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1.
N Engl J Med ; 385(17): 1570-1580, 2021 10 21.
Artículo en Inglés | MEDLINE | ID: mdl-34670044

RESUMEN

BACKGROUND: Variability in ultrafiltration influences prescriptions and outcomes in patients with kidney failure who are treated with peritoneal dialysis. Variants in AQP1, the gene that encodes the archetypal water channel aquaporin-1, may contribute to that variability. METHODS: We gathered clinical and genetic data from 1851 patients treated with peritoneal dialysis in seven cohorts to determine whether AQP1 variants were associated with peritoneal ultrafiltration and with a risk of the composite of death or technique failure (i.e., transfer to hemodialysis). We performed studies in cells, mouse models, and samples obtained from humans to characterize an AQP1 variant and investigate mitigation strategies. RESULTS: The common AQP1 promoter variant rs2075574 was associated with peritoneal ultrafiltration. Carriers of the TT genotype at rs2075574 (10 to 16% of patients) had a lower mean (±SD) net ultrafiltration level than carriers of the CC genotype (35 to 47% of patients), both in the discovery phase (506±237 ml vs. 626±283 ml, P = 0.007) and in the validation phase (368±603 ml vs. 563±641 ml, P = 0.003). After a mean follow-up of 944 days, 139 of 898 patients (15%) had died and 280 (31%) had been transferred to hemodialysis. TT carriers had a higher risk of the composite of death or technique failure than CC carriers (adjusted hazard ratio, 1.70; 95% confidence interval [CI], 1.24 to 2.33; P = 0.001), as well as a higher risk of death from any cause (24% vs. 15%, P = 0.03). In mechanistic studies, the rs2075574 risk variant was associated with decreases in AQP1 promoter activity, aquaporin-1 expression, and glucose-driven osmotic water transport. The use of a colloid osmotic agent mitigated the effects of the risk variant. CONCLUSIONS: A common variant in AQP1 was associated with decreased ultrafiltration and an increased risk of death or technique failure among patients treated with peritoneal dialysis. (Funded by the Swiss National Science Foundation and others.).


Asunto(s)
Acuaporina 1/genética , Transporte Biológico/genética , Variación Genética , Diálisis Peritoneal , Insuficiencia Renal/terapia , Agua/metabolismo , Animales , Acuaporina 1/metabolismo , Transporte Biológico/fisiología , Femenino , Genotipo , Humanos , Masculino , Ratones , Ratones Noqueados , Persona de Mediana Edad , Modelos Animales , Ósmosis , Insuficiencia Renal/genética , Insuficiencia Renal/mortalidad , Factores de Riesgo , Transcripción Genética , Insuficiencia del Tratamiento
2.
Nephrol Dial Transplant ; 39(1): 114-121, 2023 Dec 20.
Artículo en Inglés | MEDLINE | ID: mdl-37715343

RESUMEN

BACKGROUND: Ischemia-reperfusion injury (IRI) upon transplantation is one of the most impactful events that the kidney graft suffers during its life. Its clinical manifestation in the recipient, delayed graft function (DGF), has serious prognostic consequences. However, the different definitions of DGF are subject to physicians' choices and centers' policies, and a more objective tool to quantify IRI is needed. Here, we propose the use of donor-derived cell-free DNA (ddcfDNA) for this scope. METHODS: ddcfDNA was assessed in 61 kidney transplant recipients of either living or deceased donors at 24 h, and 7, 14 and 30 days after transplantation using the AlloSeq cfDNA Kit (CareDx, San Francisco, CA, USA). Patients were followed-up for 6 months and 7-year graft survival was estimated through the complete and functional iBox tool. RESULTS: Twenty-four-hour ddcfDNA was associated with functional DGF [7.20% (2.35%-15.50%) in patients with functional DGF versus 2.70% (1.55%-4.05%) in patients without it, P = .023] and 6-month estimated glomerular filtration rate (r = -0.311, P = .023). At Day 7 after transplantation, ddcfDNA was associated with dialysis duration in DGF patients (r = 0.612, P = .005) and worse 7-year iBox-estimated graft survival probability (ß -0.42, P = .001) at multivariable analysis. Patients with early normalization of ddcfDNA (<0.5% at 1 week) had improved functional iBox-estimated probability of graft survival (79.5 ± 16.8%) in comparison with patients with 7-day ddcfDNA ≥0.5% (67.7 ± 24.1%) (P = .047). CONCLUSIONS: ddcfDNA early kinetics after transplantation reflect recovery from IRI and are associated with short-, medium- and long-term graft outcome. This may provide a more objective estimate of IRI severity in comparison with the clinical-based definitions of DGF.


