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Buse M, Cheng M, Jankowski V, Lellig M, Sterzer V, Strieder T, Leuchtle K, Martin IV, Seikrit C, Brinkkoettter P, Crispatzu G, Floege J, Boor P, Speer T, Kramann R, Ostendorf T, Moeller MJ, Costa IG, Stamellou E. Lineage tracing reveals transient phenotypic adaptation of tubular cells during acute kidney injury. iScience 2024; 27:109255. [PMID: 38444605 PMCID: PMC10914483 DOI: 10.1016/j.isci.2024.109255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/05/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
Tubular injury is the hallmark of acute kidney injury (AKI) with a tremendous impact on patients and health-care systems. During injury, any differentiated proximal tubular cell (PT) may transition into a specific injured phenotype, so-called "scattered tubular cell" (STC)-phenotype. To understand the fate of this specific phenotype, we generated transgenic mice allowing inducible, reversible, and irreversible tagging of these cells in a murine AKI model, the unilateral ischemia-reperfusion injury (IRI). For lineage tracing, we analyzed the kidneys using single-cell profiling during disease development at various time points. Labeled cells, which we defined by established endogenous markers, already appeared 8 h after injury and showed a distinct expression set of genes. We show that STCs re-differentiate back into fully differentiated PTs upon the resolution of the injury. In summary, we show the dynamics of the phenotypic transition of PTs during injury, revealing a reversible transcriptional program as an adaptive response during disease.
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Affiliation(s)
- Marc Buse
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Mingbo Cheng
- Institute for Computational Genomics, RWTH Aachen University Hospital, Aachen, Germany
| | - Vera Jankowski
- Institute for Molecular Cardiovascular Research, RWTH Aachen University Hospital, Aachen, Germany
| | - Michaela Lellig
- Institute for Molecular Cardiovascular Research, RWTH Aachen University Hospital, Aachen, Germany
| | - Viktor Sterzer
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Thiago Strieder
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Katja Leuchtle
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Ina V. Martin
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Claudia Seikrit
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Paul Brinkkoettter
- Department II of Internal Medicine and Centre for Molecular Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Giuliano Crispatzu
- Department II of Internal Medicine and Centre for Molecular Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Peter Boor
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
- Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany
| | - Timotheus Speer
- Medical Clinic 4, Nephrology, University of Frankfurt und Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Rafael Kramann
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
- Institute of Experimental Medicine and Systems Biology, RWTH Aachen University, Aachen, Germany
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Tammo Ostendorf
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Marcus J. Moeller
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Ivan G. Costa
- Institute for Computational Genomics, RWTH Aachen University Hospital, Aachen, Germany
| | - Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
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Stamellou E, Saritas T, Froissart M, Kronenberg F, Stenvinkel P, Wheeler DC, Eckardt KU, Floege J, Fotheringham J. Identifying individuals at risk of needing CKD associated medications in a European kidney disease cohort. BMC Nephrol 2024; 25:60. [PMID: 38378456 PMCID: PMC10880231 DOI: 10.1186/s12882-024-03497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND The consequences of chronic kidney disease (CKD) can be addressed with a range of pharmacotherapies primarily prescribed by nephrologists. More accurate information regarding future CKD-related pharmacotherapy requirements could guide clinical decisions including follow-up frequency. METHODS Following assignment to derivation and validation groups (2,1), variables predicting individually future use of vitamin D receptor agonists (VDRA), phosphate binders, erythropoiesis stimulating agents (ESAs) and iron were identified using logistic regression in a prospective cohort study containing demography, comorbidity, hospitalization, laboratory, and mortality data in patients with CKD stage G4/G5 across six European countries. Discriminative ability was measured using C-statistics, and predicted probability of medication use used to inform follow-up frequency. RESULTS A total of 2196 patients were included in the analysis. During a median follow-up of 735 days 648 initiated hemodialysis and 1548 did not. Combinations of age, diabetes status and iPTH, calcium, hemoglobin and serum albumin levels predicted the use of ESA, iron, phosphate binder or VDRA, with C-statistics of 0.70, 0.64, 0.73 and 0.63 in derivation cohorts respectively. Model performance in validation cohorts were similar. Sixteen percent of patients were predicted to have a likelihood of receiving any of these medications of less than 20%. CONCLUSIONS In a multi-country CKD cohort, prediction of ESA and phosphate binder use over a two-year period can be made based on patient characteristics with the potential to reduce frequency of follow-up in individuals with low risk for requiring these medications.
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Affiliation(s)
- Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany.
- Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece.
| | - Turgay Saritas
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany
| | - Marc Froissart
- Centre de Recherche Clinique (CRC), Lausanne University Hospital, Lausanne, Switzerland
| | - Florian Kronenberg
- Department of Genetics, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - David C Wheeler
- Department of Renal Medicine, University College London, London, United Kingdom
| | - Kai-Uwe Eckardt
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany
| | - James Fotheringham
- Northern General Hospital, Sheffield Kidney Institute, Herries Road, Sheffield, South Yorkshire, S5 7AU, United Kingdom
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Chia-Gil A, Floege J, Stamellou E, Moeller MJ. Perihilar FSGS lesions originate from flat parietal epithelial cells. J Nephrol 2024:10.1007/s40620-024-01886-y. [PMID: 38300433 DOI: 10.1007/s40620-024-01886-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/01/2024] [Indexed: 02/02/2024]
Abstract
Graphical Abstract
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Affiliation(s)
- Arnaldo Chia-Gil
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
- Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece.
