M, Antoine MH, Kryshen K, Atsapkina A, Shikov AN, Twyffels L, Nachtergael A, Duez P, Nortier J. Assessment of the Cytotoxicity, Mutagenicity, and Genotoxicity of Two Traditional Chinese Herbs: Aristolochia baetica and Magnolia officinalis. Toxins (Basel) 2023; 15:52. [PMID: 36668872 PMCID: PMC9864762 DOI: 10.3390/toxins15010052] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Herbal remedies used in traditional medicine often contain several compounds combined in order to potentiate their own intrinsic properties. However, herbs can sometimes cause serious health troubles. In Belgium, patients who developed severe aristolochic acid nephropathy ingested slimming pills containing root extracts of an Aristolochia species, as well as the bark of Magnolia officinalis. The goal of the study was to evaluate, on a human renal cell line, Aristolochia and Magnolia extracts for their cytotoxicity by a resazurin cell viability assay, and their genotoxicity by immunodetection and quantification of the phosphorylated histone γ-H2AX. The present study also sought to assess the mutagenicity of these extracts, employing an OECD recognized test, the Ames test, using four Salmonella typhimurium strains with and without a microsomial fraction. Based on our results, it has been demonstrated that the Aristolochia-Magnolia combination (aqueous extracts) was more genotoxic to human kidney cells, and that this combination (aqueous and methanolic extracts) was more cytotoxic to human kidney cells after 24 and 48 h. Interestingly, it has also been shown that the Aristolochia-Magnolia combination (aqueous extracts) was mutagenic with a TA98 Salmonella typhimurium strain in the presence of a microsomial liver S9 fraction. This mutagenic effect appears to be dose-dependent.
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Affiliation(s)
- Mélanie Poivre
- Laboratory of Experimental Nephrology, Faculty of Medecine, Université Libre de Bruxelles, 1000 Bruxelles, Belgium
- Saint-Petersburg Institute of Pharmacy, 197376 Saint Petersburg, Russia
- Laboratory of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine and Pharmacy, Research Institute for Health Sciences and Technology, University of Mons—UMONS, 7000 Mons, Belgium
| | - Marie-Hélène Antoine
- Laboratory of Experimental Nephrology, Faculty of Medecine, Université Libre de Bruxelles, 1000 Bruxelles, Belgium
| | - Kirill Kryshen
- Saint-Petersburg Institute of Pharmacy, 197376 Saint Petersburg, Russia
| | | | - Alexander N. Shikov
- Department of Technology of Pharmaceutical Formulations, St. Petersburg State Chemical Pharmaceutical University, Prof. Popov 14a, 197376 Saint Petersburg, Russia
| | - Laure Twyffels
- CMMI Center for Microscopy and Molecular Imaging, 6041 Charleroi, Belgium
| | - Amandine Nachtergael
- Laboratory of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine and Pharmacy, Research Institute for Health Sciences and Technology, University of Mons—UMONS, 7000 Mons, Belgium
| | - Pierre Duez
- Laboratory of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine and Pharmacy, Research Institute for Health Sciences and Technology, University of Mons—UMONS, 7000 Mons, Belgium
| | - Joëlle Nortier
- Laboratory of Experimental Nephrology, Faculty of Medecine, Université Libre de Bruxelles, 1000 Bruxelles, Belgium
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Cubilier E, Salaouatchi MT, Taghavi M, Kaysi S, Nortier J, Mesquita MDCF. Undetected Iatrogenic Drug-Induced Complications in a Hemodialyzed Anuric Patient: A Case Report and Review of the Literature. Case Rep Nephrol Dial 2022; 12:212-218. [DOI: 10.1159/000527197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022] Open
Abstract
Anuric hemodialyzed end-stage renal disease patients are prone to multiple complications and comorbidities and are therefore often treated with various medications. Adverse drug reactions and risk factors leading to them can be difficult to discern in such polymedicated patients. Most problems regarding low phosphate levels are frequently underdiagnosed in clinical practice and sometimes overlooked in these regularly hyperphosphatemic patients. Hemodialysis vascular accesses are frequently subject to infections and therefore require adapted antibiotic treatments. We report a case of an occult severe multifactorial hypophosphatemia in an anuric hemodialyzed patient with multiple comorbidities who required two hospitalizations for encephalopathy, seizures, and cardiac failure. Retrospective analysis of the medical record revealed several underlying causes of hypophosphatemia, as well as undetected risk factors for adverse drug reactions related to cephalosporins. A global approach to these concerns in routine clinical practice would raise awareness of often disregarded issues related to hypophosphatemia and drug prescription in these patients.
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Jacobs L, Clevenbergh P, Collart F, Brayer I, Mesquita M, Taghavi M, Fosso C, Kaysi S, Nortier J, Dratwa M. Conséquences de la pandémie de COVID-19 sur le taux de péritonite de dialyse péritonéale : plaidoyer pour une formation continue ininterrompue. Nephrol Ther 2022; 18:526-533. [PMID: 36241606 PMCID: PMC9492510 DOI: 10.1016/j.nephro.2022.07.401] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022]
Abstract
Introduction La péritonite est une complication fréquente du traitement par dialyse péritonéale chronique, contribuant à l’échec de la technique et/ou au décès. Les avantages réels d’un programme de formation continue sur les taux de péritonites sont peu connus. Dans cette étude, nous avons mesuré l’influence du protocole de formation continue de nos patients sur le taux de péritonites. Nous avons également étudié les conséquences de la perturbation de notre protocole liée au Covid sur les taux de péritonites. Méthode Nous présentons nos taux annuels de péritonites depuis la mise en place de notre programme de formation continue des patients en 2010. Nous avons ensuite concentré notre étude sur trois années consécutives : 2019, 2020 (émergence de la COVID-19) et 2021, en recueillant les données microbiologiques de chaque épisode de péritonite. Des analyses statistiques ont été utilisées pour corroborer nos résultats. Résultats Depuis 2010, le taux de péritonites a diminué linéairement (R2 = 0,6556 ; df = 8 ; p < 0,01) jusqu’à son nadir en 2019 avec 4 épisodes de péritonites. La majorité des infections ont alors été traitées en ambulatoire. En 2020, notre évaluation continue des procédures de dialyse au domicile des patients a diminué de 51 % et 28 péritonites sont survenues, 47 % secondaires à des bactéries cutanées strictes, et 31 % gastro-intestinales, indépendamment de l’expérience des patients ou de la modalité de dialyse péritonéale. Le taux d’hospitalisations a atteint 71 %. Après avoir rétabli notre protocole, nous avons diminué le taux de péritonites de 50 % en 2021. Conclusions Les facteurs de risque de développer une péritonite sont identifiables et modifiables, et nécessitent des interventions soutenues, une surveillance visuelle ainsi qu’une formation continue. Ces interventions réduisent de manière significative les taux de péritonites. Toute brève interruption de l’évaluation de la technique des patients peut augmenter de manière significative les taux de péritonites.
