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1.
Cancer Sci ; 111(12): 4381-4392, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32979884

RESUMEN

Interaction of cancer cells with cancer-associated fibroblasts (CAFs) plays critical roles in tumor progression. Recently we proposed a new tumor invasion mechanism in which invasive cancer cells individually migrate on elongate protrusions of CAFs (CAF fibers) in 3-D collagen matrix. In this mechanism, cancer cells interact with fibronectin fibrils assembled on CAFs mainly through integrin-α5ß1. Here we tested whether this mechanism is applicable to the collective invasion of cancer cells, using two E-cadherin-expressing adenocarcinoma cell lines, DLD-1 (colon) and MCF-7 (breast). When hybrid spheroids of DLD-1 cells with CAFs were embedded into collagen gel, DLD-1 cells collectively but very slowly migrated through the collagen matrix in contact with CAFs. Epidermal growth factor and tumor necrosis factor-α promoted the collective invasion, possibly by reducing the E-cadherin junction, as did the transforming growth factor-ß inhibitor SB431542 by stimulating the outgrowth of CAFs. Transforming growth factor-ß itself inhibited the cancer cell invasion. Efficient collective invasion of DLD-1 cells required large CAF fibers or their assembly as stable adhesion substrates. Experiments with function-blocking Abs and siRNAs confirmed that DLD-1 cells adhered to fibronectin fibrils on CAFs mainly through integrin-α5ß1. Anti-E-cadherin Ab promoted the single cell invasion of DLD-1 cells by dissociating the E-cadherin junction. Although the binding affinity of MCF-7 cells to CAFs was lower than DLD-1, they also collectively invaded the collagen matrix in a similar fashion to DLD-1 cells. Our results suggest that the direct interaction with CAFs, as well as environmental cytokines, contributes to the collective invasion of cancers.


Asunto(s)
Fibroblastos Asociados al Cáncer/patología , Colágeno/metabolismo , Fibroblastos/patología , Fibronectinas/metabolismo , Integrina alfa5beta1/metabolismo , Invasividad Neoplásica/patología , Células A549 , Adenocarcinoma/patología , Amidas/farmacología , Benzamidas/farmacología , Fibroblastos Asociados al Cáncer/metabolismo , Adhesión Celular , Línea Celular Tumoral , Movimiento Celular , Cromonas/farmacología , Neoplasias del Colon/metabolismo , Neoplasias del Colon/patología , Tejido Conectivo/patología , Dioxoles/farmacología , Factor de Crecimiento Epidérmico/metabolismo , Fibroblastos/metabolismo , Humanos , Inmunohistoquímica/métodos , Células MCF-7 , Morfolinas/farmacología , Invasividad Neoplásica/fisiopatología , Piridinas/farmacología , Esferoides Celulares/patología , Factor de Crecimiento Transformador beta/antagonistas & inhibidores , Factor de Necrosis Tumoral alfa/metabolismo
2.
Sci Rep ; 9(1): 292, 2019 01 22.
Artículo en Inglés | MEDLINE | ID: mdl-30670761

RESUMEN

Cancer-associated fibroblasts (CAFs) play critical roles in the tumor progression. However, it remains unclear how cancer cells migrate in the three-dimensional (3D) matrix of cancer tissues and how CAFs support the cancer invasion. Here we propose a novel mechanism of fibroblast-dependent cancer cell invasion in the 3D collagen matrix. Human cancer cell lines from the pancreas (Panc-1), lung (A549) and some other organs actively adhered to normal fibroblasts and primary lung CAFs in cultures. To show its significance in tumor invasion, we designed a new invasion assay in which homogeneous microspheroids consisting of cancer cells and fibroblasts were embedded into collagen gel. Time-lapse experiments showed that cancer cells adhered to and quickly migrated on the long protrusions of fibroblasts in the 3D collagen matrix. Fibroblast-free cancer cells poorly invaded the matrix. Experiments with function-blocking antibodies, siRNAs, and immunocytochemistry demonstrated that cancer cells adhered to fibroblasts through integrin α5ß1-mediated binding to fibronectin on the surface of fibroblasts. Immunochemical analyses of the co-cultures and lung cancers suggested that cancer cells could acquire the migratory force by the fibronectin/integrin signaling. Our results also revealed that the fibroblast-bound fibronectin was a preferential substrate for cancer cells to migrate in the collagen matrix.


Asunto(s)
Fibroblastos Asociados al Cáncer/patología , Técnicas de Cultivo de Célula/métodos , Movimiento Celular , Integrina alfa5beta1/metabolismo , Invasividad Neoplásica/patología , Adhesión Celular , Línea Celular Tumoral , Células Cultivadas , Técnicas de Cocultivo , Colágeno , Humanos
3.
Nephrology (Carlton) ; 23(3): 210-216, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28024168