| | - Marcus J Moeller
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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Stamellou E, Agrawal S, Siegerist F, Buse M, Kuppe C, Lange T, Buhl EM, Alam J, Strieder T, Boor P, Ostendorf T, Gröne HJ, Floege J, Smoyer WE, Endlich N, Moeller MJ. Inhibition of the glucocorticoid receptor attenuates proteinuric kidney diseases in multiple species. Nephrol Dial Transplant 2023:gfad254. [PMID: 38037533 DOI: 10.1093/ndt/gfad254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND AND HYPOTHESIS Glucocorticoids are the treatment of choice for proteinuric patients with minimal-change disease (MCD) and primary focal and segmental glomerulosclerosis (FSGS). Immunosuppressive as well as direct effects on podocytes are believed to mediate their actions. In this study, we analyzed the anti-proteinuric effects of inhibition of the glucocorticoid receptor (GR) in glomerular epithelial cells, including podocytes. METHODS We employed genetic and pharmacological approaches to inhibit the GR. Genetically, we used Pax8-Cre/GRfl/fl mice to specifically inactivate the GR in kidney epithelial cells. Pharmacologically, we utilized a glucocorticoid antagonist called mifepristone. RESULTS Genetic inactivation of GR, specifically in kidney epithelial cells, using Pax8-Cre/GRfl/fl mice, ameliorated proteinuria following protein overload. We further tested the effects of pharmacological GR inhibition in three models and species: the puromycin-aminonucleoside-induced nephrosis model in rats, the protein overload model in mice and the inducible transgenic NTR/MTZ zebrafish larvae with specific and reversible podocyte injury. In all three models, both pharmacological GR activation and inhibition consistently and significantly ameliorated proteinuria. Additionally, we translated our findings to humans, where three nephrotic adult patients with MCD or primary FSGS with contraindications or insufficient responses to corticosteroids, were treated with mifepristone. This treatment resulted in a clinically relevant reduction of proteinuria. CONCLUSIONS Thus, across multiple species and proteinuria models, both genetic and pharmacological GR inhibition was at least as effective as pronounced GR activation. While, the mechanism remains perplexing, GR inhibition may be a novel and targeted therapeutic approach to treat glomerular proteinuria potentially bypassing adverse actions of steroids.
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Affiliation(s)
- Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
- Institute of Pathology and Electron Microscopy Facility, RWTH University of Aachen, Aachen, Germany
- Department of Nephrology, Medical School, University of Ioannina, Ioannina, Greece
| | - Shipra Agrawal
- Division of Nephrology and Hypertension, Department of Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Florian Siegerist
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Marc Buse
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Christoph Kuppe
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
- Institute of Experimental Medicine and Systems Biology, RWTH Aachen University, Aachen, Germany
| | - Tim Lange
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Eva Miriam Buhl
- Institute of Pathology and Electron Microscopy Facility, RWTH University of Aachen, Aachen, Germany
| | - Jessica Alam
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Thiago Strieder
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - Peter Boor
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
- Institute of Pathology and Electron Microscopy Facility, RWTH University of Aachen, Aachen, Germany
| | - Tammo Ostendorf
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | | | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
| | - William E Smoyer
- Center for Clinical and Translational Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, OH,USA
| | - Nicole Endlich
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
- NIPOKA, Greifswald, Germany
| | - Marcus J Moeller
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany
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Abstract
IgA nephropathy (IgAN), the most prevalent primary glomerulonephritis worldwide, carries a considerable lifetime risk of kidney failure. Clinical manifestations of IgAN vary from asymptomatic with microscopic or intermittent macroscopic haematuria and stable kidney function to rapidly progressive glomerulonephritis. IgAN has been proposed to develop through a 'four-hit' process, commencing with overproduction and increased systemic presence of poorly O-glycosylated galactose-deficient IgA1 (Gd-IgA1), followed by recognition of Gd-IgA1 by antiglycan autoantibodies, aggregation of Gd-IgA1 and formation of polymeric IgA1 immune complexes and, lastly, deposition of these immune complexes in the glomerular mesangium, leading to kidney inflammation and scarring. IgAN can only be diagnosed by kidney biopsy. Extensive, optimized supportive care is the mainstay of therapy for patients with IgAN. For those at high risk of disease progression, the 2021 KDIGO Clinical Practice Guideline suggests considering a 6-month course of systemic corticosteroid therapy; however, the efficacy of systemic steroid treatment is under debate and serious adverse effects are common. Advances in understanding the pathophysiology of IgAN have led to clinical trials of novel targeted therapies with acceptable safety profiles, including SGLT2 inhibitors, endothelin receptor blockers, targeted-release budesonide, B cell proliferation and differentiation inhibitors, as well as blockade of complement components.
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Affiliation(s)
- Eleni Stamellou
- Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece
- Department of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Claudia Seikrit
- Department of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Sydney C W Tang
- Division of Nephrology, Department of Medicine, University of Hong Kong, Hong Kong, China
| | - Peter Boor
- Department of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
- Department of Pathology, RWTH Aachen University, Aachen, Germany
| | - Vladimir Tesař
- Department of Nephrology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Jürgen Floege
- Department of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Jonathan Barratt
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Rafael Kramann
- Department of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus Medical Center, Rotterdam, Netherlands.
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Seikrit C, Schimpf JI, Wied S, Stamellou E, Izcue A, Pabst O, Rauen T, Lenaerts K, Floege J. Intestinal permeability in patients with IgA nephropathy and other glomerular diseases: an observational study. J Nephrol 2023; 36:463-474. [PMID: 36107369 PMCID: PMC9998562 DOI: 10.1007/s40620-022-01454-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/23/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND A dysregulated 'gut-kidney axis' may contribute to immunoglobulin A nephropathy (IgAN). We studied whether IgAN patients have disturbed intestinal permeability. METHODS In a prospective, cross sectional, pilot study we assessed intestinal permeability in 35 IgAN patients, 18 patients with non-IgAN glomerulonephritides (GNs) and 19 healthy controls. After an overnight fast, trial participants ingested a multi-sugar solution and samples were obtained from 0 to 2, 2 to 5- and 5 to 24-h urine portions. Urinary sugar concentrations were quantified using isocratic ion-exchange high performance liquid chromatography. Indices of small intestinal permeability (0-2-h lactulose/L-rhamnose (L/R) ratio), distal small intestinal and proximal colonic permeability (2-5-h sucralose/erythritol (S/E) ratio) and colonic permeability (5-24-h sucralose/erythritol (S/E) ratio) were evaluated. Associations between groups and indices of intestinal permeability were investigated by a linear mixed model. RESULTS Small intestinal permeability (0-2 h L/R-ratio) was significantly increased in patients with glomerular diseases versus healthy controls. More precisely, increased small intestinal permeability was exclusively noted in non-IgAN GN patients, whereas IgAN patients exhibited a trend towards elevated small intestinal permeability. In total, 54% of patients with IgAN and 67% of non-IgAN GN patients had increased small intestinal permeability. Neither distal small intestinal and proximal colonic permeability nor colonic gut permeability indices (i.e., 2-5 h and 5-24 h S/E ratios) were significantly different between controls and any of the GN patient groups. CONCLUSION The present single center pilot study suggests that disturbed intestinal permeability is common in patients with glomerular diseases and is not specific for IgAN. TRIAL REGISTRATION NUMBER German Clinical Trials Register DRKS00021533, Date: 24.04.2020.
