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2.
J Med Internet Res ; 21(12): e14204, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31821152

RESUMO

BACKGROUND: The rise in the number of patients with chronic kidney disease (CKD) and consequent end-stage renal disease necessitating renal replacement therapy has placed a significant strain on health care. The rate of progression of CKD is influenced by both modifiable and unmodifiable risk factors. Identification of modifiable risk factors, such as lifestyle choices, is vital in informing strategies toward renoprotection. Modification of unhealthy lifestyle choices lessens the risk of CKD progression and associated comorbidities, although the lifestyle risk factors and modification strategies may vary with different comorbidities (eg, diabetes, hypertension). However, there are limited studies on suitable lifestyle interventions for CKD patients with comorbidities. OBJECTIVE: The objectives of our study are to (1) identify the lifestyle risk factors for CKD with common comorbid chronic conditions using a US nationwide survey in combination with literature mining, and (2) demonstrate the potential effectiveness of association rule mining (ARM) analysis for the aforementioned task, which can be generalized for similar tasks associated with noncommunicable diseases (NCDs). METHODS: We applied ARM to identify lifestyle risk factors for CKD progression with comorbidities (cardiovascular disease, chronic pulmonary disease, rheumatoid arthritis, diabetes, and cancer) using questionnaire data for 450,000 participants collected from the Behavioral Risk Factor Surveillance System (BRFSS) 2017. The BRFSS is a Web-based resource, which includes demographic information, chronic health conditions, fruit and vegetable consumption, and sugar- or salt-related behavior. To enrich the BRFSS questionnaire, the Semantic MEDLINE Database was also mined to identify lifestyle risk factors. RESULTS: The results suggest that lifestyle modification for CKD varies among different comorbidities. For example, the lifestyle modification of CKD with cardiovascular disease needs to focus on increasing aerobic capacity by improving muscle strength or functional ability. For CKD patients with chronic pulmonary disease or rheumatoid arthritis, lifestyle modification should be high dietary fiber intake and participation in moderate-intensity exercise. Meanwhile, the management of CKD patients with diabetes focuses on exercise and weight loss predominantly. CONCLUSIONS: We have demonstrated the use of ARM to identify lifestyle risk factors for CKD with common comorbid chronic conditions using data from BRFSS 2017. Our methods can be generalized to advance chronic disease management with more focused and optimized lifestyle modification of NCDs.

3.
Clin Lab ; 65(10)2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31625369

RESUMO

BACKGROUND: Our multicenter clinical trial study for stage 4 chronic kidney disease (CKD) populations was conducted at 21 centers in China during the period 2011 to 2016. The CKD definition is based on glomerular filtration rate (GFR) values which can be estimated by creatinine-based predictive formulas. The validity and reliability of GFR estimation is thus largely dependent on the accurate and precise serum creatinine (SCr) measurements. As an integral part of this multicenter study, it is important to ensure the precision, accuracy, and center-to-center comparability of the SCr results. METHODS: Prior to initiating the study, we unified the measurement method of SCr determination as an enzymatic method and standardized the procedure in all of the laboratories. Then, the analytical performance of each analyzer at each laboratory was evaluated, including precision, accuracy, and comparability. RESULTS: All within-run and total CVs of the low and high level internal quality control (IQC) were comprised between 0.2% and 4.1% (< 1/3 CLIA'88). Total error of the IQC fall within the maximum 12% at all centers. The analytical bias against the Standard Reference material 967a target was less than ± 0.5% at Central Laboratory, indicating good accuracy. Correlation between the analyzers and the reference method were very high (r > 0.99). Passing-Bablok regression showed no significant deviation from linearity (p > 0.05). Bland-Altman analysis also showed good agreement (≥ 95% of results fell within the 95% limits of agreement). CONCLUSIONS: Performance evaluation helped in addressing preanalytical variations in measurement and gave op-timal quality assurance of laboratory measurement in the context of a multicenter clinical trial study.

4.
Patient Prefer Adherence ; 13: 1487-1495, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31507316

RESUMO

Objective: The self-reported scale is a widely used method to assess patients' medication adherence in clinical practice, but there is still a lack of medicine adherence measurement scale for patients with Chronic Kidney Disease (CKD). Therefore, this study aimed to develop a medication adherence measurement scale of traditional Chinese medicine and Western medicine, providing a tool for evaluating medicine adherence of CKD patients. Methods: In the preliminary stage, we formed the prediction scale after three rounds Delphi method and it was filled by 20 patients, who were selected randomly. After pre-investigation and language adaption, we adjusted the prediction measurement scale which included 31 items based on Knowledge-Attitude-Belief Theory. Then, 222 CKD patients in Guangdong Hospital of traditional Chinese Medicine were investigated by this 31-item scale. We screened 31 items by Items analysis theory, including critical ratio, item correlation analysis, internal consistency analysis, principal component analysis and other methods. The left 26 items made up a formal scale. We collected and analyzed data of the 26-item scale and Chinese version of MGL scale, and took their scores correlation analysis as the criterion validity of the 26-item scale. At the same time, we evaluated content validity, Cronbach alpha coefficient and retest reliability of the 26-item scale. Results: We developed a scale with 26 items and 5 dimensions finally. In the validation analysis, the scale had good construct validity and content validity. The Pearson relation index between respective scores of the scale and Chinese version of MGL scale was 0.426, P<0.01. The scale also had good reliability as its 0.915 in Cronbach alpha, 0.753 in retest reliability and P<0.01. Conclusion: The scale revealed great reliability and validity, which could be used as a measurement tool to evaluate the medication adherence of patients with CKD.

