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Rayego-Mateos S, Valdivielso JM. New therapeutic targets in chronic kidney disease progression and renal fibrosis. Expert Opin Ther Targets 2020; 24:655-670. [PMID: 32338087 DOI: 10.1080/14728222.2020.1762173] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The current therapeutic armamentarium to prevent chronic kidney disease (CKD) progression is limited to the control of blood pressure and in diabetic patients, the strict control of glucose levels. Current research is primarily focused on the reduction of inflammation and fibrosis at different levels. AREAS COVERED This article examines the latest progress in this field and places an emphasis on inflammation, oxidative stress, and fibrosis. New therapeutic targets are described and evidence from experimental and clinical studies is summarized. We performed a search in Medline for articles published over the last 10 years. EXPERT OPINION The search for therapeutic targets of renal inflammation is hindered by an incomplete understanding of the pathophysiology. The determination of the specific inducers of inflammation in the kidney is an area of heightened potential. Prevention of the progression of renal fibrosis by blocking TGF-β signaling has been unsuccessful, but the investigation of signaling pathways involved in late stages of fibrosis progression could yield improved results. Preventive strategies such as the modification of microbiota-inducers of uremic toxins involved in CKD progression is a promising field because of the interaction between the gut microbiota and the renal system.
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Affiliation(s)
- Sandra Rayego-Mateos
- Red De Investigación Renal (Redinren) , Spain.,Vascular and Renal Translational Research Group, Institut De Recerca Biomèdica De Lleida IRBLleida , Lleida, Spain
| | - Jose M Valdivielso
- Red De Investigación Renal (Redinren) , Spain.,Vascular and Renal Translational Research Group, Institut De Recerca Biomèdica De Lleida IRBLleida , Lleida, Spain
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Inhibition of dipeptidyl peptidase IV protects tacrolimus-induced kidney injury. J Transl Med 2015; 95:1174-85. [PMID: 26237274 DOI: 10.1038/labinvest.2015.93] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 04/20/2015] [Accepted: 05/13/2015] [Indexed: 01/14/2023] Open
Abstract
Accumulating evidence shows that a gut-released hormone, the glucagon-like peptide-1 (GLP-1), has not only a glucose-lowering effect but also a renoprotective effect against kidney injury. In this study, we investigated whether a dipeptidyl peptidase (DPP) IV inhibitor has a protective effect against tacrolimus-induced renal injury. Rats were treated with tacrolimus (1.5 mg/kg, subcutaneously) and the DPP IV inhibitor MK0626 (10 or 20 mg/kg, oral gavage) for 4 weeks. MK0626 treatment attenuated tacrolimus-induced renal dysfunction, tubulointerstitial fibrosis, and arteriolopathy. Moreover, these improvements were accompanied by a reduction in oxidative stress and apoptosis. MK0626 treatment increased the blood level of GLP-1 and the level of its receptor in tissue sections but did not alter the levels of other DPP IV substrates, such as neuropeptide Y and the stromal cell-derived factor-1. These data suggest that DPP IV inhibition has an important role in the renoprotection against tacrolimus-induced nephrotoxicity via antioxidative and antiapoptotic effects and preservation of the GLP-1 system.
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Jiang Y, Gu L, Zhang R, Zhang Y, Zhang L, Ju P, Ma B, Zhang K, Bi K, Chen X. Evaluation of the indicative roles of seven potential biomarkers on hepato-nephrotoxicity induced by Genkwa Flos. JOURNAL OF ETHNOPHARMACOLOGY 2014; 158 Pt A:317-324. [PMID: 25446584 DOI: 10.1016/j.jep.2014.10.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 10/24/2014] [Accepted: 10/26/2014] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Genkwa Flos, a classical traditional Chinese medicine, is used for the definite antitumor activity and tends to be taken overdose or long term in these years. While the excessive application can result in damage to liver and kidney. In this study, the indicative roles of seven potential biomarkers were evaluated to investigate hepato-nephrotoxicity in the early stages after oral administration of Genkwa Flos for 14 days. MATERIALS AND METHODS Histopathology, serum biochemistry and seven potential biomarkers in serum or urine from male Sprague-Dawley rats were monitored. Hepatic and renal tissues were histopathologically examined to identify specific changes occurring. Routine serum biochemical parameters were tested by using standard clinical laboratory methods. Seven biomarkers including cholic acid, taurine, 5-oxoproline, hippuric acid, uric acid, 3-indoxyl sulfate and kynurenic acid were detected by a developed LC-MS method. RESULTS The histopathological alterations and the increased levels of serum biochemistry were detected on the 8th day after Genkwa Flos treated. The seven analytes were also found significantly changed in Genkwa Flos treated group, especially cholic acid, taurine, 5-oxoproline and hippuric acid which were changed on the 2nd or 4th day. CONCLUSIONS Although serum biochemistry and histopathology suggested that Genkwa Flos was responsible for the hepato-nephrotoxicity that occurred following the ingestion of this medicinal herb, evaluation of these biomarkers might be more beneficial for the early detection of liver and kidney injuries. This study could be further used in hepatic and renal failures caused by other reasons in the following research works.
