Targeting NF-κB by the Cell-Permeable NEMO-Binding Domain Peptide Improves Albuminuria and Renal Lesions in an Experimental Model of Type 2 Diabetic Nephropathy.

Diabetic nephropathy (DN) is a multifactorial disease characterized by hyperglycemia and close interaction of hemodynamic, metabolic and inflammatory factors. Nuclear factor-κB (NF-κB) is a principal matchmaker linking hyperglycemia and inflammation. The present work investigates the cell-permeable peptide containing the inhibitor of kappa B kinase γ (IKKγ)/NF-κB essential modulator (NEMO)-binding domain (NBD) as therapeutic option to modulate inflammation in a preclinical model of type 2 diabetes (T2D) with DN. Black and tan, brachyuric obese/obese mice were randomized into 4 interventions groups: Active NBD peptide (10 and 6 µg/g body weight); Inactive mutant peptide (10 µg/g); and vehicle control. In vivo/ex vivo fluorescence imaging revealed efficient delivery of NBD peptide, systemic biodistribution and selective renal metabolization. In vivo administration of active NBD peptide improved albuminuria (>40% reduction on average) and kidney damage, decreased podocyte loss and basement membrane thickness, and modulated the expression of proinflammatory and oxidative stress markers. In vitro, NBD blocked IKK-mediated NF-κB induction and target gene expression in mesangial cells exposed to diabetic-like milieu. These results constitute the first nephroprotective effect of NBD peptide in a T2D mouse model that recapitulates the kidney lesions observed in DN patients. Targeting IKK-dependent NF-κB activation could be a therapeutic strategy to combat kidney inflammation in DN.

Effects of Zinc Supplementation on Nutritional Status in Children with Chronic Kidney Disease: A Randomized Trial.

BACKGROUND: Zinc is an essential micronutrient for human beings and its deficiency affects their normal growth and development. OBJECTIVE: The main aim was to evaluate the effect of two doses of zinc supplementation (ZS) on the nutritional status in chronic kidney disease (CKD) children. METHODS: A randomized-trial multicentric study was conducted in 48 CKD (23 females) patients under 18-years-old, for a year. At random, participants took 30 or 15 mg/day of ZS, respectively. Anthropometric measurements and biochemical analysis were performed. Hypozincemia was determined by serum zinc concentration (SZC) using atomic absorption spectrophotometry. The positive or negative change in patients' body mass index (BMI) Z-score, serum albumin, zinc and C-reactive protein (CRP) levels were used to evaluate the effect of ZS. RESULTS: Mean SZC was normal before and after ZS. Despite ZS, there were no significant changes in serum albumin, zinc and CRP levels. A positive and significant association was observed between SZC and serum albumin before (p = 0.000) and after (p = 0.007) ZS. In both groups of ZS, there was a small but positive and significant change in body mass and normalization in BMI Z-score, hypoalbuminemia, hypozincemia and high CRP, especially with 30 mg/day of ZS. CONCLUSIONS: Zinc supplementation may be beneficial for nutritional status in children and adolescents with CKD.

Evaluation of the use of tacrolimus ointment for the prevention of hypertrophic scars in experimental model.

BACKGROUND: Tacrolimus, for its activity on modulation of collagen production and fibroblast activity, may have a role in the prevention of hypertrophic scars. OBJECTIVES: Evaluate macroscopic, microscopic, metabolic, laboratory effects and side effects of the use of topical tacrolimus ointment, in different concentrations, in the prevention of hypertrophic scars. METHODS: Twenty-two rabbits were submitted to the excision of 2 fragments of 1 cm of each ear, 4 cm apart, down to cartilage. The left ear of the animals was standardized as control and Vaseline applied twice a day. The right ear received tacrolimus ointment, at concentrations of 0.1% on the upper wound and 0.03% on the lower wound, also applied twice a day. Macroscopic, microscopic, laboratory criteria and the animals' weight were evaluated after 30 days of the experiment. RESULTS: Wounds treated with tacrolimus, at concentrations of 0.1% and 0.03%, when compared to control, showed a lower average degree of thickening (p = 0.048 and p <0.001, respectively). The average of scar thickness and lymphocyte, neutrophil and eosinophil concentrations are lower in the treated wounds compared to the control (p <0.001, p=0.022, p=0.007, p=0.044, respectively). The mean concentration of lymphocytes is lower in wounds treated with a higher concentration of the drug (p=0.01). STUDY LIMITATIONS: experiment lasted only 30 days. CONCLUSIONS: Tacrolimus at the 2 concentrations evaluated reduced the severity of inflammatory changes and positively altered the macroscopic aspect of the scar in the short term. Its use was shown to be safe, with no evidence of systemic or local adverse effects.

