Effectively Decontaminating Protein-Bound Uremic Toxins in Human Serum Albumin Using Cationic Metal-Organic Frameworks

Efficient uremic toxins adsorption from simulated blood by immobilization of metal organic frameworks anchored Sephadex beads

The current study outlines the removal of Creatinine, p-Cresol sulfate, and Hippuric acid from simulated blood using three new granules: Fe-BTC@Sephadex, Cu-BTC@Sephadex, and Co-BTC@Sephadex. Beads were used to adsorbed toxic chemicals, and the effects of various experimental parameters were examined in the adsorption optimization process. The framework's adsorption isotherms were explained by the application of the Freundlich and Langmuir models. The kinetics of adsorption is represented by a pseudo-first and second-order equation. The morphology and structure of the Fe-BTC@ Sephadex, Co-BTC@ Sephadex, and Cu-BTC@Sephadex beads were investigated using Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), and X-ray diffraction (XRD). The adsorption capacities for creatinine were 545.69, 339.76, and 189.88 mg/g for Fe-BTC@ Sephadex, Cu-BTC@ Sephadex, and Co-BTC@ Sephadex, respectively, according to the results; the corresponding adsorption capacities for hippuric acid were 323.78, 206.79, and 68.059 mg/g, and the maximum adsorption capacities for p-Cresol sulfate were 122.65, 71.268, and 40.347 mg/g, respectively. These were, in fact, promising findings that have implications for an industrial-scale transportable artificial kidney.

Clearance of Protein-Bound Uremic Toxins Using Anion Nanotraps with Record High Uptake

Traditional hemodialysis often fails to remove protein-bound uremic toxins (PBUTs) like p-cresyl sulfate (pCS) and indoxyl sulfate (IS) due to their strong binding to human serum albumin, which is linked to adverse cardiovascular outcomes. Herein, a class of cationic polymeric networks, denoted as CPN-X6-CPN-X9, are reported for the efficient removal of PBUTs. The abundant imidazole-based nanotraps in these cationic polymeric networks confer a highly positive charge density, resulting in CPN-X7 achieving a maximum sorption capacity of 1000.8 mg/g for pCS and CPN-X6 offering a maximum sorption capacity of 1028.4 mg/g for IS, surpassing all previously reported sorbents. Furthermore, CPN-X9, which is relatively hydrophobic, exhibits remarkable selectivity in competitive experiments involving large amount of chloride ions and serum albumin, attaining removal rates of up to 74% for pCS and 93% for IS in the recycling in vitro dialysis mode. Meanwhile, CPN-X9 demonstrates excellent recyclability over five cycles, and the cationic polymeric network materials exhibit satisfactory hemocompatibility. The sorption mechanism of the anion exchange process is fully elucidated and verified by density functional theory (DFT) calculations. This study provides valuable insights into enhancing the removal efficiency of PBUTs and presents broad prospects in the field of clinical blood purification.

Functionalization strategy of carboxymethyl cotton gauze fabrics with zeolitic imidazolate framework-67 (ZIF-67) as a recyclable material for biomedical applications

The accumulation of uremic toxins in the human body poses a deadly risk because it causes chronic kidney disease. To increase the effectiveness of hemodialysis and raise the survival rate, these toxins must be effectively removed from the bloodstream. Developing effective materials for removing these dangerous substances requires a thorough understanding of the interactions between an adsorbent and the uremic toxins. Thankfully, metal-organic frameworks (MOFs) have shown considerable promise for the identification and treatment of kidney disorders. Herein, cotton gauze fabrics (CGF) were carboxylated using monochloroacetic acid to produce carboxymethylated cotton gauze fabrics (CM-CGF). CM-CGF was subsequently decorated in situ with zeolitic imidazolate framework-67, resulting in carboxymethylated cotton gauze fabrics-zeolitic imidazolate framework-67 (CM-CGF-ZIF). The CGF, CM-CGF, and CM-CGF-ZIF were evaluated for potential kidney applications by removing uric acid and creatinine from mimic blood. The results showed that CM-CGF-ZIF had the highest adsorption of uric acid and creatinine. The maximum adsorption capacity of uric acid and creatinine was 164 and 222 mg/g for CM-CGF-ZIF, respectively, compared to 45 and 67 mg/g for CGF. CM-CGF-ZIF showed excellent antibacterial activity, good antifungal activity, low cytotoxicity, and a satisfactory level of blood compatibility.