Asunto(s)
Ácidos Nucleicos Libres de Células , Trasplante de Riñón , Humanos , Funcionamiento Retardado del Injerto , Diálisis Renal , Trasplante de Riñón/efectos adversos , Donantes de Tejidos , Supervivencia de Injerto , Rechazo de Injerto/diagnóstico , Factores de Riesgo
3.
Transpl Int ; 36: 10840, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36713113

RESUMEN

Extracorporeal photopheresis (ECP) is an immunomodulatory therapy based on the infusion of autologous cellular products exposed to ultraviolet light (UV) in the presence of a photosensitizer. The study evaluates the ECP efficacy as induction therapy in a full-mismatch kidney transplant rat model. Dark Agouti to Lewis (DA-L) kidney transplant model has been established. ECP product was obtained from Lewis rat recipients after DA kidney graft transplantation (LewDA). Leukocytes of those LewDA rats were exposed to 8-methoxy psoralen, and illuminated with UV-A. The ECP doses assessed were 10 × 106 and 100 × 106 cells/time point. Lewis recipients received seven ECP infusions. DA-L model was characterized by the appearance of donor-specific antibodies (DSA) and kidney function deterioration from day three after kidney transplant. The dysfunction progressed rapidly until graft loss (6.1 ± 0.5 days). Tacrolimus at 0.25 mg/kg prolonged rat survival until 11.4 ± 0.7 days (p = 0.0004). In this context, the application of leukocytes from LewDA sensitized rats accelerated the rejection (8.7 ± 0.45, p = 0.0012), whereas ECP product at high dose extended kidney graft survival until 26.3 ± 7.3 days, reducing class I and II DSA in surviving rats. ECP treatment increases kidney graft survival in full-mismatch rat model of acute rejection and is a suitable immunomodulatory therapy to be explored in kidney transplantation.


Asunto(s)
Trasplante de Riñón , Fotoféresis , Ratas , Animales , Supervivencia de Injerto , Ratas Endogámicas Lew , Rechazo de Injerto/prevención & control , Anticuerpos
4.
Kidney Int ; 102(2): 421-430, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35644282

RESUMEN

Several organ allocation protocols give priority to wait-listed simultaneous kidney-pancreas (SPK) transplant recipients to mitigate the higher cardiovascular risk of patients with diabetes mellitus on dialysis. The available information regarding the impact of preemptive simultaneous kidney-pancreas transplantation on recipient and graft outcomes is nonetheless controversial. To help resolve this, we explored the influence of preemptive simultaneous kidney-pancreas transplants on patient and graft survival through a retrospective analysis of the OPTN/UNOS database, encompassing 9690 simultaneous transplant recipients between 2000 and 2017. Statistical analysis was performed applying a propensity score analysis to minimize bias. Of these patients, 1796 (19%) were transplanted preemptively. At ten years, recipient survival was significantly superior in the preemptive group when compared to the non-preemptive group (78.9% vs 71.8%). Dialysis at simultaneous kidney-pancreas transplantation was an independent significant risk for patient survival (hazard ratio 1.66 [95% confidence interval 1.32-2.09]), especially if the dialysis duration was 12 months or longer. Preemptive transplantation was also associated with significant superior kidney graft survival compared to those on dialysis (death-censored: 84.3% vs 75.4%, respectively; estimated half-life of 38.57 [38.33 -38.81] vs 22.35 [22.17 - 22.53] years, respectively). No differences were observed between both groups neither for pancreas graft survival nor for post-transplant surgical complications. Thus, our results sustain the relevance of early referral for pancreas transplantation and the importance of pancreas allocation priority in reducing patient mortality after simultaneous kidney-pancreas transplantation.


