A Long-Term follow-up Study of Lupus Nephritis in a Single Tertiary Care Centre.

Introduction: Lupus nephritis (LN) is an immune complex glomerulonephritis, which is a very serious complication of systemic lupus erythematosus (SLE) as it can progress to end-stage kidney disease (ESKD). Methods: In this study of 92 renal biopsy-proven LN, the patients were followed up for a minimum period of 2 years with a mean follow-up period of 5.4 ± 3.4 years. Results: The mean serum creatinine of our study population was 1.4 ± 1.53. Our study population included 2 patients with class I lesions, 5 with class II, 22 with Class III, 53 with Class IV, and 10 with Class V lesions. Our therapeutic approach included only oral steroids for class I and class II lesions; for class III, IV, and V lesions, our approach included pulse steroids followed by oral steroids with either intravenous (IV) monthly cyclophosphamide (CYC) or mycophenolate mofetil (MMF). For maintenance, azathioprine or MMF were used along with low-dose oral steroids after 6 months of CYC or MMF. In CYC induction group containing 78 patients (84.7%), 66 patients (84.6%) attained remission (CR + PR), relapse in five patients (6.4%), ESRD on HD in five patients (6.4%), and death in two patients (2.6%). Conclusion: At the end of the study, in all groups, 79 patients (85.86%) were in remission (CR + PR), six patients (6.5%) were in relapse, five patients (5.4%) had reached the ESKD stage on HD, and two patients (2.2%) died.

Clinicopathological profile and outcome of adult infection-related glomerulonephritis: A prospective follow-up study.

Background: . Infection-related glomerulonephritis (IRGN) in adults is witnessing a dramatic shift in its epidemiology and outcome. Adult IRGN studies are all retrospective in nature, and Indian studies are scarce. Methods: . We did this prospective study (September 2016-April 2018) on all patients with biopsy-proven IRGN and age ≥18 years satisfying three of five diagnostic criteria. Patients with persistent hypocomplementaemia (>3 months) were excluded. We did electron microscopy in those without a minimum of three diagnostic criteria and did an extensive search for any occult infection in every patient. Results: . Forty-five patients were studied with a mean (SD) follow-up of 45.7 (20) weeks. Their mean age was 41.5 years (18-70 years), with a female preponderance (1:1.25). At presentation, the majority had oedema (100%), oliguria (84.4%), hypertension (80%) and haematuria (77.8%). Of them, 86.7% had renal insufficiency and 35.6% required dialysis. Only 53.3% of them had evidence of antecedent/ current infection, with skin/subcutaneous focus being the most common site. Hypocomplementaemia was present in 82.2% of patients. Salient pathological features were endocapillary proliferation (93.3%), neutrophilic infiltration (88.9%), presence of crescents (17.8%), interstitial infiltration (24.4%), moderate-to-severe interstitial fibrosis with tubular atrophy (IFTA; 15.5%) and underlying diabetic glomerulosclerosis (8.9%). Only 66.7% of patients made complete renal recovery. By logistic regression analysis, the predictors of poor outcome were a requirement for dialysis at presentation (p=0.04) and presence of IFTA (p = 0.03). Conclusion: . A proportion of adult IRGN patients progress to chronic kidney disease.

Effects of aqueous extracts of garlic (Allium sativum) and neem (Azadirachta indica) leaf on hepatic and blood oxidant-antioxidant status during experimental gastric carcinogenesis.

The modifying effects of aqueous extracts of garlic and neem leaf during the pre-initiation and post-initiation phases of gastric carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine were investigated in male Wistar rats. The extent of lipid peroxidation and the status of phase II biotransformation enzymes such as glutathione peroxidase and glutathione-S-transferase that use reduced glutathione (GSH) as substrate were used to biomonitor the chemopreventive potential of these extracts. Enhanced lipid peroxidation in the liver and blood of tumor-bearing animals was accompanied by significant decreases in the activities of GSH-dependent antioxidants in the pre-initiation as well as in the post-initiation phases. Our results suggest that the modulatory effects of garlic and neem leaf on hepatic and blood oxidant-antioxidant status may play a key role in preventing cancer development at extrahepatic sites.

