RESUMO
SUMMARY: Although tacrolimus (TAC) significantly reduces allograft rejection incidence in solid-organ transplantation, its long-term use is associated with an increased risk of TAC-induced nephrotoxicity. In this study, we investigated the renoprotective effects of green tea extract (GTE) with or without the dipeptidyl peptidase 4 inhibitor, gemigliptin, by assessing serum creatinine levels, the amount of proteinuria, and histopathology in TAC-induced nephrotoxicity. TAC-induced nephrotoxicity was induced by intraperitoneal TAC injection, GTE was administered via subcutaneous injection, and gemigliptin was administered orally. Mice with TAC-induced nephrotoxicity exhibited a significant increase in both serum creatinine levels and 24-hour urine protein. However, when treated with GTE via subcutaneous injection, mice showed a decrease in serum creatinine levels and the amount of proteinuria. When GTE was combined with gemigliptin, further renoprotective effects were observed in biochemical assessments, consistent with the attenuation of TAC-induced nephrotoxicity in histopathology. The expression of p53 protein was lower in the mice treated with the combination of GTE and gemigliptin compared to mice with TAC-induced nephrotoxicity. Our results demonstrate that the combination of GTE and gemigliptin treatment reveals synergistic renoprotective effects by decreasing the expression of p53 protein. These findings suggest that the combination of GTE and gemigliptin could potentially be used as a prophylactic or therapeutic strategy for TAC-induced nephrotoxicity.
Aunque tacrolimus (TAC) reduce significativamente la incidencia de rechazo de aloinjertos en trasplantes de órganos sólidos, su uso a largo plazo se asocia con un mayor riesgo de nefrotoxicidad inducida por TAC. En este estudio, investigamos los efectos renoprotectores del extracto de té verde (GTE) con o sin el inhibidor de la dipeptidil peptidasa 4, gemigliptina, mediante la evaluación de los niveles de creatinina sérica, la cantidad de proteinuria y la histopatología en la nefrotoxicidad inducida por TAC. La nefrotoxicidad inducida por TAC se indujo mediante inyección intraperitoneal de TAC, el GTE se administró mediante inyección subcutánea y la gemigliptina se administró por vía oral. Los ratones con nefrotoxicidad inducida por TAC mostraron un aumento significativo tanto en los niveles de creatinina sérica como en la proteína en orina de 24 horas. Sin embargo, cuando se trataron con GTE mediante inyección subcutánea, los ratones mostraron una disminución en los niveles de creatinina sérica y en la cantidad de proteinuria. Cuando se combinó GTE con gemigliptina, se observaron efectos renoprotectores adicionales en las evaluaciones bioquímicas, lo que concuerda con la atenuación de la nefrotoxicidad inducida por TAC en histopatología. La expresión de la proteína p53 fue menor en los ratones tratados con la combinación de GTE y gemigliptina en comparación con los ratones con nefrotoxicidad inducida por TAC. Nuestros resultados demuestran que la combinación de tratamiento con GTE y gemigliptina revela efectos renoprotectores sinérgicos al disminuir la expresión de la proteína p53. Estos hallazgos sugieren que la combinación de GTE y gemigliptina podría usarse potencialmente como estrategia profiláctica o terapéutica para la nefrotoxicidad inducida por TAC.
Assuntos
Animais , Camundongos , Piperidonas/administração & dosagem , Pirimidinas/administração & dosagem , Chá , Extratos Vegetais/administração & dosagem , Tacrolimo/toxicidade , Nefropatias/tratamento farmacológico , Piperidonas/farmacologia , Pirimidinas/farmacologia , Extratos Vegetais/farmacologia , Substâncias Protetoras , Sinergismo Farmacológico , Imunossupressores/toxicidade , Rim/efeitos dos fármacos , Nefropatias/induzido quimicamenteRESUMO
SUMMARY: One of the reasons for acute kidney damage is renal ischemia. Nevertheless, there are limited protective and therapeutic approaches for this problem. Diacerein is an anti-inflammatory drug characterized by numerous biological activities. We aimed to determine the ameliorative impact of diacerein on renal ischemia/reperfusion injury (I/R) condition, exploring the underlying mechanisms. Twenty-four male rats were allotted into four groups (n= 6): sham group; Diacerein (DIA) group; I/R group, in which a non-crushing clamp occluded the left renal pedicle for 45 min, and the right kidney was nephrectomized for 5 min before the reperfusion process; I/R + diacerein group, injected intraperitoneally with 50 mg diacerein/kg i.m 30 minutes prior to I/R operation. Ischemia/ reperfusion was found to affect renal function and induce histopathological alterations. The flow cytometry analysis demonstrated an elevated expression of innate and mature dendritic cells in I/R renal tissues. Moreover, upregulation in the expression of the inflammatory genes (TLR4, Myd88, and NLRP3), and overexpression of the pro-inflammatory cytokines (IL-1β), apoptotic (caspase-3) and pyroptotic (caspase-1) markers were observed in I/R-experienced animals. The aforementioned deteriorations were mitigated by pre-I/R diacerein treatment. Diacerein alleviated I/R-induced inflammation and apoptosis. Thus, it could be a promising protective agent against I/R.
La isquemia renal es una de los motivos del daño renal agudo. Sin embargo, los enfoques protectores y terapéuticos para este problema son limitados. La diacereína es un fármaco antiinflamatorio caracterizado por numerosas actividades biológicas. Nuestro objetivo fue determinar el impacto de mejora de la diacereína en la condición de lesión por isquemia/ reperfusión renal (I/R), explorando los mecanismos subyacentes. Veinticuatro ratas macho se distribuyeron en cuatro grupos (n= 6): grupo simulado; grupo de diacereína (DIA); grupo I/R, en el que una pinza no aplastante ocluyó el pedículo renal izquierdo durante 45 min, y el riñón derecho fue nefrectomizado durante 5 min antes del proceso de reperfusión; Grupo I/R + diacereína, inyectado por vía intraperitoneal con 50 mg de diacereína/kg i.m. 30 min antes de la operación I/R. Se encontró que la isquemia/ reperfusión afecta la función renal e induce alteraciones histopatológicas. El análisis de citometría de flujo demostró una expresión elevada de células dendríticas innatas y maduras en tejidos renales I/R. Además, se observó una regulación positiva en la expresión de los genes inflamatorios (TLR4, Myd88 y NLRP3) y una sobreexpresión de las citoquinas proinflamatorias (IL-1β), marcadores apoptóticos (caspasa-3) y piroptóticos (caspasa-1) en animales con experiencia en I/R. Los deterioros antes mencionados fueron mitigados por el tratamiento previo a la diacereína I/R. La diacereína alivió la inflamación y la apoptosis inducidas por I/R. Por lo tanto, podría ser un agente protector prometedor contra I/R.