Asunto(s)
Diabetes Mellitus Tipo 1 , Trasplante de Riñón , Trasplante de Páncreas , Diabetes Mellitus Tipo 1/cirugía , Supervivencia de Injerto , Humanos , Trasplante de Riñón/métodos , Páncreas , Trasplante de Páncreas/efectos adversos , Estudios Retrospectivos
5.
Transpl Int ; 35: 10639, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36466442

RESUMEN

Profiling of circulating immune cells provides valuable insight to the pathophysiology of acute rejection in organ transplantation. Herein we characterized the peripheral blood mononuclear cells in simultaneous kidney-pancreas transplant recipients. We conducted a retrospective analysis in a biopsy-matched cohort (n = 67) and compared patients with biopsy proven acute rejection (BPAR; 41%) to those without rejection (No-AR). We observed that CD3+ T cells, both CD8+ and CD4+, as well as CD19+ B cells were increased in patients with BPAR, particularly in biopsies performed in the early post-transplant period (<3 months). During this period immune subsets presented a good discriminative ability (CD4+ AUC 0.79; CD8+ AUC 0.80; B cells AUC 0.86; p < 0.05) and outperformed lipase (AUC 0.62; p = 0.12) for the diagnosis of acute rejection. We further evaluated whether this could be explained by differences in frequencies prior to transplantation. Patients presenting with early post-transplant rejection (<3 months) had a significant increase in T-cell frequencies pre-transplant, both CD4+ T cells and CD8+ T cells (p < 0.01), which were associated with a significant inferior rejection-free graft survival. T cell frequencies in peripheral blood correlated with pancreas acute rejection episodes, and variations prior to transplantation were associated with pancreas early acute rejection.


Asunto(s)
Leucocitos Mononucleares , Trasplante de Páncreas , Humanos , Estudios Retrospectivos , Páncreas , Riñón
6.
Am J Transplant ; 21(8): 2727-2739, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34036720

RESUMEN

According to preliminary data, seroconversion after mRNA SARS-CoV-2 vaccination might be unsatisfactory in Kidney Transplant Recipients (KTRs). However, it is unknown if seronegative patients develop at least a cellular response that could offer a certain grade of protection against SARS-CoV-2. To answer this question, we prospectively studied 148 recipients of either kidney (133) or kidney-pancreas (15) grafts with assessment of IgM/IgG spike (S) antibodies and ELISpot against the nucleocapside (N) and the S protein at baseline and 2 weeks after receiving the second dose of the mRNA-1273 (Moderna) vaccine. At baseline, 31 patients (20.9%) had either IgM/IgG or ELISpot positivity and were considered to be SARS-CoV-2-pre-immunized, while 117 (79.1%) patients had no signs of either cellular or humoral response and were considered SARS-CoV-2-naïve. After vaccination, naïve patients who developed either humoral or cellular response were finally 65.0%, of which 29.9% developed either IgG or IgM and 35.0% S-ELISpot positivity. Factors associated with vaccine unresponsiveness were diabetes and treatment with antithymocytes globulins during the last year. Side effects were consistent with that of the pivotal trial and no DSAs developed after vaccination. In conclusion, mRNA-1273 SARS-CoV-2 vaccine elicits either cellular or humoral response in almost two thirds of KTRs.


Asunto(s)
COVID-19 , Trasplante de Riñón , Anticuerpos Antivirales , Vacunas contra la COVID-19 , Humanos , Trasplante de Riñón/efectos adversos , ARN Mensajero/genética , SARS-CoV-2
7.
Int J Mol Sci ; 21(16)2020 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-32823722

RESUMEN

Peritoneal hyalinizing vasculopathy (PHV) represents the cornerstone of long-term peritoneal dialysis (PD), and especially characterizes patients associated with encapsulating peritoneal sclerosis. However, the mechanisms of PHV development remain unknown. A cross sectional study was performed in 100 non-selected peritoneal biopsies of PD patients. Clinical data were collected and lesions were evaluated by immunohistochemistry. In selected biopsies a microRNA (miRNA)-sequencing analysis was performed. Only fifteen patients (15%) showed PHV at different degrees. PHV prevalence was significantly lower among patients using PD fluids containing low glucose degradation products (GDP) (5.9% vs. 24.5%), angiotensin converting enzyme inhibitors (ACEIs) (7.5% vs. 23.4%), statins (6.5% vs. 22.6%) or presenting residual renal function, suggesting the existence of several PHV protective factors. Peritoneal biopsies from PHV samples showed loss of endothelial markers and induction of mesenchymal proteins, associated with collagen IV accumulation and wide reduplication of the basement membrane. Moreover, co-expression of endothelial and mesenchymal markers, as well as TGF-ß1/Smad3 signaling activation were found in PHV biopsies. These findings suggest that an endothelial-to-mesenchymal transition (EndMT) process was taking place. Additionally, significantly higher levels of miR-7641 were observed in severe PHV compared to non-PHV peritoneal biopsies. Peritoneal damage by GDPs induce miRNA deregulation and an EndMT process in submesothelial vessels, which could contribute to collagen IV accumulation and PHV.


