The Expression of Tristetraprolin and Its Relationship with Urinary Proteins in Patients with Diabetic Nephropathy.

OBJECTIVE: Tristetraprolin (TTP), also known as zinc finger protein 36, is an RNA binding protein that has a significant role in regulating the expression of mRNAs containing AU-rich elements. We postulated that TTP might regulate interleukin (IL)-6 and IL-18 expression in diabetes. This study aimed to test the hypothesis that the levels of TTP are correlated with nephropathy in patients with type 2 diabetes. METHODS: Eighty-seven patients (61.3±9.6 years old) who had been diagnosed with type 2 diabetes mellitus and 41 age and sex matched healthy control subjects were enrolled. The diabetes patients were classified into those without proteinuria, with microalbuminuria, and with clinical proteinuria groups according to the ratio of urinary excretion of albumin/creatinine (ACR). RESULTS: Serum and urinary levels of IL-6 and IL-18 were significantly elevated, but those of TTP were significantly decreased in patients with diabetes as compared with control subjects. In addition, serum and urinary levels of IL-6 and IL-18 were significantly higher, but those of TTP were significantly lower in patients with proteinuria than in patients without proteinuria or with microalbuminuria. There was a significant correlation between serum TTP and IL-6/IL-18 (correlation coefficients of -0.572 and -0.685, P < 0.05). CONCLUSION: These results show that diabetes with clinical proteinuria is accompanied by decreased urinary and serum level of TTP and increased levels of IL-6 and IL-18. Decreased TTP expression might occur prior to the increase in IL-6 and IL-18, and decrease of TTP might provide an earlier marker for glomerular dysfunction than IL-6 and IL-18.

[Effects of bushen huoxue recipe on urinary levels of albumin, IL-6, TGF-beta1 and MCP-1 in chronic nephritis patients of shen-deficiency blood-stasis syndrome].

OBJECTIVE: To observe the effect of Bushen Huoxue Recipe (BSHXR, a Chinese medicine recipe for Shen reinforcing and blood circulation activating) on the levels of urinary albumin, interleukin-6 (IL-6), transforming growth factor-beta1 (TGF-beta1), and monocyte chemotactic protein-1 (MCP-1) in chronic nephritis patients of Shen-deficiency blood-stasis syndrome. METHODS: Forty-five patients were blocking assigned randomly to two groups, fifteen patients in the control group and thirty in the treatment group. All orally took Monopril 10 mg, once daily. But BSHXR was given additionally to patients in the treatment group after decocting,one dose per day (taken in two times). The treatment course for both groups was eight weeks. Besides, a normal control group consisting of six healthy subjects from health examination of Shuguang Hospital was set up. The 24-h urinary albumin and contents of TGF-beta1, IL-6 and MCP-1 in urine of all subjects were observed. RESULTS: Compared with before treatment the 24-h urinary albumin was obviously reduced in the treatment group, showing significant difference (P<0.01). The urinary 24-h albumin decreased in the control group, with statistical significance (P<0.05). Statistical difference existed between the treatment group and the control group after treatment (P<0.01). Compared with before treatment, urinary levels of IL-6, TGF-beta1, and MCP-1 were all down-regulated in the treatment group and the control group after treatment (P<0.01), and the decreasing of IL-6 and TGF-beta1, levels was more significant in the treatment group statistically (P<0.05). CONCLUSIONS: BSHXR could attenuate the albuminuria in patients of chronic nephritis. Its mechanism might be possibly correlated with its down-regulation of IL-6, TGF-beta1, and MCP-1 levels.

[Clinical effect of shenbing mistura combined with glucocorticoid on recurrent nephrotic syndrome in children and levels of interleukin-6 and tumor necrosis factor-alpha in blood and urine].

OBJECTIVE: To study the effect of Shenbing Mistura (SM) combined with glucocorticoid on recurrent nephrotic syndrome (RNS) in children and levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) in blood and urine. METHODS: The treatment group was treated with SM plus glucocorticoid, the control group with glucocorticoid alone, and a healthy control group was adopted, 30 cases in each group. The clinical effect and recurrence rate were observed, and levels of IL-6 and TNF-alpha in blood and urine were determined before treatment and at the 4th, 8th, 12th week after treatment. RESULTS: Significant difference of IL-6 and TNF-alpha levels in blood and urine was found in either the pre- and post- treatment auto-control of both the treatment group and control group, or in the inter-group comparison of them (P < 0.01); clinical effect also showed remarkable difference between the two groups (P < 0.01). Furthermore, the recurrence rate of the treatment group was lower than that of the control group showed by a 18-month follow-up (P < 0.01). CONCLUSION: SM combined with glucocorticoid could significantly reduce the recurrence rate and elevate the clinical effect in children with RNS, it could also lower the levels of IL-6 and TNF-alpha in patients' blood and urine.

