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Mudrik-Zohar H, Alon D, Nacasch N, Sternschuss A, Greenberg M, Benchetrit S, Gavrieli R, Zitman-Gal T, Cohen-Hagai K. Neutrophil reactive oxygen formation, bacterial infections and mortality in malnourished hemodialysis patients: Evaluation of clinical outcomes. Semin Dial 2023; 36:399-406. [PMID: 37424019 DOI: 10.1111/sdi.13168] [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] [Received: 07/29/2022] [Revised: 03/21/2023] [Accepted: 06/10/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Patients with end stage kidney disease undergoing maintenance hemodialysis (MHD) are prone to malnutrition and infections. OBJECTIVE The objective of this study was to evaluate the effect of polymorphonuclear (PMN) cell dysfunction on clinical outcomes of MHD patients, in association with nutritional status. METHODS This prospective study investigated 39 MHD patients by evaluating the oxidative activity of their PMN cells using Phorbol 12-Myristate-13-Acetate (PMA) stimulation. Blood samples were taken from each participant at dialysis initiation. Demographics, laboratory data, and clinical outcomes during a 24-month follow-up period were obtained from electronic medical records. RESULTS Phagocytic activity was described in percentiles of mean fluorescence intensity (MFI) of PMA levels. There were no differences in comorbidities between patients with low or high MFI-PMA percentiles. Patients in the lowest (25th) MFI-PMA percentile (N = 10) had poorer nutritional status and more frequent severe infections compared to the other 29 patients (4.3 ± 3.4 events versus 2 ± 2.2 events, p = 0.017). Furthermore, they had more frequent hospitalizations (>3) due to infections (70% versus 41%, p = 0.073) and their mortality rate was higher (80% versus 31%, p = 0.007). The odds ratio for all-cause mortality was 8.85. In multivariate analysis, the MFI-PMA percentile and ischemic heart disease were the strongest predictors of all-cause mortality (p = 0.02 and p = 0.005, respectively). CONCLUSIONS Low MFI-PMA levels were associated with poor nutritional status and adverse clinical outcomes and might serve as a prognostic biomarker, predicting severe infections and mortality among malnourished MHD patients.
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Affiliation(s)
- Hadar Mudrik-Zohar
- Department of Internal Medicine A, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Danny Alon
- Department of Internal Medicine A, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naomi Nacasch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Aviad Sternschuss
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Meidad Greenberg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Ronit Gavrieli
- Laboratory for Leukocyte Functions, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Keren Cohen-Hagai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
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Cohen-Hagai K, Benchetrit S, Wand O, Grupper A, Shashar M, Solo O, Pereg D, Zitman-Gal T, Haskiah F, Erez D. The Clinical Significance of LDL-Cholesterol on the Outcomes of Hemodialysis Patients with Acute Coronary Syndrome. Medicina (Kaunas) 2023; 59:1312. [PMID: 37512123 PMCID: PMC10385584 DOI: 10.3390/medicina59071312] [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] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/03/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
Background and objectives: Dyslipidemia is one of the most important modifiable risk factors in the pathogenesis of cardiovascular disease in the general population, but its importance in the hemodialysis (HD) population is uncertain. Materials and Methods: This retrospective cohort study includes HD patients hospitalized due to acute coronary syndrome (ACS) in the period 2015-2020 with lipid profile data during ACS. A control group with preserved kidney function was matched. Risk factors for 30-day and 1-year mortality were assessed. Results: Among 349 patients included in the analysis, 246 were HD-dependent ("HD group"). HD group patients had higher prevalence of diabetes, hypertension, and heart disease than the control group. At ACS hospitalization, lipid profile and chronic statin treatment were comparable between groups. Odds ratios for 30-day mortality in HD vs. control group was 5.2 (95% CI 1.8-15; p = 0.002) and for 1-year, 3.4 (95% CI 1.9-6.1; p <0.001). LDL and LDL < 70 did not change 30-day and 1-year mortality rates in the HD group (p = 0.995, 0.823, respectively). However, survival after ACS in HD patients correlated positively with nutritional parameters such as serum albumin (r = 0.368, p < 0.001) and total cholesterol (r = 0.185, p < 0.001), and inversely with the inflammatory markers C-reactive protein (CRP; r = -0.348, p < 0.001) and neutrophils-to-lymphocytes ratio (NLR; r = -0.181, p = 0.019). Multivariate analysis demonstrated that heart failure was the only significant predictor of 1-year mortality (OR 2.8, p = 0.002). LDL < 70 mg/dL at ACS hospitalization did not predict 1-year mortality in the HD group. Conclusions: Despite comparable lipid profiles and statin treatment before and after ACS hospitalization, mortality rates were significantly higher among HD group. While malnutrition-inflammation markers were associated with survival of dialysis patients after ACS, LDL cholesterol was not. Thus, our study results emphasize that better nutritional status and less inflammation are associated with improved survival among HD patients.
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Affiliation(s)
- Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba 44281, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba 44281, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Ori Wand
- Division of Pulmonary Medicine, Barzilai University Medical Center, Ashkelon 7830604, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Ayelet Grupper
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Department of Nephrology and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Moshe Shashar
- Department of Nephrology and Hypertension, Laniado Hospital, Netanya 4244916, Israel
| | - Olga Solo
- Department of Anesthesiology, Pain and Intensive Care, Meir Medical Center, Kfar Saba 4428164, Israel
| | - David Pereg
- Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba 44281, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Feras Haskiah
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Department of Internal Medicine D, Meir Medical Center, Kfar Saba 4428164, Israel
| | - Daniel Erez
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Department of Internal Medicine D, Meir Medical Center, Kfar Saba 4428164, Israel
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Cohen-Hagai K, Kashua H, Benchetrit S, Zitman-Gal T. Hemodialysis Serum Stimulates the TXNIP-eNOS-STAT3 Inflammatory Pathway In Vitro. Antioxidants (Basel) 2023; 12:antiox12051109. [PMID: 37237975 DOI: 10.3390/antiox12051109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/27/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Endothelial dysfunction, vascular inflammation and accelerated atherosclerosis have been investigated extensively in patients with chronic kidney disease (CKD). These conditions, as well as protein-energy malnutrition and oxidative stress, impair kidney function and contribute to increased morbidity and mortality among patients with end-stage kidney disease undergoing hemodialysis (HD). TXNIP, a key regulator of oxidative stress, has been linked to inflammation and suppresses eNOS activity. STAT3 activation adds to endothelial cell dysfunction, macrophage polarization, immunity and inflammation. Therefore, it is critically involved in atherosclerosis. This study evaluated the effect of sera from HD patients on the TXNIP-eNOS-STAT3 pathway using an in vitro model of human umbilical vein endothelial cells (HUVECs). METHODS Thirty HD patients with end-stage kidney disease and ten healthy volunteers were recruited. Serum samples were taken at dialysis initiation. HUVECs were treated with HD or healthy serum (10% v/v) for 24 h. Then, cells were collected for mRNA and protein analysis. RESULTS TXNIP mRNA and protein expression were significantly increased in HUVECs treated with HD serum compared to healthy controls (fold changes: 2.41 ± 1.84 vs. 1.41 ± 0.5 and 2.04 ± 1.16 vs. 0.92 ± 0.29, respectively), as were IL-8 mRNA (fold changes: 2.22 ± 1.09 vs. 0.98 ± 0.64) and STAT3 protein expression (fold changes: 1.31 ± 0.75 vs. 0.57 ± 0.43). The expression of eNOS mRNA and protein (fold changes: 0.64 ± 0.11 vs. 0.95 ± 0.24; 0.56 ± 0.28 vs. 4.35 ± 1.77, respectively) and that of SOCS3 and SIRT1 proteins were decreased. Patients' nutritional status, reflected by their malnutrition-inflammation scores, did not affect these inflammatory markers. CONCLUSIONS This study showed that sera from HD patients stimulated a novel inflammatory pathway, regardless of their nutritional status.
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Affiliation(s)
- Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba 44281, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Hadil Kashua
- Department of Pediatric, Meir Medical Center, Kfar Saba 44281, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba 44281, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba 44281, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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4
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Silber M, Dekel N, Heusler I, Biron-Shental T, Amiel A, Kidron D, Weisz A, Benchetrit S, Zitman-Gal T. Inflammasome activation in preeclampsia and intrauterine growth restriction. Am J Reprod Immunol 2022; 88:e13598. [PMID: 35976163 DOI: 10.1111/aji.13598] [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: 06/07/2022] [Revised: 06/30/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022] Open
Abstract
PROBLEM Preeclampsia (PE) and intrauterine growth restriction (IUGR) are leading causes of perinatal complications, affecting 8%-10% of all pregnancies. Inflammasomes are suspected to be one of the mechanisms that lead to the process of term and preterm labors. This study evaluated the inflammasome-dependent inflammation processes in placental tissue of women with PE and IUGR. METHODS OF STUDY In this prospective cohort study, 14 women with PE, 15 with placental-related IUGR and 19 with normal pregnancy (NP) were recruited during admission for delivery. Maternal blood was obtained prior to delivery and neonatal cord blood and placental tissue were obtained after delivery. RESULTS NLRP7 and PYCARD protein expression were higher in placental PE and IUGR samples versus NP samples. Immunostaining revealed that NLRP7 and PYCARD were upregulated in PE and IUGR placental syncytiotrophoblast, stroma and endothelial cells. PYCARD serum levels were significantly higher in women with PE and IUGR. No significant changes were observed in neonatal cord blood. CONCLUSIONS NLRP7 and PYCARD are key inflammatory proteins that are significantly elevated in PE and IUGR. Better understanding their significance may enable them to become markers of prediction or progression of PE and IUGR.
