RESUMEN
Antibiotics excreted into the intestinal tract may disrupt the microbiota that provide colonization resistance against enteric pathogens and alter normal metabolic functions of the microbiota. Many of the bacterial metabolites produced in the intestinal tract are absorbed systemically and excreted in urine. Here, we used a mouse model to test the hypothesis that alterations in levels of targeted bacterial metabolites in urine specimens could provide useful biomarkers indicating disrupted or intact colonization resistance. To assess in vivo colonization resistance, mice were challenged with Clostridium difficile spores orally 3, 6, and 11 days after the completion of 2 days of treatment with piperacillin-tazobactam, aztreonam, or saline. For concurrent groups of antibiotic-treated mice, urine samples were analyzed by using liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify the concentrations of 11 compounds targeted as potential biomarkers of colonization resistance. Aztreonam did not affect colonization resistance, whereas piperacillin-tazobactam disrupted colonization resistance 3 days after piperacillin-tazobactam treatment, with complete recovery by 11 days after treatment. Three of the 11 compounds exhibited a statistically significant and >10-fold increase (the tryptophan metabolite N-acetyltryptophan) or decrease (the plant polyphenyl derivatives cinnamoylglycine and enterodiol) in concentrations in urine 3 days after piperacillin-tazobactam treatment, followed by recovery to baseline that coincided with the restoration of in vivo colonization resistance. These urinary metabolites could provide useful and easily accessible biomarkers indicating intact or disrupted colonization resistance during and after antibiotic treatment.
Asunto(s)
Microbioma Gastrointestinal/efectos de los fármacos , Glicina/análogos & derivados , Intestinos/microbiología , Lignanos/orina , Triptófano/análogos & derivados , Animales , Antibacterianos/farmacología , Aztreonam/metabolismo , Aztreonam/farmacología , Biomarcadores/orina , Cromatografía Liquida , Clostridioides difficile/efectos de los fármacos , Farmacorresistencia Bacteriana/fisiología , Glicina/orina , Intestinos/efectos de los fármacos , Metaboloma/efectos de los fármacos , Metabolómica , Ratones , Ácido Penicilánico/análogos & derivados , Ácido Penicilánico/metabolismo , Ácido Penicilánico/farmacología , Piperacilina/metabolismo , Piperacilina/farmacología , Combinación Piperacilina y Tazobactam , Espectrometría de Masas en Tándem , Triptófano/orinaRESUMEN
CpG oligodeoxynucleotides (ODNs) signal through TLR9 to induce type I IFN (IFN-alphabeta) in dendritic cells (DCs). CpG-A ODNs are more efficacious than CpG-B ODNs for induction of IFN-alphabeta. Because IFN-alphabeta may contribute to autoimmunity, it is important to identify mechanisms to inhibit induction of IFN-alphabeta. In our studies, CpG-B ODN inhibited induction of IFN-alphabeta by CpG-A ODN, whereas induction of TNF-alpha and IL-12p40 by CpG-A ODN was not affected. CpG-B inhibition of IFN-alphabeta was observed in FLT3 ligand-induced murine DCs, purified murine myeloid DCs, plasmacytoid DCs, and human PBMCs. CpG-B ODN inhibited induction of IFN-alphabeta by agonists of multiple receptors, including MyD88-dependent TLRs (CpG-A ODN signaling via TLR9, or R837 or Sendai virus signaling via TLR7) and MyD88-independent receptors (polyinosinic:polycytidylic acid signaling via TLR3 or ds break-DNA signaling via a cytosolic pathway). CpG-B ODN did not inhibit the IFN-alphabeta positive feedback loop second-wave IFN-alphabeta, because IFN-alphabeta-induced expression of IFN-alphabeta was unaffected, and CpG-B inhibition of IFN-alphabeta was manifested in IFN-alphabetaR(-/-) DCs, which lack the positive feedback mechanism. Rather, CpG-B ODN inhibited early TLR-induced first wave IFN-alpha4 and IFN-beta. Chromatin immunoprecipitation revealed that association of IFN regulatory factor 1 with the IFN-alpha4 and IFN-beta promoters was induced by CpG-A ODN but not CpG-B ODN. Moreover, CpG-A-induced association of IFN regulatory factor 1 with these promoters was inhibited by CpG-B ODN. Our studies demonstrate a novel mechanism of transcriptional regulation of first-wave IFN-alphabeta that selectively inhibits induction of IFN-alphabeta downstream of multiple receptors and may provide targets for future therapeutic inhibition of IFN-alphabeta expression in vivo.