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Affiliation(s)
- Claudia Seikrit
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Pauwelsstr. 30, 52057, Aachen, Germany.
| | - Judith I Schimpf
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Pauwelsstr. 30, 52057, Aachen, Germany
- Department of Internal Medicine III, Nephrology and Dialysis, Feldkirch Academic Teaching Hospital, Feldkirch, Austria
| | - Stephanie Wied
- Department of Medical Statistics, RWTH Aachen University, Aachen, Germany
| | - Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Pauwelsstr. 30, 52057, Aachen, Germany
| | - Ana Izcue
- Department of Molecular Medicine, RWTH Aachen University, Aachen, Germany
| | - Oliver Pabst
- Department of Molecular Medicine, RWTH Aachen University, Aachen, Germany
| | - Thomas Rauen
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Pauwelsstr. 30, 52057, Aachen, Germany
| | - Kaatje Lenaerts
- Department of Surgery, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH Aachen University, Pauwelsstr. 30, 52057, Aachen, Germany
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Barratt J, Lafayette R, Kristensen J, Stone A, Cattran D, Floege J, Tesar V, Trimarchi H, Zhang H, Eren N, Paliege A, Rovin BH, Karl A, Losisolo P, Trimarchi H, Hoyos IG, Lampo MG, Monkowski M, De La Fuente J, Alvarez M, Stoppa D, Chiurchiu C, Novoa PA, Orias M, Barron MB, Giotto A, Arriola M, Cassini E, Maldonado R, Dionisi MP, Ryan J, Toussaint N, Luxton G, Peh CA, Levidiotis V, Francis R, Phoon R, Fedosiuk E, Toropilov D, Yakubtsevich R, Mikhailova E, Bovy C, Demoulin N, Hougardy JM, Maes B, Speeckaert M, Laurin LP, Barbour S, Masse M, Hladunewich M, Reich H, Cournoyer S, Tennankore K, Barbour S, Lv J, Liu Z, Wang C, Li S, Luo Q, Ni Z, Yan T, Fu P, Cheng H, Liu B, Lu W, Wang J, Chen Q, Wang D, Xiong Z, Chen M, Xu Y, Wei J, Pai P, Chen L, Rehorova J, Maixnerova D, Safranek R, Rychlik I, Hruby M, Makela S, Vaaraniemi K, Ortiz F, Alamartine E, Daroux M, Cartery C, Vrtovsnik F, Serre JE, Stamellou E, Vielhauer V, Hugo C, Budde K, Otte B, Nitschke M, Ntounousi E, Boletis I, Papagianni A, Goumenos D, Stylianou K, Zermpala S, Esposito C, Cozzolino MG, Viganò SM, Gesualdo L, Nowicki M, Stompor T, Kurnatowska I, Kim SG, Kim YL, Na KR, Kim DK, Kim SH, Porras LQ, Garcia ER, Pamplona IA, Segarra A, Goicoechea M, Fellstrom B, Lundberg S, Hemmingsson P, Guron G, Sandell A, Chen CH, Tokgoz B, Duman S, Altiparmak MR, Ergul M, Maxwell P, Mark P, McCafferty K, Khwaja A, Cheung CK, Hall M, Power A, Kanigicherla D, Baker R, Moriarty J, Mohamed A, Aiello J, Canetta P, Ayoub I, Robinson D, Thakar S, Mottl A, Sachmechi I, Fischbach B, Singh H, Mulhern J, Kamal F, Linfert D, Rizk D, Wadhwani S, Sarav M, Campbell K, Coppock G, Luciano R, Sedor J, Avasare R, Lau WL. Results from part A of the multi-center, double-blind, randomized, placebo-controlled NefIgArd trial, which evaluated targeted-release formulation of budesonide for the treatment of primary immunoglobulin A nephropathy. Kidney Int 2023; 103:391-402. [PMID: 36270561 DOI: 10.1016/j.kint.2022.09.017] [Citation(s) in RCA: 72] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/23/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022]
Abstract
The therapeutic potential of a novel, targeted-release formulation of oral budesonide (Nefecon) for the treatment of IgA nephropathy (IgAN) was first demonstrated by the phase 2b NEFIGAN trial. To verify these findings, the phase 3 NefigArd trial tested the efficacy and safety of nine months of treatment with Nefecon (16 mg/d) versus placebo in adult patients with primary IgAN at risk of progressing to kidney failure (ClinicalTrials.gov: NCT03643965). NefIgArd was a multicenter, randomized, double-blind, placebo-controlled two-part trial. In Part A, 199 patients with IgAN were treated with Nefecon or placebo for nine months and observed for an additional three months. The primary endpoint for Part A was 24-hour urine protein-to-creatinine ratio (UPCR) after nine months. Secondary efficacy outcomes evaluated included estimated glomerular filtration rate (eGFR) at nine and 12 months and the UPCR at 12 months. At nine months, UPCR was 27% lower in the Nefecon group compared with placebo, along with a benefit in eGFR preservation corresponding to a 3.87 ml/min/1.73 m2 difference versus placebo (both significant). Nefecon was well-tolerated, and treatment-emergent adverse events were mostly mild to moderate in severity and reversible. Part B is ongoing and will be reported on later. Thus, NefIgArd is the first phase 3 IgA nephropathy trial to show clinically important improvements in UPCR and eGFR and confirms the findings from the phase 2b NEFIGAN study.