Evaluation of the use of tacrolimus ointment for the prevention of hypertrophic scars in experimental model

Abstract BACKGROUND: Tacrolimus, for its activity on modulation of collagen production and fibroblast activity, may have a role in the prevention of hypertrophic scars. OBJECTIVES: Evaluate macroscopic, microscopic, metabolic, laboratory effects and side effects of the use of topical tacrolimus ointment, in different concentrations, in the prevention of hypertrophic scars. METHODS: Twenty-two rabbits were submitted to the excision of 2 fragments of 1 cm of each ear, 4 cm apart, down to cartilage. The left ear of the animals was standardized as control and Vaseline applied twice a day. The right ear received tacrolimus ointment, at concentrations of 0.1% on the upper wound and 0.03% on the lower wound, also applied twice a day. Macroscopic, microscopic, laboratory criteria and the animals' weight were evaluated after 30 days of the experiment. RESULTS: Wounds treated with tacrolimus, at concentrations of 0.1% and 0.03%, when compared to control, showed a lower average degree of thickening (p = 0.048 and p <0.001, respectively). The average of scar thickness and lymphocyte, neutrophil and eosinophil concentrations are lower in the treated wounds compared to the control (p <0.001, p=0.022, p=0.007, p=0.044, respectively). The mean concentration of lymphocytes is lower in wounds treated with a higher concentration of the drug (p=0.01). STUDY LIMITATIONS: experiment lasted only 30 days. CONCLUSIONS: Tacrolimus at the 2 concentrations evaluated reduced the severity of inflammatory changes and positively altered the macroscopic aspect of the scar in the short term. Its use was shown to be safe, with no evidence of systemic or local adverse effects.

Systemic toxic effects during early phases of topical 4-NQO-induced oral carcinogenesis in rats.

BACKGROUND: Most studies have demonstrated 4-NQO toxicity to oral epithelium during oral carcinogenesis induction, but systemic toxicity has been poorly addressed. The aim of this study was to describe the systemic effect of 4-NQO topical application during early phases of oral cancer induction. METHODS: A 4-NQO propylene glycol ointment was topically applied on the rat tongue three times a week for 16 weeks. Local and systemic 4-NQO toxicity was evaluated by body weight gain, hematology, and serum chemistry analyses, histopathology, and proliferating cell nuclear antigen (PCNA) immunohistochemistry. RESULTS: Significant reduction in body weight gain and in white blood cell count as well as significant increase in serum ALT and AST was observed after 16 weeks of 4-NQO topical application. Focal hepatic lobular necrosis, renal tubular degeneration, and decreased cellularity in the splenic white pulp were also detected. CONCLUSIONS: 4-NQO topical application on the tongue of rats for 16 weeks seems to have caused hepatic, renal, and splenic toxicity. Potential systemic toxicity should be considered to monitor for variables that could interfere in topical oral carcinogenesis experiments.

Association of valdecoxib, a nonsteroidal anti-inflammatory drug, with human serum albumin.

Valdecoxib addition quenches the intrinsic human serum albumin (HSA) fluorescence. This allows an evaluation of the drug-protein association. However, both the number of binding sites and their affinity for the drug depend upon the methodology employed for their evaluation and the employed protein concentration. In this work, we measured the effect of valdecoxib on HSA fluorescence yield over a wide range of experimental conditions and discuss the validity of the binding parameters derived from the different data treatments: Stern-Volmer, Scatchard, double logarithmic, quadratic equation, Benesi-Hilderand, and Encinas-Lissi. It is proposed that a combination of Encinas-Lissi and Scatchard treatments of the data renders the most reliable results. From these data, it is concluded that HSA presents three high-affinity binding sites for valdecoxib (K(as) = 4.5 × 10(4) m(-1)) and several secondary sites of smaller activity.