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Affiliation(s)
- Lucas Jacobs
- Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique.
| | - Philippe Clevenbergh
- Clinique des maladies infectieuses, Département de médecine interne, Centre Hospitalier Universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Frédéric Collart
- Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Isabelle Brayer
- Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Maria Mesquita
- Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Maxime Taghavi
- Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Christelle Fosso
- Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Saleh Kaysi
- Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Joëlle Nortier
- Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Max Dratwa
- Service de néphrologie et de dialyse, Centre hospitalier universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique
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Fosso C, Carlin A, Olivier C, Pozdzik A, Vieru E, Dratwa M, Collart F, Jani J, Nortier J. Bénéfice de l’initiation précoce d’une dialyse péritonéale chez une patiente enceinte présentant une maladie rénale chronique avancée. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.083] [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: 11/29/2022]
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Kaysi S, Pacha B, Collart F, Nortier J. Quel moment pour mesurer la congestion pulmonaire en hémodialyse par échographie ? Associations avec les paramètres cardiaques et volémiques. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.228] [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: 11/30/2022]
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Lukinich-Gruia AT, Nortier J, Pavlović NM, Milovanović D, Popović M, Drăghia LP, Păunescu V, Tatu CA. Aristolochic acid I as an emerging biogenic contaminant involved in chronic kidney diseases: A comprehensive review on exposure pathways, environmental health issues and future challenges. Chemosphere 2022; 297:134111. [PMID: 35231474 DOI: 10.1016/j.chemosphere.2022.134111] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/13/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Described in the 1950s, Balkan Endemic Nephropathy (BEN) has been recognized as a chronic kidney disease (CKD) with clinical peculiarities and multiple etiological factors. Environmental contaminants - aromatic compounds, mycotoxins and phytotoxins like aristolochic acids (AAs) - polluting food and drinking water sources, were incriminated in BEN, due to their nephrotoxic and carcinogenic properties. The implication of AAs in BEN etiology is currently a highly debated topic due to the fact that they are found within the Aristolochiaceae plants family, used around the globe as traditional medicine and they were also incriminated in Aristolochic Acid Nephropathy (AAN). Exposure pathways have been investigated, but it is unclear to what extent AAs are acting alone or in synergy with other cofactors (environmental, genetics) in triggering kidney damage. Experimental studies strengthen the hypothesis that AAI, the most studied compound in the AAs class, is a significant environmental contaminant and a most important causative factor of BEN. The aim of this review is to compile information about the natural exposure pathways to AAI, via traditional medicinal plants, soil, crop plants, water, food, air. Data that either supports or contradicts the AAI theory concerning BEN etiology was consolidated and available solutions to reduce human exposure were discussed. Because AAI is a phytotoxin with physicochemical properties that allow its transportation in environmental matrices from different types of areas (endemic, nonendemic), and induce CKDs (BEN, AAN) and urinary cancers through bioaccumulation, this review aims to shed a new light on this compound as a biogenic emerging pollutant.
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Affiliation(s)
- Alexandra T Lukinich-Gruia
- OncoGen Centre, Clinical County Hospital "Pius Branzeu", Blvd. Liviu Rebreanu 156, 300723, Timisoara, Romania.
| | - Joëlle Nortier
- Nephrology Department, Brugmann Hospital & Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Belgium.
| | - Nikola M Pavlović
- Kidneya Therapeutics, Klare Cetkin 11, 11070, Belgrade, Serbia; University of Niš, Univerzitetski Trg 2, 18106, Niš, Serbia.
| | | | - Miloš Popović
- Department for Biology and Ecology, Faculty of Natural Sciences and Mathematics, University of Niš, Višegradska 33, 18000, Niš, Serbia.
| | - Lavinia Paula Drăghia
- OncoGen Centre, Clinical County Hospital "Pius Branzeu", Blvd. Liviu Rebreanu 156, 300723, Timisoara, Romania.
| | - Virgil Păunescu
- OncoGen Centre, Clinical County Hospital "Pius Branzeu", Blvd. Liviu Rebreanu 156, 300723, Timisoara, Romania; Department of Immunology, University of Medicine and Pharmacy "Victor Babes", Eftimie Murgu Sq. 2, Timisoara, 300041, Romania.
| | - Călin A Tatu
- OncoGen Centre, Clinical County Hospital "Pius Branzeu", Blvd. Liviu Rebreanu 156, 300723, Timisoara, Romania; Department of Immunology, University of Medicine and Pharmacy "Victor Babes", Eftimie Murgu Sq. 2, Timisoara, 300041, Romania.
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Taghavi M, Stordeur P, Collart F, Dachy B, Pozdzik A, Carmo Filomena Mesquita MD, Nortier J. Interferon-beta1a-induced thrombotic microangiopathy: Possible implication of the alternative pathway of the complement. Kidney Int Rep 2022; 7:1917-1921. [PMID: 35967109 PMCID: PMC9366298 DOI: 10.1016/j.ekir.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022] Open
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Antoine MH, Husson C, Yankep T, Mahria S, Tagliatti V, Colet JM, Nortier J. Protective Effect of Nebivolol against Oxidative Stress Induced by Aristolochic Acids in Endothelial Cells. Toxins (Basel) 2022; 14:toxins14020132. [PMID: 35202159 PMCID: PMC8876861 DOI: 10.3390/toxins14020132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 02/06/2023] Open
Abstract
Aristolochic acids (AAs) are powerful nephrotoxins that cause severe tubulointerstitial fibrosis. The biopsy-proven peritubular capillary rarefaction may worsen the progression of renal lesions via tissue hypoxia. As we previously observed the overproduction of reactive oxygen species (ROS) by cultured endothelial cells exposed to AA, we here investigated in vitro AA-induced metabolic changes by 1H-NMR spectroscopy on intracellular medium and cell extracts. We also tested the effects of nebivolol (NEB), a β-blocker agent exhibiting antioxidant properties. After 24 h of AA exposure, significantly reduced cell viability and intracellular ROS overproduction were observed in EAhy926 cells; both effects were counteracted by NEB pretreatment. After 48 h of exposure to AA, the most prominent metabolite changes were significant decreases in arginine, glutamate, glutamine and glutathione levels, along with a significant increase in the aspartate, glycerophosphocholine and UDP-N-acetylglucosamine contents. NEB pretreatment slightly inhibited the changes in glutathione and glycerophosphocholine. In the supernatants from exposed cells, a decrease in lactate and glutamate levels, together with an increase in glucose concentration, was found. The AA-induced reduction in glutamate was significantly inhibited by NEB. These findings confirm the involvement of oxidative stress in AA toxicity for endothelial cells and the potential benefit of NEB in preventing endothelial injury.
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Affiliation(s)
- Marie-Hélène Antoine
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, B-1070 Brussels, Belgium; (C.H.); (T.Y.); (S.M.); (J.N.)
- Correspondence:
| | - Cécile Husson
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, B-1070 Brussels, Belgium; (C.H.); (T.Y.); (S.M.); (J.N.)
| | - Tatiana Yankep
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, B-1070 Brussels, Belgium; (C.H.); (T.Y.); (S.M.); (J.N.)
| | - Souhaila Mahria
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, B-1070 Brussels, Belgium; (C.H.); (T.Y.); (S.M.); (J.N.)
| | - Vanessa Tagliatti
- Laboratory of Human Toxicology, University of Mons (UMONS), 6 Avenue du Champ de Mars, B-7000 Mons, Belgium; (V.T.); (J.-M.C.)
| | - Jean-Marie Colet
- Laboratory of Human Toxicology, University of Mons (UMONS), 6 Avenue du Champ de Mars, B-7000 Mons, Belgium; (V.T.); (J.-M.C.)
| | - Joëlle Nortier
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles, Erasme Campus, 808 Route de Lennik, B-1070 Brussels, Belgium; (C.H.); (T.Y.); (S.M.); (J.N.)
