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Aguilera M, Tobar-Calfucoy E, Rojas-Martínez V, Norambuena R, Serrano MJ, Cifuentes O, Zamudio MS, San Martín D, Lara P, Sabag A, Zabner M, Tichy D, Camejo P, León L, Pino M, Ulloa S, Rojas F, Pieringer C, Muster C, Castillo D, Ferreira N, Avendaño C, Canaval M, Pieringer H, Cifuentes P, Cifuentes Muñoz N. Development and characterization of a bacteriophage cocktail with high lytic efficacy against field-isolated Salmonella enterica. Poult Sci 2023; 102:103125. [PMID: 37879168 PMCID: PMC10618821 DOI: 10.1016/j.psj.2023.103125] [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: 08/14/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 10/27/2023] Open
Abstract
Salmonella spp. is a prevalent pathogen that causes great public health concern worldwide. Bacteriophage-based cocktails have arisen as an alternative to antibiotics to inhibit the growth of Salmonella. However, the bactericidal effect of bacteriophage cocktails in vivo largely differs from their observed effect in vitro. This is partly because in vitro developments of cocktails do not always consider the bacterial diversity nor the environmental conditions where bacteriophages will have to replicate. Here, we isolated and sequenced 47 bacteriophages that showed variable degrees of lytic activity against 258 Salmonella isolates from a commercial broiler company in Brazil. Three of these bacteriophages were characterized and selected to assemble a cocktail. In vitro quantitative assays determined the cocktail to be highly effective against multiple serovars of Salmonella, including Minnesota and Heidelberg. Remarkably, the in vitro lytic activity of the cocktail was retained or improved in conditions that more closely resembled the chicken gut, such as anaerobiosis, 42°C, and Salmonella mono-strain biofilms. Analysis of bacterial cross-resistance between the 3 bacteriophages composing the cocktail revealed limited or no generation of cross-resistance. Our results highlight the relevance of an optimized flux of work to develop bacteriophage cocktails against Salmonella with high lytic efficacy and strong potential to be applied in vivo in commercial broiler farms.
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Affiliation(s)
- Matías Aguilera
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Eduardo Tobar-Calfucoy
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Victoria Rojas-Martínez
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Rodrigo Norambuena
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - María Jesús Serrano
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Onix Cifuentes
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - María Sofía Zamudio
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Daniel San Martín
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Pabla Lara
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Andrea Sabag
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Marcela Zabner
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Daniel Tichy
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Pamela Camejo
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Luis León
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Michael Pino
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Soledad Ulloa
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Felipe Rojas
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Christian Pieringer
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Cecilia Muster
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Daniel Castillo
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Nicolás Ferreira
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Camilo Avendaño
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Mauro Canaval
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Hans Pieringer
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Pablo Cifuentes
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile
| | - Nicolás Cifuentes Muñoz
- PhageLab Chile SpA, Vicuña Mackenna 4860, Centro de Innovación Anacleto Angelini 5th floor, Santiago, Chile..
