RESUMO
BACKGROUND: The current study tested the hypothesis that urinary angiotensinogen (UAGT) and urinary monocyte chemoattractant protein-1 (UMCP-1) levels provide a specific index of intrarenal renin-angiotensin system (RAS) status and the degree of infiltration of macrophages associated with RAS blockade and immunosuppressant treatment in pediatric patients with chronic glomerulonephritis. METHODS: We measured baseline UAGT and UMCP-1 levels to examine the correlation between glomerular injury in 48 pediatric chronic glomerulonephritis patients before treatment. Furthermore, we performed immunohistochemical analysis of angiotensinogen (AGT) and CD68 in 27 pediatric chronic glomerulonephritis patients treated with RAS blockades and immunosuppressants for 2 years. Finally, we examined the effects of angiotensin II (Ang II) on monocyte chemoattractant protein-1 (MCP-1) expression in cultured human mesangial cells (MCs). RESULTS: Baseline UAGT and UMCP-1 levels positively correlated with urinary protein levels, scores for mesangial hypercellularity, rate of crescentic formation, and expression levels of AGT and CD68 in renal tissues (p < 0.05). UAGT and UMCP-1 levels were significantly decreased after RAS blockade and immunosuppressant treatment (p < 0.01), which was accompanied by AGT and CD68 (p < 0.01), as well as the magnitude of glomerular injury. Cultured human MCs showed increased MCP-1 messenger ribonucleic acid and protein levels after Ang II treatment (p < 0.01). CONCLUSIONS: The data indicates that UAGT and UMCP-1 are useful biomarkers of the degree of glomerular injury during RAS blockade and immunosuppressant treatment in pediatric patients with chronic glomerulonephritis.
Assuntos
Glomerulonefrite , Sistema Renina-Angiotensina , Humanos , Criança , Angiotensinogênio/urina , Rim/metabolismo , Quimiocina CCL2 , Glomerulonefrite/metabolismo , Angiotensina II/metabolismo , Doença Crônica , Imunossupressores/farmacologia , Imunossupressores/uso terapêutico , Macrófagos/metabolismoRESUMO
Nephrotic syndrome (NS) is a renal disease characterized by severe proteinuria and hypoproteinemia. Although several single-gene mutations have been associated with steroid-resistant NS, causative genes for steroid-sensitive NS (SSNS) have not been clarified. While seeking to identify causative genes associated with SSNS by whole-exome sequencing, we found compound heterozygous variants/mutations (c.524T>C; p.I175T and c.662G>A; p.R221H) of the interleukin-1 receptor accessory protein (IL1RAP) gene in two siblings with SSNS. The siblings' parents are healthy, and each parent carries a different heterozygous IL1RAP variant/mutation. Since IL1RAP is a critical subunit of the functional interleukin-1 receptor (IL-1R), we investigated the effect of these variants on IL-1R subunit function. When stimulated with IL-1ß, peripheral blood mononuclear cells from the siblings with SSNS produced markedly lower levels of cytokines compared with cells from healthy family members. Moreover, IL-1R with a variant IL1RAP subunit, reconstituted on a hematopoietic cell line, had impaired binding ability and low reactivity to IL-1ß. Thus, the amino acid substitutions in IL1RAP found in these NS patients are dysfunctional variants/mutations. Furthermore, in the kidney of Il1rap-/- mice, the number of myeloid-derived suppressor cells, which require IL-1ß for their differentiation, was markedly reduced although these mice did not show significantly increased proteinuria in acute nephrotic injury with lipopolysaccharide treatment. Together, these results identify two IL1RAP variants/mutations in humans for the first time and suggest that IL1RAP might be a causative gene for familial NS.