Assuntos
Animais , Ratos , Traumatismo por Reperfusão/tratamento farmacológico , Antraquinonas/administração & dosagem , Nefropatias/tratamento farmacológico , Anti-Inflamatórios/administração & dosagem , Células Dendríticas/efeitos dos fármacos , Traumatismo por Reperfusão/imunologia , Transdução de Sinais , NF-kappa B/metabolismo , Antraquinonas/imunologia , Apoptose/efeitos dos fármacos , Estresse Oxidativo , Receptor 4 Toll-Like/metabolismo , Interleucina-1beta/metabolismo , Citometria de Fluxo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Inflamação , Injeções Intraperitoneais , Nefropatias/imunologiaRESUMO
Diabetic kidney disease (DKD) is the most common complication of diabetes mellitus (DM). Qianjin Wenwu decoction (QWD), a well-known traditional Korean medicine, has been used for the treatment of DKD, with satisfactory therapeutic effects. This study was designed to investigate the active components and mechanisms of action of QWD in the treatment of DKD. The results demonstrated that a total of 13 active components in five types were found in QWD, including flavonoids, flavonoid glycosides, phenylpropionic acids, saponins, coumarins, and lignins. Two key proteins, TGF-β1 and TIMP-1, were identified as the target proteins through molecular docking. Furthermore, QWD significantly suppressed Scr and BUN levels which increased after unilateral ureteral obstruction (UUO). Hematoxylin & eosin (H&E) and Masson staining results demonstrated that QWD significantly alleviated renal interstitial fibrosis in UUO mice. We also found that QWD promoted ECM degradation by regulating MMP-9/TIMP-1 homeostasis to improve renal tubulointerstitial fibrosis and interfere with the expression and activity of TGF- β1 in DKD treatment. These findings explain the underlying mechanism of QWD for the treatment of DKD, and also provide methodological reference for investigating the mechanism of traditional medicine in the treatment of DKD.
Assuntos
Ratos , Camundongos , Animais , Obstrução Ureteral/metabolismo , Rim/metabolismo , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Simulação de Acoplamento Molecular , Ratos Sprague-Dawley , Nefropatias/tratamento farmacológico , Matriz Extracelular/metabolismo , Flavonoides/metabolismo , FibroseRESUMO
Abstract Background: Type 2 diabetes mellitus (T2DM) is an independent risk factor for cardiovascular impairment, increasing the rates of atherosclerotic and non-atherosclerotic events. Additionally, adverse kidney events are directly linked with T2DM and cardiovascular diseases. In this context, the sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated both cardioprotective and renoprotective effects in patients with or without T2DM. Therefore, the present meta-analysis aims to evaluate cardiovascular outcomes involving SGLT2i as monotherapy or other add-on antidiabetic agents (ADA) in patients with or without T2DM. Objetive: The present meta-analysis aims to evaluate cardiovascular outcomes involving SGLT2i as monotherapy or add-on other ADA in patients with or without T2DM. Methods: The entrance criteria to SGLT2i studies were: describing any data regarding cardiovascular effects; enrolling more than 1,000 participants; being approved by either the FDA or the EU, and having available access to the supplementary data. The trial had to exhibit at least one of the following results: major adverse cardiovascular events (MACE), cardiovascular death or hospitalization for heart failure, cardiovascular death, hospitalization for heart failure, renal or cardiovascular adverse events, or non-cardiovascular death. The significance level of 0.05 was adopted in the statistical analysis. Results: Nine trials with a total of 76,285 participants were included in the meta-analysis. SGLT2i reduced MACE (RR 0.75, 95% CI [0.55-1.01]), cardiovascular death or hospitalization for heart failure (RR 0.72, 95% CI [0.55-0.93]), cardiovascular death (RR 0.66, 95% CI [0.48-0.91]), hospitalization for heart failure (RR 0.58, 95% CI [0.46-0.73]), renal or cardiovascular adverse events (RR 0.55, 95% CI [0.39-0.78]), and non-cardiovascular death (RR 0.88, 95% CI [0.60-1.00]). Conclusions: Conjunction overall data suggests that these drugs can minimize the risk of cardiovascular events, thus decreasing mortality in patients, regardless of the presence of T2DM.
Assuntos
Humanos , Cardiotônicos , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/tratamento farmacológico , Diabetes Mellitus Tipo 2 , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Reprodutibilidade dos Testes , Avaliação de Resultados em Cuidados de Saúde , Transportador 2 de Glucose-Sódio , Hospitalização , Nefropatias/tratamento farmacológicoRESUMO
OBJECTIVE@#To investigate the protective effects of Schisandra chinensis oil (SCEO) against aristolochic acid I (AA I)-induced nephrotoxicity in vivo and in vitro and elucidate the underlying mechanism.@*METHODS@#C57BL/6 mice were randomly divided into 5 groups according to a random number table, including control group, AA I group, and AA I +SCEO (0.25, 0.5 and 1 g/kg) groups (n=5 per group). Pretreatment with SCEO was done for 2 days by oral administration, while the control and AA I groups were treated with sodium carboxymethyl cellulose. Mice of all groups except for the control group were injected intraperitoneally with AA I (5 mg/kg) from day 3 until day 7. Histopathological examination and apoptosis of kidney tissue were observed by hematoxylin and eosin and TdT-mediated dUTP nick-end labeling (TUNEL) staining, respectively. The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and serum creatinine (SCr), as well as renal malondialdehyde (MDA), glutathione, r-glutamyl cysteingl+glycine (GSH), and superoxide dismutase (SOD) were analyzed using enzyme-linked immunosorbent assay (ELISA). Expressions of hepatic cytochrome P450 1A1 (CYP1A1), CYP1A2, and nad(p)hquinonedehydrogenase1 (NQO1) were analyzed using ELISA, quantitative real-time polymerase chain reaction (qPCR) and Western blot, respectively. In vitro, SCEO (40 µ g/mL) was added 12 h before treatment with AA I (40 µ mol/mL for 48 h) in human renal proximal tubule cell line (HK-2), then apoptosis and reactive oxygen species (ROS) were analyzed by flow cytometry.@*RESULTS@#SCEO 0.5 and 1 g/kg ameliorated histopathological changes and TUNEL+ staining in the kidney tissues of mice with AA I-induced nephrotoxicity, and reduced serum levels of ALT, AST, BUN and SCr (P<0.01 or P<0.05). SCEO 0.5 and 1 g/kg alleviated the ROS generation in kidney, containing MDA, GSH and SOD (P<0.01 or P<0.05). SCEO 1 g/kg increased the expressions of CYP1A1 and CYP1A2 and decreased NQO1 level in the liver tissues (P<0.01 or P<0.05). Besides, in vitro studies also demonstrated that SCEO 40 µ g/mL inhibited apoptosis and ROS generation (P<0.05 or P<0.01).@*CONCLUSIONS@#SCEO can alleviate AA I-induced kidney damage both in vivo and in vitro. The protective mechanism may be closely related to the regulation of metabolic enzymes, thereby inhibiting apoptosis and ROS production.
