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1.
Small ; : e2403899, 2024 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-38984756

RESUMEN

Biosensors have emerged as vital tools for the detection and monitoring of essential biological information. However, their efficiency is often constrained by limitations in the power supply. To address this challenge, energy harvesting systems have gained prominence. These off-grid, independent systems harness energy from the surrounding environment, providing a sustainable solution for powering biosensors autonomously. This continuous power source overcomes critical constraints, ensuring uninterrupted operation and seamless data collection. In this article, a comprehensive review of recent literature on energy harvesting-based biosensors is presented. Various techniques and technologies are critically examined, including optical, mechanical, thermal, and wireless power transfer, focusing on their applications and optimization. Furthermore, the immense potential of these energy harvesting-driven biosensors is highlighted across diverse fields, such as medicine, environmental surveillance, and biosignal analysis. By exploring the integration of energy harvesting systems, this review underscores their pivotal role in advancing biosensor technology. These innovations promise improved efficiency, reduced environmental impact, and broader applicability, marking significant progress in the field of biosensors.

2.
Acta Oncol ; 62(6): 648-656, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37338525

RESUMEN

INTRODUCTION: The objective of this study was a multicentric evaluation of professional practices, analyzing the irradiation technique itself and its impact on survival and recurrence sites, in primary central nervous system lymphomas (PCNSLs). METHODS: We retrospectively analyzed the technical and clinical records of 79 PCNSL patients included in the database of the national expert network for oculocerebral lymphoma ('LOC') who were treated with brain radiotherapy as first-line treatment for newly diagnosed primary central nervous system lymphoma between 2011 and 2018. RESULTS: The number of patients treated with brain radiotherapy gradually decreased over time. The heterogeneity of radiotherapy prescriptions was significant, and 55% of them did not comply with published recommendations in terms of irradiation dose and/or volume. The proportion of complete responders to induction chemotherapy treated with reduced-dose radiotherapy increased over time. Partial brain radiotherapy was associated with significantly lower overall survival in univariate analysis. In partial responders to induction chemotherapy, increasing the total dose to the brain >30 Gy and adding a boost to the WBRT induced a trend toward improved progression-free and overall survival. Five recurrences (13%) occurred exclusively in the eyes, all in patients whose eyes had been excluded from the irradiation target volume and including 2 patients without ocular involvement at diagnosis. CONCLUSION: The visibility of recommendations for prescribing brain radiotherapy for the treatment of newly diagnosed primary central nervous system lymphoma needs to be improved to harmonize practices and improve their quality. We propose an update of the recommendations.


Asunto(s)
Neoplasias del Sistema Nervioso Central , Linfoma , Humanos , Neoplasias del Sistema Nervioso Central/radioterapia , Estudios Retrospectivos , Linfoma/radioterapia , Linfoma/patología , Encéfalo/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Metotrexato , Terapia Combinada
3.
J Nanosci Nanotechnol ; 19(8): 4638-4642, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-30913760

RESUMEN

We demonstrate the preparation of water-dispersible polyaniline:polystyrene sulfonate (PANI:PSS), which was doped with camphorsulfonic acid (CSA) and co-doped with poly (4-styrenesulfonic acid) (PSS). The proper formation of the PANI and PANI:PSS was verified by FTIR measurements. The synthesized samples were further characterized via UV-vis spectroscopy. The intensive study on the current density (J)-voltage (V) characteristics within the temperature range (143-303 K) of the synthesized sample was performed systematically. The electrical study shows that the doping of PANI with CSA as a dopant and PSS as a co-dopant significantly improves the overall semi-conducting property of PANI. The detailed analysis of the current density (J)-voltage (V) curve at various temperatures reveals the electrical conduction behavior, which follows the trap-dependent space-charge limited conduction (SCLC) mechanism.

4.
Nephrol Dial Transplant ; 33(4): 709-716, 2018 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-29346631

RESUMEN

Background: In kidney transplant recipients, anticardiolipin (ACL) antibodies without antiphospholipid syndrome (APS) are found in up to 38% of patients and could be associated with thrombotic events (TEs). However, the prognostic role of ACL regarding kidney transplant and patients outcomes have still not been well defined. Methods: We conducted an observational, monocentric, retrospective cohort study including 446 kidney transplant recipients and standardized follow-up: 36-month allograft and patient survival, 12-month estimated glomerular filtration rate (eGFR) and 3- and 12-month screening biopsies. Results: ACL tests were run on 247 patients, 101 were positive (ACL+ group, 41%) and 146 were negative (ACL- group, 59%). Allografts and patient survival within 36 months as TE were similar between both groups [hazard ratio (HR) = 1.18 and HR = 0.98, respectively]. The 12-month eGFR was significantly lower in the ACL+ group [median (95% confidence interval) 48.5 (35.1-60.3) versus 51.9 (39.1-65.0) mL/min/1.73 m2, P= 0.042]. ACL+ was independently associated with eGFR decrease (P = 0.04). In 12-month screening biopsies, tubular atrophy was significantly more severe in the ACL+ group compared with the ACL- group (P = 0.02). Conclusions: ACL without APS before kidney transplantation is an independent risk factor of eGFR decline within the first year post-transplant without over-incidence of TEs. Specific immunosuppressive therapy including mammalian target of rapamycin inhibitors should be discussed in the future.


