RESUMO
AIMS: Increased plasma uric acid (PUA) levels are associated with impaired renal function in patients with Type 1 diabetes, but the mechanisms are not well understood. Our aim was to evaluate whether higher PUA levels are associated with increased afferent arteriolar resistance in patients with Type 1 diabetes vs. healthy controls, thereby influencing renal function. METHODS: PUA, GFR (inulin) and effective renal plasma flow (ERPF; para-aminohippurate) were measured in 70 otherwise healthy patients with Type 1 diabetes and 60 healthy controls. Gomez's equations were used to estimate afferent (RA ) and efferent (RE ) arteriolar resistances, glomerular hydrostatic pressure (PGLO ) and filtration pressure (ΔPF ). The relationships between PUA and glomerular haemodynamic parameters were evaluated by univariable linear regression correlation coefficients. RESULTS: In patients with Type 1 diabetes, higher PUA correlated with lower PGLO (P = 0.002) and ΔPF (P = 0.0007), with higher RA (P = 0.001), but not with RE (P = 0.55). These associations were accompanied by correlations between higher PUA with lower GFR (P = 0.0007), ERPF (P = 0.008), RBF (P = 0.047) and higher RVR (P = 0.021). There were no significant correlations between PUA and renal haemodynamic parameters in the healthy controls. CONCLUSIONS: The association between higher PUA with lower GFR and lower ERPF in patients with Type 1 diabetes is driven by alterations in the estimated RA . PUA-mediated RA may be caused by increased tone or thickening of the afferent renal arteriole, which might potentiate renal injury by causing ischaemia to the renal microcirculation.
Assuntos
Diabetes Mellitus Tipo 1/sangue , Pressão Hidrostática , Glomérulos Renais/irrigação sanguínea , Fluxo Plasmático Renal Efetivo , Ácido Úrico/sangue , Resistência Vascular , Adulto , Estudos de Casos e Controles , Feminino , Taxa de Filtração Glomerular , Hemodinâmica , Humanos , Modelos Lineares , Masculino , Adulto JovemRESUMO
BACKGROUND AND PURPOSE: T2 hypointensity in the basal ganglia of patients with MS has been associated with clinical progression and cognitive decline. Our objectives were the following: 1) to compare signal in T2WI, R2 (ie, 1/T2), and R2* (ie, 1/T2*) relaxation rates and quantitative susceptibility mapping; and 2) to investigate the associations among MR imaging, clinical scores, and cognitive measures of inhibitory control linked to basal ganglia functioning. MATERIALS AND METHODS: Twenty-nine patients with MS underwent a battery of neuropsychological tests including the Flanker and Stroop tasks. 7T MR imaging included 3D gradient-echo and single-echo multishot spin-echo EPI. Quantitative susceptibility mapping images were calculated by using a Wiener filter deconvolution algorithm. T2WI signal was normalized to CSF. R2 and R2* were calculated by log-linear regression. Average MR imaging metrics for the globus pallidus, putamen, and caudate were computed from manually traced ROIs including the largest central part of each structure. RESULTS: Marked spatial variation was consistently visualized on quantitative susceptibility mapping and T2/T2*WI within each basal ganglia structure. MR imaging metrics correlated with each other for each basal ganglia structure individually. Notably, caudate and putamen quantitative susceptibility mapping metrics were similar, but the putamen R2 was larger than the caudate R2. This finding suggests that tissue features contribute differently to R2 and quantitative susceptibility mapping. Caudate and anterior putamen quantitative susceptibility mapping correlated with the Flanker but not Stroop measures; R2 did not correlate with inhibitory control measures. Putamen quantitative susceptibility mapping and caudate and putamen R2 correlated with the Expanded Disability Status Scale. CONCLUSIONS: Our study showed that quantitative susceptibility mapping and R2 may be complementary indicators for basal ganglia tissue changes in MS. Our findings are consistent with the hypothesis that decreased performance of basal ganglia-reliant tasks involving inhibitory control is associated with increased quantitative susceptibility mapping.