5.
Front Pharmacol ; 10: 978, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31551783

RESUMO

Mesangial proliferative glomerulonephritis (MPGN) is the most common type of chronic kidney disease in China, characterized by mesangial cell proliferation and inflammatory response. Paeoniflorin, an effective composition extracted from Radix Paeoniae Alba, has been used for various kinds of kidney diseases. However, there are no studies reporting the effects of paeoniflorin on MPGN. The present study aims to investigate whether paeoniflorin plays a role in MPGN and confirm the underlying molecular mechanisms. Our results manifested that paeoniflorin strongly restrained 24 h urinary protein and promoted renal function and dyslipidemia in a MPGN rat model. Moreover, paeoniflorin attenuated mesangial cell proliferation and inflammation both in MPGN rats and human mesangial cells (HMCs) treated with lipopolysaccharide (LPS). In detail, paeoniflorin decreased the number of mesangial cells and expressions of proliferation marker Ki67 in MPGN rats. Paeoniflorin also inhibited HMC proliferation and blocked cell cycle progression. In addition, the contents of inflammatory factors and the expressions of macrophage marker iNOS were decreased after paeoniflorin treatment. Furthermore, we found that the protective effect of paeoniflorin was accompanied by a strong inhibition of the phosphatidylinositol 3-kinase (PI3K)/AKT/glycogen synthase kinase (GSK)-3ß pathway. Paeoniflorin enhanced the inhibitory effect of PI3K inhibitor LY294002 and suppressed the activated effect of PI3K agonist insulin-like growth factor 1 (IGF-1) on PI3K/AKT/GSK-3ß pathway. In conclusion, these results demonstrated that paeoniflorin ameliorates MPGN by inhibiting mesangial cell proliferation and inflammatory response through the PI3K/AKT/GSK-3ß pathway.

6.
Biomed Pharmacother ; 118: 109232, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31369987

RESUMO

Triptolide(T9) is a predominant bioactive component extracted from Chinese herb Tripterygium wilfordii Hook F. (TwHF), and has multiple pharmacological activities, such as immunosuppressive and anti-inflammatory activities, et al. However, severe adverse effects and toxicity, particularly nephrotoxicity, limit its clinical application. It has been demonstrated that the activation of nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway could alleviate T9-induced nephrocyte damage. The aim of this study was to investigate the potential protective role of triptriolide (T11) against T9-induced nephrocyte apoptosis in vitro and in vivo. Renal injury models were established in human kidney 2 (HK2) cells and BALB/c mice using T9, and the protective effects of T11 were probed in vitro and in vivo, respectively. T9 induced nephrocyte damage in HK2 cells and BALB/c mice by induction of reactive oxygen species (ROS), lactate dehydrogenase (LDH), malondialdehyde (MDA) and glutathione (GSH) and reduction of superoxide dismutase (SOD), which resulted in the apoptosis of nephrocyte and injury of renal function. While, pretreatment of T11 effectively reversed these changes, resulting in the obvious decrease of oxidative stress and renal function parameters, ameliorated nephrocyte apoptosis, improved cell morphology, and higher increase of Nrf2, NAD(P)H: quinine oxidoreductase 1 (NQO1) and heme oxygenase 1 (HO-1) protein levels in vitro and in vivo. Altogether, T11 protected against T9-induced nephrocyte apoptosis possibly via suppressing oxidative stress.