Assuntos
Proteína Acessória do Receptor de Interleucina-1/genética , Síndrome Nefrótica/genética , Esteroides/efeitos adversos , Animais , Pré-Escolar , Feminino , Variação Genética , Humanos , Recém-Nascido , Proteína Acessória do Receptor de Interleucina-1/sangue , Lipopolissacarídeos , Camundongos , Camundongos Endogâmicos C57BL , Mutação , Síndrome Nefrótica/induzido quimicamente , Síndrome Nefrótica/tratamento farmacológico , Irmãos , Esteroides/uso terapêuticoRESUMO
(Pro)renin receptor [(P)RR] has multiple functions, but its regulation and role in the pathogenesis in glomerulonephritis (GN) are poorly defined. The aims of the present study were to determine the effects of direct renin inhibition (DRI) and demonstrate the role of (P)RR on the progression of crescentic GN. The anti-glomerular basement membrane nephritis rat model developed progressive proteinuria (83.64 ± 10.49 mg/day) and glomerular crescent formation (percent glomerular crescent: 62.1 ± 2.3%) accompanied by increased macrophage infiltration and glomerular expression of monocyte chemoattractant protein (MCP)-1, (P)RR, phospho-extracellular signal-regulated kinase (ERK)1/2, Wnt4, and active ß-catenin. Treatment with DRI ameliorated proteinuria (20.33 ± 5.88 mg/day) and markedly reduced glomerular crescent formation (20.9 ± 2.6%), induction of macrophage infiltration, (P)RR, phospho-ERK1/2, Wnt4, and active ß-catenin. Furthermore, primary cultured parietal epithelial cells stimulated by recombinant prorenin showed significant increases in cell proliferation. Notably, while the ERK1/2 inhibitor PD98059 or (P)RR-specific siRNA treatment abolished the elevation in cell proliferation, DRI treatment did not abrogate this elevation. Moreover, cultured mesangial cells showed an increase in prorenin-induced MCP-1 expression. Interestingly, (P)RR or Wnt4-specific siRNA treatment or the ß-catenin antagonist XAV939 inhibited the elevation of MCP-1 expression, whereas DRI did not. These results suggest that (P)RR regulates glomerular crescent formation via the ERK1/2 signaling and Wnt/ß-catenin pathways during the course of anti-glomerular basement membrane nephritis and that DRI mitigates the progression of crescentic GN through the reduction of (P)RR expression but not inhibition of prorenin binding to (P)RR.
Assuntos
Proliferação de Células , Glomerulonefrite/enzimologia , Células Mesangiais/enzimologia , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Receptores de Superfície Celular/metabolismo , Via de Sinalização Wnt , Amidas/farmacologia , Animais , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Modelos Animais de Doenças , Fumaratos/farmacologia , Glomerulonefrite/patologia , Glomerulonefrite/prevenção & controle , Masculino , Células Mesangiais/efeitos dos fármacos , Células Mesangiais/patologia , Fosforilação , Ratos Endogâmicos WKY , ATPases Vacuolares Próton-Translocadoras , Via de Sinalização Wnt/efeitos dos fármacos , Proteína Wnt4/metabolismo , beta Catenina/metabolismoRESUMO
WDR19 has been reported as a causative gene of nephronophthisis-related ciliopathies. Patients with WDR19 mutations can show various extrarenal manifestations such as skeletal disorders, Caroli disease, and retinal dystrophy, and typically display nephronophthisis as a renal phenotype. However, there is limited information on the renal phenotypes of patients with WDR19 mutations. We report two Japanese infants with Sensenbrenner syndrome caused by WDR19 mutations who demonstrated different features in renal ultrasound and histopathological results, despite several common extrarenal manifestations. Patient 1 had normal sized and hyperechogenic kidneys with several small cysts and histopathological findings compatible with infantile nephronophthisis. Renal ultrasound of Patient 2 showed enlarged kidneys with diffuse microcysts resembling those of autosomal recessive polycystic kidney disease. Her renal histopathology revealed dysplastic kidney with diffuse glomerular cysts. Genetic testing identified compound heterozygous mutations in WDR19 in both patients (Patient 1: c.953delA, c.3533G > A, Patient 2: c.2645 + 1G > T, c.3533G > A). Our patients suggest that WDR19 mutations can cause dysplastic kidney in addition to nephronophthisis pathologically. In addition, differences in pathology of the kidneys from WDR19 mutations may result in heterogeneous features in renal ultrasound findings. Renal phenotypes from WDR19 mutations may thus be more diverse than previously reported. Extrarenal manifestations and genetic testing can therefore help to diagnosis this disease more precisely.
