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Few studies have reported the application of vacuum-sealing drainage of infected dialysis vascular access wounds. Herein, we present a case of buttonhole-related arteriovenous fistula infection treated with vacuum-sealing drainage. A 53-year-old female hemodialysis patient was hospitalized with an inflamed arteriovenous fistula. The patient underwent non-tunneled catheterization for dialysis and was treated with moxifloxacin and vancomycin for staphylococcal infection. On Day 3, the skin overlying the inflamed fistula was ulcerated, resulting in severe hemorrhage. Emergency surgery was performed along with vacuum-sealing drainage for fistula reconstruction. Vacuum-sealing drainage accelerated the recovery of the wound without complications. No further access complications occurred during over a 3-year follow-up.
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BACKGROUND: IgA nephropathy (IgAN) is the most common cause of primary glomerulonephritis, with complex pathogenic mechanisms involving abnormal B-cell activation. As a novel biologic agent, telitacicept inhibits both B-lymphocyte stimulating factor and a proliferation-inducing ligand. It also inhibits both B cells and plasma cells and the production of galactose-deficient IgA1 (Gd-IgA1) and its autoantibodies, thus exerting an immunosuppressive effect. Women with IgAN are at a higher risk of adverse pregnancy outcomes such as preeclampsia and miscarriage, especially those with uncontrolled massive proteinuria and advanced chronic kidney disease. Therefore, IgAN disease control before and during pregnancy is essential. Here, we report the case of a woman with IgAN who had a successful pregnancy with significant improvement and long-term remission after treatment with telitacicept. This is the first report of a pregnancy following exposure to telitacicept. CONCLUSION: This report describes the efficacy of telitacicept in patients with IgAN and explores its value in women of childbearing age, suggesting effective and safe treatment options for women who wish to conceive.
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Glomerulonefrite por IGA , Complicações na Gravidez , Humanos , Feminino , Glomerulonefrite por IGA/tratamento farmacológico , Glomerulonefrite por IGA/complicações , Gravidez , Adulto , Complicações na Gravidez/tratamento farmacológico , Resultado da GravidezRESUMO
A series of conjugated polymers bearing thiophene-based donors and pyromellitic diimide (PMDI) acceptor were prepared, and their electrochromic (EC) properties were studied via using fabricated thin-film EC devices. It was observed that structurally regular alternating polymers with fewer (1 and 2) thiophene donors do not exhibit any EC properties while increasing the number of donors eventually led to the emergence of orange-red-to-green colour switching. On this basis, two more random co-polymers containing higher donor-to-acceptor ratios were synthesized to further improve EC switching properties. The two polymers, which bear a PMDI-to-thiophene ratio of ca. 1 : 7 and 1 : 8, revealed orange red-to-blue colour switching and generally improved optical contrasts and switching speeds in both the visible and near infra-red (NIR) region. In addition, the subtle modulation of polymer colour and hue via variation of the number of thiophene donors was evident through colorimetric study. This work therefore demonstrates the potential and possibility of using the PMDI acceptor unit to construct EC-active conjugated polymers, and considerations for future tuning of colour and switching performances.