Asunto(s)
Células Dendríticas/inmunología , Regulación de la Expresión Génica/inmunología , Interferón Tipo I/biosíntesis , Oligodesoxirribonucleótidos/inmunología , Transducción de Señal/inmunología , Adyuvantes Inmunológicos/farmacología , Animales , Western Blotting , Células Cultivadas , Ensayo de Inmunoadsorción Enzimática , Expresión Génica , Regulación de la Expresión Génica/genética , Humanos , Interferón Tipo I/genética , Interferón Tipo I/inmunología , Ratones , Oligodesoxirribonucleótidos/farmacología , Análisis de Secuencia por Matrices de Oligonucleótidos , Regiones Promotoras Genéticas , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Transcripción GenéticaRESUMEN
Since influenza and coronaviruses are currently deadly and emerging threats worldwide, better treatment, remediation and prevention options are needed. In that regard, a basic understanding of severe acute respiratory syndrome (SARS)-CoV-2/COVID-19 (Betacoronaviridae) and other viral pathogen mechanisms of transmission are expected. Unfortunately, unprecedented, and growing distrust of vaccines and even masks or personal protective equipment (PPE) in the United States and elsewhere presents itself as an added challenge. We postulate that development of improved and highly effective prophylactic measures, together with new life-saving therapies that do inhibit or otherwise treat infection of SARS-CoV-2, influenza and other viral pathogens, could be an adjunct measure to globally protect vulnerable individuals from pandemic threats. In this review, we share what we learned from the past COVID experience to offer a multifactorial and improved approach to current and future pandemic infections or threats using low-cost means.
RESUMEN
To study the predictive value of biopsy lesions in IgA nephropathy in a range of patient ages we retrospectively analyzed the cohort that was used to derive a new classification system for IgA nephropathy. A total of 206 adults and 59 children with proteinuria over 0.5 g/24 h/1.73 m(2) and an eGFR of stage-3 or better were followed for a median of 69 months. At the time of biopsy, compared with adults children had a more frequent history of macroscopic hematuria, lower adjusted blood pressure, and higher eGFR but similar proteinuria. Although their outcome was similar to that of adults, children had received more immunosuppressants and achieved a lower follow-up proteinuria. Renal biopsies were scored for variables identified by an iterative process as reproducible and independent of other lesions. Compared with adults, children had significantly more mesangial and endocapillary hypercellularity, and less segmental glomerulosclerosis and tubulointerstitial damage, the four variables previously identified to predict outcome independent of clinical assessment. Despite these differences, our study found that the cross-sectional correlation between pathology and proteinuria was similar in adults and children. The predictive value of each specific lesion on the rate of decline of renal function or renal survival in IgA nephropathy was not different between children and adults.
Asunto(s)
Glomerulonefritis por IGA/clasificación , Glomerulonefritis por IGA/patología , Adulto , Biopsia , Niño , Enfermedad Crónica , Femenino , Glomerulonefritis/clasificación , Glomerulonefritis/patología , Hematuria/clasificación , Hematuria/patología , Humanos , Inmunosupresores/clasificación , Riñón/patología , Pruebas de Función Renal , Masculino , Proteinuria/clasificación , Proteinuria/patologíaRESUMEN
BACKGROUND: Patients with IgA nephropathy (IgAN) have an increased amount of abnormally O-glycosylated IgA1 in circulation, in glomerular deposits and produced by tissue cells in vitro. Although increased production of Th2 cytokines by peripheral blood lymphocytes and a functional abnormality of core 1 ß1,3-galactosyltransferase (C1ß3Gal-T) have been proposed as mechanisms underlying pathogenesis of IgAN, they are still obscure and are not connected. METHODS: To clarify the effect of T-cell cytokines, we analysed the mRNA levels of C1ß3Gal-T and its molecular chaperone Cosmc, C1ß3Gal-T activity and subsequent O-glycosylation of IgA1 in a human B-cell line stimulated with these cytokines. The surface IgA1-positive human B-cell line was cultured with recombinant human IFN-γ, IL-2, IL-4 or IL-5. The production and glycosylation of IgA1 were determined by sandwich ELISA and enzyme-linked lectin binding assay, respectively. The mRNA levels of C1ß3Gal-T and Cosmc were quantitatively measured by real-time PCR. C1ß3Gal-T activity was analysed using high-performance liquid chromatography. RESULTS: IgA1 production by IL-4-stimulated cells was significantly higher than controls or after IFN-γ or IL-5. The terminal glycosylation of secreted IgA1 was altered in response to IL-4. IL-4 stimulation significantly decreased the mRNA levels of both C1ß3Gal-T and Cosmc and of C1ß3Gal-T activity. IL-4 stimulation was clearly blocked by recombinant human IL-4 soluble receptor. CONCLUSIONS: It appears that Th2 cytokine IL-4 may play a key role in controlling glycosylation of the IgA1 hinge region.
