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Sobiak J, Resztak M, Sikora W, Zachwieja J, Ostalska-Nowicka D. Liquid chromatography-tandem mass spectrometry method for mycophenolic acid and its glucuronide determination in saliva samples from children with nephrotic syndrome. Pharmacol Rep 2024; 76:600-611. [PMID: 38485859 DOI: 10.1007/s43440-024-00574-9] [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: 11/20/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Saliva sampling is one of the methods of therapeutic drug monitoring for mycophenolic acid (MPA) and its metabolite, mycophenolic acid glucuronide (MPAG). The study describes the liquid chromatography tandem mass spectrometry (LC-MS/MS) method developed for saliva MPA and MPAG determination in children with nephrotic syndrome. METHODS The mobile phase consisted of methanol and water at gradient flow, both with 0.1% formic acid. Firstly, 100 µL of saliva was evaporated at 45 °C for 2 h to dryness, secondly, it was reconstituted in the mobile phase, and finally 10 µL was injected into the LC-MS/MS system. Saliva from ten children with nephrotic syndrome treated with mycophenolate mofetil was collected with Salivette®. RESULTS For MPA and MPAG, within the 2-500 ng/mL range, the method was selective, specific, accurate and precise within-run and between-run. No carry-over and matrix effects were observed. Stability tests showed that MPA and MPAG were stable in saliva samples if stored for 2 h at room temperature, 18 h at 4 °C, and at least 5 months at - 80 °C as well as after three freeze-thaw cycles, in a dry extract for 16 h at 4 °C, and for 8 h at 15 °C in the autosampler. The analytes were not adsorbed onto Salivette® cotton swabs. For concentrations above 500 ng/mL, the samples may be diluted twofold. In children, saliva MPA and MPAG were within the ranges of 4.6-531.8 ng/mL and 10.7-183.7 ng/mL, respectively. CONCLUSIONS The evaluated LC-MS/MS method has met the validation requirements for saliva MPA and MPAG determination in children with nephrotic syndrome. Further studies are needed to explore plasma-saliva correlations and assess their potential contribution to MPA monitoring.
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Affiliation(s)
- Joanna Sobiak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806, Poznan, Poland.
| | - Matylda Resztak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806, Poznan, Poland
| | - Weronika Sikora
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
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Soltysiak J, Ostalska-Nowicka D, Mackowiak-Lewandowicz K, Skowronska B, Fichna P, Stankiewicz W, Zaorska K, Zachwieja J. Early kidney damage in diabetic adolescents with increased blood pressure and glomerular hyperfiltration. Minerva Pediatr (Torino) 2024; 76:37-45. [PMID: 32748608 DOI: 10.23736/s2724-5276.20.05812-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/21/2024]
Abstract
BACKGROUND The early impact of type 1 diabetes mellitus (DM1), increased blood pressure and glomerular hyperfiltration (GHF) on kidney damage in adolescents using two urinary markers of kidney injury - neutrophil gelatinase-associated lipocalin (uNGAL) and transferrin (uTransf) - was assessed. METHODS The study group consisted of 80 adolescents with DM1, of whom 42 were patients with increased blood pressure (IBP), and 38 were patients with normal blood pressure (NBP). Blood pressure was assessed by 24-hour ambulatory blood-pressure monitoring. All patients showed estimated glomerular-filtration rates (eGFRs) above 90 mL/min/1.73 m2. The control group consisted of 19 healthy, age and gender-matched adolescents. RESULTS All diabetic children showed a significant increase in uNGAL (P<0.001). This increase was not related to blood pressure. The uNGAL was elevated in all patients with normal albuminuria, normal eGFR and NBP. The concentration of uTransf was not increased in the entire studied group and was not related to blood pressure. Children with GHF had significantly higher levels of both uTransf (P=0.010) and uNGAL (P<0.001). In patients with GHF, blood pressure was normal. Patients with IBP showed a significantly higher value for triglycerides (r=0.247; P=0.032) and a longer duration of diabetes (r=0.264; P=0.019). CONCLUSIONS Diabetes is the leading risk factor for early kidney injury. However, increased blood pressure does not lead to kidney damage, at least in the early stage of DM1. The uNGAL is the early indicator of kidney injury and increases in patients with normal albuminuria, normal glomerular filtration and normal blood pressure. Glomerular hyperfiltration seems to be a marker of diabetic-kidney involvement.
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Affiliation(s)
- Jolanta Soltysiak
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland -
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Bogda Skowronska
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Fichna
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Witold Stankiewicz
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Zaorska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
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Sobiak J, Resztak M, Banasiak J, Zachwieja J, Ostalska-Nowicka D. High-performance liquid chromatography with fluorescence detection for mycophenolic acid determination in saliva samples. Pharmacol Rep 2023; 75:726-736. [PMID: 36905501 PMCID: PMC10007665 DOI: 10.1007/s43440-023-00474-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND For therapeutic drug monitoring (TDM) of mycophenolic acid (MPA), which is frequently proposed, saliva might be a suitable and easy-to-obtain biological matrix. The study aimed to validate an HPLC method with fluorescence detection for determining mycophenolic acid in saliva (sMPA) in children with nephrotic syndrome. METHODS The mobile phase was composed of methanol and tetrabutylammonium bromide with disodium hydrogen phosphate (pH 8.5) at a 48:52 ratio. To prepare the saliva samples, 100 µL of saliva, 50 µL of calibration standards, and 50 µL of levofloxacin (used as an internal standard) were mixed and evaporated to dryness at 45 °C for 2 h. The resulting dry extract was reconstituted in the mobile phase and injected into the HPLC system after centrifugation. Saliva samples from study participants were collected using Salivette® devices. RESULTS The method was linear within the range of 5-2000 ng/mL, was selective with no carry-over effect and met the acceptance criteria for within-run and between-run accuracy and precision. Saliva samples can be stored for up to 2 h at room temperature, for up to 4 h at 4 °C, and for up to 6 months at - 80 °C. MPA was stable in saliva after three freeze-thaw cycles, in dry extract for 20 h at 4 °C, and for 4 h in the autosampler at room temperature. MPA recovery from Salivette® cotton swabs was within the range of 94-105%. The sMPA concentrations in the two children with nephrotic syndrome who were treated with mycophenolate mofetil were within 5-112 ng/mL. CONCLUSIONS The sMPA determination method is specific, selective, and meets the validation requirements for analytic methods. It may be used in children with nephrotic syndrome; however further studies are required to investigate focusing on sMPA and the correlation between sMPA and total MPA and its possible contribution to MPA TDM is required.
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Affiliation(s)
- Joanna Sobiak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806, Poznan, Poland.
| | - Matylda Resztak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806, Poznan, Poland
| | - Joanna Banasiak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
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Sobiak J, Żero P, Zachwieja J, Ostalska-Nowicka D, Pawiński T. Limited sampling strategy to predict free mycophenolic acid area under the concentration-time curve in paediatric patients with nephrotic syndrome. Clin Exp Pharmacol Physiol 2023; 50:486-496. [PMID: 36846865 DOI: 10.1111/1440-1681.13765] [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] [Received: 10/07/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/01/2023]
Abstract
In paediatric patients, there is no data on the recommended area under the concentration-time curve from 0 to 12 h (AUC0-12 ) for free mycophenolic acid (fMPA), which is the active form of the drug, responsible for the pharmacological effect. We decided to establish the limited sampling strategy (LSS) for fMPA for its use in MPA therapeutic monitoring in children with nephrotic syndrome treated with mycophenolate mofetil (MMF). This study included 23 children (aged 11 ± 4 years) from whom eight blood samples were collected within 12 h after MMF administration. The fMPA was determined using the high-performance liquid chromatography with fluorescence detection method. LSSs were estimated with the use of R software and bootstrap procedure. The best model was chosen based on a number of profiles with AUC predicted within ± 20% of AUC0-12 (good guess), r2 , mean prediction error (%MPE) of ±10% and mean absolute error (%MAE) of less than 25%. The fMPA AUC0-12 was 0.1669 ± 0.0697 μg h/mL and the free fraction was within 0.16%-0.81%. In total, there were 92 equations developed of which five fulfilled the acceptance criteria for %MPE, %MAE, good guess >80% and r2 > 0.900. These equations consisted of three time points: model 1 (C1 , C2 , C6 ), model 2 (C1 , C3 , C6 ), model 3 (C1 , C4 , C6 ), model 5 (C0 , C1 , C2 ), and model 6 (C1 , C2 , C9 ). Although blood sampling up to 9 h after MMF dosing is impractical, it is crucial to include C6 or C9 in LSS to assess fMPA AUCpred correctly. The most practical fMPA LSS, which fulfilled the acceptance criteria in the estimation group, was fMPA AUCpred = 0.040 + 2.220 × C0 + 1.130 × C1 + 1.742 × C2 . Further studies should define the recommended fMPA AUC0-12 value in children with nephrotic syndrome.
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Affiliation(s)
- Joanna Sobiak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznań, Poland
| | - Paweł Żero
- Department of Drug Chemistry, Medical University of Warsaw, Warsaw, Poland
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznań, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznań, Poland
| | - Tomasz Pawiński
- Department of Drug Chemistry, Medical University of Warsaw, Warsaw, Poland
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Sobiak J, Resztak M, Zachwieja J, Ostalska-Nowicka D. Inosine monophosphate dehydrogenase activity and mycophenolate pharmacokinetics in children with nephrotic syndrome treated with mycophenolate mofetil. Clin Exp Pharmacol Physiol 2022; 49:1197-1208. [PMID: 35877984 DOI: 10.1111/1440-1681.13706] [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] [Received: 04/04/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 11/28/2022]
Abstract
Some studies have shown that the area under the concentration-time curve (AUC) of mycophenolic acid (MPA) should be higher for children with nephrotic syndrome (NS) than after renal transplantation. The pharmacodynamic aspect of MPA, the activity of inosine monophosphate dehydrogenase (IMPDH), has not been studied in children with NS. The study included 21 children (4-16 years) with NS treated with mycophenolate mofetil. MPA and its glucuronide plasma concentrations were determined using validated high-performance liquid chromatography (HPLC-UV). The separate HPLC-UV method was applied for IMPDH activity determination. The variability was expressed by the coefficient of variation (CV). IMPDH activity and MPA concentration (Ctrough ) before the morning dose amounted to 29.95 μmol·s-1 ·mol-1 AMP (range, 6.71-98.60 μmol·s-1 ·mol-1 AMP) and 1.72 μg/mL (range, 0.39-4.34 μg/mL), respectively, whereas the area under the effect-time curve from 0 to 4 h and MPA AUC0-4 were 130.36 μmol·s-1 ·mol-1 AMP∙h (range, 23.58-306.57 μmol·s-1 ·mol-1 AMP∙h) and 24.63 μg·h/mL (range, 12.21-67.48 μg·h/mL), respectively. IMPDH activity decreased concomitantly with MPA concentration increase, however, the variability of the pharmacodynamic parameters was greater than of the pharmacokinetics. The median degree of maximum IMPDH inhibition was 61%. MPA Ctrough and predicted AUC were lower than in our previous study. Only a few MPA pharmacokinetic parameters correlated with the pharmacodynamics. IMPDH activity did not correlate with children's age and did not differ between boys and girls. MPA clearance was the highest in younger children (median 10.54 L/m2 /h) and cholesterol correlated negatively with children's age (r=-0.659, p=0.003). IMPDH minimum activity and the degree of maximum IMPDH inhibition were similar to those obtained in renal transplant recipients. IMPDH activity does not undergo developmental or gender-specific regulation in children with NS. MPA underexposure might be more frequent in younger children, especially with high cholesterol and triglycerides levels due to high MPA clearance.
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Affiliation(s)
- Joanna Sobiak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences
| | - Matylda Resztak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences
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Mackowiak-Lewandowicz K, Ostalska-Nowicka D, Zaorska K, Kaczmarek E, Zachwieja J, Witt M, Nowicki M. Chronic kidney disease predictors in obese adolescents. Pediatr Nephrol 2022; 37:2479-2488. [PMID: 35211791 PMCID: PMC8869344 DOI: 10.1007/s00467-021-05403-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Glomerular hyperfiltration, initiating development of obesity-related glomerulopathy, results in an enlargement of the glomeruli and unsealing of the filtration barrier. It can be followed by adaptive focal segmental glomerulosclerosis and chronic kidney disease (CKD). The aim of the study was to determine the expression pattern of lipid metabolism and selected kidney damage markers in obese adolescents and to identify potential factors which can predict CKD. METHODS The study group consisted of 142 adolescents with a BMI z-score > 2. Sixty-two healthy and normal-weight individuals served as controls. The factors associated with the rate of glomerular filtration in obese adolescents were assessed by linear regression methods using univariate and multivariate analyses. The risk of developing CKD was estimated using the Fisher's exact test. RESULTS The study group was divided into "elevated," "normal," and "decreased" glomerular filtration rate (GFR) patients. Increased urine galectin-3 (Gal-3) concentration was diagnosed in all patients. "Decreased GFR" subjects expressed increased urine concentration of neutrophil gelatinase-associated lipocalin (NGAL) and daily megalin excretion. Thirty-nine study participants developed CKD. Increased uric acid (UA) concentration was associated with CKD development both in "normal" and "decreased GFR" patients. Additionally, in "normal" GFR patients, increased concentrations of cholesterol (Ch), triglycerides (TG), and NGAL were associated with CKD. CONCLUSIONS Increased serum concentrations of Ch, TG, and UA and increased urine concentration of NGAL might predict CKD development in obese adolescents with normal and decreased GFR. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Zaorska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | - Elzbieta Kaczmarek
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Martin Witt
- Department of Anatomy, Rostock Univ. Med. Ctr., Rostock, Germany
| | - Michal Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland.