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OBJECTIVE: Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease (CKD). Hungry bone syndrome (HBS) after parathyroidectomy (PTX) is a serious complication, which can lead to diarrhea, convulsion, arrhythmia and even death. This study was aimed to determine the risk factors for HBS after PTX in dialysis patients with SHPT and construct a nomogram prediction model to predict the incidence of postoperative complications. METHODS: Clinical data were collected from 80 maintenance hemodialysis (MHD) patients with SHPT who received total PTX in the Second Hospital of Jilin University from January 2018 to September 2021. In line with the inclusion and exclusion criteria, totally 75 patients were finally enrolled for analysis. Patients were divided into two groups for retrospective analysis according to the severity of postoperative HBS, including HBS group and non-HBS (N-HBS) group. Univariate and multivariate logistic regression analyses were conducted to determine the risk factors for postoperative HBS. Afterwards, the receiver operating characteristic (ROC) curves were plotted based on the statistical analysis results, aiming to compare the prediction effects of different predicting factors. Finally, the nomogram was established to evaluate the occurrence probability of postoperative complications predicted by the risk factors. RESULTS: Among the 75 patients, 32 had HBS (HBS group), while 43 did not have HBS (N-HBS group). Univariate analysis results indicated that, the preoperative intact parathyroid hormone (iPTH) and serum alkaline phosphatase (ALP) levels in HBS group were significantly higher than those in N-HBS group, while preoperative hemoglobin and preoperative albumin (Alb) levels were significantly lower than those in N-HBS group. As discovered by multivariate logistic regression analysis, preoperative iPTH (OR = 1.111, P = 0.029) and ALP (OR = 1.010, P < 0.001) were the independent risk factors for postoperative HBS. ROC curve analysis suggested that the area under the curve (AUC) values of these two indicators were 0.873 and 0.926, respectively (P < 0.0001). Subsequently, the nomogram model for predicting HBS was constructed. The model verification results indicated that the predicted values were basically consistent with the measured values, with the C-index of 0.943 (95% CI 0.892-0.994). Besides, the calibration curve was consistent with the ideal curve, demonstrating the favorable accuracy and discrimination of the model. CONCLUSIONS: Preoperative iPTH and preoperative ALP are the risk factors for postoperative HBS, which can be used to guide the early clinical intervention.
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Doenças Ósseas Metabólicas , Hiperparatireoidismo Secundário , Hipocalcemia , Humanos , Paratireoidectomia/efeitos adversos , Paratireoidectomia/métodos , Diálise Renal/efeitos adversos , Estudos Retrospectivos , Nomogramas , Hipocalcemia/epidemiologia , Hipocalcemia/etiologia , Hipocalcemia/cirurgia , Hiperparatireoidismo Secundário/etiologia , Hiperparatireoidismo Secundário/cirurgia , Hormônio Paratireóideo , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgiaRESUMO
BACKGROUND: Elabela, a recently discovered hormonal peptide containing 32 amino acids, is a ligand for the apelin receptor. It can lower blood pressure and attenuate renal fibrosis. However, the clinicopathological relationship between Elabela level and renal damage caused by benign hypertension (BHT) and malignant hypertension (MHT) has not been elucidated. Therefore, we investigated the clinicopathological correlation between serum Elabela level and renal damage caused by BHT and MHT. METHODS: The participants comprised 50 patients and 25 age-matched healthy adults. The 50 patients were separated into two groups: MHT (n = 25) and BHT groups (n = 25). We analyzed their medical histories, demographics, and clinical examinations, including physical and laboratory tests. RESULTS: The results showed that serum Elabela level decreased gradually with a continuous increase in blood pressure from the healthy control group, BHT, to MHT. Moreover, Elabela levels negatively correlated with BMI (R = - 0.27, P = 0.02), SBP (r = - 0.64, P < 0.01), DBP (r = - 0.58, P < 0.01), uric acid (r = - 0.39, P < 0.01), bun (r = - 0.53, P < 0.01), and Scr (r = - 0.53 P < 0.01) but positively correlated with eGFR (r = 0.54, P < 0.01). Stepwise multivariate linear regression analysis showed that SBP was the variable most related to Elabela (t = - 5.592, P < 0.01). CONCLUSIONS: Serum Elabela levels decreased in patients with hypertension, especially malignant hypertension, and has the potential to be a marker of hypertension-related kidney damage.
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Hipertensão Maligna , Hipertensão , Adulto , Humanos , Rim , Pressão Sanguínea , Análise MultivariadaRESUMO
IgA nephropathy (IgAN) is the most common primary glomerular disease in the world, and up to 40% of patients with IgAN develop end-stage renal disease (ESRD). At present, an increasing amount of evidence indicates that the pathogenesis of IgAN is related to autoimmunity. In recent years, several studies have shown that B cell activating factors (BAFF), also known as B lymphocyte stimulators (BLyS), and proliferation-inducing ligand APRIL are extremely important for the activation of autoimmune signalling pathways, which have become key targets for the treatment of IgAN. As a dual-target biological agent, telitacicept can inhibit both BLyS and APRIL cytokines, improve the function of renal immune complexes, and reduce haematuria and proteinuria, which play important roles in IgAN pathogenesis and long-term prognosis. This article reviews the role of telitacicept in IgA nephropathy and discusses its potential for use in the treatment of IgAN and other autoimmune diseases where pathogenesis is driven by B cells.