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Affiliation(s)
- Yu Jiang
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Liqiang Gu
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Ruowen Zhang
- Department of Pathology, School of Medicine and Health Sciences, University of North Dakota, 501 North Columbia Rd., Grand Forks, ND 58202 USA
| | - Yuanyuan Zhang
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Lunhui Zhang
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Ping Ju
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Bingjie Ma
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Kexia Zhang
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Kaishun Bi
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Xiaohui Chen
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China.
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Lim SW, Doh KC, Jin L, Jin J, Piao SG, Heo SB, Chung BH, Yang CW. Ginseng treatment attenuates autophagic cell death in chronic cyclosporine nephropathy. Nephrology (Carlton) 2014; 19:490-9. [DOI: 10.1111/nep.12273] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2014] [Indexed: 12/16/2022]
Affiliation(s)
- Sun Woo Lim
- Convergent Research Consortium for Immunologic Disease; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
- Transplant Research Center; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
| | - Kyoung Chan Doh
- Convergent Research Consortium for Immunologic Disease; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
- Transplant Research Center; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
| | - Long Jin
- Convergent Research Consortium for Immunologic Disease; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
- Transplant Research Center; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
| | - Jian Jin
- Convergent Research Consortium for Immunologic Disease; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
- Transplant Research Center; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
| | - Shang Guo Piao
- Convergent Research Consortium for Immunologic Disease; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
- Transplant Research Center; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
| | - Seong Beom Heo
- Convergent Research Consortium for Immunologic Disease; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
| | - Byung Ha Chung
- Convergent Research Consortium for Immunologic Disease; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
- Division of Nephrology; Department of Internal Medicine; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
| | - Chul Woo Yang
- Convergent Research Consortium for Immunologic Disease; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
- Transplant Research Center; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
- Division of Nephrology; Department of Internal Medicine; Seoul St. Mary's Hospital; The Catholic University of Korea; Seoul Korea
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Ligustrazine attenuates elevated levels of indoxyl sulfate, kidney injury molecule-1 and clusterin in rats exposed to cadmium. Food Chem Toxicol 2013; 63:62-8. [PMID: 24200859 DOI: 10.1016/j.fct.2013.10.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/14/2013] [Accepted: 10/24/2013] [Indexed: 02/05/2023]
Abstract
In this study, we aimed at evaluating the effect of ligustrazine, a major constituent of Ligusticum wallichii from traditional Chinese medicine, on Cd-induced changes in nephrotoxicity indices. Rats were divided into four experimental groups: control; ligustrazine; Cd and ligustrazine+Cd. Cd treated alone group showed significant decreases (P<0.05) in body weight, renal levels of superoxide dismutase (SOD) and glutathione reductase (GR); and significant increases (P<0.05) in urine volume (24h), pH values, serum blood urea nitrogen (BUN), serum uric acid, kidney malondialdehyde (MDA), urinary total protein, urinary glucose, urinary lactate dehydrogenase (LDH) and urinary alkaline phosphatase (ALP). Apart from indoxyl sulfate (a uremic toxin), two newly accepted nephrotoxicity biomarkers including kidney injury molecule-1 (kim-1) and clusterin were also found to be increased. Nonetheless, all these effects induced by Cd were reversed upon treatment by ligustrazine although it failed in decreasing the concentrations of Cd in kidney and urine. Histopathological studies in Cd-treated rats exhibited renal tubule damage, which was also ameliorated by ligustrazine pretreatment. These results suggest that ligustrazine exhibits protective effects on Cd-induced nephrotoxicity. Additionally, this study also demonstrates Cd exposure induces elevated levels of indoxyl sulfate in serum and kidney, and clusterin in urine.