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Vargas-Straube MJ, Beard S, Norambuena R, Paradela A, Vera M, Jerez CA. High copper concentration reduces biofilm formation in Acidithiobacillus ferrooxidans by decreasing production of extracellular polymeric substances and its adherence to elemental sulfur. J Proteomics 2020; 225:103874. [PMID: 32569817 DOI: 10.1016/j.jprot.2020.103874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/08/2020] [Revised: 06/04/2020] [Accepted: 06/06/2020] [Indexed: 12/14/2022]
Abstract
Acidithiobacillus ferrooxidans is an acidophilic bacterium able to grow in environments with high concentrations of metals. It is a chemolithoautotroph able to form biofilms on the surface of solid minerals to obtain its energy. The response of both planktonic and sessile cells of A. ferrooxidans ATCC 23270 grown in elemental sulfur and adapted to high copper concentration was analyzed by quantitative proteomics. It was found that 137 proteins varied their abundance when comparing both lifestyles. Copper effllux proteins, some subunits of the ATP synthase complex, porins, and proteins involved in cell wall modification increased their abundance in copper-adapted sessile lifestyle cells. On the other hand, planktonic copper-adapted cells showed increased levels of proteins such as: cupreredoxins involved in copper cell sequestration, some proteins related to sulfur metabolism, those involved in biosynthesis and transport of lipopolysaccharides, and in assembly of type IV pili. During copper adaptation a decreased formation of biofilms was measured as determined by epifluorescence microscopy. This was apparently due not only to a diminished number of sessile cells but also to their exopolysaccharides production. This is the first study showing that copper, a prevalent metal in biomining environments causes dispersion of A. ferrooxidans biofilms. SIGNIFICANCE: Copper is a metal frequently found in high concentrations at mining environments inhabitated by acidophilic microorganisms. Copper resistance determinants of A. ferrooxidans have been previously studied in planktonic cells. Although biofilms are recurrent in these types of environments, the effect of copper on their formation has not been studied so far. The results obtained indicate that high concentrations of copper reduce the capacity of A. ferrooxidans ATCC 23270 to form biofilms on sulfur. These findings may be relevant to consider for a bacterium widely used in copper bioleaching processes.
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Affiliation(s)
- M J Vargas-Straube
- Laboratory of Molecular Microbiology and Biotechnology, Department of Biology, Faculty of Sciences, University of Chile, Santiago, Chile
| | - S Beard
- Fundación Ciencia y Vida, Santiago, Chile
| | - R Norambuena
- Laboratory of Molecular Microbiology and Biotechnology, Department of Biology, Faculty of Sciences, University of Chile, Santiago, Chile
| | - A Paradela
- Proteomics Laboratory, National Biotechnology Center, CSIC, Madrid, Spain
| | - M Vera
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile.; Department of Hydraulic and Environmental Engineering, School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - C A Jerez
- Laboratory of Molecular Microbiology and Biotechnology, Department of Biology, Faculty of Sciences, University of Chile, Santiago, Chile..
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Ramos-Zúñiga J, Gallardo S, Martínez-Bussenius C, Norambuena R, Navarro CA, Paradela A, Jerez CA. Response of the biomining Acidithiobacillus ferrooxidans to high cadmium concentrations. J Proteomics 2019; 198:132-144. [DOI: 10.1016/j.jprot.2018.12.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 11/28/2022]
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Oetiker N, Norambuena R, Martínez-Bussenius C, Navarro CA, Amaya F, Álvarez SA, Paradela A, Jerez CA. Possible Role of Envelope Components in the Extreme Copper Resistance of the Biomining Acidithiobacillus ferrooxidans. Genes (Basel) 2018; 9:genes9070347. [PMID: 29996532 PMCID: PMC6070983 DOI: 10.3390/genes9070347] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 05/30/2018] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 01/01/2023] Open
Abstract
Acidithiobacillus ferrooxidans resists extremely high concentrations of copper. Strain ATCC 53993 is much more resistant to the metal compared with strain ATCC 23270, possibly due to the presence of a genomic island in the former one. The global response of strain ATCC 53993 to copper was analyzed using iTRAQ (isobaric tag for relative and absolute quantitation) quantitative proteomics. Sixty-seven proteins changed their levels of synthesis in the presence of the metal. On addition of CusCBA efflux system proteins, increased levels of other envelope proteins, such as a putative periplasmic glucan biosynthesis protein (MdoG) involved in the osmoregulated synthesis of glucans and a putative antigen O polymerase (Wzy), were seen in the presence of copper. The expression of A. ferrooxidansmdoG or wzy genes in a copper sensitive Escherichia coli conferred it a higher metal resistance, suggesting the possible role of these components in copper resistance of A. ferrooxidans. Transcriptional levels of genes wzy, rfaE and wzz also increased in strain ATCC 23270 grown in the presence of copper, but not in strain ATCC 53993. Additionally, in the absence of this metal, lipopolysaccharide (LPS) amounts were 3-fold higher in A. ferrooxidans ATCC 53993 compared with strain 23270. Nevertheless, both strains grown in the presence of copper contained similar LPS quantities, suggesting that strain 23270 synthesizes higher amounts of LPS to resist the metal. On the other hand, several porins diminished their levels in the presence of copper. The data presented here point to an essential role for several envelope components in the extreme copper resistance by this industrially important acidophilic bacterium.