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Doenças Autoimunes , Glomerulonefrite por IGA , Humanos , Glomerulonefrite por IGA/tratamento farmacológico , Rim , Glomérulos RenaisRESUMO
Supercritical CO2 (scCO2) extrusion foamed high-melt-strength (HMS) polypropylene (PP) often suffers from low cell density, large cell sizes, and poor cell structure uniformity due to the poor nucleation rates of CO2 in the PP. To remedy this, various inorganic fillers have been used as heterogeneous nucleation agents. Although their efficient nucleation effects have been demonstrated, the preparation of these fillers causes some adverse effects on the environment/human health or involves relatively expensive processes or non-eco-friendly chemicals. In this work, biomass-based lignin is studied as a sustainable, lightweight, and cost-effective nucleating agent. It is found that scCO2 could assist in situ dispersion of lignin in the PP in the foaming process, leading to significantly increased cell density, smaller cells, and improved cell uniformity. The Expansion Ratio is also simultaneously improved due to reduced diffusive gas loss. The PP/lignin foams with low lignin loadings exhibit higher compression moduli and plateau strengths than the PP foams with the same densities owing to the improved cell uniformity and probably also the reinforcing effect of the small lignin particles in cell walls. Moreover, the energy absorption capability of the PP/lignin foam with 1 wt% lignin could match the PP foam with similar compression plateau strengths; even the density of the former is 28% lower than the latter. Therefore, this work provides a promising approach to a cleaner and more sustainable production of HMS PP foams.
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Ultralight and highly flexible aerogel sensors, composed of reduced graphene oxide cross-linked by sustainable-macromolecule-derived carbon, are prepared via facile freeze-drying and thermal annealing. The synergistic combination of cross-linked graphene nanosheets and micrometer-sized honeycomb pores gives rise to the exceptional properties of the aerogels, including superior compressibility and resilience, good mechanical strength and durability, satisfactory fire-resistance, and outstanding electromechanical sensing performances. The corresponding aerogel sensors, operated at an ultralow voltage of 0.2 V, can efficiently respond to a wide range of strains (0.1-80%) and pressures (13-2750 Pa) even at temperatures beyond 300 °C. Moreover, the ultrahigh-pressure sensitivity of 10 kPa-1 and excellent sensing stability and durability are accomplished. Strikingly, the aerogel sensors can also sense the vibration signals with ultrahigh frequencies of up to 4000 Hz for >1 000 000 cycles, significantly outperforming those of other sensors. These enable successful demonstration of the exceptional performance of the cross-linked graphene-based biomimetic aerogels for sensitive monitoring of mechanical signals, e.g., acting as wearable devices for monitoring human motions, and for nondestructive monitoring of cracks on engineering structures, showing the great potential of the aerogel sensors as next-generation electronics.
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Grafite , Dispositivos Eletrônicos Vestíveis , Carbono/química , Eletrônica , Grafite/química , Humanos , VibraçãoRESUMO
Lupus nephritis (LN) is a significant cause of various acute and chronic renal diseases, which can eventually lead to end-stage renal disease. The pathogenic mechanisms of LN are characterized by abnormal activation of the immune responses, increased cytokine production, and dysregulation of inflammatory signaling pathways. LN treatment is an important issue in the prevention and treatment of systemic lupus erythematosus. Mesenchymal stem cells (MSCs) have the advantages of immunomodulation, anti-inflammation, and anti-proliferation. These unique properties make MSCs a strong candidate for cell therapy of autoimmune diseases. MSCs can suppress the proliferation of innate and adaptive immune cells, such as natural killer cells (NKs), dendritic cells (DCs), T cells, and B cells. Furthermore, MSCs suppress the functions of various immune cells, such as the cytotoxicity of T cells and NKs, maturation and antibody secretion of B cells, maturation and antigen presentation of DCs, and inhibition of cytokine secretion, such as interleukins (ILs), tumor necrosis factor (TNF), and interferons (IFNs) by a variety of immune cells. MSCs can exert immunomodulatory effects in LN through these immune functions to suppress autoimmunity, improve renal pathology, and restore kidney function in lupus mice and LN patients. Herein, we review the role of immune cells and cytokines in the pathogenesis of LN and the mechanisms involved, as well as the progress of research on the immunomodulatory role of MSCs in LN.