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Affiliation(s)
- Michal Silber
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nadav Dekel
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
| | - Ishai Heusler
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Biron-Shental
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aliza Amiel
- School of Nursing, Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
| | - Debora Kidron
- Pathology Department, Meir Medical Center, Kfar Saba, Israel
| | - Avivit Weisz
- Pathology Department, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
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5
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Rozenberg I, Benchetrit S, Raigorodetsky M, Fajer S, Shnaker A, Nacasch N, Einbinder Y, Zitman-Gal T, Cohen-Hagai K. Clinical Outcomes of Vascular Accesses in Hemodialysis Patients. Isr Med Assoc J 2022; 24:514-519. [PMID: 35972011] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Reliable vascular access is a fundamental tool for providing effective hemodialysis. Vascular access dysfunction is associated with increased morbidity and mortality among hemodialysis patients. Current vascular access guidelines strongly recommend creating an arteriovenous fistula (AVF) as the first option; however, a substantial proportion of new AVFs may not be usable. OBJECTIVES To assess possible predictors of primary and secondary failure of vascular access. METHODS This retrospective cohort study included all vascular access sites created at Meir Medical Center from 2006 through 2012. Vascular access site, primary and secondary failure rates, and relevant demographic and clinical data were recorded during 60 months of follow-up. RESULTS A total of 612 vascular accesses were created and followed for a median of 32 ± 29.4 months. Of these, 490 (80%) were suitable for initiating hemodialysis. Vascular access site was the most important predictor of primary failure but did not predict secondary failure. Co-morbidities such as diabetes mellitus and congestive heart failure, as well as the use of antiplatelet agents did not predict primary or secondary failure. Preoperative vascular mapping using Doppler ultrasonography was performed in 36.4% of cases and was not associated with lower rates of primary or secondary failure. CONCLUSIONS Vascular access site is an important predictor of primary failure. We did not find a benefit of pre-operative vessel mapping or chronic antiplatelet therapy in terms of decreasing primary and secondary failure rates. Physicians should carefully consider the characteristics of the patient and blood vessels before creating vascular access in patients requiring chronic hemodialysis.
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Affiliation(s)
| | - Sydney Benchetrit
- Departments of Nephrology and Hypertension
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Simone Fajer
- Vascular Surgery, Meir Medical Center, Kfar Saba, Israel
| | - Ali Shnaker
- Vascular Surgery, Meir Medical Center, Kfar Saba, Israel
| | - Naomi Nacasch
- Departments of Nephrology and Hypertension
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Einbinder
- Departments of Nephrology and Hypertension
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Departments of Nephrology and Hypertension
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Keren Cohen-Hagai
- Departments of Nephrology and Hypertension
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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6
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Silber M, Dekel N, Heusler I, Biron-Shental T, Amiel A, Kidron D, Weisz A, Benchetrit S, Zitman-Gal T. Inflammasome activation in preeclampsia and intrauterine growth restriction. Am J Reprod Immunol 2022. [PMID: 35810355 DOI: 10.1111/aji13598] [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: 06/07/2022] [Revised: 06/30/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022] Open
Abstract
PROBLEM Preeclampsia (PE) and intrauterine growth restriction (IUGR) are leading causes of perinatal complications, affecting 8-10% of all pregnancies. Inflammasomes are suspected to be one of the mechanisms that lead to the process of term and preterm labors. This study evaluated the inflammasome-dependent inflammation processes in placental tissue of women with PE and IUGR. METHODS OF STUDY In this prospective cohort study, 14 women with PE, 15 with placental-related IUGR and 19 with normal pregnancy (NP) were recruited during admission for delivery. Maternal blood was obtained prior to delivery and neonatal cord blood and placental tissue were obtained after delivery. RESULTS NLRP7 and PYCARD protein expression were higher in placental PE and IUGR samples vs. NP samples. Immunostaining revealed that NLRP7 and PYCARD were upregulated in PE and IUGR placental syncytiotrophoblast, stroma and endothelial cells. PYCARD serum levels were significantly higher in women with PE and IUGR. No significant changes were observed in neonatal cord blood. CONCLUSIONS NLRP7 and PYCARD are key inflammatory proteins that are significantly elevated in PE and IUGR. Better understanding their significance may enable them to become markers of prediction or progression of PE and IUGR. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Michal Silber
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nadav Dekel
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
| | - Ishai Heusler
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Biron-Shental
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aliza Amiel
- School of Nursing, Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
| | - Debora Kidron
- Pathology Department, Meir Medical Center, Kfar Saba, Israel
| | - Avivit Weisz
- Pathology Department, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
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7
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Einbinder Y, Hornik-Lurie T, Cohen-Hagai K, Goldman S, Tanasiychuk T, Nacasch N, Erez D, Magen S, Zitman-Gal T, Wiener-Well Y, Frajewicki V, Benchetrit S, Shavit L, Bnaya A. Correction to: Comparison of long-term antibody response to mRNA SARS-CoV-2 vaccine among peritoneal dialysis and hemodialysis patients. Nephrol Dial Transplant 2022; 37:1780. [PMID: 35639832 DOI: 10.1093/ndt/gfac141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shira Goldman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Nephrology and Hypertension, Rabin Medical Center, Pathach Tikva, Israel
| | - Tatiana Tanasiychuk
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Naomi Nacasch
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Daniel Erez
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Internal Medicine D, Meir Medical Center, Kfar Saba, Israel
| | - Sophie Magen
- Clinical Endocrinology Laboratory, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yonit Wiener-Well
- Hebrew University of Jerusalem, Jerusalem, Israel.,Infectious Disease Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Victor Frajewicki
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Linda Shavit
- Hebrew University of Jerusalem, Jerusalem, Israel.,Institute of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Alon Bnaya
- Hebrew University of Jerusalem, Jerusalem, Israel.,Institute of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel
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8
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Silber M, Dekel N, Heuzler I, Gershnabel SF, Biron-Shental T, Shechter-Maor G, Amiel A, Weisz A, Cohen-Hagai K, Benchetrit S, Zitman-Gal T. Inflammasome activation in preeclampsia and intrauterine growth restriction. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.11.1251] [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: 11/01/2022]
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9
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Einbinder Y, Hornik-Lurie T, Cohen-Hagai K, Goldman S, Tanasiychuk T, Nacasch N, Erez D, Magen S, Zitman-Gal T, Wiener-Well Y, Frajewicki V, Benchetrit S, Shavit L, Bnaya A. Comparison of long-term antibody response to mRNA SARS-CoV-2 vaccine among peritoneal dialysis and hemodialysis patients. Nephrol Dial Transplant 2021; 37:602-604. [PMID: 34788861 PMCID: PMC8767896 DOI: 10.1093/ndt/gfab321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shira Goldman
- Department of Nephrology and Hypertension, Rabin Medical Center, Pathach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tatiana Tanasiychuk
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Naomi Nacasch
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Daniel Erez
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Internal Medicine D, Meir Medical Center, Kfar Saba, Israel
| | - Sophie Magen
- Clinical Endocrinology Laboratory, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yonit Wiener-Well
- Infectious Disease Unit, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
| | - Victor Frajewicki
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Linda Shavit
- Clinical Endocrinology Laboratory, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
| | - Alon Bnaya
- Clinical Endocrinology Laboratory, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
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10
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Farladansky-Gershnabel S, Heusler I, Biron-Shental T, Shechter-Maor G, Amiel A, Kidron D, Weisz A, Einbinder Y, Cohen-Hagai K, Benchetrit S, Zitman-Gal T. Elevated expression of galectin-3, thioredoxin and thioredoxin interacting protein in preeclampsia. Pregnancy Hypertens 2021; 26:95-101. [PMID: 34700108 DOI: 10.1016/j.preghy.2021.10.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/09/2021] [Accepted: 10/11/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Preeclampsia (PE) is a pregnancy-related syndrome characterized by the onset of hypertension and proteinuria that can lead to end-organ dysfunction. Galectin-3 (Gal-3) is involved in cell growth, differentiation, inflammation and fibrosis. Thioredoxin (TXN) acts as antioxidant enzyme in several cellular processes, regulating inflammation and inhibiting apoptosis. TXNIP is an endogenous inhibitor of TXN. We evaluated changes in the inflammatory response of Gal-3, TXN, and TXNIP at the level of maternal blood, placenta, and umbilical cord blood of women with PE. STUDY DESIGN Ten women with PE and 20 with normal pregnancy (NP) were recruited during admission for delivery. Blood samples were obtained from parturients and umbilical cords, and placental tissue for analysis. RESULTS Gal-3 and TXNIP mRNA expression were higher in maternal plasma in PE group compared to NP and were lower in cord blood plasma and placentas in the PE group. In the PE group, TXN/TXNIP mRNA ratio was higher in cord blood plasma (2.07) compared to maternal plasma (1.09). TXN/TXNIP placental protein ratio was similar between PE (0.89) and NP (0.79). ELISA demonstrated that Gal-3 levels in maternal serum were significantly higher in the PE vs. the NP group. CONCLUSIONS Pro-inflammatory changes were expressed by high Gal-3 and TXNIP mRNA in maternal blood of PE women, but not in their placental and cord blood samples. These findings may imply that the placenta has a role in protecting the fetus from the damages of inflammatory response, which is more common in PE than in NP.
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Affiliation(s)
- Sivan Farladansky-Gershnabel
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ishai Heusler
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Biron-Shental
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Shechter-Maor
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aliza Amiel
- School of Nursing, Academic College of Tel Aviv-Jaffo, Tel Aviv-Jaffo, Israel
| | - Debora Kidron
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pathology Department, Meir Medical Center, Kfar Saba, Israel
| | - Avivit Weisz
- Pathology Department, Meir Medical Center, Kfar Saba, Israel
| | - Yael Einbinder
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Keren Cohen-Hagai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.
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11
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Einbinder Y, Siboni A, Zaidenstein S, Cohen-Hagai K, Benchetrit S, Zitman-Gal T. Presence of galectin-3 in peritoneal dialysate. Does it have a role in the peritoneal membrane inflammatory process? Nephrology (Carlton) 2021; 27:104-108. [PMID: 34611952 DOI: 10.1111/nep.13981] [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: 06/23/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022]
Abstract
Peritoneal dialysis (PD) causes structural and functional changes in the peritoneal membrane, which are attributed to local inflammatory process. This study assessed the presence of galectin-3 (Gal-3), a known inflammatory modulator, in dialysate effluent and correlated its levels with markers of inflammatory process. Gal-3 levels in serum and dialysate effluent were measured in prevalent PD patients on morning visits (n = 27) or during peritoneal equilibration tests (PET, n = 16), it association with clinical and laboratory parameters, including dialysate/plasma creatinine (D/P creatinine) and interleukin-6 (IL-6) levels was analysed. Gal-3 levels in dialysate effluent correlated with D/P creatinine (0.663, p = 0.005) and dialysate effluent IL-6 levels (0.674, p = 0.002), but not with serum Gal-3 levels or dialysis vintage. Patients who were high transporters had higher Gal-3 levels in dialysate effluent, as compared to lower transporters. In multivariate regression analysis, dialysate IL-6 level was the strongest predictor of dialysate Gal-3 levels. This study found Gal-3 in dialysate effluent correlated with D/P creatinine and dialysate IL-6 levels. These findings may imply that Gal-3 has a role in the intraperitoneal inflammatory process. However, this needs to be investigated further.