Assuntos
Osso e Ossos/anormalidades , Craniossinostoses/genética , Displasia Ectodérmica/genética , Doenças Renais Císticas/genética , Rim/anormalidades , Mutação , Rim Policístico Autossômico Recessivo/genética , Proteínas/genética , Biópsia , Pré-Escolar , Craniossinostoses/diagnóstico , Craniossinostoses/terapia , Proteínas do Citoesqueleto , Análise Mutacional de DNA , Displasia Ectodérmica/diagnóstico , Displasia Ectodérmica/terapia , Feminino , Predisposição Genética para Doença , Heterozigoto , Humanos , Lactente , Peptídeos e Proteínas de Sinalização Intracelular , Rim/diagnóstico por imagem , Doenças Renais Císticas/diagnóstico , Doenças Renais Císticas/terapia , Imageamento por Ressonância Magnética , Fenótipo , Rim Policístico Autossômico Recessivo/diagnóstico , Rim Policístico Autossômico Recessivo/terapia , UltrassonografiaRESUMO
AIM: Extracellular signal regulated kinase (ERK)1/2 and ERK5 are key kinases of the signalling pathways involved in various cellular responses to kidney injury; however, the mechanistic links between those kinase and renin-angiotensin system (RAS) activations in glomerulonephritis (GN) have not been fully elucidated. In this study, we sought to clarify the potential roles of ERK1/2 and ERK5 via RAS activation in the pathogenesis of GN. METHODS: A rat model of progressive GN was induced by anti-glomerular basement membrane (GBM) injection and the signal transduction pathway in angiotensin II (Ang II)-induced glomerular pathologic alterations were investigated in primary cultured mesangial cells (MCs). RESULTS: Rats developed typical cellular crescents in glomeruli on day 7 that progressed to severe fibrocellular crescents and glomerulosclerosis on day 28. Strong expression of phospho-ERK1/2 was observed on day 7 and phospho-ERK5 expression was markedly increased on day 28 of GN. An angiotensin II type 1 receptor blocker (ARB) suppressed those augmentations. Moreover, ARB treatment attenuated the increases in macrophage infiltration and PCNA-positive cells observed on day 7 in GN rats, as well as the increase in collagen type 1 expression on day 28. Consistently, MCs stimulated by Ang II showed significant increases in proliferation and the expression of MCP-1 and collagen type 1. Interestingly, while the ERK1/2 inhibitor PD98059 abolished the elevations in MCP-1 expression and cell proliferation, the ERK5 inhibitor BIX02189 abrogated the elevation in collagen type 1 expression. CONCLUSION: Altogether, these data suggest that ERK1/2 regulates acute inflammatory reactions, while ERK5 promotes the development of RAS-induced chronic glomerular fibrosis activation in GN.
Assuntos
Angiotensina II/metabolismo , Mesângio Glomerular/metabolismo , Glomerulonefrite , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Sistema Renina-Angiotensina/efeitos dos fármacos , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Animais , Modelos Animais de Doenças , Fibrose/metabolismo , Mesângio Glomerular/patologia , Glomerulonefrite/metabolismo , Glomerulonefrite/patologia , Glomerulonefrite/fisiopatologia , Inflamação/metabolismo , Ratos , Transdução de Sinais/efeitos dos fármacosRESUMO
BACKGROUND AND AIM: No nationally representative survey of irritable bowel syndrome (IBS) among adolescents has ever been performed in Japan. In the present study, we aimed to clarify the prevalence of IBS among Japanese adolescents and the factors associated with it. METHODS: The items related to the diagnostic criteria for IBS based on the Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders were included in a cross-sectional nationwide survey of "alcohol consumption and smoking habits among junior and senior high school students." The participating schools were sampled from among all junior and senior high schools in Japan using the cluster-sampling method, and self-administered questionnaires were sent to the selected schools by mail. Among 99 416 questionnaires that were collected, data from 98 411 valid responses were analyzed. RESULTS: The results showed that the prevalence of IBS was 18.6%. Although no sex difference was observed in the overall prevalence of IBS, the prevalence of diarrhea-predominant IBS was higher among boys than among girls, and the prevalence of constipation-predominant IBS was higher among girls than among boys. The prevalence of IBS increased with progression of the school grade, and there were the significant relationships between IBS and sleep-phase delay and insomnia symptoms. IBS was also significantly associated with poor mental health status. CONCLUSION: These results indicate that IBS is common among junior and senior high school students, and associated with lifestyle and mental health.