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Chraibi S, Rosière R, De Prez E, Gérard P, Antoine MH, Langer I, Nortier J, Remmelink M, Amighi K, Wauthoz N. Preclinical tolerance evaluation of the addition of a cisplatin-based dry powder for inhalation to the conventional carboplatin-paclitaxel doublet for treatment of non-small cell lung cancer. Biomed Pharmacother 2021; 139:111716. [PMID: 34243618 DOI: 10.1016/j.biopha.2021.111716] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 12/24/2022] Open
Abstract
Despite the advances in targeted therapies and immunotherapy for non-small cell lung cancer (NSCLC) patients, the intravenous administration of carboplatin (CARB) and paclitaxel (PTX) in well-spaced cycles is widely indicated for the treatment of NSCLC from stage II to stage IV. Our strategy was to add a controlled-release cisplatin-based dry-powder for inhalation (CIS-DPI-ET) to the conventional CARB-PTX-IV doublet, administered during the treatment off-cycles to intensify the therapeutic response while avoiding the impairment of pulmonary, renal and haematological tolerance of these combinations. The co-administration of CIS-DPI-ET (0.5 mg/kg) and CARB-PTX-IV (17-10 mg/kg) the same day showed a higher proportion of neutrophils in BALF (35 ± 7% vs 1.3 ± 0.8%), with earlier regenerative anaemia than with CARB-PTX-IV alone. A first strategy of CARB-PTX-IV dose reduction by 25% also induced neutrophil recruitment, but in a lower proportion than with the first combination (20 ± 6% vs 0.3 ± 0.3%) and avoiding regenerative anaemia. A second strategy of delaying CIS-DPI-ET and CARB-PTX-IV administrations by 24 h avoided both the recruitment of neutrophils in BALF and regenerative anaemia. Moreover, all these groups showed higher cytotoxicity (LDH activity, protein content) with no higher renal toxicities. These two strategies seem interesting to be assessed in terms of antitumor efficacy in mice.
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Affiliation(s)
- S Chraibi
- Unit of Pharmaceutics and Biopharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles (ULB), Brussels, Belgium.
| | - R Rosière
- Unit of Pharmaceutics and Biopharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles (ULB), Brussels, Belgium; InhaTarget Therapeutics, Rue Auguste Piccard 37, 6041 Gosselies, Belgium
| | - E De Prez
- Laboratory of Experimental Nephrology, Faculty of Medicine, ULB, Brussels, Belgium
| | - P Gérard
- InhaTarget Therapeutics, Rue Auguste Piccard 37, 6041 Gosselies, Belgium
| | - M H Antoine
- Laboratory of Experimental Nephrology, Faculty of Medicine, ULB, Brussels, Belgium
| | - I Langer
- Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM), ULB, Brussels, Belgium
| | - J Nortier
- Laboratory of Experimental Nephrology, Faculty of Medicine, ULB, Brussels, Belgium
| | - M Remmelink
- Department of Pathology, ULB, Hôpital Erasme, Brussels, Belgium
| | - K Amighi
- Unit of Pharmaceutics and Biopharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - N Wauthoz
- Unit of Pharmaceutics and Biopharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles (ULB), Brussels, Belgium
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Chraibi S, Rosière R, De Prez E, Antoine MH, Remmelink M, Langer I, Nortier J, Amighi K, Wauthoz N. Pulmonary and renal tolerance of cisplatin-based regimens combining intravenous and endotracheal routes for lung cancer treatment in mice. Int J Pharm 2021; 599:120425. [PMID: 33647417 DOI: 10.1016/j.ijpharm.2021.120425] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/16/2021] [Accepted: 02/20/2021] [Indexed: 12/25/2022]
Abstract
Despite recent advances, platinum-based chemotherapy (partially composed of cisplatin, CIS) remains the backbone of non-small-cell lung cancer treatment. As CIS presents a cumulative and dose-limiting nephrotoxicity, it is currently administered with an interruption phase of 3-4 weeks between treatment cycles. During these periods, the patient recovers from the treatment side effects but so does the tumour. Our strategy is to increase the treatment frequency by delivering a cisplatin controlled-release dry powder for inhalation (CIS-DPI) formulation during these off-cycles to expose the tumour environment for longer to CIS, increasing its effectiveness. This is promising as long as the pulmonary and renal toxicities remain acceptable. The aim of the present investigation was to evaluate the pulmonary and renal tolerance of CIS-DPI (three times per cycle) and CIS using the intravenous (IV) route (CIS-IV) (one time per cycle) as monotherapies and to optimize their combination in terms of dose and schedule. At the maximum tolerated dose (MTD), combining CIS-DPI and CIS-IV impaired the pulmonary and the renal tolerance. Therefore, pulmonary tolerance was improved when the CIS-IV dose was decreased by 25% (to 1.5 mg/kg) while maintaining the MTD for CIS-DPI. In addition to this dose adjustment, a delay of 24 h between CIS-DPI and CIS-IV administrations limited the acute kidney injury.
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Affiliation(s)
- S Chraibi
- Unit of Pharmaceutics and Biopharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles (ULB), Brussels, Belgium.
| | - R Rosière
- Unit of Pharmaceutics and Biopharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles (ULB), Brussels, Belgium; InhaTarget Therapeutics, Rue Auguste Piccard 37, Gosselies, Belgium
| | - E De Prez
- Laboratory of Experimental Nephrology, Faculty of Medicine, ULB, Brussels, Belgium
| | - M H Antoine
- Laboratory of Experimental Nephrology, Faculty of Medicine, ULB, Brussels, Belgium
| | - M Remmelink
- Department of Pathology, ULB, Hôpital Erasme, Brussels, Belgium
| | - I Langer
- Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM), ULB, Brussels, Belgium
| | - J Nortier
- Laboratory of Experimental Nephrology, Faculty of Medicine, ULB, Brussels, Belgium
| | - K Amighi
- Unit of Pharmaceutics and Biopharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - N Wauthoz
- Unit of Pharmaceutics and Biopharmaceutics, Faculty of Pharmacy, Université libre de Bruxelles (ULB), Brussels, Belgium
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Baudoux T, des Grottes J, Tournay Y, Marchal M, Nortier J. Bénéfices de la dialyse longue de nuit : expérience multicentrique belge. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.052] [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: 10/23/2022]
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El kaddouri H, Doerfler A, Broeders N, Nortier J, Lemoine A, Quackels T, Roumeguère T. Cancer de la vessie et transplantation rénale. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.093] [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: 11/17/2022]
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Nortier J, Ntumba Mulunda A, Plennevaux V, Néron A, Hougardy J, Broeders N, Simon I, Madhoun P, Le Moine A, Godin I. Implémentation d’un programme d’éducation thérapeutique spécifique à l’IRC co-animé par des patients partenaires. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.260] [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: 11/27/2022]
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Nortier J, Baudoux T, Bunel V, Jadot I, Antoine M, Roumeguere T, Broeders N, Vanherweghem J. Intoxications aux aristoloches dans le monde : le point en 2018. Toxicologie Analytique et Clinique 2018. [DOI: 10.1016/j.toxac.2018.07.100] [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: 10/28/2022]
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Antoine MH, Redjeb R, Husson C, Pozdzik A, Jadot I, Declèves A, Nortier J. Effets in vitro des acides aristolochiques (AA) sur la cellule endothéliale. Toxicologie Analytique et Clinique 2018. [DOI: 10.1016/j.toxac.2018.07.061] [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: 10/28/2022]