Asunto(s)
Anticuerpos Anticardiolipina/efectos adversos , Tasa de Filtración Glomerular , Rechazo de Injerto/etiología , Supervivencia de Injerto , Enfermedades Renales/cirugía , Trasplante de Riñón/efectos adversos , Adulto , Anticuerpos Anticardiolipina/sangre , Anticuerpos Anticardiolipina/inmunología , Femenino , Rechazo de Injerto/sangre , Rechazo de Injerto/patología , Humanos , Enfermedades Renales/sangre , Enfermedades Renales/inmunología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia , Receptores de Trasplantes
5.
Transpl Int ; 31(4): 377-385, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-28945291

RESUMEN

Solid organ transplantation societies recommend a relative contraindication of transplantation for people with bipolar or psychotic disorders. Very few data are available on the outcome of kidney transplantation and the increased risk of kidney disease in those patients. We conducted a retrospective multicenter cohort study (1979-2014) including kidney allograft recipients with either bipolar (BD) or psychotic disorders prior to transplant. Objectives were kidney allograft and patient outcomes compared to a matched control group without psychiatric disorders and the evolution of psychiatric disorder at 60 months after transplantation. Forty-seven patients including 25 women were identified, 34 with BD and 13 with psychotic disorder. Patients' overall cumulative death rates at 60 months were not significantly different in both groups [12.2%; 95% confidence interval: (4.5-24.1) in the group with psychiatric disorder versus 5.2%; (1.7-11.7) in control group P = 0.11] as for cumulative allograft loss rates [11.7% (3.5-25.2) vs. 9.4% (4.4-16.8) in control group (P = 0.91)]. Twenty-three patients (16 with BD and seven with psychotic disorder) experienced at least one psychiatric relapse [incidence rate: 1.8/100 persons- months; 95% CI; (1.2-2.7)] totaling 13 hospitalizations within 60 months of follow-up. Four patients stopped immunosuppressive therapy leading to allograft loss in three. Our study suggests that patients with BD or psychotic disorders have to be considered for renal transplantation with close psychiatric follow-up after transplant.


Asunto(s)
Trastorno Bipolar/complicaciones , Fallo Renal Crónico/complicaciones , Trasplante de Riñón/mortalidad , Complicaciones Posoperatorias/epidemiología , Trastornos Psicóticos/complicaciones , Adulto , Femenino , Francia/epidemiología , Supervivencia de Injerto , Humanos , Fallo Renal Crónico/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
6.
Am J Kidney Dis ; 69(1): 51-59, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27663041

RESUMEN

BACKGROUND: Our understanding of the pathophysiologic processes underlying sickle cell nephropathy remains incomplete. We performed a pilot study to investigate the potential value of magnetic resonance imaging (MRI) for the assessment of kidney oxygenation and detection of potential changes to tissue perfusion and cellular integrity during a vaso-occlusive crisis. STUDY DESIGN: A case-control study. SETTING & PARTICIPANTS: 10 homozygous patients with sickle cell disease (SCD), without kidney disease (based on estimated glomerular filtration rate and albuminuria), underwent renal MRI during a vaso-occlusive crisis episode. The imaging data obtained were compared with those for a second MRI performed at steady state (median, 56 [IQR, 37-72] days after the vaso-occlusive crisis MRI). The control group consisted of 10 apparently healthy individuals. MEASUREMENTS: Deoxyhemoglobin level assessed by R2* value was calculated using the blood oxygen level-dependent technique. The intravoxel incoherent motion diffusion-weighted imaging technique was used to calculate D, D*, and F parameters. RESULTS: Median medullary R2* values on steady-state MRI were significantly higher for patients with SCD than for controls (P=0.01) and did not change significantly during the vaso-occlusive crisis. No significant differences in median cortical R2* values were observed. Both cellular integrity (D) and local perfusion (D* and F) were significantly altered in medullary and cortical areas during vaso-occlusive crises in comparison to steady state in patients with SCD. These parameters did not differ significantly between patients with SCD assessed at steady state and the control group. LIMITATIONS: Small sample size, estimation of glomerular filtration rate according to CKD-EPI creatinine equation without adjustment for race. CONCLUSIONS: Deoxyhemoglobin levels in the medullary area are higher in patients with SCD, during vaso-occlusive crises and at steady state, than in controls. Alterations to the tissue perfusion and cellular integrity of renal parenchyma are a common finding during vaso-occlusive crises that provide additional evidence that a vaso-occlusive crisis may be associated with subclinical kidney injury detectable on MRI.