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Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ayala Siboni
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Shirley Zaidenstein
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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12
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Heusler I, Biron-Shental T, Farladansky-Gershnabel S, Pasternak Y, Kidron D, Vulih-Shuitsman I, Einbinder Y, Cohen-Hagai K, Benchetrit S, Zitman-Gal T. Enhanced expression of Galectin-3 in gestational diabetes. Nutr Metab Cardiovasc Dis 2021; 31:1791-1797. [PMID: 34023181 DOI: 10.1016/j.numecd.2021.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/01/2021] [Accepted: 03/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Gestational diabetes mellitus (GDM), hyperglycemia diagnosed during pregnancy, is one of the most common medical complications of pregnancy, treated primarily by diet and pharmacotherapy, if indicated. It is well-established that GDM increases the risk of adverse pregnancy outcomes and long-term complications in mothers and infants. Galectin-3 (Gal-3) is important in processes of cell growth, differentiation, inflammation, and fibrosis. We evaluated Gal-3 expression in pregnancies complicated by GDM as a parameter that might explain how GDM influences early onset of future complications. METHODS AND RESULTS Forty-four women with GDM and 40 with normal pregnancy (NP) were recruited during delivery admission. Blood samples were obtained from parturients and umbilical cords blood, as well as placental tissue for analysis. Gal-3 mRNA expression was increased in maternal blood samples and placental tissue of women with GDM compared to NP. In GDM, Gal-3 mRNA was decreased in cord blood compared to maternal blood and placental tissue. Gal-3 GDM placental protein expression was increased compared to NP. Immunostaining revealed that Gal-3 is upregulated in GDM placental extravillous trophoblast. ELISA of Gal-3 maternal serum levels between GDM and NP were similar. CONCLUSION Gal-3 is strongly expressed at molecular levels (mRNA and protein expression) in GDM maternal blood and placental tissue, and decreased in cord blood. These findings highlight the role of the placenta in protecting the fetus from potential Gal-3 damage. Gal-3 expression at mRNA and protein levels might be influenced by diabetes, even if blood glucose is balanced by medication or diet.
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Affiliation(s)
- Ishai Heusler
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Biron-Shental
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sivan Farladansky-Gershnabel
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Pasternak
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Debora Kidron
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pathology Department, Meir Medical Center, Kfar Saba, Israel
| | | | - Yael Einbinder
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Keren Cohen-Hagai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.
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13
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Cohen Hagai K, Erez D, Zitman-Gal T, Fanadka F, Einbinder Y, Benchetrit S. MO750THE COMBINED PROGNOSTIC SIGNIFICANCE OF ALKALINE PHOSPHATASE AND INTRA-CRANIAL ARTERIAL CALCIFICATIONS IN HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab097.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Intra-cranial arterial calcification (ICAC) in hemodialysis (HD) patients has a prevalence of about 90%, and its severity is correlated with age, hemodialysis vintage and mineral bone disease. Elevated concentrations of calcium and phosphorus are not sufficient to induce medial calcification because of inhibition by pyrophosphate. Alkaline Phosphatase (ALP) promotes vascular calcification by hydrolyzing pyrophosphate. Epigenetic mechanisms regulation by Apabetalone downregulates pathways involved in vascular calcification.
This study assessed the combined impact of ICAC and elevated serum ALP on mortality among chronic HD patients.
Method
vascular calcifications represented by ICAC were measured simultaneous with mineral bone disease parameters including serum ALP of chronic HD patients who underwent non-contrast brain computerized tomography (CT) from 2015 to 2018 in our institution.
Results
This retrospective study included 153 hemodialysis patients (mean age 71.3±12.1 years, 60.1% male). Of the total cohort, 12(7.8%) had no brain calcifications and 69 (45.1%) had multiple intracranial calcifications. Considering the patients with normal ALP and no calcification as the reference group yielded adjusted odds ratios for all-cause mortality of 4.6 (95%CI 1.7-12.7) among patients with brain calcifications and normal ALP, p=0.003, and odds ratios for all-cause mortality of 6.1 (95%CI 2.1-17.7) among patients with brain calcifications and increased ALP.
Conclusion
We founded an independent association between ICAC and the risk of death among hemodialysis patients. The combined effect of ICAC and increased ALP was significantly associated with higher odds-ratio for all-cause mortality in chronic HD patients and may contribute to the risk stratification of these patients.
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Affiliation(s)
- Keren Cohen Hagai
- Meir medical center, Nephrology and Hypertension, Israel
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv-Yafo, Israel
| | - Daniel Erez
- Meir Medical Center, Department of Internal Medicine D
| | - Tali Zitman-Gal
- Meir medical center, Nephrology and Hypertension, Israel
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv-Yafo, Israel
| | | | - Yael Einbinder
- Meir medical center, Nephrology and Hypertension, Israel
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv-Yafo, Israel
| | - Sydney Benchetrit
- Meir medical center, Nephrology and Hypertension, Israel
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv-Yafo, Israel
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14
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Einbinder Y, Cohen-Hagai K, Benchetrit S, Zitman-Gal T. MO710GALECTIN-3, IS IT A NEW PLAYER IN PERITONEAL INFLAMMATION AMONG PATIENTS UNDERGOING PERITONEAL DIALYSIS? Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab101.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Peritoneal dialysis (PD) is a common used method for renal replacement therapy. Prolonged PD treatment causes structural and functional changes in the peritoneal membrane which are attributed to local inflammatory process in the peritoneal cavity. Galectin-3 (Gal-3) is a galactoside-binding lectin with pro-inflammatory and pro-fibrotic effects. The aim of this study was to assess correlation between Gal-3 serum and dialysate effluent levels with peritoneal membrane transport characteristics.
Method
Gal-3 levels in serum and dialysate effluent were measured simultaneously in prevalent PD patients in morning visit or during peritoneal equilibration test (PET). Gal-3 levels were correlated with clinical and laboratory parameters. Interlukin (IL) -6 levels were measured in dialysate effluent. Gal-3 mRNA and protein expression were evaluated after exposure of primary endothelial cell culture to several dialysate solutions.
Results
37 PD patients were included in the study; mean age was 65.7±13.1 years, mean dialysis vintage was 17.5±13 months. Gal-3 levels in dialysate effluent correlated with peritoneal equilibration test (PET) results (0.663, p=0.005) and effluent IL-6 levels (0.674, p=0.002) but not with serum Gal-3 levels or dialysis vintage. Patients with high PET results had higher effluent Gal-3 levels as compared average low PET results. In multivariate regression analysis effluent IL-6 level was the most dominant predictor of effluent Gal-3 levels. Gal-3 mRNA and protein expression in primary endothelial cell culture were not affected by stimulation with dialysate solutions.
Conclusion
Our study demonstrated presence of Gal-3 within the dialysate effluent in PD patients. Gal-3 levels correlated with peritoneal membrane transport characteristics and effluent IL-6 levels suggesting a role in the inflammatory process within the peritoneal cavity.
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Affiliation(s)
- Yael Einbinder
- Meir Medical Center, Kefar Sava, Israel
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv-Yafo, Israel
| | - Keren Cohen-Hagai
- Meir Medical Center, Kefar Sava, Israel
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv-Yafo, Israel
| | - Sydney Benchetrit
- Meir Medical Center, Kefar Sava, Israel
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv-Yafo, Israel
| | - Tali Zitman-Gal
- Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv-Yafo, Israel
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15
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Cohen-Hagai K, Fanadka F, Grumberg T, Topaz G, Nacasch N, Greenberg M, Zitman-Gal T, Benchetrit S. Diastolic blood pressure is associated with brain atrophy in hemodialysis patients: A single center case-control study. Ther Apher Dial 2021; 26:94-102. [PMID: 33763913 DOI: 10.1111/1744-9987.13647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/03/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 11/30/2022]
Abstract
Brain atrophy (BA) is often found in neuroimaging of hemodialysis patients, representing parenchymal cerebral damage. Likely contributing factors to BA are age, chronic hypertension, diabetes mellitus and other cardiovascular risk factors of atherosclerosis that are also common among hemodialysis patients. BA may also occur due to focal ischemia and hypoperfusion during hemodialysis. However, data on optimal blood pressure (BP) in these patients are limited. The goal of this study was to determine whether the prevalence and severity of BA would be higher among hemodialysis patients with lower BP. A blinded neuroradiologist graded BA of all hemodialysis patients who underwent brain non-contrast computerized tomography (CT) from 2015 to 2017 in our institution. Age- and sex-matched patients with normal kidney function who underwent brain CT during the same period and technique served as the control group. A total of 280 patients were included in this retrospective study, with average BP of 140/70 mmHg among hemodialysis patients and 142/75 mmHg in the control group. BA was more common in dialysis patients and its severity increased with age and traditional cardiovascular risk factors. We observed a significant negative correlation between diastolic BP (DBP) at dialysis initiation and BA. Average DBP decreased with increasing severity of BA. These findings were observed in both hemodialysis and non-CKD patients. BA was associated with lower DBP, which may induce cerebral hypoperfusion and ischemia. This finding should discourage over-treatment of hypertension among hemodialysis patients.