Assuntos
Animais , Camundongos , Apoptose , Ácidos Aristolóquicos/toxicidade , Citocromo P-450 CYP1A1/metabolismo , Citocromo P-450 CYP1A2/metabolismo , Glutationa/metabolismo , Rim/efeitos dos fármacos , Nefropatias/tratamento farmacológico , Camundongos Endogâmicos C57BL , Estresse Oxidativo , Óleos de Plantas/uso terapêutico , Substâncias Protetoras/uso terapêutico , Espécies Reativas de Oxigênio/metabolismo , Schisandra , Superóxido Dismutase/metabolismoRESUMO
Se comunica una serie de tres casos clínicos que consultaron al servicio de Reumatología por compromiso orbitario y renal. Uno de ellos presentó pseudotumor orbitario con proteinuria en rango nefrótico; se realizó biopsia y se encontró infiltrado linfoplasmocitario denso y fibrosis estoriforme con inmunohistoquímica: 15 células IgG4+ por campo de alto poder y relación IgG/IgG4 ≤40%, concluyendo diagnóstico de enfermedad relacionada por IgG4. El segundo y tercer caso presentaron compromiso ocular con "ojos de mapache" y lesiones amarillentas en párpados, ambos con proteinuria >500 mg/24 h, con biopsia de piel rojo Congo positiva y birrefringencia verde manzana con luz polarizada. Se discuten distintos diagnósticos diferenciales poco frecuentes a tener en cuenta en estos pacientes.
A series of three cases that consulted the rheumatology service due to orbital and renal involvement is reported. One of them presented orbital pseudotumor with proteinuria in the nephrotic range, a biopsy was performed, finding dense lymphoplasmacytic infiltrate and storiform fibrosis with immunohistochemistry: 15 IgG4 positive cells per HPF and IgG/IgG4 ratio ≤40%, concluding diagnosis of IgG4 related disease. The second and third cases presented ocular involvement with raccoon eyes and yellowish lesions on the eyelids, both with proteinuria greater than 500 mg/24 h, with apple-green birefringence of amyloid on congo red staining. Different rare differential diagnoses to take into account in these patients are discussed.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Doenças Orbitárias/diagnóstico , Dermatopatias/diagnóstico , Doença Relacionada a Imunoglobulina G4/diagnóstico , Amiloidose/diagnóstico , Nefropatias/diagnóstico , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Sarcoidose/diagnóstico , Dermatopatias/patologia , Dermatopatias/tratamento farmacológico , Diagnóstico Diferencial , Doença Relacionada a Imunoglobulina G4/patologia , Doença Relacionada a Imunoglobulina G4/tratamento farmacológico , Amiloidose/patologia , Amiloidose/tratamento farmacológico , Nefropatias/patologia , Nefropatias/tratamento farmacológicoRESUMO
Introducción: Las infecciones de tracto urinario se encuentran entre las infecciones de mayor prevalencia en la parte clínica. Son un problema de salud global y se pueden presentar con o sin síntomas. Los agentes bacterianos aislados en mayor frecuencia son Escherichia coli, Klebsiella spp y Proteus spp. Objetivo: Caracterizar las infecciones de tracto urinario producidas por enterobacterias productoras de betalactamasas de espectro extendido en pacientes hospitalizados, Lima 2016-2018. Métodos: Se realizó un estudio descriptivo en 2 instituciones prestadoras de salud, en Lima, Perú, durante el periodo 2016-2018, a partir de los aislamientos de patógenos blee asociados a infecciones de tracto urinario. Se tuvieron en cuenta variables sociodemográficas, enfermedades asociadas, agentes aislados, tratamiento y respuesta clínica. Resultados: Se obtuvo un registro de 117 pacientes, con edad promedio de 58,18 ± 11,8 años; 65,0 por ciento fueron mujeres y 89,74 por ciento provenían del área urbana de Lima. Las enfermedades asociadas más frecuentes fueron diabetes (39,3 por ciento) y enfermedad renal moderada o grave (12,8 por ciento), con índice de Charlson medio de 2,70 ± 1,21. Los agentes aislados más comunes fueron Escherichia coli (92,3 por ciento), Klebsiella spp (6,0 por ciento) y Proteus spp (1,7 por ciento). Los tratamientos empíricos usados fueron ampicilina/sulbactam (18,9 por ciento), ciprofloxacino (49,6 por ciento) y nitrofurantoína (16,7 por ciento). El 49,2 por ciento de los pacientes recibió tratamiento dirigido, 22,8 por ciento ertapenem y 13,9 por ciento piperacilina/tazobactam. Conclusiones: Las personas con diabetes y enfermedad renal son un grupo vulnerable a las infecciones de tracto urinario. El agente causal aislado en mayor frecuencia fue Escherichia coli blee+. Los tratamientos de inicio luego de la identificación clínica de la infección urinaria fueron ciprofloxacino y cefalosporinas. Una vez obtenidos los resultados microbiológicos se modificó el tratamiento antibiótico a carbapenémicos y penicilinas. La revaloración de los antibióticos usados en pacientes con enfermedades asociadas es importante para el éxito del tratamiento(AU)
Introduction: Urinary tract infections are among the most prevalent infections in clinical practice. They are a global health problem and may present with or without symptoms. The bacterial agents most commonly isolated are Escherichia coli, Klebsiella spp. and Proteus spp. Objective: Characterize urinary tract infections caused by extended-spectrum betalactamase producing enterobacteria in hospitalized patients from Lima in the period 2016-2018. Methods: A descriptive study was conducted at two health institutions from Lima, Peru, in the period 2016-2018, based on isolation of ESBL pathogens associated to urinary tract infections. Attention was paid to sociodemographic variables, associated conditions, agents isolated, treatment and clinical response. Results: A sample was selected of 117 patients; mean age was 58.18 ± 11.8 years; 65.0 percent were women and 89.74 percent came from the urban area of Lima. The most common associated conditions were diabetes (39.3 percent) and moderate or serious kidney disease (12.8 percent), with a mean Charlson index of 2.70 ± 1.21. The most common isolated agents were Escherichia coli (92.3 percent), Klebsiella spp. (6.0 percent and Proteus spp. (1.7 percent). The empirical treatments used were ampicillin/sulbactam (18.9 percent), ciprofloxacin (49.6 percent) and nitrofurantoin (16.7 percent). 49.2 percent of the patients received targeted treatment, 22.8 percent ertapenem and 13.9 percent piperacillin/tazobactam. Conclusions: People with diabetes and kidney disease are vulnerable to urinary tract infections. The causative agent most commonly isolated was ESBL Escherichia coli. The initial treatments indicated after clinical identification of urinary infection were ciprofloxacin and cephalosporins. When microbiological results were obtained, antibiotic therapy was changed to carbapenems and penicillins. Reassessment of the antibiotics used in patients with associated conditions is important for the success of the treatment(AU)
Assuntos
Humanos , Masculino , Feminino , Sistema Urinário , Carbapenêmicos , Nefropatias/tratamento farmacológico , AntibacterianosRESUMO
