1
|
Abdelmaksoud NM, Al-Noshokaty TM, Abdelhamid R, Abdellatif N, Mansour A, Mohamed R, Mohamed AH, Khalil NAE, Abdelhamid SS, Mohsen A, Abdelaal H, Tawfik A, Elshaer SS. Deciphering the role of MicroRNAs in diabetic nephropathy: Regulatory mechanisms and molecular insights. Pathol Res Pract 2024; 256:155237. [PMID: 38492358 DOI: 10.1016/j.prp.2024.155237] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/22/2024] [Accepted: 03/02/2024] [Indexed: 03/18/2024]
Abstract
A serious consequence of diabetes mellitus, diabetic nephropathy (DN) which causes gradual damage to the kidneys. Dietary changes, blood pressure control, glucose control, and hyperlipidemia are all important components of DN management. New research, however, points to microRNAs (miRNAs) as having a pivotal role in DN pathogenesis. Miniature non-coding RNA molecules such as miRNAs control gene expression and impact several biological processes. The canonical and non-canonical routes of miRNA biogenesis are discussed in this article. In addition, several important signaling pathways are examined in the study of miRNA regulation in DN. A deeper knowledge of these regulatory mechanisms would allow for a better understanding of the molecular basis of DN and the development of innovative therapeutic strategies. Finally, miRNAs show tremendous potential as DN diagnostic biomarkers and treatment targets, opening up promising avenues for further study and potential clinical use.
Collapse
Affiliation(s)
- Nourhan M Abdelmaksoud
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Tohada M Al-Noshokaty
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt.
| | - Rehab Abdelhamid
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Nourhan Abdellatif
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Abdallah Mansour
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Reem Mohamed
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Asmaa Hamouda Mohamed
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Nada Abd Elatif Khalil
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Sara Sobhy Abdelhamid
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Alaa Mohsen
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Heba Abdelaal
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Ahmed Tawfik
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Shereen Saeid Elshaer
- Department of Biochemistry, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt; Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Girls), Al-Azhar University, Nasr city, Cairo 11754, Egypt.
| |
Collapse
|
4
|
Bradley P, Wilson J, Taylor R, Nixon J, Redfern J, Whittemore P, Gaddah M, Kavuri K, Haley A, Denny P, Withers C, Robey RC, Logue C, Dahanayake N, Min DSH, Coles J, Deshmukh MS, Ritchie S, Malik M, Abdelaal H, Sivabalah K, Hartshorne MD, Gopikrishna D, Ashish A, Nuttall E, Bentley A, Bongers T, Gatheral T, Felton TW, Chaudhuri N, Pearmain L. Conventional oxygen therapy versus CPAP as a ceiling of care in ward-based patients with COVID-19: a multi-centre cohort evaluation. EClinicalMedicine 2021; 40:101122. [PMID: 34514360 PMCID: PMC8424135 DOI: 10.1016/j.eclinm.2021.101122] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Continuous positive airway pressure (CPAP) therapy is commonly used for respiratory failure due to severe COVID-19 pneumonitis, including in patients deemed not likely to benefit from invasive mechanical ventilation (nIMV). Little evidence exists demonstrating superiority over conventional oxygen therapy, whilst ward-level delivery of CPAP presents practical challenges. We sought to compare clinical outcomes of oxygen therapy versus CPAP therapy in patients with COVID-19 who were nIMV. METHODS This retrospective multi-centre cohort evaluation included patients diagnosed with COVID-19 who were nIMV, had a treatment escalation plan of ward-level care and clinical frailty scale ≤ 6. Recruitment occurred during the first two waves of the UK COVID-19 pandemic in 2020; from 1st March to May 31st, and from 1st September to 31st December. Patients given CPAP were compared to patients receiving oxygen therapy that required FiO2 ≥0.4 for more than 12 hours at hospitals not providing ward-level CPAP. Logistic regression modelling was performed to compare 30-day mortality between treatment groups, accounting for important confounders and within-hospital clustering. FINDINGS Seven hospitals provided data for 479 patients during the UK COVID-19 pandemic in 2020. Overall 30-day mortality was 75.6% in the oxygen group (186/246 patients) and 77.7% in the CPAP group (181/233 patients). A lack of evidence for a treatment effect persisted in the adjusted model (adjusted odds ratio 0.84 95% CI 0.57-1.23, p=0.37). 49.8% of patients receiving CPAP-therapy (118/237) chose to discontinue it. INTERPRETATION No survival difference was found between using oxygen alone or CPAP to treat patients with severe COVID-19 who were nIMV. A high patient-initiated discontinuation rate for CPAP suggests a significant treatment burden. Further reflection is warranted on the current treatment guidance and widespread application of CPAP in this setting. FUNDING L Pearmain is supported by the MRC (MR/R00191X/1). TW Felton is supported by the NIHR Manchester Biomedical Research Centre.
Collapse
Affiliation(s)
- P Bradley
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Respiratory department, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
- NWCORR North West Collaborative Organisation for Respiratory Research
| | - J Wilson
- Respiratory department, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
- Department of infectious diseases and tropical medicine. North Manchester General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - R Taylor
- Research and Development, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - J Nixon
- Respiratory department, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
- NWCORR North West Collaborative Organisation for Respiratory Research
| | - J Redfern
- Respiratory department, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - P Whittemore
- Department of infectious diseases and tropical medicine. North Manchester General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - M Gaddah
- Respiratory department, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK
| | - K Kavuri
- Respiratory department, Royal Albert Edward Infirmary, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
| | - A Haley
- Respiratory department, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK
| | - P Denny
- Respiratory department, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK
| | - C Withers
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - RC Robey
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - C Logue
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - N Dahanayake
- Department of infectious diseases and tropical medicine. North Manchester General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - D Siaw Hui Min
- Department of infectious diseases and tropical medicine. North Manchester General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - J Coles
- Department of infectious diseases and tropical medicine. North Manchester General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - M S Deshmukh
- Department of infectious diseases and tropical medicine. North Manchester General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - S Ritchie
- Department of infectious diseases and tropical medicine. North Manchester General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - M Malik
- Respiratory department, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - H Abdelaal
- Respiratory department, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - K Sivabalah
- Respiratory department, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - MD Hartshorne
- Respiratory department, Royal Albert Edward Infirmary, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
| | - D Gopikrishna
- Respiratory department, Royal Albert Edward Infirmary, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
| | - A Ashish
- Respiratory department, Royal Albert Edward Infirmary, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
| | - E Nuttall
- Respiratory department, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - A Bentley
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK
| | - T Bongers
- Respiratory department, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - T Gatheral
- Respiratory department, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK
| | - TW Felton
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK
| | - N Chaudhuri
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK
| | - L Pearmain
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- NWCORR North West Collaborative Organisation for Respiratory Research
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Wellcome Centre for Cell-Matrix Research, Faculty of Biology, Medicine and Health and Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Corresponding author. L Pearmain. Piper Hanley Laboratory, Floor 3 AV Hill Building, The University of Manchester, Manchester, UK, M13 9PT
| |
Collapse
|