N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced in vivo clastogenicity: protective effects of aqueous neem leaf extract.

We evaluated the modifying effects of aqueous neem leaf extract on the in vivo clastogenicity of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), a potent gastric carcinogen by quantitation of micronuclei and chromosomal aberrations in metaphase cells from the bone marrow of male Wistar rats. Intraperitoneal injection of MNNG (40 mg/kg body weight) induced a significant increase in the frequency of micronuclei and chromosomal aberrations. Pretreatment with aqueous neem leaf extract (100 mg/kg body weight) significantly reduced MNNG-induced increase in micronuclei and chromosomal aberrations. These results reveal the chemoprotective potential of aqueous neem leaf extract against the clastogenic effects of MNNG.

Protection of N-methyl-N'-nitro-N-nitrosoguanidine-induced in vivo clastogenicity by aqueous garlic extract.

The modulatory effects of garlic extract on the in vivo clastogenicity of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), a carcinogenic nitrosamine, were evaluated by quantification of micronuclei and chromosomal aberrations in metaphase cells from the bone marrow of male Wistar rats. A single intraperitoneal injection of MNNG (40 mg/kg bodyweight) was found to be clastogenic as revealed by the increased frequency of micronucleated polychromatic erythrocytes and chromosomal aberrations. Pretreatment with aqueous garlic extract (250 mg/kg bodyweight) for 5 days significantly reduced the frequencies of MNNG-induced micronuclei and chromosomal aberrations. The results demonstrate that administration of garlic extract protects against the clastogenic effects of MNNG.

Garlic enhances circulatory antioxidants during 7, 12-dimethylbenz[a]anthracene-induced hamster buccal pouch carcinogenesis.

The protective effect of garlic (Allium sativum Linn.) on circulatory lipid peroxidation and antioxidants was investigated during 7,12-dimethylbenz[a]anthracene (DMBA)-induced hamster buccal pouch carcinogenesis in male Syrian hamsters. Enhanced lipid peroxidation in the circulation of tumour-bearing animals was accompanied by a significant decrease in the levels of ascorbic acid, vitamin E, reduced glutathione (GSH), glutathione peroxidase (GPx), superoxide dismutase (SOD) and catalase. Administration of garlic extract significantly decreased lipid peroxidation with simultaneous depletion of antioxidants. We speculate that garlic exerts its protective effects by decreasing circulatory lipid peroxides and enhancing antioxidants.

Garlic and neem leaf extracts enhance hepatic glutathione and glutathione dependent enzymes during N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced gastric carcinogenesis in rats.

The protective effect of garlic (Allium sativum L.) and neem leaf (Azadirachta indica A. Juss.) was investigated on hepatic lipid peroxidation and antioxidant status during N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced gastric carcinogenesis in male Wistar rats. Enhanced lipid peroxidation in the liver of tumour-bearing animals was accompanied by significant decreases in the activities of glutathione peroxidase (GPx), glutathione-S-transferase (GST), gamma-glutamyl transpeptidase (GGT) and reduced glutathione (GSH) levels. Administration of garlic and neem leaf extracts significantly lowered lipid peroxidation and enhanced the hepatic levels of glutathione and glutathione dependent enzymes. We speculate that garlic and neem leaf significantly alter cancer development at extrahepatic sites by influencing hepatic biotransformation enzymes and antioxidants.

Modulatory effects of garlic and neem leaf extracts on N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced oxidative stress in Wistar rats.