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Nefrite Lúpica , Células-Tronco Mesenquimais , Animais , Citocinas/metabolismo , Humanos , Imunidade , Imunomodulação , Células-Tronco Mesenquimais/metabolismo , CamundongosRESUMO
Membrane-less scenarios that involve liquid-liquid phase separation (coacervation) provide clues for how protocells might emerge. Here, we report a versatile approach to construct coacervates by mixing fatty acid with biomolecule dopamine as the protocell model. The coacervate droplets are easily formed over a wide range of concentrations. The solutes with different interaction characteristics, including cationic, anionic, and hydrophobic dyes, can be well concentrated within the coacervates. In addition, reversible self-assemblies of the coacervates can be controlled by concentration, pH, temperature, salinity, and bioreaction realizing cycles between compartmentalization and noncompartmentalization. Through in situ dopamine polymerization, the stability of coacervate droplets is significantly improved, leading to higher resistance toward external factors. Therefore, the coacervates based on fatty acid and dopamine could serve as a bottom-up membrane-less protocell model that provides the links between the simple (small molecule) and complex (macromolecule) systems in the process of cell evolution.
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Células Artificiais , Células Artificiais/química , Dopamina , Ácidos Graxos , Interações Hidrofóbicas e Hidrofílicas , Substâncias MacromolecularesRESUMO
Psoriasis is a systemic inflammatory disease that is associated with increased risk of several diseases, such as psoriatic arthritis (PsA), inflammatory bowel disease, and cardiovascular diseases. About 20 to 30% patients with psoriasis subsequently develop PsA. IgA nephropathy is the most common primary glomerular disease world-wide. Psoriasis and IgA nephropathy appear to be associated, but the mechanism underlying this connection is unclear. Tofacitinib and leflunomide are common treatments for psoriatic arthritis. We administered tofacitinib combined with leflunomide to a 38-year-old female patient who presented with PsA and IgA nephropathy. After treatment, she experienced significant reductions in the psoriatic lesions, pain in the right knee joint, and proteinuria. Administration of tofacitinib combined with leflunomide for treatment of a patient who had PsA complicated with IgA nephropathy led to significant resolution of the symptoms of both conditions. These results suggest similarities in the pathogenesis of PsA and IgA nephropathy and a possible new treatment for IgA nephropathy.
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Artrite Psoriásica , Glomerulonefrite por IGA , Psoríase , Adulto , Artrite Psoriásica/complicações , Artrite Psoriásica/tratamento farmacológico , Feminino , Glomerulonefrite por IGA/complicações , Glomerulonefrite por IGA/tratamento farmacológico , Humanos , Leflunomida/uso terapêutico , Piperidinas , PirimidinasRESUMO
HYPOTHESIS: Supramolecular self-assemblies involving non-covalent interactions play important roles in material science as well as living systems as they result in unique properties and/or functions. However, understanding of their self-assembly mechanism and crystallization has remained rudimentary. EXPERIMENT: Here, we focus on biomolecular fatty acid and dopamine, which commonly exist in biological systems and closely related to neurodegenerative diseases, and investigate their self-assembly pathway by optical and fluorescence microscopy, DLS, SAXS, TEM, 2D-NMR, etc. FINDINGS: It is found that they could form the crystalline plates in solution or via a metastable liquid - liquid phase separation (LLPS). The nucleation and growth of crystalline plates observed occurs in solution or the dilute phase of LLPS, and not within the concentrated coacervate phase. This is because in coacervate, dopamine intercalates into fatty acid through hydrophobic and electrostatic interaction, which hinders the rearrangement of molecules and nucleation process, whereas in solution or dilute phase, they have the mobility to arrange into ordered structures to maximize electrostatic, hydrogen bonding and π-π interactions, leading to nucleation and crystallization. Moreover, the transitions between the coacervates and crystalline phase can be realized by adjusting the temperature. Our results shed light on the multistep nucleation in the presence of LLPS, as well as molecular mechanisms involved, thus further extending the nucleation-growth mechanisms.