7.
Biochem Pharmacol ; 169: 113619, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31465776

RESUMO

Immunoglobulin A nephropathy (IgAN) is an autoimmune kidney disease with complex pathogenesis leading to end-stage renal damage. The prime pathological characteristics of IgAN are IgA immune complexes deposition accompany with mesangial cell proliferation and urine protein elevation. Artemisinin (ART) is extracted from traditional Chinese medicine Artemisia annua L. Hydroxychloroquine (HCQ) is a classical antimalarial drug applied in the treatment of autoimmune diseases. Both of them possess anti-inflammatory and immunomodulatory properties. The purpose of this research was to investigate the pharmacological effects of ART combined with HCQ (AH) and discuss thoroughly the potential molecular mechanisms in IgAN. In vivo, our results demonstrated that AH could efficiently ameliorate kidney damage by improving kidney dysfunction and reducing the levels of 24 h urine protein, IgA and IgG immune complexes deposition in glomerulus of IgAN rats. Interestingly, AH obviously promoted the secretion of exosomes in renal tissues, inhibited the expressions of nuclear factor-κB (NF-κB) signaling and NLRP3 inflammasome-related proteins, including IκB-α, p-p65, NLRP3, ASC, IL-1ß and caspase-1 in IgAN rats. In vitro, further mechanistic study illustrated that exosomes derived from human renal tubular epithelial cells (HK-2) were significantly enhanced by AH, which could be utterly taken up in human mesangial cells (HMCs) and inhibited the activation of NF-κB pathway and NLRP3 inflammasome after AH intervention. However, GW4869 interdicted the promotive effect of AH on exosomes from HK-2 cells and the suppression of exosomes on NF-κB/NLRP3 activation in HMCs. Taken together, this study demonstrated that there was an inhibitory effect of AH therapy on NF-κB/NLRP3 signaling via mediating exosomes release in IgAN rats, which provided an alternative approach for IgAN treatment.

8.
Food Funct ; 10(8): 5102-5114, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31363726

RESUMO

The present study was designed to investigate the protective effects of Cordyceps militaris polysaccharides (CMP) on STZ-treated DN mice. CMP were identified by FT-IR and HPLC. Diabetic nephropathy (DN) was induced in male C57BL/6 mice by the injection of streptozotocin (STZ, 50 mg kg-1) in citrate buffer on 5 consecutive days. Administration of CMP at 200 and 400 mg kg-1 or irbesartan at 60 mg kg-1 in the STZ-treated mice could prevent the damage caused by STZ. CMP significantly reduced the STZ-induced higher expression of the kidney index, TC, TG, MDA, urinary protein, Scr, and BUN, while it markedly increased the STZ-induced decrease in GSH levels compared with the DN group. Histopathology analysis of the kidney by PAS, Masson, and HE staining confirmed the renal injury induced by STZ and the protective effects of CMP. Transmission electron microscopy (TEM) results confirmed the severe foot process effacement induced by STZ, but CMP treatment inhibited the podocytes' structure defects and ameliorated the function of podocytes. Desmin was measured by immunofluorescence and was related to podocyte injury. The results showed that CMP lessened the expression of desmin induced by STZ. CD68 expression was measured by immunohistochemistry analysis, and the expressions of IL-1ß, IL-6, and MCP-1 mRNA were measured by qRT-PCR. The results showed that CMP suppressed the expressions of CD68, IL-1ß, IL-6, and MCP-1 mRNA induced by STZ. The role of autophagy in the treatment of DN mice with CMP was detected by TEM and western blotting. The results showed that the administration of CMP was able to overcome the STZ-treated autophagy deficiency, significantly increase the rate of autophagy in the kidney, promote the expression of Atg5, beclin1 and LC3 protein, and reduce the expression of p62 protein. In conclusion, the present study demonstrates that CMP exert a protective effect on DN in STZ-treated mice possibly via activation of autophagy.

9.
BMJ Open ; 9(4): e025653, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31048437

RESUMO

OBJECTIVES: To provide a broad evaluation of the efficacy and safety of oral Chinese herbal medicine (CHM) as an adjunctive treatment for diabetic kidney disease (DKD), including mortality, progression to end-stage kidney disease (ESKD), albuminuria, proteinuria and kidney function. DESIGN: A systematic review and meta-analysis. METHODS: Randomised controlled trials (RCTs) comparing oral CHM with placebo as an additional intervention to conventional treatments were retrieved from five English (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Allied and Complementary Medicine Database and Cumulative Index of Nursing and Allied Health Literature) and four Chinese databases (China BioMedical Literature, China National Knowledge Infrastructure, Chonqing VIP and Wanfang) from inception to May 2018. RCTs recruiting adult DKD patients induced by primary diabetes were considered eligible, regardless of the form and ingredients of oral CHM. Mean difference (MD) or standardised mean difference (SMD) was used to analyse continuous variables and RR for dichotomous data. RESULTS: From 7255 reports retrieved, 20 eligible studies involving 2719 DKD patients were included. CHM was associated with greater reduction of albuminuria than placebo, regardless of whether renin-angiotensin system (RAS) inhibitors were concurrently administered (SMD -0.56, 95% CI [-1.04 to -0.08], I2=64%, p=0.002) or not (SMD -0.92, 95% CI [-1.35 to -0.51], I2=87%, p<0.0001). When CHM was used as an adjunct to RAS inhibitors, estimated glomerular filtration rate was higher in the CHM than placebo group (MD 6.28 mL/min; 95% CI [2.42 to 10.14], I2=0%, p=0.001). The effects of CHM on progression to ESKD and mortality were uncertain due to low event rates. The reported adverse events in CHM group included digestive disorders, elevated liver enzyme level, infection, anaemia, hypertension and subarachnoid haemorrhage, but the report rates were low and similar to control groups. The favourable results of CHM should be balanced with the limitations of the included studies such as high heterogeneity, short follow-up periods, small numbers of clinical events and older patients with less advanced disease. CONCLUSIONS: Based on moderate to low quality evidence, CHM may have beneficial effects on renal function and albuminuria beyond that afforded by conventional treatment in adults with DKD. Further well-conducted, adequately powered trials with representative DKD populations are warranted to confirm the long-term effect of CHM, particularly on clinically relevant outcomes. PROSPERO REGISTRATION NUMBER: CRD42015029293.