Asunto(s)
Citocinas/farmacología , Regulación hacia Abajo/fisiología , Inmunoglobulina A/metabolismo , Chaperonas Moleculares/metabolismo , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Citocinas/metabolismo , Galactosiltransferasas/metabolismo , Glomerulonefritis por IGA/metabolismo , Glomerulonefritis por IGA/patología , Glicosilación/efectos de los fármacos , Humanos , Interleucina-4/metabolismo , Interleucina-4/farmacología , Linfoma de Células B/metabolismo , Linfoma de Células B/patología , ARN Mensajero/metabolismoRESUMEN
UNLABELLED: Apoptosis is the likely mechanism behind the effects of chemotherapeutic and radiation treatments, rejection of organ transplants, and cell death due to hypoxic-ischemic injury. A simplified method capable of imaging apoptosis in living animals could have many applications leading to understanding of the involvement of apoptosis in biologic and therapeutic processes. To accomplish this goal we developed a method for the preparation of (99m)Tc-annexin V and evaluated its usefulness to detect apoptosis that occurs during tumor shrinkage after photodynamic therapy (PDT). PDT is a cancer treatment modality that leads to rapid induction of apoptosis both in vitro and in in vivo animal models. METHODS: A novel synthesis of (99m)Tc-annexin V was performed in a simple 1-pot procedure. Radiation-induced fibrosarcoma (RIF-1) tumors grown in C(3)H mice were treated with PDT, followed by injection of (99m)Tc-annexin V and measurement of its tumor uptake at 2, 4, and 7 h after PDT by autoradiography. RESULTS: The radiochemical purity of (99m)Tc-annexin V was >95%. At all time points, (99m)Tc-annexin V was clearly imaged in the PDT-treated tumors, whereas the untreated tumors showed no uptake of the radiolabeled compound. Histopathology and immunohistochemistry of PDT-treated tumors confirmed the evidence of apoptosis compared with untreated tumors. CONCLUSION: These data demonstrate the detection of apoptosis using (99m)Tc-annexin V in tumor tissue in living animals after PDT treatment. This novel technique could be used as a noninvasive means to detect and serially image tissues undergoing apoptosis after cancer treatment protocols in humans. Other potential applications of this technique could be the diagnosis of several human disorders, such as myocardial ischemia or infarct, rejection of organ transplantation, and neonatal cerebral ischemia.
Asunto(s)
Anexina A5 , Apoptosis/efectos de los fármacos , Fibrosarcoma/patología , Marcaje Isotópico/métodos , Neoplasias Inducidas por Radiación/patología , Compuestos de Organotecnecio , Animales , Anexina A5/farmacocinética , Autorradiografía/métodos , Fibrosarcoma/tratamiento farmacológico , Fibrosarcoma/metabolismo , Ratones , Ratones Endogámicos C3H , Trasplante de Neoplasias , Neoplasias Inducidas por Radiación/tratamiento farmacológico , Neoplasias Inducidas por Radiación/metabolismo , Compuestos de Organotecnecio/farmacocinética , Fotoquimioterapia/métodos , Valores de ReferenciaRESUMEN
OBJECTIVE: To review the histologic findings in patients diagnosed with "atypical glandular cells of uncertain significance, endocervical cell type" (AGUS-EC) by ThinPrep Pap Test (TPPT) or conventional Pap smear (CPS) and to evaluate the clinical value of subclassifying AGUS-EC as "favor reactive" or "favor neoplastic." STUDY DESIGN: All TPPT and CPS diagnosed as AGUS-EC (favor reactive, unspecified and favor neoplastic) from January 1998 through December 1999 and all available histologic follow-up (defined as endocervical curettage, cervical biopsy, cervical conization or hysterectomy obtained within six months of the time of an AGUS-EC diagnosis) were obtained from a computerized database. RESULTS: AGUS-EC was diagnosed in 0.77% of CPS (683 of 88,825) and 0.59% of TPPT (183 of 30,968) (P = NS). There was no statistically significant difference in any of the follow-up histologic diagnoses between the CPS and TPPT groups. The majority of the follow-up biopsies demonstrated benign processes in both groups. Patients with a diagnosis of AGUS-EC "favor neoplastic" had a greater proportion of true glandular pathology as compared with AGUS-EC "unspecified" or "favor reactive" (P < .001). None of the patients with a diagnosis of AGUS-EC "favor reactive" were found to have true glandular pathology; however, a minority of them proved to have squamous pathology. CONCLUSION: In this study there was no difference in CPS and TPPT in regard to the specificity of a diagnosis of AGUS-EC for true glandular pathology. Subclassifying AGUS-EC as "favor reactive" or "favor neoplastic" may provide valuable information for directing patient follow-up.
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Cuello del Útero/patología , Prueba de Papanicolaou , Lesiones Precancerosas/patología , Enfermedades del Cuello del Útero/patología , Frotis Vaginal/métodos , Adenocarcinoma/patología , Adolescente , Adulto , Anciano , Conización , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Neoplasias de Células Escamosas/patología , Lesiones Precancerosas/clasificación , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Sensibilidad y Especificidad , Enfermedades del Cuello del Útero/clasificación , Displasia del Cuello del Útero/patología , Neoplasias del Cuello Uterino/patología , Cervicitis Uterina/patologíaRESUMEN
The link between glomerular IgA nephropathy (IgAN) and T helper 2 (Th2) response has been implicated, however, the mechanisms are poorly defined because of the lack of an appropriate model. Here we report a novel murine model characterized by lineage-restricted deletion of the gene encoding MAD homologue 4 (Smad4) in T cells (Smad4(co/co;Lck-cre) ). Loss of Smad4 expression in T cells results in overproduction of Th2 cytokines and high serum IgA levels. We found that Smad4(co/co;Lck-cre) mice exhibited massive glomerular IgA deposition, increased albumin creatinine ratio, aberrant glycosylated IgA, IgA complexed with IgG1 and IgG2a, and polymeric IgA, all known features of IgAN in humans. Furthermore, we examined the ß1, 4-galactosyltransferases (ß4GalT) enzyme which is involved in the synthesis of glycosylated murine IgA, and we found reduced ß4GalT2 and ß4GalT4 mRNA levels in B cells. These findings indicate that Smad4(co/co;Lck-cre) mice could be a useful model for studying the mechanisms between IgAN and Th2 response, and further, disruption of Smad4-dependent signaling in T cells may play an important role in the pathogenesis of human IgAN and contributing to a Th2 T cell phenotype.