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Affiliation(s)
- Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Feda Fanadka
- Department of Radiology, Meir Medical Center, Kfar Saba, Israel
| | - Tania Grumberg
- Department of Anesthesiology, Meir Medical Center, Kfar Saba, Israel
| | - Guy Topaz
- Department of Internal Medicine C, Meir Medical Center, Kfar Saba, Israel
| | - Naomi Nacasch
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Meidad Greenberg
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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16
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Farladansky-Gershnabel S, Heusler I, Biron-Shental T, Cohen-Hagai K, Benchetrit S, Zitman-Gal T. 374 Thioredoxin, thioredoxin interacting protein and galectin-3 in preeclampsia. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2020.12.397] [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: 11/28/2022]
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17
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Shochet GE, Pomerantz A, Shitrit D, Bardenstein-Wald B, Ask K, Surber M, Rabinowicz N, Levy Y, Benchetrit S, Edelstein E, Zitman-Gal T. Galectin-3 levels are elevated following nintedanib treatment. Ther Adv Chronic Dis 2020; 11:2040622320968412. [PMID: 33708368 PMCID: PMC7907712 DOI: 10.1177/2040622320968412] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/02/2020] [Indexed: 12/12/2022] Open
Abstract
Background and Aims: Idiopathic pulmonary fibrosis (IPF) is a common and severe form of pulmonary fibrosis. Nintedanib, a triple angiokinase inhibitor, is approved for treating IPF. Galectin 3 (Gal-3) activates a variety of profibrotic processes. Currently, the Gal-3 inhibitor TD139 is being tested in phase II clinical trials. Since this treatment is given ‘on top’ of nintedanib, it is important to estimate its effect on Gal-3 levels. Therefore, we evaluated the impact of nintedanib on Gal-3 expression using both in vitro and in vivo models, in addition to serum samples from patients with IPF. Methods: Gal-3 levels were evaluated in IPF and control tissue samples, primary human lung fibroblasts (HLFs) following nintedanib treatment (10–100 nM, quantitative polymerase chain reaction), and in a silica-induced fibrosis mouse model with/without nintedanib (0.021–0.21 mg/kg) by immunohistochemistry. In addition, Gal-3 levels were analyzed in serum samples from 41 patients with interstitial lung disease patients with/without nintedanib treatment by ELISA. Results: Nintedanib addition to HLFs resulted in significant elevations in Gal-3, phospho-signal transducer and activator of transcription 3 (pSTAT3), as well as IL-8 mRNA levels (p < 0.05). Gal-3 expression was higher in samples from IPF patients compared with non-IPF controls at the protein and mRNA levels (p < 0.05). In the in vivo mouse model, Gal-3 levels were increased following fibrosis induction and even further increased with the addition of nintedanib, mostly in macrophages (p < 0.05). Patients receiving nintedanib presented with higher Gal-3 serum levels compared with those who did not receive nintedanib (p < 0.05). Conclusion: Nintedanib elevates Gal-3 levels in both experimental models, along with patient samples. These findings highlight the possibility of using combined inhibition therapy for patients with IPF.
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Affiliation(s)
- Gali Epstein Shochet
- Pulmonary Department, Meir Medical Center, 59 Tchernichovsky Street, Kfar Saba 4428164, Israel
| | - Alon Pomerantz
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Shitrit
- Pulmonary Department, Meir Medical Center, Kfar Saba, Israel
| | | | - Kjetil Ask
- McMaster University, Hamilton, ON, Canada
| | | | - Noa Rabinowicz
- Internal Medicine E Department, Meir Medical Center, Kfar Saba, Israel
| | - Yair Levy
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Tali Zitman-Gal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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18
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Einbinder Y, Shnaider A, Ghanayem K, Basok A, Rogachev B, Lior Y, Haviv YS, Cohen-Hagai K, Nacasch N, Rozenberg I, Benchetrit S, Zitman-Gal T, Douvdevani A. Elevated Circulating Cell-Free DNA in Hemodialysis-Treated Patients Is Associated with Increased Mortality. Am J Nephrol 2020; 51:852-860. [PMID: 33105130 DOI: 10.1159/000510771] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/06/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Predicting the mortality risk of patients un-dergoing hemodialysis (HD) is challenging. Cell-free DNA (cfDNA) is released into circulation from dying cells, and its elevation is predictive of unfavorable outcome. In a pilot study, we found post-HD cfDNA level to be a predictor of all-cause mortality. Thus, the aim of this study was to confirm the prognostic power of cfDNA in a larger prospective cohort study conducted at 2 medical centers. METHODS CfDNA levels were measured by a rapid fluorometric assay on sera obtained before and after 1 HD session. One hundred fifty-three patients were followed up to 46 months for mortality during which time 47 patients died. We compared the predictive value of cfDNA to age, comorbidities, and standard blood tests. RESULTS Examining standard blood tests, only post-HD cfDNA levels were elevated in the non-survivor group compared to survivors (959 vs. 803 ng/mL, p = 0.04). Pre- and post-HD cfDNA levels correlated with age and diabetes. Patients with elevated cfDNA (>850 ng/mL) showed lower survival than those with normal levels. A Cox proportional hazard regression model demonstrated a significant hazard ratio of 1.92 for post-HD cfDNA levels. Logistic regression models showed that post-HD cfDNA was a significant predictor of mortality at 1-3 years with odd ratios of 4.61, 4.36, and 6.22, respectively. CONCLUSIONS Post-HD cfDNA level was superior to standard blood tests and could serve as a biomarker to assist in decision-making for HD-treated patients.
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Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alla Shnaider
- Department of Nephrology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Khaled Ghanayem
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anna Basok
- Department of Nephrology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Boris Rogachev
- Department of Nephrology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yotam Lior
- Department of Clinical Biochemistry and Pharmacology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Clinical Research Center, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yosef Shmuel Haviv
- Department of Nephrology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naomi Nacasch
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Ilan Rozenberg
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amos Douvdevani
- Department of Nephrology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel,
- Department of Clinical Biochemistry and Pharmacology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel,
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19
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Topaz G, Ben-Zvi E, Pereg D, Kitay-Cohen Y, Benchetrit S, Zitman-Gal T, Lotan S, Cohen-Hagai K. Prediction of acute-coronary-syndrome using newly-defined R 2-CHA 2DS 2-VASc score among patients with chest pain. J Cardiol 2020; 77:370-374. [PMID: 32988692 DOI: 10.1016/j.jjcc.2020.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/18/2020] [Revised: 07/26/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Chest-pain patients with no evidence of acute coronary syndrome might still be at risk for adverse outcomes. Adding renal function to the classic scoring of CHADS and CHA2DS2 VASC may improve risk stratification of chest-pain patients discharged from internal medicine wards after acute coronary syndrome (ACS) rule-out. METHODS We accessed medical records of patients admitted to internal medicine wards during 2010-2016 and discharged following ACS rule-out. A R2CHA2DS2-VASc score model that included higher scores as kidney function deteriorated was calculated and compared to CHADS and CHA2DS2 VASC scores. The primary endpoint was the composite of 30-day ACS and mortality. One-year ACS and 1-year mortality were the secondary endpoints. The study included 12,449 patients, stratified into three risk groups according to their R2CHA2DS2-VASc score. RESULTS Participants were stratified into 3 groups according to R2CHA2DS2-VASc score. R2CHA2DS2-VASc score predicted better the composite outcome of ACS and 30-day and 1-year mortality after discharge (OR: 4, 95%, CI 2.3-7, p < 0.01 and OR: 13.3, 95% CI 7.8-22.7, p < 0.01, respectively). Receiver operating characteristic curve analysis showed better risk stratification of the R2CHA2DS2-VASc compared with both CHADS and CHA2DS2 VASC score. CONCLUSIONS The R2CHA2DS2-VASc score is a better predictor of short- and long-term cardiovascular morbidity and mortality after hospital discharge.
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Affiliation(s)
- Guy Topaz
- Department of Internal Medicine C, Meir Medical Center, Kfar Saba, Israel
| | - Elad Ben-Zvi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Pereg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
| | - Yona Kitay-Cohen
- Department of Internal Medicine C, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Nephrology, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Nephrology, Meir Medical Center, Kfar Saba, Israel
| | - Shilo Lotan
- Department of Internal Medicine C, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Keren Cohen-Hagai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Nephrology, Meir Medical Center, Kfar Saba, Israel.
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Tanasiychuk T, Kushnir D, Vardi Y, Cohen-Hagai K, Zitman-Gal T, Frajewicki V, Benchetrit S, Einbinder Y. A simple novel device can provide independence for peritoneal dialysis patients. Perit Dial Int 2020; 41:344-346. [PMID: 32964803 DOI: 10.1177/0896860820958956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Tatiana Tanasiychuk
- Department of Nephrology and Hypertension, 549236Carmel Medical Center, Haifa, Israel
| | - Daniel Kushnir
- Department of Nephrology and Hypertension, 549236Carmel Medical Center, Haifa, Israel
| | - Yafa Vardi
- Department of Nephrology and Hypertension, 549236Carmel Medical Center, Haifa, Israel
| | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Victor Frajewicki
- Department of Nephrology and Hypertension, 549236Carmel Medical Center, Haifa, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
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21
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COHEN HAGAI KEREN, Fanadka F, Grumberg T, Topaz G, Nacasch N, Greenberg M, Zitman-Gal T, Benchetrit S. P1260INTRA CRANIAL AND HEART VALVES CALCIFICATIONS IN HEMODIALYSIS PATIENTS - INTERRELATIONSHIP AND CLINICAL IMPACTS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Arterial calcification is an integral component of active atherosclerosis and is an independent risk factor for cardiovascular disease. Intra-cranial calcification (ICC) in hemodialysis (HD) patients has a prevalence of about 90%, and its severity is correlated with age, hemodialysis vintage and mineral bone disease.
Heart valves calcifications are also considered as a local manifestation of atherosclerosis and have been associated with poor cardiovascular outcomes.
This study assessed the correlation between valvular and ICCs in hemodialysis patients and its clinical impact on mortality.
Method
A blinded neuroradiologist graded ICC of all HD patients who underwent non-contrast brain computerized tomography (CT) from 2015 to 2017 in our institution. Valvular calcifications were recorded according to echocardiography study. Only hemodialysis patients with available echocardiography and brain CT were included.
Results
This retrospective study included 119 hemodialysis patients (mean age 70.6±12.6 years, 57.1% male). Of the total cohort, 19 (16%) had no cardiac or brain calcifications and 65 (54.6%) had both valvular and intracranial calcifications. Considering the patients with no calcification as the reference group yielded adjusted odds ratios for all-cause mortality of 3.68 (95%CI 1.55-8.75) among patients with any brain calcifications, p=0.002. ICC was the most important predictor of mortality in the study cohort.