Assuntos
Síndrome do Intestino Irritável/epidemiologia , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Povo Asiático , Análise por Conglomerados , Constipação Intestinal/epidemiologia , Constipação Intestinal/etiologia , Estudos Transversais , Diarreia/epidemiologia , Diarreia/etiologia , Feminino , Humanos , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/psicologia , Japão/epidemiologia , Estilo de Vida , Masculino , Saúde Mental , Prevalência , Fatores Sexuais , Fumar/epidemiologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Recently, we demonstrated that urinary angiotensinogen (AGT) levels are increased and reflect intrarenal renin-angiotensin system (RAS) status in pediatric patients with chronic glomerulonephritis. Therefore, this study was performed to test the hypothesis that urinary AGT (UAGT) levels provide a specific index of intrarenal RAS status associated with RAS blockade treatment in pediatric IgA nephropathy (IgAN) patients. METHODS: We measured plasma and UAGT levels and urinary transforming growth factor beta (TGF-ß) levels, after which we performed immunohistochemical analysis of AGT, angiotensin II (Ang II), and TGF-ß in 24 pediatric IgAN patients treated with RAS blockades for 2 years. Paired tests were used to analyze the changes from baseline to study end. RESULTS: Although there was no change in plasma AGT levels, UAGT and TGF-ß levels were significantly decreased after RAS blockade, which was accompanied by the expression levels of AGT, Ang II, and TGF-ß, as well as the magnitude of glomerular injury. Baseline UAGT levels positively correlated with diastolic blood pressure, urinary protein levels, scores for mesangial hypercellularity, and the expression levels of AGT, Ang II, and TGF-ß in renal tissues. CONCLUSIONS: These data indicate that UAGT is a useful biomarker of intrarenal RAS activation, which is associated with glomerular injury during RAS blockade in pediatric IgAN patients.
Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Angiotensinogênio/urina , Glomerulonefrite por IGA/tratamento farmacológico , Rim/efeitos dos fármacos , Sistema Renina-Angiotensina/efeitos dos fármacos , Adolescente , Angiotensina II/sangue , Angiotensina II/urina , Angiotensinogênio/sangue , Biomarcadores/sangue , Biomarcadores/urina , Biópsia , Criança , Ensaio de Imunoadsorção Enzimática , Feminino , Glomerulonefrite por IGA/diagnóstico , Glomerulonefrite por IGA/fisiopatologia , Glomerulonefrite por IGA/urina , Humanos , Imuno-Histoquímica , Rim/metabolismo , Rim/patologia , Rim/fisiopatologia , Masculino , Valor Preditivo dos Testes , Fatores de Tempo , Fator de Crescimento Transformador beta/sangue , Fator de Crescimento Transformador beta/urina , Resultado do Tratamento , UrináliseRESUMO
BACKGROUND: Equations for the creatinine-based estimated glomerular filtration rate (eGFR) were recently established for Japanese adults (>18 years old) and children (2-11 years old), respectively, but it is unclear whether eGFR can be as useful as 24-h creatinine clearance (CCr) for assessing renal function in patients receiving chemotherapy. This study examined the degree of concordance between eGFR and CCr and the risk factors leading to the overestimation of renal function by eGFR. METHODS: A total of 53 data points of 19 children and 56 data points of 16 adults who received chemotherapy were analyzed retrospectively. Body mass index, serum creatinine concentration, 24-h urinary creatinine excretion (UCr), and nephrectomy were considered as risk factors for overestimation by eGFR. RESULTS: In the pediatric part of the study, 7 data points from 3 patients who underwent nephrectomy were included. The eGFR in patients with bilateral kidneys overestimated renal function to a greater degree than in patients with a unilateral kidney. In 45.7 % of pediatric patients with bilateral kidneys and in 19.6 % of adult patients, eGFR overestimated renal function. The risk factor for overestimation was lower UCr in pediatric patients with bilateral kidneys and adult patients. CONCLUSIONS: Concordance between eGFR and CCr in pediatric patients with a unilateral kidney should be assessed separately from that in patients with bilateral kidneys. In restricting calculation of eGFR to pediatric patients with bilateral kidneys and adult patients without little muscle mass, eGFR may be useful regardless of whether patients are receiving chemotherapy.