Asunto(s)
MicroARNs/genética , Diálisis Peritoneal/efectos adversos , Enfermedades Peritoneales/etiología , Enfermedades Peritoneales/genética , Biopsia , Colágeno Tipo IV/metabolismo , Endotelio/patología , Femenino , Humanos , Masculino , Mesodermo/patología , MicroARNs/metabolismo , Persona de Mediana Edad , Peritoneo/patología , Fosforilación , Molécula-1 de Adhesión Celular Endotelial de Plaqueta/metabolismo , Análisis de Componente Principal , Proteína smad3/metabolismo , España
8.
Hum Psychopharmacol ; 34(2): e2689, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30762913

RESUMEN

OBJECTIVE: The correct production of speech depends on the effective use of inhibitory control. Cocaine abuse has been linked to impaired inhibition in the verbal and nonverbal domains. The aim of this study was to evaluate the possible impairment of the inhibitory control process engaged in the production of language among chronic cocaine users, both in rehabilitation and recreational contexts. METHOD: Researchers obtained an index of semantic interference from a picture-word task performed by chronic cocaine users in rehabilitation (Experiment 1) and recreational cocaine polydrug users (Experiment 2). Cocaine users in both groups were matched for age and intelligence with cocaine-free health controls. Performance on the picture-word task was analyzed by repeated-measures analyses of variance. RESULTS: Both groups of cocaine users showed significantly more semantic interference than their respective cocaine-free control group. These results suggest a deficit in the ability to inhibit interfering information. CONCLUSIONS: The present findings suggest that cocaine use, even at recreational levels, is associated with specific impairments in the inhibitory mechanism that reduces the activation of overt competing responses in language production. This impairment results in the inefficient avoidance of irrelevant information, inducing errors and slower responses during the production of spoken language.


Asunto(s)
Trastornos Relacionados con Cocaína/psicología , Cocaína/efectos adversos , Drogas Ilícitas/efectos adversos , Inhibición Psicológica , Estimulación Luminosa/métodos , Desempeño Psicomotor/efectos de los fármacos , Adulto , Cocaína/administración & dosificación , Inhibidores de Captación de Dopamina/administración & dosificación , Inhibidores de Captación de Dopamina/efectos adversos , Femenino , Humanos , Masculino , Desempeño Psicomotor/fisiología , Semántica , Adulto Joven
9.
Blood Purif ; 46(2): 103-110, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29672317

RESUMEN

BACKGROUND/AIMS: Peritoneal protein loss (PPL) is associated with cardiovascular disease and mortality in peritoneal dialysis (PD). Controversial results have been published about the effect of paricalcitol in PPL among PD patients. This study intends to analyze the relationship between paricalcitol and PPL in PD. METHODS: In a retrospective study, prevalent PD patients were divided into 2 groups: "with paricalcitol" and "without paricalcitol". X2-test, Student's t test, Pearson correlation coefficient and Logistic Regression analysis were applied. RESULTS: Eighty-two patients were included. PPL was lower among patients medicated with paricalcitol (5.17 ± 1.71 vs. 6.79 ± 2.10 g/24 h, p = 0.0001). In multivariate analysis, paricalcitol and dialysate/plasma ratio of creatinine (D/P creatinine) were independently related to PPL (OR 4.270 [1.437-12.684], p = 0.009 and OR 0.205 [0.064-0.659], p = 0.008, respectively), adjusted for diabetes. CONCLUSION: Paricalcitol and D/P creatinine were independently related to PPL. Paricalcitol may have an effect on PPL in PD patients.