Conclusion
We found an independent association between ICC and the risk of death among hemodialysis patients. Assessing ICC in non-contrast CT may contribute to the risk stratification of HD patients. These calcifications are no less important than valvular calcifications are. Additional studies are needed to confirm these findings.
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Affiliation(s)
| | | | | | - Guy Topaz
- Meir medical center, Internal medicine C, Israel
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22
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Cohen-Hagai K, Nacasch N, Sternschuss A, Ohana M, Wolach B, Benchetrit S, Gavrieli R, Zitman-Gal T. Malnutrition and inflammation in hemodialysis patients: Comparative evaluation of neutrophil reactive oxygen formation. Nutrition 2020; 78:110793. [PMID: 32454385 DOI: 10.1016/j.nut.2020.110793] [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] [Received: 10/15/2019] [Revised: 01/27/2020] [Accepted: 02/01/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Impaired phagocytic function has been established in uremic patients. Chemotaxis, particle ingestion, and free radical and metabolic activity were all found to be disturbed in dialysis patients. Malnutrition is common among hemodialysis (HD) patients, with an estimated prevalence of 40% to 70%. Malnutrition-Inflammation Score (MIS) appears to be a useful tool for risk stratification of chronic HD patients. We assessed the correlation between MIS and phagocyte function in HD patients. METHODS Forty-four chronic HD patients were enrolled from the dialysis unit. The patients were divided into two groups according to the MIS: 1 to 12 (normal-mild) and 13 to 30 (severely malnourished). Hydrogen peroxide release by polymorphonuclear leukocytes was evaluated using the dihydrorhodamine 123 method. Phagocytic activity of neutrophils was evaluated after stimulation with Escherichia coli bacteria and phorbol 12-myristate 13-acetate (PMA) (positive control). RESULTS Neutrophil oxidative activity in all HD patients versus healthy controls was significantly lower in median fluorescence intensity (MdFI)-E. coli and MdFI-PMA. We found significant correlations among MdFI-PMA and calculated MIS and other nutritional parameters in chronic HD patients. CONCLUSIONS Impaired phagocytic function was identified in chronic HD patients. The severity of the impairment was associated with nutrition and inflammation parameters, as well as Malnutrition-Inflammation Score.
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Affiliation(s)
- Keren Cohen-Hagai
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Naomi Nacasch
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviad Sternschuss
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Meital Ohana
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Baruch Wolach
- Laboratory for Leukocyte Functions, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Gavrieli
- Laboratory for Leukocyte Functions, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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23
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Pasternak Y, Ohana M, Biron-Shental T, Cohen-Hagai K, Benchetrit S, Zitman-Gal T. Thioredoxin, thioredoxin interacting protein and transducer and activator of transcription 3 in gestational diabetes. Mol Biol Rep 2019; 47:1199-1206. [PMID: 31848914 DOI: 10.1007/s11033-019-05221-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 09/25/2019] [Accepted: 12/03/2019] [Indexed: 12/13/2022]
Abstract
To evaluate changes in the inflammatory response of thioredoxin (TXN), thioredoxin interacting protein (TXNIP), transducer and activator of transcription 3, NFƙB-p50 and STAT3 at the level of maternal serum, placenta, and umbilical cord blood of women with gestational diabetes mellitus type 2 (GDMA2) compared to normal pregnancies (NP). Thirty pregnant women (20 with GDMA2 and 10 NP) were recruited during admission for delivery. Blood samples were obtained from the parturients and umbilical cords, as well as placental tissue for mRNA and protein extraction. TXNIP mRNA expression was significantly increased in maternal serum of women with GDMA2 compared to NP women. TXNIP mRNA was significantly decreased in GDMA2 placentas and cord blood compared to NP. TXN/TXNIP mRNA ratio showed significantly high absolute values in placental and cord blood (2.39 and 1.66) respectively, compared to maternal ratio (1.084) (P < 0.001). TXN/TXNIP placenta protein ratio showed similar values between GDMA2 and NP (0.98 and 0.86; P = 0.7). STAT3 and its target protein SOCS3, as well as NFƙB-p50 mRNA expression were significantly increased in placentas of GDMA2. NFƙB-p50 mRNA expression was significantly decreased in cord blood compared to both maternal and placental mRNA expression. Pro-inflammatory changes are expressed by low mRNA TXN/TXNIP ratio in maternal blood of GDMA2 patients, but not in placental and umbilical cord blood samples. This, as well as the feedback role of SOCS3 in STAT3 pathway and NFƙB-p50 expression, may indicate that the placenta has a role in protecting the fetus from damage due to inflammatory response, which is common in diabetes.
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Affiliation(s)
- Yael Pasternak
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Meital Ohana
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tal Biron-Shental
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Keren Cohen-Hagai
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.
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24
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Zitman-Gal T, Einbinder Y, Ohana M, Katzav A, Kartawy A, Benchetrit S. Effect of liraglutide on the Janus kinase/signal transducer and transcription activator (JAK/STAT) pathway in diabetic kidney disease in db/db mice and in cultured endothelial cells. J Diabetes 2019; 11:656-664. [PMID: 30575282 DOI: 10.1111/1753-0407.12891] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/11/2018] [Accepted: 12/18/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Emerging evidence demonstrates the involvement of Janus tyrosine kinase/signal transducer and transcription activator (JAK/STAT) proteins in the pathophysiology of diabetic kidney disease (DKD). The JAK/STAT pathway is involved in the inflammatory response and endothelial cell dysfunction observed in DKD. The glucagon-like peptide-1 (GLP-1) analog liraglutide is an effective treatment for type 2 diabetes because it improves the inflammatory changes observed in experimental models of DKD. This study used db/db mice and endothelial cells (ECs) to determine the effect of diabetic environment on the JAK/STAT pathway and to assess the potential effect of liraglutide (200 μg/kg) in both models. METHODS Diabetic db/db mice (12 weeks old) were treated with liraglutide for 14 weeks. The kidneys were then perfused with saline and removed for mRNA, protein, and immunohistochemical analyses. Endothelial cells were stimulated advanced glycation end products (AGEs) (200 μg/μL) glucose (200 mg/dL) and liraglutide (100 nM) for 24 hours. Total RNA and protein were extracted and analyzed for expression of JAK/STAT signaling. RESULTS Phosphorylated (p-) STAT3 was significantly upregulated in db/db mice compared with non-diabetic mice. Liraglutide significantly downregulated p-STAT3 protein expression in db/db mice. In db/db mice, p-STAT3 was primarily expressed in the glomeruli, whereas p-JAK2 was also expressed in kidney tubules. In ECs, liraglutide treatment prevented increased expression of p-STAT3 and p-JAK2. Liraglutide inhibited the target gene suppressor of cytokine signaling 3 (SOCS3) and sirtuin 1 (SIRT1) in db/db mice and in cultured EC. CONCLUSIONS This study suggests that the GLP-1 analog liraglutide inhibits the JAK/STAT pathway, which participates in intracellular processes in experimental models of diabetes.
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Affiliation(s)
- Tali Zitman-Gal
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Einbinder
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Meital Ohana
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Aviva Katzav
- Department of Pathology, Meir Medical Center, Kfar Saba, Israel
| | - Amany Kartawy
- Department of Pathology, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Nephrology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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25
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Cohen-Hagai K, Nacasch N, Rozenberg I, Korzets Z, Einbinder Y, Zitman-Gal T, Benchetrit S. Clinical outcomes of stroke in hemodialysis patients: a retrospective single-center study. Int Urol Nephrol 2019; 51:1435-1441. [PMID: 31264088 DOI: 10.1007/s11255-019-02218-x] [Citation(s) in RCA: 4] [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] [Received: 04/11/2019] [Accepted: 06/18/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The incidence of stroke in patients undergoing hemodialysis (HD) is eight-to-ten times greater than that of the general population. However, data on the outcome of stroke in these patients are limited. METHODS In this retrospective observational cohort study, electronic medical records of all patients undergoing HD from 1.1.2014 to 31.12.2017 at Meir Medical Center, Israel, were reviewed. Stroke was defined as a focal neurological deficit of cerebrovascular origin, and confirmed as ischemic or hemorrhagic by computed tomography. Age- and sex-matched HD patients who did not experience a stroke (HD-NS) and hospitalized stroke patients with normal kidney function (NRF-S) served as the two control groups. Baseline demographic, clinical, and laboratory data were collected. Thrombolytic therapy, duration of hospital stay, and mortality were recorded. Functional status at discharge was assessed by the Modified Rankin Scale. RESULTS In the cohort study group (HD-S), 52 strokes occurred during 248.3 patient years, an incidence rate of 8.13%, and a stroke rate of 0.19% patients/month. Most strokes in HD patients were ischemic, and only four patients were administered tissue plasminogen activator. HD-S had longer hospitalization than did NRF-S (10.6 ± 9.9 vs. 5.96 ± 5.3 days, p = 0.004) and lower functional status at discharge (Rankin score 3.75 ± 1.57 vs. 2.29 ± 1.89, p < 0.001). HD-S patients had a higher mortality than both HD-NS and NRF-S patients. CONCLUSIONS Stroke outcome in these patients is dismal with prolonged hospital stay, poor functional status at discharge, very limited response to rehabilitation, and increased mortality.