RESUMEN

AIM: Liver cysts are the most common extrarenal manifestation in patients with autosomal dominant polycystic kidney disease (ADPKD). Carbohydrate antigen 19-9 (CA19-9) is generally used as a marker for biliopancreatic malignancies, although CA19-9 levels in patients with ADPKD are largely unknown. METHODS: A prospective observational study of 53 ADPKD patients and 83 non-ADPKD control subjects was performed. The serum levels of CA19-9 were studied to evaluate the association with clinical parameters and liver cysts. RESULTS: The serum CA19-9 levels were significantly higher in the ADPKD group than in the control group (32.9 U/mL vs. 9.8 U/mL, respectively, P < 0.001). The serum CA19-9 levels in the ADPKD group were positively correlated with the mean blood pressure (rho = 0.335, P < 0.05), gamma-glutamyl transferase (GTP) levels (rho = 0.541, P < 0.001), the largest cyst size (rho = 0.536, P < 0.001) and the liver cyst volume (rho = 0.682, P < 0.001). Multiple regression analyses showed that the gamma-GTP levels (P < 0.001) and the liver cyst volumes (P < 0.001) were independent predictors for serum CA19-9 levels. CONCLUSIONS: Serum CA19-9 levels are significantly elevated and appear to be dependent on the gamma-GTP levels and the volume of liver cysts in patients with ADPKD. Our findings indicate that the measurement of the baseline CA19-9 level in each patient with ADPKD may be useful for the interpretation of the value and the differential diagnosis of liver diseases, particularly the liver cyst infection.


Asunto(s)
Antígeno CA-19-9/sangre , Quistes/sangre , Hepatopatías/sangre , Riñón Poliquístico Autosómico Dominante/sangre , Anciano , Estudios de Casos y Controles , Quistes/diagnóstico por imagen , Quistes/fisiopatología , Diagnóstico Diferencial , Femenino , Humanos , Hepatopatías/diagnóstico por imagen , Hepatopatías/fisiopatología , Masculino , Persona de Mediana Edad , Riñón Poliquístico Autosómico Dominante/diagnóstico , Riñón Poliquístico Autosómico Dominante/fisiopatología , Riñón Poliquístico Autosómico Dominante/terapia , Valor Predictivo de las Pruebas , Estudios Prospectivos , Diálisis Renal , Tomografía Computarizada por Rayos X , Regulación hacia Arriba , gamma-Glutamiltransferasa/sangre
4.
Am J Physiol Renal Physiol ; 313(3): F805-F814, 2017 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-28701315

RESUMEN

A low-protein diet (LPD) protects against the progression of renal injury in patients with chronic kidney disease (CKD). However, LPD may accelerate muscle wasting in these patients. Both exercise and branched-chain amino acids (BCAA) are known to increase muscle protein synthesis by activating the mammalian target of rapamycin (mTOR) pathway. The aim of this study was to investigate whether endurance exercise and BCAA play a role for increasing muscle protein synthesis in LPD-fed CKD (5/6 nephrectomized) rats. Both CKD and sham rats were pair-fed on LPD or LPD fortified with a BCAA diet (BD), and approximately one-half of the animals in each group was subjected to treadmill exercise (15 m/min, 1 h/day, 5 days/wk). After 7 wk, renal function was measured, and soleus muscles were collected to evaluate muscle protein synthesis. Renal function did not differ between LPD- and BD-fed CKD rats, and the treadmill exercise did not accelerate renal damage in either group. The treadmill exercise slightly increased the phosphorylation of p70s6 kinase, a marker of mTOR activity, in the soleus muscle of LPD-fed CKD rats compared with the sham group. Furthermore, BCAA supplementation of the LPD-fed, exercise-trained CKD rats restored the phosphorylation of p70s6 kinase to the same level observed in the sham group; however, the corresponding induced increase in muscle protein synthesis and muscle mass was marginal. These results indicate that the combination of treadmill exercise and BCAA stimulates cell signaling to promote muscle protein synthesis; however, the implications of this effect for muscle growth remain to be clarified.


Asunto(s)
Aminoácidos de Cadena Ramificada/administración & dosificación , Dieta con Restricción de Proteínas , Terapia por Ejercicio/métodos , Proteínas Musculares/biosíntesis , Músculo Esquelético/metabolismo , Atrofia Muscular/prevención & control , Resistencia Física , Insuficiencia Renal Crónica/dietoterapia , Alimentación Animal , Animales , Dieta con Restricción de Proteínas/efectos adversos , Modelos Animales de Enfermedad , Interleucina-6/biosíntesis , Interleucina-6/genética , Riñón/fisiopatología , Masculino , Músculo Esquelético/fisiopatología , Atrofia Muscular/etiología , Atrofia Muscular/metabolismo , Atrofia Muscular/fisiopatología , Fosforilación , Proteolisis , Ratas Wistar , Insuficiencia Renal Crónica/metabolismo , Insuficiencia Renal Crónica/fisiopatología , Proteínas Quinasas S6 Ribosómicas 70-kDa/biosíntesis , Transducción de Señal , Serina-Treonina Quinasas TOR/biosíntesis , Factores de Tiempo
5.
Nephron Exp Nephrol ; 128(1-2): 9-20, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25403022