Asunto(s)
Ergocalciferoles/deficiencia , Diálisis Peritoneal/efectos adversos , Deficiencia de Proteína/etiología , 25-Hidroxivitamina D 2/análogos & derivados , Anciano , Creatinina/análisis , Ergocalciferoles/farmacología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Deficiencia de Vitamina D/complicaciones
10.
BMC Nephrol ; 19(1): 262, 2018 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-30314451

RESUMEN

BACKGROUND: Utilization of home hemodialysis (HHD) is low in Europe. The Knowledge to Improve Home Dialysis Network in Europe (KIHDNEy) is a multi-center study of HHD patients who have used a transportable hemodialysis machine that employs a low volume of lactate-buffered, ultrapure dialysate per session. In this retrospective cohort analysis, we describe patient factors, HHD prescription factors, and biochemistry and medication use during the first 6 months of HHD and rates of clinical outcomes thereafter. METHODS: Using a standardized digital form, we recorded data from 7 centers in 4 Western European countries. We retained patients who completed ≥6 months of HHD. We summarized patient and HHD prescription factors with descriptive statistics and used mixed modeling to assess trends in biochemistry and medication use. We also estimated long-term rates of kidney transplant and death. RESULTS: We identified 129 HHD patients; 104 (81%) were followed for ≥6 months. Mean age was 49 years and 66% were male. Over 70% of patients were prescribed 6 sessions per week, and the mean treatment duration was 15.0 h per week. Median HHD training duration was 2.5 weeks. Mean standard Kt/Vurea was nearly 2.7 at months 3 and 6. Pre-dialysis biochemistry was generally stable. Between baseline and month 6, mean serum bicarbonate increased from 23.1 to 24.1 mmol/L (P = 0.01), mean serum albumin increased from 36.8 to 37.8 g/L (P = 0.03), mean serum C-reactive protein increased from 7.3 to 12.4 mg/L (P = 0.05), and mean serum potassium decreased from 4.80 to 4.59 mmol/L (P = 0.01). Regarding medication use, the mean number of antihypertensive medications fell from 1.46 agents per day at HHD initiation to 1.01 agents per day at 6 months (P < 0.001), but phosphate binder use and erythropoiesis-stimulating agent dose were stable. Long-term rates of kidney transplant and death were 15.3 and 5.4 events per 100 patient-years, respectively. CONCLUSIONS: Intensive HHD with low-flow dialysate delivers adequate urea clearance and good biochemical outcomes in Western European patients. Intensive HHD coincided with a large decrease in antihypertensive medication use. With relatively rapid training, HHD should be considered in more patients.


Asunto(s)
Hemodiálisis en el Domicilio , Fallo Renal Crónico/terapia , Adulto , Antihipertensivos/administración & dosificación , Bicarbonatos/sangre , Proteína C-Reactiva/metabolismo , Calcio/sangre , Femenino , Humanos , Fallo Renal Crónico/sangre , Masculino , Persona de Mediana Edad , Fósforo/sangre , Potasio/sangre , Estudios Retrospectivos , Albúmina Sérica/metabolismo , Resultado del Tratamiento
11.
Rev Endocr Metab Disord ; 18(1): 131-144, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-27864708

RESUMEN

Thyroid hormones influence renal development, kidney hemodynamics, glomerular filtration rate and sodium and water homeostasis. Hypothyroidism and hyperthyroidism affect renal function by direct renal effects as well as systemic hemodynamic, metabolic and cardiovascular effects. Hypothyroidism has been associated with increased serum creatinine and decreased glomerular filtration rate. The reverse effects have been reported in thyrotoxicosis. Most of renal manifestations of thyroid dysfunction are reversible with treatment. Kidney disease may also cause thyroid dysfunction by several mechanisms. Nephrotic syndrome has been associated to changes in serum thyroid hormone concentrations. Different forms of glomerulonephritis and tubulointerstitial disease may be linked to thyroid derangements. A high prevalence of thyroid hormone alteration has been reported in acute kidney injury. Thyroid dysfunction is highly prevalent in chronic kidney disease patients. Subclinical hypothyroidism and low triiodothyronine syndrome are common features in patients with chronic kidney disease. Patients treated by both hemodialysis and peritoneal dialysis, and renal transplantation recipients, exhibit thyroid hormone alterations and thyroid disease with higher frequency than that found in the general population. Drugs used in the therapy of thyroid disease may lead to renal complications and, similarly, drugs used in kidney disorders may be associated to thyroid alterations. Lastly, low thyroid hormones, especially low triiodothyronine levels, in patients with chronic kidney disease have been related to a higher risk of cardiovascular disease and all-cause mortality. Interpretation of the interactions between thyroid and renal function is a challenge for clinicians involved in the treatment of patients with thyroid and kidney disease.