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Zaorska K, Zawierucha P, Świerczewska M, Ostalska-Nowicka D, Zachwieja J, Nowicki M. Prediction of steroid resistance and steroid dependence in nephrotic syndrome children. J Transl Med 2021; 19:130. [PMID: 33785019 PMCID: PMC8011118 DOI: 10.1186/s12967-021-02790-w] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/15/2021] [Indexed: 01/16/2023] Open
Abstract
Background Steroid resistant (SR) nephrotic syndrome (NS) affects up to 30% of children and is responsible for fast progression to end stage renal disease. Currently there is no early prognostic marker of SR and studied candidate variants and parameters differ highly between distinct ethnic cohorts. Methods Here, we analyzed 11polymorphic variants, 6 mutations, SOCS3 promoter methylation and biochemical parameters as prognostic markers in a group of 124 Polish NS children (53 steroid resistant, 71 steroid sensitive including 31 steroid dependent) and 55 controls. We used single marker and multiple logistic regression analysis, accompanied by prediction modeling using neural network approach. Results We achieved 92% (AUC = 0.778) SR prediction for binomial and 63% for multinomial calculations, with the strongest predictors ABCB1 rs1922240, rs1045642 and rs2235048, CD73 rs9444348 and rs4431401, serum creatinine and unmethylated SOCS3 promoter region. Next, we achieved 80% (AUC = 0.720) in binomial and 63% in multinomial prediction of SD, with the strongest predictors ABCB1 rs1045642 and rs2235048. Haplotype analysis revealed CD73_AG to be associated with SR while ABCB1_AGT was associated with SR, SD and membranoproliferative pattern of kidney injury regardless the steroid response. Conclusions We achieved prediction of steroid resistance and, as a novelty, steroid dependence, based on early markers in NS children. Such predictions, prior to drug administration, could facilitate decision on a proper treatment and avoid diverse effects of high steroid doses. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-02790-w.
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Affiliation(s)
- Katarzyna Zaorska
- Department of Histology and Embryology, University of Medical Sciences, Swiecickiego St 6, 60-781, Poznan, Poland.
| | - Piotr Zawierucha
- Institute of Bioorganic Chemistry, Department of RNA Metabolism, Polish Academy of Sciences, Zygmunta Noskowskiego St 12/14, 61-704, Poznan, Poland
| | - Monika Świerczewska
- Department of Histology and Embryology, University of Medical Sciences, Swiecickiego St 6, 60-781, Poznan, Poland
| | - Danuta Ostalska-Nowicka
- Clinic of Pediatric Nephrology and Hypertension, University of Medical Sciences, Szpitalna St 27/33, 60-572, Poznan, Poland
| | - Jacek Zachwieja
- Clinic of Pediatric Nephrology and Hypertension, University of Medical Sciences, Szpitalna St 27/33, 60-572, Poznan, Poland
| | - Michał Nowicki
- Department of Histology and Embryology, University of Medical Sciences, Swiecickiego St 6, 60-781, Poznan, Poland
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Żurowska AM, Bielska O, Daca-Roszak P, Jankowski M, Szczepańska M, Roszkowska-Bjanid D, Kuźma-Mroczkowska E, Pańczyk-Tomaszewska M, Moczulska A, Drożdż D, Hadjipanagi D, Deltas C, Ostalska-Nowicka D, Rabiega A, Taraszkiewicz J, Taranta-Janusz K, Wieczorkiewicz-Plaza A, Jobs K, Mews J, Musiał K, Jakubowska A, Nosek H, Jander AE, Koutsofti C, Stanisławska-Sachadyn A, Kuleszo D, Ziętkiewicz E, Lipska-Ziętkiewicz BS. Mild X-linked Alport syndrome due to the COL4A5 G624D variant originating in the Middle Ages is predominant in Central/East Europe and causes kidney failure in midlife. Kidney Int 2020; 99:1451-1458. [PMID: 33309955 DOI: 10.1016/j.kint.2020.10.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 03/13/2020] [Revised: 10/23/2020] [Accepted: 10/30/2020] [Indexed: 12/14/2022]
Abstract
A study of 269 children enrolled into a National Registry for children with persistent glomerular hematuria identified 131 individuals with genetically confirmed X-linked Alport Syndrome. A single variant c.1871G>A p.Gly624Asp (G624D) in COL4A5 was predominant and accounted for 39% of X-linked Alport Syndrome in unrelated Polish families (44 of 113). To evaluate its origins, the genetic variation in a 2.79 Mb segment encompassing the COL4A5 locus on chromosome X was assessed. All G624D alleles were found on the same rare haplotype background, indicating a founder effect dating back to the 12-13th century. The phenotypic data of 131 children with X-linked Alport Syndrome and their 195 affected adult relatives revealed that the G624D variant was associated with a significantly milder clinical course in comparison to other pathogenic COL4A5 variants. Furthermore the clinical course of this genetically uniform cohort was milder than that observed in individuals with other COL4A5 missense mutations. In spite of the benign clinical manifestation throughout childhood and early adulthood, the G624D variant confers significant risk for both kidney failure and deafness in males, albeit 20-30 years later than that observed in individuals with other COL4A5 pathogenic variants (50% cumulative risk of starting dialysis at 54 years (95% confidence interval: 50-62) v. 26 years (95% confidence interval: 22-30)). Thus, males with G624D are candidates for existing and emerging therapies for Alport Syndrome.
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Affiliation(s)
- Aleksandra M Żurowska
- Rare Diseases Centre, Medical University of Gdańsk, Gdańsk, Poland; Department of Pediatrics, Nephrology and Hypertension, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
| | - Olga Bielska
- Department of Pediatrics, Nephrology and Hypertension, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Maciej Jankowski
- Department of Biology and Medical Genetics, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Maria Szczepańska
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Dagmara Roszkowska-Bjanid
- Pediatric Nephrology Ward With Dialysis Division for Children, Public Clinical Hospital, Zabrze, Poland
| | | | | | - Anna Moczulska
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Cracow, Poland
| | - Dorota Drożdż
- Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Cracow, Poland
| | - Despina Hadjipanagi
- Center of Excellence in Biobanking and Biomedical Research, Molecular Medicine Research Center, University of Cyprus Medical School, Nicosia, Cyprus
| | - Constantinos Deltas
- Center of Excellence in Biobanking and Biomedical Research, Molecular Medicine Research Center, University of Cyprus Medical School, Nicosia, Cyprus
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Cardiology and Hypertensiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Alina Rabiega
- Department of Pediatric Cardiology and Hypertensiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Janina Taraszkiewicz
- Department of Pediatric Nephrology, Team of Municipal Hospitals in Chorzów, Chorzów, Poland
| | | | | | - Katarzyna Jobs
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Judyta Mews
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Kinga Musiał
- Department of Pediatric Nephrology, Wrocław Medical University, Wrocław, Poland
| | - Anna Jakubowska
- Department of Pediatric Nephrology, Wrocław Medical University, Wrocław, Poland
| | - Hanna Nosek
- Department of Pediatrics, Gastroenterology and Nutrition, University of Warmia and Mazury, Olsztyn, Poland
| | - Anna E Jander
- Department of Pediatrics, Immunology and Nephrology, Polish Mothers Memorial Hospital Research Institute, Łódź, Poland
| | - Constantina Koutsofti
- Center of Excellence in Biobanking and Biomedical Research, Molecular Medicine Research Center, University of Cyprus Medical School, Nicosia, Cyprus
| | | | - Dominka Kuleszo
- Department of Biology and Medical Genetics, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Ewa Ziętkiewicz
- Institute of Human Genetics, Polish Academy of Sciences, Poznań, Poland
| | - Beata S Lipska-Ziętkiewicz
- Rare Diseases Centre, Medical University of Gdańsk, Gdańsk, Poland; Clinical Genetics Unit, Department of Biology and Medical Genetics, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
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Ostalska-Nowicka D, Paszyńska E, Dmitrzak-Węglarz M, Neyman-Bartkowiak A, Rabiega A, Zachwieja J, Nowicki M. Dental caries-related primary hypertension in children and adolescents: Cross-sectional study. Oral Dis 2020; 27:1822-1833. [PMID: 33128414 DOI: 10.1111/odi.13700] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/20/2020] [Revised: 09/27/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hypertension is a growing clinical problem in pediatric population. Also, the cause of hypertension is usually unknown and it may result from systemic inflammation related to tooth decay. AIM To estimate the potential association in cross-sectional study between tooth decay and hypertension in children and adolescents. PATIENTS AND METHODS Study group-65 children diagnosed with primary arterial hypertension; control subjects-44 normotensive children. Blood pressure, dental examination, measurement of salivary cortisol, alpha-amylase, secretory IgA, and lysozyme concentrations were performed in all of the children. RESULTS Hyper- and normotensive children had similar peripheral blood morphology and serum biochemical parameters, except of uric acid concentration, which was significantly higher in the study group (p = .047). Salivary evening concentrations of cortisol and alpha-amylase were significantly higher in hypertensive children (p = .002 and p = .004, respectively). Although 24-hr systolic blood pressure (SBP), including daytime and nighttime SBP, correlated with "decay," "microalbuminuria," "BMI," and "glomerular filtration rate" (r > .75, r > .7, r < .68, and r < .43, respectively), in multivariate analysis only "decay" was associated with hypertension both in children and in adolescents (p < .0001). CONCLUSION Tooth decay in children/adolescents might be regarded as a potent trigger factor of hypertension in individuals in whom all other causes of secondary arterial hypertension have been excluded.
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Affiliation(s)
- Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Paszyńska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Dmitrzak-Węglarz
- Department of Genetics in Psychiatry, Psychiatric Genetics Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Neyman-Bartkowiak
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Alina Rabiega
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
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Paszynska E, Dmitrzak-Weglarz M, Ostalska-Nowicka D, Nowicki M, Gawriolek M, Zachwieja J. Association of Oral Status and Early Primary Hypertension Biomarkers among Children and Adolescents. Int J Environ Res Public Health 2020; 17:ijerph17217981. [PMID: 33143057 PMCID: PMC7662220 DOI: 10.3390/ijerph17217981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
The aim of this case-control study was the evaluation of the association between biomarkers of early primary arterial hypertension (HA) and oral diseases among children and adolescents. Material and methods. Subjects suspected of primary HA (n = 180) underwent a complex evaluation of their vascular status: blood pressure, heart rate, vascular stiffness, sympathetic activity in a 24 h ambulatory examination, followed by measurement of serum uric acid (UA), cystatin C, and creatinine. This procedure allowed the identification of children with primary (n = 58) and secondary HA (n = 74), as well as of children with normal arterial blood pressure, who served as a control group (n = 48). All subjects with secondary HA were excluded from further investigation. Oral examination included the measurement of caries intensity (using the decayed, missing, filled index for permanent teeth DMFT /primary teeth dmft), bacterial plaque (by the plaque control record index, PCR%), and gingivitis (by the bleeding on probing index, BOP%). For statistical analysis, a linear regression model and Spearman rank correlation were used. Results. UA, cystatin C, and creatinine were not altered in the HA group. However, the number of decayed permanent teeth (DT) and the DMFT, PCR%, and BOP% indexes were significantly higher in the primary HA group compared to the control group (p = 0.0006; p = 0.02; p = 0.0009; p = 0.003). Our results are not sufficient to prove the important role of caries and gingival inflammation in the modulation of HA symptoms, although they prove the association of oral diseases with primary HA symptoms. This may indicate future strategies for preventive measures for hypertensive children and adolescents.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
- Correspondence:
| | - Monika Dmitrzak-Weglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (D.O.-N.); (J.Z.)
| | - Michal Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-781 Poznan, Poland;
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (D.O.-N.); (J.Z.)
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11
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Soltysiak J, Ostalska-Nowicka D, Maćkowiak-Lewandowicz K, Skowronska B, Fichna P, Stankiewicz W, Zaorska K, Zachwieja J. Early kidney damage in diabetic adolescents with increased blood pressure and glomerular hyperfiltration. Minerva Pediatr 2020:S0026-4946.20.05812-0. [PMID: 32748608 DOI: 10.23736/s0026-4946.20.05812-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The early impact of type-1 diabetes mellitus (DM1), increased blood pressure and glomerular hyperfiltration (GHF) on kidney damage in adolescents using two urinary markers of kidney injury - neutrophil gelatinase-associated lipocalin (uNGAL) and transferrin (uTransf) was assessed. METHODS The study group consisted of 80 adolescents with DM1, of whom 42 were patients with increased blood pressure (IBP), and 38 were patients with normal blood pressure (NBP). Blood pressure was assessed by 24-hour ambulatory bloodpressure monitoring. All patients showed estimated glomerular-filtration rates (eGFRs) above 90 ml/min/1.73m2. The control group consisted of 19 healthy, age and gender-matched adolescents. RESULTS All diabetic children showed a significant increase in uNGAL (p<0.001). This increase was not related to blood pressure. The uNGAL was elevated in all patients with normal albuminuria, normal eGFR and NBP. The concentration of uTransf was not increased in the entire studied group and was not related to blood pressure. Children with GHF had significantly higher levels of both uTransf (p=0.010) and uNGAL (p<0.001). In patients with GHF, blood pressure was normal. Patients with IBP showed a significantly higher value for triglycerides (r=0.247; p=0.032) and a longer duration of diabetes (r=0.264; p=0.019). CONCLUSIONS Diabetes is the leading risk factor for early kidney injury. However, increased blood pressure does not lead to kidney damage, at least in the early stage of DM1. The uNGAL is the early indicator of kidney injury and increases in patients with normal albuminuria, normal glomerular filtration and normal blood pressure. Glomerular hyperfiltration seems to be a marker of diabetic-kidney involvement.