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Affiliation(s)
- Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.
| | - Naomi Nacasch
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Rozenberg
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ze'ev Korzets
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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26
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Einbinder Y, Cohen-Hagai K, Shitrit P, Zitman-Gal T, Erez D, Benchetrit S, Korzets Z, Kotliroff A. ISPD guideline-driven retraining, exit site care and decreased peritonitis: a single-center experience in Israel. Int Urol Nephrol 2019; 51:723-727. [PMID: 30834483 DOI: 10.1007/s11255-019-02100-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 08/16/2018] [Accepted: 02/08/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE Evaluate the efficacy of retraining and catheter exit site care in reducing peritonitis rates. METHODS This interventional study included all prevalent PD patients from 1/2009 to 12/2017 from a single center. Peritonitis rates and causative organisms were assessed and compared in three periods: (1) Before intervention (01/2009-12/2014), (2) after educational intervention: assessment of training process by infection control nurse and repeat training every 3 months, after each peritonitis episode and after hospitalizations > 2 weeks (01/2015-02/2016), and (3) in addition to the measures in period 2, an exit site care protocol including postoperative care, topical antibacterial therapy and nasal Staph aureus screening and eradication was implemented (03/2016-12/2017). RESULTS The study included 201 patients (149 men, 52 women), mean age was 65.1 ± 12.6 years. After both interventions, including educational and exit site care strategies, peritonitis decreased significantly from 1.05 episodes per patient-year (n = 113) to 0.67 (n = 54); P = 0.017 between periods 1 and 3. The percentage of peritonitis-free patients increased from 27.4 to 52.4 and 55.6%, respectively (P = 0.001 between period 1 vs. 2 and period 1 vs. 3.). Coagulase-negative staph was the most common pathogen, causing 7.56 peritonitis episodes per year, followed by pseudomonas at 4.33 episodes annually and staph aureus at 3.44 episodes per year. CONCLUSIONS Enforcement of an educational program and strict adherence to an exit site care protocol was associated with a significant decrease in peritonitis rates.
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Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Pnina Shitrit
- Infection Control Unit, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Erez
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ze'ev Korzets
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andy Kotliroff
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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27
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Cohen-Hagai K, Kotliroff A, Rozenberg I, Korzets Z, Zitman-Gal T, Benchetrit S. Effectiveness of Influenza Vaccine in Hemodialyzed Patients: A Retrospective Study. Ther Apher Dial 2018; 23:38-43. [PMID: 30125465 DOI: 10.1111/1744-9987.12742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 11/19/2017] [Revised: 05/13/2018] [Accepted: 06/19/2018] [Indexed: 11/28/2022]
Abstract
Infection is one of the leading causes of mortality in dialysis patients, second only to cardiovascular disease. This retrospective study assessed the efficacy and clinical outcomes of influenza vaccination among hemodialysis (HD) patients. In the 2014-2015 season, 104 of 164 (63.6%) HD patients were vaccinated for influenza by the outpatient community health system facilities. Significantly more patients, 159 of 170 (93.8%), were vaccinated in 2015-2016 by the hospital dialysis unit staff during an inpatient HD session (P <0.001). A trend toward fewer complications from influenza infection was observed in vaccinated patients. Among HD patients with diabetes (who comprised 56% of the study population), the incidence of influenza was 17% among nonvaccinated patients vs. 6.3% among those who were vaccinated (P =0.026). The inpatient vaccination policy resulted in a greater rate of vaccination. HD patients with diabetes benefit from influenza vaccination, with a significantly lower incidence of influenza infection.
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Affiliation(s)
- Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Andy Kotliroff
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Rozenberg
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Zeev Korzets
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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28
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Einbinder Y, Agur T, Davidov K, Zitman-Gal T, Golan E, Benchetrit S. Anemia Management among Hemodialysis Patients with High Ferritin Levels. Isr Med Assoc J 2018; 20:405-411. [PMID: 30109787] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Anemia management strategies among chronic hemodialysis patients with high ferritin levels remains challenging for nephrologists. OBJECTIVES To compare anemia management in stable hemodialysis patients with high (≥ 500 ng/ml) vs. low (< 500 ng/ml) ferritin levels. METHODS In a single center, record review, cohort study of stable hemodialysis patients who were followed for 24 months, an anemia management policy was amended to discontinue intravenous (IV) iron therapy for stable hemodialysis patients with hemoglobin > 10 g/dl and ferritin ≥ 500 ng/ml. Erythropoiesis-stimulating-agents (ESA), IV iron doses, and laboratory parameters were compared among patients with high vs. low baseline ferritin levels before and after IV iron cessation. RESULTS Among 87 patients, 73.6% had baseline ferritin ≥ 500 ng/ml. Weekly ESA dose was greater among patients with high vs. low ferritin (6788.8 ± 4727.8 IU/week vs. 3305.0 ± 2953.9 IU/week, P = 0.001); whereas, cumulative and monthly IV iron doses were significantly lower (1628.2 ± 1491.1 mg vs. 2557.4 ± 1398.9 mg, P = 0.011, and 82.9 ± 85 vs. 140.7 ± 63.9 mg, P = 0.004). Among patients with high ferritin, IV iron was discontinued for more than 3 months in 41 patients (64%) and completely avoided in 6 (9.5%).ESA dose and hemoglobin levels did not change significantly during this period. CONCLUSIONS Iron cessation in chronic hemodialysis patients with high ferritin levels did not affect hemoglobin level or ESA dose and can be considered as a safe policy for attenuating the risk of chronic iron overload.
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Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Timna Agur
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Kirill Davidov
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eliezer Golan
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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29
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Einbinder Y, Biron-Shental T, Agassi-Zaitler M, Tzadikevitch-Geffen K, Vaya J, Khatib S, Ohana M, Benchetrit S, Zitman-Gal T. High-density lipoproteins (HDL) composition and function in preeclampsia. Arch Gynecol Obstet 2018; 298:405-413. [PMID: 29938347 DOI: 10.1007/s00404-018-4824-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 03/27/2018] [Accepted: 06/13/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate (a) the properties of high-density lipoproteins (HDL)/cholesterol, which include apolipoprotein A-1 (ApoA1) and paraoxonase1 (PON1), both are negative predictors of cardiovascular risk and (b) HDL function, among women with preeclampsia (PE). PE is a multi-system disorder, characterized by onset of hypertension and proteinuria or other end-organ dysfunction in the second half of pregnancy. Preeclampsia is associated with increased risk for later cardiovascular disease. The inverse association between HDL, cholesterol levels and the risk of developing atherosclerotic cardiovascular disease is well-established. METHODS Twenty-five pregnant women [19 with PE and 6 with normal pregnancy (NP)] were recruited during admission for delivery. HDL was isolated from blood samples. PON1 activity and HDL were analyzed. An in vitro model of endothelial cells was used to evaluate the effect of HDL on the transcription response of vascular cell adhesion molecule-1 (VCAM-1) and endothelial nitric oxide synthase (eNOS) mRNA expression. RESULTS PON1 activity (units/ml serum) was lower in the PE group compared to normal pregnancy (NP) (6.51 ± 0.73 vs. 9.98 ± 0.54; P = 0.015). Increased ApoA1 was released from PE-HDL as compared to NP-HDL (3.54 ± 0.72 vs. 0.89 ± 0.35; P = 0.01). PE-HDL exhibited increased VCAM-1 mRNA expression and decreased eNOS mRNA expression on TNF-α stimulated endothelial cells as compared to NP-HDL. CONCLUSIONS HDL from women with PE reduced PON1 activity and increased ApoA1 release from HDL particles. This process was associated with increased HDL diameter, suggesting impaired HDL anti-oxidant activity. These changes might contribute to higher long-term cardiovascular risks among women with PE.
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Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Biron-Shental
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
| | | | - Keren Tzadikevitch-Geffen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
| | - Jacob Vaya
- Laboratory of Oxidative Stress and Human Diseases, Migdal-Galilee Technology Center, Tel Hai College, Kiryat Shmona, Israel
| | - Soliman Khatib
- Laboratory of Oxidative Stress and Human Diseases, Migdal-Galilee Technology Center, Tel Hai College, Kiryat Shmona, Israel
| | - Meital Ohana
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, 44281, Kfar Saba, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Abstract
BACKGROUND The third-generation bio-intact parathyroid hormone (PTH) (1-84) assay was designed to overcome problems associated with the detection of C-terminal fragments by the second-generation intact PTH assay. The two assays have been compared primarily among dialysis populations. The present study evaluated the correlations and differences between these two PTH assays among patients with chronic kidney disease (CKD) stages 3 to 5 not yet on dialysis. METHODS Blood samples were collected from 98 patients with CKD stages 3 to 5. PTH concentrations were measured simultaneously by using the second-generation - PTH intact-STAT and third-generation bio-intact 1-84 PTH assays. Other serum biomarkers of bone mineral disorders were also assessed. CKD stage was calculated by using the CKD-Epidemiology Collaboration (EPI) formula. RESULTS Serum bio-intact PTH concentrations were strongly correlated but significantly lower than the intact PTH concentrations (r=0.963, P<0.0001). This finding was consistent among CKD stages 3 to 5. PTH concentrations by both assays (intact and bio-intact PTH) positively correlated with urea (r=0.523, r=0.504; P=0.002, respectively), phosphorus (r=0.532, r=0.521; P<0.0001, respectively) and negatively correlated with blood calcium (r=-0.435, r=-0.476; P<0.0001, respectively), 25(OH) vitamin D, (r=-0.319, r=-0.353; respectively, P<0.0001) and the estimated glomerular filtration rate (r=-0.717, r=-0.688; P<0.0001, respectively). CONCLUSIONS Among patients with CKD stages 3 to 5 not on dialysis, the bio-intact PTH assay detected significantly lower PTH concentrations compared with intact PTH assay. Additional studies that correlate the diagnosis and management of CKD mineral and bone disorders with bone histomorphometric findings are needed to determine whether bio-intact PTH assay results are better surrogate markers in these early stages of CKD.
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Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eliezer Golan
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Cohen-Hagai K, Rashid G, Ohana M, Benchetrit S, Zitman-Gal T. [THE EFFECT OF VITAMIN D ON THE EXPRESSION OF ADAMTS13 IN CULTURED ENDOTHELIAL CELLS EXPOSED TO A DIABETIC-LIKE ENVIRONMENT]. Harefuah 2017; 156:486-489. [PMID: 28853522] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is the leading cause of end-stage kidney disease. Inflammation, fibrosis, coagulability and oxidative stress exacerbate kidney disease. The glycoprotein, Von Willebrand Factor (VWF) has a crucial role in platelet thrombus formation. The enzyme ADAMTS13 is responsible for VWF cleavage. Both are important in the interface between diabetic nephropathy, hypercoagulability and atherosclerotic cardiovascular disease. Vitamin D inhibits endothelial proliferation, blunts angiogenesis and is a cardioprotective agent. This study evaluated the role of vitamin D on ADAMTS13 activity in human umbilical vein endothelial cells (HUVEC) exposed to a diabetic-like environment. METHODS HUVEC were stimulated with 200µg/µl AGE-HSA, 250mg/dl glucose, and 10-10mol/l vitamin D for 24 hours. Western blot and ELISA techniques were used to determine ADAMTS13 protein expression and IL6 and IL8 protein secretion. RESULTS ADAMTS13 protein expression decreased and IL6 and IL8 protein secretion increased in HUVEC exposed to a diabetic-like environment. The addition of vitamin D significantly down-regulated IL6 and IL8 secretion and up-regulated ADAMST13 expression. CONCLUSIONS Decreased ADAMTS13 expression in HUVEC exposed to a diabetic-like environment may contribute to the pathogenesis of hypercoagulability observed in DM. Normalization of ADAMTS13 by vitamin D may contribute to improvement in hypercoagulability.