Asunto(s)
Mesangio Glomerular/metabolismo , Glomerulonefritis por IGA/genética , Proteína Smad4/genética , Linfocitos T/metabolismo , Animales , Células Cultivadas , Citocinas/sangre , Citocinas/metabolismo , Ensayo de Inmunoadsorción Enzimática , Femenino , Galactosiltransferasas/genética , Regulación Enzimológica de la Expresión Génica , Mesangio Glomerular/patología , Mesangio Glomerular/ultraestructura , Glomerulonefritis por IGA/sangre , Glomerulonefritis por IGA/metabolismo , Inmunoglobulina A/sangre , Inmunoglobulina A/metabolismo , Isoenzimas/genética , Ratones , Ratones de la Cepa 129 , Ratones Endogámicos C57BL , Ratones Noqueados , Ratones Transgénicos , Microscopía Electrónica , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Transducción de Señal/genética , Proteína Smad4/metabolismo , Células Th2/metabolismoRESUMEN
Immunoglobulin A nephropathy (IgAN) is the most common form of glomerulonephritis throughout the world. A majority (approx. 60%) of patients with IgAN experience disease exacerbations associated with an acute respiratory or gastrointestinal illness that appears to represent a viral infection. However, the exact mechanism of the disease exacerbation by viral infection is not understood, especially at the cellular and molecular levels. Here we report that glomerular podocytes express the major sensors for double-stranded RNA (dsRNA), a common byproduct of viral replication. In addition to these receptors, Toll-like receptor 3 (TLR3) and retinoic acid-inducible gene 1 (RIG-I)-like helicases (RLHs), podocytes express the collateral proteins required to support intracellular signaling. The pathways that mediate responses to dsRNA are fully functional in podocytes. The transcription factor interferon regulatory factor 3 (IRF3) and nuclear factor kappa B (NF-ĸB) are phosphorylated and translocate to the nucleus, and dsRNA increases synthesis of proteins driven by IRF3 (P54, P56 and P60) or NF-ĸB (interleukin 8 and A20). Furthermore, dsRNA suppresses podocyte cell migration, alters the expression of a panel of podocyte essential proteins (nephrin, podocin and CD2-associated protein or CD2AP) and changes transepithelial albumin flux. These effects are dsRNA sensor-specific: TLR3-/- podocytes do not respond to extracellular dsRNA, while intracellular dsRNA has no effect on podocytes bearing a dominant negative form of the major active RLH. These results demonstrate that innate responses to viruses can disturb podocyte cell function in vitro.
Asunto(s)
Movimiento Celular/inmunología , Núcleo Celular/inmunología , Inmunidad Innata , Podocitos/inmunología , ARN Bicatenario/inmunología , Transporte Activo de Núcleo Celular/efectos de los fármacos , Transporte Activo de Núcleo Celular/genética , Transporte Activo de Núcleo Celular/inmunología , Animales , Movimiento Celular/efectos de los fármacos , Movimiento Celular/genética , Núcleo Celular/genética , Células Cultivadas , Glomerulonefritis por IGA/genética , Glomerulonefritis por IGA/inmunología , Glomerulonefritis por IGA/patología , Factor 3 Regulador del Interferón/genética , Factor 3 Regulador del Interferón/inmunología , Proteínas de la Membrana/genética , Proteínas de la Membrana/inmunología , Ratones , Ratones Noqueados , FN-kappa B/genética , FN-kappa B/inmunología , Proteínas del Tejido Nervioso/genética , Proteínas del Tejido Nervioso/inmunología , Podocitos/patología , ARN Bicatenario/farmacología , Receptores de Superficie Celular , Receptor Toll-Like 3/genética , Receptor Toll-Like 3/inmunología , Virosis/complicaciones , Virosis/inmunología , Virosis/patologíaRESUMEN
BACKGROUND: We previously reported renal arterial periarteritis after implantation of a continuous-flow left ventricular assist device in calves. The purpose of the present study was to investigate whether the same periarteritis changes occur in the intrapulmonary arteries after implantation of a continuous-flow right ventricular assist device (CFRVAD) in calves and to determine the mechanism of those histologic changes. METHODS: Ten calves were implanted with a CFRVAD for 29 ± 7 days, and we compared pulmonary artery samples and hemodynamic data before and after CFRVAD implantation prospectively. RESULTS: After implantation, the pulsatility index (pulmonary arterial pulse pressure/pulmonary arterial mean pressure) significantly decreased (0.88 ± 0.40 before vs 0.51 ± 0.22 after; p < 0.05), with severe periarteritis of the intrapulmonary arteries in all animals. Periarterial pathology included hyperplasia and inflammatory cell infiltration. The number of inflammatory cells positive for the angiotensin II type 1 receptor was significantly higher after implantation (7.8 ± 6.5 pre-CFRVAD vs 313.2 ± 145.2 at autopsy; p < 0.01). Serum angiotensin-converting enzyme activity significantly decreased after implantation from 100% to 49.7 ± 17.7% at week 1 (p = 0.01). Tissue levels of angiotensin-converting enzyme also demonstrated a significant reduction (0.381 ± 0.232 before implantation vs 0.123 ± 0.096 at autopsy; p = 0.043). CONCLUSIONS: Periarteritis occurred in the intrapulmonary arteries of calves after CFRVAD implantation. The local renin-angiotensin system (not the angiotensin-converting enzyme pathway) plays an important role in such changes.