RESUMEN

BACKGROUND: Cisplatin (CDDP)-induced acute kidney injury (AKI) involves pro-inflammatory responses, apoptosis of renal tubular epithelial cells and vascular damage. AKI increases the risk of chronic kidney disease. Relaxin (RLX) has anti-apoptotic and anti-fibrosis properties. The aim of this study was to investigate the effects of RLX on CDDP-induced nephrotoxicity. METHODS: We investigated the mitigating effects of RLX based on the etiopathology of AKI induced by CDDP, and also the anti-fibrotic effect of RLX on renal fibrosis after AKI. In the short-term experiments, rats were divided into the control group, CDDP group, and CDDP+RLX group. In the latter group, RLX was infused for 5 or 14 days using an implanted osmotic minipump. CDDP was injected intraperitoneally (6 mg/kg) after RLX or saline infusion. At 5 and 14 days post-CDDP, the kidneys were removed for analysis. The effect of RLX on renal fibrosis after AKI was evaluated at 6 weeks post-CDDP. RESULTS: In short-term experiments, CDDP transiently increased plasma creatinine and blood urea nitrogen with peaks at day 5, and RLX prevented such rises. Semiquantitative analysis of the histological lesions indicated marked structural damage and apoptotic cells in the CDDP group, with the lesions being reduced by RLX treatment. Overexpression of Bax, interleukin-6 and tumor necrosis factor-α observed in the kidneys of the CDDP group was reduced in the CDDP+RLX group. In the long-term experiments, RLX significantly reduced renal fibrosis compared with the CDDP group. CONCLUSIONS: The results suggested that RLX provided protection against CDDP-induced AKI and subsequent fibrosis by reducing apoptosis and inflammation.


Asunto(s)
Lesión Renal Aguda/inducido químicamente , Lesión Renal Aguda/prevención & control , Apoptosis/efectos de los fármacos , Cisplatino/efectos adversos , Cisplatino/farmacología , Relaxina/uso terapéutico , Lesión Renal Aguda/patología , Animales , Nitrógeno de la Urea Sanguínea , Creatinina/sangre , Modelos Animales de Enfermedad , Células Epiteliales/efectos de los fármacos , Células Epiteliales/patología , Fibrosis , Bombas de Infusión Implantables , Inyecciones Intraperitoneales , Interleucina-6/sangre , Túbulos Renales/efectos de los fármacos , Túbulos Renales/patología , Masculino , Ratas , Ratas Sprague-Dawley , Relaxina/administración & dosificación , Relaxina/farmacología , Factor de Necrosis Tumoral alfa/sangre
7.
Int Urol Nephrol ; 46(5): 985-91, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-23979817

RESUMEN

PURPOSE: Although skeletal muscle wasting can occur in chronic kidney diseases, its relationship with the serum testosterone concentration remains uncertain. This study investigates the relationship between serum testosterone and skeletal muscle mass in men under hemodialysis (HD). METHODS: Sixty men aged between 41 and 89 years undergoing HD for 15.0 ± 8.1 years were enrolled for this study. The muscle areas of the thigh (TMA) and abdomen (AMA) were measured by computed tomography (CT), and the association between these muscle areas and serum total testosterone was examined with adjustment of age and other nutritional variables. RESULTS: The mean serum total testosterone in our HD patients (6.33 ± 2.90 ng/mL) was not lower than that of the Japanese general population, but showed a positive correlation with TMA (r = 0.39, p < 0.05), AMA (r = 0.52, p < 0.001), serum creatinine (r = 0.33, p < 0.05), and the creatinine generation rate (r = 0.26, p < 0.05). Serum total testosterone was inversely correlated with age (r = -0.32, p < 0.05), CRP (r = -0.31, p < 0.05), and IL-6 (r = -0.24, p < 0.05). A multiple-regression analysis showed both serum total testosterone and age to be an independent determinant of the muscle mass in these patients. CONCLUSIONS: This study identified testosterone as a determinant of muscle mass in HD men.


Asunto(s)
Músculos Abdominales/patología , Insuficiencia Renal Crónica/sangre , Insuficiencia Renal Crónica/terapia , Testosterona/sangre , Muslo/patología , Músculos Abdominales/diagnóstico por imagen , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/metabolismo , Creatinina/sangre , Humanos , Interleucina-6/sangre , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Diálisis Renal , Muslo/diagnóstico por imagen , Tomografía Computarizada por Rayos X
8.
Nutr Res ; 33(9): 761-71, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24034576

RESUMEN

The mammalian target of rapamycin (mTOR), a regulator of cellular protein synthesis and cell growth, plays an important role in the progression of renal hypertrophy and renal dysfunction in experimental chronic kidney disease models. Because the mTOR activity is regulated by nutrients including amino acids, we tested the hypothesis that the renoprotective effect of a low-protein diet (LPD) might be associated with the attenuation of the renal mTOR pathway. In this study, 5/6 nephrectomized rats were fed an LPD or a normal protein diet (NPD), and a number of rats that were fed an NPD received rapamycin (1.0 mg kg⁻¹ d⁻¹), a specific inhibitor of mTOR. After 6 weeks, renal tissue was collected to evaluate the activity of the mTOR pathway and histologic changes. The phosphorylation of p70S6k, a kinase in the downstream of mTOR, was significantly higher in the NPD-fed rats that showed progressive renal dysfunction than in the sham-operated rats (NPD). The LPD attenuated the excessive phosphorylation of p70S6k concomitant with reduced proteinuria and improved renal histologic changes in the 5/6 nephrectomized rats. The effects of the LPD were similar to the effects of rapamycin. The expression of phosphorylated p70S6k was significantly correlated with proteinuria (r² = 0.63, P < .001), the glomerular area (r² = 0.60, P < .001), and the number of phosphorylated Smad2-positive cells in the glomerulus (r² = 0.26, P < .05) of these rats. These results suggest that the preventive effect of an LPD on the progression of renal failure is associated with attenuation of the activated mTOR/p70S6k pathway in the rat remnant kidney model.