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Affiliation(s)
- Nia Oetiker
- Laboratory of Molecular Microbiology and Biotechnology, Department of Biology, Faculty of Sciences, University of Chile, Santiago 7800003, Chile.
| | - Rodrigo Norambuena
- Laboratory of Molecular Microbiology and Biotechnology, Department of Biology, Faculty of Sciences, University of Chile, Santiago 7800003, Chile.
| | - Cristóbal Martínez-Bussenius
- Laboratory of Molecular Microbiology and Biotechnology, Department of Biology, Faculty of Sciences, University of Chile, Santiago 7800003, Chile.
| | - Claudio A Navarro
- Laboratory of Molecular Microbiology and Biotechnology, Department of Biology, Faculty of Sciences, University of Chile, Santiago 7800003, Chile.
| | - Fernando Amaya
- Department of Biochemistry and Molecular Biology, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago 7800003, Chile.
| | - Sergio A Álvarez
- Department of Biochemistry and Molecular Biology, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago 7800003, Chile.
| | - Alberto Paradela
- Proteomics Laboratory, National Biotechnology Center, CSIC, 28049 Madrid, Spain.
| | - Carlos A Jerez
- Laboratory of Molecular Microbiology and Biotechnology, Department of Biology, Faculty of Sciences, University of Chile, Santiago 7800003, Chile.
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Dominguez J, Kompatzki A, Norambuena R, Arenas J, Dell'Oro A, Bustamante A, Pinochet R, Cabello JM, Alvarez S, Pais E, Llanos R, Cortes-Monroy G. Benefits of Early Biopsy on the Outcome of Kidney Transplantation. Transplant Proc 2005; 37:3361-3. [PMID: 16298596 DOI: 10.1016/j.transproceed.2005.09.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Delayed graft function has been associated with worse long-term kidney allograft survival. Adequate diagnosis of the etiology of dysfunction is crucial, often requiring routine early biopsies. The aim of this article was to report the results and safety of early kidney allograft biopsies and how they influenced its management. METHOD Between September 1994 and July 2004, 134 renal transplant recipients were prescribed cyclosporine (CsA; Neoral, Novartis, Chile), steroids, and a third agent (azathioprine in 92% of the graft recipients). Thirty-four patients (26%) had a kidney biopsy performed within the first week because of allograft dysfunction. RESULTS The main diagnosis was acute tubular necrosis (ATN) in 22 patients (65%), whereas 6 (18%) were diagnosed with an acute rejection episode (ARE), allowing prompt initiation of therapy with reversal of rejection in 4 of them. Two patients (6%) showed signs of thrombotic microangiopathy (TMA) induced by CsA, which subsided following a switch from CsA to tacrolimus (Prograf Pharmainvesti, Chile). In 2 patients, the biopsy specimen showed signs of CsA nephrotoxicity that reverted following dose reduction. Finally, in 2 patients, the biopsy specimen showed chronic nephropathy of donor origin, which had not been previously recognized, resulting in graft loss. There was only one major complication related to the biopsy, intraperitoneal bleeding that required surgical treatment. CONCLUSIONS Early allograft biopsy is safe and, in a significant number of cases (30%), it detects important allograft pathology (ARE, TMA, and drug toxicity), which when adequately and promptly treated may rescue the graft.