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Arteritis/patología , Insuficiencia Cardíaca/cirugía , Corazón Auxiliar/efectos adversos , Pulmón/irrigación sanguínea , Arteria Pulmonar , Sistema Renina-Angiotensina/fisiología , Animales , Arteritis/etiología , Arteritis/metabolismo , Western Blotting , Bovinos , Modelos Animales de Enfermedad , Insuficiencia Cardíaca/metabolismo , Insuficiencia Cardíaca/fisiopatología , Hemodinámica , Inmunohistoquímica , Masculino , Peptidil-Dipeptidasa A/metabolismo , Receptor de Angiotensina Tipo 1/metabolismoRESUMEN
BACKGROUND: Antibodies of the IgG3 subclass have been implicated in the pathogenesis of the spontaneous glomerulonephritis observed in mice of the MRL/MpJ-Tnfrsf6lpr (MRL/lpr) inbred strain which have been widely studied as a model of systemic lupus erythematosus We have produced IgG3-deficient (-/-) mice with the MRL/lpr genetic background to determine whether IgG3 antibodies are necessary for or at least contributory to MRL/lpr-associated nephritis. RESULTS: The gamma3 genotype (+/+ vs. +/- vs. -/-) did not appear to significantly affect serum titers of IgG auto-antibodies specific for double-stranded DNA (dsDNA) or α-actinin. However, while substantial serum titers of IgG3 auto-antibodies specific for double-stranded DNA (dsDNA) or α-actinin were seen in gamma3 +/+ mice, somewhat lower serum titers of these IgG3 auto-antibodies were found in gamma3 +/- mice, and gamma3 -/- mice exhibited baseline concentrations of these auto-antibodies. Analysis of immunoglobulins eluted from snap-frozen kidneys obtained from mice of all three gamma3 genotypes at ~18 weeks of age revealed much higher quantities of IgG in the kidneys from gamma3 +/+ than gamma3 -/- mice, and most IgG eluted from +/+ mice was IgG3. The serum creatinine levels in gamma3 +/+ mice substantially exceeded those of age-matched gamma3 -/- mice after ~21 weeks of age. Histopathological examination of kidneys from mice sacrificed at pre-determined ages also revealed more extensive glomerulosclerosis in gamma3 +/+ or +/- mice than in -/- mice beginning at 21 weeks of age. Survival analysis for IgG3-deficient and IgG3-producing MRL/lpr mice revealed that gamma3 -/- mice lived significantly longer (p = 0.0006) than either gamma3 +/- or +/+ mice. Spontaneous death appeared to be due to irreversible renal failure, because > 85% of glomeruli in kidneys from mice that died spontaneously were obliterated by glomerulosclerosis. CONCLUSIONS: The available evidence suggests that IgG3 deficiency partially protects MRL/lpr mice against glomerulonephritis-associated morbidity and mortality by slowing or arresting the progression to glomerulosclerosis.
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Progresión de la Enfermedad , Glomerulonefritis/patología , Inmunoglobulina G/inmunología , Longevidad , Actinina/genética , Actinina/inmunología , Factores de Edad , Alelos , Animales , Autoanticuerpos/sangre , Autoanticuerpos/inmunología , Creatinina/sangre , Creatinina/orina , ADN/genética , ADN/inmunología , Femenino , Genotipo , Glomerulonefritis/sangre , Glomerulonefritis/genética , Glomerulonefritis/inmunología , Inmunoglobulina G/análisis , Inmunoglobulina G/sangre , Síndromes de Inmunodeficiencia/inmunología , Síndromes de Inmunodeficiencia/patología , Endogamia , Riñón/citología , Riñón/inmunología , Riñón/patología , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Endogámicos MRL lpr , Polimorfismo de Nucleótido Simple , Análisis de SupervivenciaRESUMEN
The focus of this chapter is a systematic and critical review of the insights that experimental models have contributed to our understanding of IgA nephropathy (IgAN). We consider the generation of IgA subject to glomerular deposition, the partitioning of IgA between the circulation and glomeruli, the clearance of IgA and complexes containing IgA from the circulation, the 'upstream' effectors of glomerular pathophysiology, the inflammatory mediators that connect intraglomerular stimuli to functional and morphologic effects, and the contribution of animal models to our current understanding of the role that glycosylation of IgA plays in the genesis of IgAN. In each of these subsections, the evidence in favor of each principle or hypothesis is weighed in consideration of other potentially contradictory evidence and relevant issues related to IgAN in patients. The key limitations of each model system are presented, and where possible, reconciliation of discrepant observations are proposed. Subsequently, a synopsis of spontaneous models that do not offer particular mechanistic insights, and a compilation of experimental therapeutic initiatives, are reviewed. In all respects, the discussion of observations in patients or cells in vitro is limited to points where these data impinge upon interpretation of the data derived from the animal models.
