Potential Role of High-Dose Steroids in the Treatment of COVID-19-Associated Nephropathy.

With the increasing number of COVID-19-associated nephropathy (COVAN), biopsy-proven cases of collapsing variety of focal segmental glomerulosclerosis (FSGS) are emerging. Though the recommendations on treatment for COVID-19-associated respiratory symptoms are evolving, there is still no definitive treatment for the collapsing FSGS secondary to COVAN. We report a case of a 47-year-old male admitted with acute kidney injury from COVID-19 infection and found to have collapsing FSGS on renal biopsy. Almost all the patients who were found to have similar conditions were treated with a relatively smaller dose of steroids and ultimately required dialysis. Our patient showed improvement with the trial of higher doses of steroids and never required dialysis. Hence, our case report emphasizes the need for a randomized controlled trial (RCT) with regard to the use of high-dose steroids in COVAN.

A multi-center retrospective cohort study defines the spectrum of kidney pathology in Coronavirus 2019 Disease (COVID-19).

Kidney failure is common in patients with Coronavirus Disease-19 (COVID-19), resulting in increased morbidity and mortality. In an international collaboration, 284 kidney biopsies were evaluated to improve understanding of kidney disease in COVID-19. Diagnoses were compared to five years of 63,575 native biopsies prior to the pandemic and 13,955 allograft biopsies to identify diseases that have increased in patients with COVID-19. Genotyping for APOL1 G1 and G2 alleles was performed in 107 African American and Hispanic patients. Immunohistochemistry for SARS-CoV-2 was utilized to assess direct viral infection in 273 cases along with clinical information at the time of biopsy. The leading indication for native biopsy was acute kidney injury (45.4%), followed by proteinuria with or without concurrent acute kidney injury (42.6%). There were more African American patients (44.6%) than patients of other ethnicities. The most common diagnosis in native biopsies was collapsing glomerulopathy (25.8%), which was associated with high-risk APOL1 genotypes in 91.7% of cases. Compared to the five-year biopsy database, the frequency of myoglobin cast nephropathy and proliferative glomerulonephritis with monoclonal IgG deposits was also increased in patients with COVID-19 (3.3% and 1.7%, respectively), while there was a reduced frequency of chronic conditions (including diabetes mellitus, IgA nephropathy, and arterionephrosclerosis) as the primary diagnosis. In transplants, the leading indication was acute kidney injury (86.4%), for which rejection was the predominant diagnosis (61.4%). Direct SARS-CoV-2 viral infection was not identified. Thus, our multi-center large case series identified kidney diseases that disproportionately affect patients with COVID-19 and demonstrated a high frequency of APOL1 high-risk genotypes within this group, with no evidence of direct viral infection within the kidney.

Tuning of the optoelectronic properties of peptide-appended core-substituted naphthalenediimides: the role of self-assembly of two positional isomers.

This study demonstrates how the self-assembly pattern of two different and isomeric peptide-appended core-substituted naphthalenediimides (NDIs) affects the modulation of their optoelectronic properties. Two isomeric peptide-attached NDIs were synthesized, purified and characterized. Interchanging the position of attachment of the peptide units and the alkyl chains in the NDI has altered the respective self-assembling patterns of these isomeric molecules in the aggregated states. The isomer having a peptide moiety in the core position and the alkyl chain in the imide position (compound N1) forms face to face stacking or 'H' aggregates in aliphatic solvents including n-hexane, and n-decane, whereas compound N2, in which the peptide moiety is at the imide position and the alkyl chain is attached at the core position of NDI exhibits edge to edge stacking or J aggregates under the same conditions as it is evident from their UV-vis studies. The H aggregated species (obtained from N1) show inter-connected nanofibers, whereas the J aggregated species (obtained from N2) exhibit the morphology of helical nanoribbons. FT-IR and X-ray diffraction studies are in favor of the same aggregation behavior. The individual packing patterns of these two peptide-based isomers have a direct impact on their respective electrical conductivity. Interestingly, the H aggregated species shows 100 times greater current conductivity than that of the J aggregate. Moreover, it is only the H aggregated species that exhibits a photocurrent, and no such photocurrent response is observed with the J aggregates. Computational studies also support that different types of aggregation patterns are formed by these two isomeric molecules in the same solvent system. This unique example of tuning of optoelectronic behavior holds future promise for the development of new peptide-conjugated π-functional materials.

Solvent-Directed Transformation of the Self-assembly and Optical Property of a Peptide-Appended Core-Substituted Naphthelenediimide and Selective Detection of Nitrite Ions in an Aqueous Medium.

This study vividly displays the different self-assembling behavior and consequent tuning of the fluorescence property of a peptide-appended core-substituted naphthalenediimide (N1) in the aliphatic hydrocarbon solvents (n-hexane/n-decane/methyl cyclohexane) and in an aqueous medium within micelles. The N1 is highly fluorescent in the monomeric state and self-aggregates in a hydrocarbon solvent, exhibiting "H-type" or "face-to-face" stacking as indicated by a blue shift of absorption maxima in the UV-vis spectrum. In the H-aggregated state, the fluorescence emission of N1 changes to green from the yellow emission obtained in the monomeric state. In the presence of a micelle-forming surfactant, cetyl trimethylammonium bromide (CTAB), the N1 is found to be dispersed in a water medium. Interestingly, upon encapsulation of N1 into the micelle, the molecule alters its self-assembling pattern and optical property compared to its behavior in the hydrocarbon solvent. The N1 exhibits "edge-to-edge" stacking or J aggregates inside the micelle as indicated by the UV-vis spectroscopic study, which shows a red shift of the absorption maxima compared to that in the monomeric state. The fluorescence emission also differs in the water medium with the NDI derivative exhibiting red emission. FT-IR studies reveal that all amide NHs of N1 are hydrogen-bonded within the micelle (in the J-aggregated state), whereas both non-bonding and hydrogen-bonding amide NHs are present in the H-aggregated state. This is a wonderful example of solvent-mediated transformation of the aggregation pattern (from H to J) and solvatochromism of emission over a wide range from green in the H-aggregated state to yellow in the monomeric state and orangish-red in the J-aggregated state. Moreover, the J aggregate has been successfully utilized for selective and sensitive detection of nitrite ions in water even in the presence of other common anions (NO3-, SO42-, HSO4-, CO32-, and Cl-).