Asunto(s)
Anemia de Células Falciformes/metabolismo , Anemia de Células Falciformes/fisiopatología , Riñón/irrigación sanguínea , Riñón/metabolismo , Imagen por Resonancia Magnética , Oxígeno/metabolismo , Adulto , Anemia de Células Falciformes/diagnóstico por imagen , Estudios de Casos y Controles , Femenino , Humanos , Riñón/diagnóstico por imagen , Masculino , Proyectos Piloto , Flujo Sanguíneo Regional , Adulto Joven
7.
Transpl Int ; 30(3): 277-287, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27992962

RESUMEN

After kidney transplantation, C4d is an incomplete marker of acute antibody-mediated rejection (AMR) and C1q-binding donor-specific antibodies (DSA) have been associated with allograft survival. However, the impact on allograft survival of C1q+ DSA after clinical AMR has not been studied yet. We analysed retrospectively in clinical AMR C4d staining and C1q-binding impact on allograft survival. We compared clinical, histological and serological features of C4d- and C4d+ AMR, C1q+ and C1q- DSA AMR and analysed C4d and C1q-binding impact on allograft survival. Among 500 for-cause kidney allograft biopsies, 48 fulfilled AMR criteria. C4d+ AMR [N = 18 (37.5%)] have significantly higher number class I DSA (P = 0.02), higher microvascular score (P = 0.02) and more transplant glomerulopathy (P = 0.04). C1q+ AMR [N = 20 (44%)] presented with significantly more class I and class II DSA (P = 0.005 and 0.04) and C4d+ staining (P = 0.01). Graft losses were significantly higher in the C4d+ group (P = 0.04) but similar in C1q groups. C4d+ but not C1q+ binding was an independent risk factor for graft loss [HR = 2.65; (1.11-6.34); P = 0.028]. In our cohort of clinical AMR, C4d+ staining but not C1q+ binding is an independent risk factor for graft loss. Allograft loss and patient survival were similar in C1q+ and C1q- AMR.


Asunto(s)
Complemento C1q/metabolismo , Rechazo de Injerto/etiología , Rechazo de Injerto/inmunología , Isoanticuerpos/metabolismo , Trasplante de Riñón/efectos adversos , Adulto , Estudios de Cohortes , Complemento C4b/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fragmentos de Péptidos/metabolismo , Estudios Retrospectivos , Factores de Riesgo , Donantes de Tejidos
8.
J Am Soc Nephrol ; 27(6): 1847-53, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26586692

RESUMEN

The earliest symptom of glomerular injury in patients with sickle cell disease (SCD) is microalbuminuria. The effect of hydroxyurea (HU) on urine albumin-to-creatinine ratio (ACR) is unclear and should be determined, because increasing numbers of patients with SCD take this drug to improve red blood cell function. In this cohort study of 58 SS-homozygous adults with SCD who initiated HU therapy, we evaluated ACR changes and relationships of these changes with demographic, clinical, and biologic parameters at HU initiation (baseline) and 6 months later (follow-up). Between baseline and follow-up, ACR declined significantly for the entire population (3.0-1.7 mg/mmol; P<0.01), but this was primarily driven by the ACR reduction in the microalbuminuria subgroup (8.1-2.3 mg/mmol; P=0.03; n=23). According to bivariate analyses on 39 patients who did not receive a blood transfusion during the study period, the baseline to follow-up ACR decline was strongly associated with decreases in levels of hemolysis markers, percentage of dense red blood cells, and systolic BP. Bivariate analysis also revealed a close association between the ACR decrease and high baseline levels of hemolysis markers and percentage of dense red blood cells. These results show that urine ACR decreased significantly after 6 months of HU and confirm a close relationship between ACR and hemolysis evolution in patients with SCD.


Asunto(s)
Albuminuria/tratamiento farmacológico , Albuminuria/etiología , Anemia de Células Falciformes/complicaciones , Antidrepanocíticos/administración & dosificación , Hidroxiurea/administración & dosificación , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Factores de Tiempo
9.
Br J Haematol ; 174(1): 148-52, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26992059

RESUMEN

We performed a retrospective study to assess the changes in clinical, biological and heart echocardiographic parameters in 32 sickle cell disease (SCD) patients beginning haemodialysis. Acute SCD-related complications were similar at 6 months before and 6 months after the initiation of haemodialysis. Median haemoglobin level did not change significantly, but the need for blood transfusions increased (P < 0·001). The 5-year incidence of death was higher in SCD patients (P < 0·0001). The 5-year likelihood of receiving a renal graft was lower in SCD patients (P = 0·022). Our findings suggest that SCD patients have poorer survival and a lower likelihood of receiving a renal graft.