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Affiliation(s)
- Jolanta Soltysiak
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland -
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Bogda Skowronska
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Fichna
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Witold Stankiewicz
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Zaorska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
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12
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Zachwieja J, Neyman-Bartkowiak A, Rabiega A, Wojciechowska M, Barabasz M, Musielak A, Silska-Dittmar M, Ostalska-Nowicka D. Comparison of cuff-based and cuffless continuous blood pressure measurements in children and adolescents. Clin Exp Hypertens 2020; 42:512-518. [PMID: 31941385 DOI: 10.1080/10641963.2020.1714642] [Citation(s) in RCA: 3] [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: 10/25/2022]
Abstract
OBJECTIVE In recent times, new methods of blood pressure measurements have been introduced, including cuffless blood pressure (BP) measurement device using pulse transit time (PTT) for calculation of BP values. However, it is still unknown how values obtained with a new cuffless device compare with standard ambulatory measurements in children. The main aim of the study was to investigate whether BP values measured by a cuffless PTT device are comparable with measurements by a standard upper arm cuff-based BP device. METHODS Thirty children were prospectively included. Blood pressure measurements using the cuffless device (Somnotouch-NIBP) and cuff-based standard device (Omron 907) were performed simultaneously on the left and right arm. RESULTS Mean systolic BP of the standard measurements was 123,47 ± 14,91 mmHg and 127,48 ± 15,98 mmHg (p < .001) measured by cuffless method. Mean diastolic BP of the standard ABPM measurements was 66,88 ± 11,86 mmHg and 68,52 ± 12,36 mmHg (p < .001). There were significant positive correlations between standard and cuffless measurements. CONCLUSION The results show that the created PWV-BP function produces a significant correlation between BP derived from the PWV and the SBP measured by sphygmomanometry. When applying this device in clinical practice, one may keep in mind that the reported mean values over 24 hours, awake and asleep time are not directly interchangeable with cuff-based standard 24-hour BP values. The measured BP values were higher by the new technique. Although differences in SBP between both methods reached values up to 20 mmHg, we think that the development of a cuffless BP monitoring system will provide novel solutions in various medical situations.
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Affiliation(s)
- Jacek Zachwieja
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences , Poznan, Poland
| | - Anna Neyman-Bartkowiak
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences , Poznan, Poland
| | - Alina Rabiega
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences , Poznan, Poland
| | - Marta Wojciechowska
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences , Poznan, Poland
| | - Małgorzata Barabasz
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences , Poznan, Poland
| | - Anna Musielak
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences , Poznan, Poland
| | - Magdalena Silska-Dittmar
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences , Poznan, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Hypertension, Poznan University of Medical Sciences , Poznan, Poland
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Tykarski A, Filipiak KJ, Januszewicz A, Litwin M, Narkiewicz K, Prejbisz A, Ostalska-Nowicka D, Widecka K, Kostka-Jeziorny K. 2019 Guidelines for the Management of Hypertension — Part 8–9. Arterial Hypertension 2019. [DOI: 10.5603/ah.a2019.0021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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14
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Perek B, Kowalska K, Kempisty B, Nawrocki M, Nowicki M, Puślecki M, Ostalska-Nowicka D, Szarpak Ł, Ahmadi N, Malińska A. Infiltration of CD68+ cells correlates positively with matrix metalloproteinase 2 expression in the arteries used as aortocoronary bypass grafts. Possible clinical implications. Cardiol J 2019; 27:817-824. [PMID: 31489609 DOI: 10.5603/cj.a2019.0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 12/03/2018] [Revised: 03/08/2019] [Accepted: 03/27/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Late failure of arterial aortocoronary conduits may result from abnormal activity of cells found in the vessel wall, including macrophages. The purpose of this study was to assess if there are any associations between the number of macrophages and overexpression of matrix metalloproteinases (MMPs) in the wall of arterial grafts, as well as their clinical significance. METHODS This study involved 128 consecutive patients with a mean age of 64.9 ± 9.7 years who underwent elective surgery for coronary artery disease (CAD). The surplus segments of internal thoracic artery (ITA) and radial arteries (RA) were taken for immunohistochemical analysis of macrophage numbers and MMPs expression. The participants who reached the clinical primary end-point (cardiacrelated death, acute coronary syndrome or progression of CAD) had a follow-up angiography. RESULTS The mean numbers of macrophages were higher on RA (70 [24; 112]) than ITA cross-sections (44 [24; 59]; p < 0.001). Median expression of both MMP2 and MMP9 were stronger in the ITA than RA cross-sections (p < 0.001). A significant positive correlation of MMP2 expression and a number of macrophages infiltrating the tunica media of arterial segments were noted on both ITA and RA cross-sections. In addition, the arterial segments of the 6 patients who reached clinical end-point had higher numbers of macrophages and stronger MMP2 expression when compared to the rest of the participants. CONCLUSIONS Macrophage infiltration of arterial wall grafts prior to harvesting may be associated with higher risk of late occlusion and MMP2 might be facilitating this process.
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Affiliation(s)
- Bartłomiej Perek
- Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland.
| | - Katarzyna Kowalska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Ul. Święcickiego6, 60-781 Poznań, Poland
| | - Bartosz Kempisty
- Department of Histology and Embryology, Poznan University of Medical Sciences, Ul. Święcickiego6, 60-781 Poznań, Poland.,Department of Anatomy, Poznan University of Medical Sciences, Poland
| | - Mariusz Nawrocki
- Department of Anatomy, Poznan University of Medical Sciences, Poland
| | - Michał Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Ul. Święcickiego6, 60-781 Poznań, Poland
| | - Mateusz Puślecki
- Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | - Navid Ahmadi
- Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Malińska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Ul. Święcickiego6, 60-781 Poznań, Poland
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15
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Tykarski A, Filipiak KJ, Januszewicz A, Litwin M, Narkiewicz K, Prejbisz A, Ostalska-Nowicka D, Widecka K, Kostka-Jeziorny K. 2019 Guidelines for the Management of Hypertension — Part 1–7. Arterial Hypertension 2019. [DOI: 10.5603/ah.a2019.0008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Sobiak J, Resztak M, Pawiński T, Żero P, Ostalska-Nowicka D, Zachwieja J, Chrzanowska M. Limited sampling strategy to predict mycophenolic acid area under the curve in pediatric patients with nephrotic syndrome: a retrospective cohort study. Eur J Clin Pharmacol 2019; 75:1249-1259. [PMID: 31172249 DOI: 10.1007/s00228-019-02701-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 01/07/2019] [Accepted: 05/27/2019] [Indexed: 01/07/2023]
Abstract
PURPOSE Limited sampling strategy (LSS) is a precise and relatively convenient therapeutic drug monitoring method. We evaluated LSSs for mycophenolic acid (MPA) in children with nephrotic syndrome treated with mycophenolic mofetil (MMF) and validated the LSSs using two different approaches. METHODS We measured MPA plasma concentrations in 31 children using HPLC-UV method and received 37 MPA pharmacokinetic profiles (0-12 h). For six children, MPA profiles were estimated twice after two MMF doses. LSSs were developed using multilinear regression with STATISTICA and R software and validated using validation group and bootstrap method, respectively. RESULTS The best three time point equations included C1, C3, C6 (good guess 83%, bias - 2.78%; 95% confidence interval (CI) - 9.85-0.46); C1, C2, C6 (good guess 72%, bias 0.72%; 95% CI - 5.33-7.69); and C1, C2, C4 (good guess 72%, bias 2.05%; 95% CI - 4.92-13.01) for STATISTICA software. For R software, the best equations consisted of C1, C3, C6 (good guess 92%, bias - 2.69%; 95% CI - 27.18-33.75); C0, C1, C3 (good guess 84%, bias - 2.11%; 95% CI - 24.19-22.29); and C0, C1, C2 (good guess 84%, bias - 0.48%; 95% CI - 30.77-54.07). During validation, better results were obtained for R evaluations, i.e., bootstrap method. CONCLUSIONS The most useful equations included C0, C1, C3 and C0, C1, C2 time points; however, the most precise included C1, C3, C6 time points because of MPA enterohepatic recirculation. Better results were obtained for bootstrap validation due to greater number of patients. Validated LSS should be used only in the population for which it was developed. As there is growing evidence that underexposure of MPA is associated with insufficient treatment response, we recommend the introduction of therapeutic drug monitoring for MPA in children with nephrotic syndrome.
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Affiliation(s)
- Joanna Sobiak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Święcickiego Street, 60-781, Poznan, Poland.
| | - Matylda Resztak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Święcickiego Street, 60-781, Poznan, Poland
| | - Tomasz Pawiński
- Department of Drug Chemistry, Medical University of Warsaw, 1 Banacha Street, 02-097, Warsaw, Poland
| | - Paweł Żero
- Department of Drug Chemistry, Medical University of Warsaw, 1 Banacha Street, 02-097, Warsaw, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland
| | - Maria Chrzanowska
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Święcickiego Street, 60-781, Poznan, Poland
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17
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Ostalska-Nowicka D, Mackowiak-Lewandowicz K, Perek B, Zaorska K, Zachwieja J, Nowicki M. Megalin - a facultative marker of obesity-related glomerulopathy in children. J BIOL REG HOMEOS AG 2019; 33:415-420. [PMID: 30968683] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Obesity-related glomerulopathy (ORG) is an increasingly detected syndrome present in children with obesity. Megalin, a constitutive proximal tubule cell protein, when present in urine, can be considered as a biomarker indicating renal injury in these children.
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Affiliation(s)
- D Ostalska-Nowicka
- Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - K Mackowiak-Lewandowicz
- Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - B Perek
- Department of Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - K Zaorska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | - J Zachwieja
- Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, Poznan, Poland
| | - M Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
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18
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Zachwieja J, Silska-Dittmar M, Żurowska A, Drożyńska-Duklas M, Hyla-Klekot L, Kucharska G, Stankiewicz R, Olszak-Szot I, Drożdż D, Moczulska A, Zwolińska D, Medyńska A, Sikora P, Bieniaś B, Tkaczyk M, Rogowska-Kalisz A, Ostalska-Nowicka D. Multicenter analysis of the efficacy and safety of a non-standard immunosuppressive therapy with rituximab in children with steroid-resistant nephrotic syndrome. Clin Exp Pharmacol Physiol 2018; 46:313-321. [PMID: 30346047 DOI: 10.1111/1440-1681.13046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 03/05/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 12/20/2022]
Abstract
The aim of the study was a multicenter analysis of the efficacy and safety of a non-standard immunosuppressive therapy with rituximab (Rtx) in children with steroid-resistant nephrotic syndrome (SRNS) with particular emphasis on the possibility of permanent discontinuation or dose reduction of other immunosuppressive drugs such as glucocorticoids and cyclosporine A after 6 months of observation. The study group consisted of 30 children with idiopathic nephrotic syndrome, who were unresponsive to standard immunosuppressive treatment, and hospitalized in the years 2010-2017 in eight paediatric nephrology centres in Poland. The children were administered a single initial infusion of rituximab at the dose of 375 mg/m2 of the body surface area. Proteinuria, the daily supply of glucocorticoids, and cyclosporine were assessed at the moment of the start of the treatment and after 6 months since its commencement. Before Rtx therapy, complete remission was found in 13 patients (43%) and partial remission was found in 8 patients (26%). These numbers increased to 16 (53%) and 12 (40%), respectively. At the start of the treatment 23 patients (76.6%) were treated with cyclosporine A. After 6 months, this number decreased to 15 patients (35%). At the start of the treatment, 18 patients (60%) were treated with prednisone. After 6 months, this number decreased to 8 patients (44%). Children with SRNS may potentially benefit from Rtx treatment despite relative risk of side effects. The benefits may include reduction of proteinuria or reduction of other immunosuppressants.
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Affiliation(s)
- Jacek Zachwieja
- Department of Paediatric Nephrology and Dialysis, University of Poznan, Poznan, Poland
| | | | - Aleksandra Żurowska
- Department of Paediatric Nephrology and Dialysis, University of Gdansk, Gdansk, Poland
| | | | - Lidia Hyla-Klekot
- Department of Paediatric Nephrology and Dialysis, University of Katowice, Katowice, Poland
| | - Grażyna Kucharska
- Department of Paediatric Nephrology and Dialysis, University of Katowice, Katowice, Poland
| | - Roman Stankiewicz
- Department of Paediatric Nephrology and Dialysis, University of Torun, Torun, Poland
| | - Ilona Olszak-Szot
- Department of Paediatric Nephrology and Dialysis, University of Torun, Torun, Poland
| | - Dorota Drożdż
- Department of Paediatric Nephrology and Dialysis, University of Krakow, Krakow, Poland
| | - Anna Moczulska
- Department of Paediatric Nephrology and Dialysis, University of Krakow, Krakow, Poland
| | - Danuta Zwolińska
- Department of Paediatric Nephrology and Dialysis, University of Wroclaw, Wroclaw, Poland
| | - Anna Medyńska
- Department of Paediatric Nephrology and Dialysis, University of Wroclaw, Wroclaw, Poland
| | - Przemysław Sikora
- Department of Paediatric Nephrology and Dialysis, University of Lublin, Lublin, Poland
| | - Beata Bieniaś
- Department of Paediatric Nephrology and Dialysis, University of Lublin, Lublin, Poland
| | - Marcin Tkaczyk
- Department of Paediatric Nephrology and Dialysis, University of Lodz, Lodz, Poland
| | - Anna Rogowska-Kalisz
- Department of Paediatric Nephrology and Dialysis, University of Lodz, Lodz, Poland
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19
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Perek B, Kowalska K, Kempisty B, Nowicki M, Dyszkiewicz-Konwińska M, Puślecki M, Ostalska-Nowicka D, Jemielity M, Jankowski M, Nawrocki MJ, Malińska A. Gender and age-related variability of macrophage representation in the internal thoracic artery wall: does it matter? J BIOL REG HOMEOS AG 2018; 32:791-802. [PMID: 30043561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Some recent reports suggested that elderly and female patients did not benefit from implantation of the second internal thoracic artery (ITA) during coronary artery bypass surgery (CABG). Macrophages, among other cells, were described to be involved in both atherosclerosis and aortocoronary grafts failure. The aim of the study was to examine the age and gender association with different distribution of CD68+ cells within the layers of ITA wall. This study involved 158 consecutive patients (95 male and 63 female), with the mean age of 64.5±9.5 years, who underwent elective CABG procedures. During surgery, the surplus distal segments of ITA were harvested for immunohistochemical analysis. The number and distribution of CD68+ cells was calculated and plotted against the age and gender of the study participants. CD68+ cells were present in all of the harvested ITA fragments (median 44), more in women (55) than in men (42) (p less than 0.001). However, this difference was of statistical significance exclusively in the tunica intima. Approximately 70% of macrophages were found in the tunica adventitia. The total number of CD68+ cells the in arterial wall as well as in the tunica intima and adventitia correlated positively with the age of patients (r=0.544, r=501 and r=0.462, respectively). The lack of significant advantages of the use of two thoracic arteries, in elderly patients and women, might have resulted from the larger population of CD68+ cells in their walls, especially the tunica intima. However, this result from immunohistochemical analysis needs validation in long-term clinical research on a larger cohort of patients.
