肾移植术后的临床药学监护实践

目的提高肾移植术后患者药物治疗效果,降低术后不良反应。方法加强血药浓度监测,调整用药剂量和品种,为患者建立药历,开展用药指导。结果与结论通过实施药学监护有效降低了肾移植术后药物不良反应发生率。     

森林脑炎病毒不同感染途径对小鼠模型的感染性分析

目的分析森林脑炎病毒不同感染途径对小鼠模型的致病性、病毒分布及增殖动态。方法将适应原代地鼠肾(primary hamster kidney,PHK)细胞的森林脑炎病毒进行10倍系列稀释,取4个连续稀释度的病毒液,分别通过脑腔注射、灌胃、滴鼻、肌肉注射、腹腔注射的感染方式,对昆明小鼠进行攻毒,逐日连续观察14 d,计算半数致死量(median lethal dose,LD₅₀);并分别取攻毒后第3、5、7天发病典型的腹腔感染组小鼠脑、肺、肾脏、肝脏、心脏、小肠、血液7种组织器官,采用蚀斑法检测病毒滴度。结果脑腔、灌胃、滴鼻、肌肉注射和腹腔注射攻毒方式的LD₅₀分别为10、10^5.1、10⁵、10^1.2和10²PFU/mL。所有攻毒途径小鼠的脑腔中病毒滴度最高,达10⁹PFU/mL,肺组织为10^6.5PFU/mL,肾脏为10⁵PFU/mL,心脏和肝脏中病毒滴度较低,分别为10²     

红芸豆多糖联合运动改善饮食诱导的肥胖小鼠糖脂代谢紊乱

目的：观察红芸豆多糖（Polysaccharides from red kidney bean,PRK）联合运动（Exercise,E）改善饮食诱导的肥胖小鼠代谢紊乱,并分析其机制。方法：40只C57BL/6小鼠随机分为5组：对照组（正常饮食）、模型组（高脂饮食）、PRK组（400 mg/kg PRK）、E组（运动）、PRK+E组（400 mg/kg PRK+运动）,连续干预12周,并进行口服葡萄糖耐量试验（OGTT）,生化分析仪测定血糖、胰岛素、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL)、肝脏TC、TG、超氧化物歧化酶（SOD）、丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH-Px）水平。酶联免疫试剂盒检测胰岛素、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、IL-1β含量。H&E染色对肝脏进行病理分析,Western Blot实验检测PPARα、FASN、Nrf2、NQO1、HO-1水平。结果：与对照组比较,模型组小鼠的体重和肝质量极显著增加（P<0.01）;与模型组比较,PRK联合运动极显著降低肥胖小鼠的体重和脂质,降低血糖和胰岛素水平（P<0.01）。与模型组比较,PRK联合运动极显著降低血清中TG、TC、LDL含量,极显著增加HDL,极显著降低肝脏TNF-α、IL-6和IL-1β水平,极显著下调肝脏TG、TC水平,极显著增加肝脏中PPARα水平,极显著降低FASN水平（P<0.01）。与模型组比较,PRK、E或PRK+E联合干预极显著提高肝脏GSH-Px和SOD水平,极显著降低MDA含量,极显著增加Nrf2、NQO1和HO-1蛋白水平,尤其PRK+E联合干预更加明显（P<0.01）。结论：PRK联合运动通过减少脂质积累、抑制炎症、氧化应激改善肥胖引起的代谢障碍,其机制与调节PGC-1α、FASN、Nrf2/NQO1/HO-1 信号通路相关。     

Development of Cell Therapies for Renal Disease and Regenerative Medicine

The incidence of renal disease is gradually increasing worldwide, and this condition has become a major public health problem because it is a trigger for many other chronic diseases. Cell therapies using multipotent mesenchymal stromal cells, hematopoietic stem cells, macrophages, and other cell types have been used to induce regeneration and provide a cure for acute and chronic kidney disease in experimental models. This review describes the advances in cell therapy protocols applied to acute and chronic kidney injuries and the attempts to apply these treatments in a clinical setting.     

英国红芸豆抗氧化肽对氧化应激斑马鱼的保护作用研究

为探究英国红芸豆抗氧化肽组分(BRKBPAPC)的体内抗氧化作用,利用2,2′-偶氮二异丁基脒二盐酸盐诱导建立氧化应激斑马鱼模型,研究BRKBPAPC对氧化应激斑马鱼的影响。结果表明：BRKBPAPC能显著提高(P<0.05)斑马鱼体内过氧化氢酶(CAT)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)的活力和总抗氧化能力(T-AOC),显著降低(P<0.05)丙二醛(MDA)含量;同时BRKBPAPC还具有调节斑马鱼脂代谢的能力,随着处理浓度的增加斑马鱼脂代谢指标逐渐恢复正常水平;高剂量BRKBPAPC可使斑马鱼行为轨迹增多,高速运动次数、时间、距离显著上升。高剂量抗氧化肽处理21 d时,CAT、SOD、T-AOC、GSH-Px分别增至(28.29±3.29)、(126.59±6.39)、(2.07±0.18)、(84.75±7.77)U/mg prot, MDA含量降至(3.35±0.29)nmol/mg prot。由此可见,BRKBPAPC具有较好的体内抗氧化作用及脂代谢调节能力。     

Macrophage Migration Inhibitory Factor (MIF) as a Stress Molecule in Renal Inflammation

Renal inflammation is an initial pathological process during progressive renal injury regardless of the initial cause. Macrophage migration inhibitory factor (MIF) is a truly proinflammatory stress mediator that is highly expressed in a variety of both inflammatory cells and intrinsic kidney cells. MIF is released from the diseased kidney immediately upon stimulation to trigger renal inflammation by activating macrophages and T cells, and promoting the production of proinflammatory cytokines, chemokines, and stress molecules via signaling pathways involving the CD74/CD44 and chemokine receptors CXCR2, CXCR4, and CXCR7 signaling. In addition, MIF can function as a stress molecule to counter-regulate the immunosuppressive effect of glucocorticoid in renal inflammation. Given the critical position of MIF in the upstream inflammatory cascade, this review focuses on the regulatory role and molecular mechanisms of MIF in kidney diseases. The therapeutic potential of targeting MIF signaling to treat kidney diseases is also discussed.     