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Affiliation(s)
- Keren Cohen-Hagai
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Gloria Rashid
- Medical Laboratories, Meir Medical Center, Kfar Saba, Israel
| | - Meital Ohana
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Tali Zitman-Gal
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
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Einbinder Y, Biron-Shental T, Agassi-Zaitler M, Tzadikevitch-Geffen K, Vaya J, Khatib S, Ohana M, Benchetrit S, Zitman-Gal T. MP050IDENTIFYING HDL COMPOSITION AND FUNCTION IN PREECLAMPTIC AND NORMAL PREGNANCIES. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx161.mp050] [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: 11/15/2022] Open
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Cohen-Hagai K, Rashid G, Einbinder Y, Ohana M, Benchetrit S, Zitman-Gal T. Effect of Vitamin D Status on Von Willebrand Factor and ADAMTS13 in Diabetic Patients on Chronic Hemodialysis. Ann Lab Med 2017; 37:155-158. [PMID: 28029003 PMCID: PMC5203994 DOI: 10.3343/alm.2017.37.2.155] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/29/2016] [Accepted: 12/08/2016] [Indexed: 11/25/2022] Open
Abstract
Von Willebrand factor (vWF) is a glycoprotein with a crucial role in the formation of platelet thrombi, and ADAMTS13 is the main enzyme responsible for vWF cleavage. Both are important in the relationship between diabetic nephropathy, hypercoagulability, and cardiovascular disease. This study evaluated a potential relationship between vitamin D (vitD) levels, vWF, ADAMTS13 activity, and inflammation in diabetic patients on chronic hemodialysis (HD). Blood samples from 52 diabetic patients on chronic HD were obtained to determine vitD levels, vWF, and ADAMTS13 activity, and inflammatory markers. HD patients were grouped according to 25-hydroxyvitamin D [25(OH) VitD]<25 nmol/L (n=16) or >25 nmol/L (n=36). vWF antigen and vWF activity were elevated in both groups, with an average of 214.3±82.6% and 175.8±72.6%, respectively. Average ADAMTS13 activity was within the normal range in both groups. Blood samples from the vitD <25 nmol/L group showed a positive correlation between c-reactive protein (CRP) and vWF levels (P=0.023; r=0.564; 95% confidence interval=0.095-0.828), with a negative correlation between HbA1c and 25(OH) VitD (P=0.015; r=-0.337; 95% confidence interval=-0.337-0.19). Diabetic patients on chronic HD had elevated vWF levels and activity with no significant change in ADAMTS13 activity. The correlation between CRP and vWF levels in the 25(OH) VitD<25 nmol/L group suggests inflammatory-related endothelial dysfunction in these patients.
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Affiliation(s)
- Keren Cohen-Hagai
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Gloria Rashid
- Medical Laboratories, Meir Medical Center, Kfar Saba, Israel
| | - Yael Einbinder
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Meital Ohana
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Sydney Benchetrit
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Einbinder Y, Ohana M, Benchetrit S, Zehavi T, Nacasch N, Bernheim J, Zitman-Gal T. Glucagon-like peptide-1 and vitamin D: anti-inflammatory response in diabetic kidney disease in db/db mice and in cultured endothelial cells. Diabetes Metab Res Rev 2016; 32:805-815. [PMID: 26991522 DOI: 10.1002/dmrr.2801] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/01/2016] [Accepted: 03/08/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Glucagon-like peptide-1 (GLP-1) is a gut incretin hormone that stimulates insulin secretion and may affect the inflammatory pathways involved in diabetes mellitus. Calcitriol, an active form of vitamin D, plays an important role in renal, endothelial and cardiovascular protection. We evaluated the anti-inflammatory and histologic effects of a GLP-1 analogue (liraglutide) and of calcitriol in a db/db mouse diabetes model and in endothelial cells exposed to a diabetes-like environment. METHODS Diabetic db/db mice were treated with liraglutide and calcitriol for 14 weeks, after which the kidneys were perfused and removed for mRNA and protein analysis and histology. Endothelial cells were stimulated with advanced glycation end products (AGEs), glucose, liraglutide and calcitriol. Total RNA and protein were extracted and analysed for the expression of selected inflammatory markers. RESULTS Typical histological changes, glomerular enlargement and mesangial expansion were seen in db/db mice compared with control mice. Glomerular hypertrophy was ameliorated with liraglutide, compared with db/db controls. Liraglutide up-regulated endothelial nitric oxide synthase protein expression compared with the db/db control group and down-regulated p65 protein expression. Calcitriol did not further improve the beneficial effect observed on protein expression. In endothelial cells, liraglutide treatment exhibited a dose-dependent ability to prevent an inflammatory response in the selected markers: thioredoxin-interacting protein, p65, IL6 and IL8. In most gene and protein expressions, addition of calcitriol did not enhance the effect of liraglutide. CONCLUSIONS The GLP-1 analogue liraglutide prevented the inflammatory response observed in endothelial cells exposed to a diabetes-like environment and in db/db mice at the level of protein expression and significantly ameliorated the glomerular hypertrophy seen in the diabetic control group. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Yael Einbinder
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Meital Ohana
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tania Zehavi
- Pathology Department, Meir Medical Center, Kfar Saba, Israel
| | - Naomi Nacasch
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacques Bernheim
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.
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Cohen-Hagai K, Rozenberg I, Korzets Z, Zitman-Gal T, Einbinder Y, Benchetrit S. Upper Respiratory Tract Infection among Dialysis Patients. Isr Med Assoc J 2016; 18:557-560. [PMID: 28471606] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Upper respiratory tract infection (URTI) occurs frequently in the general population and is considered a benign self-limited disease. Dialysis patients constitute a high risk population whose morbidity and mortality rate as a result of URTI is unknown. OBJECTIVES To assess the local incidence, morbidity and mortality of URTI in dialysis patients compared to the general population. METHODS In this retrospective cohort study we reviewed the charts of all chronic dialysis patients diagnosed with URTI at Meir Medical Center, Kfar Saba, Israel during the 2014-2015 winter season. RESULTS Among 185 dialysis patients, 40 were found to be eligible for the study. The average age was 66.1 ± 15.7 years, and the co-morbidity index was high. Influenza A was the most common pathogen found, followed by rhinovirus, respiratory syncytial virus and para-influenza. Of the 40 patients 21 (52.5%) developed complications: pneumonia in 20%, hospitalization in 47.5%, and respiratory failure requiring mechanical ventilation in 12.5%. Overall mortality was 10%. General population data during the same seasonal period showed a peak pneumonia incidence of 4.4% compared to 20% in the study population (P < 0.0001). CONCLUSIONS The study findings show that compared to the general population, URTI in dialysis patients is a much more severe disease and has a higher complication rate. Influenza A, the most common pathogen, is associated with a worse prognosis.
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Affiliation(s)
- Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Hospital, Kfar Saba, Israel
| | - Ilan Rozenberg
- Department of Nephrology and Hypertension, Meir Hospital, Kfar Saba, Israel
| | - Ze'ev Korzets
- Department of Nephrology and Hypertension, Meir Hospital, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Hospital, Kfar Saba, Israel
| | - Yael Einbinder
- Department of Nephrology and Hypertension, Meir Hospital, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Hospital, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Cohen-Hagai K, Rashid G, Einbinder Y, Ohana M, Benchetrit S, Zitman-Gal T. MP564THE EFFECT OF VITAMIN D STATUS ON ADAMTS13 AND VON WILLEBRAND FACTOR IN DIABETIC PATIENTS ON CHRONIC HEMODIALYSIS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw196.43] [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: 11/12/2022] Open
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37
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Zitman-Gal T, Ohana M, Einbinder Y, Bernheim J, Benchetrit S. FP455THE EFFECTS OF GLUCAGON-LIKE-PEPTIDE 1 AND VITAMIN D ON THE INFLAMMATORY RESPONSE OF ENDOTHELIAL CELLS EXPOSED TO A DIABETIC-LIKE ENVIRONMENT. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv178.15] [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: 11/12/2022] Open
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Zitman-Gal T, Green J, Korzets Z, Bernheim J, Benchetrit S. Kruppel-like factors in an endothelial and vascular smooth muscle cell coculture model: impact of a diabetic environment and vitamin D. In Vitro Cell Dev Biol Anim 2015; 51:470-8. [PMID: 25743914 DOI: 10.1007/s11626-014-9858-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 12/08/2014] [Indexed: 11/25/2022]
Abstract
Endothelial cells (EC) and vascular smooth muscle cells (VSMC) are involved in the development of local and diffuse vasculopathies by participating in inflammatory processes that can lead to uncontrolled vascular complications. Our aim was to study the possible interactions of EC and VSMC in an in vitro coculture model exposed to diabetic-like conditions and the effect of vitamin D on cellular pathways that might lead to an inflammatory response. EC and VSMC were isolated from different umbilical cords and stimulated in an in vitro coculture model in a diabetic-like environment and calcitriol for 24 h. Total RNA and protein were extracted from cells and analyzed for the expression of selected inflammatory-related markers. The EC-VSMC coculture in a diabetic-like environment induced the expression of inflammatory markers such as Kruppel-like factors, thioredoxin-interacting protein (TXNIP), IL-6, and IL-8. Addition of vitamin D to the EC-VSMC coculture induced selective changes in the inflammatory response. This model could lead to a better understanding of the interactions between EC and VSMC in the inflammatory processes involved in diabetes and emphasizes the role of vitamin D in the inflammatory response. The use of different donors strengthens the significance of our findings showing that genetic variations do not affect the impact of vitamin D on the expression of inflammatory-related proteins in our model.