Asunto(s)
Enfermedades Renales , Enfermedades de la Tiroides , Humanos , Enfermedades Renales/complicaciones , Enfermedades Renales/etiología , Enfermedades Renales/metabolismo , Enfermedades de la Tiroides/complicaciones , Enfermedades de la Tiroides/etiología , Enfermedades de la Tiroides/metabolismo
12.
Psychol Health Med ; 22(4): 474-482, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-27335100

RESUMEN

Healthcare professionals currently working in Advanced Chronic Kidney Disease (ACKD) units must cope with difficult situations regarding assisting patients with the dialysis decision-making process, and they are often untrained for these conversations. Although we have evidence from the literature that these skills can be learned, few professionals feel confident in this area. A Communication and Bioethical Training (CoBiT) Program for ACKD staff (physicians, nurses and allied health professionals) was developed to improve their ability and self-confidence in conducting these conversations. A four-stage study was conducted: (1) development of the CoBiT program, beginning with the creation of an interdisciplinary focus group (N = 10); (2) design of a questionnaire to assess self-confidence based on the areas identified by the focus group. The face validity of the instrument was tested using an inter-judge methodology (N = 6); (3) design of the format and contents of the program; (4) piloting the program. Thirty-six health professionals took an 8-h workshop based on role-playing methodology. Participants assessed their self-confidence in their communication skills before and after the program using self-report measures. The results show that after the program, participants reported significantly higher levels of self-confidence measured with a five-point Likert scale (p < 0.001). Participants felt that communication with colleagues of other professions significantly increased after the workshop (p = 0.004). The CoBiT program improves ACKD Unit healthcare professionals' self-confidence in their ability to perform a specific communication task.


Asunto(s)
Bioética/educación , Toma de Decisiones , Personal de Salud/educación , Fallo Renal Crónico/terapia , Relaciones Profesional-Paciente , Diálisis Renal/normas , Adulto , Toma de Decisiones/ética , Femenino , Personal de Salud/ética , Humanos , Masculino , Persona de Mediana Edad , Relaciones Profesional-Paciente/ética , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , España
13.
Memory ; 23(4): 507-17, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-24758404

RESUMEN

When people try not to think about a certain item, they can accomplish this goal by using a thought substitution strategy and think about something else. Research conducted with the think/no-think (TNT) paradigm indicates that such strategy leads subsequently to forgetting the information participants tried not to think about. The present study pursued two goals. First, it investigated the mechanism of forgetting due to thought substitution, contrasting the hypothesis by which forgetting is due to blocking caused by substitutes with the hypothesis that forgetting is due to inhibition (using an independent cue methodology). Second, a boundary condition for forgetting due to thought substitution was examined by creating conditions under which the generation of appropriate substitutes would be impaired. In two experiments, participants completed a TNT task under thought substitution instructions in which either words or pseudo-words were used as original cues and memory was assessed with original and independent cues. The results revealed forgetting in both original and independent cue tests, supporting the inhibitory account of thought substitution, but only when cues were words, and not when they were non-words, pointing to the ineffectiveness of a thought substitution strategy when original cues lack semantic content.


Asunto(s)
Señales (Psicología) , Inhibición Psicológica , Recuerdo Mental , Pensamiento , Adulto , Femenino , Humanos , Masculino , Semántica , Adulto Joven
14.
Diabetes Ther ; 15(1): 165-181, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37917327

