RESUMO
Background: Autoimmune tubulointerstitial nephritis (TIN) is characterized by immune-mediated tubular injury and requires immunosuppressive therapy. However, diagnosing TIN and assessing therapeutic response are challenging for clinicians due to the lack of useful biomarkers. Pathologically, CD4+ T cells infiltrate to renal tubulointerstitium, and soluble interleukin-2 receptor (sIL-2R) has been widely known as a serological marker of activated T cell. Here, we explored the usefulness of serum sIL-2R to predict the treatment outcome in patients with autoimmune TIN. Methods: Study Design: Single-center retrospective observational study. Participants: 62 patients were diagnosed of TIN from 2005 to April 2018 at Hokkaido University Hospital. Among them, 30 patients were diagnosed with autoimmune TIN and treated with corticosteroids. We analyzed the association between baseline characteristics including sIL-2R and the change of estimated glomerular filtration rate (eGFR) after initiation of corticosteroids. Results: The serum sIL-2R level in patients with autoimmune TIN was significantly higher than that in chronic kidney disease patients with other causes. Mean eGFR in autoimmune TIN patients treated with corticosteroids increased from 43.3 ± 20.4 mL/min/1.73 m2 (baseline) to 50.7 ± 19.9 mL/min/1.73 m2 (3 months) (ΔeGFR; 22.8 ± 26.0%). Multivariate analysis revealed that higher sIL-2R (per 100 U/mL, ß = 1.102, P < 0.001) level was independently associated with the renal recovery. In ROC analysis, sIL-2R had the best area under the curve value (0.805) and the cutoff point was 1182 U/mL (sensitivity = 0.90, 1-specificity = 0.45). Conclusions: Our study showed that elevated serum sIL-2R levels might become a potential predictive marker for therapeutic response in autoimmune TIN.
RESUMO
A nanometer sized solid solution of NiO and Al2O3 was synthesized by calcination of Ni-Al layered double hydroxides (LDHs). The crystal structure of the obtained compound was determined by XRD and XAFS analyses: Ni2+ and Al3+ ions are located at the metal ion site of the rock salt structure and a certain amount of cation vacancies are also introduced for charge compensation. The electrochemical properties of the Ni-Al binary metal oxide as an anode material for lithium ion batteries were examined by the constant current charge-discharge test. Ni-Al oxide showed higher charging capacity in comparison with pristine NiO. In particular, the capacity in the lower voltage region (below 1.5 V), the limited capacity in this region is the weak point of the conversion anode, was improved to 540 mA h g-1 that is about twice that of pristine NiO. This improvement in the capacity in the lower voltage region is concluded to be due to the redox activity of Al3+ ions during the charge-discharge on the basis of the results of electrochemical measurements and ex situ XAFS measurements at the Ni and Al edge. The reaction mechanism of this compound is investigated using ex situ XRD and XAFS methods. For the charge (reduction) in the higher voltage region (OCV-1.0 V), lithium ion intercalation into the cation vacancy sites and/or lithium ion adsorption on the surface of particles are proceeding. For the charge in the lower voltage region (1.0-0.03 V), conversion reaction occurs by the reduction of Ni2+ and Al3+ ions to metal particles with surface electrolyte interface (SEI) layer formation. For the discharge in the lower voltage region (0.03-1.5 V), only Al metal particles are oxidized to Al3+ ions and some intermediate complexes are formed. For the discharge in the higher voltage region (1.5-3.0 V), the lattice of the Ni-Al binary oxide solid solution is reconstructed with the oxidation of Ni to Ni2+.