Asunto(s)
Dieta con Restricción de Proteínas , Riñón/efectos de los fármacos , Transducción de Señal , Serina-Treonina Quinasas TOR/genética , Animales , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Proteínas en la Dieta/administración & dosificación , Modelos Animales de Enfermedad , Hipertrofia/patología , Riñón/patología , Masculino , Fosforilación , Proteinuria/dietoterapia , Proteínas Proto-Oncogénicas c-akt/genética , Proteínas Proto-Oncogénicas c-akt/metabolismo , Ratas , Ratas Sprague-Dawley , Ratas Wistar , Proteínas Quinasas S6 Ribosómicas 70-kDa/antagonistas & inhibidores , Proteínas Quinasas S6 Ribosómicas 70-kDa/genética , Proteínas Quinasas S6 Ribosómicas 70-kDa/metabolismo , Sirolimus/administración & dosificación , Proteína Smad2/genética , Proteína Smad2/metabolismo , Serina-Treonina Quinasas TOR/antagonistas & inhibidores , Serina-Treonina Quinasas TOR/metabolismo
9.
Am J Physiol Renal Physiol ; 305(8): F1169-76, 2013 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-23946288

RESUMEN

Relaxin, a pregnancy hormone, has antiapoptotic and anti-inflammatory properties. The aim of this study was to determine the effects of relaxin on ischemia-reperfusion (IR)-induced acute kidney injury. Male rats underwent unilateral nephrectomy and contralateral renal IR (45 min of renal pedicle clamping). Rats were divided into three groups: 1) sham group, 2) IR group, and 3) IR-RLX group (rats treated with relaxin before ischemia). In this group, relaxin was infused at 500 ng/h via subcutaneous osmotic minipump for 24 h beginning 2 h before renal ischemia. At 24 h after reperfusion, renal function was assessed and kidneys were removed for analysis. There was no significant difference in blood pressure among the three groups. IR increased plasma levels of creatinine and urea nitrogen, and relaxin provided protection against the increases in these two parameters. Relaxin significantly decreased plasma TNF-α levels and renal TNF receptor 1 mRNA expression, compared with the IR group. Semiquantitative assessment of the histological lesions showed marked structural damage in IR rats compared with the IR-RLX rats. RLX significantly reduced apoptotic cell counts compared with the IR group. Overexpression of caspase-3 observed in the IR kidneys was reduced in the IR-RLX group. The results demonstrated that relaxin provided protection against IR-induced renal injury by reducing apoptosis and inflammation.


Asunto(s)
Lesión Renal Aguda/tratamiento farmacológico , Lesión Renal Aguda/patología , Relaxina/uso terapéutico , Daño por Reperfusión/tratamiento farmacológico , Daño por Reperfusión/patología , Lesión Renal Aguda/sangre , Animales , Apoptosis/efectos de los fármacos , Apoptosis/fisiología , Evaluación Preclínica de Medicamentos , Inflamación/sangre , Inflamación/tratamiento farmacológico , Inflamación/patología , Pruebas de Función Renal , Masculino , Distribución Aleatoria , Ratas , Relaxina/farmacología , Daño por Reperfusión/sangre , Sus scrofa , Factor de Necrosis Tumoral alfa/sangre
10.
Nephrology (Carlton) ; 18(8): 539-44, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23718260

RESUMEN

AIM: Hypoalbuminaemia is a common complication of peritoneal dialysis (PD), and the leakage of albumin through peritoneal membrane may be a principal reason for hypoalbuminaemia. However, the relationship between peritoneal inflammation, peritoneal transport properties and hypoalbuminaemia has not been fully elucidated. METHODS: A cross-sectional study was performed on 76 Japanese PD patients who had been using a low-glucose PD solution and icodextrin. Systemic inflammatory markers of C-reactive protein (CRP) and serum interleukin-6 (IL-6), peritoneal effluent markers of dialysate IL-6 and CA125, the dialysate-to-plasma ratio of creatinine (D/Pcr) and the dialysate protein concentration were measured and examined for their relationship with hypoalbuminaemia. RESULTS: There was a significant positive correlation between serum IL-6 and dialysate IL-6, mean dialysate IL-6 being significantly higher than mean serum IL-6, suggesting that intraperitoneal inflammation was a principal origin of systemic inflammation. Both serum and dialysate IL-6 were significantly correlated with serum albumin (r= -0.25, P<0.05 and r=-0.32, P<0.01, respectively). Dialysate IL-6 was significantly correlated with D/Pcr and the dialysate protein concentration, and there was a significantly positive association between D/Pcr and the dialysate protein concentration. Dialysate CA125, which is argued to be a marker of mesothelial cell mass in this study, was positively correlated with D/Pcr and the dialysate protein concentration. The dialysate protein, dialysate IL-6 and dialysate CA125 all increased according to the peritoneal transport rate defined by D/Pcr. A multiple-regression analysis showed that serum albumin was independently associated with the age, D/Pcr and serum IL-6. CONCLUSION: Hypoalbuminaemia was attributable to both the increased peritoneal permeability and systemic inflammation, and intraperitoneal inflammation might contribute to developing these complications.