RESUMEN

INTRODUCTION: An increased midnight cortisol (MC) has been described in end-stage kidney disease (ESKD) and type 1 diabetes (T1D). Lower circulating levels of the cytokine soluble tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) have been found in T1D and ESKD and associated with cardiovascular (CV) events in the latter. We aimed to study MC and sTWEAK in simultaneous pancreas-kidney transplant (SPKT) recipients, and the association of these markers with CV risk factors and transplant outcomes. METHODS: This was a retrospective cohort study including subjects with T1D who received a first SPKT between 2008 and 2020. MC and sTWEAK at baseline were correlated with CV risk factors and evolution 1 year after SPKT. RESULTS: We included 29 subjects (58.6% women, mean age 43.5 ± 7.5 years, diabetes duration 31.9 ± 9.4 years). Systolic blood pressure (SBP) increased directly with MC quartiles, despite similar hypertension prevalence (p < 0.05). At 1 year, antihypertensive treatment was deintensified in those in lower MC quartiles (p < 0.05). Diabetic neuropathy prevalence decreased progressively in higher cortisol quartiles (p for trend = 0.005). Low MC was associated with delayed kidney graft function (p for trend = 0.044), and high sTWEAK with kidney graft rejection (p for trend = 0.018). In multivariate analyses, MC (standardized-ß 0.505, p = 0.004) and age (standardized-ß - 0.460, p = 0.040) were independently correlated with SBP, and MC was independently associated with the presence of diabetic neuropathy (OR 0.633, 95% CI 0.425-0.944, p = 0.025), adjusted for confounders. CONCLUSIONS: In this exploratory study, lower MC was associated with a lower baseline SBP, an improvement of antihypertensive treatment 1 year after transplant, and a higher diabetic neuropathy prevalence in SPKT recipients.

16.
Int J Biol Sci ; 20(5): 1547-1562, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38481808

RESUMEN

Renal ischemia-reperfusion injury (IRI) leads to endoplasmic reticulum (ER) stress, thereby initiating the unfolded protein response (UPR). When sustained, this response may trigger the inflammation and tubular cell death that acts to aggravate the damage. Here, we show that knockdown of the BET epigenetic reader BRD4 reduces the expression of ATF4 and XBP1 transcription factors under ER stress activation. BRD4 is recruited to the promoter of these highly acetylated genes, initiating gene transcription. Administration of the BET protein inhibitor, JQ1, one hour after renal damage induced by bilateral IRI, reveals reduced expression of ATF4 and XBP1 genes, low KIM-1 and NGAL levels and recovery of the serum creatinine and blood urea nitrogen levels. To determine the molecular pathways regulated by ATF4 and XBP1, we performed stable knockout of both transcription factors using CRISPR-Cas9 and RNA sequencing. The pathways triggered under ER stress were mainly XBP1-dependent, associated with an adaptive UPR, and partially regulated by JQ1. Meanwhile, treatment with JQ1 downmodulated most of the pathways regulated by ATF4 and related to the pathological processes during exacerbated UPR activation. Thus, BRD4 inhibition could be useful for curbing the maladaptive UPR activation mechanisms, thereby ameliorating the progression of renal disease.


Asunto(s)
Antineoplásicos , Daño por Reperfusión , Humanos , Factores de Transcripción/genética , Factores de Transcripción/metabolismo , Proteínas Nucleares/genética , Estrés del Retículo Endoplásmico/genética , Respuesta de Proteína Desplegada , Antineoplásicos/farmacología , Daño por Reperfusión/tratamiento farmacológico , Daño por Reperfusión/genética , Daño por Reperfusión/metabolismo , Proteínas que Contienen Bromodominio , Proteínas de Ciclo Celular/genética , Proteínas de Ciclo Celular/metabolismo
17.
J Biol Chem ; 287(29): 24131-8, 2012 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-22613719

RESUMEN

The tubular epithelium of the kidney is susceptible to injury from a number of different causes, including inflammatory and immune disorders, oxidative stress, and nephrotoxins, among others. Primary renal epithelial cells remain one of the few tools for studying the biochemical and physiological characteristics of the renal tubular system. Nevertheless, differentiated primary cells are not suitable for recapitulation of disease properties that might arise during embryonic kidney formation and further maturation. Thus, cellular systems resembling kidney characteristics are in urgent need to model disease as well as to establish reliable drug-testing platforms. Induced pluripotent stem cells (iPSCs) bear the capacity to differentiate into every cell lineage comprising the adult organism. Thus, iPSCs bring the possibility for recapitulating embryonic development by directed differentiation into specific lineages. iPSC differentiation ultimately allows for both disease modeling in vitro and the production of cellular products with potential for regenerative medicine. Here, we describe the rapid, reproducible, and highly efficient generation of iPSCs derived from endogenous kidney tubular renal epithelial cells with only two transcriptional factors, OCT4 and SOX2. Kidney-derived iPSCs may provide a reliable cellular platform for the development of kidney differentiation protocols allowing drug discovery studies and the study of kidney pathology.