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Affiliation(s)
- Jonathan Barratt
- College of Medicine Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - Richard Lafayette
- Division of Nephrology, Department of Medicine, Stanford University, Stanford, California, USA
| | | | | | - Daniel Cattran
- Division of Nephrology, Toronto General Hospital Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Jürgen Floege
- Department of Nephrology and Clinical Immunology, Rheinisch Westfälische Technische Hochschule Aachen University Hospital, Aachen, Germany
| | - Vladimir Tesar
- Department of Nephrology, 1st School of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Hernán Trimarchi
- Nephrology Service, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Hong Zhang
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Necmi Eren
- Department of Nephrology, Kocaeli University, Kocaeli, Turkey
| | - Alexander Paliege
- Division of Nephrology, Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - Brad H Rovin
- Division of Nephrology, the Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
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Seikrit C, Stamellou E, Rauen T, Floege J. TESTING the effects of corticosteroids in patients with IgA nephropathy. Nephrol Dial Transplant 2022; 37:1786-1788. [PMID: 35881470 DOI: 10.1093/ndt/gfac221] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Claudia Seikrit
- Division of Nephrology and Rheumatology, RWTH University of Aachen, Aachen, Germany
| | - Eleni Stamellou
- Division of Nephrology and Rheumatology, RWTH University of Aachen, Aachen, Germany
| | - Thomas Rauen
- Division of Nephrology and Rheumatology, RWTH University of Aachen, Aachen, Germany
| | - Jürgen Floege
- Division of Nephrology and Rheumatology, RWTH University of Aachen, Aachen, Germany
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Buse M, Moeller MJ, Stamellou E. What We Have Learned so far From Single Cell Sequencing in Acute Kidney Injury. Front Physiol 2022; 13:933677. [PMID: 35755431 PMCID: PMC9217124 DOI: 10.3389/fphys.2022.933677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
Acute Kidney injury is a major clinical problem associated with increased morbidity and mortality. Despite, intensive research the clinical outcome remains poor and apart from supportive therapy no other specific therapy exists. Single cell technologies have enabled us to get deeper insights into the transcriptome of individual cells in complex tissues like the kidney. With respect to kidney injury, this would allow us to better define the unique role of individual cell populations in the pathophysiology of acute kidney injury and progression to chronic kidney disease. In this mini review, we would like to give an overview and discuss the current major findings in the field of acute kidney injury through Single-Cell technologies.
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Affiliation(s)
- Marc Buse
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Marcus J Moeller
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
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Abstract
Acute tubular injury accounts for the most common intrinsic cause for acute kidney injury. Normally, the tubular epithelium is mitotically quiescent. However, upon injury, it can show a brisk capacity to regenerate and repair. The scattered tubular cell (STC) phenotype was discovered as a uniform reaction of tubule cells triggered by injury. The STC phenotype is characterized by a unique protein expression profile, increased robustness during tubular damage and increased proliferation. Nevertheless, the exact origin and identity of these cells have been unveiled only in part. Here, we discuss the classical concept of renal regeneration. According to this model, surviving cells dedifferentiate and divide to replace neighbouring lost tubular cells. However, this view has been challenged by the concept of a pre-existing and fixed population of intratubular progenitor cells. This review presents a significant body of previous work and animal studies using lineage-tracing methods that have investigated the regeneration of tubular cells. We review the experimental findings and discuss whether they support the progenitor hypothesis or the classical concept of renal tubular regeneration. We come to the conclusion that any proximal tubular cell may differentiate into the regenerative STC phenotype upon injury thus contributing to regeneration, and these cells differentiate back into tubular cells once regeneration is finished.
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Affiliation(s)
- Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Katja Leuchtle
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Marcus J Moeller
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
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Strieder T, Puelles VG, Vogt M, Buhl EM, Saritas T, Hausmann R, Sterzer V, Leuchtle K, Boor P, Floege J, Moeller MJ, Stamellou E. Effects of Perfusion Pressures on Podocyte Loss in the Isolated Perfused Mouse Kidney. Cell Physiol Biochem 2021; 55:1-12. [PMID: 33851800 DOI: 10.33594/000000355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND/AIMS Podocytes are lost in most glomerular diseases, leading to glomerulosclerosis and progressive kidney disease. It is generally assumed, that podocytes are exposed to the filtration flow and thus to significant shear forces driving their detachment from the glomerular basement membrane (GBM). In this context, foot process effacement has been proposed as potential adaptive response to increase adhesion of podocytes to the GBM. METHODS We have tested these hypotheses using optical clearing and high-resolution 3-dimensional morphometric analysis in the isolated perfused murine kidney. We investigated the dynamics of podocyte detachment at different perfusion pressures (50, 300 and more than 450 mmHg) in healthy young or old mice (20 vs. 71 weeks of age), or mice injected with anti-GBM serum to induce global foot process effacement. RESULTS Results show that healthy podocytes in young mice are tightly attached onto the GBM and even supramaximal pressures did not cause significant detachment. Compared to young mice, in aged mice and mice with anti-GBM nephritis and foot process effacement, gradual progressive loss of podocytes had occurred already before perfusion. High perfusion pressures resulted in a relatively minor additional loss of podocytes in aged mice. In mice with anti-GBM nephritis significant additional podocyte loss occurred at this early time point when increasing perfusion pressures to 300 mmHg or higher. CONCLUSION This work provides the first experimental evidence that podocytes are extraordinarily resistant to acutely increased perfusion pressures in an ex vivo isolated kidney perfusion model. Only in glomerular disease, significant numbers of injured podocytes detached following acute increases in perfusion pressure.
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Affiliation(s)
- Thiago Strieder
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Victor G Puelles
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.,Department of Medicine III, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Vogt
- Core Facility "Two-Photon Imaging" IZKF Aachen, RWTH University of Aachen, Aachen, Germany
| | - Eva M Buhl
- Institute of Pathology and Electron Microscopy Facility, RWTH University of Aachen, Aachen, Germany
| | - Turgay Saritas
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Ralf Hausmann
- Institute of Clinical Pharmacology, RWTH Aachen University Hospital, Aachen, Germany
| | - Viktor Sterzer
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Katja Leuchtle
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Peter Boor
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.,Institute of Pathology and Electron Microscopy Facility, RWTH University of Aachen, Aachen, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Marcus J Moeller
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany,
| | - Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany, .,Institute of Pathology and Electron Microscopy Facility, RWTH University of Aachen, Aachen, Germany
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Seikrit C, Rauen T, Stamellou E, Floege J. Precision medicine in immunoglobulin A nephropathy: still a journey ahead. Nephrol Dial Transplant 2021; 36:24-30. [PMID: 34153983 DOI: 10.1093/ndt/gfab032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Indexed: 11/12/2022] Open
Abstract
Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide and since its first description extensive research has identified a number of key central pathogenetic contributors, including genetic, immunological and environmental factors. Along with its multifaceted pathophysiology, the clinical presentation of IgAN varies, ranging from mild forms with only minor urinary findings and preserved renal function to cases that rapidly progress to end-stage renal disease. Because of this, early identification of patients at risk for a progressive course is urgently needed. The search for valid and easily accessible biomarkers showed urinary Dickkopf-3 as a promising candidate to predict the course of kidney function. In addition, a recently established IgAN risk prediction tool derived from an international cohort of IgAN patients allows estimation of the risk of a 50% loss of kidney function over several years upon diagnosis. This might serve as a significant tool to individually predict the course of renal function by combining biometric, clinical, histological and treatment information at the time of diagnosis. Today there is no doubt that a comprehensive supportive treatment regimen is the main pillar for all IgAN patients. The value of an additional immunosuppressive treatment in IgAN patients at risk for disease progression is less clear. Early risk stratification and individualized therapies would be desirable for IgAN patients to facilitate the choice of treatment strategies, which is still a matter of ongoing discussion.