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Dopamina , Cristalização , Ácidos Decanoicos , Espalhamento a Baixo Ângulo , Difração de Raios XRESUMO
Enhancing the deposition of fragrance delivery systems contained in personal care products on target surfaces is crucial for increasing the longevity of scent, efficiently utilizing expensive functional compounds and limiting the generation of microplastics in domestic waste water. In this work, we designed and synthesized a new type of biomimetic macromolecules, chitosan-graft-L-lysine-L-DOPA (C-L-D), as a versatile biodegradable adhesion promoter to facilitate the deposition of biodegradable fragrance carriers on diverse surfaces including hair, cotton and skin. The C-L-D has hyperbranched chain architecture with many oligopeptide adhesive tentacles, each being a simple mimic of mussel adhesive proteins. It also exhibits unique amphiphilic characteristic. As a result, it could be facilely anchored on cargo-loaded poly(lactic-co-glycolic acid) nanoparticle surface via self-assembly in the particle preparation process. The C-L-D-modified nanoparticles show significantly higher deposition efficiencies than polyvinyl alcohol- and chitosan-coated particles when deposited on the target surfaces in different aqueous media as the lysine and DOPA units are capable of providing multi-noncovalent interactions, including electrostatic, polar, hydrophobic interactions, and bidentate hydrogen bonds, with the target surfaces, and possibly also inducing oxidative cross-linking. A much higher retention rate of the C-L-D-modified nanoparticles on cotton surface is also observed after washing with a soap solution, which could be attributed to the significant role played by bidentate hydrogen bonds. These findings suggest that C-L-D is a versatile biodegradable adhesion promoter and has the potential to be applied for various personal care applications and beyond.
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Bivalves , Cosméticos , Adesivos , Animais , Microplásticos , Plásticos , PolímerosRESUMO
INTRODUCTION: Renal ischemia/reperfusion injury (IRI) is the most common cause of acute kidney injury (AKI), and patients with AKI have a high rate of mortality. Apelin is a therapeutic candidate for treatment of IRI and Elabela (ELA) is a recently discovered hormone that also activates the apelin receptor (APJ). We examined the use of ELA as a preventive treatment for IRI using in vitro and in vivo models. METHODS: Male mice were subjected to renal IRI, with or without administration of a stabilized form of ELA (Fc-ELA-21) for 4 days. Renal tubular lesions were measured using H&E staining, reactive oxygen species (ROS) were measured using a dihydroethidium stain assay, and renal cell apoptosis was measured using the TUNEL assay and flow cytometry. Immortalized human proximal tubular epithelial (HK-2) cells were pretreated with or without LY294002 and/or ELA-32, maintained at normoxic or hypoxic conditions, and then returned to normal culture conditions to mimic IRI. Cell apoptosis was determined using the TUNEL assay and cell proliferation was determined using the MTT assay. The levels of Akt, p-Akt, ERK1/2, p- ERK1/2, Bcl-2, Bax, caspase-3 and cleaved caspase-3 were measured using western blotting. RESULTS: Fc-ELA-21 administration reduced renal tissue damage, ROS production, and apoptosis in mice that had renal IRI. ELA-32 reduced HK-2 cell apoptosis and restored the proliferation of cells subjected to IRI. Akt phosphorylation had a role in the anti-apoptotic effect of ELA. CONCLUSION: This study of in vitro and in vivo models of IRI indicated that the preventive and anti-apoptotic effects of ELA were mediated via the PI3K/Akt signaling pathway.
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Injúria Renal Aguda/tratamento farmacológico , Apoptose/efeitos dos fármacos , Hormônios Peptídicos/farmacologia , Traumatismo por Reperfusão/tratamento farmacológico , Injúria Renal Aguda/patologia , Animais , Apoptose/fisiologia , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Meia-Vida , Humanos , Túbulos Renais/citologia , Masculino , Camundongos Endogâmicos C57BL , Hormônios Peptídicos/química , Hormônios Peptídicos/metabolismo , Hormônios Peptídicos/farmacocinética , Fosfatidilinositol 3-Quinases/metabolismo , Fosforilação , Proteínas Proto-Oncogênicas c-akt/metabolismo , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/patologiaRESUMO
Bio-based and biodegradable polymer composites, most notably poly(l-lactic acid) (PLLA) and poly(3-hydroxybutyrate) (PHB), represent a promising solution to replace conventional petroleum-based plastics. However, the brittleness and low miscibility of PLLA and PHB remain two major obstacles to practical applications. In this work, first PLLA/PHB blends are reported by melt mixing with a rigid component, poly(methyl methacrylate) (PMMA). Driven by favorable entropy, PMMA forms an interfacial nanolayer, which transforms the morphology of resultant blends. The ternary blends show 55-fold increase in elongation, 50-fold in toughness, and metal-like malleability (≈180° bending and twisting), while retaining its high stiffness (3.4 GPa) and strength (≈50 MPa). The mechanical improvement arises from numerous craze fibrils and shear deformation of the matrix, induced by the incorporated PMMA. Furthermore, this generic strategy can be applied to design other mechanically robust biocomposites for advanced green devices.