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Affiliation(s)
- B Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - K Kowalska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | - B Kempisty
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
- Department of Anatomy, Poznan University of Medical Sciences, Poznan, Poland
- Department of Obstetrics and Gynecology, University Hospital and Masaryk University, Brno, Czech Republic
| | - M Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - M Puślecki
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
- Department of Medical Rescue, Poznan University of Medical Science, Poznan, Poland
| | - D Ostalska-Nowicka
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Science, Poznan, Poland
| | - M Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - M Jankowski
- Department of Anatomy, Poznan University of Medical Sciences, Poznan, Poland
| | - M J Nawrocki
- Department of Anatomy, Poznan University of Medical Sciences, Poznan, Poland
| | - A Malińska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
- Department of Anatomy and Histology, Faculty of Medicine and Health Sciences, University of Zielona Gora, Poland
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Kroll P, Zachwieja J, Ostalska-Nowicka D. A proposal of a follow-up protocol for children with neurogenic bladder. Minerva Pediatr 2017; 69:559-560. [PMID: 29181965 DOI: 10.23736/s0026-4946.17.04702-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Paweł Kroll
- Unit of Neurourology, Pediatric Surgery and Urology Clinic, Poznań, Poland -
| | - Jacek Zachwieja
- Department of Pediatric Nephrology, University of Medical Sciences, Poznań, Poland
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Ostalska-Nowicka D, Mackowiak-Lewandowicz K, Konwerska A, Zachwieja J. Early Progression of Xanthogranulomatous Pyelonephritis in Children Might Be Dependent on Vimentin Expression. Am J Case Rep 2017; 18:1066-1072. [PMID: 28978905 PMCID: PMC5637626 DOI: 10.12659/ajcr.904376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Xanthogranulomatous pyelonephritis (XP) is an extremely rare, severe, atypical form of chronic renal parenchymal inflammation accompanied by hydronephrosis and/or urolithiasis. The pathomechanism of XP is not yet fully understood. Microscopically, XP is indicated by the presence of multinucleated giant cells and lipid-laden macrophages, as well as inflammatory infiltration and intensive renal fibrosis. The lipid accumulation in kidney parenchyma may be secondary to the altered flow of low-density lipoprotein (LDL)-derived cholesterol particles inside the affected cells. Physiologically, the process of LDL-derived cholesterol transport from lysosomes to the sites of its esterification is dependent on vimentin, which is a molecule comprising the cytoskeleton in mesenchymal cells. CASE REPORT A 7-year old girl was hospitalized because of the finding of unexplained kidney lesions on an abdominal ultrasound examination (an enlarged and deformed collecting system of the right kidney with hyperechogenic, solid, staghorn lesions in the calyces). Three months earlier, the patient had experienced recurrent urinary tract infection. Based on the subsequent laboratory and imaging diagnostics, the final diagnosis of XP was established and the girl was qualified for right-sided nephrectomy Microscopic examination revealed numerous foci of granuloma formations with no evident exponents of dysplastic or neoplastic abnormalities. Significant CD68-positive cell infiltrations and scattered foam cells arranging the numerous foci of granuloma inflammation were noticed. Renal parenchyma, adjacent to granuloma lesions, presented a vimentin expression. CONCLUSIONS Vimentin expression in XP may confirm a focal character of chronic granuloma formation and may suggest the complexity of XP pathogenesis involving not only macrophage and fibroblast activation but also local lipid deregulation and fibrosis.
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Affiliation(s)
- Danuta Ostalska-Nowicka
- Department of Pediatric Cardiology, Nephrology and Hypertensiology, Poznań University of Medical Sciences, Poznań, Poland
| | | | - Aneta Konwerska
- Department of Histology and Embryology, Poznań University of Medical Sciences, Poznań, Poland
| | - Jacek Zachwieja
- Department of Pediatric Cardiology, Nephrology and Hypertensiology, Poznań University of Medical Sciences, Poznań, Poland
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Kroll P, Gajewska E, Zachwieja J, Ostalska-Nowicka D, Micker M, Jankowski A. Continent catheterizable conduits in pediatric urology: One-center experience. ADV CLIN EXP MED 2017; 26:1107-1112. [PMID: 29211359 DOI: 10.17219/acem/63032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 11/24/2022]
Abstract
BACKGROUND Clean intermittent catheterization (CIC) is a standard treatment for patients who are unable to empty the bladder. In the absence of the urethra or if catheterization through the urethra is problematic, a continent vesicostomy is used as a catheterizable conduit. The Malone procedure is an established treatment option for children with neurogenic constipation and fecal incontinence. OBJECTIVES The aim of the study was to report the authors' experience with continent catheterizable conduits (CCCs) in children, to review the results and to determine the efficacy of the technique, with an emphasis on continence and the need for revision. MATERIAL AND METHODS The retrospective study involved children who underwent catheterizable conduit procedures from 2000 to 2015. Two kinds of continent stomas were performed: Mitrofanoff vesicostomies for CIC and Malone antegrade continence enemas (MACEs). The 115 patients treated included 66 girls and 49 boys. A total of 134 operations were performed; 62 were Mitrofanoff vesicostomies and 72 were Malone appendicostomies. In 19 cases, both Mitrofanoff and Malone appendicostomies were formed out of 1 appendix divided into 2 parts. In 5 children vesicocutaneous stomas were constructed using Monti's procedure, and in 1 it was constructed from an intussuscepted ileal loop. In 27 patients Malone procedures were performed laparoscopically. RESULTS The mean follow-up period was 8.6 years. There was no serious morbidity in relation to the surgery. In 9 children local wound infection was noted, and in 9 others stomal stenosis developed. Out of the 62 children with catheterizable vesicostomies, 59 were continent. The MACE procedure was successful in all 72 patients; problems with constipation and fecal incontinence were resolved in all cases. None of the laparoscopies needed conversion. CONCLUSIONS Continent catheterizable conduits help patients achieve both fecal and urinary continence. Laparoscopy is effective in performing the Malone procedure. Stoma-related complications could be avoided using end-to-side appendix anastomoses to the skin. Stomal incontinence is rare even when a simplified technique is employed, using the appendix without cecoplication.
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Affiliation(s)
- Paweł Kroll
- Department of Pediatric Surgery, Poznan University of Medical Sciences, Poland
- Department of Pediatric Urology, Poznan University of Medical Sciences, Poland
- Neurology Unit, Poznan University of Medical Sciences, Poland
| | - Ewa Gajewska
- Department of Rehabilitation, Faculty of Physical Culture in Gorzów Wielkopolski, University School of Physical Education in Poznań, Poland
| | - Jacek Zachwieja
- Neurology Unit, Poznan University of Medical Sciences, Poland
| | | | - Maciej Micker
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poland
- Department of Angiology, Poznan University of Medical Sciences, Poland
| | - Andrzej Jankowski
- Department of Pediatric Surgery, Poznan University of Medical Sciences, Poland
- Department of Pediatric Urology, Poznan University of Medical Sciences, Poland
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Soltysiak J, Ostalska-Nowicka D, Zaorska K, Sterzyńska K, Derwich K, Zachwieja J. Atypical thymic carcinoid manifesting with nephrotic-range proteinuria in a 7-year-old boy. Pediatr Nephrol 2017; 32:1465-1468. [PMID: 28477260 DOI: 10.1007/s00467-017-3685-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/15/2017] [Accepted: 04/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nephrotic-range proteinuria as a paraneoplastic syndrome (PNS) is an exceptional presentation, especially in children. It is usually associated with hematologic malignancies. Solid tumors are very rare causes of proteinuria. CASE-DIAGNOSIS/TREATMENT We present the case of a 7-year-old boy with an extremely rare atypical thymic carcinoid accompanied by nephrotic-range proteinuria as PNS. The kidney biopsy was consistent with minimal change disease (MCD). Tests for a neuroendocrine tumor were performed due to symptoms of hypercortisolemia and an elevated concentration of chromogranin A in the serum. The chest computed tomography revealed a tumor in the anterior mediastinum, which was diagnosed as an atypical thymic carcinoid. A complete resolution of the nephrotic-range proteinuria was observed within 1 week after the first thoracoscopic surgery, with almost complete reduction of the tumor mass. CONCLUSIONS This extremely rare case shows that MCD can occur as a PNS even in children. Nephrotic-range proteinuria can be a symptom of malignant solid tumor. This case highlights the possibility of secondary causes of MCD in children.
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Affiliation(s)
- Jolanta Soltysiak
- Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, 27/33 Szpitalna Str, 60-572, Poznan, Poland.
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, 27/33 Szpitalna Str, 60-572, Poznan, Poland
| | - Katarzyna Zaorska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | - Karolina Sterzyńska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Derwich
- Department of Pediatric Hematology and Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, 27/33 Szpitalna Str, 60-572, Poznan, Poland
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Sołtysiak J, Skowrońska B, Fichna P, Stankiewicz W, Lewandowska-Stachowiak M, Ostalska-Nowicka D, Zachwieja J. Neutrophil gelatinase-associated lipocalin and Cathepsin L as early predictors of kidney dysfunction in children with type 1 diabetes. Endokrynol Pol 2016; 65:479-84. [PMID: 25554617 DOI: 10.5603/ep.2014.0067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 07/12/2014] [Accepted: 07/24/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate serum levels and urinary excretion of neutrophil-gelatinase associated lipocalin (respectively sNGAL and uNGAL) and urinary excretion of Cathepsin L (uCathL) in children with type 1 diabetes mellitus (DM1) who presented normoalbuminuria and the estimated glomerular filtration rate (eGFR) above 90 mL/min/1.73 m2. MATERIAL AND METHODS The study group consisted of 63 children with a diabetes duration of 5.16 ± 3.39 years. The degree of albuminuria was based on urine albumin-to-creatinine ratio (ACR), while eGFR was based on serum cystatin C. Glomerular hyperfiltration (GH) was defined as an eGFR value above 135 mL/min/1.73 m2. RESULTS Children with DM1 showed significantly higher concentrations of uNGAL, and lower sNGAL and uCathL. Significant changes of uNGAL and uCathL levels were even found in children without GH and with optimal glycaemic control (HbA1c < 7.5%). Positive correlations between uNGAL, ACR and eGFR were shown, as well as between uCathL and eGFR. CONCLUSIONS Significant changes in the concentration of markers of early kidney injury: sNGAL, uNGAL, and uCathL, can occur in children with DM1 and normoalbuminuria. The changes of uNGAL and uCathL can be even found in children without GH and with optimal glycaemic control. The earliest signs of diabetic kidney dysfunction seem to result from tubular damage.
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Affiliation(s)
- Jolanta Sołtysiak
- Department of Paediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poland.