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Affiliation(s)
- Claudia Seikrit
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Thomas Rauen
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
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Stamellou E, Cheng M, Sterzer V, Leuchtle K, Strieder T, Boor P, Floege J, Costa IG, Möller MJ. MO331LINEAGE TRACING OF REGENERATING PROXIMAL TUBULE CELLS (STC) BY SINGLE CELL PROFILING IN ACUTE KIDNEY INJURY. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab084.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Acute tubular injury accounts for the most common intrinsic cause for acute kidney injury (AKI). The scattered tubular cell (STC) phenotype was discovered as a uniform reaction of tubule cells triggered by injury. Our group was the first to identify an inducible transgenic mouse (PEC-rtTA-mouse) specifically labeling STCs with eGFP. Analysis of the transcriptional factors and associated signaling pathways might reveal the function and role of STCs in AKI.
Method
Here, we performed single-cell RNA sequencing of unilateral ischemia-reperfusion murine model of AKI 8, 24, 48 hours and 6 and 12 days after AKI induction.
Results
Genes expressing proximal tubular proteins and transporters were markedly downregulated during transition into the STC phenotype upon injury; but expression recovered over time and upon resolution and tubular cells re-differentiated into proximal tubule cells. This provides evidence for the first time that the STC phenotype is a transient and reversible phenotype triggered by injury. Among cells in the STC phenotype, we could identify 2 sub-clusters; a highly proliferating sub-cluster that in the cell cycle analysis showed the highest proportion of cycling cells. The second eGFP-positive cluster appeared very early after AKI and expressed a distinct set of genes (defined by 7 anchor genes). Some of the highly up-regulated genes are known markers of STCs hence confirming the specificity of our transgenic mouse line.
Conclusion
Our study provides gene expression patterns specifically in STCs upon injury and repair at multiple time points and suggests that the STC phenotype is a transient and reversible phenotype triggered by injury.
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Affiliation(s)
- Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany
- Institute of Pathology and Electron Microscopy Facility, RWTH University of Aachen, Aachen, Germany
| | - Mingbo Cheng
- Institute for Computational Genomics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Viktor Sterzer
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany
| | - Katja Leuchtle
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany
| | - Thiago Strieder
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany
| | - Peter Boor
- Institute of Pathology and Electron Microscopy Facility, RWTH University of Aachen, Aachen, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany
| | - Ivan G Costa
- Institute for Computational Genomics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Marcus Johannes Möller
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany
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Stamellou E, Floege J. Erratum to: Novel oral anticoagulants in patients with chronic kidney disease and atrial fibrillation. Nephrol Dial Transplant 2021; 36:952. [PMID: 32869061 DOI: 10.1093/ndt/gfaa190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Seikrit C, Schimpf J, Stamellou E, Pabst O, Rauen T, Lenaerts K, Floege J. SAT-396 INTESTINAL PERMEABILITY IS IMPAIRED IN PATIENTS WITH GLOMERULAR DISEASES. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Pallavi P, Pretze M, Caballero J, Li Y, Hofmann BB, Stamellou E, Klotz S, Wängler C, Wängler B, Loesel R, Roth S, Theisinger B, Moerz H, Binzen U, Greffrath W, Treede RD, Harmsen MC, Krämer BK, Hafner M, Yard BA, Kälsch AI. Analyses of Synthetic N-Acyl Dopamine Derivatives Revealing Different Structural Requirements for Their Anti-inflammatory and Transient-Receptor-Potential-Channel-of-the-Vanilloid-Receptor-Subfamily-Subtype-1 (TRPV1)-Activating Properties. J Med Chem 2018. [PMID: 29543451 DOI: 10.1021/acs.jmedchem.8b00156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We studied the chemical entities within N-octanoyl dopamine (NOD) responsible for the activation of transient-receptor-potential channels of the vanilloid-receptor subtype 1 (TRPV1) and inhibition of inflammation. The potency of NOD in activating TRPV1 was significantly higher compared with those of variants in which the ortho-dihydroxy groups were acetylated, one of the hydroxy groups was omitted ( N-octanoyl tyramine), or the ester functionality consisted of a bulky fatty acid ( N-pivaloyl dopamine). Shortening of the amide linker (ΔNOD) slightly increased its potency, which was further increased when the carbonyl and amide groups (ΔNODR) were interchanged. With the exception of ΔNOD, the presence of an intact catechol structure was obligatory for the inhibition of VCAM-1 and the induction of HO-1 expression. Because TRPV1 activation and the inhibition of inflammation by N-acyl dopamines require different structural entities, our findings provide a framework for the rational design of TRPV1 agonists with improved anti-inflammatory properties.