SUMMARY: We aimed to investigate the possible protective effects of Potentilla fulgens on kidney tissue with ischemia- reperfusion using immunohistochemical methods. Wistar rats were grouped as sham, ischemia, ischemia-reperfusion (I/R) and I/R treated with Potentilla fulgens. Renal vessels of the left rat kidney were clamped for 60 minutes for ischemia, IR group had 6 h of reperfusion. 400 mg/kg Potentilla fulgens were given intraperitoneally 5 days before ischemia+reperfusion procedure. Biochemical analysis (MDA, GSH and MPO) of samples were performed. Kidney tissues were fixed with 10 % neutral formalin and routine paraffin tissue follow-up protocol was applied, stained with routine Hematoxylin and Eosin. ADAMTS-5 and Caspase-3 immunostaining was applied for immunohistochemistry and examined under a light microscope. In the ischemia group, inflammation and congestion in the vessels and increased ADAMTS-5 expression in glomerular cells and tubule cells were observed. In reperfusion, an increase in degenerative glomerular cells, tubule cells and intertubular connective tissue and inflammatory cells ADAMTS-5 expression was observed. In the P. fulgens group, degeneration and inflammation decreased and positive ADAMTS-5 expression was observed. In the ischemia and ischemia reperfusion group, increased apoptotic appearance and Caspase-3 positive expression in glomerular and tubular cells, and negative expression in most cells in the P. fulgens group. Potentilla fulgens are thought to stop apoptotic cell development at a certain stage, which affects the cytokine mechanism and plays an important role in the reduction of inflammatory cells and angiogenic regulation.
RESUMEN: El objetivo de este estudio fue investigar los posibles efectos protectores de Potentilla fulgens en el tejido renal con isquemia-reperfusión utilizando métodos inmunohistoquímicos. Se agruparon ratas Wistar como simulación, isquemia, isquemia-reperfusión (I / R) e I / R tratadas con Potentilla fulgens. Los vasos renales del riñón iz- quierdo de las ratas se fijaron durante 60 min por isquemia, el grupo de IR tuvo 6 h de reperfusión. Se administraron 400 mg / kg de Potentilla fulgens por vía intraperitoneal 5 días antes del procedimiento de isquemia + reperfusión. Se realizaron análisis bioquímicos (MDA, GSH y MPO) de muestras. Los tejidos renales se fijaron con formalina neutra al 10 % y se aplicó el protocolo de seguimiento de tejido de parafina de rutina y teñido con hematoxilina y eosina. Se aplicó inmunotinción de ADAMTS-5 y Caspasa-3 para inmunohistoquímica y se examinó con un microscopio óptico. En el grupo de isquemia, se observó inflamación y congestión en los vasos y el aumento de la expresión de ADAMTS-5 en células glomerulares y células tubulares. En la reperfusión, se observó un aumento en la expresión de ADAMTS-5 de células glomerulares degenerativas, células tubulares y tejido conjuntivo intertubular y células inflamatorias. En el grupo de Potentilla fulgens, la degeneración y la inflamación disminuyeron y se observó expresión positiva de ADAMTS-5. En el grupo de isquemia y reperfusión de isquemia, aumentó la apariencia apoptótica y expresión positiva de Caspasa-3 en células glomerulares y tubulares, y expresión negativa en la mayoría de las células del grupo de Potentilla fulgens. Se cree que Potentilla fulgens detiene el desarrollo de las células apoptóticas en una determinada etapa, lo que afecta el mecanismo de las citocinas y juega un papel importante en la reducción de las células inflamatorias y la regulación angiogénica.
Assuntos
Animais , Masculino , Ratos , Extratos Vegetais/administração & dosagem , Traumatismo por Reperfusão/tratamento farmacológico , Potentilla/química , Nefropatias/tratamento farmacológico , Imuno-Histoquímica , Extratos Vegetais/farmacologia , Ratos Wistar , Substâncias Protetoras , Modelos Animais de Doenças , Caspase 3/metabolismo , Proteína ADAMTS5/metabolismoRESUMO
OBJECTIVE@#To investigate the effect of Chinese medicine Wubi Shanyao pills on sexual function of kidney-yang-deficiency mice induced by hydrocortisone.@*METHODS@#Male Kunming mice were injected with hydrocortisone for 10 days to prepare the kidney-yang-deficiency model, and administrated with Wubi Shanyao pills (0.91, 1.82, 2.73 g/kg) for 9 weeks. The general behaviors of mice (autonomous activity, grasping power) were observed; sexual behaviors (capture, straddle, ejaculation frequency and incubation period) of mice were detected by mating experiment. The serum levels of cortisol, adrenocorticotropic hormone (ACTH), luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E@*RESULTS@#Wubi Shanyao pills increased the number of independent activities, grasping power, capture frequency of model mice and shortened the capture latency (all @*CONCLUSIONS@#Wubi Shanyao pills can improve the sexual function of mice with kidney-yang-deficiency induced by hydrocortisone, which may be related to regulating the hypothalamus-pituitary-adrenal axis (HPA axis), promoting the proliferation of testicular cells, and inhibiting cell apoptosis.
Assuntos
Animais , Masculino , Camundongos , Hormônio Foliculoestimulante/sangue , Hidrocortisona , Sistema Hipotálamo-Hipofisário , Rim/efeitos dos fármacos , Nefropatias/tratamento farmacológico , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Distribuição Aleatória , Comportamento Sexual Animal/efeitos dos fármacos , Deficiência da Energia Yang/tratamento farmacológicoRESUMO
Abstract Gallic acid (GA), as a strong antioxidant, was selected in this study to investigate its possible nephroprotective effects against gentamicin (GM)-induced nephrotoxicity. Twenty-four rats were separated into three groups (n=8): group 1 (control group) received saline (0.5 mL/day), group 2 (GM group) received GM (100 mg/kg/day), and group 3 (treated group) received GM (100 mg/kg/day) and GA (100mg/kg/day). All treatments were performed intraperitoneally for 12 days. After 12 days, the rats were euthanized, and kidneys were removed immediately. For serum preparation, blood samples were collected before killing. Kidney paraffin sections were prepared from one of the kidneys and stained by the periodic acid-Schiff process. GA significantly decreased GM-induced renal histopathological injuries, including tubular necrosis, tubular cast, and leucocyte infiltration compared with the GM group. Additionally, GA significantly improved proteinuria, serum levels of urea and creatinine, and serum activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) compared with nephrotoxic animals. Furthermore, GA caused a significant improvement in the levels of cholesterol (Chol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and cardiac risk ratios 1 and 2 in comparison with nephrotoxic animals. GA administration was observed to significantly improve the levels of lipid peroxidation, nitric oxide (NO), and glutathione (GSH) compared with the GM group. Finally, the activities and gene expression levels of catalase (CAT) and glutathione peroxidase (GPX) significantly increased following GA administration compared with the GM group. Our results indicated that GA has potential protective effects against GM nephrotoxicity by reducing oxidative stress in rats.