10.
PLoS One ; 14(5): e0216391, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31050683

RESUMO

BACKGROUND: With the advance of medical care, chronic non-communicable diseases, like chronic kidney disease (CKD), have become the predominant diseases around the world. With heavy society and economy burden, we shall make full use of chronic disease management, including precision therapies. And the prerequisite for implementing precision medicine is to fully understand the characteristics of patients. Being the basis of the Knowledge-Attitude-Practice Model, patient's awareness is essential to conduct individualized treatments. However, there have been no validated questionnaires specific to the awareness of patients with CKD. Therefore, this study aims to develop and validate an awareness questionnaire for patients with CKD. METHODS: From March 2013 to September 2014, a cross-sectional study was conducted at Guangdong Provincial Hospital of Chinese Medicine. Age 18 or above were enrolled in the study. After signing the informed consent, they received a self-developed questionnaire to evaluate their CKD-related awareness. Then we collected their demographic data for further analyses. We also conducted item analyses/ validity and reliability analysis to filter out improper items and to retain the eligible ones. RESULTS: We totally distributed 110 copies of the questionnaires and 100 of them were returned. After item analyses, 2 items were excluded because of Cronbach's Alpha analysis. In total, 18 items were retained, comprising the final set of the questionnaire. For validity analysis, 4 components could explain the cumulative 73.966% extraction sums of the squared loadings; for reliability analysis, the Guttman Split-Half coefficient was 0.918. CONCLUSIONS: This awareness questionnaire has favorable validity and reliability. It is a sound method for evaluating and measuring levels of disease-related awareness in CKD patients.


Assuntos
Atitude Frente a Saúde , Conscientização , Insuficiência Renal Crônica , Inquéritos e Questionários , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
J Biol Chem ; 294(26): 10172-10181, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31088910

RESUMO

The Toll signaling pathway in Drosophila melanogaster regulates several immune-related functions, including the expression of antimicrobial peptide (AMP) genes. The canonical Toll receptor (Toll-1) is activated by the cytokine Spätzle (Spz-1), but Drosophila encodes eight other Toll genes and five other Spz genes whose interactions with one another and associated functions are less well-understood. Here, we conducted in vitro assays in the Drosophila S2 cell line with the Toll/interleukin-1 receptor (TIR) homology domains of each Toll family member to determine whether they can activate a known target of Toll-1, the promoter of the antifungal peptide gene drosomycin. All TIR family members activated the drosomycin promoter, with Toll-1 and Toll-7 TIRs producing the highest activation. We found that the Toll-1 and Toll-7 ectodomains bind Spz-1, -2, and -5, and also vesicular stomatitis virus (VSV) virions, and that Spz-1, -2, -5, and VSV all activated the promoters of drosomycin and several other AMP genes in S2 cells expressing full-length Toll-1 or Toll-7. In vivo experiments indicated that Toll-1 and Toll-7 mutants could be systemically infected with two bacterial species (Enterococcus faecalis and Pseudomonas aeruginosa), the opportunistic fungal pathogen Candida albicans, and VSV with different survival times in adult females and males compared with WT fly survival. Our results suggest that all Toll family members can activate several AMP genes. Our results further indicate that Toll-1 and Toll-7 bind multiple Spz proteins and also VSV, but they differentially affect adult survival after systemic infection, potentially because of sex-specific differences in Toll-1 and Toll-7 expression.