MOF-Based Platform for Kidney Diseases: Advances, Challenges, and Prospects

Kidney diseases are important diseases that affect human health worldwide. According to the 2020 World Health Organization (WHO) report, kidney diseases have become the top 10 causes of death. Strengthening the prevention, primary diagnosis, and action of kidney-related diseases is of great significance in maintaining human health and improving the quality of life. It is increasingly challenging to address clinical needs with the present technologies for diagnosing and treating renal illness. Fortunately, metal-organic frameworks (MOFs) have shown great promise in the diagnosis and treatment of kidney diseases. This review summarizes the research progress of MOFs in the diagnosis and treatment of renal disease in recent years. Firstly, we introduce the basic structure and properties of MOFs. Secondly, we focus on the utilization of MOFs in the diagnosis and treatment of kidney diseases. In the diagnosis of kidney disease, MOFs are usually designed as biosensors to detect biomarkers related to kidney disease. In the treatment of kidney disease, MOFs can not only be used as an effective adsorbent for uremic toxins during hemodialysis but also as a precise treatment of intelligent drug delivery carriers. They can also be combined with nano-chelation technology to solve the problem of the imbalance of trace elements in kidney disease. Finally, we describe the current challenges and prospects of MOFs in the diagnosis and treatment of kidney diseases.

Metal-organic framework-based adsorbents for blood purification: progress, challenges, and prospects

Blood purification, such as hemodialysis (HD), plasma exchange (PE), and hemoperfusion (HP), is widely applied in patients with organ failure (such as kidney and liver failure). Among them, HP mainly relies on porous adsorbents to efficiently adsorb accumulated metabolic wastes and toxins, thus improving purification efficiency. Metal-organic frameworks (MOFs), with a high porosity, large surface area, high loading capacity, and tailorable topology, are emerging as some of the most promising materials for HP. Compared with non-metal framework counterparts, the self-built metal centers of MOFs feature the intrinsic advantages of coordination with toxin molecules. However, research on MOFs in blood purification is insufficient, particularly in contrast to materials applied in other biomedical applications. Thus, to broaden this area, this review first discusses the essential characteristics, potential mechanisms, and structure-function relationship between MOFs and toxin adsorption based on porosity, topology, ligand functionalization, metal centers, and toxin types. Moreover, the stability, utilization safety, and hemocompatibility of MOFs are illustrated for adsorbent selection. The current development and progress in MOF composites for HD, HP, and extracorporeal membrane oxygenation (ECMO) are also summarized to highlight their practicability. Finally, we propose future opportunities and challenges from materials design and manufacture to the computational prediction of MOFs in blood purification. It is anticipated that our review will expand the interest of researchers for more impact in this area.

Uremic toxins mediate kidney diseases: the role of aryl hydrocarbon receptor

Aryl hydrocarbon receptor (AhR) was originally identified as an environmental sensor that responds to pollutants. Subsequent research has revealed that AhR recognizes multiple exogenous and endogenous molecules, including uremic toxins retained in the body due to the decline in renal function. Therefore, AhR is also considered to be a uremic toxin receptor. As a ligand-activated transcriptional factor, the activation of AhR is involved in cell differentiation and senescence, lipid metabolism and fibrogenesis. The accumulation of uremic toxins in the body is hazardous to all tissues and organs. The identification of the endogenous uremic toxin receptor opens the door to investigating the precise role and molecular mechanism of tissue and organ damage induced by uremic toxins. This review focuses on summarizing recent findings on the role of AhR activation induced by uremic toxins in chronic kidney disease, diabetic nephropathy and acute kidney injury. Furthermore, potential clinical approaches to mitigate the effects of uremic toxins are explored herein, such as enhancing uremic toxin clearance through dialysis, reducing uremic toxin production through dietary interventions or microbial manipulation, and manipulating metabolic pathways induced by uremic toxins through controlling AhR signaling. This information may also shed light on the mechanism of uremic toxin-induced injury to other organs, and provide insights into clinical approaches to manipulate the accumulated uremic toxins.