[Investigation of urinary interleukin-6 level in chronic renal failure patients and the influence of Rheum palmatum in treating it].

OBJECTIVE: To assess the clinical significance of urinary interleukin-6 (IL-6) level in chronic renal failure (CRF) patients and the effect of Rheum palmatum (RP) in treating it. METHODS: RP and captopril were given to the study group, while captopril was given to the control group alone, and level of urinary IL-6 was determined by sandwich-ELISA. RESULTS: Urinary IL-6 level in CRF patients was obviously higher, than that in healthy control (P < 0.01). After treatment, the urinary IL-6 and serum creatinine reduced significantly in the study group (P < 0.05), and there was significant difference compared with that in the control group (P < 0.05). CONCLUSIONS: Determination of urinary IL-6 level is useful in studying the severity of immune inflammation of CRF. RP improves renal function by inhibiting the production of IL-6 and lowering immune inflammation.

[Clinical observation on therapeutical effect of prepared rhubarb in treating pregnancy induced hypertension].

OBJECTIVE: To study the effect of prepared rhubarb in treating patients with pregnancy induced hypertension (PIH) and its therapeutic mechanisms. METHODS: Prepared rhubarb and nifedipine were given to the study group, while the nifedipine was given to the control group alone. The blood lipid, renal function, blood coagulation, fibrinolysis and immunological parameters were monitored. RESULTS: In the study group, (1) Levels of triglycerides (TG) and low density lipoprotein-cholesterol (LDL-C) decreased and high density lipoprotein-cholesterol (HDL-C) level increased significantly; (2) Plasma level of fibronectin (FN) and plasminogen activator inhibitor (PAI) lowered significantly, plasma antithrombin (AT-III) level unchanged; (3) Serum beta 2 microglobulin (beta 2-MG) level and urinary level of N-acetyl-beta-D-glucosaminidase (NAG) and interleukin-6 (IL-6) decreased significantly; (4) CD8 of blood increased, CD4/CD8 and circulating immune complex (CIC) of blood reduced obviously. All of the above-mentioned parameters in the study group were significantly different from that of the control group. CONCLUSION: The prepared rhubarb could reduce the vascular endothelial cell's damage significantly and alter the immune balance, which is effective in treating the PIH.

[Gammopathies of indeterminant significance and osteoporosis: association or coincidence?]. / Gammapathie de signification indéterminée et ostéoporose: association ou coïncidence?

OBJECTIVES: Osteoporosis is common in subjects over 70 years of age. Likewise, the incidence of monogammapathies of undetermined signification (MGUS) increases with age. We conducted this study to determine whether the biological and histomorphometric characteristics of osteoporosis in patients with MGUS are different from those in primary osteoporosis and to ascertain whether any cause and effect relationships could exist between MGUS and osteoporosis, excluding signs of active myeloma. PATIENTS AND METHODS: Serum and urinary phosphorus and calcium, histomorphometric measurements, hormone levels and serum cytokines (IL1, IL6 and TNF alpha) were determined in 7 patients (mean age 71.8 years, 2 men and 5 women) with MGUS associated with osteoporosis with vertebral fractures (OP) and compared with those in 7 osteoporosis patients without MGUS matched for age, sex, and osteoporosis severity and 7 other age and sex matched patients with MGUS without OS. The MGUS + PS patients were followed for 9 years (4.5 to 20) so slowly progressive myeloma could be excluded. RESULTS: Cytokine levels were the same in the three groups of patients but MGUS + OP patients had higher urinary calcium levels (ca/cr = 0.21 +/- 0.08 vs 0.12 +/- 0.1 (OP) and 0.13 (MGUS); p = 0.04), decreased osteocalcin levels (7 +/- 4.6 ng/ml vs. 12 +/- 4 (OP) and 11.5 +/- 5 (MGUS); p = 0.01) and increased surface resorption (8 +/- 1.4 vs. 3.6 +/- 1.2 (OP) and 5.5 +/- 1.7 (MGUS); p = 0.05). DISCUSSION: It has been demonstrated that MGUS in patients with increased resorption and lower osteocalcin levels frequently progresses to active myeloma. The question is raised as to whether, in certain cases of MGUS, in situ stimulation of bone cells by monoclonal plasma cells could exist without ongoing transformation to active myeloma.