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Affiliation(s)
- J Dominguez
- Department of Urology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Dominguez J, Kompatzki A, Velasco A, Turpaud F, Norambuena R, Arenas J, Pais E, Llanos R, Cortes-Monroy G. Importance of Early Adequate Exposure to Cyclosporine in Renal Transplant Outcome: Study of 1-Year Creatinine. Transplant Proc 2005; 37:3358-60. [PMID: 16298595 DOI: 10.1016/j.transproceed.2005.09.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION One-year serum creatinine (SCr) level has been used as a surrogate marker for graft survival in kidney transplantation. We evaluated the importance of different factors on this parameter, emphasizing the importance of adequate exposure to Cyclosporine (CyA). METHODS Ninety-six consecutive renal transplant recipients who underwent transplantation between 1996 and 2002 were treated with CyA, steroids, and azathioprine. Univariate and multivariate regression analyses were performed for 1-year SCr, acute rejection episodes (ARE), and duration of delayed graft function (DGF). We considered adequate CyA levels within 1 week to be >250 ng/mL trough levels (38%) or 3 hour postdose level (C3) >1100 ng/mL (62%). RESULTS Mean 1-year SCr was 1.52 +/- 0.5, ARE rate was 27%, and DGF rate was 31%. Overall, 53% of patients achieved adequate exposure to CyA at 1 week (68% on those monitored by C3). Univariate analysis identified female recipient gender, decreasing donor age, absence of ARE, and decreased DGF duration to yield lower 1-year SCr (P < .05). On multivariate analysis for donor age (lower), ARE rate, and duration of DGF (shorter) were the only factors considered to be significant for a lower 1-year SCr level. Multivariate analysis for ARE showed that adequate CyA exposure and lower HLA mismatch decreased ARE, whereas the ability to achieve adequate exposure to CyA and shorter cold ischemia time (CIT) correlated with a reduced incidence of DGF. CONCLUSIONS One-year SCr level is affected primarily by the incidence of ARE, by donor age, and by duration of DGF. Adequate CyA exposure is related to lower ARE; however, its relation to DGF may be influenced by the reluctance to increase exposure on patients with a nonfunctioning graft.
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Affiliation(s)
- J Dominguez
- Department of Urology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 437 Depto. C, Santiago, Chile.
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Domínguez J, Fuenzalida D, Norambuena R, Pais E, Cortes Monroy G, Llanos R. C2 monitoring of cyclosporine in stable renal transplant patients results in lower costs and improved renal function. Transplant Proc 2005; 37:1583-5. [PMID: 15866680 DOI: 10.1016/j.transproceed.2004.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION C2 (2-hour post-absorption levels) monitoring of cyclosporine (CsA) seems to reduce the rate of acute rejection episodes (ARE) without increasing nephrotoxicity during the first months after transplant. There are a few reports on the impact of adopting this strategy in patients with stable renal transplants. We herein report a prospective trial in long-term renal transplant patients (>6 months) monitored by C0 or C3 who were switched to C2 monitoring. METHODS Seventy-six (mean age = 43 +/- 11 years) kidney transplant patients (mean = 37 +/- 21 months after transplant) receiving CsA, steroids, and azathioprine were switched to C2 monitoring, seeking to achieve a target range of 800 +/- 100 ng/mL. The patients were followed for at least 6 months. RESULTS At conversion the C2 values of 61% of the patients were above and 17% below the therapeutic range. Six months after conversion there was a significant reduction in BUN (29 +/- 11 vs 27 +/- 10, P < .01), Creatinine (Cr), cholesterol, and triglyceride levels were unchanged. Mean CsA dose was decreased 10% from 244 +/- 63 to 220 +/- 52 (P < .01), implying a net savings of 390 US dollars per patient per year. Among the group of patients who showed a high C2 level, there was also a reduction in BUN (30 +/- 12 vs 27 +/- 10, P < .01) and a nonsignificant decrease in Cr (1.53 +/- 0.6 vs 1.50 +/- 0.6). CONCLUSIONS C2 monitoring in stable kidney transplant recipients is feasible and safe. The strategy results in reduced drug costs and improved renal function.