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Antoine MH, Marhia S, Husson C, Nortier J. Effets protecteurs du nébivolol sur la cellule endothéliale intoxiquée aux acides aristolochiques (AA). Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.358] [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: 10/28/2022]
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Houem I, Fagnoul S, Nortier J, Ghisdal L, Bienfait L, Rasquin F, Sava R, Simon I. Cystinose juvénile révélée au stade d’insuffisance rénale chronique terminale. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.214] [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: 10/28/2022]
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Duquesne M, Declèves AE, De Prez E, Nortier J, Colet J. Interest of metabonomic approach in environmental nephrotoxicants: Application to aristolochic acid exposure. Food Chem Toxicol 2017; 108:19-29. [DOI: 10.1016/j.fct.2017.07.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/23/2017] [Accepted: 07/06/2017] [Indexed: 01/10/2023]
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Catalano C, Garjau M, Kemlin D, Bienfait L, Rorive S, Depierreux M, Hougardy J, Pozdzik A, Nortier J. Pièges diagnostiques de la GEM idiopathique : à propos de trois cas. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.217] [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: 11/16/2022]
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Jadot I, Colombaro V, Martin B, Habsch I, Botton O, Nortier J, Declèves AE, Caron N. Restored nitric oxide bioavailability reduces the severity of acute-to-chronic transition in a mouse model of aristolochic acid nephropathy. PLoS One 2017; 12:e0183604. [PMID: 28832640 PMCID: PMC5568239 DOI: 10.1371/journal.pone.0183604] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 08/08/2017] [Indexed: 01/06/2023] Open
Abstract
Aristolochic Acid (AA) nephropathy (AAN) is a progressive tubulointerstitial nephritis characterized by an early phase of acute kidney injury (AKI) leading to chronic kidney disease (CKD). The reduced nitric oxide (NO) bioavailability reported in AAN might contribute to renal function impairment and progression of the disease. We previously demonstrated that L-arginine (L-Arg) supplementation is protective in AA-induced AKI. Since the severity of AKI may be considered a strong predictor of progression to CKD, the present study aims to assess the potential benefit of L-Arg supplementation during the transition from the acute phase to the chronic phase of AAN. C57BL/6J male mice were randomly subjected to daily i.p. injections of vehicle or AA for 4 days. To determine whether renal AA-induced injuries were linked to reduced NO production, L-Arg was added to drinking water from 7 days before starting i.p. injections, until the end of the protocol. Mice were euthanized 5, 10 and 20 days after vehicle or AA administration. AA-treated mice displayed marked renal injury and reduced NO bioavailability, while histopathological features of AAN were reproduced, including interstitial cell infiltration and tubulointerstitial fibrosis. L-Arg treatment restored renal NO bioavailability and reduced the severity of AA-induced injury, inflammation and fibrosis. We concluded that reduced renal NO bioavailability contributes to the processes underlying AAN. Furthermore, L-Arg shows nephroprotective effects by decreasing the severity of acute-to-chronic transition in experimental AAN and might represent a potential therapeutic tool in the future.
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Affiliation(s)
- Inès Jadot
- Molecular Physiology Research Unit — URPhyM, NARILIS (Namur Research Institute for Life Sciences), University of Namur (UNamur), Namur, Belgium
- * E-mail:
| | - Vanessa Colombaro
- Molecular Physiology Research Unit — URPhyM, NARILIS (Namur Research Institute for Life Sciences), University of Namur (UNamur), Namur, Belgium
| | - Blanche Martin
- Molecular Physiology Research Unit — URPhyM, NARILIS (Namur Research Institute for Life Sciences), University of Namur (UNamur), Namur, Belgium
| | - Isabelle Habsch
- Molecular Physiology Research Unit — URPhyM, NARILIS (Namur Research Institute for Life Sciences), University of Namur (UNamur), Namur, Belgium
| | - Olivia Botton
- Molecular Physiology Research Unit — URPhyM, NARILIS (Namur Research Institute for Life Sciences), University of Namur (UNamur), Namur, Belgium
| | - Joëlle Nortier
- Nephrology Department, Erasme Academic Hospital and Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Anne-Emilie Declèves
- Laboratory of Molecular Biology, Faculty of Medicine and Pharmacy, Research Institute for Health Sciences and Technology, University of Mons (UMONS), Mons, Belgium
| | - Nathalie Caron
- Molecular Physiology Research Unit — URPhyM, NARILIS (Namur Research Institute for Life Sciences), University of Namur (UNamur), Namur, Belgium
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Van de Velde C, Blok E, Meershoek-Klein Kranenbarg E, Putter H, Van den Bosch J, Maartense E, Duijm-de Carpentier M, Van Leeuwen-Stok E, Liefers G, Nortier J, Rutgers E, Kroep J. Optimal duration of extended letrozole treatment after 5 years of adjuvant endocrine therapy; results of the randomized phase III IDEAL trial (BOOG 2006–05). Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30108-9] [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: 10/20/2022]
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Jadot I, Declèves AE, Nortier J, Caron N. An Integrated View of Aristolochic Acid Nephropathy: Update of the Literature. Int J Mol Sci 2017; 18:ijms18020297. [PMID: 28146082 PMCID: PMC5343833 DOI: 10.3390/ijms18020297] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 01/09/2023] Open
Abstract
The term “aristolochic acid nephropathy” (AAN) is used to include any form of toxic interstitial nephropathy that is caused either by ingestion of plants containing aristolochic acids (AA) as part of traditional phytotherapies (formerly known as “Chinese herbs nephropathy”), or by the environmental contaminants in food (Balkan endemic nephropathy). It is frequently associated with urothelial malignancies. Although products containing AA have been banned in most of countries, AAN cases remain regularly reported all over the world. Moreover, AAN incidence is probably highly underestimated given the presence of AA in traditional herbal remedies worldwide and the weak awareness of the disease. During these two past decades, animal models for AAN have been developed to investigate underlying molecular and cellular mechanisms involved in AAN pathogenesis. Indeed, a more-in-depth understanding of these processes is essential to develop therapeutic strategies aimed to reduce the global and underestimated burden of this disease. In this regard, our purpose was to build a broad overview of what is currently known about AAN. To achieve this goal, we aimed to summarize the latest data available about underlying pathophysiological mechanisms leading to AAN development with a particular emphasis on the imbalance between vasoactive factors as well as a focus on the vascular events often not considered in AAN.
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Affiliation(s)
- Inès Jadot
- Molecular Physiology Research Unit-URPhyM, Namur Research Institute for Life Sciences (NARILIS), University of Namur (UNamur), Namur 5000, Belgium.
| | - Anne-Emilie Declèves
- Laboratory of Molecular Biology, Faculty of Medicine and Pharmacy, Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons 7000, Belgium.
| | - Joëlle Nortier
- Nephrology Department, Erasme Academic Hospital and Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels 1070, Belgium.
| | - Nathalie Caron
- Molecular Physiology Research Unit-URPhyM, Namur Research Institute for Life Sciences (NARILIS), University of Namur (UNamur), Namur 5000, Belgium.