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Modelos Animales de Enfermedad , Glomerulonefritis por IGA/fisiopatología , Animales , Glomerulonefritis por IGA/metabolismo , Glomerulonefritis por IGA/terapia , Glicosilación , Inmunoglobulina A/metabolismo , Glomérulos Renales/metabolismo , Glomérulos Renales/patología , Glomérulos Renales/fisiopatología , RatonesRESUMEN
Differences in acute ventilatory behavior are associated with carotid body (CB) structural and immunohistologic profiles in some, but not all, reports. Brown Norway (BN) rats exhibit lower acute ventilatory responses to hypoxia and hypercapnia compared to Sprague Dawley (SD) rats. We hypothesized that BN rats possess CB with fewer glomus cells. Ventilation was recorded in 6-month-old BN and SD rats exposed to hypoxia-reoxygenation and hypercapnia. Extracted CBs were examined using H&E staining, and immunohistochemistry with antibodies specific for tyrosine hydroxylase (TH), neural nitric oxide synthase (nNOS), and pyruvate dehydrogenase (PD). Sections were analyzed for cell and immunostaining density. SD displayed greater hypoxic and hypercapnic responses, and post-hypoxic short term potentiation, whereas BN exhibited post-hypoxic frequency decline. Contrary to our hypothesis, BN demonstrated a denser arrangement of glomus cells with a larger TH stained area (31.7% BN, 22.6% SD; p<0.0001), and nNOS stained area (37.3% BN, 32.1%; SD; p=0.01). Hence, respiratory phenotype does not correlate intuitively with these anatomic features.
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Cuerpo Carotídeo/anatomía & histología , Cuerpo Carotídeo/fisiología , Ventilación Pulmonar/fisiología , Animales , Masculino , Ratas , Ratas Endogámicas BN , Ratas Sprague-Dawley , Especificidad de la EspecieRESUMEN
The hallmark of IgA nephropathy (IgAN), the most common form of glomerulonephritis, is the presence of mesangial deposits containing IgA, specifically the IgA1 subclass, as the most prominent component. The deposited IgA is considered to be part of an immune complex. The family of enzymes known as bacterial IgA proteases exhibits substrate specificity that is essentially limited to the hinge region of IgA1. Here we demonstrate the ability of systemically administered IgA protease to remove glomerular IgA immune complexes, both the antigen and antibody components, in a passive mouse model of IgAN. Thus, IgA protease may have potential as a therapeutic agent for human IgAN.
Asunto(s)
Glomerulonefritis por IGA/patología , Inmunoglobulina A/metabolismo , Glomérulos Renales/inmunología , Serina Endopeptidasas/fisiología , Animales , Complejo Antígeno-Anticuerpo , Modelos Animales de Enfermedad , Glomerulonefritis por IGA/terapia , Haemophilus influenzae/metabolismo , Humanos , Riñón/patología , Riñón/ultraestructura , Glomérulos Renales/metabolismo , Glomérulos Renales/ultraestructura , Ratones , Microscopía Electrónica , Microscopía Fluorescente/métodos , Modelos Estadísticos , Estructura Terciaria de Proteína , Serina Endopeptidasas/metabolismoRESUMEN
OBJECTIVE: The need for pulsatility in the circulation during long-term mechanical support has been a subject of debate. We compared histologic changes in calf renal arteries subjected to various degrees of pulsatile circulation in vivo. We addressed the hypothesis that the local renin-angiotensin system may be implicated in these histologic changes. METHODS AND RESULTS: Sixteen calves were implanted with devices giving differing degrees of pulsatile circulation: 6 had a continuous flow left ventricular assist device (LVAD); 6 had a continuous flow right ventricular assist device (RVAD); and 4 had a pulsatile total artificial heart (TAH). Six other calves were histologic and immunohistochemical controls. In the LVAD group, the pulsatility index was significantly lower (0.28 +/- 0.07 LVAD vs 0.56 +/- 0.08 RVAD, vs 0.53 +/- 0.10 TAH; P < 0.01), and we observed severe periarteritis in all cases in the LVAD group. The number of angiotensin II type 1 receptor-positive cells and angiotensin converting enzyme-positive cells in periarterial areas was significantly higher in the LVAD group (angiotensin II type 1 receptor: 350 +/- 139 LVAD vs 8 +/- 6 RVAD, vs 3 +/- 2 TAH, vs 3 +/- 2 control; P < .001; angiotensin-converting enzyme: 325 +/- 59 LVAD vs 6 +/- 4 RVAD, vs 6 +/- 5 TAH, vs 3 +/- 1 control; P < .001). CONCLUSIONS: The reduced pulsatility produced by a continuous flow LVAD implantation induced severe periarteritis in the kidneys. The local renin-angiotensin system was up-regulated in the inflammatory cells only in the continuous flow LVAD group.