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Poliésteres , Polímeros , Polimetil MetacrilatoRESUMO
PURPOSE: To investigate the clinical and pathological characteristics of lupus nephritis (LN) patients with serositis and analyse the relationship between serositis and hyperuricemia (HUA) in LN patients in northeast China. METHODS: The data of patients with LN diagnosed by renal biopsy in our hospital from April 2013 to May 2020 were retrospectively analyzed. The differences between the non-serositis and serositis groups were compared by t tests and Chi-square test. Factors with P < 0.05 in the univariate analyses were investigated further using binary logistic regression analysis to investigate the independent risk factors of serositis in patients with LN. RESULTS: LN patients with serositis were more likely to have fever, hypertension, neuropsychiatric and hematological involvement than those without serositis (P < 0.05). Compared with the non-serositis group, LN patients with serositis were prone to have HUA, high D-dimer, high triglycerides, and had significant differences in the levels of plasma albumin (Alb), estimated glomerular filtration rate (eGFR), erythrocyte sedimentation rate, C-reactive protein, complement C3, 24-h urinary protein, pathological types, pathological score and SLEDAI score. Logistic regression analysis showed that HUA was one of risk factors for serositis in LN patients. The rate of complete remission in LN patients with serositis was significantly lower (P < 0.05) and the rate of no remission and mortality were significantly higher (P < 0.05) than LN patients without serositis. CONCLUSION: LN patients with serositis had more severe clinical and pathological manifestations, higher systemic lupus erythematosus (SLE) activity and worse prognosis. Hyperuricemia is associated with serositis in LN patients.
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Hiperuricemia/complicações , Nefrite Lúpica/complicações , Serosite/complicações , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: There are arguments for individualized treatments and the necessity of non-invasive biomarkers for patients with IgA nephropathy (IgAN) according to gender, but the rationale remains unclear. We aimed to investigate the relationship between urine exosomal circular RNA (circRNA) levels, related genes, clinical features, and renal pathological features in IgA nephropathy patients of different genders. METHODS: Clinicopathological data from patients of different genders from a multicenter cohort were retrospectively analyzed. We used the Oxford classification to examine the severity of pathological damage in these patients. We compared clinical features and renal pathologies between IgAN patients of different genders. Using findings of urine exosomal circRNAs from male IgAN patients, we analyzed the relationship between this factor, the regulated genes located on the sex chromosomes, and renal pathologies. RESULTS: A total of 502 IgAN patients were included. The proportion of male patients with crescent formation was higher than that of females (p = 0.019). Multivariate logistic regression analysis showed that proteinuria was an independent marker for crescent formation in male and female patients with IgAN, while smoking and higher low-density lipoprotein cholesterol (LDL-C) levels were independent risk factors for crescent formation in males alone. Urine exosomal circRNA chrY:15478147-15481229- located on the Y chromosome in male patients was negatively correlated with the expressions of UTY in specific regions of the Y chromosome. CONCLUSION: Compared with female patients, males with IgAN had more severe renal dysfunction and a higher probability of glomerular crescent formation. Urine exosomal circRNA chrY:15478147-15481229- might participate in the pathogenesis of IgAN in male patients by altering UTY expressions.