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Simon I, Legrand F, Des Grottes JM, Cotton F, Nortier J, Roumeguère T. [Diagnosis and treatment of nephrolithiasis and prevention of recurrences]. Rev Med Brux 2017; 38:279-283. [PMID: 28981230] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
despite fluctuations, the prevalence of nephrolithiasis has significantly increased during the last decades in industrialized nations worldwide (1 to 15 %), which has a significant impact on the cost of healthcare. This increased prevalence is mainly explained by diet modifications. Environmental, metabolic and genetic factors may also influence the formation of kidney stones. As a consequence, the medical management of this disease is preferentially multidisciplinary and involves urologists, nephrologists, radiologists, biologists and dietitians. Urological management : may be mandatory during any acute and/or remote phase of an episode of renal colic, in case of residual stones. Several techniques are available: insertion of double J stent, extracorporeal shock wave lithotripsy, ureteroscopy (flexible or rigid), percutaneous nephrolithotomy and more occasionally, open surgery. Nephrological management: is justified in the course of the acute episode and aims to identify the causal factor(s) of kidney stones formation. The diagnostic approach involves a thorough interrogation (personal medical and surgical history, details of the kidney stone disease and family medical history) as well as a metabolic assessment. Moreover, given the high rate of recurrence (about 50 % within 5 to 10 years), individualized secondary prevention measures are necessary. The recommendations should take into account the identified risk factors and any metabolic abnormalities.
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Affiliation(s)
- I Simon
- Service de Néphrologie, Hôpital Erasme, ULB
| | - F Legrand
- Service d'Urologie, Hôpital Erasme, ULB
| | | | - F Cotton
- Service de Chimie Médicale, Centre de Diagnostic, Traitement et Prévention de la Néphrolithiase, Hôpital Erasme, ULB
- Laboratoire Hospitalo-Universitaire de Bruxelles (LHUB), ULB
| | - J Nortier
- Service de Néphrologie, Hôpital Erasme, ULB
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Nortier J, Plennevaux V, Nolf A, Hougardy JM, Petit AD. [Clinical care pathway for chronic kidney disease : development and perspectives]. Rev Med Brux 2017; 38:271-278. [PMID: 28981229] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Because of the significant costs related to the treatment of end-stage kidney disease by dialysis, Belgian Health Care Authorities proposed in June 2009 to launch an early multidisciplinary care plan for chronic kidney disease (CKD) patients in the form of a clinical care pathway (CCP) focusing on a combined follow-up by the general practitioner and the nephrologist. The objective was to increase nephro-protection measures, reduce patient morbidity and mortality, and delay admission on dialysis. Our Nephrology Department at Erasme Hospital took the opportunity of CCP to set up workshops on therapy education which promote CKD patients' compliance and autonomy regarding their treatment (" empowerment "). These workshops are conducted by a health professional together with a patient partner recruited by our team according to the model developed by the faculty of medicine at the University of Montreal. This model is based on the patient's valued experience of living with a chronic disease, a knowledge which is complementary to that acquired by any health professional. This patient partnership (PP) may also be implemented in teaching and research. In health care services, patient partners with a resource profile are involved not only in the organization of these services, but also in the development and management of health care political programs. The PP model currently developed in the Nephrology Department is part of the Quality project of our academic hospital and helps to further the co-construction of future health care networks.
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Affiliation(s)
- J Nortier
- Service de Néphrologie, Dialyse et Transplantation rénale, Hôpital Erasme, ULB
| | - V Plennevaux
- Service de Néphrologie, Dialyse et Transplantation rénale, Hôpital Erasme, ULB
| | - A Nolf
- Service de Néphrologie, Dialyse et Transplantation rénale, Hôpital Erasme, ULB
| | - J M Hougardy
- Service de Néphrologie, Dialyse et Transplantation rénale, Hôpital Erasme, ULB
| | - A D Petit
- Service Qualité, Hôpital Erasme, ULB
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Fadel S, Dorthu L, Lespagnard J, Cornet G, Nortier J. Douleurs intenses au décours d’une angioplastie des membres inférieurs chez une patiente hémodialysée : quel est votre diagnostic ? Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.053] [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: 10/21/2022]
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Baudoux T, Hougardy J, Husson C, De Prez E, Antoine M, Nortier J. Rôles protecteurs des lymphocytes T dans un modèle murin de la néphropathie aux acides aristolochiques. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.277] [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: 11/16/2022]
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Duquesne M, Dika Z, Jelakovic B, Colet JM, Nortier J. Apport de la métabonomique urinaire en néphrologie environnementale : détection des sujets à risque de néphropathie endémique des Balkans. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.344] [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: 10/21/2022]
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Sava R, Gastaldello K, Verset G, Fontanges Q, D’haene N, Nortier J. Lésion cæcale pseudo-tumorale chez un patient hémodialysé : quel est votre diagnostic ? Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.107] [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: 11/17/2022]
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Nortier J, Duquesne M, Decleves A, Coulon F, De Prez E, Colet J. Profils métabonomiques urinaires des acides aristolochiques I et II comparés à trois toxiques tubulaires connues selon Comet : vers de nouveaux biomarqueurs de néphrotoxicité ? Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.362] [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: 10/21/2022]
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Castells X, Ardin M, Rorive S, Broeders N, Heguy A, Bringuier P, Quackels T, Roumeguere T, Nortier J, Zavadil J. Genome-wide sequencing identifies genetic relationship between first and late-onset second cancers in aristolochic acid nephropathy patients. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61121-8] [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: 11/28/2022]
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Ben Omar Bridi S, PIennevaux V, Racapé J, Nortier J. [Not Available]. Rev Med Brux 2016; 37:5-12. [PMID: 27120930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Because of the significant costs related to the treatment of end-stage kidney disease by dialysis, Belgian Health Care Authorities proposed in June 2009 an early multidisciplinary care of the chronic kidney disease (CKD) in a so-called clinical pathway (CP). Working on the hypothesis that inclusion into a CP could result in reduced morbidity and mortality and delayed admission on dialysis, we initiated a retrospective cohort study on dialyzed patients for whom a prior CKD diagnosis was made between June 1, 2009 and August 31, 2013 in the Nephrology Dept of Erasme Hospital. The exposed patient group was defined as enrolled patients into a CP (n = 25), the control patients were free of any CP (n = 25). Survival analyses were performed to search for an association between the inclusion into a CP and the time period needed to reach dialysis, but also to find a possible impact of CP on mortality and risk of hospitalization. The present study showed that CKD-CP significantly delayed the time of dialysis initiation (HR = 0.48 [0.27-0.87]; p = 0.015) but also reduced mortality (HR = 0.10 [0.02-0.53]; p = 0.007) and hospitalization risk (HR = 0.30 [0.11-0.83]; p = 0.020) after starting dialysis. These data suggest the benefit of a multidisciplinary care of CKD patients. However, a larger scale study is necessary to confirm these results.