Asunto(s)
Anemia de Células Falciformes/complicaciones , Adulto , Anemia de Células Falciformes/mortalidad , Anemia de Células Falciformes/terapia , Transfusión Sanguínea/estadística & datos numéricos , Estudios de Cohortes , Femenino , Hemoglobinas/análisis , Humanos , Trasplante de Riñón/estadística & datos numéricos , Masculino , Morbilidad , Mortalidad , Diálisis Renal , Insuficiencia Renal Crónica/mortalidad , Insuficiencia Renal Crónica/terapia , Estudios Retrospectivos , Adulto Joven
10.
Clin Transplant ; 30(6): 731-40, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27140447

RESUMEN

The analysis of anti-HLA sensitization at the time of and following allograft nephrectomy may help clinicians to define better both the indications for nephrectomy and preventive therapeutic strategies. We carried out a retrospective analysis of anti-HLA antibodies in 63 clinically indicated nephrectomies (baseline and three and 12 months after) according to the time elapsed since transplantation (six months) and clinical background. An intervention study included 10 patients without donor-specific antibodies (DSA) at the time of nephrectomy treated with high-dose intravenous immunoglobulin (IVIG) (1.5 g/kg). Early nephrectomies were performed in 15 patients (24%). Among the late nephrectomies, 14 patients (22%) were asymptomatic and 34 (54%) had graft intolerance syndrome (GIS). At baseline, anti-HLA sensitization was significantly lower in the early and late asymptomatic groups than in the GIS group, but increased considerably within the three months following surgery. In the group of 10 patients treated with IVIG, only the number of class I non-DSA increased in the three months after surgery, whereas in the control group (N = 13), all anti-HLA variables increased significantly. All patients undergoing a clinically indicated allograft nephrectomy become highly sensitized within the 12 months after surgery. In patients without DSA before nephrectomy, high doses of IVIG may prevent anti-HLA sensitization.


Asunto(s)
Rechazo de Injerto/prevención & control , Antígenos HLA/inmunología , Inmunoglobulinas Intravenosas/uso terapéutico , Trasplante de Riñón/efectos adversos , Nefrectomía/efectos adversos , Complicaciones Posoperatorias/prevención & control , Adulto , Estudios de Cohortes , Femenino , Rechazo de Injerto/inmunología , Supervivencia de Injerto , Histocompatibilidad , Humanos , Isoanticuerpos , Masculino , Persona de Mediana Edad , Trasplante Homólogo , Resultado del Tratamiento
11.
J Nanosci Nanotechnol ; 16(3): 2779-82, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27455707

RESUMEN

Nonlinear transport is intensively explained through Poole-Frenkel (PF) transport mechanism in organic thin film transistors with solution-processed small molecules, which is, 6,13-bis(triisopropylsilylethynyl) (TIPS) pentacene. We outline a detailed electrical study that identifies the source to drain field dependent mobility. Devices with diverse channel lengths enable the extensive exhibition of field dependent mobility due to thermal activation of carriers among traps.


Asunto(s)
Compuestos Orgánicos/química , Semiconductores
12.
Kidney Int ; 85(2): 457-70, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24067439

RESUMEN

Renal toxicity constitutes a dose-limiting side effect of anticancer therapies targeting vascular endothelial growth factor (VEGF). In order to study this further, we followed up 29 patients receiving this treatment, who experienced proteinuria, hypertension, and/or renal insufficiency. Eight developed minimal change nephropathy/focal segmental glomerulopathy (MCN/FSG)-like lesions and 13 developed thrombotic microangiopathy (TMA). Patients receiving receptor tyrosine kinase inhibitors (RTKIs) mainly developed MCN/FSG-like lesions, whereas TMA complicated anti-VEGF therapy. There were no mutations in factor H, factor I, or membrane cofactor protein of the complement alternative pathway, while plasma ADAMTS13 activity persisted and anti-ADAMTS13 antibodies were undetectable in patients with TMA. Glomerular VEGF expression was undetectable in TMA and decreased in MCN/FSG. Glomeruli from patients with TMA displayed a high abundance of RelA in endothelial cells and in the podocyte nuclei, but c-mip was not detected. Conversely, MCN/FSG-like lesions exhibited a high abundance of c-mip, whereas RelA was scarcely detected. RelA binds in vivo to the c-mip promoter and prevents its transcriptional activation, whereas RelA knockdown releases c-mip activation. The RTKI sorafenib inhibited RelA activity, which then promoted c-mip expression. Thus, our results suggest that c-mip and RelA define two distinct types of renal damage associated with VEGF-targeted therapies.