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Affiliation(s)
- Prama Pallavi
- Institute for Molecular and Cellular Biology , Mannheim University of Applied Sciences , Mannheim 68163 , Germany
| | | | - Julio Caballero
- Center for Bioinformatics and Molecular Simulations, Faculty of Engineering in Bioinformatics , Universidad de Talca , Talca 3460000 , Chile
| | | | | | | | | | | | | | - Ralf Loesel
- Department of Applied Chemistry , Technical University of Applied Sciences , Nuremberg 90489 , Germany
| | - Steffen Roth
- Department of Applied Chemistry , Technical University of Applied Sciences , Nuremberg 90489 , Germany
| | | | | | | | | | | | - Martin C Harmsen
- Department of Pathology and Medical Biology, University Medical Centre Groningen , University of Groningen , Groningen 9713 , The Netherlands
| | | | - Mathias Hafner
- Institute for Molecular and Cellular Biology , Mannheim University of Applied Sciences , Mannheim 68163 , Germany
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Stamellou E, Floege J. Novel oral anticoagulants in patients with chronic kidney disease and atrial fibrillation. Nephrol Dial Transplant 2017; 33:1683-1689. [DOI: 10.1093/ndt/gfx322] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/14/2017] [Indexed: 02/03/2023] Open
Affiliation(s)
- Eleni Stamellou
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany
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18
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Wedel J, Pallavi P, Stamellou E, Yard BA. N-acyl dopamine derivates as lead compound for implementation in transplantation medicine. Transplant Rev (Orlando) 2014; 29:109-13. [PMID: 25576467 DOI: 10.1016/j.trre.2014.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 12/01/2014] [Accepted: 12/06/2014] [Indexed: 02/07/2023]
Abstract
Conjugates of fatty acids with ethanolamine, amino acids or monoamine neurotransmitters occur widely in nature giving rise to so-called endocannabinoids. Anandamide and 2-arachidonoyl glycerol are the best characterized endocannabinoids activating both cannabinoid receptors (CB1 and CB2) and transient receptor potential vanilloid type 1 (TRPV1) channels (anandamide) or activating cannabinoid receptors only (2-arachidonoyl glycerol). TRPV1 is also activated by vanilloids, such as capsaicin, and endogenous neurolipins, e.g. N-arachidonoyl dopamine (NADA) and N-oleoyl dopamine (OLDA). Because donor dopamine treatment has shown to improve transplantation outcome in renal and heart recipients, this review will mainly focus on the biological activities of N-acyl dopamine derivates (NADD) as potential non-hemodynamic alternative for implementation in transplantation medicine. Hence the influence of NADD on transplantation relevant entities, i.e. cold inflicted injury, cytoprotection, I/R-injury, immune-modulation and inflammation will be summarized. The cytoprotective properties of endogenous endocannabinoids in this context will be briefly touched upon.
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Affiliation(s)
- Johannes Wedel
- Department of Medicine, Nephrology, Endocrinology, Diabetology, Rheumatology; Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Prama Pallavi
- Institute for Molecular and Cellular Biology, Mannheim University of Applied Sciences, Windeckstr. 98, 68163 Mannheim, Germany
| | - Eleni Stamellou
- Department of Medicine, Nephrology, Endocrinology, Diabetology, Rheumatology; Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Benito A Yard
- Department of Medicine, Nephrology, Endocrinology, Diabetology, Rheumatology; Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
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Wedel J, Hottenrott MC, Stamellou E, Breedijk A, Tsagogiorgas C, Hillebrands JL, Yard BA. N-Octanoyl dopamine transiently inhibits T cell proliferation via G1 cell-cycle arrest and inhibition of redox-dependent transcription factors. J Leukoc Biol 2014; 96:453-62. [PMID: 24929005 DOI: 10.1189/jlb.3a0813-455r] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Recently, we developed a nonhemodynamic dopamine derivative, NOD, which has profound anti-inflammatory effects in vitro. As NOD also protects rats from ischemic AKI, the present study tested whether NOD is able to modulate cellular immunity for potential use as a T cell-suppressive agent. To this end, T cells were stimulated by anti-CD3/CD28 or PMA/ionomycin in the presence or absence of different concentrations of NOD. T cell proliferation, activation markers, intracellular cytokine expression, and activation of transcription factors were assessed. Whereas T cell proliferation was inhibited significantly by NOD at Day 3, proliferation was restored at Day 7 or later depending on the NOD concentration used. Inhibition of proliferation was reflected by a diminished CD25 expression and switch from naive to memory T cells. Early TCR activation events were unaffected, yet NF-κB and AP-1 were strongly inhibited by NOD. The inhibitory effect of NOD seemed to be dependent on its redox activity, as NOT, a redox-inactive NOD derivate, did not influence proliferation. NOD displayed synergistic effects with CNIs on T cell proliferation. Our data demonstrate that NOD displays T cell-suppressive activity. In keeping with its anti-inflammatory action and its beneficial effect on ischemia-induced AKI, NOD may be an interesting drug candidate to prevent CNI-related side-effects.
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Affiliation(s)
- Johannes Wedel
- Departments of Medicine, Nephrology, Endocrinology, Diabetology, Rheumatology and
| | - Maximillia C Hottenrott
- Anesthesia and Critical Care, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; and
| | - Eleni Stamellou
- Departments of Medicine, Nephrology, Endocrinology, Diabetology, Rheumatology and
| | - Annette Breedijk
- Departments of Medicine, Nephrology, Endocrinology, Diabetology, Rheumatology and
| | - Charalambos Tsagogiorgas
- Anesthesia and Critical Care, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; and
| | - Jan-Luuk Hillebrands
- Department of Pathology and Medical Biology, Pathology Section, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Benito A Yard
- Departments of Medicine, Nephrology, Endocrinology, Diabetology, Rheumatology and
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Stamellou E, Storz D, Botov S, Ntasis E, Wedel J, Sollazzo S, Krämer BK, van Son W, Seelen M, Schmalz HG, Schmidt A, Hafner M, Yard BA. Different design of enzyme-triggered CO-releasing molecules (ET-CORMs) reveals quantitative differences in biological activities in terms of toxicity and inflammation. Redox Biol 2014; 2:739-48. [PMID: 25009775 PMCID: PMC4085349 DOI: 10.1016/j.redox.2014.06.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 05/29/2014] [Accepted: 06/02/2014] [Indexed: 11/17/2022] Open
Abstract
Acyloxydiene–Fe(CO)3 complexes can act as enzyme-triggered CO-releasing molecules (ET-CORMs). Their biological activity strongly depends on the mother compound from which they are derived, i.e. cyclohexenone or cyclohexanedione, and on the position of the ester functionality they harbour. The present study addresses if the latter characteristic affects CO release, if cytotoxicity of ET-CORMs is mediated through iron release or inhibition of cell respiration and to what extent cyclohexenone and cyclohexanedione derived ET-CORMs differ in their ability to counteract TNF-α mediated inflammation. Irrespective of the formulation (DMSO or cyclodextrin), toxicity in HUVEC was significantly higher for ET-CORMs bearing the ester functionality at the outer (rac-4), as compared to the inner (rac-1) position of the cyclohexenone moiety. This was paralleled by an increased CO release from the former ET-CORM. Toxicity was not mediated via iron as EC50 values for rac-4 were significantly lower than for FeCl2 or FeCl3 and were not influenced by iron chelation. ATP depletion preceded toxicity suggesting impaired cell respiration as putative cause for cell death. In long-term HUVEC cultures inhibition of VCAM-1 expression by rac-1 waned in time, while for the cyclohexanedione derived rac-8 inhibition seems to increase. NFκB was inhibited by both rac-1 and rac-8 independent of IκBα degradation. Both ET-CORMs activated Nrf-2 and consequently induced the expression of HO-1. This study further provides a rational framework for designing acyloxydiene–Fe(CO)3 complexes as ET-CORMs with differential CO release and biological activities. We also provide a better understanding of how these complexes affect cell-biology in mechanistic terms.