Assuntos
Animais , Masculino , Ratos , Gentamicinas/efeitos adversos , Estresse Oxidativo/efeitos dos fármacos , Ácido Gálico/uso terapêutico , Nefropatias/tratamento farmacológico , Antibacterianos/efeitos adversos , Antioxidantes/uso terapêutico , Biomarcadores , Colesterol , Ratos Wistar , Modelos Animais de Doenças , Ácido Gálico/química , Nefropatias/induzido quimicamente , Nefropatias/patologia , Lipoproteínas HDL , Lipoproteínas LDLRESUMO
Bone metabolism disorders are characterized by an imbalance of bone resorption and formation in the bone remodeling process. Glucocorticoids that are used to treat kidney diseases exacerbate these disorders. P-selectin and galectin-3 are molecules involved in the sclerotic process in kidney, whereas bone resorption is regulated by the interaction between the nuclear factor activator kappa b receptor (RANK), its ligand (RANKL) and the RANKL decoy receptor osteoprotegerin (OPG). The aim of this study was to investigate the cellular and molecular mechanisms of disruption of bone remodeling regulation processes, reflected by intercellular mediators (RANKL, OPG, P-selectin and galectin-3) in chronic kidney disease experimental model treated with glucocorticoids. Rats were divided into four groups of 10 animals each. The first group, the control group, included intact animals. The second group consisted of rats with impaired bone remodeling resulting from chronic kidney disease (experimental group (CKD). The third group was a group of animals with impaired bone remodeling due to exposure to glucocorticoids (experimental group (GCs)). The fourth group consisted of rats with impaired bone remodeling in chronic kidney disease, followed by exposure to glucocorticoids (experimental group (CKD + GCs)). The effects of CKD and glucocorticoid were evaluated biochemically, histologically and by measuring bone density. An enzymelinked immunoassay was used to measure intercellular mediator levels in the serum. The bone density in the experimental groups was reduced compared to the control group. RANKL levels in animals of three experimental groups were higher than in intact animals. Serum levels of OPG were higher in CKD and GCs groups than in intact animals. At the same time, in the animals' blood serum of the CKD + GCs group, the levels of OPG were lower, than those in animals from the control group. The levels of galectin-3 in the serum of the experimental groups GCs and CKD + GCs were lower than in intact animals. The serum levels of galectin-3 in animals of the CKD group were higher than those in animals from the control group. The levels of P-selectin were lower in the serum of the GCs group than in intact animals. At the same time, the levels of P-selectin were higher in the CKD and CKD + GCs groups, than those in animals from the control group. In conclusion, the study of the complex system of bone remodeling regulation, which includes many factors and their interactions, may lead to the development of new methods for treating patients with chronic kidney disease in order to prevent osteoporosis in the future. (AU)
Las enfermedades metabólicas óseas se caracterizan por un desequilibrio en el proceso de remodelación ósea en los que participan mediadores tales como receptor del activador del factor nuclear- kappa- b (RANK), su ligando (RANKL) y la osteoprotegerina (OPG). Los glucocorticoides, recuentemente empleados en el tratamiento de la enfermedad renal crónica, exacerban este desequilibrio. En la enfermedad esclerótica renal, las moléculas de adhesión celular P-selectina and galectina-3 tienen un rol fundamental. El objetivo de esta trabajo fue estudiar las alteraciones en los mediadores de la remodelación ósea (RANKL, OPG, P-selectina and galectina-3) en un modelo de enfermedad renal crónica con tratamiento glucocorticoideo. Ratas Wistar hembras fueron divididos en 4 grupos: control (C); enfermedad renal crónica con afección de la remodelación ósea (ERC); animales con afección de la remodelación ósea expuestos a glucocorticoides (GC); enfermedad renal crónica con afección de la remodelación ósea tratados con glucocorticoides (ERC+GC). Los efectos de la ERC y los GC fueron evaluados bioquímicamente, histológicamente y por medición de la densidad ósea. RANKL, OPG, Pselectina and galectina-3 se cuantificaron en muestras de sangre venosa empleando enzimoinmuno análisis. En los 3 grupos experimentales la densidad ósea se evidenció reducida y los niveles séricos de RANKL elevados respecto al grupo control. Los niveles de OPG en los grupos ERC y GC fueron superiores mientras que en el grupo ERC+GC menores respecto a los animales controles. Galectina 3 plasmática en GC y ERC+GC se encontró reducida y aumentada en los animales ERC, en comparación con los animales controles. La concentración sérica de P-selectina sérica fue mayor en los grupos ERC y ERC+GC, y menor en los animales GC respecto a los niveles plasmáticos de los animales intactos. El avance del conocimiento sobre la regulación de la remodelación ósea a través de la interacción de mediadores sistémicos, en un futuro, puede conducir al desarrollo de nuevas estrategias terapéuticas para la prevención de la osteoporosis en pacientes con enfermedad renal crónica. (AU)
Assuntos
Animais , Ratos , Distúrbio Mineral e Ósseo na Doença Renal Crônica/induzido quimicamente , Remodelação Óssea/efeitos dos fármacos , Nefropatias/fisiopatologia , Osteoporose/prevenção & controle , Doenças Ósseas Metabólicas/diagnóstico , Dexametasona/administração & dosagem , Densidade Óssea/efeitos dos fármacos , Clorofórmio/uso terapêutico , Ratos Wistar , Selectina-P/efeitos dos fármacos , Selectina-P/sangue , Galectina 3/efeitos dos fármacos , Galectina 3/sangue , Ligante RANK/efeitos dos fármacos , Ligante RANK/sangue , Osteoprotegerina/efeitos dos fármacos , Osteoprotegerina/sangue , Glucocorticoides/efeitos adversos , Glicerol/administração & dosagem , Nefropatias/tratamento farmacológicoRESUMO
ABSTRACT Objective: It has been reported that phosphodiesterase-5 (PDE-5) inhibitors improve kidney function during acute and chronic renal failure. This study aimed to determine the possible therapeutic effects of tadalafil, a specific PDE-5 inhibitor, on renal fibrosis induced by unilateral ureteral obstruction (UUO). Methods: Male Sprague-Dawley rats were used and randomly divided into three groups (n = 6) as sham-operated, UUO and tadalafil-treated (10 mg/72 hours, ig) UUO (UUO+T) groups. Unilateral ureteral obstruction was induced by complete ligation of the left ureter and 14 days after surgery creatinine clearance, urinary cyclic guanosine monophosphate (cGMP), renal alpha-smooth muscle actin (α-sma) and transforming growth factor βeta (TGF-β) levels, as well as histologic changes, were observed in all the animals. Results: Unilateral ureteral obstruction-induced renal fibrosis was confirmed by increased α-sma level, collagen deposition, tubular dilation, inflammatory cell infiltration and necrosis. An increased renal TGF-β level and decreased urinary cGMP level was also observed in obstructed animals in addition to reduced creatinine clearance. Tadalafil treatment, which restored the animals 'urinary cGMP level, significantly attenuated the fibrotic changes and TGF-β increase in their kidneys. Conclusion: This study suggests that tadalafil treatment ameliorates renal fibrosis by reducing TGF-β expression and may have important clinical relevance since tadalafil is currently used clinically to treat erectile dysfunction and pulmonary hypertension.