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Bunel V, Antoine MH, Stévigny C, Nortier J, Duez P. New in vitro insights on a cell death pathway induced by magnolol and honokiol in aristolochic acid tubulotoxicity. Food Chem Toxicol 2016; 87:77-87. [DOI: 10.1016/j.fct.2015.11.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 11/21/2015] [Accepted: 11/23/2015] [Indexed: 12/18/2022]
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Pozdzik AA, Fernandez V, Demetter P, Tooulou M, Matos C, Gammar N, Broeders N, Dratwa M, Nortier J. Encapsulating Peritoneal Sclerosis In a Kidney Graft Recipient Unmasked by Everolimus Switch. Perit Dial Int 2015; 35:769-71. [PMID: 26703854 DOI: 10.3747/pdi.2014.00157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Agnieszka A Pozdzik
- Department of Nephrology, Dialysis and Renal Transplantation, Clinique Universitaire de Bruxelles (CUB), Erasme Hospital, Université Libre de Bruxelles (ULB) Brussels, Belgium
| | - Vasco Fernandez
- Department of Nephrology, Cury Cabral Hospital, Lisbon, Portugal
| | | | - Monika Tooulou
- Department of Nephrology, Dialysis and Renal Transplantation, Clinique Universitaire de Bruxelles (CUB), Erasme Hospital, Université Libre de Bruxelles (ULB) Brussels, Belgium
| | - Celso Matos
- Department of Radiology, Erasme Hospital, Brussels, Belgium
| | - Nadia Gammar
- Department of Nephrology, Dialysis and Renal Transplantation, Clinique Universitaire de Bruxelles (CUB), Erasme Hospital, Université Libre de Bruxelles (ULB) Brussels, Belgium
| | - Nilufer Broeders
- Department of Nephrology, Dialysis and Renal Transplantation, Clinique Universitaire de Bruxelles (CUB), Erasme Hospital, Université Libre de Bruxelles (ULB) Brussels, Belgium
| | - Max Dratwa
- Department of Nephrology, Brugmann Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Joëlle Nortier
- Department of Nephrology, Dialysis and Renal Transplantation, Clinique Universitaire de Bruxelles (CUB), Erasme Hospital, Université Libre de Bruxelles (ULB) Brussels, Belgium
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Declèves AÉ, Jadot I, Colombaro V, Martin B, Voisin V, Nortier J, Caron N. Protective effect of nitric oxide in aristolochic acid-induced toxic acute kidney injury: an old friend with new assets. Exp Physiol 2015; 101:193-206. [PMID: 26442795 DOI: 10.1113/ep085333] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 09/30/2015] [Indexed: 12/16/2022]
Abstract
Aristolochic acid (AA) nephropathy (AAN), a progressive tubulointerstitial injury of toxic origin, is characterized by early and transient acute tubular necrosis. This process has been demonstrated to be associated with reduced nitric oxide (NO) production, which can disrupt the regulation of renal function. In this study, we tested the hypothesis that L-arginine (L-Arg) supplementation could restore renal function and reduce renal injury after AA intoxication. C57BL/6 J male mice were randomly subjected to daily i.p. injection of either sterile saline solution or AA (2.5 mg kg(-1)) for 4 days. To determine whether AA-induced renal injuries were linked to reduced NO production, L-Arg, a substrate for NO synthase, was supplemented (5%) in drinking water. Mice intoxicated with AA exhibited features of rapid-onset acute kidney injury, including polyuria, significantly increased plasma creatinine concentrations, proteinuria and fractional excretion of sodium (P < 0.05), along with severe proximal tubular cell injury and increased NADPH oxidase 2 (Nox2)-derived oxidative stress (P < 0.05). This was associated with a significant reduction in NO bioavailability. L-Arg supplementation in AA-treated mice significantly increased NO bioavailability, which in turn improved renal function (creatininaemia, polyuria, proteinuria, fractional excreted sodium and N-acetyl-β-D-glucosaminidase enzymuria) and renal structure (tubular necrosis and tubular cell apoptosis). These changes were associated with significant reductions in Nox2 expression and in production of reactive oxygen species and with an increase in antioxidant concentrations. Our results demonstrate that preservation of NO bioavailability leads to renal protection in AA-induced acute kidney injury by reducing oxidative stress and maintaining renal function.
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Affiliation(s)
- Anne-Émilie Declèves
- Molecular Physiology Research Unit-URPHYM, University of Namur (UNamur), B-5000, Namur, Belgium.,Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), B-1070, Brussels, Belgium
| | - Inès Jadot
- Molecular Physiology Research Unit-URPHYM, University of Namur (UNamur), B-5000, Namur, Belgium
| | - Vanessa Colombaro
- Molecular Physiology Research Unit-URPHYM, University of Namur (UNamur), B-5000, Namur, Belgium
| | - Blanche Martin
- Molecular Physiology Research Unit-URPHYM, University of Namur (UNamur), B-5000, Namur, Belgium
| | - Virginie Voisin
- Molecular Physiology Research Unit-URPHYM, University of Namur (UNamur), B-5000, Namur, Belgium
| | - Joëlle Nortier
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), B-1070, Brussels, Belgium
| | - Nathalie Caron
- Molecular Physiology Research Unit-URPHYM, University of Namur (UNamur), B-5000, Namur, Belgium
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Nortier J, Pozdzik A, Roumeguere T, Vanherweghem JL. Néphropathie aux acides aristolochiques (« néphropathie aux herbes chinoises »). Nephrol Ther 2015; 11:574-88. [DOI: 10.1016/j.nephro.2015.10.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bunel V, Antoine MH, Nortier J, Duez P, Stévigny C. Potential nephroprotective effects of the Chinese herb Angelica sinensis against cisplatin tubulotoxicity. Pharm Biol 2015; 53:985-994. [PMID: 25495691 DOI: 10.3109/13880209.2014.951726] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
CONTEXT Acute kidney injury (AKI) is often encountered in patients receiving cisplatin (CisPt), a chemotherapeutic drug that induces numerous toxic side effects. Techniques used to limit nephrotoxicity during CisPt treatment are not fully effective; about a third of patients experience AKI. New nephroprotective strategies, including pharmacological approaches, must be developed. OBJECTIVE The present study investigated the nephroprotective potential of Angelica sinensis (Oliv.) Diels (Apiaceae) root towards CisPt tubulotoxicity. MATERIALS AND METHODS HK-2 cells were incubated with CisPt (10 µM) and/or with a methanolic extract of A. sinensis (AS). Nephroprotective capacity was evaluated by means of cellular viability (resazurin assay) and apoptosis (annexin-V/PI staining), oxidative stress generation (H2DCF-DA oxidation), Ki-67 index (immunofluorescence), cell cycle analysis (DNA staining), cell migration rate (scratch assay), extracellular matrix deposition (collagen determination), and β-catenin relocalization. RESULTS CisPt decreased cell viability [76% versus Ctrl], which was associated with an increased apoptosis. Simultaneous treatment with 50 µg/ml AS enhanced cell survival [84% versus Ctrl] and decreased the apoptosis rate. AS could not alleviate CisPt-induced oxidative stress; but doses of 5 and 50 µg/ml raised the Ki-67 index [135 and 244% versus Ctrl] and cell migration rates [1.2 and 1.3-fold versus Ctrl]. Finally, both doses of AS limited the amount of collagen deposition [121.6 and 119.6% for 5 and 50 µg/ml, respectively, versus 131.0% for CisPt-treated cells] and prevented the relocalization of β-catenin from the membrane to the nucleus. CONCLUSION These results confirm the nephroprotective potential of A. sinensis and require further investigations aiming at identifying its active compounds.