12.
Phytomedicine ; 59: 152913, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30991182

RESUMO

BACKGROUND: Zhen-wu-tang (ZWT), a traditional herbal formula, has been widely used for the treatment of kidney diseases in clinics, but the underlying molecular mechanisms have not been fully understood. PURPOSE: Inflammation mediated podocyte injury has been reported to constitute a crucial part in the pathogenesis of membranous nephropathy (MN). The current study was designed to evaluate the effect of ZWT on MN related to nuclear factor-κB (NF-κB) pathway and NLRP3 inflammasome. METHODS: The main components of ZWT were identified by 3D-ultra performance liquid chromatography (3D-UPLC) assay. A MN rat model induced by cationic-bovine serum albumin (C-BSA) and podocytes stimulated by TNF-α were used in this study. The 24 h urine protein, serum total cholesterol (TC) and triglyceride (TG), as well as kidney histology were measured to evaluate kidney damage. The expressions of IgG and complement 3 (C3), and the co-localization of NLRP3 and ASC were detected by immunofluorescence. The expressions of podocyte injury related protein desmin, podocin were measured by immunohistochemistry and western blot. Cell vitality of cultured podocytes was detected by MTT assay, as apoptosis assay was measured via flow cytometry. The protein expressions of p-p65, p-IκBα, NLRP3, Caspase-1, IL-1ß were detected by western blot. RESULTS: Our results showed that ZWT significantly ameliorated kidney damage in MN model rats by decreasing the levels of 24 h urine protein, TC and TG. ZWT also improved renal histology and reduced the expressions of IgG and C3 in glomerulus. In addition, ZWT lessened the expressions of desmin, but increased podocin expression in vivo and vitro. ZWT protected cultured podocytes by maintaining cell vitality and inhibiting apoptosis. Moreover, we found that ZWT suppressed the expressions of NLRP3, Caspase-1, IL-1ß and the co-localization of NLRP3 and ASC. Furthermore, the inhibition of NLRP3 inflammasome under ZWT treatment were accompanied by down-regulation of NF-κB pathway, as the p-p65 and p-IκBα protein expression were reduced. CONCLUSIONS: Our present study indicates that the inhibition of NF-κB pathway and NLRP3 inflammasome might be the potential mechanisms for the therapeutic effects of ZWT against MN.


Assuntos
Medicamentos de Ervas Chinesas/farmacologia , Glomerulonefrite Membranosa/tratamento farmacológico , NF-kappa B/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Animais , Apoptose/efeitos dos fármacos , Caspase 1/metabolismo , Regulação para Baixo , Regulação da Expressão Gênica/efeitos dos fármacos , Proteínas I-kappa B/metabolismo , Inflamassomos/efeitos dos fármacos , Inflamação/metabolismo , Interleucina-1beta/metabolismo , Glomérulos Renais/efeitos dos fármacos , Masculino , Inibidor de NF-kappaB alfa/metabolismo , Ratos , Fator de Necrose Tumoral alfa/metabolismo
13.
BMC Nephrol ; 20(1): 142, 2019 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-31027481

RESUMO

BACKGROUND: Self-management intervention aims to facilitate an individual's ability to make lifestyle changes. The effectiveness of this intervention in non-dialysis patients with chronic kidney disease (CKD) is limited. In this study, we applied a systematic review and meta-analysis to investigate whether self-management intervention improves renoprotection for non-dialysis chronic kidney disease. METHODS: We conducted a comprehensive search for randomized controlled trials addressing our objective. We searched for studies up to May 12, 2018. Two reviewers independently evaluated study quality and extracted characteristics and outcomes among patients with CKD within the intervention phase for each trial. Meta-regression and subgroup analyses were conducted to explore heterogeneity. RESULTS: We identified 19 studies with a total of 2540 CKD patients and a mean follow-up of 13.44 months. Compared with usual care, self-management intervention did not show a significant difference for risk of all-cause mortality (5 studies, 1662 participants; RR 1.13; 95% CI 0.68 to 1.86; I2 = 0%), risk of dialysis (5 studies, 1565 participants; RR 1.35; 95% CI 0.84 to 2.19; I2 = 0%), or change in eGFR (8 studies, 1315 participants; SMD -0.01; 95% CI -0.23 to 0.21; I2 = 64%). Moreover, self-management interventions were associated with a lower 24 h urinary protein excretion (4 studies, 905 participants; MD - 0.12 g/24 h; 95% CI -0.21 to - 0.02; I2 = 3%), a lower blood pressure level (SBP: 7 studies, 1201 participants; MD - 5.68 mmHg; 95%CI - 9.68 to - 1.67; I2 = 60%; DBP: 7 studies, 1201 participants; MD - 2.64 mmHg, 95% CI -3.78 to - 1.50; I2 = 0%), a lower C-reactive Protein (CRP) level (3 studies, 123 participants; SMD -2.8; 95% CI -2.90 to - 2.70; I2 = 0%) and a longer distance on the 6-min walk (3 studies, 277 participants; SMD 0.70; 95% CI 0.45 to 0.94; I2 = 0%) when compared with the control group. CONCLUSIONS: We observed that self-management intervention was beneficial for urine protein decline, blood pressure level, exercise capacity and CRP level, compared with the standard treatment, during a follow-up of 13.44 months in patients with CKD non-dialysis. However, it did not provide additional benefits for renal outcomes and all-cause mortality.