Modulation of the reactivity of the thiol of human serum albumin and its sulfenic derivative by fatty acids.

The single cysteine residue of human serum albumin (HSA-SH) is the most abundant plasma thiol. HSA transports fatty acids (FA), a cargo that increases under conditions of diabetes, exercise or adrenergic stimulation. The stearic acid-HSA (5/1) complex reacted sixfold faster than FA-free HSA at pH 7.4 with the disulfide 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB) and twofold faster with hydrogen peroxide and peroxynitrite. The apparent pK(a) of HSA-SH decreased from 7.9±0.1 to 7.4±0.1. Exposure to H(2)O(2) (2mM, 5min, 37°C) yielded 0.29±0.04mol of sulfenic acid (HSA-SOH) per mole of FA-bound HSA. The reactivity of HSA-SOH with low molecular weight thiols increased ∼threefold in the presence of FA. The enhanced reactivity of the albumin thiol at neutral pH upon FA binding can be rationalized by considering that the corresponding conformational changes that increase thiol exposure both increase the availability of the thiolate due to a lower apparent pK(a) and also loosen steric constraints for reactions. Since situations that increase circulating FA are associated with oxidative stress, this increased reactivity of HSA-SH could assist in oxidant removal.

Renal and cardiorespiratory effects of treatment with lactated Ringer's solution or physiologic saline (0.9% NaCl) solution in cats with experimentally induced urethral obstruction.

OBJECTIVE: To compare the renal and cardiorespiratory effects of IV treatment with lactated Ringer's solution (LRS) or physiologic saline (0.9% NaCl) solution (PSS) in severely decompensated cats with urethral obstruction (UO). ANIMALS: 14 cats (4 cats were used only to establish infusion rates). PROCEDURES: An occluded urethral catheter was used to induce UO in each cat. After development of severe metabolic acidosis, hyperkalemia, and postrenal azotemia, the obstruction was relieved (0 hours); LRS or PSS (5 cats/group) was administered IV (gradually decreasing rate) beginning 15 minutes before and continuing for 48 hours after UO relief. Ten minutes before urethral catheter placement (baseline), at start of fluid therapy (SFT), and at intervals during fluid administration, various physical and clinicopathologic evaluations were performed. RESULTS: Metabolic acidosis was detected in the PSS-treated group at SFT and 2 hours after relief of UO and in the LRS-treated group only at SFT The PSS-treated group had significantly lower blood pH and bicarbonate concentrations at 8 through 48 hours and lower base excess values at 2 through 48 hours, compared with the LRS-treated group. Hypocalcemia and hypernatremia were detected in the PSS-treated group at 2 and 12 hours, respectively. Absolute serum potassium and chloride concentrations did not differ significantly between groups at any time point. CONCLUSIONS AND CLINICAL RELEVANCE: Treatment with LRS or PSS appeared to be safe and effective in cats with experimentally induced UO; however, LRS was more efficient in restoring the acid-base and electrolyte balance in severely decompensated cats with UO.

Antioxidant reactivity toward nitroxide probes anchored into human serum albumin. A new model for studying antioxidant repairing capacity of protein radicals.

A new strategy to evaluate accessibility of antioxidants to radical proteins has been developed using nitroxide prefluorescent probes anchored into human serum albumin (HSA). Binding association constants for the nitroxide probes C(343)T and QT with HSA were 5 x 10(4) and 9 x 10(4)M(-1), respectively. Rate constants for the nitroxide reduction by antioxidants in HSA were determined finding k(HSA)/k(buffer) ratio of 0.8, 1.9, and 0.075 for ascorbic acid, Trolox, and caffeic acid, respectively, for the nitroxide C(343)T reduction.

Effect of polymeric diets in patients on continuous ambulatory peritoneal dialysis.