Asunto(s)
Soluciones para Diálisis/uso terapéutico , Hipoalbuminemia/etiología , Mediadores de Inflamación/sangre , Inflamación/etiología , Diálisis Peritoneal/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Antígeno Ca-125/sangre , Creatinina/sangre , Estudios Transversales , Soluciones para Diálisis/metabolismo , Femenino , Humanos , Hipoalbuminemia/sangre , Hipoalbuminemia/inmunología , Inflamación/sangre , Inflamación/inmunología , Interleucina-6/sangre , Japón , Masculino , Proteínas de la Membrana/sangre , Persona de Mediana Edad , Peritoneo/metabolismo , Permeabilidad
11.
Nucleic Acids Res ; 41(10): 5382-99, 2013 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-23563150

RESUMEN

The Schizosaccharomyces pombe genome is one of the smallest among the free-living eukaryotes. We further reduced the S. pombe gene number by large-scale gene deletion to identify a minimal gene set required for growth under laboratory conditions. The genome-reduced strain has four deletion regions: 168.4 kb in the left arm of chromosome I, 155.4 kb in the right arm of chromosome I, 211.7 kb in the left arm of chromosome II and 121.6 kb in the right arm of chromosome II. The deletions corresponded to a loss of 223 genes of the original ~5100. The quadruple-deletion strain, with a total deletion size of 657.3 kb, showed a decreased ability to uptake glucose and some amino acids in comparison with the parental strain. The strain also showed increased gene expression of the mating pheromone M-factor precursor and the nicotinamide adenine dinucleotide phosphate -specific glutamate dehydrogenase. There was also a 2.7-fold increase in the concentration of cellular adenosine triphosphate, and levels of the heterologous proteins, enhanced green fluorescent protein and secreted human growth hormone were increased by 1.7- and 1.8-fold, respectively. The transcriptome data from this study have been submitted to the Gene Expression Omnibus (GEO: http://www.ncbi.nlm.nih.gov/geo/) under the accession number GSE38620 (http://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?token=vjkxjewuywgcovc&acc=GSE38620).


Asunto(s)
Tamaño del Genoma , Genoma Fúngico , Schizosaccharomyces/genética , Adenosina Trifosfato/metabolismo , Aminoácidos/metabolismo , Amoníaco/metabolismo , Deleción Cromosómica , Expresión Génica , Glucosa/metabolismo , Biosíntesis de Proteínas , Schizosaccharomyces/crecimiento & desarrollo , Schizosaccharomyces/metabolismo
12.
Nephron Extra ; 3(1): 91-100, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24403910

RESUMEN

BACKGROUND/AIMS: Systemic inflammation-based prognostic scores have prognostic power in patients with cancer, independently of tumor stage and site. Although inflammatory status is associated with mortality in hemodialysis (HD) patients, it remains to be determined as to whether these composite scores are useful in predicting clinical outcomes. METHODS: We calculated the 6 prognostic scores [Glasgow prognostic score (GPS), modified GPS (mGPS), neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), prognostic index (PI) and prognostic nutritional index (PNI), which have been established as a useful scoring system in cancer patients. We enrolled 339 patients on regular HD (age: 64 ± 13 years; time on HD: 129 ± 114 months; males/females = 253/85) and followed them for 42 months. The area under the receiver-operating characteristics curve was used to determine which scoring system was more predictive of mortality. RESULTS: Elevated GPS, mGPS, NLR, PLR, PI and PNI were all associated with total mortality, independent of covariates. If GPS was raised, mGPS, NLR, PLR and PI were also predictive of all-cause mortality and/or hospitalization. GPS and PNI were associated with poor nutritional status. Using overall mortality as an endpoint, the area under the curve (AUC) was significant for a GPS of 0.701 (95% CI: 0.637-0.765; p < 0.01) and for a PNI of 0.616 (95% CI: 0.553-0.768; p = 0.01). However, AUC for hypoalbuminemia (<3.5 g/dl) was comparable to that of GPS (0.695, 95% CI: 0.632-0.759; p < 0.01). CONCLUSION: GPS, based on serum albumin and highly sensitive C-reactive protein, has the most prognostic power for mortality prediction among the prognostic scores in HD patients. However, as the determination of serum albumin reflects mortality similarly to GPS, other composite combinations are needed to provide additional clinical utility beyond that of albumin alone in HD patients.