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Lim SW, Doh KC, Jin L, Piao SG, Heo SB, Zheng YF, Bae SK, Chung BH, Yang CW. Oral administration of ginseng ameliorates cyclosporine-induced pancreatic injury in an experimental mouse model. PLoS One 2013; 8:e72685. [PMID: 24009697 PMCID: PMC3757011 DOI: 10.1371/journal.pone.0072685] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 07/16/2013] [Indexed: 11/23/2022] Open
Abstract
Background This study was performed to investigate whether ginseng has a protective effect in an experimental mouse model of cyclosporine-induced pancreatic injury. Methods Mice were treated with cyclosporine (30 mg/kg/day, subcutaneously) and Korean red ginseng extract (0.2 or 0.4 g/kg/day, oral gavage) for 4 weeks while on a 0.01% salt diet. The effect of ginseng on cyclosporine-induced pancreatic islet dysfunction was investigated by an intraperitoneal glucose tolerance test and measurements of serum insulin level, β cell area, macrophage infiltration, and apoptosis. Using an in vitro model, we further examined the effect of ginseng on a cyclosporine-treated insulin-secreting cell line. Oxidative stress was measured by the concentration of 8-hydroxy-2′-deoxyguanosine in serum, tissue sections, and culture media. Results Four weeks of cyclosporine treatment increased blood glucose levels and decreased insulin levels, but cotreatment with ginseng ameliorated the cyclosporine-induced glucose intolerance and hyperglycemia. Pancreatic β cell area was also greater with ginseng cotreatment compared with cyclosporine monotherapy. The production of proinflammatory molecules, such as induced nitric oxide synthase and cytokines, and the level of apoptotic cell death also decreased in pancreatic β cell with ginseng treatment. Consistent with the in vivo results, the in vitro study showed that the addition of ginseng protected against cyclosporine-induced cytotoxicity, inflammation, and apoptotic cell death. These in vivo and in vitro changes were accompanied by decreases in the levels of 8-hydroxy-2′-deoxyguanosine in pancreatic β cell in tissue section, serum, and culture media during cotreatment of ginseng with cyclosporine. Conclusions The results of our in vivo and in vitro studies demonstrate that ginseng has a protective effect against cyclosporine-induced pancreatic β cell injury via reducing oxidative stress.
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Affiliation(s)
- Sun Woo Lim
- Convergent Research Consortium for Immunologic Disease, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, The Catholic University of Korea, Seoul, Korea
| | - Kyoung Chan Doh
- Convergent Research Consortium for Immunologic Disease, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, The Catholic University of Korea, Seoul, Korea
| | - Long Jin
- Convergent Research Consortium for Immunologic Disease, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, The Catholic University of Korea, Seoul, Korea
| | - Shang Guo Piao
- Convergent Research Consortium for Immunologic Disease, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, The Catholic University of Korea, Seoul, Korea
- Nephrology and Dialysis Unit, Department of Internal Medicine, YanBian University Hospital, Jilin, China
| | - Seong Beom Heo
- Convergent Research Consortium for Immunologic Disease, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, The Catholic University of Korea, Seoul, Korea
| | - Yu Fen Zheng
- College of Pharmacy, Seoul National University. Seoul, Korea
| | - Soo Kyung Bae
- College of Pharmacy, The Catholic University of Korea, Seoul, Korea
| | - Byung Ha Chung
- Convergent Research Consortium for Immunologic Disease, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, The Catholic University of Korea, Seoul, Korea
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Chul Woo Yang
- Convergent Research Consortium for Immunologic Disease, The Catholic University of Korea, Seoul, Korea
- Transplant Research Center, The Catholic University of Korea, Seoul, Korea
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
- * E-mail:
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Sato T, Ishikawa A, Homma Y. Effect of reduced form of coenzyme Q10 on cyclosporine nephrotoxicity. EXP CLIN TRANSPLANT 2012. [PMID: 23194328 DOI: 10.6002/ect.2012.0126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Cyclosporine, a potent immunosuppressant, has nephrotoxic adverse effects that may be mediated by oxidative stress. The reduced form of coenzyme Q10 has antioxidant effects. The aim of the present study was to evaluate the effect of the reduced form of coenzyme Q10 on cyclosporine nephrotoxicity. MATERIALS AND METHODS Six-week-old male Wistar rats were divided into 3 groups (10 animals each). Group 1 (control) received olive oil only. Group 2 received cyclosporine (30 mg/kg/d, which is an experimentally nephrotoxic dose). Group 3 received cyclosporine (30 mg/kg/d) and the reduced form of coenzyme Q10 (600 mg/kg/d). The cyclosporine and the reduced form of coenzyme Q10 were given orally for 4 weeks. Daily urinary albumin excretion, serum creatinine level, and urinary 8-hydroxydeoxyguanosine level were measured, and renal tissue was evaluated by immunohistochemistry. RESULTS In rats treated with cyclosporine and the reduced form of coenzyme Q10 (group 3), there were significantly less abnormalities in mean urinary albumin excretion (group 1: 2.8 ± 0.5; group 2: 41 ± 7; group 3: 21 ± 4 μg/d), serum creatinine (group 1: 1.0 ± 0.2; group 2: 1.8 ± 0.4; group 3: 1.4 ± 0.3 mg/dL), and urine 8-hydroxydeoxyguanosine levels (group 1: 7 ± 3; group 2: 10 ± 3; group 3: 7 ± 1 mg/mL creatinine) than rats treated with cyclosporine alone (group 2). There were 8-hydroxydeoxyguanosine deposits seen in the proximal tubular cells of group 2 that were not present in rats treated with the reduced form of coenzyme Q10 (group 3). CONCLUSIONS The reduced form of coenzyme Q10 may prevent or minimize cyclosporine nephrotoxicity by an antioxidant effect.