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Affiliation(s)
- E Stamellou
- Institute for Molecular and Cellular Biology, Mannheim University of Applied Sciences, Mannheim, Germany ; Vth. Medical Department, Medical Faculty Mannheim, Ruprecht Karls University, Heidelberg Mannheim, Germany
| | - D Storz
- Vth. Medical Department, Medical Faculty Mannheim, Ruprecht Karls University, Heidelberg Mannheim, Germany
| | - S Botov
- Department of Chemistry, University of Cologne, Cologne, Germany
| | - E Ntasis
- Vth. Medical Department, Medical Faculty Mannheim, Ruprecht Karls University, Heidelberg Mannheim, Germany
| | - J Wedel
- Vth. Medical Department, Medical Faculty Mannheim, Ruprecht Karls University, Heidelberg Mannheim, Germany
| | - S Sollazzo
- Department of Chemistry, University of Cologne, Cologne, Germany
| | - B K Krämer
- Vth. Medical Department, Medical Faculty Mannheim, Ruprecht Karls University, Heidelberg Mannheim, Germany
| | - W van Son
- Department of Nephrology, Academic Medical Center, Groningen, The Netherlands
| | - M Seelen
- Department of Nephrology, Academic Medical Center, Groningen, The Netherlands
| | - H G Schmalz
- Department of Chemistry, University of Cologne, Cologne, Germany
| | - A Schmidt
- Department of Chemistry, University of Cologne, Cologne, Germany
| | - M Hafner
- Institute for Molecular and Cellular Biology, Mannheim University of Applied Sciences, Mannheim, Germany
| | - B A Yard
- Vth. Medical Department, Medical Faculty Mannheim, Ruprecht Karls University, Heidelberg Mannheim, Germany
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Romanski S, Stamellou E, Jaraba JT, Storz D, Krämer BK, Hafner M, Amslinger S, Schmalz HG, Yard BA. Enzyme-triggered CO-releasing molecules (ET-CORMs): evaluation of biological activity in relation to their structure. Free Radic Biol Med 2013; 65:78-88. [PMID: 23774042 DOI: 10.1016/j.freeradbiomed.2013.06.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 02/08/2013] [Accepted: 06/07/2013] [Indexed: 10/26/2022]
Abstract
Acyloxydiene-Fe(CO)3 complexes act as enzyme-triggered CO-releasing molecules (ET-CORMs) and can deliver CO intracellularly via esterase-mediated hydrolysis. The protective properties of structurally different ET-CORMs on hypothermic preservation damage and their ability to inhibit VCAM-1 expression were tested on cultured human umbilical vein endothelial cells (HUVEC) and renal proximal tubular epithelial cells (PTEC) using a structure-activity approach. Cytotoxicity of ET-CORMs, protection against hypothermic preservation damage, and inhibition of VCAM-1 expression were assessed. Cytotoxicity of 2-cyclohexenone and 1,3-cyclohexanedione-derived ET-CORMs was more pronounced in HUVEC compared to PTEC and was dependent on the position and type of the ester (acyloxy) substituent(s) (acetate>pivalate>palmitate). Protection against hypothermic preservation injury was only observed for 2-cyclohexenone-derived ET-CORMs and was not mediated by the ET-CORM decomposition product 2-cyclohexenone itself. Structural requirements for protection by these ET-CORMs were different for HUVEC and PTEC. Protection was affected by the nature of the ester functionality in both cell lines. VCAM-1 expression was inhibited by both 2-cyclohexenone- and 1,3-cyclohexanedione-derived ET-CORMs. 2-Cyclohexenone, but not 1,3-cyclohexanedione, also inhibited VCAM-1 expression. We demonstrate that structural alterations of ET-CORMs significantly affect their biological activity. Our data also indicate that different ET-CORMs behave differently in various cell types (epithelial vs endothelial). These findings warrant further studies not only to elucidate the structure-activity relation of ET-CORMs in mechanistic terms but also to assess if structural optimization will yield ET-CORMs with restricted cell specificity.