13.
Ren Fail ; 33(4): 382-7, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21529266

RESUMEN

BACKGROUND: Oxidative stress has been implicated in the cardiovascular complications that affect hemodialysis (HD) patients. Ethylene-vinyl alcohol copolymer (EVAL) dialyzer membrane induces less production of reactive oxygen species as compared to conventional dialyzers. We evaluated the impact of EVAL membrane on plasma protein oxidation in HD patients. METHODS: HD patients treated with cellulose triacetate (CTA) dialyzers were selected. In the first study performed in a 2-month crossover design alternating between CTA and EVAL, nonmercaptalbumin and advanced oxidation protein products levels were measured in the predialysis blood from 10 subjects. In the second study, predialysis plasma myeloperoxidase levels were measured before and after a 2-week EVAL treatment on 12 patients. RESULTS: Plasma advanced oxidation protein products levels were reduced after a 2-month EVAL treatment and increased again after CTA treatment, although the nonmercaptalbumin proportions were not affected significantly by the change in dialyzer membranes. The following study, a 2-week EVAL treatment, showed the decrease in myeloperoxidase levels immediately before HD. CONCLUSION: The frequent use of EVAL dialyzers has been shown to reduce protein oxidation, possibly through the suppression of circulating phagocytes. This novel biocompatible dialyzer is expected to protect cardiovascular mortality in HD patients.


Asunto(s)
Fallo Renal Crónico/terapia , Membranas Artificiales , Polivinilos/uso terapéutico , Diálisis Renal/instrumentación , Albúmina Sérica/metabolismo , Anciano , Anciano de 80 o más Años , Estudios Cruzados , Femenino , Humanos , Fallo Renal Crónico/sangre , Masculino , Persona de Mediana Edad , Estrés Oxidativo , Peroxidasa/sangre , Proteínas/metabolismo , Albúmina Sérica Humana
14.
Am J Kidney Dis ; 55(6): 1069-78, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20430500

RESUMEN

BACKGROUND: Serum asymmetric dimethylarginine (ADMA) levels are increased in maintenance hemodialysis patients, and this abnormality may increase cardiovascular risk. We investigated whether combined administration of oral folate and intravenous methylcobalamin in such patients is more beneficial than oral folate alone at decreasing circulating ADMA levels. STUDY DESIGN: Randomized controlled trial. SETTING & PARTICIPANTS: Patients undergoing hemodialysis. INTERVENTION: 40 patients were randomly assigned to 1 of 2 groups. For 3 weeks, they received supplementation with either folate alone (15 mg/d; n = 20; folate group) or coadministered folate (15 mg/d) and methylcobalamin (500 mug after each hemodialysis treatment 3 times weekly; n = 20; methylcobalamin group). PRIMARY OUTCOMES: normalization of plasma homocysteine levels (<15 mumol/L), decrease in serum ADMA levels. SECONDARY OUTCOMES: change in augmentation index in the carotid artery and ratios of S-adenosylmethionine to S-adenosylhomocysteine (as a transmethylation indicator) and dimethylamine to ADMA (as an indicator of ADMA hydrolysis). MEASUREMENTS: Blood samples were collected under fasting conditions during the prehemodialysis procedure. RESULTS: The proportion showing normalization of plasma homocysteine levels was much greater in the methylcobalamin group (18 of 20 patients; 90%) than in the folate group (6 of 20; 30%; P < 0.001). The percentage of decrease in ADMA levels was greater in the methylcobalamin than folate group (25.4% +/- 10.2% vs 13.2% +/- 11.2%; P < 0.001). The increase in ratio of S-adenosylmethionine to S-adenosylhomocysteine was not different between the 2 groups; however, the ratio of dimethylamine to ADMA was increased in only the methylcobalamin group (P = 0.04). Augmentation index was decreased in only the methylcobalamin group (P = 0.03). LIMITATIONS: This study had an open-label nature and did not examine long-term effects of homocysteine-normalizing therapy (no clinical end points). CONCLUSION: Coadministration of intravenous methylcobalamin and oral folate in hemodialysis patients normalized hyperhomocysteinemia and decreased ADMA levels and arterial stiffness. We suggest that this regimen may have greater potential than folate alone to decrease cardiovascular risk in such patients.


Asunto(s)
Arginina/análogos & derivados , Ácido Fólico/uso terapéutico , Fallo Renal Crónico/sangre , Fallo Renal Crónico/terapia , Diálisis Renal , Vitamina B 12/análogos & derivados , Administración Oral , Anciano , Arginina/sangre , Enfermedades Cardiovasculares/epidemiología , Quimioterapia Combinada , Femenino , Ácido Fólico/administración & dosificación , Homocisteína/sangre , Humanos , Hiperhomocisteinemia/prevención & control , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Factores de Riesgo , Vitamina B 12/administración & dosificación , Vitamina B 12/uso terapéutico , Complejo Vitamínico B/administración & dosificación , Complejo Vitamínico B/uso terapéutico
15.
Am J Clin Nutr ; 87(1): 106-13, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18175743