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Affiliation(s)
- Valérian Bunel
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB) , Brussels , Belgium
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Yamani A, Bunel V, Antoine MH, Husson C, Stévigny C, Duez P, Elachouri M, Nortier J. Substitution between Aristolochia and Bryonia genus in North-Eastern Morocco: toxicological implications. J Ethnopharmacol 2015; 166:250-260. [PMID: 25797117 DOI: 10.1016/j.jep.2015.03.036] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 02/23/2015] [Accepted: 03/12/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Although acknowledged as toxic herbs, Aristolochia species are still widely used worldwide. The aristolochic acids (AA) they contain can induce the so-called "aristolochic acid nephropathy", leading to renal fibrosis and upper urinary tract cancer. Traditional Moroccan medicine still often uses Aristolochia species under the vernacular name of Bereztem for the treatment of numerous ailments, notably cancer, diabetes or digestive tract disorders. As the botanical identity and renal toxicity of used species remain unexplored, the safety of patients may be threatened. MATERIAL AND METHODS Ethnopharmacological data were collected from herbalists from the provinces of Oujda and Berkane, located in North-Eastern Morocco. Samples of Bereztem were collected at herbalist shops and checked for their content in AA using TLC and LC-MS methods. The toxicity of crude methanolic extracts of each herb was assessed on a HK-2 cell-based in vitro model by measurement of the cell survival to evaluate cytotoxicity and by assessment of renal-specific toxicity via (i) the evaluation of genes (E-cadherin and α-smooth muscle actin) expression by RT-qPCR; (ii) the quantities of β-catenin and vimentin by immunofluorescence microscopy; (iii) the secretion of fibronectin; and (iv) the excretion of interleukin-6. RESULTS The survey indicated that, among 42 herbalists visited, 33 were retailers of Bereztem, which was generally sold as a cancer treatment. Botanical investigations revealed that Aristolochia longa was frequently substituted by Bryonia dioica, which was associated with a higher cytotoxicity. Parameters specific to renal toxicity were also found to be enhanced, as compared to Aristolochia baetica and A. longa: down-regulation of β-catenin and E-cadherin and up-regulation of vimentin and α-smooth muscle actin, and secretion of fibronectin and interleukin-6. CONCLUSION In accordance with the Moroccan regulations, the use of so-called Aristolochia species should be discontinued. On one hand, the correctly identified aristolochia contain nephrotoxic aristolochic acids; on the other hand, aristolochia are massively substituted in North-Eastern Morocco and adulterated by a well-known toxic herb, B. dioica. Our data indicate that the bryony renal toxicity may be deleterious in shorter time periods than aristolochia. Reinforced on-site controls are needed to remind herbalists and harvesters that these herbs should be prohibited.
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Affiliation(s)
- Amal Yamani
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Pharmacognosy, Bromatology and Human Nutrition, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Physiology and Ethnopharmacology, URAC-40, Department of Biology, Faculty of Sciences, Mohammed First University, Oujda, Morocco
| | - Valérian Bunel
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Pharmacognosy, Bromatology and Human Nutrition, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Brussels, Belgium.
| | - Marie-Hélène Antoine
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Cécile Husson
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Caroline Stévigny
- Laboratory of Pharmacognosy, Bromatology and Human Nutrition, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Pierre Duez
- Laboratory of Pharmacognosy, Bromatology and Human Nutrition, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Therapeutical Chemistry and Pharmacognosy, Université de Mons (UMONS), Mons, Belgium
| | - Mostafa Elachouri
- Laboratory of Physiology and Ethnopharmacology, URAC-40, Department of Biology, Faculty of Sciences, Mohammed First University, Oujda, Morocco
| | - Joëlle Nortier
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Pozdzik AA, Debiec H, Husson C, Rorive S, Broeders N, Le Moine A, Ronco P, Nortier J. [Anti-NEP and anti-PLA2R antibodies in membranous nephropathy: an update]. Rev Med Brux 2015; 36:166-171. [PMID: 26372979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Membranous nephropathy (MN) is the most common cause for nephrotic syndrome in adults and occurs as an idiopathic (primary) or secondary disease. Since the early 2000's, substantial advances have been made in the understanding of the molecular bases of MN. The neutral endopeptidase (NEP) and the receptor for secretory phospholipase A2 (PLA2R) have been identified as target antigens for circulating and deposited antibodies in allo-immune neonatal and adult " idiopathic " MN, respectively. These antibodies recognize specific antigens of podocytes, precipitate as subepithelial immune complexes and activate complement leading to proteinuria. Anti-PLA2R antibodies are of particular clinical importance. Indeed, they are detected in approximately 70% of primary MN in adults, demonstrating that MN actually is an autoimmune condition specific to the kidney. In Europeans, genome-wide studies have shown an association between alleles of PLA2R1 and HLA DQA1 (class II genes of tissue histocompatibility complex) genes and idiopathic MN. Newly developed diagnostic tests detecting circulating anti-PLA2R antibody and PLA2R antigen in glomerular deposits have induced a change in paradigm in the diagnostic approach of idiopathic MN. Measurement of circulating anti-PLA2R antibody is also very useful for the monitoring of MN activity. However, the mechanisms responsible for the formation of anti-PLA2R antibodies as well as those involved in the progression of MN to end-stage renal disease remain to be defined.
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Simon I, Roumeguère T, Devuyst F, Cotton F, Tang BNT, Cappello M, Corbetta S, Idrissi M, Pozdzik A, Nortier J. [Recurrent episodes of brushite nephrolithiasis revealing primary hyperparathyroidism]. Rev Med Brux 2015; 36:172-176. [PMID: 26372980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Nephrolithiasis is a frequent disease observed in 1 to 20 % of the general population. This disease predominates in male patients (2:1) and is characterized by a high rate of recurrences (about 50 %). CASE REPORT We report the case of a 45-year old male patient who experienced during about ten years recurrent bilateral renal colic episodes due to brushite lithiasis. These stones were treated with multiple extracorporeal shock wave lithotripsy sessions. A pyeloureteral junction syndrome predisposing to bulky stones formation has been put in evidence and required a pyeloplasty. After more than ten years of disease activity, a biochemical screening diagnosed primary hyperparathyroidism (PHPT). Radiological assessment identified a parathyroid gland adenoma. Successful surgical removal of this lesion was followed by resolution of the symptomatic kidney stones formation. DISCUSSION PHPT is associated with kidney stones in about 20 % of the patients. Hypercalciuria is the main risk factor of stones formation but other predisposing factors are also probably involved. Patients carrying a polymorphism located in the coding sequence of the calcium-sensing receptor gene or in the regulatory region of this gene seem to experience an increased occurrence of urinary lithiasis. CONCLUSION The present case stresses the importance of a metabolic assessment in all patients with recurrent nephrolithiasis, especially in case of bilateral episodes.