OBJECTIVE: To determine if a diet complemented with calcium caseinate is better than a natural high protein diet for increasing serum albumin levels in patients on continuous ambulatory peritoneal dialysis (CAPD). PATIENTS AND METHODS: A 4-month clinical trial involving 100 patients older than 18 years was performed. Patients were randomized into two groups: group A, high protein diet (1.4 g natural protein/kg target weight/day and 35 kcal/kg target weight/day); and group B, calcium caseinate (0.7 g calcium caseinate plus 0.7 g natural protein diet/kg target weight/day and 35 kcal/kg target weight/day). Serum levels of albumin, total proteins (TP), BUN, creatinine, glucose, urea, sodium, and potassium, and hematocrit, leukocytes, erythrocytes, and hemoglobin were analyzed at baseline and every 30 days. RESULTS: The final mean albumin value was, for group A, 3.04 +/- 0.39 g/dL, and for group B, 3.12 +/- 0.41 g/dL (p < 0.05); TP for group A, 6.29 +/- 0.47 g/dL, and for group B, 6.49 +/- 0.51 g/dL (p < 0.05); leukocytes for group A, 6888 +/- 1282/mm3, for group B, 7288 +/- 1878/mm3 (p = 0.05); BUN for group A, 47 +/- 11 mg/dL, for group B, 50 +/- 16 mg/dL (p = 0.05). Regression analysis showed a treatment effect in serum albumin and TP levels from the third month in both groups. In group B, a constant elevation of serum albumin of 0.19 mg/dL and TP of 0.27 mg/dL was observed in every month of treatment with calcium caseinate. In the regression analysis of group A we observed a smaller increase in serum albumin, 0.06 mg/dL, and in TP, 0.11 mg/dL, in each month of treatment with the high protein diet. Both differences are significant (p < 0.05). CONCLUSION: Calcium caseinate used in CAPD patients suffering from malnutrition increases serum albumin levels.

Sulfenic acid formation in human serum albumin by hydrogen peroxide and peroxynitrite.

Human serum albumin (HSA), the most abundant protein in plasma, has been proposed to have an antioxidant role. The main feature responsible for this property is its only thiol, Cys34, which comprises approximately 80% of the total free thiols in plasma and reacts preferentially with reactive oxygen and nitrogen species. Herein, we show that the thiol in HSA reacted with hydrogen peroxide with a second-order rate constant of 2.26 M(-1) s(-1) at pH 7.4 and 37 degrees C and a 1:1 stoichiometry. The formation of intermolecular disulfide dimers was not observed, suggesting that the thiol was being oxidized beyond the disulfide. With the reagent 7-chloro-4-nitrobenzo-2-oxa-1,3-diazol (NBD-Cl), we were able to detect the formation of sulfenic acid (HSA-SOH) from the UV-vis spectra of its adduct. The formation of sulfenic acid in Cys34 was confirmed by mass spectrometry using 5,5-dimethyl-1,3-cyclohexanedione (dimedone). Sulfenic acid was also formed from exposure of HSA to peroxynitrite, the product of the reaction between nitric oxide and superoxide radicals, in the absence or in the presence of carbon dioxide. The latter suggests that sulfenic acid can also be formed through free radical pathways since following reaction with carbon dioxide, peroxynitrite yields carbonate radical anion and nitrogen dioxide. Sulfenic acid in HSA was remarkably stable, with approximately 15% decaying after 2 h at 37 degrees C under aerobic conditions. The formation of glutathione disulfide and mixed HSA-glutathione disulfide was determined upon reaction of hydrogen peroxide-treated HSA with glutathione. Thus, HSA-SOH is proposed to serve as an intermediate in the formation of low molecular weight disulfides, which are the predominant plasma form of low molecular weight thiols, and in the formation of mixed HSA disulfides, which are present in approximately 25% of circulating HSA.

Enhanced weight gain in preterm infants receiving lactase-treated feeds: a randomized, double-blind, controlled trial.

OBJECTIVE: To evaluate whether lactase-treated preterm feeds enhance weight gain and feeding tolerance in premature infants. STUDY DESIGN: Prospective, double-blind, randomized, controlled trial involving 130 infants (26-34 weeks postconceptual age). The primary outcome variable was weight gain (g per day). Other outcome measures included gains in length and head circumference, biochemical indexes of nutritional status, feeding intolerance, and incidence of necrotizing enterocolitis. RESULTS: On study day 10, weight gain (mean +/- SEM) of the treatment group was significantly greater (P <.05) than that of the control group (20.4 +/- 1.8 g/day vs 15.5 +/- 1.6 g/day). By study end, no significant difference in weight gain between treatment and control groups was observed. The difference in serum albumin level was significant at study day 14, with a value of 29.3 +/- 0.6 g/L in the treatment group compared with 27.1 +/- 0.4 g/L in the control group (P <.01). There were no significant differences in caloric intakes, length gain, head circumference gain, feeding intolerance, and incidence of necrotizing enterocolitis. CONCLUSIONS: Weight gain may be enhanced during the period of low functional lactase activity of prematurity by addition of lactase to preterm feeds. No adverse effects on feeding tolerance resulted from this treatment.