RESUMEN

BACKGROUND: Malnutrition is a prevalent complication in patients on maintenance hemodialysis. Nutritional screening tools may be useful to identify those patients at nutritional risk from among hundreds of hemodialysis patients in a large facility. OBJECTIVE: We tested several simplified nutritional screening tools on hemodialysis patients to validate the potential application of the tools. DESIGN: The simplified nutritional screening tools were chosen from references published between 1985 and 2005. Nutritional assessments, including history taking, and anthropometric and biochemical measurements were performed on 422 hemodialysis patients. These results were applied to obtain the score of each nutritional screening tool and the malnutrition-inflammation score (MIS), a comprehensive nutritional assessment tool, as the reference standard. The usefulness of each nutritional screening tool for identifying nutritional risk was assessed by comparison with the MIS value and various individual nutritional measures. RESULTS: Five reliable nutritional screening tools were found by the literature search. Among them, the geriatric nutritional risk index (GNRI) was considered to be the most accurate in identifying hemodialysis patients at nutritional risk, because the area under the receiver operating characteristic curve generated with the MIS value was the largest. The GNRI showed a significantly negative correlation with the MIS (r=-0.67, P<0.0001), and the most accurate GNRI cutoff to identify a malnourished patient according to the MIS was <91.2. The GNRI's sensitivity, specificity, and accuracy of <91.2 in predicting malnutrition according to the MIS were 0.730, 0.819, and 0.787, respectively. CONCLUSION: The GNRI was the simplest and most accurate risk index for identifying hemodialysis patients at nutritional risk according to the MIS.


Asunto(s)
Inflamación/diagnóstico , Desnutrición/diagnóstico , Tamizaje Masivo , Evaluación Nutricional , Diálisis Renal/efectos adversos , Anciano , Antropometría , Análisis Químico de la Sangre , Composición Corporal , Índice de Masa Corporal , Femenino , Evaluación Geriátrica/métodos , Humanos , Masculino , Desnutrición/etiología , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Persona de Mediana Edad , Estado Nutricional , Curva ROC , Reproducibilidad de los Resultados , Factores de Riesgo , Sensibilidad y Especificidad
16.
Hum Mol Genet ; 16(6): 618-29, 2007 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-17331981

RESUMEN

Dysferlin is a type-II transmembrane protein and the causative gene of limb girdle muscular dystrophy type 2B and Miyoshi myopathy (LGMD2B/MM), in which specific loss of dysferlin labeling has been frequently observed. Recently, a novel mutant (L1341P) dysferlin has been shown to aggregate in the muscle of the patient. Little is known about the relationship between degradation of dysferlin and pathogenesis of LGMD2B/MM. Here, we examined the degradation of normal and mutant (L1341P) dysferlin. Wild-type (wt) dysferlin mainly localized to the ER/Golgi, associated with retrotranslocon, Sec61alpha, and VCP(p97), and was degraded by endoplasmic reticulum (ER)-associated degradation system (ERAD) composed of ubiquitin/proteasome. In contrast, mutant dysferlin spontaneously aggregated in the ER and induced eukaryotic translation initiation factor 2alpha (eIF2alpha) phosphorylation and LC3 conversion, a key step for autophagosome formation, and finally, ER stress cell death. Unlike proteasome inhibitor, E64d/pepstatin A, inhibitors of lysosomal proteases did not stimulate the accumulation of the wt-dysferlin, but stimulated aggregation of mutant dysferlin in the ER. Furthermore, deficiency of Atg5 and dephosphorylation of eIF2alpha, key molecules for LC3 conversion, also stimulated the mutant dysferlin aggregation in the ER. Rapamycin, which induces eIF2alpha phosphorylation-mediated LC3 conversion, inhibited mutant dysferlin aggregation in the ER. Thus, mutant dysferlin aggregates in the ER-stimulated autophagosome formation to engulf them via activation of ER stress-eIF2alpha phosphorylation pathway. We propose two ERAD models for dysferlin degradation, ubiquitin/proteasome ERAD(I) and autophagy/lysosome ERAD(II). Mutant dysferlin aggregates on the ER are degraded by the autophagy/lysosome ERAD(II), as an alternative to ERAD(I), when retrotranslocon/ERAD(I) system is impaired by these mutant aggregates.


Asunto(s)
Autofagia , Retículo Endoplásmico/metabolismo , Lisosomas/metabolismo , Proteínas de la Membrana/metabolismo , Complejo de la Endopetidasa Proteasomal/metabolismo , Animales , Muerte Celular , Línea Celular Tumoral , Disferlina , Embrión de Mamíferos , Factor 2 Eucariótico de Iniciación/metabolismo , Humanos , Proteínas de la Membrana/genética , Ratones , Fosforilación , Pliegue de Proteína , Sirolimus/farmacología , Ubiquitina/metabolismo
17.
Yeast ; 23(2): 83-99, 2006 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-16491466

RESUMEN

One of the major problems hindering effective production and purification of heterologous proteins from the fission yeast Schizosaccharomyces pombe is proteolytic degradation of the recombinant gene products by host-specific proteases. As an initial solution to this problem, we constructed a protease-deficient disruptant set by respective disruption of 52 Sz. pombe protease genes. Functional screening of the resultant set was performed by observing secretory production of a proteolytically sensitive model protein, human growth hormone (hGH). The results indicated that some of the resultant disruptants were effective in reducing hGH degradation, as observed during the hGH expression procedure and mainly as a result of unknown serine- and/or cysteine-type proteases in the culture medium. These findings also demonstrated that construction of a protease-deficient strain set is not only useful for practical application in protein production, but also for functional screening, specification and modification of proteases in Sz. pombe, where further investigations of proteolytic processes and improvement through multiple gene manipulations are required.