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Goldman M, Nortier J, Dhaene M, Amraoui Z, Vanherweghem JL. Fate of beta-2-microglobulin during dialysis on polysulfone and AN69 membranes. Contrib Nephrol 2015; 74:127-31. [PMID: 2702129 DOI: 10.1159/000417481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M Goldman
- Département de Néphrologie, Dialyse et Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Belgique
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Nortier J, Abramowicz D, Najdovski T, Kinnaert P, Vanherweghem JL, Goldman M, Deschodt-Lanckman M. Urinary endopeptidase 24.11 as a new marker of proximal tubular injury. Preliminary study in kidney transplant recipients. Contrib Nephrol 2015; 101:169-76. [PMID: 8467672 DOI: 10.1159/000422127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- J Nortier
- Laboratoire Pluridisciplinaire de Recherche Expérimentale Biomédicale, Faculté de Médecine, Université Libre de Bruxelles, Belgium
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Bunel V, Antoine MH, Nortier J, Duez P, Stévigny C. In vitro effects of Panax ginseng in aristolochic acid-mediated renal tubulotoxicity: apoptosis versus regeneration. Planta Med 2015; 81:363-372. [PMID: 25798640 DOI: 10.1055/s-0035-1545839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This in vitro study aimed to determine the effects of a Panax ginseng extract on aristolochic acid-mediated toxicity in HK-2 cells. A methanolic extract of ginseng (50 µg/mL) was able to reduce cell survival after treatment with 50 µM aristolochic acid for 24, 48, and 72 h, as evidenced by a resazurin reduction assay. This result was confirmed by a flow cytometric evaluation of apoptosis using annexin V-PI staining, and indicated higher apoptosis rates in cells treated with aristolochic acid and P. ginseng extract compared with aristolochic acid alone. However, P. ginseng extract by itself (5 and 50 µg/mL) increased the Ki-67 index, indicating an enhancement in cellular proliferation. Cell cycle analysis excluded a P. ginseng extract-mediated induction of G2/M cell cycle arrest such as the one typically observed with aristolochic acid. Finally, β-catenin acquisition was found to be accelerated when cells were treated with both doses of ginseng, suggesting that the epithelial phenotype of renal proximal tubular epithelial cells was maintained. Also, ginseng treatment (5 and 50 µg/mL) reduced the oxidative stress activity induced by aristolochic acid after 24 and 48 h. These results indicate that the ginseng extract has a protective activity towards the generation of cytotoxic reactive oxygen species induced by aristolochic acid. However, the ginseng-mediated alleviation of oxidative stress did not correlate with a decrease but rather with an increase in aristolochic acid-induced apoptosis and death. This deleterious herb-herb interaction could worsen aristolochic acid tubulotoxicity and reinforce the severity and duration of the injury. Nevertheless, increased cellular proliferation and migration, along with the improvement in the epithelial phenotype maintenance, indicate that ginseng could be useful for improving tubular regeneration and the recovery following drug-induced kidney injury. Such dual activities of ginseng certainly warrant further in vivo studies.
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Affiliation(s)
- Valérian Bunel
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Marie-Hélène Antoine
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Joëlle Nortier
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Pierre Duez
- Laboratory of Pharmacognosy, Bromatology and Human Nutrition, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Caroline Stévigny
- Laboratory of Pharmacognosy, Bromatology and Human Nutrition, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Nortier J. [Dialysis treatment for diabetic patients]. Soins 2015:S18-S20. [PMID: 26036125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Advanced-stage diabetic nephropathy requires multidisciplinary treatment for the patient. He/she must be informed, when necessary, of the possible dialysis methods and the assessment of the transplant options. Haemodialysis and peritoneal dialysis offer comparable survival rates. The enlightened choice of the patient is guided by the nephrology team. Survival on dialysis unfortunately remains uncertain due to numerous comorbidities, in particular cardiovascular conditions.
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Goubella A, Broeders N, Racapé J, Hamade A, Massart A, Hougardy JM, Hoang AD, Mikhalski D, Baudoux T, Gankam F, Madhoun P, Janssen F, Moine AL, Nortier J, Vereerstraeten P. Patient and graft outcome in current era of immunosuppression: a single centre pilot study. Acta Clin Belg 2015; 70:23-9. [PMID: 25257447 DOI: 10.1179/2295333714y.0000000078] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The present single centre study aims at analyzing the impact on renal allograft outcome of the important changes which occurred in the transplant population and immunosuppressive therapy during the last two decades. METHODS From 2000 to 2013, 779 single kidney transplantations were performed on 635 patients who all received on an intent-to-treat basis steroids, a calcineurin inhibitor, mycophenolate mofetil and an induction therapy with either antithymocyte globulin or an antagonist directed to the interleukin (IL)-2 receptor. Uni- and multivariate analyses of patient and immunologic graft survival were conducted. RESULTS The sole factor predicting patient survival is recipient's age: 10-year survival rates are 94·7, 81·6 and 57·9% for the <45, 45-60 and >60 years age groups, respectively (P<0·001). Peak (>50% panel reactive antibodies) anti-human leucocyte antigens (HLA) sensitization, cold ischaemia time and HLA-B and -DR mismatches (MM) influence graft outcome: at 10 years, the difference in 10-year survival rates is 5·9% between grafts from sensitized and not sensitized patients (90·9 vs 96·8%, P = 0·002), 3·8% between grafts with <18 and ≧18 hours cold ischaemia (96·6 vs 92·8%, P = 0·003), 7·3% between grafts with no MM and either B or DR MM versus those with B and DR MM (96·8 vs 89·5%, P = 0·002). CONCLUSION In our single centre experience, graft survival was most strongly determined by HLA matching, offering excellent long term graft outcome to most patients.
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Affiliation(s)
- A. Goubella
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - N. Broeders
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - J. Racapé
- Research Center of BiostatisticsEpidemiology and Clinical Research, School of Public Health, Université libre de Bruxelles, Brussels, Belgium
| | - A. Hamade
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - A. Massart
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - J.-M. Hougardy
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - A. D. Hoang
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - D. Mikhalski
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - T. Baudoux
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - F. Gankam
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - P. Madhoun
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - F. Janssen
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - A. Le Moine
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - J. Nortier
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
| | - P. Vereerstraeten
- Department of NephrologyDialysis and Transplantation and Department of Abdominal Surgery, Cliniques Universitaires de Bruxelles, Hôpital Erasme
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Bunel V, Antoine MH, Nortier J, Duez P, Stévigny C. Nephroprotective effects of ferulic acid, Z-ligustilide and E-ligustilide isolated from Angelica sinensis against cisplatin toxicity in vitro. Toxicol In Vitro 2015; 29:458-67. [PMID: 25561245 DOI: 10.1016/j.tiv.2014.12.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 08/22/2014] [Revised: 11/20/2014] [Accepted: 12/24/2014] [Indexed: 01/23/2023]
Abstract
Cisplatin (CisPt), a chemotherapeutic drug applied against solid tumors, is highly detrimental to the kidney. The risk of acute kidney injury implies adequate patient hydration to ensure sufficient diuresis; this strategy, now implemented in clinical practice, remains however incompletely satisfactory. New pharmacological approaches relying on the discovery of bioactive compounds need to be developed. Based on previous studies reporting renoprotective activities for extracts of Angelica sinensis (Oliv.) Diels roots, three of its major active compounds, ferulic acid, Z-ligustilide and E-ligustilide, were investigated for possible alleviation of CisPt-induced nephrotoxicity. Five phenomena involved in acute kidney injury and subsequent fibrosis were investigated: (i) modulation of cell survival via reduction of the apoptosis rate; (ii) reduction of oxidative stress; (iii) improvement of tubular regeneration capacities through proliferation and migration; (iv) limitation of extracellular matrix and collagen deposition; and (v) prevention of the dedifferentiation processes via the β-catenin pathway. Ferulic acid emerged as the most potent compound for alleviating cell death and collagen deposition, and for enhancing cell regeneration capacities. It also partially inhibited the β-catenin pathway, but was ineffective in lowering oxidative stress. Z- and E-ligustilides, however, were effective for limiting the oxidative stress, but only moderately affected other parameters. Ferulic acid appears to be a promising nephroprotective drug lead deserving further preclinical investigation.
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Affiliation(s)
- Valérian Bunel
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Pharmacognosy, Bromatology and Human Nutrition, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Brussels, Belgium.
| | - Marie-Hélène Antoine
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Joëlle Nortier
- Laboratory of Experimental Nephrology, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Pierre Duez
- Laboratory of Pharmacognosy, Bromatology and Human Nutrition, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Therapeutical Chemistry and Pharmacognosy, Université de Mons (UMONS), Mons, Belgium
| | - Caroline Stévigny
- Laboratory of Pharmacognosy, Bromatology and Human Nutrition, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), Brussels, Belgium
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