RESUMEN Objetivo: Se ha reportado que los inhibidores de la fosfodiesterasa-5 (PDE-5) mejoran las funciones renales durante la insuficiencia renal aguda y crónica. Este estudio tuvo por objetivo determinar los posibles efectos terapéuticos del tadalafil - un inhibidor específico de la PDE-5 - sobre la fibrosis renal inducida por una obstrucción ureteral unilateral (OUU). Métodos: Se utilizaron ratas machos Sprague-Dawley, divididas de manera aleatoria en tres grupos (n = 6): operación simulada, OUU y tratamiento con tadalafil (10 mg/72 horas, IG), y OUU (OUU+T). La obstrucción uretral unilateral fue inducida por una ligadura completa del uréter izquierdo y 14 días después de la cirugía, se observaron niveles de monofosfato de guanosina cíclico (GMP) urinario, alfa-actina de músculo liso (α-SMA), y factor de crecimiento transformante βeta (FCT-β), así como cambios histológicos en todos los animales. Resultados: La fibrosis renal inducida por obstrucción uretral unilateral fue confirmada por un aumento del nivel de α-SMA, deposición de colágeno, dilatación tubular, infiltración de células inflamatorias y necrosis. También se observó un aumento del nivel de FCT-β renal y una disminución del nivel de GMP urinario en los animales con obstrucción, además de una reducción del aclaramiento de la creatinina. El tratamiento con tadalafil, que restauró el nivel de GMP urinario de los animales, atenuó significativamente los cambios fibróticos y el aumento de FCT-β en los riñones. Conclusión: Este estudio sugiere que el tratamiento con tadalafil mejora la fibrosis renal al reducir la expresión de FCT-β y puede tener una importante relevancia clínica por cuanto el tadalafil se usa hoy día clínicamente para tratar la disfunción eréctil y la hipertensión pulmonar.
Assuntos
Animais , Ratos , Fármacos Renais/farmacologia , Fibromialgia/tratamento farmacológico , Tadalafila/farmacologia , Nefropatias/tratamento farmacológico , Obstrução Ureteral/complicações , Fibromialgia/etiologia , Ratos Sprague-Dawley , Modelos Animais de Doenças , Nefropatias/etiologiaRESUMO
Obesity is a modifiable risk factor for the development and progression of kidney disease. Obesity may harm kidneys in individuals without hypertension, diabetes, or pre-existing renal disease. Ginger, Zingiber officinale, has many beneficial pharmaceutical benefits. This study aimed to evaluate the Zingiber officinale protective effect against obesity complications which induced by high fat diet and caused renal dysfunctions. The study period was two months, and the experimental animals' groups were four, 80 Wistar rats were appropriated similarly 20 animals/group: control group; ginger extract group (GE); high-fat diet (HFD); and GE+HFD group. Body and fat weight, creatinine, leptin, TNF-α, total antioxidants, renal histopathological and ultrastructure were investigated. Rats in group of HFD showed a significant increase (P<0.05) in the body and fat weights, creatinine, leptin and TNF-α, and significant decrease (P<0.05) in total antioxidants (TAS). Ginger administration significantly showed the protective restoring the altered parameters. Furthermore, rats co-treated with ginger extract improved the histopathological and ultrastructural renal injury induced by obesity. The study concluded that the ginger extract used could suppress and decrease the renal damage induced by high-fat diet as it possesses potential medicinal values.
La obesidad es un factor de riesgo modificable para el desarrollo y la progresión de la enfermedad renal. La obesidad puede dañar los riñones en personas sin hipertensión, diabetes o enfermedad renal preexistente. El jengibre, Zingiber officinale, tiene muchos beneficios farmacéuticos. Este estudio tuvo como objetivo evaluar el efecto protector de Zingiber officinale en las complicaciones de la obesidad inducida por una dieta alta en grasas y las enfermedad renal. El período de estudio fue de dos meses, y los grupos de animales experimentales fueron cuatro, se asignaron 80 ratas Wistar de manera similar, 20 animales por grupo: grupo de control; grupo de extracto de jengibre (GE); dieta alta en grasas (DAG); y el grupo GE + DAG. Se evaluó el peso corporal y la grasa, creatinina, leptina, TNF-α, antioxidantes totales, histopatología renal y ultraestructura. Las ratas en el grupo de DAG mostraron un aumento significativo (P<0,05) en el peso corporal y de grasa, creatinina, leptina y TNF-a, y una disminución significativa (P<0,05) en los antioxidantes totales. La administración de jengibre mostró una protección significativa restaurando los parámetros alterados. Además, las ratas tratadas conjuntamente con extracto de jengibre mejoraron la lesión renal histopatológica y ultraestructural inducida por la obesidad. El estudio concluyó que el extracto de jengibre podría suprimir y disminuir el daño renal inducido por la dieta alta en grasas, ya que posee potenciales valores medicinales.