Asunto(s)
Arteritis/fisiopatología , Riñón/irrigación sanguínea , Nefritis/fisiopatología , Arteria Renal/patología , Arteria Renal/fisiopatología , Sistema Renina-Angiotensina , Angiotensina II/biosíntesis , Animales , Arteritis/patología , Bovinos , Hemodinámica , Inmunohistoquímica , Riñón/metabolismo , Masculino , Nefritis/patología , Peptidil-Dipeptidasa A/metabolismo , Flujo Pulsátil , Receptores de Angiotensina/metabolismoRESUMEN
Defective adaptive humoral immune responses to mucosal immunogens, but intact systemic responses, are increasingly recognized in patients with IgA nephropathy (IgAN). Reduced expression of IgA+, J chain+ cells in the gut lamina propria, with collateral increases in these cells in the marrow, is also documented. Thus, there seems to be a derangement in a 'mucosa-marrow axis' in IgAN patients. Recent evidence indicates that chemokines regulate the localization of B cells and their progeny into respiratory and intestinal lamina propria, and into other lymphoid organs as well. Particularly, secretory epithelial cells express the chemokine CCL28, whereas small bowel cells uniquely express CCL25. Extramucosal sites preferentially express CXCL12, CXCL13 and/or CXCL16. Reciprocally, plasmablasts committed to IgA synthesis ubiquitously express the receptor (CCR10) for CCL28, and a subset also express the receptor (CCR9) for CCL25; neither of these is present on cells committed to IgG or IgM synthesis. Herein, the potential contributions of virally induced innate responses to defective mucosal immunity and overproduction of oligomeric IgA in the marrow and tonsils will be reviewed, particularly with respect to the influence that viral infection exerts upon the expression of selected chemokine and receptor pairs. The ramifications for pathogenesis of IgAN will be considered.
Asunto(s)
Quimiocinas/inmunología , Glomerulonefritis por IGA/inmunología , Glomerulonefritis por IGA/patología , Linfocitos/patología , Receptores de Quimiocina/inmunología , Humanos , Linfocitos/inmunologíaRESUMEN
In a model of IgA nephropathy (IgAN) induced by Sendai virus (SeV) without Th1/Th2 polarizing immunization, Th2-prone BALB/c mice develop more severe nephritis with acute renal insufficiency than Th1-prone C3H mice. To determine whether Th1 or Th2 predominance influences the severity of experimental IgAN in mice, we employed polarizing immunizations in a SeV-induced IgAN model in Th1-prone C57Bl/6 mice and Th2-prone BALB/c mice. C57Bl/6 mice, immunized with SeV +CFA or +IFA, showed: (1) clear cytokine polarity by splenocytes in recall assays. (2) Total serum IgA and especially SeV-specific IgA from the IFA group showed a selective defect in galactosylation, not seen in the CFA group, and (3) serum creatinine in the IFA group was higher than in the CFA group or nonimmune controls. However, BALB/c mice did not show clear cytokine polarity with CFA/IFA adjuvant. Moreover, spleen cells from naive BALB/c mice produce IFN-gamma (but not IL-2, -4, -5, or -13) upon stimulation with inactivated SeV in vitro. By flow cytometry, IFN-gamma producing cells are CD3(-), CD19(-), CD49b(+) natural killer cells. IFN-gamma production by naive splenocytes is blocked partially by anti-IL12 blocking Abs, and completely by anti-IL18R blocking Abs. In conclusion, C57Bl/6 mice with polarizing priming with SeV showed clear cytokine polarity and distinct kidney injuries. However, BALB/c mice did not show clear cytokine polarity in the same immunizing system, presumably due to the effects of innate responses to SeV upon antigen-specific lymphocytes. Natural IFN-gamma production may influence the risk of renal failure in IgAN.
Asunto(s)
Modelos Animales de Enfermedad , Glomerulonefritis por IGA/inmunología , Ratones Endogámicos C57BL , Infecciones por Respirovirus/inmunología , Virus Sendai/inmunología , Animales , Glomerulonefritis por IGA/virología , Ratones , Ratones Endogámicos BALB C , Infecciones por Respirovirus/complicacionesRESUMEN
Endothelin-1 has been implicated in diabetic kidney injury, but there are few firm data establishing the temporal and spatial expression of kidney endothelin-1 in diabetes. We performed an immunohistochemical and histopathological analysis to determine endothelin-1 peptide expression in the kidneys of diabetic db/db mice and non-diabetic db/m controls. Diabetic mice were studied at 8 weeks, before histological damage is evident, and again at 16 weeks, when significant glomerular injury has occurred. Urinary endothelin-1 was 6.2- and 3.6-fold higher in 8- and 16-week diabetic mice compared to age-matched controls (P<0.01 db/db vs. db/m). Compared to non-diabetic kidneys, immunoreactive endothelin-1 was first elevated 2.5-fold (P=0.02) in the tubulointerstitial compartment at 8-week and remained high (3.8-fold, P<0.01) at 16 weeks. In contrast, glomerular endothelin-1 was elevated 3.2-fold (P=0.03) only in 16-week diabetic mice. Glomerular and tubulointerstitial endothelin-1 were unchanged in 8- and 16-week non-diabetic mice. Elevated endothelin-1 in diabetic mice associated temporally and spatially with collagen deposition, especially in the tubulointerstitial compartment. The localization of kidney endothelin-1 is consistent with a role for this peptide in renal fibrogenesis. These results also highlight the potential role of ET-1 in the pathogenesis of early tubulointerstitial changes in diabetes.