Asunto(s)
Hormona de Crecimiento Humana/biosíntesis , Péptido Hidrolasas/deficiencia , Proteínas Recombinantes/biosíntesis , Proteínas de Schizosaccharomyces pombe/genética , Schizosaccharomyces/genética , Biotecnología/métodos , Southern Blotting , ADN de Hongos/química , ADN de Hongos/genética , Hormona de Crecimiento Humana/genética , Hormona de Crecimiento Humana/metabolismo , Mutagénesis Insercional , Péptido Hidrolasas/genética , Péptido Hidrolasas/metabolismo , Reacción en Cadena de la Polimerasa , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Schizosaccharomyces/enzimología , Schizosaccharomyces/metabolismo , Proteínas de Schizosaccharomyces pombe/metabolismo
19.
Blood Purif ; 23(4): 311-6, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-15980621

RESUMEN

BACKGROUND: beta2-Microglobulin (beta2MG) and carbonyl stress are reported to contribute to the development of dialysis-related amyloidosis. The aim of this study was to determine whether the purity of dialysate affects plasma levels of beta2MG and pentosidine (a surrogate marker of carbonyl stress) in hemodialysis patients. METHODS: Sixteen patients on hemodialysis with a polysulfone membrane participated in this study. We switched the dialysate from conventional dialysate (endotoxin level 0.055-0.066 endotoxin units (EU)/ml) to ultrapure dialysate (endotoxin level <0.001 EU/ml), followed patients for 6 months, and then switched back to conventional dialysate once again. Plasma levels of beta2MG, pentosidine, CRP and interleukin-6 (IL-6) were determined before the switch to ultrapure dialysate, 1 and 6 months after the switch to ultrapure dialysate, and 1 month after the switch back to conventional dialysate. RESULTS: The switch from conventional to ultrapure dialysate significantly decreased plasma levels of beta2MG, from 30.1 +/- 1.4 to 27.1 +/- 1.4 mg/dl (p < 0.05) and pentosidine, from 1,535.8 +/- 107.5 to 1,267.6 +/- 102.9 nmol/l (p < 0.01) after 1 month of use. The change of dialysate also significantly decreased plasma levels of CRP, from 0.28 +/- 0.09 to 0.14 +/- 0.05 mg/dl (p < 0.05) and IL-6, from 9.4 +/- 2.7 to 3.5 +/- 0.8 pg/ml (p < 0.01) over the 1-month period. These changes in plasma levels of beta2MG, pentosidine, CRP and IL-6 were maintained over 6 months after switching to ultrapure dialysate and returned to basal levels by switching back to a conventional dialysate. CONCLUSIONS: Ultrapure dialysate decreases plasma levels of beta2MG, pentosidine and inflammatory markers in hemodialysis patients. The use of ultrapure dialysate might be useful in preventing and/or treating complications of dialysis, such as dialysis-related amyloidosis, atherosclerosis and malnutrition.


Asunto(s)
Arginina/análogos & derivados , Soluciones para Hemodiálisis/normas , Fallo Renal Crónico/terapia , Lisina/análogos & derivados , Microglobulina beta-2/sangre , Anciano , Amiloidosis/prevención & control , Arginina/sangre , Proteína C-Reactiva/metabolismo , Endotoxinas/análisis , Femenino , Humanos , Interleucina-6/sangre , Fallo Renal Crónico/sangre , Lisina/sangre , Masculino , Persona de Mediana Edad , Diálisis Renal/efectos adversos
20.
Nephrol Dial Transplant ; 19(4): 797-804, 2004 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15031332

RESUMEN

BACKGROUND: Although hypoalbuminaemia is a significant predictor of mortality in haemodialysis (HD) patients, the pathophysiological mechanisms involved remain to be determined. Albumin is a negative acute-phase reactant and many proinflammatory substances are elevated in HD patients. We investigated factors that may affect liver albumin synthesis. METHODS: Hepatocytes were isolated from rat livers and were cultured with interleukin (IL)-4, IL-6, IL-12, tumor necrosis factor (TNF)-alpha, procalcitonin (PCT), a sensitive marker of infection, and indoxyl sulphate (IS), a uraemic toxin. Albumin levels in the supernatant were measured by enzyme-linked immunosorbent assay. Albumin mRNA expression was determined by reverse transcriptase polymerase chain reaction. RESULTS: IL-6 and TNF-alpha significantly decreased albumin levels in a dose-dependent manner (P<0.01 and P<0.05, respectively). In contrast, IL-4 and IL-12 did not modulate albumin production. PCT and IS significantly and dose-dependently increased albumin levels (both P<0.01). PCT increased albumin mRNA expression in the hepatocytes (P = 0.05) and dose-dependently abrogated IL-6-induced suppression of albumin synthesis (P<0.01). IS also blocked the IL-6-induced decrease in net albumin secretion (P<0.01). CONCLUSION: Our findings indicate that PCT and IS protect against suppression of hepatic albumin synthesis caused by proinflammatory cytokines, suggesting their potential role in preventing hypoalbuminaemia in HD patients.


Asunto(s)
Albúminas/metabolismo , Calcitonina/fisiología , Indicán/fisiología , Hígado/citología , Hígado/metabolismo , Precursores de Proteínas/fisiología , Animales , Péptido Relacionado con Gen de Calcitonina , Células Cultivadas , Citocinas/fisiología , Masculino , Ratas , Ratas Sprague-Dawley
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