14.
Am J Transl Res ; 11(3): 1403-1416, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30972170

RESUMO

A random skin flap is commonly applied in plastic and reconstructive surgery. The distal part of the random skin flap often risks necrosis because the blood flow may be compromised. Prevascularization is a widely used technology to intensify the vascularization function of biomaterials. In fact, human mesenchymal stem cell (hMSC) sheets promote neoangiogenesis. We speculated that prevascularized hMSC cell sheets (PHCS) would further improve neovascularization by producing more angiogenic growth factors in a random skin flap animal model. In this study, PHCS were set up by co-culturing human umbilical vein endothelial cells (HUVECs) with hMSC cell sheets (HCS). In vitro, we observed microvessel formation and significantly increased production of angiogenesis-related factors. Thus, we analyzed the microvessel networks, vascular maturation, and angiogenic growth factors of the cell sheet. In vivo, PHCS and HCS were implanted in a murine ischemic random skin flap model. Implanted PHCS significantly increased blood perfusion and improved skin flap survival when compared to untreated control skin flaps. The survival rate of the prevascularized and control skin flaps was assessed after 3, 5, and 7 days via analysis of macroscopic images and Laser Doppler Perfusion Imaging (LDPI). Additionally, the numbers of skin appendages, collagen fibers deposition, and epidermal thickness were evaluated. Moreover, the PHCS group also induced the most intense neovascularization, the upshot of which was a robust blood microcirculation supporting skin flap survival. Therefore, PHCS implantation can effectively enhance local neoangiogenesis and hence increase the survival of otherwise ischemic skin flaps. Hence, local administration of PHCS may serve as an alternative approach in improving random skin flap survival.

15.
BMC Genomics ; 20(1): 161, 2019 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-30813894

RESUMO

BACKGROUND: Mermithid nematodes, such as Ovomermis sinensis, display a broad host range including some lepidopteran pests. Infective juveniles penetrate their host through the cuticle, complete their growth within the hemocoel and eventually kill the host upon their emergence. Hence, mermithid nematodes are considered potential biological control agents of insect pests. Our previous data indicate that the infection rate of O. sinensis on cotton bollworm (Helicoverpa armigera) is low, which may be largely due to the strong immune system of the host. However, current knowledge on the interactions of mermithid nematodes with their hosts and the mechanisms employed by hosts to defend themselves against mermithid nematodes is limited. RESULTS: Here, we investigated the response of H. armigera to O. sinensis infection. Parasitism by O. sinensis caused a sharp decline in the survival rate of H. armigera. The hemocytic phagocytosis ability, antibacterial activity, and phenoloxidase (PO) activity in plasma of H. armigera increased at 1 d post parasitism (dpp) but decreased at 3 dpp. Further, we investigated gene expression in the fat body of parasitized and non-parasitized H. armigera larvae at 1, 3, and 5 dpp using a digital gene expression system. In total, 41, 60 and 68 immune-related differentially expressed genes were identified at 1, 3, and 5 dpp, respectively. These genes encoded pattern recognition receptors (PRRs), antimicrobial peptides (AMPs), serine proteases (SPs), SP inhibitors, mucins and other immune-related proteins. The expression of most PRRs, AMPs, SPs, and mucins was upregulated in the fat body of larvae at 1 dpp, downregulated at 3 dpp, and then again upregulated at 5 dpp by O. sinensis. The increased expression of SP inhibitors may contribute to the inhibited PO activity at 5 dpp. CONCLUSIONS: This study demonstrates that parasitism by O. sinensis modulates the immune reaction of the host H. armigera by altering the expression of immune-related genes. Our data provide a basis for future investigation of the molecular mechanisms employed by the mermithid nematode O. sinensis to modulate the immunity of the host H. armigera. These data will also likely facilitate the improvement of success in parasitism of H. armigera by O. sinensis.


Assuntos
Mermithoidea/fisiologia , Mariposas/imunologia , Mariposas/parasitologia , Animais , Perfilação da Expressão Gênica , Larva/imunologia , Larva/parasitologia , Mariposas/genética , Mariposas/metabolismo , Receptores de Reconhecimento de Padrão/genética , Receptores de Reconhecimento de Padrão/metabolismo , Análise de Sequência de RNA , Serina Proteases/genética , Serina Proteases/metabolismo , Análise de Sobrevida
16.
Int Immunopharmacol ; 70: 313-323, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30852287

RESUMO

Immunoglobulin A nephropathy (IgAN) is an autoimmune kidney disease with complex pathogenesis leading to end-stage renal damage. The crucial pathological characteristic in IgAN is IgA immune complexes deposition accompany with mesangial cell proliferation and mesangial matrix expansion. Artemisinin (ART) is isolated from traditional Chinese medicine Artemisia annua L. Hydroxychloroquine (HCQ) is a classical antimalarial drug used to treat autoimmune diseases. Both of them possess immunosuppressive, immunomodulatory and anti-inflammatory features. The aim of this study was to investigate the pharmacological effects of ART combined with HCQ (AH) and explore the underlying mechanisms in IgAN. In vivo, our results showed that AH could significantly improve kidney dysfunction, decrease mesangial matrix expansion as well as immune complexes in mesangial area visualized by H&E and PAS staining. The depositions of IgA immune complexes and complement 3 (C3) were obviously reduced after AH treatment by immunofluorescence. Interestingly, the morphology of kidney and spleen was significantly swelled but reverted by AH in IgAN rats. Further mechanistic study showed that the higher proportions of the Th2 and Th17 cells were reduced but the lower differentiation of Th1 and Treg cells subsets were promoted by AH. Taken together, this study demonstrated that there was an immunosuppressive effect of AH therapy on IgAN rats via regulating the differentiation of CD4+ T cell subsets, which provided an alternative approach for IgAN treatment.