Assuntos
Antineoplásicos/uso terapêutico , Creatinina/sangue , Creatinina/urina , Taxa de Filtração Glomerular , Conceitos Matemáticos , Neoplasias/tratamento farmacológico , Adulto , Área Sob a Curva , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Japão , Lactonas , Masculino , Neoplasias/cirurgia , Nefrectomia , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
Since the direct method of LDL measurement is easy and convenient, many health evaluation and promotion facilities adopted it without sufficient discussion after specific health checkups started in Japan. For the purpose of reliable, specific health checkup data, we must review the methods and standardization of LDL measurement. I hope that medical societies, the Ministry of Health, Labour and Welfare, and reagent manufacturers will collaborate.
Assuntos
Arteriosclerose/prevenção & controle , LDL-Colesterol/sangue , Promoção da Saúde , Triagem Multifásica , Biomarcadores/sangue , Testes Hematológicos/métodos , Testes Hematológicos/normas , HumanosRESUMO
BACKGROUND: Angiotensin-converting enzyme (ACE) 2 is a homolog of ACE and is thought to be a potent counter-regulator against ACE activity. However, the role of ACE2 has not been investigated in pediatric patients with IgA nephropathy (IgAN). This study was performed to examine the relationship between ACE2 expression and the development of pediatric IgAN. METHODS: We performed immunohistochemical analysis of ACE2 and ACE in 39 patients with pediatric IgAN and 14 patients with minor glomerular abnormalities, and elucidated the effects of various cytokines on ACE2 expression in cultured human mesangial cells. RESULTS: ACE2 expression levels in glomeruli and tubules were positively correlated with the mesangial hypercellularity score, while ACE expression levels in glomeruli and tubules are not. Multiple regression analysis showed that the mesangial hypercellularity score correlated with the ACE2 expression level in glomeruli and the urinary protein-creatinine ratio. In IgAN patients not treated with a renin-angiotensin system blocker, ACE2 expression levels in glomeruli were significantly increased compared to patients with minor glomerular abnormalities. IgAN patients treated with a renin-angiotensin system blocker did not show this increase in ACE2 expression. Furthermore, cultured human MC showed increased ACE2 mRNA and protein after treatment with IL-1ß, a pro-inflammatory cytokine in IgAN. In fact, glomerular expressions of IL-1ß were remarkably increased in patients with IgAN. CONCLUSION: These data indicate that ACE2 expression in glomeruli is associated with mesangial hypercellularity in early lesions of pediatric IgAN.
Assuntos
Glomerulonefrite por IGA/diagnóstico , Glomerulonefrite por IGA/enzimologia , Glomérulos Renais/enzimologia , Peptidil Dipeptidase A/metabolismo , Adolescente , Enzima de Conversão de Angiotensina 2 , Biópsia , Células Cultivadas , Criança , Creatinina/sangue , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/metabolismo , Glomérulos Renais/metabolismo , Masculino , Células Mesangiais/enzimologia , RNA Mensageiro/metabolismo , Análise de Regressão , Sistema Renina-AngiotensinaRESUMO
OBJECTIVES: Osteomyelitis (OM) and septic arthritis (SA) in childhood might cause complications, sequelae, or even death if diagnosis and treatment are delayed. Here, we examined the outcomes of OM/SA at a pediatric emergency core hospital in Japan. METHODS: This was a single-center, retrospective, observational cohort study at a pediatric emergency core hospital in Japan. Pediatric outpatients who underwent magnetic resonance imaging at the hospital in the period 2012?2020 were recruited. Primary outcomes were sequelae, recurrent symptoms, chronicity, and death. RESULTS: Fifteen OM/SA patients (9 OM, 4 SA, 2 OM+SA) were recruited. The identified major pathogens included methicillin-susceptible Staphylococcus aureus (40.0 %, n=6) and methicillin-resistant S. aureus (13.3 %, n=2). Mean time from onset to first hospital visit, hospitalization, and initiation of effective antibiotics was 2 days, 3.9?±?1.8 days, and 4.9±2.2 days, respectively. All OM/SA patients recovered without complications or sequelae. CONCLUSIONS: In this study, all patients with OM/SA showed a good prognosis. Despite the small sample size, this pilot study suggests that the pediatric emergency core system in Japan provides early treatment and a good prognosis for patients diagnosed with OM/SA. J. Med. Invest. 70 : 236-240, February, 2023.