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Musielak A, Warzywoda A, Wojtalik M, Kociński B, Kroll P, Ostalska-Nowicka D, Zachwieja J. Outcomes of Continuous Renal Replacement Therapy With Regional Citrate Anticoagulation in Small Children After Cardiac Surgery: Experience and Protocol From a Single Center. Ther Apher Dial 2016; 20:639-644. [DOI: 10.1111/1744-9987.12456] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/25/2016] [Accepted: 05/26/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Anna Musielak
- Pediatric Cardiology and Nephrology; Poznan University of Medical Sciences; Poznan Poland
| | - Alfred Warzywoda
- Pediatric Cardiology and Nephrology; Poznan University of Medical Sciences; Poznan Poland
| | - Michał Wojtalik
- Pediatric Cardiology and Nephrology; Poznan University of Medical Sciences; Poznan Poland
| | - Bartłomiej Kociński
- Pediatric Cardiology and Nephrology; Poznan University of Medical Sciences; Poznan Poland
| | - Paweł Kroll
- Pediatric Cardiology and Nephrology; Poznan University of Medical Sciences; Poznan Poland
| | | | - Jacek Zachwieja
- Pediatric Cardiology and Nephrology; Poznan University of Medical Sciences; Poznan Poland
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Maćkowiak-Lewandowicz K, Ostalska-Nowicka D, Zachwieja J. SP714EARLY MARKERS OF KIDNEY INJURY IN CHILDREN WITH OBESITY. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw179.21] [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: 11/14/2022] Open
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27
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Silska-Dittmar M, Musielak A, Sołtysiak J, Ostalska-Nowicka D, Zachwieja J. SP737PAMIDRONATE AS AN EFFECTIVE AND SAFE ALTERNATIVE TREATMENT IN CHILDREN WITH SECONDARY POSTSTEROID OSTEOPOROSIS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw179.44] [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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Musielak A, Silska-Dittmar M, Benedyk A, Ostalska-Nowicka D, Zachwieja J. SP736EARLY SIGNS OF ACUTE KIDNEY INJURY IN CHILDREN WITH CONGENITAL HEART DISEASE. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw179.43] [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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Sobiak J, Resztak M, Ostalska-Nowicka D, Zachwieja J, Kurnatowska M, Chrzanowska M. SP700LIMITED SAMPLING STRATEGY FOR THE AREA UNDER CONCENTRATION-TIME CURVE ESTIMATION IN CHILDREN WITH NEPHROTIC SYNDROME TREATED WITH MYCOPHENOLATE MOFETIL. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw179.07] [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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Sołtysiak J, Zachwieja J, Benedyk A, Lewandowska-Stachowiak M, Nowicki M, Ostalska-Nowicka D. Circulating suPAR as a biomarker of disease severity in children with proteinuric glomerulonephritis. Minerva Pediatr 2016; 71:4-11. [PMID: 27070416 DOI: 10.23736/s0026-4946.16.04461-3] [Citation(s) in RCA: 4] [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] [Indexed: 11/08/2022]
Abstract
BACKGROUND The increase of circulating urokinase plasminogen activator receptor (suPAR) was demonstrated in various diseases showing its prognostic value as well as the link to the inflammatory reaction. In glomerular diseases, suPAR was considered a causative factor of proteinuria. In the present study we aimed to evaluate serum concentration of suPAR in children with primary and secondary glomerulonephritis (GN) and its association with disease severity. METHODS The study involved 22 children with minimal change disease (MCD), nine with primary focal segmental glomerulosclerosis (FSGS), seven with Henoch-Schönlein nephritis, seven with lupus nephritis (LN) and 16 controls. RESULTS Serum suPAR was significantly higher in children with FSGS and LN than controls (4.47±1.39 ng/mL vs. 3.23±0.76 ng/mL; P=0.011 and 6.17±1.12 ng/mL vs. 3.23±0.76 ng/mL, respectively; P<0.0001). Further, suPAR was increased in LN when compared to FSGS (P=0.031). In the total group suPAR showed negative correlation with eGFR, serum complement C3 and positive with left ventricular mass index. In children with MCD and FSGS the inverse association of suPAR with eGFR was also shown. CONCLUSIONS In children with primary and secondary glomerulonephritis suPAR levels are not associated with proteinuria. In primary GN elevated suPAR levels may result from reduced eGFR reflecting renal damage. In LN circulating suPAR can be increased further indicating both multi-organ involvement and systemic inflammation reflecting disease severity.
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Affiliation(s)
- Jolanta Sołtysiak
- Department of Pediatric Nephrology and Cardiology, Poznan University of Medical Sciences, Poznan, Poland -
| | - Jacek Zachwieja
- Department of Pediatric Nephrology and Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Benedyk
- Department of Pediatric Nephrology and Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Michal Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Nephrology and Cardiology, Poznan University of Medical Sciences, Poznan, Poland
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Zaorska K, Zawierucha P, Ostalska-Nowicka D, Nowicki M. SOCS3 is epigenetically up-regulated in steroid resistant nephrotic children. Acta Biochim Pol 2016; 63:131-138. [PMID: 26828667 DOI: 10.18388/abp.2015_1105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/18/2015] [Accepted: 12/18/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND The mechanism of steroid resistance in children with the nephrotic syndrome is yet unknown. About 20% of patients demonstrate steroid unresponsiveness and progress to end stage renal disease. Aberrant SOCS3 and SOCS5 expression in steroid resistant and sensitive patients has previously been demonstrated. Here, we investigate genetic and epigenetic mechanisms of regulation of SOCS3 and SOCS5 transcription in nephrotic children. METHODS 76 patients with the nephrotic syndrome (40 steroid resistant and 36 steroid sensitive) and 33 matched controls were included in this study. We performed genotyping of a total of 34 single nucleotide polymorphisms for SOCS3 and SOCS5 promoters and evaluated their methylation status using MS-PCR and QMSP methods. RESULTS Steroid resistant patients had a significantly lower methylation of one region of SOCS3 promoter in comparison with steroid sensitive patients and controls (p < 0.0001). However, the relative methylation level in the steroid sensitive patients and controls differed significantly even before the first steroid dose (p = 0.001758). Other SOCS3 and SOCS5 promoter regions displayed no differences in methylation or were fully methylated/unmethylated in all study groups, showing site-specific methylation. The allele and genotype distribution for SOCS3 and SOCS5 markers did not differ statistically between the groups. CONCLUSIONS We demonstrate an epigenetic mechanism of SOCS3 up-regulation in steroid resistant children with the nephrotic syndrome. The assessment of methylation/unmethylation of SOCS3 promoter might be an early marker for steroid responsiveness in NS patients.
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Affiliation(s)
- Katarzyna Zaorska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznań, Poland
| | - Piotr Zawierucha
- Department of Anatomy, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Michał Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poznań, Poland
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Perek B, Malinska A, Gasowski J, Ostalska-Nowicka D, Perek A, Jemielity M, Zabel M, Nowicki M. Potentially positive ageing-related variations of medial smooth muscle cells in the saphenous veins used as aortocoronary bypass grafts. Folia Histochem Cytobiol 2016; 54:91-98. [PMID: 27845500 DOI: 10.5603/fhc.a2016.0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/13/2016] [Accepted: 06/30/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Currently, elderly people constitute a large proportion of patients undergoing coronary artery bypass grafting (CABG). Activated smooth muscle cells in the tunica media of saphenous vein (SV) grafts are thought to play a key role in the formation of neointima and development of occluding atherosclerotic plaques. The aim of this study was to identify ageing-related variations in the expression of the smooth muscle cells pro-teins that may impact on patency rate of the grafts and the CABG outcomes. MATERIAL AND METHODS The study involved 216 consecutive patients with the mean of 62.7 ± 8.4 years who underwent isolated CABG with at least one SV aortocoronary bypass graft. Expression of a-smooth muscle actin (a-SM actin), smooth muscle-myosin heavy chain (SM-MHC), calponin (CALP), cytokeratin 8 (CK-8), metalloproteinase-2 (MMP-2) and tissue inhibitors of metalloproteinases-2 and -3 (TIMP-2, TIMP-3) in the SV wall was assessed by immunohistochemistry and correlated with the age of patients. RESULTS Calponin and a-SM actin were expressed in all studied SV transplants. SM-MHC immunoreactivity was observed in SV segments in 68.5% of patients, whereas MMP-2a and TIMPs expression was found in 75% of cases. In more than 50% of analyzed SV transplants, no expression of cytokeratin-8 was found. Moderate correlations between preexisting expressions of either cytoskeletal or hemostatic proteins in the tunica media of the SV grafts and the age of CABG patients were demonstrated. They were positive for SM-MHC (r = 0.494), CALP (r = 0.548), TIMP-2 (r = 0.413) and TIMP-3 (r = 0.406) whereas negative for CK-8 (r = -0.528) and MMP-2 (r = -0.417). CONCLUSIONS Age-dependent decreases in the expression of MMP-2 and CK-8 accompanied by increases in expression of SM-MHC, TIMP-2 and TIMP-3 may promote SV graft patency and, thus, suggest a rationale for common use of SV grafts in the elderly.
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Affiliation(s)
- Bartlomiej Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poland.
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Sobiak J, Resztak M, Ostalska-Nowicka D, Zachwieja J, Gąsiorowska K, Piechanowska W, Chrzanowska M. Monitoring of mycophenolate mofetil metabolites in children with nephrotic syndrome and the proposed novel target values of pharmacokinetic parameters. Eur J Pharm Sci 2015; 77:189-96. [PMID: 26102431 DOI: 10.1016/j.ejps.2015.06.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 03/21/2015] [Revised: 05/22/2015] [Accepted: 06/19/2015] [Indexed: 11/30/2022]
Abstract
The aim of the study was to estimate target values of mycophenolate mofetil (MMF) pharmacokinetic parameters in children with proteinuric glomerulopathies by calculating the pharmacokinetic parameters of MMF metabolites (mycophenolic acid [MPA], free MPA [fMPA] and MPA glucuronide [MPAG]) and assessing their relation to proteinuria recurrence. One hundred and sixty-eight blood samples were collected from children, aged 3-18 years, diagnosed with nephrotic syndrome or lupus nephritis. MMF metabolites concentrations were examined before drug administration (Ctrough) and up to 12h afterward employing high-performance liquid chromatography. Dose-normalized MPA Ctrough and area under the concentration-time curve from 0 to 12h (AUC12) were within 0.29-6.47 μg/mL/600 mg/m(2) and 9.97-105.52 μg h/mL/600 mg/m(2), respectively. MPA Ctrough was twofold lower (p=0.024) in children with proteinuria recurrence. MPA, fMPA and MPAG concentrations correlated positively to respective AUC12. It may be suggested MMF metabolites monitoring in children with proteinuric glomerulopathies is justified by MPA Ctrough<2 μg/mL in patients at risk of the proteinuria recurrence. Such a recurrence is most probably caused by not sufficient MPA concentration during proteinuric glomerulopathies treatment. MPA Ctrough>3 μg/mL may be considered as an efficient one to avoid proteinuria recurrence. Finally, MPA target AUC12 should exceed 60 μg h/mL to ensure the safe and effective treatment in children with nephrotic syndrome, however, the upper limit is still to be established.
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Affiliation(s)
- Joanna Sobiak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781 Poznan, Poland.