Asunto(s)
Inhibidores de la Angiogénesis/efectos adversos , Proteínas Portadoras/metabolismo , Enfermedades Renales/inducido químicamente , Glomérulos Renales/efectos de los fármacos , Niacinamida/análogos & derivados , Compuestos de Fenilurea/efectos adversos , Inhibidores de Proteínas Quinasas/efectos adversos , Factor de Transcripción ReIA/metabolismo , Factores de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Proteínas Adaptadoras Transductoras de Señales , Adulto , Anciano , Animales , Secuencia de Bases , Sitios de Unión , Biomarcadores/metabolismo , Proteínas Portadoras/genética , Estudios de Casos y Controles , Línea Celular , Femenino , Regulación de la Expresión Génica , Glomeruloesclerosis Focal y Segmentaria/inducido químicamente , Glomeruloesclerosis Focal y Segmentaria/diagnóstico , Glomeruloesclerosis Focal y Segmentaria/enzimología , Humanos , Hipertensión/inducido químicamente , Hipertensión/diagnóstico , Hipertensión/enzimología , Enfermedades Renales/diagnóstico , Enfermedades Renales/enzimología , Glomérulos Renales/enzimología , Glomérulos Renales/patología , Masculino , Ratones , Ratones Noqueados , Persona de Mediana Edad , Datos de Secuencia Molecular , Nefrosis Lipoidea/inducido químicamente , Nefrosis Lipoidea/diagnóstico , Nefrosis Lipoidea/enzimología , Niacinamida/efectos adversos , Valor Predictivo de las Pruebas , Regiones Promotoras Genéticas , Proteinuria/inducido químicamente , Proteinuria/diagnóstico , Proteinuria/enzimología , Insuficiencia Renal/inducido químicamente , Insuficiencia Renal/diagnóstico , Insuficiencia Renal/enzimología , Sorafenib , Microangiopatías Trombóticas/inducido químicamente , Microangiopatías Trombóticas/diagnóstico , Microangiopatías Trombóticas/enzimología , Factor de Transcripción ReIA/deficiencia , Factor de Transcripción ReIA/genética , Transcripción Genética , Transfección , Factores de Crecimiento Endotelial Vascular/metabolismo , Adulto Joven
13.
Liver Transpl ; 20(12): 1475-85, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25267365

RESUMEN

Primary hyperoxaluria type 1 (PH1) is a hepatic metabolic defect leading to end-stage renal failure. The posttransplant recurrence of kidney disease can suggest a need for combined liver-kidney transplantation (LKT). However, the risk of LKT is theoretically far higher than the risk of kidney-alone transplantation (KAT). An unselected consecutive series of 54 patients with PH1 was analyzed according to the type of transplantation initially performed between May 1979 and June 2010 at 10 French centers. The duration of dialysis, extrarenal lesions, age, and follow-up were similar between the groups. Postoperative morbidity and mortality did not differ between the groups, and 10-year patient survival rates were similar for the LKT (n = 33) and KAT groups (n = 21; 78% versus 70%). Kidney graft survival at 10 years was better after LKT (87% versus 13%, P < .001) . Four patients (12.1%) lost their first kidney graft in the LKT group, whereas 19 (90%) did in the KAT group (P < .001). The recurrence of oxalosis occurred in 11 renal grafts (52%) in the KAT group but in none in the LKT group (P < .001). End-stage renal failure resulting from rejection was also higher in the KAT group (19% versus 9%, P < 0.0001). A second kidney transplant was performed for 15 patients (71%) in the KAT group versus 4 patients (12%) in the LKT group (P < 0.001). In conclusion, LKT for PH1 provides better kidney graft survival, less rejection, and similar long-term patient survival and is not associated with an increased short-term mortality risk. LKT must be the first-line treatment for PH1 patients with end-stage renal disease.


Asunto(s)
Hiperoxaluria Primaria/cirugía , Trasplante de Riñón , Trasplante de Hígado , Adolescente , Adulto , Niño , Preescolar , Femenino , Estudios de Seguimiento , Francia , Supervivencia de Injerto , Humanos , Hiperoxaluria/complicaciones , Hiperoxaluria/cirugía , Hiperoxaluria Primaria/mortalidad , Inmunosupresores/uso terapéutico , Lactante , Fallo Renal Crónico/cirugía , Masculino , Persona de Mediana Edad , Reoperación , Resultado del Tratamiento , Adulto Joven
14.
Am J Kidney Dis ; 63(5): 816-9, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24518129

RESUMEN

We report an occurrence of progressive loss of transplant function and ultimately transplant failure after living related kidney transplantation involving monozygotic twin brothers of Afro-Caribbean origin who were both heterozygous for the G1 and G2 kidney disease risk alleles in the APOL1 gene, which encodes apolipoprotein L-I. A 21-year-old man with end-stage kidney disease of unknown cause received a kidney from his brother, who was confirmed as a monozygotic twin by microsatellite analysis. Thirty months after transplantation, the patient presented with proteinuria and decreased estimated glomerular filtration rate; a biopsy of the transplant showed typical focal segmental glomerulosclerosis lesions. He received steroid therapy, but progressed to kidney failure 5 years later. The twin brother had normal kidney function without proteinuria at the time of transplantation; however, 7 years later, he was found to have decreased estimated glomerular filtration rate (40mL/min/1.73m(2)) and proteinuria (protein excretion of 2.5g/d). APOL1 genotyping revealed that both donor and recipient were heterozygous for the G1 and G2 alleles. This case is in stark contrast to the expected course of kidney transplantation in identical twins and suggests a role for APOL1 polymorphisms in both the donor and recipient.