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Affiliation(s)
- Toshikazu Sato
- Department of Urology, Tokyo Teishin Hospital, Chiyoda-ku, Tokyo, Japan
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Sun CY, Hsu HH, Wu MS. p-Cresol sulfate and indoxyl sulfate induce similar cellular inflammatory gene expressions in cultured proximal renal tubular cells. Nephrol Dial Transplant 2012; 28:70-8. [PMID: 22610984 DOI: 10.1093/ndt/gfs133] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND p-Cresol sulfate (PCS) and indoxyl sulfate (IS) have important roles in the kidney injury. The aim of this study was to determine the inflammatory response to PCS and IS. METHODS Cultured mouse proximal renal tubular cells were treated with PCS or IS and analyzed by polymerase chain reaction array with an inflammation and immune panel. Gene annotation enrichment and functional annotation clustering were analyzed with the Database for Annotation, Visualization, and Integrated Discovery (DAVID). Functional networks of the target genes were analyzed with the algorithm GeneMANIA. RESULTS PCS and IS increased the expression of inflammation associated genes. Sixteen upregulated gene clusters of cells treated with PCS or IS were found. The major cytokines in the functional networks generated by PCS or IS treatment were Tgfb1, Fasl, Il6/15, Il15, Csf1/3 and Cxcl10. The major intracellular signal triggered by PCS or IS included Stats, Smads, Nfkb2, Ikbkb, Bcl2 and Bax. In both PCS- and IS-treated cells, Col4a5, Cxc10, Fasl, Stat1 and Ikbkb were the target genes in the predicted molecular functional networks connected to Tgfb1. CONCLUSIONS PCS and IS stimulate significant cellular inflammation. Similar immune and cellular inflammatory responses were induced by PCS or IS on cultured proximal renal tubular cells.
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Affiliation(s)
- Chiao-Yin Sun
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
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Kim SH, Yu MA, Ryu ES, Jang YH, Kang DH. Indoxyl sulfate-induced epithelial-to-mesenchymal transition and apoptosis of renal tubular cells as novel mechanisms of progression of renal disease. J Transl Med 2012; 92:488-98. [PMID: 22231736 DOI: 10.1038/labinvest.2011.194] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Indoxyl sulfate (IS), one of the uremic toxins, is regarded to have a substantial role in the progression of chronic kidney disease (CKD). Epithelial-to-mesenchymal transition (EMT) and apoptosis of renal tubular cells are known to be the critical mechanisms of the development and aggravation of CKD. We investigated the effect of IS on EMT and apoptosis in renal proximal tubular cells, NRK-52E cells. IS significantly inhibited cell proliferation and induced cell migration with a morphological transition from cuboidal epithelial cells to spindle-shaped scattered fibroblast-like cells. IS downregulated the expressions of zonula occluden-1 and E-cadherin, whereas upregulated α-SMA expression at 48 h, which was blocked by a pretreatment of the organic anion transporter, probenecid. IS also induced apoptosis of NRK cells from a concentration of 25 μg/ml with an activation of ERK1/2 and p38 MAP kinase (MAPK). Pretreatment of ERK1/2 or p38 MAPK inhibitors, PD98059 or SB203580, resulted in no significant effect on IS-induced EMT, whereas it ameliorated IS-induced apoptosis of NRK cells. These findings suggested phenotypic transition and apoptosis as potential mechanisms of IS-induced renal damage and the differential role of MAPK activation in IS-induced EMT and apoptosis of renal tubular cells.
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Affiliation(s)
- Su Hyun Kim
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University, Seoul, Korea
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