Contrast nephropathy in cancer patients receiving anti-VEGF therapy: a prospective study

The Protective Role of Intermedin in Contrast-Induced Acute Kidney Injury: Enhancing Peritubular Capillary Endothelial Cell Adhesion and Integrity Through the cAMP/Rac1 Pathway

Contrast-induced acute kidney injury (CIAKI) is a common complication with limited treatments. Intermedin (IMD), a peptide belonging to the calcitonin gene-related peptide family, promotes vasodilation and endothelial stability, but its role in mitigating CIAKI remains unexplored. This study investigates the protective effects of IMD in CIAKI, focusing on its mechanisms, particularly the cAMP/Rac1 signaling pathway. Human umbilical vein endothelial cells (HUVECs) were treated with iohexol to simulate kidney injury in vitro. The protective effects of IMD were assessed using CCK8 assay, flow cytometry, ELISA, and Western blotting. A CIAKI rat model was utilized to evaluate renal peritubular capillary endothelial cell injury and renal function through histopathology, immunohistochemistry, immunofluorescence, Western blotting, and transmission electron microscopy. In vitro, IMD significantly enhanced HUVEC viability and mitigated iohexol-induced toxicity by preserving intercellular adhesion junctions and activating the cAMP/Rac1 pathway, with Rac1 inhibition attenuating these protective effects. In vivo, CIAKI caused severe damage to peritubular capillary endothelial cell junctions, impairing renal function. IMD treatment markedly improved renal function, an effect negated by Rac1 inhibition. IMD protects against renal injury in CIAKI by activating the cAMP/Rac1 pathway, preserving peritubular capillary endothelial integrity and alleviating acute renal injury from contrast media. These findings suggest that IMD has therapeutic potential in CIAKI and highlight the cAMP/Rac1 pathway as a promising target for preventing contrast-induced acute kidney injury in at-risk patients, ultimately improving clinical outcomes.

VEGFA gene variants are associated with breast cancer progression

Angiogenesis is recognized as a hallmark of cancer, and vascular endothelial growth factor (VEGF) is a key regulator of the angiogenic process and is related to cancer progression. Anti-VEGF therapy has been tried but with limited success and without useful stratification for angiogenesis markers. Further, the landscape of VEGF single nucleotide polymorphisms (SNPs) in breast cancer and their clinical relevance is not well studied, and their relation to tissue-based angiogenesis markers has not been explored. Here, we studied a selection of VEGFA SNPs in nontumor lymph nodes from a population-based breast cancer cohort (n = 544), and their relation to clinicopathologic variables, vascular tissue metrics, and breast cancer-specific survival. Two of the SNP candidates (rs833068GA genotype and rs25648CC genotype) showed associations with angiogenesis tissue markers, and the VEGFA rs833068GA genotype was associated with breast cancer-specific survival among ER-negative cases. We also found trends of association between the rs699947CA genotype and large tumor diameter and ER-negative tumors, and between the rs3025039CC genotype and large tumor diameter. Our findings indicate some associations between certain VEGF SNPs, in particular the rs833068GA genotype, and both vascular metrics and patient survival. These findings and their potential implications need to be validated by independent studies.

Artificial Intelligence Algorithm-Based Computed Tomography Image in Assessment of Acute Renal Insufficiency of Patients Undergoing Percutaneous Coronary Intervention

This study was aimed to analyze the changes in renal function of patients undergoing percutaneous coronary intervention (PCI) surgery and the characteristics of their computed tomography (CT) image based on artificial intelligence algorithms. In this study, 104 patients with coronary atherosclerotic heart disease (CAHD) were treated as the research objects. They were divided into an experimental group (patients who underwent CAG and PCI within 1 week after enhanced coronary CT (ECCT)) and the control group (patients who underwent CAG and PCI within 1-3 weeks after ECCT). Renal imaging scans of patients were performed by CT based on discrete inseparable shear transform (DNST) optimized algorithm, which was named as O-DNST. The results showed that the serum creatinine (Scr), blood urea nitrogen (BUN), and urine protein (UP) levels of patients in the experimental group were significantly higher than those of the control group 24-72 hours after surgery, while the levels of endogenous creatinine clearance (Ccr) and estimated glomerular filtration rate (eGFR) were significantly lower than those of the control group (P < 0.05). The levels of β2 microglobulin (β2-MG), C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor (TNF-α) in the experimental group were significantly higher than those in the control group 24-72 hours after surgery (P < 0.05). The incidence of contrast-induced nephropathy (CIN) in the experimental group (15.38%) was significantly higher than that in the control group (5.8%), and the difference was statistically significant (P < 0.05). The results showed that repeated application of contrast agent in a short period of time can promote the increase of serum inflammation levels in PCI patients, which may be a risk factor for CIN in PCI patients.