| | - Matylda Resztak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781 Poznan, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572 Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572 Poznan, Poland
| | - Karolina Gąsiorowska
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781 Poznan, Poland
| | - Wiktoria Piechanowska
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781 Poznan, Poland
| | - Maria Chrzanowska
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781 Poznan, Poland
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Soltysiak J, Silska-Dittmar M, Ostalska-Nowicka D, Lewandowska-Stachowiak M, Zachwieja J. SP142IS CIRCULATING SUPAR A POTENTIAL BIOMARKER OF LUPUS NEPHRITIS IN CHILDREN WITH NEPHROTIC PROTEINURIA? Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv189.15] [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: 11/14/2022] Open
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Sikora P, Zaniew M, Haisch L, Pulcer B, Szczepa ska M, Moczulska A, Rogowska-Kalisz A, Bienia B, Tkaczyk M, Ostalska-Nowicka D, Zachwieja K, Hyla-Klekot L, Schlingmann KP, Konrad M. Retrospective cohort study of familial hypomagnesaemia with hypercalciuria and nephrocalcinosis due to CLDN16 mutations. Nephrol Dial Transplant 2014; 30:636-44. [DOI: 10.1093/ndt/gfu374] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chamney P, Moissl U, Wabel P, Amato C, Stuard S, Menzer M, Vollmeier C, Williams G, Shrivastava R, Chess J, Catling E, Brown C, Baker E, Ashcroft R, Mikhail A, Djukanovic L, Djuric Z, Knezevic V, Lazarevic T, Ljubenovic S, Markovic R, Rabrenovic V, Marinkovic J, Dimkovic N, Lebourg L, Ridel C, De Preneuf H, Le Roy F, Petitclerc T, Wester M, Simonis F, Kooman JP, Boer WH, Gerritsen KGF, Joles JA, Yamamoto KI, Eguchi K, Hirakawa S, Murakami J, Akiba T, Mineshima M, Stamopoulos D, Mpakirtzi N, Lavranos A, Panagiotou M, Barbarousi D, Matsouka C, Grapsa E, Abbas SR, Zhu F, Kaysen GA, Kotanko P, Levin NW, Vasilevsky A, Konoplev G, Stepanova O, Rubinsky A, Zemchenkov A, Gerasimchuk R, Frorip A, Abe T, Yamamoto KI, Ishimori I, Eguchi K, Murakami J, Mineshima M, Akiba T, Kusztal M, Go Biowski, T, Letachowicz K, Koni Ski P, Witkowski G, Pozna Ski P, Weyde W, Klinger M, Ito M, Ito S, Suzuki M, Masakane I, Navarro D, Goncalves C, Ferreira AC, Jorge C, Gil C, Aires I, Matias P, Mendes M, Azevedo A, Gomes F, Ferreira A, Perazzini C, Scutiero L, Brighenti L, Surace A, Steckiph D, Rovatti P, Severi S, Soltysiak J, Warzywoda A, Musielak A, Ostalska-Nowicka D, Zachwieja J, Goeksel T, Garnier H, Ritzerfeld M, Mann H, Babinet F, Allard B, Todorova V, Hamont C, Begri R, Dekker M, Taks M, Konings C, Scharnhorst V, Borawski J, Gozdzikiewicz-Lapinska J, Naumnik B, Lodi CA, Surace A, Grandi E, Rovatti P, Mancini E, Santoro A, Sereni L, Caiazzo M, Corazza L, Atti M, Palladino G, Sakurai K, Saito T, Hosoya H, Yamauchi F, Kurihara T, Tanibayashi Y, Ikebe N, Antonic M, Gubensek J, Drozg A, Vannier E, Mattio E, Todorova V, Ragon A, Brunet P, Klimm W, Pleskacz K, Pietrzak B, Niemczyk S, Leypoldt JK, Bernardo A, Muller M, Marbury TC, Culleton BF, Zeraati AA, Hekmat R, Reyhani HR, Sharifipoor F, Bolasco P, Sitzia I, Monni A, Mereu MC, Pinna AM, Logias F, Ghisu T, Passaghe M, Gazzanelli L, Ganadu M, Piras A, Cossu M, Contu B, Palleschi S, Rossi B, Atti M, Caiazzo M, Sereni L, Palladino G, Ghezzi PM, Kron S, Schneditz D, Leimbach T, Aign S, Kron J, Seker Kockara A, Kayatas M, Huzmeli C, Candan F, Yilmaz MB, Ahmed BA, Bejosano CN, Samra Abouchacra SA, Al Falahi SZ, Abdul Moniem KM, Dastoor H, Kim S, Oh J, Sin Y, Kim J, Lee J. HAEMODIALYSIS TECHNIQUES AND ADEQUACY 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mekahli D, Van Straelen K, Jager K, Schaefer F, Groothoff J, Assadi MH, Landau D, Chen Y, Rabkin R, Medrano J, Segev Y, Donadio ME, Loiacono E, Peruzzi L, Amore A, Camilla R, Chiale F, Vergano L, Boido A, Conrieri M, Bianciotto M, Bosetti FM, Lastauka I, Coppo R, Laszki-SzczaChor K, Dorota PJ, Zwolinska D, Filipowski H, Rusiecki L, Sobieszczanska M, Dagan R, Davidovits M, Cleper R, Krause I, Chesnaye NC, Jager KJ, Schaefer F, Groothoff JW, Heaf JG, Topaloglu R, Merenmies J, Lewis M, Shtiza D, Maurer E, Zaicova N, Kushnirenko S, Zampetoglou A, Van Stralen KJ, Milo evski-Lomi G, Lezaic V, Radivojevic D, Kostic M, Paripovic D, Peco-Antic A, Benedyk A, Sobiak J, Resztak M, Ostalska-Nowicka D, Zachwieja J, Jarosz K, Chrzanowska M, Soltysiak J, Skowronska B, Stankiewicz W, Fichna P, Lewandowska-Stachowiak M, Silska-Dittmar M, Ostalska-Nowicka D, Zachwieja J, Lemoine S, De Souza V, Ranchin B, Cartier R, Pottel H, Dolomanova O, Hadj-Aissa A, Cochat P, Dubourg L, Hoelttae T, Van Stralen KJ, Groothoff JW, Schaefer F, Bjerre A, Jager KJ, Jobs K, Jung A, Lichosik M, Placzynska M, Tjaden LA, Noordzij M, Van Stralen KJ, Schaefer F, Groothoff JW, Jager KJ, Lazzeri E, Ronconi E, Angelotti ML, Peired AJ, Mazzinghi B, Becherucci F, Sansavini G, Sisti A, Provenzano A, Giglio S, Lasagni L, Romagnani P, Pozziani G, Sinatora F, Benetti E, Ghirardo G, Longo G, Cattelan C, Murer L, Malina M, Dusatkova P, Dusek J, Slamova Z, Cinek O, Pruhova S, Bergmann C, Seeman T, Schaefer F, Arbeiter K, Hoppe B, Jungraithmayr T, Klaus G, Pape L, Dinavahi R, Farouk M, Manamley N, Vondrak K, Vidal E, Ranieri M, Ghirardo G, Scavia G, Benetti E, Longo G, Parolin M, Murer L, Aksu N, Yavascan O, Alparslan C, Elmas CH, Saritas S, Anil AB, Kamit Can F, Anil M, Bal A, Kasap Demir B, Mutlubas Ozsan F, Van Huis M, Bonthuis M, Van Stralen KJ, Schaefer F, Jager KJ, Groothoff JW, Makieieva NI, Gramatiuk SM, Tsymbal VM, Buzhynskaya NR, Oborn H, Forinder U, Herthelius M, Westland R, Schreuder MF, Van Der Lof DF, Vermeulen A, Dekker IMJ, Bokenkamp A, Van Wijk JAE, Gramatiuk S, Makieieva NI, Tsymbal VM, Ghirardo G, Seveso M, Della Vella M, Cozzi E, Murer L, Garzotto F, Vidal E, Zanella M, Murer L, Ronco C, Prikhodina L, Chumak O, Dobrynina M, Nusken E, Von Gersdorff G, Schaller M, Rascher K, Barth C, Bach D, Weber L, Dotsch J, Roszkowska-Blaim M, Skrzypczyk P, Jander A, Tkaczyk M, Balasz-Chmielewska I, Zurowska A, Drozdz D, Pietrzyk JA, Aksenova M, Zhetlina V, Mitrofanova A, Choi Y, Cho BS, Suh JS, Abd El-Fattah MA, El-Ghoneimy DH, Elhakim IZ, El-Owaidy RH, Afifi HM, Abo-Elnaga GM, Zvenigorodska A, Tasic V, Gucev Z, Polenakovic M, Silska-Dittmar M, Zaorska K, So tysiak J, Ostalska-Nowicka D, Zachwieja J, Nowicki M, Jobs K, Jung A, Emirova K, Tolstova E, Zaytseva O, Muzurov A, Makulova A, Zverev D, Kamit Can F, Mutlbas Ozsan F, Alparslan C, Elmas CH, Saritas S, Manyas H, Kasap Demir B, Yavascan O, Aksu N, Hoste L, Braat E, De Waele L, Goemans N, Vermeersch P, Gheysens O, Levtchenko E, Pottel H, Golovachova VA, Odinets YV, Zharkova TS, Trynduk YS, Odinets YV, Kharchenko TV, Musial K, Zwolinska D, Roomizadeh P, Gheissari A, Abedini A, Mehdikhani B, Gheissari A, Rezaii Z, Merrikhi A, Madihi Y, Kelishadi R, Dryl IS, Senatorova GS, Kolybaeva TF, Muratov GR, Yavascan O, Aksu N, Alparslan C, Eliacik K, Kanik A, Saritas S, Elmas CH, Mutlubas Ozsan F, Kasap Demir B, Anil M, Bal A, Postorino V, Guzzo G, Ghiotto S, Mazzone L, Loi V, Maxia S, Roggero S, Attini R, Piga A, Postorino M, Pani A, Cabiddu G, Piccoli GB, Peco-Antic A, Kostic M, Spasojevic-Dimitrijeva B, Milosevski-Lomic G, Cvetkovic M, Kruscic D, Paripovic D. PAEDIATRIC NEPHROLOGY. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu181] [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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Świerczewska M, Ostalska-Nowicka D, Kempisty B, Szczepankiewicz A, Nowicki M. Polymorphic variants of MIF gene and prognosis in steroid therapy in children with idiopathic nephrotic syndrome. Acta Biochim Pol 2014; 61:67-75. [PMID: 24644543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 11/25/2013] [Accepted: 01/22/2014] [Indexed: 06/03/2023]
Abstract
UNLABELLED Nephrotic syndrome (NS) is the most common reason of proteinuria in children and can be caused by the pathology of renal glomeruli. Steroid therapy is typically used in this disorder. It has been shown that MIF is a cytokine which counteracts the immunosuppressive properties of glucocorticoids. The aim of this study was looking for a correlation between MIF polymorphisms and genetic susceptibility to steroid resistance in children with INS (Idiopathic NS). METHODS The study was performed in 71 patients with INS including SRNS (steroid resistance nephrotic syndrome) (41) and SSNS (steroid sensitive nephrotic syndrome) (30) and in 30 control subjects. We employed Sanger sequencing and capillary electrophoresis. Linkage disequilibrium was made using Haploview and PHASE. RESULTS We didn't observe a statistical significance between SNPs detected in patients with INS and controls. Our studies revealed statistical significance for two polymorphisms: rs2070767C > T and rs2000466T > G between patients with SRNS and SSNS. The results for rs34383331T > A are close to being statistically significant. Statistical significance was revealed for CATT5/CATT6 genotype in SRNS group vs SSNS group (OR=4.604, 95%CI=1.356-15.632, p=0.0168). We found that the frequency of 5/X-CATT genotype compared with X/X-CATT genotype was significantly higher in SRNS patients vs SSNS (OR=3.167, 95%CI=1.046-9.585, p=0.0426). In linkage disequilibrium analysis we didn't show involvement in susceptibility to INS and steroid sensitive phenotype. CONCLUSIONS Our results suggest that the role of MIF polymorphisms in the susceptibility to positive response to steroid therapy is still unresolved. It indicates that MIF may be involved in indirect and complex molecular mechanisms of steroid activity in hormone-dependent metabolic pathways in children with INS. Because of ambiguous findings, pleiotropic features of this cytokine require that more research should be undertaken.
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Affiliation(s)
- Monika Świerczewska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poland
| | - Bartosz Kempisty
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poland and Department of Anatomy, Poznan University of Medical Sciences, Poland
| | - Aleksandra Szczepankiewicz
- Laboratory of Molecular and Cell Biology, Department of Pulmonology, Pediatric Allergy and Clinical Immunology, Poznan University of Medical Sciences, Poland
| | - Michał Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poland
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Świerczewska M, Ostalska-Nowicka D, Kempisty B, Szczepankiewicz A, Nowicki M. Polymorphic variants of MIF gene and prognosis in steroid therapy in children with idiopathic nephrotic syndrome. Acta Biochim Pol 2014. [DOI: 10.18388/abp.2014_1925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Nephrotic syndrome (NS) is the most common reason of proteinuria in children and can be caused by the pathology of renal glomeruli. Steroid therapy is typically used in this disorder. It has been shown that MIF is a cytokine which counteracts the immunosuppressive properties of glucocorticoids. The aim of this study was looking for a correlation between MIF polymorphisms and genetic susceptibility to steroid resistance in children with INS (Idiopathic NS).
The study was performed in 71 patients with INS including SRNS (steroid resistance nephrotic syndrome) (41) and SSNS (steroid sensitive nephrotic syndrome) (30) and in 30 control subjects. We employed Sanger sequencing and capillary electrophoresis. Linkage disequilibrium was made using Haploview and PHASE.
We didn't observe a statistical significance between SNPs detected in patients with INS and controls. Our studies revealed statistical significance for two polymorphisms: rs2070767C > T and rs2000466T > G between patients with SRNS and SSNS. The results for rs34383331T > A are close to being statistically significant. Statistical significance was revealed for CATT5/CATT6 genotype in SRNS group vs SSNS group (OR=4.604, 95%CI=1.356-15.632, p=0.0168). We found that the frequency of 5/X-CATT genotype compared with X/X-CATT genotype was significantly higher in SRNS patients vs SSNS (OR=3.167, 95%CI=1.046-9.585, p=0.0426). In linkage disequilibrium analysis we didn't show involvement in susceptibility to INS and steroid sensitive phenotype.
Our results suggest that the role of MIF polymorphisms in the susceptibility to positive response to steroid therapy is still unresolved. It indicates that MIF may be involved in indirect and complex molecular mechanisms of steroid activity in hormone-dependent metabolic pathways in children with INS. Because of ambiguous findings, pleiotropic features of this cytokine require that more research should be undertaken.
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Soltysiak J, Warzywoda A, Kociński B, Ostalska-Nowicka D, Benedyk A, Silska-Dittmar M, Zachwieja J. Citrate anticoagulation for continuous renal replacement therapy in small children. Pediatr Nephrol 2014; 29:469-75. [PMID: 24337319 PMCID: PMC3913856 DOI: 10.1007/s00467-013-2690-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 10/07/2013] [Accepted: 10/29/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Regional citrate anticoagulation (RCA) is one of the methods used to prevent clotting in continuous renal replacement therapy (CRRT). The aim of this study was to describe the outcomes and complications of RCA-CRRT in comparison to heparin anticoagulation (HA)-CRRT in critically ill children. METHODS This study was a retrospective review of 30 critically ill children (16 on RCA- and 14 on HA-CRRT) who underwent at least 24 h of CRRT. The mean body weight of the children was 8.69 ± 5.63 kg. RCA-CRRT was performed with a commercially available pre-dilution citrate solution (Prismocitrate 18/0). RESULTS The mean time on RCA-CRRT and HA-CRRT was 148.73 ± 131.58 and 110.24 ± 105.38 h, respectively. Circuit lifetime was significantly higher in RCA-CRRT than in HA-CRRT (58.04 ± 51.18 h vs. 37.64 ± 32.51 h, respectively; p = 0.030). Circuit clotting was observed in 11.63 % of children receiving RCA-CRRT and 34.15 % of those receiving HA-CRRT. Episodic electrolyte and metabolic disturbances were more common in children receiving RCA-CRRT. The survival at discharge from the hospital was 37.5 and 14.3 % among children receiving RCA-CRRT and HA-CRRT, respectively. CONCLUSIONS In critically ill children with a low body weight, RCA appeared to be safe and easy to used. Among our patient cohort, RCA was more effective in preventing circuit clotting and provided a better circuit lifetime than HA.