Asunto(s)
Colágeno/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Endotelina-1/metabolismo , Riñón/metabolismo , Animales , Diabetes Mellitus Tipo 2/patología , Modelos Animales de Enfermedad , Riñón/patología , Glomérulos Renales/metabolismo , Glomérulos Renales/patología , Túbulos Renales/metabolismo , Túbulos Renales/patología , Masculino , RatonesRESUMEN
Chronic injection of dextran into normal mice elicits a glomerulonephritis (GN) that models IgA nephropathy (IgAN) in humans. Since athymic mice lack T cells but nonetheless develop antibodies to polysaccharide antigens such as dextran (DEX), we used athymic mice to study the role of T lymphocytes in the induction of this form of GN, independent of the role of T cells in antibody synthesis. Both mice given injections of diethylaminoethyl (DEAE)-DEX and uninjected mice had circulating IgM and IgA anti-DEX antibodies, which apparently arise as 'natural antibodies', but immune complex GN was observed only in the injected mice. All of 15 injected mice exhibited capillary staining for IgA and IgM; none of 12 control mice contained such IgA deposits and only one had capillary staining for IgM (both P<0.001). In addition, IgG and C3 were detected in injected but not control animals. By light microscopy, injected mice exhibited marked expansion of mesangial matrix relative to controls. Electron microscopy showed no glomerular abnormalities in control mice, whereas injected mice showed large organized fibrillar deposits principally in the mesangium. Hematuria and proteinuria were present in all 15 injected mice, but only one of 11 control mice showed hematuria or proteinuria (both P<0.001). These results indicate that chronic injection of DEAE-DEX into athymic mice generates the same clinical and histologic features of GN as in euthymic mice, suggesting that T cells are not necessary to promote GN in this model.
Asunto(s)
Mesangio Glomerular/inmunología , Glomerulonefritis por IGA/etiología , Glomerulonefritis por IGA/inmunología , Inmunoglobulina A/inmunología , Inmunoglobulina M/inmunología , Ratones Desnudos/inmunología , Linfocitos T/inmunología , Animales , Dextranos , Etanolaminas , Mesangio Glomerular/patología , Glomerulonefritis por IGA/patología , Hematuria/fisiopatología , Humanos , Inmunización , Ratones , Microscopía Electrónica de Transmisión , Proteinuria/fisiopatología , Linfocitos T/patologíaRESUMEN
BACKGROUND: In response to chronic hyperglycemia, microvascular cells undergo stress and injury, which can lead to cell death. We characterized a proapoptotic signaling pathway whereby high glucose evokes an intrinsic, caspase-9-dependent mechanism of cell death in human mesangial cells. METHODS: Biochemical (caspase activity, cytochrome-c release, etc.) and morphologic (chromatin condensation and nuclear segmentation) features of apoptotic cell death were assessed in cultured human mesangial cells exposed to high glucose, a risk factor for mesangial cell injury and diabetic glomerulosclerosis. Proapoptotic signaling was also analyzed in the db/db murine model of kidney injury in diabetes. RESULTS: Incubation in high glucose caused cytotoxicity and apoptosis in mesangial cells. High glucose stimulated mitochondrial release of cytochrome-c, cleavage of procaspase-9, and caspase-9 enzyme activity, suggesting an intrinsic pathway of proapoptotic signaling. In contrast, caspase-8 was unaffected by high glucose. A cell-permeable, caspase-9-selective inhibitor blocked caspase-3 activation and prevented chromatin condensation and nuclear segmentation in cells treated with high glucose. To determine whether an intrinsic signaling pathway occurs in the diabetic kidney in vivo, apoptosis was investigated in diabetic 8- and 16-week db/db murine kidneys. Effector caspases-3 and -7 were activated in diabetic db/db kidneys but not in age-matched nondiabetic db/m controls. At 16 weeks, apoptotic cells in db/db glomeruli were identified on the basis of nuclear segmentation and DNA fragmentation. Apoptosis of glomerular cells correlated with expansion of the mesangial matrix and with worsening of albuminuria. Consistent with an intrinsic signaling pathway, caspase-9 cleavage was elevated only in db/db kidneys, whereas activation of caspase-8 and caspase-12 was undetectable. CONCLUSION: These findings support the hypothesis that hyperglycemia evokes an intrinsic pathway of proapoptotic signaling in mesangial cells. In addition, these results point to an important role for the intrinsic pathway in microvascular injury in the diabetic kidney in vivo.