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Affiliation(s)
- J Domínguez
- Department of Urology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Dominguez J, Gonzalez A, Crossley N, Norambuena R. Renal transplants with delayed graft function show decreased renal function despite monitoring with postabsorptive levels. Transplant Proc 2004; 36:1655-8. [PMID: 15350442 DOI: 10.1016/j.transproceed.2004.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cyclosporine (CyA) monitoring with postabsorptive levels can predict the risk of an acute rejection episode (ARE). Large doses of CyA are needed to obtain adequate drug exposure. The impact of this strategy on renal function, especially in patients with delayed graft function (DGF), is unknown. We report our experience comparing C3 (3-hour postdose) monitoring with a historical series of cadaveric renal transplants. Sixty-three consecutive patients who received cadaveric renal transplants were followed for 1 year. Group A (historical n = 31) patients received 6 mg/kg/d CyA with the dose adjusted according to the trough level (target, 250-350 ng/mL), group B (study n = 32) received 10 mg/kg/d CyA with dose adjustments based upon C3 (target, 1100-1500 ng/mL). All patients received cyclosporine prednisone and a third agents. The general characteristics of the donors and recipients were comparable. The incidence of biopsy-proven ARE at 1 year in group A was 42% and 19% in group B (P <.05). Patients achieving C3 levels >1000 ng/mL at 1 week displayed significantly lower ARE rates (8% vs 50%; P <.05). The rate of DGF was similar in both groups, but the duration was longer in group B (15 vs 21 days, P <.05). The serum creatinine (SCr) level was significantly higher in group B at 3 months (1.47 mg/dL group A vs 1.76 mg/dL group B; P <.05). Patients in group B with DGF showed significantly higher SCr values at 1 year (1.18mg% vs 2.03 mg%; P <.05). C3 level monitoring of CyA yields excellent results in terms of decreased ARE, but an increased SCR was observed among patients with DGF.
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Affiliation(s)
- J Dominguez
- Department of Urology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Abstract
Ketoconazole (KET) is frequently used as a cyclosporine (CyA)-sparing agent. Adequate exposure to CyA is critical to avoid acute rejection (AR) or chronic rejection (CR). We compared the pharmacokinetic profiles of nine stable renal transplant patients on CyA before and after conversion to KET (200 mg/d of KET simultaneous with CyA). The CyA doses were adjusted to achieve similar drug exposures. The mean dose reduction of CyA while on KET was 83% from 3.2 +/- 0.9 to 0.6 +/- 0.2 (P <.000). Addition of KET produced a significant decrease in the absorption parameters of CyA and an increased elimination half-life. Coefficient of variation (CV) of AUC was significantly increased. Serum creatinine (SCr) at 3 months after switch remained the same. One patient experienced a grade I AR episode (11%). There were no adverse effects related to KET. Although addition of KET to CyA can significantly decrease the CyA dose, the observed pharmacokinetic changes involved decreased absorption and increased CV, which may respectively relate to AR and CR. The 11% AR rate observed is of concern. We do not recommend switching patients to KET as this may imply an increased risk of late AR or CR.
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Affiliation(s)
- J Dominguez
- Servicio de Urologia Hospital Sotero del Rio y Departamento de Urologia y Unidad de Laboratorio Clinico Pontificia Universidad Católica de Chile, Santiago, Chile
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Affiliation(s)
- J Domínguez
- Department of Urology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Zemelman R, Norambuena R, Vergara L, Gacitúa R. [B-lactam antibiotics: grouping according to their chemical structure and bacteriological properties]. Rev Med Chil 1987; 115:983-91. [PMID: 3333440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Repetto A, Rossel K, Rivera E, Parada L, Norambuena R, Nuñez M, Parada R, Muñoz J, Podesta L, Peirano R. [Epidemiological description of the medical care of adults in an emergency service]. Rev Med Chil 1983; 111:1177-82. [PMID: 6678460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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