Assuntos
Artemisininas/uso terapêutico , Quimioterapia Combinada , Glomerulonefrite por IGA/tratamento farmacológico , Hidroxicloroquina/uso terapêutico , Imunossupressores/uso terapêutico , Células Mesangiais/fisiologia , Linfócitos T Reguladores/imunologia , Células Th17/imunologia , Células Th2/imunologia , Animais , Complexo Antígeno-Anticorpo/metabolismo , Artemisia annua/imunologia , Antígenos CD4/metabolismo , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Humanos , Masculino , Medicina Tradicional Chinesa , Ratos , Ratos Sprague-Dawley
17.
Dev Comp Immunol ; 95: 10-18, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30731096

RESUMO

Drosophila melanogaster possesses a sophisticated and effective immune system composed of humoral and cellular immune responses, and production of antimicrobial peptides (AMPs) is an important defense mechanism. Expression of AMPs is regulated by the Toll and IMD (immune deficiency) pathways. Production of AMPs can be systemic in the fat body or a local event in the midgut and epithelium. So far, most studies focus on systemic septic infection in adult flies and little is known about AMP gene activation after ingestion of killed bacteria. In this study, we investigated activation of AMP genes in the wild-type w1118, MyD88 and Imd mutant flies after ingestion of heat-killed Escherichia coli and Staphylococcus aureus. We showed that ingestion of E. coli activated most AMP genes, including drosomycin and diptericin, in the first to third instar larvae and pupae, while ingestion of S. aureus induced only some AMP genes in some larval stages or in pupae. In adult flies, ingestion of killed bacteria activated AMP genes differently in males and females. Interestingly, ingestion of killed E. coli and S. aureus in females conferred resistance to septic infection by both live pathogenic Enterococcus faecalis and Pseudomonas aeruginosa, and ingestion of E. coli in males conferred resistance to P. aeruginosa infection. Our results indicated that E. coli and S. aureus can activate both the Toll and IMD pathways, and systemic and local immune responses work together to provide Drosophila more effective protection against infection.


Assuntos
Peptídeos Catiônicos Antimicrobianos/imunologia , Bactérias/imunologia , Drosophila melanogaster/imunologia , Ingestão de Alimentos/imunologia , Sepse/imunologia , Animais , Bactérias/patogenicidade , Resistência à Doença/imunologia , Proteínas de Drosophila/imunologia , Proteínas de Drosophila/metabolismo , Feminino , Masculino , Sepse/microbiologia , Fatores Sexuais , Transdução de Sinais/imunologia , Receptores Toll-Like/imunologia , Receptores Toll-Like/metabolismo
18.
Dev Comp Immunol ; 95: 50-58, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30735676

RESUMO

An important innate immune response in Drosophila melanogaster is the production of antimicrobial peptides (AMPs). Expression of AMP genes is mediated by the Toll and immune deficiency (IMD) pathways via NF-κB transcription factors Dorsal, DIF and Relish. Dorsal and DIF act downstream of the Toll pathway, whereas Relish acts in the IMD pathway. Dorsal and DIF are held inactive in the cytoplasm by the IκB protein Cactus, while Relish contains an IκB-like inhibitory domain at the C-terminus. NF-κB factors normally form homodimers and heterodimers to regulate gene expression, but formation of heterodimers between Relish and DIF or Dorsal and the specificity and activity of the three NF-κB homodimers and heterodimers are not well understood. In this study, we compared the activity of Rel homology domains (RHDs) of Dorsal, DIF and Relish in activation of Drosophila AMP gene promoters, demonstrated that Relish-RHD (Rel-RHD) interacted with both Dorsal-RHD and DIF-RHD, Relish-N interacted with DIF and Dorsal, and overexpression of individual RHD and co-expression of any two RHDs activated the activity of AMP gene promoters to various levels, suggesting formation of homodimers and heterodimers among Dorsal, DIF and Relish. Rel-RHD homodimers were stronger activators than heterodimers of Rel-RHD with either DIF-RHD or Dorsal-RHD, while DIF-RHD-Dorsal-RHD heterodimers were stronger activators than either DIF-RHD or Dorsal-RHD homodimers in activation of AMP gene promoters. We also identified the nucleotides at the 6th and 8th positions of the 3' half-sites of the κB motifs that are important for the specificity and activity of NF-κB transcription factors.