Assuntos
Gânglios da Base/patologia , Mapeamento Encefálico/métodos , Imageamento por Ressonância Magnética/métodos , Esclerose Múltipla/patologia , Adulto , Idoso , Gânglios da Base/fisiopatologia , Progressão da Doença , Feminino , Humanos , Ferro/análise , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/fisiopatologiaRESUMO
AIMS: To evaluate the glomerular haemodynamic profile of patients with Type 1 diabetes with either renal hyperfiltration (GFR ≥ 135 ml/min/1.73 m2 ) or renal normofiltration (GFR 90-134 ml/min/1.73 m2 ) during euglycaemic and hyperglycaemic conditions, and to compare this profile with that of a similar group of healthy control subjects. METHODS: Gomez's equations were used to derive afferent and efferent arteriolar resistances, glomerular hydrostatic pressure and filtration pressure. RESULTS: At baseline, during clamped euglycaemia, patients with Type 1 diabetes and hyperfiltration had lower mean ± sd afferent arteriolar resistance than both those with Type 1 diabetes and normofiltration (914 ± 494 vs. 2065 ± 597 dyne/s/cm5 ; P < 0.001) and healthy control subjects (1676 ± 707 dyne/s/cm(5) ; p < 0.001). By contrast, efferent arteriolar resistance was similar in the three groups. Patients with Type 1 diabetes and hyperfiltration also had higher mean ± sd glomerular hydrostatic pressure than both healthy control subjects and patients with Type 1 diabetes and normofiltration (66 ± 6 vs. 60 ± 3 vs. 55 ± 3 mmHg; P < 0.05). Similar findings for afferent arteriolar resistance, efferent arteriolar resistance, glomerular hydrostatic pressure and filtration pressure were observed during clamped hyperglycaemia. CONCLUSION: Hyperfiltration in Type 1 diabetes is primarily driven by alterations in afferent arteriolar resistance rather than efferent arteriolar resistance. Renal protective therapies should focus on afferent renal arteriolar mechanisms through the use of pharmacological agents that target tubuloglomerular feedback, including sodium-glucose cotransporter 2 inhibitors and incretins.
Assuntos
Diabetes Mellitus Tipo 1/complicações , Nefropatias Diabéticas/fisiopatologia , Glomerulonefrite/complicações , Hiperglicemia/fisiopatologia , Glomérulos Renais/fisiopatologia , Circulação Renal , Adulto , Vias Aferentes/fisiopatologia , Algoritmos , Arteríolas/inervação , Arteríolas/fisiopatologia , Estudos de Coortes , Diabetes Mellitus Tipo 1/sangue , Vias Eferentes/fisiopatologia , Feminino , Barreira de Filtração Glomerular/irrigação sanguínea , Barreira de Filtração Glomerular/inervação , Barreira de Filtração Glomerular/fisiopatologia , Taxa de Filtração Glomerular , Glomerulonefrite/fisiopatologia , Técnica Clamp de Glucose , Humanos , Hiperglicemia/prevenção & controle , Glomérulos Renais/irrigação sanguínea , Glomérulos Renais/inervação , Masculino , Resistência Vascular , Adulto JovemAssuntos
Neisseria elongata/isolamento & purificação , Infecções por Neisseriaceae/etiologia , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Peritonite/tratamento farmacológico , Peritonite/microbiologia , Antibacterianos/uso terapêutico , Seguimentos , Humanos , Infusões Parenterais , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Neisseria elongata/classificação , Infecções por Neisseriaceae/tratamento farmacológico , Diálise Peritoneal Ambulatorial Contínua/métodos , Peritonite/etiologia , Doenças Raras , Medição de Risco , Resultado do TratamentoRESUMO
The anti-senility effects of Kuangquan 851 Oral Liquor type R and type Y were studied and compared with Qing Chun Bao Oral Liquor as control in 303 subjects of geratic period or presenium with senile syndromes of Kidney or Spleen Deficiency. The results indicated that both type R and Y could improve the Kidney and Spleen Deficiency. The effective rates of type R and Y were 96.6% and 92.3% respectively and were much better than that of the control group. The laboratory findings before and after treatment revealed that effects of Kuangquan 851 Oral Liquor were as follows: increasing antioxidation and clearing away free-radicals; promoting collagen metabolism; enhancing the function of T lymphocytes; improving pulmonary, cardiovasular, brain function; raising male serum testosterone and estradiol levels. The two types were similar in effect.
Assuntos
Envelhecimento/efeitos dos fármacos , Medicamentos de Ervas Chinesas/farmacologia , Sequestradores de Radicais Livres/farmacologia , Idoso , Feminino , Humanos , Nefropatias/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Esplenopatias/tratamento farmacológico , Subpopulações de Linfócitos T/imunologia , Deficiência da Energia Yang/tratamento farmacológico , Deficiência da Energia Yin/tratamento farmacológicoRESUMO
Macrophages from mice were cultured at 37 degrees C with 1640 medium containing 10% bovine serum. The macrophage suspension was made from 50 Swiss mice and was cultured in the following groups: control group; coal dust group (with added coal dust particles (10 micrograms/ml) smaller than 4 microns diameter); subdivided zinc-coal dust group (as coal dust group with zinc added in three different concentrations--namely, 10 ppm, 30 ppm, and 60 ppm). Cells were examined by light microscopy. Obvious differences were found in the rate of cell deaths between the coal dust group and the zinc-coal dust group after culture for 48 hours. The cell membranes were ruptured after culturing with coal dust, and the presence of zinc appeared in some degree to protect cell membranes from damage caused by the dust. Staining the cells with Gomori's modified method, showed that acid phosphatase particles in the zinc-coal dust group were more numerous than in the coal dust group. The results indicate that the trace element zinc may play an important part in protecting against the cytotoxic action of coal dust.