Assuntos
Artrite Infecciosa , Staphylococcus aureus Resistente à Meticilina , Osteomielite , Infecções Estafilocócicas , Criança , Humanos , Estudos Retrospectivos , Japão/epidemiologia , Projetos Piloto , Artrite Infecciosa/terapia , Artrite Infecciosa/complicações , Artrite Infecciosa/diagnóstico , Progressão da Doença , Osteomielite/terapia , Osteomielite/complicações , Osteomielite/diagnóstico , Antibacterianos/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/diagnósticoRESUMO
Pediatric ulcerative colitis is likely to be more severe than adult ulcerative colitis. Failure to thrive should be considered during therapy. A 10-year-old boy was diagnosed with ulcerative colitis based on his clinical presentation and colonoscopy and biopsy results. The administration of 5-aminosalicylic acid and prednisolone resulted in remission ; however, the symptoms reappeared after the discontinuation of prednisolone. Then, infliximab was administered ; however, the patient was resistant to it and appeared to be dependent on prednisolone. Vedolizumab, a monoclonal antibody against ?4?7 integrin, was administered, which resulted in rapid remission. A steady decrease in prednisolone followed, and remission was maintained even after prednisolone discontinuation. Vedolizumab may be effective in pediatric patients with moderate-to-severe refractory ulcerative colitis. Vedolizumab prevents lymphocytes from binding to MAdCAM-1, which is selectively expressed in the gastrointestinal submucosa, leading to the mitigation of the systemic side effects of immunosuppression, such as infections. In Japan, vedolizumab use is not yet approved for use in children, but its effectiveness and safety in children is expected to be investigated in the future. J. Med. Invest. 70 : 294-297, February, 2023.
Assuntos
Colite Ulcerativa , Masculino , Adulto , Humanos , Criança , Infliximab/uso terapêutico , Colite Ulcerativa/tratamento farmacológico , Colite Ulcerativa/induzido quimicamente , Anticorpos Monoclonais Humanizados/uso terapêutico , Prednisolona/uso terapêuticoRESUMO
The outbreak of coronavirus disease (COVID-19) resulted in implementation of social distancing and other public health measures to control the spread of infection and improve prevention, resulting in a decrease in respiratory syncytial virus (RSV) and pediatric respiratory tract infection rates. However, there was a rapid and large re-emergence of RSV infection in Japan. Notably, we were faced with a difficult situation wherein there was a shortage of hospital beds. This study aimed to examine the epidemiological patterns of RSV-related hospitalizations among children before and after the COVID-19 pandemic onset at two pediatric emergency referral hospitals covering the entire Tokushima Prefecture. Data were extracted from electronic medical records of children hospitalized with RSV infection between January 1, 2018, and December 31, 2021. All patients meeting the eligibility criteria were included in this study. The rates of study outcomes were documented annually during 2018-2021 and compared between the 2018-2020 and 2021 periods. In 2020, there was no RSV infection outbreak. Hospitalizations at the peak week in 2021 were 2.2- and 2.8-fold higher than those in 2018 and 2019, respectively. Hospitalizations in 2021 were concentrated within a short period. In addition, there was a significant increase in hospitalizations among children aged 3-5 months and those older than 24 months. The high-flow nasal cannula (HFNC) use rate nearly doubled in 2021. A new pandemic in the future may cause an outbreak of RSV infection that can result in an intensive increase in the number of hospitalizations of pediatric patients requiring respiratory support, especially in infants aged <6 months. There is an urgent need to improve the preparedness of medical systems, particularly in terms of the number of inpatient beds and the immediate availability of HFNC.