Asunto(s)
Apolipoproteínas/genética , Enfermedades en Gemelos , Trasplante de Riñón/efectos adversos , Lipoproteínas HDL/genética , Donadores Vivos , Polimorfismo Genético , Insuficiencia Renal Crónica/genética , Gemelos Monocigóticos/genética , Apolipoproteína L1 , Apolipoproteínas/metabolismo , Biopsia , Estudios de Seguimiento , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Riñón/patología , Lipoproteínas HDL/metabolismo , Masculino , Insuficiencia Renal Crónica/metabolismo , Insuficiencia Renal Crónica/cirugía , Adulto Joven
15.
Kidney Int ; 83(3): 511-6, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23325085

RESUMEN

Development of steroid dependency in patients with nephrotic syndrome may require a long-term multi-drug therapy at risk of drug toxicity and renal failure. Rituximab treatment reduces the steroid dosage and the need for immunosuppressive therapy in pediatric patients. Here we retrospectively analyze the efficacy and safety of rituximab in adult patients with steroid-dependent minimal change disease. To do this, we analyzed the outcome of all adult patients treated with rituximab for steroid-dependent minimal change nephrotic syndrome over a mean follow-up of 29.5 months (range 5.1-82 months). Seventeen patients with steroid-dependent or frequently relapsing minimal change nephrotic syndrome, unresponsive to several immunosuppressive medications, were treated with rituximab. Eleven patients had no relapses after rituximab infusion (mean follow-up 26.7 months, range 5.1-82 months) and nine of them were able to come off all other immunosuppressive drugs and steroids during follow-up. Six patients relapsed at least once after a mean time of 11.9 months (mean follow-up 34.5 months, range 16.9-50.1 months), but their immunosuppressive drug treatment could be stopped or markedly reduced during this time. No adverse events were recorded. Thus, rituximab is efficient and safe in adult patients suffering from severe steroid-dependent minimal change disease. Prospective randomized trials are needed to confirm this study.


Asunto(s)
Anticuerpos Monoclonales de Origen Murino/uso terapéutico , Antígenos CD20/inmunología , Nefrosis Lipoidea/tratamiento farmacológico , Prednisona/uso terapéutico , Adolescente , Adulto , Anciano , Anticuerpos Monoclonales de Origen Murino/efectos adversos , Antígenos CD19/análisis , Femenino , Humanos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Rituximab
16.
Kidney Int ; 83(3): 414-25, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23302718

RESUMEN

Membranous nephropathy is a glomerular disease typified by a nephrotic syndrome without infiltration of inflammatory cells or proliferation of resident cells. Although the cause of the disease is unknown, the primary pathology involves the generation of autoantibodies against antigen targets on the surface of podocytes. The mechanisms of nephrotic proteinuria, which reflect a profound podocyte dysfunction, remain unclear. We previously found a new gene, c-mip (c-maf-inducing protein), that was associated with the pathophysiology of idiopathic nephrotic syndrome. Here we found that c-mip was not detected in the glomeruli of rats with passive-type Heymann nephritis given a single dose of anti-megalin polyclonal antibody, yet immune complexes were readily present, but without triggering of proteinuria. Rats reinjected with anti-megalin develop heavy proteinuria a few days later, concomitant with c-mip overproduction in podocytes. This overexpression was associated with the downregulation of synaptopodin in patients with membranous nephropathy, rats with passive Heymann nephritis, and c-mip transgenic mice, while the abundance of death-associated protein kinase and integrin-linked kinase was increased. Cyclosporine treatment significantly reduced proteinuria in rats with passive Heymann nephritis, concomitant with downregulation of c-mip in podocytes. Thus, c-mip has an active role in the podocyte disorders of membranous nephropathy.