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Affiliation(s)
- Jolanta Soltysiak
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland,
| | - Alfred Warzywoda
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartłomiej Kociński
- Department of Pediatric Cardiac Surgery, Chair of Cardio-Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Benedyk
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Silska-Dittmar
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland
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Soltysiak J, Skowronska B, Fichna P, Ostalska-Nowicka D, Stankiewicz W, Lewandowska-Stachowiak M, Lipkowska K, Zachwieja J. Urinary angiotensinogen and urinary sodium are associated with blood pressure in normoalbuminuric children with diabetes. Pediatr Nephrol 2014; 29:2373-8. [PMID: 24880819 PMCID: PMC4212134 DOI: 10.1007/s00467-014-2861-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 05/02/2014] [Accepted: 05/14/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the association between blood pressure (BP) and urinary angiotensinogen excretion (uAGT) and renal sodium excretion (uNa) in children with type 1 diabetes mellitus (DM1). METHODS The study group consisted of 52 children with DM1 (28 males and 24 females) with albumin/creatinine ratio (ACR) below 30 mg/g and glomerular filtration rate (eGFR) above 90 ml/min/1.73 m(2). BP was assessed by 24-h ambulatory blood pressure monitoring (ABPM). RESULTS The patients showed significantly increased uAGT values with respect to controls (median 0.00 and range 1.76 vs. 0.00 and 0.00 ng/mg, respectively). The significant increase of uAGT was observed even in prehypertensive patients. uAGT concentrations showed positive correlation with systolic and diastolic 24-h BP and with mean arterial pressure (MAP) (r = 0.594). uNa values were negatively correlated with BP parameters, uAGT, ACR and eGFR. CONCLUSIONS An increase in uAGT precedes hypertension (HTN) in normoalbuminuric children with DM1 and may be considered as a new marker of HTN. Decreased sodium excretion seems to be involved in the development of HTN and early renal injury. Both uAGT and uNa are associated with BP in normoalbuminuric diabetic children.
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Affiliation(s)
- Jolanta Soltysiak
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572, Poznan, Poland,
| | - Bogda Skowronska
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Fichna
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Danuta Ostalska-Nowicka
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland
| | - Witold Stankiewicz
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Lewandowska-Stachowiak
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland
| | - Katarzyna Lipkowska
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland
| | - Jacek Zachwieja
- Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, 27/33 Szpitalna St., 60-572 Poznan, Poland
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Perek B, Malinska A, Stefaniak S, Ostalska-Nowicka D, Misterski M, Zabel M, Suri A, Nowicki M. Predictive factors of late venous aortocoronary graft failure: ultrastructural studies. PLoS One 2013; 8:e70628. [PMID: 23940610 PMCID: PMC3734237 DOI: 10.1371/journal.pone.0070628] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [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: 03/16/2013] [Accepted: 06/20/2013] [Indexed: 11/18/2022] Open
Abstract
Background Venous aortocoronary graft arterialization may precede a preterm occlusion in some coronary artery bypass grafting (CABG) patients. The aim of the present study was to identify ultrastructural variations in the saphenous vein wall that may have an impact on the development of venous graft disease in CABG patients. Methods The study involved 365 consecutive patients with a mean age of 62.9±9.4 years who underwent isolated CABG. The thickness and area of the whole venous wall, the tunica intima, the tunica media and the adventitia and the number and shape (length, thickness and length/thickness ratio) of the nuclei in the medial smooth muscle cells nuclei in the distal saphenous vein segments were evaluated by ultrastructural studies. Patients were followed up for 41 to 50 months (mean 45.1±5.1). Saphenous vein graft patency was assessed by follow-up coronary angiography. Logistic regression models were used to identify independent risk factors for late graft failure. Results In 71 patients significant lesions in the saphenous vein grafts were observed. The whole venous wall thickness (437.5 µm vs. 405.5 µm), tunica media thickness (257.2 µm vs. 211.5 µm), whole venous wall area (2.23 mm2 vs. 2.02 mm2) and tunica media area (1.09 mm2 vs. 0.93 mm2) were significantly larger for this group of patients than for those without graft disease. In the latter group more elongated smooth muscle cell nuclei (higher length/thickness ratio) were found in the tunica media of the saphenous vein segments. Thickening of the saphenous vein tunica media and chunky smooth muscle cell nuclei were identified as independent risk factors for graft disease development. Conclusions Saphenous vein tunica media hypertrophy (resulting in wall thickening) and chunky smooth muscle cell nuclei might predict the development of venous graft disease.
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Affiliation(s)
- Bartlomiej Perek
- Department of Cardiac Surgery and Transplantology, University of Medical Science, Poznan, Poland.
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Swierczewska M, Ostalska-Nowicka D, Kempisty B, Nowicki M, Zabel M. Molecular basis of mechanisms of steroid resistance in children with nephrotic syndrome. Acta Biochim Pol 2013; 60:339-344. [PMID: 24020059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 04/15/2013] [Accepted: 07/22/2013] [Indexed: 06/02/2023]
Abstract
Steroid therapy, due to a wide range of anti-inflammatory properties of steroids, is a basic field of treatment in many human diseases including the nephrotic syndrome in children. However, not all patients respond positively to therapy which divides them into steroid sensitive (SS) and steroid resistance (SR) individuals. Many potential factors associated with steroid resistance have been identified so far. It seems that genetic factors associated with glucocorticoid receptor α (GRα), the structure of heterocomplex of GR as well as glycoprotein P or cytochrome P450 may play a role in the induction of glucocorticoid resistance. Here we described several of the molecular mechanisms, which can regulate glucocorticoid sensitivity and resistance. Moreover, we presented genetic defects, which can lead to various effects of treatment and, in a longer perspective, enable clinicians to individualize therapies.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism
- Anti-Inflammatory Agents/therapeutic use
- Child
- Cytochrome P-450 Enzyme System/genetics
- Cytochrome P-450 Enzyme System/metabolism
- Drug Tolerance/genetics
- Genetic Predisposition to Disease
- Glucocorticoids/therapeutic use
- Humans
- Kidney/metabolism
- Kidney/pathology
- Metabolism, Inborn Errors/genetics
- Metabolism, Inborn Errors/metabolism
- Metabolism, Inborn Errors/pathology
- Mutation
- Nephrotic Syndrome/drug therapy
- Nephrotic Syndrome/genetics
- Nephrotic Syndrome/metabolism
- Nephrotic Syndrome/pathology
- Polymorphism, Genetic
- Protein Isoforms/genetics
- Protein Isoforms/metabolism
- Receptors, Glucocorticoid/deficiency
- Receptors, Glucocorticoid/genetics
- Receptors, Glucocorticoid/metabolism
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Affiliation(s)
- Monika Swierczewska
- Department of Histology and Embryology, Poznań University of Medical Sciences, Poznań, Poland
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Swierczewska M, Ostalska-Nowicka D, Kempisty B, Nowicki M, Zabel M. Molecular basis of mechanisms of steroid resistance in children with nephrotic syndrome. Acta Biochim Pol 2013. [DOI: 10.18388/abp.2013_1990] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Steroid therapy, due to a wide range of anti-inflammatory properties of steroids, is a basic field of treatment in many human diseases including the nephrotic syndrome in children. However, not all patients respond positively to therapy which divides them into steroid sensitive (SS) and steroid resistance (SR) individuals. Many potential factors associated with steroid resistance have been identified so far. It seems that genetic factors associated with glucocorticoid receptor α (GRα), the structure of heterocomplex of GR as well as glycoprotein P or cytochrome P450 may play a role in the induction of glucocorticoid resistance. Here we described several of the molecular mechanisms, which can regulate glucocorticoid sensitivity and resistance. Moreover, we presented genetic defects, which can lead to various effects of treatment and, in a longer perspective, enable clinicians to individualize therapies.
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Kohlova M, Ribeiro S, do Sameiro-Faria M, Rocha-Pereira P, Fernandes J, Reis F, Miranda V, Quintanilha A, Bronze-da-Rocha E, Belo L, Costa E, Santos-Silva A, Arias-Guillen M, Maduell F, Masso E, Fontsere N, Carrera M, Ojeda R, Vera M, Cases A, Campistol J, Di Benedetto A, Ciotola A, Stuard S, Marcelli D, Canaud B, Kim MJ, Lee SW, Kweon SH, Song JH, Rosales LM, Abbas S, Zhu F, Flores C, Carter M, Apruzzese R, Kotanko P, Levin NW, Mann H, Seyffart G, Ensminger A, Goksel T, Stiller S, Zaluska W, Kotlinska-Hasiec E, Rzecki Z, Rybojad B, Zaluska A, Da'browski W, Ponce P, Chung T, Kreuzberg U, Pedrini L, Francois K, Wissing KM, Jacobs R, Boone D, Jacobs K, Tielemans C, Agar BU, Culleton BF, Fluck R, Leypoldt JK, Lentini P, Zanoli L, Granata A, Contestabile A, Basso A, Berlingo G, Pellanda V, de Cal M, Clementi A, Insalaco M, Dell'Aquila R, Panichi V, Rosati A, Casani A, Conti P, Capitanini A, Migliori M, Scatena A, Giusti R, Malagnino E, Betti G, Bernabini G, Gabbrielli C, Rollo S, Caiani D, Pizzarelli F, Cantaluppi V, Medica D, Quercia AD, Gai M, Leonardi G, Anania P, Guarena C, Giovinazzo G, Ferraresi M, Merlo I, Deambrosis I, Giaretta F, Biancone L, Segoloni GP, Surace A, Pieri M, Rovatti P, Steckiph D, Mambelli E, Mancini E, Santoro A, Devine E, Krieter D, Lemke HD, Frasca GM, Sagripanti S, Boggi R, Del Rosso G, Gattiani A, Mosconi G, Oliva S, Rigotti A, Sopranzi F, Tetta C, Cavallari C, Fonsato V, Maffei S, Collino F, Camussi G, Ksiazek A, Waniewski J, Debowska M, Wojcik-Zaluska A, Zaluska W, Maduell F, Wieneke P, Arias-Guillen M, Fontsere N, Vera M, Ojeda R, Carrera M, Cases A, Campistol J, Bunia J, Ziebig R, Wolf H, Ahrenholz P, Donadio C, Kanaki A, Sami N, Tognotti D, Goubella A, Gankam-Kengne F, Baudoux T, Fagnoul D, Husson C, Ghisdal L, Broeders NE, Nortier JL, von Albertini B, Mathieu C, Cherpillod A, Boesch A, Romo M, Zhou J, Tang L, Kong D, Zhang L, Shi S, Lv Y, Chen X, Sakurai K, Saito T, Ishii D, Fievet P, Delpierre A, Faucher J, Ghazali A, Soltani ON, Lefevre M, Stephan R, Demontis R, Hougardy JM, Husson C, Gastaldello K, Nortier JL, Mishkin GJ, McLean A, Palant C, Fievet P, Faucher J, Delpierre A, Ghazali A, Demontis R, Glorieux G, Hulko M, Speidel R, Brodbeck K, Krause B, Vanholder R, Rovatti P, Grandi E, Stefani D, Ruffo M, Solem K, Olde B, Santoro A, Sterner G, Lee YK, Lee HW, Choi KH, Kim BS, Sakurai K, Saito T, Wakabayasi Y, Djuric P, Bulatovic A, Jankovic A, Tosic J, Popovic J, Djuric Z, Bajcetic S, Dimkovic N, Golubev RV, Soltysiak J, Malke A, Warzywoda A, Blumczynski A, Silska-Dittmar M, Musielak A, Ostalska-Nowicka D, Zachwieja J, Ashcroft R, Williams G, Brown C, Chess J, Mikhail A, Steckiph D, Bertucci A, Petrarulo M, Baldini C, Calabrese G, Gonella M. Extracorporeal dialysis: techniques and adequacy II. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft144] [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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Legendre C, Cohen D, Delmas Y, Feldkamp T, Fouque D, Furman R, Gaber O, Greenbaum L, Goodship T, Haller H, Herthelius M, Hourmant M, Licht C, Moulin B, Sheerin N, Trivelli A, Bedrosian CL, Loirat C, Legendre C, Babu S, Cohen D, Delmas Y, Furman R, Gaber O, Greenbaum L, Hourmant M, Jungraithmayr T, Lebranchu Y, Riedl M, Sheerin N, Bedrosian CL, Loirat C, Sheerin N, Legendre C, Greenbaum L, Furman R, Cohen D, Gaber AO, Bedrosian C, Loirat C, Haller H, Licht C, Muus P, Legendre C, Douglas K, Hourmant M, Herthelius M, Trivelli A, Goodship T, Remuzzi G, Bedrosian C, Loirat C, Kourouklaris A, Ioannou K, Athanasiou I, Demetriou K, Panagidou A, Zavros M, Rodriguez C NY, Blasco M, Arcal C, Quintana LF, Rodriguez de Cordoba S, Campistol JM, Bachmann N, Eisenberger T, Decker C, Bolz HJ, Bergmann C, Pesce F, Cox SN, Serino G, De Palma G, Sallustio FP, Schena F, Falchi M, Pieri M, Stefanou C, Zaravinos A, Erguler K, Lapathitis G, Dweep H, Sticht C, Anastasiadou N, Zouvani I, Voskarides K, Gretz N, Deltas CC, Ruiz A, Bonny O, Sallustio F, Serino G, Curci C, Cox S, De Palma G, Schena F, Kemter E, Sklenak S, Aigner B, Wanke R, Kitzler TM, Moskowitz JL, Piret SE, Lhotta K, Tashman A, Velez E, Thakker RV, Kotanko P, Leierer J, Rudnicki M, Perco P, Koppelstaetter C, Mayer G, Sa MJN, Alves S, Storey H, Flinter F, Willems PJ, Carvalho F, Oliveira J, Arsali M, Papazachariou L, Demosthenous P, Lazarou A, Hadjigavriel M, Stavrou C, Yioukkas L, Voskarides K, Deltas C, Zavros M, Pierides A, Arsali M, Demosthenous P, Papazachariou L, Voskarides K, Kkolou M, Hadjigavriel M, Zavros M, Deltas C, Pierides A, Toka HR, Dibartolo S, Lanske B, Brown EM, Pollak MR, Familiari A, Zavan B, Sanna Cherchi S, Fabris A, Cristofaro R, Gambaro G, D'Angelo A, Anglani F, Toka H, Mount D, Pollak M, Curhan G, Sengoge G, Bajari T, Kupczok A, von Haeseler A, Schuster M, Pfaller W, Jennings P, Weltermann A, Blake S, Sunder-Plassmann G, Kerti A, Csohany R, Wagner L, Javorszky E, Maka E, Tulassay T, Tory K, Kingswood J, Nikolskaya N, Mbundi J, Kingswood J, Jozwiak S, Belousova E, Frost M, Kuperman R, Bebin M, Korf B, Flamini R, Kohrman M, Sparagana S, Wu J, Brechenmacher T, Stein K, Bissler J, Franz D, Kingswood J, Zonnenberg B, Frost M, Cheung W, Wang J, Brechenmacher T, Lam D, Bissler J, Budde K, Ivanitskiy L, Sowershaewa E, Krasnova T, Samokhodskaya L, Safarikova M, Jana R, Jitka S, Obeidova L, Kohoutova M, Tesar V, Evrengul H, Ertan P, Serdaroglu E, Yuksel S, Mir S, Yang n Ergon E, Berdeli A, Zawada A, Rogacev K, Rotter B, Winter P, Fliser D, Heine G, Bataille S, Moal V, Berland Y, Daniel L, Rosado C, Bueno E, Fraile P, Lucas C, Garcoa-Cosmes P, Tabernero JM, Gonzalez R, Rosado C, Bueno E, Fraile P, Lucas C, Garcia-Cosmes P, Tabernero JM, Gonzalez R, Silska-Dittmar M, Zaorska K, Malke A, Musielak A, Ostalska-Nowicka D, Zachwieja J, K d r V, Uz E, Yigit A, Altuntas A, Yigit B, Inal S, Uz E, Sezer M, Yilmaz R, Visciano B, Porto C, Acampora E, Russo R, Riccio E, Capuano I, Parenti G, Pisani A, Feriozzi S, Perrin A, West M, Nicholls K, Sunder-Plassmann G, Torras J, Cybulla M, Conti M, Angioi A, Floris M, Melis P, Asunis AM, Piras D, Pani A, Warnock D, Guasch A, Thomas C, Wanner C, Campbell R, Vujkovac B, Okur I, Biberoglu G, Ezgu F, Tumer L, Hasanoglu A, Bicik Z, Akin Y, Mumcuoglu M, Ecder T, Paliouras C, Mattas G, Papagiannis N, Ntetskas G, Lamprianou F, Karvouniaris N, Alivanis P. Genetic diseases and molecular genetics. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft126] [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: 11/12/2022] Open
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Okamoto S, Sakama T, Nakamura S, Niimura F, Sahin S, Ertan P, Evrengul H, Horasan G, Dede B, Berdeli A, Yildiz N, Cicek Deniz N, Asadov R, Yucelten D, Alpay H, Prado G, Schoeneman M, Mongia A, Paudyal B, Feygina V, Norin A, Hochman D, Tawadrous H, Bansilal V, Topaloglu R, Gulhan B, Bilginer Y, Celebi Tayfur A, Yildiz C, Ozaltin F, Duzova A, Ozen S, Aki T, Besbas N, Komaki F, Hamasaki Y, Ishikura K, Hamada R, Sakai T, Hataya H, Ogata K, Fukuzawa R, Ando T, Honda M, Malke A, Silska-Dittmar M, Soltysiak J, Blumczynski A, Ostalska-Nowicka D, Zachwieja J, Tabel Y, Oncul M, Elmas A, Kavaz A, Ozcakar ZB, Bulum B, Ekim M, Yalcinkaya F, Prikhodina L, Turpitko O, Dlin V, Gheith O, Alotaibi T, Nampoory N, Mosaad A, Halim M, Saied T, Abou Ateya H, Adel H, Mozarei I, Neir P, Hamasaki Y, Uemura O, Ishikura K, Ito S, Wada N, Hattori M, Ohashi Y, Tanaka R, Nakanishi K, Kaneko T, Honda M, Golovachova V, Odinets Y, Laszki-Szczachor K, Polak-Jonkisz D, Sobieszczanska M, Rusiecki L, Zwolinska D, Ninchoji T, Kaitoh H, Matsunoshita N, Nozu K, Nakanishi K, Yoshikawa N, Iijima K, Maglalang-Reed OM, Elises JS, Zamora MNV, Pasco P, Arejola-Tan A, Alparslan C, Dogan SM, Kose E, Elmas C, Kilinc S, Arslan N, Kebabci E, Karaca C, Yavascan O, Aksu N, Minson S, Munoz M, Vergara I, Mraz M, Vaughan R, Rees L, Olsburgh J, Calder F, Shroff R, Zaicova N, Kavaz A, Ozcakar ZB, Bulum B, Ekim M, Yalcinkaya F, Lavrenchuk O, Viktoria D, Savchenko V, Bagdasarova I, Doyon A, Bayazit A, Canpolat N, Duzova A, Kracht D, Litwin M, Ranchin B, Shroff R, Sozeri B, Wuhl E, Zeller R, Melk A, Querfeld U, Schaefer F, Sinha MD, Turner C, Booth CJ, Goldsmith DJA, Simpson JM. Paediatric nephrology - A. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft124] [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: 11/12/2022] Open
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Perek B, Malińska A, Ostalska-Nowicka D, Puślecki M, Ligowski M, Misterski M, Zabel M, Jemielity M, Nowicki M. Cytokeratin 8 in venous grafts: a factor of unfavorable long-term prognosis in coronary artery bypass grafting patients. Cardiol J 2013; 20:583-91. [PMID: 24338534 DOI: 10.5603/cj.2013.0142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 12/11/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Smooth muscle cells, present in the saphenous vein (SV) tunica media, may contribute to late occlusion of venous aortocoronary grafts. The aim of present study was to evaluate expression of selected cytoskeletal proteins in tunica media of SV grafts obtained from patients undergoing coronary artery bypass grafting (CABG) and correlate procured results to late venous graft failure observed in these patients. METHODS The study involved 218 patients (mean age of 62.5 ± 8.7 years) who underwent primary isolated CABG with the use of at least one venous aortocoronary bypass graft. Expressions of alpha-smooth muscle actin, smooth muscle-myosin heavy chain, calponin and cytokeratin 8 in SV wall were estimated by means of immunohistochemistry. The primary clinical endpoint was defined as the presence of any coronary artery disease (CAD) progression symptom while angiographic one as significant stenosis in the venous graft. RESULTS Thirty-eight (18.1%) patients have reached the primary clinical endpoint. Freedom from clinical CAD deterioration was 0.95 ± 0.02, 0.87 ± 0.03 and 0.83 ± 0.04, for 12-, 24-,36-month follow-up, respectively. Forty-four study participants have reached the angiographic endpoint. Multivariate logistic regression analysis revealed an increased expression of cytokeratin 8 accompanied by calponin under expression in SV tunica media were independent risk factors for venous graft failure. CONCLUSIONS An increased expression of cytokeratin 8 and weak of calponin in tunica media of SV grafts might be useful markers of unfavorable long-term prognosis in CABG patients. In the future, assessment of their expression may enable to select the most appropriate candidates for SV grafts.
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Affiliation(s)
- Bartłomiej Perek
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.
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Perek B, Malińska A, Nowicki M, Misterski M, Ostalska-Nowicka D, Jemielity M. Histological evaluation of age-related variations in saphenous vein grafts used for coronary artery bypass grafting. Arch Med Sci 2012; 8:1041-7. [PMID: 23319979 PMCID: PMC3542494 DOI: 10.5114/aoms.2012.32412] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Revised: 02/02/2011] [Accepted: 02/12/2011] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Venous coronary artery bypass grafts (CABG) might undergo a process of arterialization resulting in neointimal formation and medial hypertrophy. It is often followed by critical occlusion of the graft lumen. The aim of the study was to assess histological representative features of saphenous vein reconstruction in aging as well as to establish optimal patients' age limits applicable for optimal selection of grafts. MATERIAL AND METHODS One hundred and ten patients undergoing venous CABG were divided into 4 age subgroups: (A) 50 years and less, (B) 51-60 years, (C) 61-70 years and (D) > 70 year-old subjects. Distal venous graft segments were saved for an adequate morphometric assay which was followed by suitable statistical analysis. RESULTS The entire venous wall thickness as well as its tunica media were found to become significantly thinner between subgroups A and D. The number of smooth muscle cell (SMC) nuclei within the tunica media did not differ between study subgroups. The majority of these nuclei in subgroup D were found, however, to be more elongated than in subgroup A (SMC length/width index in subgroup D was found to be significantly higher than in subgroup A). CONCLUSIONS Progressive, age-related thinning of the venous wall and tunica media as well as SMC nucleus elongation might suggest impairment of SMCs' migration and proliferation rate. Consequently, individuals aged 70 years and over may benefit clinically more from venous CABG than younger patients due to the lower risk of arterialization and occlusion of the graft lumen in the future.
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Affiliation(s)
- Bartłomiej Perek
- Department of Cardiac Surgery, Poznan University of Medical Sciences, Poland
| | - Agnieszka Malińska
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poland
| | - Michał Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, Poland
| | - Marcin Misterski
- Department of Cardiac Surgery, Poznan University of Medical Sciences, Poland
| | - Danuta Ostalska-Nowicka
- Department of Paediatric Cardiology and Embryology, Poznan University of Medical Sciences, Poland
| | - Marek Jemielity
- Department of Cardiac Surgery, Poznan University of Medical Sciences, Poland
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Inazu T, Kawahara T, Endou H, Anzai N, Sebesta I, Stiburkova B, Ichida K, Hosoyamada M, Testa A, Testa A, Leonardis D, Catalano F, Pisano A, Mafrica A, Spoto B, Sanguedolce MC, Parlongo RM, Tripepi G, Postorino M, Enia G, Zoccali C, Mallamaci F, Working Group* M, Luque de Pablos A, Garcia-Nieto V, Lopez-Menchero JC, Ramos-Trujillo E, Gonzalez-Acosta H, Claverie-Martin F, Arsali M, Demosthenous P, Papazachariou L, Athanasiou Y, Voskarides K, Deltas C, Pierides A, Lee S, Jeong KH, Ihm C, Lee TW, Lee SH, Moon JY, Wi JG, Lee HJ, Kim EY, Rogacev K, Friedrich A, Hummel B, Berg J, Zawada A, Fliser D, Geisel J, Heine GH, Brabcova I, Brabcova I, Dusilova-Sulkova S, Dusilova-Sulkova S, Krejcik Z, Stranecky V, Lipar K, Marada T, Stepankova J, Viklicky O, Buraczynska M, Zukowski P, Zaluska W, Kuczmaszewska A, Ksiazek A, Gaggl M, Weidner S, Hofer M, Kleinert J, Fauler G, Wallner M, Kotanko P, Sunder-Plassmann G, Paschke E, Heguilen R, Heguilen R, Albarracin L, Politei J, Liste AA, Bernasconi A, Kusano E, Russo R, Pisani A, Messalli G, Imbriaco M, Prikhodina L, Ryzhkova O, Polyakov V, Lipkowska K, Ostalska-Nowicka D, Smiech M, Jaroniec M, Zaorska K, Szaflarski W, Nowicki M, Zachwieja J, Spoto B, Spoto B, Testa A, Sanguedolce MC, D'arrigo G, Parlongo RM, Pisano A, Tripepi G, Zoccali C, Mallamaci F, Moskowitz J, Piret S, Tashman A, Velez E, Lhotta K, Thakker R, Kotanko P, Cox J, Kingswood J, Mbundi J, Attard G, Patel U, Saggar A, Elmslie F, Doyle T, Jansen A, Jozwiak S, Belousova E, Frost M, Kuperman R, Bebin M, Korf B, Flamini R, Kohrman M, Sparagana S, Wu J, Ford J, Shah G, Franz D, Zonnenberg B, Cheung W, Urva S, Wang J, Frost M, Kingswood C, Budde K, Kofman T, Narjoz C, Raimbourg Q, Roland M, Loriot MA, Karras A, Hill GS, Jacquot C, Nochy D, Thervet E, Jagodzinski P, Mostowska M, Oko A, Nicolaou N, Kevelam S, Lilien M, Oosterveld M, Goldschmeding R, Van Eerde A, Pfundt R, Sonnenberg A, Ter Hal P, Knoers N, Renkema K, Storm T, Nielsen R, Christensen E, Frykholm C, Tranebjaerg L, Birn H, Verroust P, Neveus T, Sundelin B, Hertz JM, Holmstrom G, Ericson K, Fabris A, Cremasco D, Zambon A, Muraro E, Alessi M, D'angelo A, Anglani F, Del Prete D, Alkmim Teixeira A, Quinto BM, Jose Rodrigues C, Beltrame Ribeiro A, Batista M, Kerti A, Kerti A, Csohany R, Szabo A, Arkossy O, Sallai P, Moriniere V, Vega-Warner V, Lakatos O, Szabo T, Reusz G, Tory K, Addis M, Anglani F, Tosetto E, Meloni C, Ceol M, Cristofaro R, Melis MA, Vercelloni P, D'angelo A, Marra G, Kaniuka S, Nagel M, Wolyniec W, Obolonczyk L, Swiatkowska-Stodulska R, Sworczak K, Rutkowski B, Chen C, Jiang L, Chen L, Fang L, Mozes M. M, Boosi M, Rosivall L, Kokeny G, Diana R, Gross O, Johanna T, Rainer G, Ayse C, Henrik H, Gerhard-Anton M, Nabil M, Intissar E, Belge H, Belge H, Bloch J, Dahan K, Pirson Y, Vanhille P, Demoulin N. Genetic diseases. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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