The RAGE/DIAPH1 Signaling Axis & Implications for the Pathogenesis of Diabetic Complications

Increasing evidence links the RAGE (receptor for advanced glycation end products)/DIAPH1 (Diaphanous 1) signaling axis to the pathogenesis of diabetic complications. RAGE is a multi-ligand receptor and through these ligand–receptor interactions, extensive maladaptive effects are exerted on cell types and tissues targeted for dysfunction in hyperglycemia observed in both type 1 and type 2 diabetes. Recent evidence indicates that RAGE ligands, acting as damage-associated molecular patterns molecules, or DAMPs, through RAGE may impact interferon signaling pathways, specifically through upregulation of IRF7 (interferon regulatory factor 7), thereby heralding and evoking pro-inflammatory effects on vulnerable tissues. Although successful targeting of RAGE in the clinical milieu has, to date, not been met with success, recent approaches to target RAGE intracellular signaling may hold promise to fill this critical gap. This review focuses on recent examples of highlights and updates to the pathobiology of RAGE and DIAPH1 in diabetic complications.     

Enhancing the Therapeutic Potential of Mesenchymal Stromal Cell-Based Therapies with an Anti-Fibrotic Agent for the Treatment of Chronic Kidney Disease

Chronic kidney disease (CKD) affects 1 in 10 members of the general population, placing these patients at an increasingly high risk of kidney failure. Despite the significant burden of CKD on various healthcare systems, there are no effective cures that reverse or even halt its progression. In recent years, human bone-marrow-derived mesenchymal stromal cells (BM-MSCs) have been recognised as a novel therapy for CKDs, owing to their well-established immunomodulatory and tissue-reparative properties in preclinical settings, and their promising safety profile that has been demonstrated in patients with CKDs from several clinical trials. However, renal fibrosis (scarring), a hallmark of CKD, has been shown to impair the viability and functionality of BM-MSCs post-transplantation. This has suggested that BM-MSCs might require a pre-treatment or adjunct therapy that can enhance the viability and therapeutic efficacy of these stromal cells in chronic disease settings. To address this, recent studies that have combined BM-MSCs with the anti-fibrotic drug serelaxin (RLX), have demonstrated the enhanced therapeutic potential of this combination therapy in normotensive and hypertensive preclinical models of CKD. In this review, a critical appraisal of the preclinical data available on the anti-fibrotic and renoprotective actions of BM-MSCs or RLX alone and when combined, as a treatment option for normotensive vs. hypertensive CKD, is discussed.     

A Lack of GD3 Synthase Leads to Impaired Renal Expression of Connexins and Pannexin1 in St8sia1 Knockout Mice

The aim of this study was to determine the effects of altered ganglioside composition on the expression of Cx37, Cx40, Cx43, Cx45, and Panx1 in different kidney regions of St8sia1 gene knockout mice (St8sia1 KO) lacking the GD3 synthase enzyme. Experiments were performed in twelve male 6-month-old mice: four wild-type (C57BL/6-type, WT) and eight St8sia1 KO mice. After euthanasia, kidney tissue was harvested, embedded in paraffin wax, and processed for immunohistochemistry. The expression of connexins and Panx1 was determined in different regions of the kidney: cortex (CTX.), outer stripe of outer medulla (O.S.), inner stripe of outer medulla (IN.S.), and inner medulla (IN.MED.). We determined significantly lower expression of Cx37, Cx40, Cx45, and Panx1 in different parts of the kidneys of St8sia1 KO mice compared with WT. The most consistent decrease was found in the O.S. where all markers (Cx 37, 40, 45 and Panx1) were disrupted in St8si1 KO mice. In the CTX. region, we observed decrease in the expression of Cx37, Cx45, and Panx1, while reduced expression of Cx37 and Panx1 was more specific to IN.S. The results of the present study suggest that deficiency of GD3 synthase in St8sia1 KO mice leads to disruption of renal Cx expression, which is probably related to alteration of ganglioside composition.     

Muscle Wasting in Chronic Kidney Disease: Mechanism and Clinical Implications—A Narrative Review

Muscle wasting, known to develop in patients with chronic kidney disease (CKD), is a deleterious consequence of numerous complications associated with deteriorated renal function. Muscle wasting in CKD mainly involves dysregulated muscle protein metabolism and impaired muscle cell regeneration. In this narrative review, we discuss the cardinal role of the insulin-like growth factor 1 and myostatin signaling pathways, which have been extensively investigated using animal and human studies, as well as the emerging concepts in microRNA- and gut microbiota-mediated regulation of muscle mass and myogenesis. To ameliorate muscle loss, therapeutic strategies, including nutritional support, exercise programs, pharmacological interventions, and physical modalities, are being increasingly developed based on advances in understanding its underlying pathophysiology.