Asunto(s)
Proteínas Portadoras/fisiología , Glomerulonefritis Membranosa/patología , Podocitos/fisiología , Proteínas Adaptadoras Transductoras de Señales , Adulto , Proteínas Reguladoras de la Apoptosis/fisiología , Proteínas Quinasas Dependientes de Calcio-Calmodulina/fisiología , Proteínas Portadoras/análisis , Proteínas Portadoras/genética , Ciclosporina/uso terapéutico , Proteínas Quinasas Asociadas a Muerte Celular , Glomerulonefritis Membranosa/tratamiento farmacológico , Humanos , Podocitos/patología , Proteínas Serina-Treonina Quinasas/fisiología , Regulación hacia Arriba
17.
Am J Pathol ; 180(6): 2284-92, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22507836

RESUMEN

The mechanisms of podocyte disorders in cases of idiopathic nephrotic syndrome (INS) are complex and remain incompletely elucidated. The abnormal regulation of NF-κB may play a key role in the pathophysiology of these podocyte diseases, but at present, NF-κB has not been thoroughly investigated. In this study, we report that induction of c-mip in podocytes of patients with INS is associated with a down-regulation of RelA, a potent antiapoptotic factor that belongs to the NF-κB family. Overexpression of c-mip in differentiated podocytes promotes apoptosis by inducing caspase-3 activity and up-regulating the proapoptotic protein Bax, whereas the overall levels of the antiapoptotic protein Bcl-2 was concomitantly decreased. The associated overexpression of RelA prevented the proapoptotic effects of c-mip. In addition, the targeted induction of c-mip in podocytes in vivo inhibited the expression of the RelA protein and increased the Bax/Bcl-2 ratio. The expression of both c-mip and active caspase-3 increased in focal and segmental glomerulosclerosis biopsies, and both proteins displayed a close spatial relationship. These results suggest that alterations in NF-κB activity might result from the up-regulation of c-mip and are likely to contribute to podocyte disorders in cases of INS.


Asunto(s)
Apoptosis/fisiología , Proteínas Portadoras/fisiología , FN-kappa B/metabolismo , Síndrome Nefrótico/metabolismo , Podocitos/metabolismo , Proteínas Adaptadoras Transductoras de Señales , Adulto , Animales , Proteínas Portadoras/biosíntesis , Caspasa 3/metabolismo , Línea Celular , Regulación hacia Abajo/fisiología , Humanos , Etiquetado Corte-Fin in Situ , Masculino , Ratones , Ratones Transgénicos , Microscopía Confocal , Síndrome Nefrótico/patología , Podocitos/patología , Factor de Transcripción ReIA/biosíntesis , Factor de Transcripción ReIA/genética , Regulación hacia Arriba/fisiología
18.
Virol J ; 10: 119, 2013 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-23590857

RESUMEN

BACKGROUND: Because latent Epstein Barr (EBV)-infection is a specific characteristic of malignant nasopharyngeal carcinoma (NPC), various molecules of viral origin are obvious candidate biomarkers in this disease. In a previous study, we could show in a few clinical samples that it was possible to detect a category of EBV microRNAs called miR-BARTs in the plasma of at least a fraction of NPC patients. The first aim of the present study was to investigate the status of circulating miR-BART17-5p (one of the miR-BARTs hereafter called miR-BART17) and EBV DNA in a larger series of NPC plasma samples. The second aim was to determine whether or not circulating miR-BART17 was carried by plasma exosomes. PATIENTS AND METHODS: Plasma samples were collected from 26 NPC patients and 10 control donors, including 9 patients with non-NPC Head and Neck squamous cell carcinoma and one healthy EBV carrier. Concentrations of miR-BART17 and two cellular microRNAs (hsa-miR-16 and -146a) were assessed by real-time quantitative PCR with spike-in normalization and absolute quantification. In addition, for 2 patients, exosome distributions of miR-BART17 and miR-16 were investigated following plasma lipoprotein fractionation by isopycnic density gradient ultrcentrifugation. RESULTS: The miR-BART17 was significantly more abundant in plasma samples from NPC patients compared to non-NPC donors. Above a threshold of 506 copies/mL, detection of miR-BART17 was highly specific for NPC patients (ROC curve analysis: AUC=0.87 with true positive rate = 0.77, false positive rate = 0.10). In this relatively small series, the concentration of plasma miR-BART17 and the plasma EBV DNA load were not correlated. When plasma samples were fractionated, miR-BART17 co-purified with a protein-rich fraction but not with exosomes. CONCLUSIONS: Detection of high concentrations of plasma miR-BART17 is consistent in NPC patients. This parameter is, at least in part, independent of the viral DNA load. Circulating miR-BART17 does not co-purify with exosomes.