Assuntos
Animais , Ratos , Extratos Vegetais/farmacologia , Zingiber officinale/química , Dieta Hiperlipídica/efeitos adversos , Nefropatias/tratamento farmacológico , Obesidade/complicações , Peso Corporal , Fator de Necrose Tumoral alfa/análise , Ratos Sprague-Dawley , Creatinina/análise , Leptina/análise , Microscopia Eletrônica de Transmissão , Rim/patologia , Nefropatias/patologiaRESUMO
ABSTRACT BACKGROUND: Up to 5% of familial Mediterranean fever (FMF) cases are unresponsive to colchicine, through resistance, side effects and toxicity. Anakinra is an alternative treatment for FMF patients whose disease remains uncontrolled with colchicine. We aimed to evaluate anti-interleukin-1 treatment regarding clinical findings, laboratory parameters and quality of life (QoL) among FMF patients presenting resistance and toxicity towards colchicine. DESIGN AND SETTING: Descriptive observational study at the rheumatology clinic, Adnan Menderes University Medical School, Aydın, Turkey. METHODS: Among the patients included, age, sex, MEFV genotypes, acute-phase reactants, hepatic/renal function tests, average colchicine dose, disease duration, attack frequency, attack duration, disease severity, proteinuria, amyloidosis and QoL were evaluated. Colchicine resistance was defined as > 6 typical episodes/year or > 3 per 4-6 months. Kolmogorov-Smirnov, Friedman and two-way analysis of variance tests were used for statistical analyses. RESULTS: Between 2015 and 2017, 14 FMF patients receiving anakinra were enrolled. The mean colchicine dose was 1.7 ± 0.3 mg/day before use of anakinra. Ten patients were attack-free after treatment, while three showed reductions of at least 50% in attack frequency, attack duration and disease severity. Proteinuria levels in all patients with renal amyloidosis decreased after treatment. QoL among patients with renal amyloidosis differed significantly from QoL among non-amyloidosis patients. Mean visual analogue scale scores significantly improved in both groups after use of anakinra. CONCLUSIONS: Use of anakinra reduced attack frequency and proteinuria and acute-phase reactant levels, and improved QoL, with only a few uncomplicated side effects among colchicine-resistant or intolerant FMF patients. Injection-site reactions of severity insufficient to require discontinuation of treatment were seen.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Febre Familiar do Mediterrâneo/tratamento farmacológico , Qualidade de Vida , Resistência a Medicamentos/efeitos dos fármacos , Colchicina/uso terapêutico , Interleucina-1/antagonistas & inibidores , Antirreumáticos/uso terapêutico , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Febre Familiar do Mediterrâneo/fisiopatologia , Proteinúria/urina , Valores de Referência , Fatores de Tempo , Turquia , Índice de Gravidade de Doença , Sedimentação Sanguínea , Reprodutibilidade dos Testes , Estudos Retrospectivos , Análise de Variância , Resultado do Tratamento , Estatísticas não Paramétricas , Escala Visual Analógica , Amiloidose/fisiopatologia , Amiloidose/tratamento farmacológico , Nefropatias/fisiopatologia , Nefropatias/tratamento farmacológicoRESUMO
ABSTRACT Introduction: We investigated whether Oltipraz (OPZ) attenuated renal fibrosis in a unilateral ureteral obstruction (UUO) rat model. Materials and Methods: We randomly divided 32 rats into four groups, each consisting of eight animals as follows: Rats in group 1 underwent a sham operation and received no treatment. Rats in group 2 underwent a sham operation and received OPZ. Rats in group 3 underwent unilateral ureteral ligation and received no treatment. Group 4 rats were subjected to unilateral ureteral ligation plus OPZ administration. Transforming growth factor beta-1 (TGF-β1), E-cadherin, nitric oxide (NO) and hydroxyproline levels were measured. Histopathological and immunohistochemical examinations were carried out. Results: TGF-β1, NO and E-cadherin levels in the UUO group were significantly higher than the sham group and these values were significantly different in treated groups compared to the UUO group. In rats treated with UUO + OPZ, despite the presence of mild tubular degeneration and less severe tubular necrosis, glomeruli maintained a better morphology when compared to the UUO group. Expressions of α-SMA in immunohistochemistry showed that the staining positivity decreased in the tubules of the OPZ-treated group. Conclusions: While the precise mechanism of action remains unknown, our results demonstrated that OPZ exerted a protective role in the UUO-mediated renal fibrosis rat model highlighting a promising therapeutic potency of Nrf2-activators for alleviating the detrimental effects of unilateral obstruction in kidneys.
Assuntos
Animais , Masculino , Ratos , Pirazinas/uso terapêutico , Obstrução Ureteral/complicações , Fator 2 Relacionado a NF-E2/uso terapêutico , Nefropatias/tratamento farmacológico , Tionas , Tiofenos , Obstrução Ureteral/patologia , Obstrução Ureteral/tratamento farmacológico , Fibrose/etiologia , Fibrose/tratamento farmacológico , Imuno-Histoquímica , Caderinas/sangue , Ratos Wistar , Modelos Animais de Doenças , Fator de Crescimento Transformador beta1/sangue , Hidroxiprolina/sangue , Nefropatias/etiologia , Nefropatias/patologia , Óxido Nítrico/sangueRESUMO
El absceso renal representa una patología infrecuente en el recién nacido. Puede presentar consecuencias graves: sepsis con alta mortalidad, cicatrices renales y riesgo de enfermedad renal crónica. Se reporta sobre un recién nacido con absceso renal unilateral a Staphylococcus aureus, con cuadro de septicemia, sin otro foco supurativo ni malformación urinaria, que evolucionó adecuadamente con antibióticos endovenosos, sin tratamiento quirúrgico, aunque con cicatrices renales como secuela. A partir de este caso, se analizan las estrategias de diagnóstico, tratamiento y seguimiento del absceso renal en un neonato y se destaca el diagnóstico precoz para evitar cicatrices renales.
Renal abscess is a rare disease in newborn, but severe consequences can occur: sepsis with high mortality, renal scar formation and risk of chronic renal failure. A neonate with unilateral renal abscess due to Staphylococcus aureus is reported, with septicemia, with no other suppurative focus, nor with urinary malformation, with good clinical evolution with intravenous antibiotics and without surgical treatment, but with renal scars sequel. From this case, the strategies of diagnosis, treatment and followup of the renal abscess in a neonate are analyzed, emphasizing the early diagnosis to avoid renal scars.
Assuntos
Humanos , Masculino , Recém-Nascido , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Nefropatias/microbiologia , Nefropatias/diagnóstico , Nefropatias/tratamento farmacológicoRESUMO
RESUMO Objetivo: Investigar os efeitos da administração de canabidiol em um modelo de isquemia/reperfusão renal em animais. Métodos: Foi induzida uma lesão renal, por meio de 45 minutos de isquemia renal seguida por reperfusão. Administrou-se canabidiol (5mg/kg) imediatamente após a reperfusão. Resultados: A isquemia/reperfusão aumentou os níveis de interleucina 1 e fator de necrose tumoral, o que foi atenuado pelo tratamento com canabidiol. Além disso, o canabidiol foi capaz de diminuir o dano oxidativo de lipídios e proteínas, mas não os níveis de nitrito/nitrato. A lesão renal após isquemia/reperfusão pareceu ser independente da expressão dos receptores canabidiol-1 e canabidiol-2, já que não houve aumento significante desses receptores após a reperfusão. Conclusão: O tratamento com canabidiol teve um efeito protetor contra a inflamação e o dano oxidativo em um modelo de isquemia/reperfusão renal. Esses efeitos parecem não ocorrer via ativação dos receptores canabidiol-1/canabidiol-2.