RESUMO
We demonstrate the temporal contrast enhancement in a petawatt-class Ti:sapphire chirped-pulse amplification (CPA) laser system. An extra saturable absorber, introduced downstream after a low-gain optical parametric chirped-pulse amplification (OPCPA) preamplifier, has improved the temporal contrast in the system to 1.4×10(12) on the subnanosecond time scale at 70 TW power level. We have achieved 28 J of uncompressed broadband output energy with this system, indicating the potential for reaching peak powers near 600 TW.
RESUMO
The intrarenal renin-angiotensin system (RAS) has several pathophysiologic functions not only in blood pressure regulation but also in the development of glomerulonephritis (GN). Angiotensin II (Ang II) is the biologically active product of the RAS. Locally produced Ang II induces inflammation, renal cell growth, mitogenesis, apoptosis, migration, and differentiation, regulates the gene expression of bioactive substances, and activates multiple intracellular signaling pathways, leading to tissue damage. Activation of the Ang II type 1 (AT1) receptor pathway results in the production of proinflammatory mediators, cell proliferation, and extracellular matrix synthesis, which facilitates glomerular injury. Previous studies have shown that angiotensin-converting enzyme inhibitors and/or AT1 receptor blockers have beneficial effects in experimental GN models and humans with various types of GN, and that these effects are more significant than their suppressive effects on blood pressure. In this paper, we focus on intrarenal RAS activation in the pathophysiology of experimental models of GN.
Assuntos
Modelos Animais de Doenças , Glomerulonefrite/metabolismo , Glomerulonefrite/patologia , Rim/metabolismo , Rim/patologia , Sistema Renina-Angiotensina , Animais , Progressão da Doença , Humanos , Modelos BiológicosRESUMO
BACKGROUND/AIMS: Hydrogen peroxide-inducible clone-5 (Hic-5) is a transforming growth factor-ß(1) (TGF-ß(1))- and hydrogen peroxide (H(2)O(2))-inducible focal adhesion protein that may be necessary for maintaining the myofibroblastic phenotype in pathological scar formation. To investigate the involvement of Hic-5 in the pathogenesis of glomerulonephritis (GN), we examined the glomerular expression of Hic-5 in human and rat GN as well as the regulation of Hic-5 by TGF-ß(1) in vitro. METHODS AND RESULTS: Immunohistochemical analyses showed that the expression of Hic-5 was increased in mesangial cells (MCs) in human mesangial proliferative GN. Hic-5 expression was significantly correlated not only with the levels of α-smooth muscle actin (α-SMA) and TGF-ß(1), the accumulation of extracellular matrix, and the number of glomerular cells, but also with the urinary protein level in patients with GN. Glomerular Hic-5 expression increased in parallel with α-SMA expression in a rat model of mesangial proliferative GN. Combined therapy with an angiotensin type I receptor blocker and an antioxidant in this model improved the histology and the expression of Hic-5 and α-SMA. TGF-ß(1) upregulated Hic-5 and α-SMA protein levels in human cultured MCs. CONCLUSION: Our findings suggest that Hic-5 is involved in changes in the MC phenotype to produce abnormal extracellular matrix remodeling in GN.