Assuntos
Peptídeos Catiônicos Antimicrobianos/genética , Drosophila melanogaster/imunologia , NF-kappa B/metabolismo , Transdução de Sinais/genética , Motivos de Aminoácidos/genética , Animais , Peptídeos Catiônicos Antimicrobianos/imunologia , Peptídeos Catiônicos Antimicrobianos/metabolismo , Linhagem Celular , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/isolamento & purificação , Proteínas de Ligação a DNA/metabolismo , Proteínas de Drosophila/genética , Proteínas de Drosophila/isolamento & purificação , Proteínas de Drosophila/metabolismo , Regulação da Expressão Gênica/imunologia , Imunidade Inata , NF-kappa B/genética , NF-kappa B/isolamento & purificação , Proteínas Nucleares/genética , Proteínas Nucleares/isolamento & purificação , Proteínas Nucleares/metabolismo , Fosfoproteínas/genética , Fosfoproteínas/isolamento & purificação , Fosfoproteínas/metabolismo , Regiões Promotoras Genéticas/genética , Domínios Proteicos/genética , Multimerização Proteica/imunologia , Proteínas Recombinantes/genética , Proteínas Recombinantes/isolamento & purificação , Proteínas Recombinantes/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/isolamento & purificação , Fatores de Transcrição/metabolismo
19.
Chin J Integr Med ; 25(3): 168-174, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30467695

RESUMO

OBJECTIVE: To follow up the participants of the randomized clinical trial "Efficacy and Safety of Niaoduqing Particles () for Delaying Moderate-to-Severe Renal Dysfunction", and assess the long-term effects of Niaoduqing Particles on delaying the progression of renal dysfunction. METHODS: Participants, who had previously been randomly assigned to receive Niaoduqing Particles or placebo for 24 weeks (146 cases in each group), were invited to follow-up and all were administered Niaoduqing Particles 5 g thrice daily and 10 g before bedtime for 24 weeks. The primary endpoints were changes in baseline serum creatinine (Scr) and estimated glomerular filtration rate (eGFR) after completion of the open-label treatment period. RESULTS: After the double-blind period, the median (interquartile range) changes in Scr were 1.1 (-13.0-24.1) and 11.7 (-2.6-42.9) µmol/L for the Niaoduqing Particle and placebo groups, respectively (P=0.008), and the median changes in eGFRs were-0.2 (-4.3-2.7) and-2.21 (-5.7-0.8) mL•min-1•1.73 m-2, respectively (P=0.016). There were significant differences in the double-blind period changes in renal function between groups. After the open-label period, the median changes in Scr were 9.0 (-10.0-41.9) and 17.5 (-6.0-50.0) µmol/L for the Niaoduqing Particle and placebo groups according to baseline grouping, respectively (P=0.214), and the median changes in eGFRs were-2.3 (-6.4-1.9) and-3.7 (-7.5-1.1) mL•min-1•1.73 m-2, respectively (P=0.134). There were no statistical differences in the open-label period changes in renal function between groups. The eGFR reduction of participants who accepted Niaoduqing Particle treatment for 48 weeks was projected to 2.5 mL•min-1•1.73 m-2 per year. CONCLUSION: Niaoduqing Particles appear to have long-term efficacy for patients with moderate-to-severe renal dysfunction. Although there was no statistical difference, the early use of Niaoduqing Paticles seems to ameliorate the worsening of renal function. (Trial registration No. ChiCTR-TRC-12002448).


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Nefropatias/tratamento farmacológico , Adulto , Progressão da Doença , Método Duplo-Cego , Feminino , Seguimentos , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Nefropatias/fisiopatologia , Masculino , Pessoa de Meia-Idade
20.
Biomed Pharmacother ; 109: 1932-1939, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30551448

RESUMO

Triptriolide (T11) is a natural diterpene diepoxide that derived from Chinese traditional herb medicine (TCHM) Tripterygium wilfordii Hook.F (TWHF). From a structural point of view, T11 is very similar to triptolide (T9), one of the most effectively compounds in TWHF that have already been systematically investigated in the past decades. However, the basic functions and medicinal properties of T11 have not yet been well investigated mainly due to its low abundance in its plant organ. The present study aimed to investigate the protective effects of T11 on puromycin aminonucleoside (PAN) induced apoptotic mouse podocytes and the underlying mechanism. The results showed that T11 had no significant toxicity in podocytes in high dosage, and showed prominent protective effects on PAN induced podocytes injury. Further studies indicated that T11 might exert its protective effects by inhibiting of apoptosis and restoring of survival in PAN induced podocytes.


Assuntos
Apoptose/efeitos dos fármacos , Diterpenos/farmacologia , Fenantrenos/farmacologia , Podócitos/efeitos dos fármacos , Animais , Medicamentos de Ervas Chinesas/farmacologia , Compostos de Epóxi/farmacologia , Camundongos , Puromicina Aminonucleosídeo/farmacologia , Tripterygium/química
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