ABSTRACT Objective: This work aimed to investigate the effects of the administration of cannabidiol in a kidney ischemia/reperfusion animal model. Methods: Kidney injury was induced by 45 minutes of renal ischemia followed by reperfusion. Cannabidiol (5mg/kg) was administered immediately after reperfusion. Results: Ischemia/reperfusion increased the IL-1 and TNF levels, and these levels were attenuated by cannabidiol treatment. Additionally, cannabidiol was able to decrease lipid and protein oxidative damage, but not the nitrite/nitrate levels. Kidney injury after ischemia/reperfusion seemed to be independent of the cannabidiol receptor 1 and cannabidiol receptor 2 (CB1 and CB2) expression levels, as there was no significant increase in these receptors after reperfusion. Conclusion: The cannabidiol treatment had a protective effect against inflammation and oxidative damage in the kidney ischemia/reperfusion model. These effects seemed to be independent of CB1/CB2 receptor activation.
Assuntos
Animais , Masculino , Ratos , Canabidiol/farmacologia , Traumatismo por Reperfusão/tratamento farmacológico , Inflamação/tratamento farmacológico , Nefropatias/tratamento farmacológico , Traumatismo por Reperfusão/patologia , Interleucina-1/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Ratos Wistar , Estresse Oxidativo/efeitos dos fármacos , Receptor CB1 de Canabinoide/metabolismo , Receptor CB2 de Canabinoide/metabolismo , Modelos Animais de Doenças , Inflamação/patologia , Nefropatias/patologiaRESUMO
Immunoglobulin G4 (IgG4)-related kidney disease (IgG4-KD) has recently been demonstrated to be an important part of IgG4-related sclerosing disease (IgG4-SD). However, since IgG4-KD is still relatively unfamiliar to radiologists and physicians as compared to IgG4-SD involving other organs, it could, therefore, be easily missed. In this article, we present a comprehensive pictorial review of IgG4-KD with regards to the imaging spectrum, mimickers, and clinicopathologic characteristics, based on our clinical experience with 48 patients during the past 13 years, as well as a literature review. Awareness of the broad imaging spectrum of IgG4-KD and differential diagnosis from its mimickers will thus facilitate its early diagnosis and treatment.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Autoimunes/patologia , Imunoglobulina G/metabolismo , Nefropatias/tratamento farmacológico , Imageamento por Ressonância Magnética , Esteroides/uso terapêutico , Tomografia Computadorizada por Raios XRESUMO
This study investigated whether tempol, an anti-oxidant, protects against renal injury by modulating phosphatidylinositol 3-kinase (PI3K)-Akt-Forkhead homeobox O (FoxO) signaling. Mice received unilateral ureteral obstruction (UUO) surgery with or without administration of tempol. We evaluated renal damage, oxidative stress and the expression of PI3K, Akt, FoxO3a and their target molecules including manganese superoxide dismutase (MnSOD), catalase, Bax, and Bcl-2 on day 3 and day 7 after UUO. Tubulointerstitial fibrosis, collagen deposition, alpha-smooth muscle actin-positive area, and F4/80-positive macrophage infiltration were significantly lower in tempol-treated mice compared with control mice. The expression of PI3K, phosphorylated Akt, and phosphorylated FoxO3a markedly decreased in tempol-treated mice compared with control mice. Tempol prominently increased the expressions of MnSOD and catalase, and decreased the production of hydrogen peroxide and lipid peroxidation in the obstructed kidneys. Significantly less apoptosis, a lower ratio of Bax to Bcl-2 expression and fewer apoptotic cells in TUNEL staining, and decreased expression of transforming growth factor-beta1 were observed in the obstructed kidneys from tempol-treated mice compared with those from control mice. Tempol attenuates oxidative stress, inflammation, and fibrosis in the obstructed kidneys of UUO mice, and the modulation of PI3K-Akt-FoxO3a signaling may be involved in this pathogenesis.
Assuntos
Animais , Masculino , Camundongos , Antioxidantes/farmacologia , Colágeno/metabolismo , Óxidos N-Cíclicos/farmacologia , Fibrose , Fatores de Transcrição Forkhead/metabolismo , Peróxido de Hidrogênio/metabolismo , Nefropatias/tratamento farmacológico , Peroxidação de Lipídeos , Camundongos Endogâmicos C57BL , Estresse Oxidativo/efeitos dos fármacos , Fosfatidilinositol 3-Quinases/metabolismo , Fosforilação/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Índice de Gravidade de Doença , Transdução de Sinais/efeitos dos fármacos , Marcadores de Spin , Superóxido Dismutase/metabolismo , Obstrução Ureteral/complicaçõesRESUMO
Antecedentes: El fallo renal agudo(FRA) muestra una incidencia enpacientes hospitalizados en unidadde cuidados intensivos (UCI) que vade 4.7% a 9%, con un rango de edadde 50-75 años asociado a múltiplesfactores.Metodología: estudio descriptivoretrospectivo de pacientes en UCI delHospital Roosevelt en el período dediciembre 2012 a marzo del 2013,con el objetivo de determinar laincidencia de FRA. Se definió comoel aumento de creatinina séricamayor de 0.5 mg/dL en 24 horas omás, o mayor del 50% de lacreatinina basal; disminución delfiltrado glomerular del 25% de labasal y/o aumento de la relaciónnitrógeno ureico en sangre: creatininasérica (mayor de 20:1). (18, 19) Seutilizó estadística descriptiva yestadística analítica no paramétricapara el análisis secundario.Resultados: Se incluyeron 29pacientes, 20/29 (69%) fueronmujeres. Se encontró 15/29 (51%)con FRA siendo 12/15 (80%)mujeres. De los pacientes con FRA,5/15 (33%) presentó FRA pre renal,de estos 4/5 (80%) hipovolémico, 1/5(20%) isovolémica y ningunohipervolémico, FRA tipo intrínseco en10/15 (66%), no se identificó ningúncaso de tipo pos-renal. Cuando secomparó el uso de antibióticos,diuréticos, AINES (anti inflamatoriosno esteroideos) y tomografía axialcomputarizada con medio decontraste con el desarrollo o no deFRA, no se encontró diferenciaestadísticamente significativos con p:0.74, OR; 0.76; rango de OR; 0.12 5, p: 0.74, OR; 0.76; rango de OR;0.12 5, p: 0.94, OR; 0.93; rango deOR; 0.1 10.1 y p: 0.89, OR; 0.90;rango de OR; 0.2 4.5respectivamente...