The effects of garlic and neem leaf extracts on lipid peroxidation and antioxidant status during administration of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), a carcinogenic nitrosamine were evaluated in male Wistar rats. Extracts of garlic and neem leaf were administered orally for five consecutive days before intraperitoneal injection of MNNG. Enhanced lipid peroxidation in the stomach, liver and circulation of MNNG-treated rats was accompanied by a significant decrease in glutathione (GSH) and the activities of glutathione peroxidase (GPx), glutathione-S-transferase (GST) and gamma glutamyl transpeptidase (GGT). Administration of garlic and neem leaf extracts significantly decreased the formation of lipid peroxides and enhanced the levels of antioxidants and detoxifying enzymes in stomach, the primary target organ for MNNG, as well as in the liver and circulation. The results of the present study suggest that garlic and neem may exert their protective effects by modulating lipid peroxidation and enhancing the levels of GSH and GSH-dependent enzymes.

Effects of garlic on 7,12-Dimethylbenz[a]anthracene-induced hamster buccal pouch carcinogenesis.

The inhibitory effect of garlic (Allium sativum Linn) on 7, 12-dimethylbenz[a]anthracene (DMBA)-induced buccal pouch carcinogenesis was investigated in male Syrian hamsters. Measurement of lipid peroxidation, reduced glutathione (GSH), glutathione peroxidase (GPx), and glutathione S-transferase (GST) was used to monitor the chemopreventive potential of garlic. All hamsters painted on their buccal pouches with DMBA alone for 14 weeks developed well-differentiated squamous cell carcinomas. Diminished lipid peroxidation in the oral tumor tissue was accompanied by a significant increase in the levels of GSH, GPx, and GST. Administration of 250 mg/kg body weight aqueous garlic extract three times a week for 14 weeks effectively suppressed DMBA-induced oral carcinogenesis as revealed by the reduced incidence of neoplasms. The results of the present study suggest that garlic may exert its chemopreventive effects by modulating lipid peroxidation and enhancing the levels of GSH, GPx, and GST.

Chemopreventive potential of neem (Azadirachta indica) on 7,12-dimethylbenz[a]anthracene (DMBA) induced hamster buccal pouch carcinogenesis.

The inhibitory effect of the aqueous extract of neem (Azadirachta indica A. Juss.) on 7,12-dimethylbenz[a]anthracene (DMBA) induced buccal pouch carcinogenesis was investigated in Syrian male hamsters. All hamsters painted on their buccal pouch with DMBA for 14 weeks developed squamous cell carcinoma. Administration of neem leaf extract effectively suppressed oral carcinogenesis initiated with DMBA as revealed by the reduced incidence of neoplasms. Lipid peroxidation, glutathione (GSH) content and the activities of glutathione peroxidase (GPx), glutathione S-transferase (GST) and gammaglutamyl transpeptidase (GGT) were used to biomonitor the chemopreventive potential of neem. Lipid peroxidation was found to be significantly decreased, whereas GSH, GPx, GST and GGT were elevated in the oral mucosa of tumour bearing animals. Our data suggest that neem may exert its chemopreventive effects in the oral mucosa by modulation of lipid peroxidation, antioxidants and detoxification systems.

Glycoconjugate profile in plasma and erythrocytes of gastric cancer patients.

The present study has examined the glycoconjugate profile in plasma and erythrocyte membranes of 24 adult male gastric cancer patients and an equal number of age and sex-matched controls. Protein-bound hexose, hexosamine and sialic acid were significantly increased in plasma and erythrocytes of gastric cancer patients compared to controls. Elevation of glycoconjugates in circulation is suggested to be a result of increased shedding by the tumor cells or increased synthesis by liver, due to acute phase response.

Erythrocyte lipid peroxidation and antioxidants in gastric cancer patients.

The present study has analysed the relationship between lipid peroxidation and antioxidant status in erythrocytes from 24 adult male gastric cancer patients and an equal number of age- and sex-matched normal subjects. Erythrocyte lipid peroxidation was markedly increased. Both enzymic and non-enzymic antioxidants were decreased in erythrocytes of gastric cancer patients. The present study highlights the occurrence of lipid peroxidation and possible breakdown of antioxidant status in patients with gastric carcinoma.