Assuntos
Glomerulonefrite Membranoproliferativa/metabolismo , Glomérulos Renais/metabolismo , Proteínas com Domínio LIM/biossíntese , Actinas/biossíntese , Adolescente , Adulto , Idoso , Animais , Western Blotting , Células Cultivadas , Criança , Pré-Escolar , Proteínas do Citoesqueleto/biossíntese , Proteínas de Ligação a DNA/biossíntese , Feminino , Mesângio Glomerular/metabolismo , Mesângio Glomerular/patologia , Glomerulonefrite Membranoproliferativa/patologia , Humanos , Imuno-Histoquímica , Peptídeos e Proteínas de Sinalização Intracelular , Glomérulos Renais/efeitos dos fármacos , Masculino , Células Mesangiais/efeitos dos fármacos , Células Mesangiais/metabolismo , Microscopia de Fluorescência , Pessoa de Meia-Idade , Músculo Liso/química , Ratos , Fator de Crescimento Transformador beta1/biossíntese , Fator de Crescimento Transformador beta1/farmacologia , Adulto JovemRESUMO
A 6-year-old girl was admitted to our hospital with proteinuria, hematuria, skin rash and joint pain of the lower limbs. Due to rapid progression of renal insufficiency, hemodialysis and peritoneal dialysis were performed. She was diagnosed with rapidly progressive glomerulonephritis. Kidney biopsy showed severe crescent formation (50% of glomeruli) and no deposition of any immunoglobulins or complements. Serologically, anti-neutrophil cytoplasmic autoantibody (ANCA) was negative not only by ELISA against proteinase-3 and myeloperoxidase-ANCA but also by indirect immunofluorescent assay against cytoplasmic and perinuclear ANCA. Anti-glomerular basement membrane antibody was also negative. In the acute phase, proinflammatory cytokines such as soluble tumor necrosis factor receptor 1 (sTNFR1), soluble interleukin (IL)-2 receptor (sIL2R), IL-6 and chemokine IL-8 were elevated. The patient was diagnosed with ANCA-negative pauci-immune crescentic glomerulonephritis (CrGN). Intensive treatment with methylprednisolone pulse therapy, plasma exchange, and multiple drug therapy including prednisolone and cyclophosphamide resulted in histopathological improvement and complete remission of proteinuria. There was a possibility that sTNFR1, sIL2R, IL-6 and IL-8 might be involved in the initiation and progression of ANCA-negative pauci-immune CrGN, and to remove and suppress these cytokines might be an effective way to treat ANCA-negative pauci-immune CrGN.
Assuntos
Glomerulonefrite/imunologia , Anticorpos Anticitoplasma de Neutrófilos/imunologia , Autoanticorpos/análise , Criança , Ciclofosfamida/administração & dosagem , Quimioterapia Combinada , Feminino , Glomerulonefrite/tratamento farmacológico , Humanos , Metilprednisolona/administração & dosagem , Plasmaferese , Prednisolona/administração & dosagem , Proteinúria/tratamento farmacológico , Proteinúria/etiologia , PulsoterapiaRESUMO
Freshwater shrimps in the family Atyidae exhibit one of two life history traits: amphidromy, in which planktonic larvae develop in the sea; and landlocked, in which lecithotrophic larvae develop in freshwater. Temperature and salinity are the most important environmental factors that affect the survival, duration, and growth of decapod crustacean larvae. Larvae of landlocked shrimps are known to retain the ancestral habit of amphidromy, i.e., the ability to develop to the juvenile stage in saline water. Faster development exhibited by large larvae of landlocked shrimps is considered an adaptation that allows the larvae to stay in or near parental habitats. Therefore, information on larval performance under different temperature and salinity conditions is essential to obtain a better understanding of population connectivity through marine larval dispersal in amphidromous shrimps as well as larval adaptation to freshwater environments in landlocked shrimps. We examined the effects of temperature and salinity on the larval performance of two closely related atyid shrimps in the genus Paratya: the amphidromous P. compressa and the landlocked P. improvisa. Larvae were reared under the 25 combinations of five different temperatures (20, 23, 26, 29, and 32°C) and salinity levels (4.25, 8.5, 17, 25.5, and 34 ppt). In P. compressa, the rate of larvae that survived into the juvenile stage decreased linearly with increasing temperature and the larvae adapted to a wider range of salinity (8.5-34 ppt), though larval mortality increased at the high salinity (34 ppt) under the higher temperature conditions. In P. improvisa, larval survival rates were higher under a wider range of temperatures (20-29°C) in brackish water (4.25-17 ppt). Thus, P. compressa larvae may disperse broadly under the high salinity conditions of the open sea, but oceanic currents with high temperature and high salinity conditions may act as a barrier to restrict larval dispersion northwards from the southern islands. Paratya improvisa larvae adapted to a wider range of temperatures in natural freshwater environments and larval duration was shorter in P. improvisa than in P. compressa under the wide range of temperature and salinity conditions. Our results also highlight the retention strategy by which landlocked P. improvisa larvae stay in or near parental habitats.