Effects of aflatoxin B(1) on the liver and kidney of broiler chickens during development.

Aflatoxin B(1) (AFB(1)) negatively affects chicken (Gallus domesticus) growth. This effect is more severe during development. We studied the influence of age on the toxic effects of AFB(1) on plasma, renal and hepatic enzymes, under two protocols, in adult and in developing Arbor-Acres chickens. Protocol A: 100 male 4-week-old chickens (640 g), received AFB(1), 0.5, 1.0, or 2.0 microg/g of feed (daily p.o.), a fourth group received an aflatoxin-free diet. Five birds/group were slaughtered at 7, 14, 21 and 28 days of treatment. Body, hepatic and renal weights, succinate-dehydrogenase (SDH) and glutamate-dehydrogenase (GluDH) in plasma and liver were measured. Hepatic SDH and GluDH decreased (P<0.05). Protocol B: two groups of 24 male 1-week-old chickens (106 g) received either aflatoxin-free feed (n=24) or AFB(1) feed (2.0 microg/g). At days 7, 14, 21 and 28, the same parameters of Protocol A were measured. AFB(1) markedly reduced body weight gain (20-30%), plasma proteins, albumin, renal and hepatic protein content (P<0.05) and increased absolute and relative weights of the kidney (P<0.05). SDH and GluDH were reduced (P<0.05), while total renal gamma-glutamyltranspeptidase (GGT) increased (P<0.05). Results suggest that serum proteins, SDH and GluDH are sensitive early indicators of this toxicity that was more severe in developing chickens. Decrease in serum albumin might be used as an early and suitable indicator of the deleterious effect of this mycotoxin in developing chickens.

Inversión quiral de profenos: consecuencias terapéuticas y toxicológicas / Chiral inversion of profens: therapeutic and toxicological consequences

El presente trabajo tiene como objetivo describir las características farmacocinéticas, metabólicas y toxicológicas de los ácidos asimétricos aril-2-propiónicos y mostrar la importante variabilidad inter-especies existentes. Además se explican las derivaciones metabólicas del proceso de inversión quiral (camino metabólico de crucial importancia para estos compuestos) y las consecuencias toxicológicas relacionadas con su naturaleza quiral (AU)

Absorption and fluorescence spectra of polyene antibiotics in the presence of human serum albumin.

The alteration in the fluorescence spectra observed for the polyene antibiotics: nystatin and amphotericin B in the presence of human serum albumin is due to a decrease in the polar character of the antibiotic environment when these are bound to the protein. Amphotericin B showed two types of binding sites, the first having very high affinity (5.8 10(7) M(-1]) and a secondary binding site with an affinity one order lower than the primary sites. This secondary binding site was very sensitive to temperature change. Nystatin yielded only one type of binding sites with an affinity of 1.1 10(6) M(-1). An electrostatic component was found in the binding of both ligands, as well as an important disorder at the protein binding sites. However the secondary binding site for AMP showed negative entropic change value, which suggests different mechanism of binding respect to the primary one. Conformational change induced by the temperature in the albumin molecule was detected by nystatin binding. Fatty acids produced an interference in the binding of both antibiotics to albumin.

Aglutininas antialbúminas / Antialbumin agglutinins

Se presentan dos casos de donantes cuyos sueros presentaron Aglutininas Antialbúminas con diferentes patrones de reactividad serológica. Ambos casos representan los primeros observados en el Banco de Sangre del Hospital Universitario de Caracas desde su fundación en 1956. Se hace una revisión de la evolución y progresión que en el conocimiento de estos anticuerpos se ha adquirido en el transcurso de los años y se señala la necesidad de conocerlos, a fin de evitar la confusión con anticuerpos específicos para los antígenos eritrocitarios de gran importancia en la terapia transfusional