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Glomerulonefrite por IGA , Biomarcadores/metabolismo , Feminino , Glomerulonefrite por IGA/diagnóstico , Glomerulonefrite por IGA/genética , Glomerulonefrite por IGA/metabolismo , Humanos , Masculino , Proteinúria , RNA Circular , Estudos Retrospectivos , Cromossomos Sexuais/metabolismo , Cromossomos Sexuais/patologiaRESUMO
Elabela, also known as Toddler or Apela, is a recently discovered hormonal peptide containing 32 amino acids. Elabela is a ligand of the apelin receptor (APJ). APJ is a G protein-coupled receptor widely expressed throughout body, and together with its cognate ligand, apelin, it plays an important role in various physiological processes including cardiovascular functions, angiogenesis and fluid homeostasis. Elabela also participates in embryonic development and pathophysiological processes in adulthood. Elabela is highly expressed in undifferentiated embryonic stem cells and regulates endoderm differentiation and cardiovascular system development. During differentiation, Elabela is highly expressed in pluripotent stem cells and in adult renal collecting ducts and loops, where it functions to maintain water and sodium homeostasis. Other studies have also shown that Elabela plays a crucial role in the pathogenesis of kidney diseases. This review addresses the role of Elabela in kidney diseases including renal ischemia/reperfusion injury, hypertensive nephropathy, diabetic nephropathy, and cardiorenal syndrome.
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Nefropatias/etiologia , Hormônios Peptídicos/fisiologia , HumanosRESUMO
The present study aimed to detect the levels of microRNA (miR)-33a-5p in the renal tissue, serum and urine of patients with primary IgA nephropathy (IgAN), thereby preliminarily exploring the association between the levels of miR-33a-5p and the condition of primary IgAN to provide evidence for the expression of miR-33a-5p in the serum and urine of IgAN patients as a clinical marker. Reverse-transcription quantitative PCR was performed to evaluate the level of miR-33a-5p in IgAN patients according to severity and pathological classification. The results suggested that the levels of miR-33a-5p in the serum, urine and kidney tissues of patients with IgAN were lower than those of the control tissues obtained from cancer patients (0.28±0.25 vs. 1.00±0.45, P<0.05; 0.34±0.28 vs. 1.00±0.53, P<0.05; 0.47±0.27 vs. 1.00±0.38, P<0.05, respectively). Receiver operating characteristic curve analysis suggested that the serum and urine levels of miR-33a-5p may be used as a marker to differentiate renal injury in IgAN patients from healthy individuals. At the same time, according to the estimated glomerular filtration rate (eGFR) and Lee classification of nephropathy, it was determined that with the progression of renal failure and the increase of the pathological grade of kidney tissue, the relative level of miR-33a-5p in kidney tissue also decreased (eGFR <50 ml/min vs. eGFR ≥50 ml/min/1.73 m2 group: 0.38±0.27 vs. 1.00±0.34, P<0.001; Lee grade ≤3 group vs. Lee grade >3: 1.00±0.48 vs. 0.38±0.45, P<0.05). This result suggested that the levels of miR-33a-5p in serum, urine and kidney tissues decreased with the severity of renal injury and the progression of renal failure in patients with IgAN. Hence, miR-33a-5p detected in the serum and urine may be used as a non-invasive biomarker to reflect the progression of renal injury and renal failure in patients with IgAN.
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AIMS: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease to cause end-stage kidney disease. This study investigated the difference in urinary exosomal circular RNA (circRNA) expression profiles between patients with IgAN and healthy controls (HCs), for better understanding of gene regulation in exosomes of IgAN patients. METHODS: A pairwise comparison of urinary circRNA expression profiles between IgAN patients and HCs was performed using methods, including high-throughput sequencing and quantitative polymerase chain reaction. Moreover, the potential functions of differentially expressed circRNAs (DECs) in IgAN were investigated by gene ontology (GO) enrichment analysis; Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis; and the circRNA-miRNA-mRNA network. RESULTS: We identified 450 upregulated and 26 downregulated circRNAs in the IgAN patients. GO analysis showed that these enriched circRNAs might regulate primary miRNA processing, the ability of angiotensin receptor binding, and stress fibre function. KEGG analysis suggested these DECs may be closely associated with the phosphoinositide-3-kinase-protein kinase B/Akt (PI3K-Akt) signalling pathways. Network analysis revealed the relationship between circRNAs and their target genes. CONCLUSION: The identified DECs may be useful for both researches on molecular aetiology of IgAN and development of potentially novel non-invasive biomarkers of IgAN.