Asunto(s)
Diferenciación Celular/fisiología , Células Madre Pluripotentes Inducidas/citología , Células Madre Pluripotentes Inducidas/metabolismo , Túbulos Renales Proximales/citología , Túbulos Renales Proximales/metabolismo , Factor 3 de Transcripción de Unión a Octámeros/metabolismo , Factores de Transcripción SOXB1/metabolismo , Diferenciación Celular/genética , Células Cultivadas , Reprogramación Celular/genética , Reprogramación Celular/fisiología , Técnica del Anticuerpo Fluorescente , Humanos , Masculino , Persona de Mediana Edad , Factor 3 de Transcripción de Unión a Octámeros/genética , Factores de Transcripción SOXB1/genética
18.
Br J Psychol ; 114(1): 86-111, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36117407

RESUMEN

The consistency between letters and sounds varies across languages. These differences have been proposed to be associated with different reading mechanisms (lexical vs. phonological), processing grain sizes (coarse vs. fine) and attentional windows (whole words vs. individual letters). This study aimed to extend this idea to writing to dictation. For that purpose, we evaluated whether the use of different types of processing has a differential impact on local windowing attention: phonological (local) processing in a transparent language (Spanish) and lexical (global) processing of an opaque language (English). Spanish and English monolinguals (Experiment 1) and Spanish-English bilinguals (Experiment 2) performed a writing to dictation task followed by a global-local task. The first key performance showed a critical dissociation between languages: the response times (RTs) from the Spanish writing to dictation task was modulated by word length, whereas the RTs from the English writing to dictation task was modulated by word frequency and age of acquisition, as evidence that language transparency biases processing towards phonological or lexical strategies. In addition, after a Spanish task, participants more efficiently processed local information, which resulted in both the benefit of global congruent information and the reduced cost of incongruent global information. Additionally, the results showed that bilinguals adapt their attentional processing depending on the orthographic transparency.


Asunto(s)
Multilingüismo , Humanos , Lenguaje , Lectura , Escritura , Tiempo de Reacción/fisiología
19.
Br J Psychol ; 114(3): 566-579, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36748402

RESUMEN

While growing evidence supports that dispositional mindfulness relates to psychological health and cognitive enhancement, to date there have been only a few attempts to characterize its neural underpinnings. In the present study, we aimed at exploring the electrophysiological (EEG) signature of dispositional mindfulness using quantitative and complexity measures of EEG during resting state and while performing a learning task. Hundred twenty participants were assessed with the Five Facet Mindfulness Questionnaire and underwent 5 min eyes-closed resting state and 5 min at task EEG recording. We hypothesized that high mindfulness individuals would show patterns of brain activity related to (a) lower involvement of the default mode network (DMN) at rest (reduced frontal gamma power) and (b) a state of 'task readiness' reflected in a more similar pattern from rest to task (reduced overall q-EEG power at rest but not at task), as compared to their low mindfulness counterparts. Dispositional mindfulness was significantly linked to reduced frontal gamma power at rest and lower overall power during rest but not at task. In addition, we found a trend towards higher entropy during task performance in mindful individuals, which has recently been reported during mindfulness meditation. Altogether, our results add to those from expert meditators to show that high (dispositional) mindfulness seems to have a specific electrophysiological pattern characteristic of less involvement of the DMN and mind-wandering processes.


Asunto(s)
Mapeo Encefálico , Atención Plena , Humanos , Atención Plena/métodos , Ojo , Aprendizaje , Electroencefalografía , Encéfalo/fisiología
20.
Front Immunol ; 14: 1154650, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37662919

RESUMEN

Antibody-mediated rejection is the leading cause of kidney graft dysfunction. The process of diagnosing it requires the performance of an invasive biopsy and subsequent histological examination. Early and sensitive biomarkers of graft damage and alloimmunity are needed to identify graft injury and eventually limit the need for a kidney biopsy. Moreover, other scenarios such as delayed graft function or interstitial fibrosis and tubular atrophy face the same problem. In recent years, interest has grown around extracellular vesicles, specifically exosomes actively secreted by immune cells, which are intercellular communicators and have shown biological significance. This review presents their potential as biomarkers in kidney transplantation and alloimmunity.


Asunto(s)
Exosomas , Vesículas Extracelulares , Trasplante de Riñón , Trasplante de Riñón/efectos adversos , Riñón , Biomarcadores
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