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Affiliation(s)
- S Romanski
- Department of Chemistry, University of Cologne, Greinstr. 4, 50939 Köln, Germany
| | - E Stamellou
- Vth Medical Department, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - J T Jaraba
- Vth Medical Department, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - D Storz
- Vth Medical Department, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - B K Krämer
- Vth Medical Department, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - M Hafner
- Institut für Molekülar- and Zellbiologie, Hochschule Mannheim, Paul-Wittsack-Str. 10, 68163 Mannheim, Germany
| | - S Amslinger
- Institut für Organische Chemie, Universität Regensburg, Universitätsstrasse 31, 93053 Regensburg, Germany
| | - H G Schmalz
- Department of Chemistry, University of Cologne, Greinstr. 4, 50939 Köln, Germany
| | - B A Yard
- Vth Medical Department, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
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22
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Hottenrott MC, Wedel J, Gaertner S, Stamellou E, Kraaij T, Mandel L, Loesel R, Sticht C, Hoeger S, Ait-Hsiko L, Schedel A, Hafner M, Yard B, Tsagogiorgas C. N-octanoyl dopamine inhibits the expression of a subset of κB regulated genes: potential role of p65 Ser276 phosphorylation. PLoS One 2013; 8:e73122. [PMID: 24023820 PMCID: PMC3759419 DOI: 10.1371/journal.pone.0073122] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 07/18/2013] [Indexed: 11/29/2022] Open
Abstract
Background and Purpose Catechol containing compounds have anti-inflammatory properties, yet for catecholamines these properties are modest. Since we have previously demonstrated that the synthetic dopamine derivative N-octanoyl dopamine (NOD) has superior anti-inflammatory properties compared to dopamine, we tested NOD in more detail and sought to elucidate the molecular entities and underlying mechanism by which NOD down-regulates inflammation. Experimental Approach Genome wide gene expression profiling of human umbilical vein endothelial cells (HUVECs) was performed after stimulation with TNF-α or in the combination with NOD. Confirmation of these differences, NFκB activation and the molecular entities that were required for the anti-inflammatory properties were assessed in subsequent experiments. Key Results Down regulation of inflammatory genes by NOD occurred predominantly for κB regulated genes, however not all κB regulated genes were affected. These findings were explained by inhibition of RelA phosphorylation at Ser276. Leukocyte adherence to TNF-α stimulated HUVECs was inhibited by NOD and was reflected by a diminished expression of adhesion molecules on HUVECs. NOD induced HO-1 expression, but this was not required for inhibition of NFκB. The anti-inflammatory effect of NOD seems to involve the redox active catechol structure, although the redox active para-dihydroxy benzene containing compounds also displayed anti-inflammatory effects, provided that they were sufficiently hydrophobic. Conclusions and Implications The present study highlighted important mechanisms and molecular entities by which dihydroxy benzene compounds exert their potential anti-inflammatory action. Since NOD does not have hemodynamic properties, NOD seems to be a promising candidate drug for the treatment of inflammatory diseases.
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Affiliation(s)
- Maximilia C. Hottenrott
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Johannes Wedel
- Vth. Medical Department, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Sophie Gaertner
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Eleni Stamellou
- Vth. Medical Department, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Tineke Kraaij
- Vth. Medical Department, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Linda Mandel
- Vth. Medical Department, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Ralf Loesel
- Department of Applied Chemistry, George-Simon-Ohm Hochschule, Nuernberg, Germany
| | - Carsten Sticht
- Centre for Medical Research (ZMF), Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Simone Hoeger
- Vth. Medical Department, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Lamia Ait-Hsiko
- Vth. Medical Department, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Angelika Schedel
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
| | - Mathias Hafner
- Institute for Molecular and Cellular Biology, Mannheim University of Applied Sciences, Mannheim, Germany
| | - Benito Yard
- Vth. Medical Department, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
- * E-mail:
| | - Charalambos Tsagogiorgas
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany
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23
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Botov S, Stamellou E, Romanski S, Guttentag M, Alberto R, Neudörfl JM, Yard B, Schmalz HG. Synthesis and Performance of Acyloxy-diene-Fe(CO)3 Complexes with Variable Chain Lengths as Enzyme-Triggered Carbon Monoxide-Releasing Molecules. Organometallics 2013. [DOI: 10.1021/om301233h] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Svetlana Botov
- Department für Chemie, Universität zu Köln, Greinstrasse 4,
D-50939 Köln, Germany
| | - Eleni Stamellou
- Medizinische Klinik, Universitätsmedizin Mannheim, 68167 Mannheim, Germany
| | - Steffen Romanski
- Department für Chemie, Universität zu Köln, Greinstrasse 4,
D-50939 Köln, Germany
| | - Miguel Guttentag
- Institut für Anorganische Chemie, Universität Zürich, CH-8057 Zürich, Switzerland
| | - Roger Alberto
- Institut für Anorganische Chemie, Universität Zürich, CH-8057 Zürich, Switzerland
| | - Jörg-Martin Neudörfl
- Department für Chemie, Universität zu Köln, Greinstrasse 4,
D-50939 Köln, Germany
| | - Benito Yard
- Medizinische Klinik, Universitätsmedizin Mannheim, 68167 Mannheim, Germany
| | - Hans-Günther Schmalz
- Department für Chemie, Universität zu Köln, Greinstrasse 4,
D-50939 Köln, Germany
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24
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Romanski S, Rücker H, Stamellou E, Guttentag M, Neudörfl JM, Alberto R, Amslinger S, Yard B, Schmalz HG. Iron Dienylphosphate Tricarbonyl Complexes as Water-Soluble Enzyme-Triggered CO-Releasing Molecules (ET-CORMs). Organometallics 2012. [DOI: 10.1021/om300359a] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Steffen Romanski
- Department für Chemie, Universität zu Köln, Greinstrasse 4, D-50939 Köln,
Germany
| | - Hannelore Rücker
- Institut für Organische Chemie, Universität Regensburg, 93503
Regensburg, Germany
| | - Eleni Stamellou
- Medizinische Klinik, Universitätsmedizin Mannheim, 68167 Mannheim, Germany
| | - Miguel Guttentag
- Institut
für Anorganische Chemie, Universität Zürich, CH-8057 Zürich,
Switzerland
| | - Jörg-Martin Neudörfl
- Department für Chemie, Universität zu Köln, Greinstrasse 4, D-50939 Köln,
Germany
| | - Roger Alberto
- Institut
für Anorganische Chemie, Universität Zürich, CH-8057 Zürich,
Switzerland
| | - Sabine Amslinger
- Institut für Organische Chemie, Universität Regensburg, 93503
Regensburg, Germany
| | - Benito Yard
- Medizinische Klinik, Universitätsmedizin Mannheim, 68167 Mannheim, Germany
| | - Hans-Günther Schmalz
- Department für Chemie, Universität zu Köln, Greinstrasse 4, D-50939 Köln,
Germany
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25
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Tsagalis G, Bakirtzi N, Manios E, Chouliaras I, Papagiannidou P, Stamellou E, Akrivos T, Makris F, Psimenou E, Koutroubas G, Xinos K, Vemmos K. Atrial Fibrillation in Chronic Hemodialysis Patients: Prevalence, Types, Predictors, and Treatment Practices in Greece. Artif Organs 2011; 35:916-22. [PMID: 21615429 DOI: 10.1111/j.1525-1594.2011.01229.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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