Asunto(s)
Biomarcadores/sangre , Herpesvirus Humano 4/genética , MicroARNs/sangre , Neoplasias Nasofaríngeas/patología , Neoplasias Nasofaríngeas/virología , Plasma/química , ARN Viral/sangre , Adulto , Anciano , Transporte Biológico , Carcinoma , ADN Viral/sangre , Exosomas/virología , Femenino , Humanos , Masculino , MicroARNs/metabolismo , Persona de Mediana Edad , Carcinoma Nasofaríngeo , ARN Viral/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa
19.
Am J Kidney Dis ; 59(5): 711-4, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22342319

RESUMEN

We describe a new form of acute interstitial nephritis with predominant plasmacytic infiltration in 2 patients with active human immunodeficiency virus 1 (HIV-1) infection. Clinical features included acute kidney injury and proteinuria, but no sicca syndrome. Acute kidney injury was characterized by a high serum creatinine level and nephrotic syndrome with no hematuria or leukocyturia. Kidney biopsy specimens from both patients showed interstitial infiltration by mononuclear cells composed mainly of CD138(+) plasmacytes and diffuse effacement of podocyte foot processes with no deposits. In one patient with Guillain-Barré syndrome, a sural nerve biopsy showed plasmacyte infiltration and immunohistochemistry was strongly positive for HIV-1 p24 protein. In both patients, minor salivary glands and bone marrow were infiltrated by lymphocytes, consistent with B-cell activation induced by HIV-1 infection. Other common causes of acute interstitial nephritis, including B-cell lymphoma and diffuse infiltrative lymphocytosis syndrome, were actively looked for and excluded. Treatment with highly active antiretroviral therapy was effective; symptoms rapidly improved, serum creatinine level decreased, and proteinuria resolved. Exclusion of other common known causes of acute interstitial nephritis and the dramatic response with highly active antiretroviral therapy suggests HIV-1 as a likely cause. The acute interstitial nephritis probably was induced by HIV-1-driven nonspecific B-cell activation. Further investigations are needed to confirm the direct pathogenic role of HIV-1.


Asunto(s)
Movimiento Celular , Infecciones por VIH/complicaciones , VIH-1 , Nefritis Intersticial/etiología , Nefritis Intersticial/patología , Células Plasmáticas/patología , Enfermedad Aguda , Adulto , Terapia Antirretroviral Altamente Activa , Biopsia , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Riñón/patología , Linfocitosis/diagnóstico , Linfocitosis/etiología , Linfocitosis/patología , Nefritis Intersticial/diagnóstico , Células Plasmáticas/inmunología , Sindecano-1/metabolismo , Resultado del Tratamiento
20.
Blood ; 115(18): 3756-62, 2010 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-20200355

RESUMEN

It is currently considered that idiopathic minimal change nephrotic syndrome is an immune-mediated glomerular disease. Its association with classical Hodgkin lymphoma minimal change nephrotic syndrome (cHL-MCNS) suggests a molecular link, which remains to be elucidated. We analyzed the expression of cmaf inducing protein (c-mip) in lymphomatous tissues and kidney biopsy samples of patients with cHL-MCNS (n = 8) and in lymphomatous tissues of patients with isolated cHL (n = 9). Because c-mip affects the regulatory loop involving Fyn, we investigated possible structural defects in this signaling pathway, using laser capture microdissection, reverse transcription polymerase chain reaction, and Western blotting. We found that c-mip was selectively expressed in Hodgkin and Reed-Sternberg (HRS) cells and podocytes of patients with cHL-MCNS but is undetectable in patients with isolated cHL. We demonstrated that c-mip was specifically involved in the negative regulation of early proximal signaling through its interaction with phosphoprotein associated with glycosphingolipid-enriched microdomains and Fyn. We showed that the up-regulation of c-mip in cHL-MCNS was associated with a possible Fyn defect in HRS cells and podocytes. Moreover, we showed that c-mip was up-regulated in Fyn-deficient podocytes. c-mip may be a useful marker of cHL-MCNS and its induction reflects the dysregulation of proximal signaling.


Asunto(s)
Proteínas Portadoras/metabolismo , Enfermedad de Hodgkin/complicaciones , Nefrosis Lipoidea/complicaciones , Podocitos/metabolismo , Células de Reed-Sternberg/metabolismo , Proteínas Adaptadoras Transductoras de Señales/genética , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Animales , Western Blotting , Proteína Tirosina Quinasa CSK , Estudios de Casos y Controles , Células Cultivadas , Femenino , Citometría de Flujo , Regulación Neoplásica de la Expresión Génica , Enfermedad de Hodgkin/metabolismo , Humanos , Hibridación in Situ , Masculino , Proteínas de la Membrana/genética , Proteínas de la Membrana/metabolismo , Ratones , Microdisección , Nefrosis Lipoidea/metabolismo , Proteínas Tirosina Quinasas/genética , Proteínas Tirosina Quinasas/metabolismo , Proteínas Proto-Oncogénicas/genética , Proteínas Proto-Oncogénicas/metabolismo , Proteínas Proto-Oncogénicas c-fyn/genética , Proteínas Proto-Oncogénicas c-fyn/metabolismo , ARN Mensajero/genética , ARN Mensajero/metabolismo , Ratas , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Regulación hacia Arriba , Familia-src Quinasas
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