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Affiliation(s)
- Tali Zitman-Gal
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, 44281, Israel,
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Zitman-Gal T, Green J, Pasmanik-Chor M, Golan E, Bernheim J, Benchetrit S. Vitamin D manipulates miR-181c, miR-20b and miR-15a in human umbilical vein endothelial cells exposed to a diabetic-like environment. Cardiovasc Diabetol 2014; 13:8. [PMID: 24397367 PMCID: PMC3893386 DOI: 10.1186/1475-2840-13-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 12/11/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND High blood and tissue concentrations of glucose and advanced glycation end-products are believed to play an important role in the development of vascular complications in patients with diabetes mellitus (DM) and chronic kidney disease. MicroRNAs (miRNA) are non-coding RNAs that regulate gene expression in a sequence specific manner. MiRNA are involved in various biological processes and become novel biomarkers, modulators and therapeutic targets for diseases such as cancer, atherosclerosis, and DM. Calcitriol (the active form of vitamin D) may inhibit endothelial proliferation, blunt angiogenesis, and be a cardioprotective agent. Calcitriol deficiency is a risk factor for DM and hypertension. The aim of this project was to study the miRNA microarray expression changes in human umbilical vein endothelial cells (HUVEC) treated in a diabetic-like environment with the addition of calcitriol. METHODS HUVEC were treated for 24 h with 200 μg/ml human serum albumin (HSA) and 100 mg/dl glucose (control group) or 200 μg/ml AGE-HSA, and 250 mg/dl glucose (diabetic-like environment), and physiological concentrations (10-10 mol/l) of calcitriol. miRNA microarray analysis and real time PCR to validate the miRNA expression profile and mRNA target gene expression were carried out. RESULTS Compared to control, 31 mature human miRNA were differentially expressed in the presence of a diabetic-like environment. Addition of physiological concentrations of calcitriol revealed 39 differentially expressed mature human miRNA. MiR-181c, miR-15a, miR-20b, miR-411, miR-659, miR-126 and miR-510 were selected for further analysis because they are known to be modified in DM and in other biological disorders. The predicted targets of these miRNA (such as KLF6, KLF9, KLF10, TXNIP and IL8) correspond to molecular and biological processes such as immune and defense responses, signal transduction and regulation of RNA. CONCLUSION This study identified novel miRNA in the field of diabetic vasculopathy and might provide new information about the effect of vitamin D on gene regulation induced by a diabetic-like environment. New gene targets that are part of the molecular mechanism and the therapeutic treatment in diabetic vasculopathy are highlighted.
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Affiliation(s)
- Tali Zitman-Gal
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba 44281, Israel.
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Blanco-Gozalo V, Blazquez-Medela A, Garcia-Sanchez O, Quiros Y, Montero M, Martinez-Salgado C, Lopez-Hernandez F, Lopez-Novoa J, Yao L, Qing Z, Hua X, Min F, Fei M, Ning W, Cantaluppi V, Figliolini F, Delena M, Beltramo S, Medica D, Tetta C, Segoloni G, Biancone L, Camussi G, Cunha JS, Ferreira VM, Naves MA, Boim MA, Zitman-Gal T, Golan E, Green J, Pasmanik-Chor M, Bernheim J, Benchetrit S, Riera M, Clotet S, Pascual J, Soler M, Nakai K, Fujii H, Kono K, Goto S, Hirata M, Shinohara M, Fukagawa M, Nishi S, Fan Q, Du S, Jiang Y, Wang L, Fang L, Radovits T, Mozes MM, Rosivall L, Kokeny G, Aoki R, Tateoka R, Sekine F, Kikuchi K, Yamashita Y, Itoh Y, Cappuccino L, Garibotto G, D'Amato E, Villaggio B, Gianiorio F, Mij M, Viazzi F, Salvidio G, Verzola D, Piwkowska A, Rogacka D, Audzeyenka I, Kasztan M, Angielski S, Jankowski M, Gaber EW, El-Attar HA, Liu J, Zhang W, He Y, Rogacka D, Piwkowska A, Audzeyenka I, Angielski S, Jankowski M, Macsai E, Takats Z, Derzbach L, Korner A, Vasarhelyi B, Huang MS, Bo H, Liu F, Fu P, Tsotakos NE, Tsilibary EC, Drossopoulou GI, Thawho N, Farid N, Peleg A, Levy A, Nakhoul N, Lenghel AR, Borza G, Catoi C, Bondor CI, Muresan A, Kacso IM, Song JS, Song JH, Ahn SH, Choi BS, Hong YA, Kim MY, Lim JH, Yang KS, Chung S, Shin SJ, Kim HW, Chang YS, Kim YS, Park CW, Takayanagi K, Hasegawa H, Shimizu T, Ikari A, Noiri C, Iwashita T, Tayama Y, Asakura J, Anzai N, Kanozawa K, Kato H, Mitarai T, Huang M, Bo H, Liu F, Fu P, Ashour RH, Fouda AEMM, Saad MA, El-Banna FM, Moustafa FA, Fouda MI, Sanchez-Nino MD, Sanz AB, Poveda J, Saleem M, Mathieson P, Ruiz-Ortega M, Selgas R, Egido J, Ortiz A, Clotet S, Soler MJ, Rebull M, Pascual J, Riera M, Marquez E, Riera M, Pascual J, Soler MJ, Asakura J, Hasegawa H, Takayanagi K, Tayama Y, Shimizu T, Iwashita T, Okazaki S, Kogure Y, Sano T, Hatano M, Kanozawa K, Kato H, Mitarai T, Kreft E, Kowalski R, Kasztan M, Jankowski M, Szczepansk-Konkel M, Fan Q, Liu X, Yang G, Jiang Y, Wang L, Osman NA, NasrAllah MM, Kamal MM, Ahmed AI, Fekih-Mrissa N, Mrad M, Baffoun A, Sayeh A, Hmida J, Gritli N, Galchinskaya V, Topchii I, Semenovykh P, Yefimova N, Zheng D, Hu D, Li X, Peng AI, Olea-Herrero N, Arenas M, Munoz-Moreno C, Moreno-Gomez-Toledano R, Gonzalez-Santander M, Arribas I, Bosch R. Diabetes - experimental models. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft137] [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: 11/14/2022] Open
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Benchetrit S, Green J, Bernheim J, Golan E, Zitman-Gal T. Concurrent evaluation of PTH in hemodialysis patients using N-tact-IRMA and third generation Liaison 1–84 PTH (DiaSorin). Clin Biochem 2013; 46:395-6. [DOI: 10.1016/j.clinbiochem.2012.12.009] [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] [Received: 10/18/2012] [Revised: 12/07/2012] [Accepted: 12/10/2012] [Indexed: 10/27/2022]
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Zitman-Gal T, Golan E, Green J, Bernheim J, Benchetrit S. Vitamin D receptor activation in a diabetic-like environment: potential role in the activity of the endothelial pro-inflammatory and thioredoxin pathways. J Steroid Biochem Mol Biol 2012; 132:1-7. [PMID: 22531461 DOI: 10.1016/j.jsbmb.2012.04.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 03/27/2012] [Accepted: 04/06/2012] [Indexed: 11/16/2022]
Abstract
High blood and tissue concentrations of glucose and advanced glycation end products (AGEs) are thought to play an important role in the development of diabetic vascular complications. Thioredoxin interacting protein (TXNIP) is up-regulated in response to high levels of glucose and is an endogenous inhibitor of thioredoxin (TRX), and may play a contributory role in the occurrence of diabetic-related vascular diseases. Vitamin D inhibits endothelial proliferation and is a cardiovascular protective agent. The present study evaluated the impact of paricalcitol and calcitriol on the endothelial inflammatory and TXNIP pathways in cultured endothelial cells exposed to a diabetic-like environment. Fresh human umbilical vein cord endothelial cells (HUVEC) were treated for 24h with 200 μg/ml AGE-HSA and 250 mg/dl glucose concentrations, with paricalcitol or calcitriol. IL6, IL8, NFκB (p50/p65), receptor of AGE (RAGE), TXNIP, and TRX expressions were evaluated at the levels of mRNA, protein, and TRX activity. Calcitriol and paricalcitol significantly down-regulated the markers involved in the inflammatory responses. Only paricalcitol induced a significant decrease in TXNIP mRNA and protein expressions. Neither paricalcitol nor calcitriol affected TRX reductase activity or TRX mRNA and protein expressions. Our findings indicate that in an endothelial diabetic-like environment, paricalcitol and calcitriol significantly decreased the expression of genes involved in the inflammatory pathway. In this in vitro study, it seems that the TRX antioxidant system was not involved. The different effects found between paricalcitol and calcitriol might reflect the selectivity of vitamin D receptor (VDR) activation.
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Affiliation(s)
- T Zitman-Gal
- Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.
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Kang KP, Lee JE, Lee AS, Jung YJ, Lee S, Park SK, Kim W, Pokrywczynska M, Jundzill A, Krzyzanowska S, Flisinski M, Brymora A, Bodnar M, Deptula A, Marszalek A, Manitius J, Drewa T, Kloskowski T, Grosjean F, Esposito V, Torreggiani M, Esposito C, Zheng F, Vlassara H, Striker G, Michael S, Viswanathan P, Ganesh R, Kimachi M, Nishio S, Nakazawa D, Ishikawa Y, Toyoyama T, Satou A, Nakagaki T, Shibasaki S, Atumi T, Gattone V, Peterson R, Zimmerman K, Mega C, Reis F, Teixeira de Lemos E, Vala H, Fernandes R, Oliveira J, Teixeira F, Reis F, Niculae A, Niculae A, Checherita IA, Ciocalteu A, Hamano Y, Udagawa Y, Ueda Y, Yokosuka O, Ogawa M, Satoh M, Kidokoro K, Nagasu H, Nishi Y, Ihoriya C, Kadoya H, Yada T, Channon KM, Sasaki T, Kashihara N, Nyengaard JR, Razga Z, Hartono S, Knudsen B, Grande J, Watanabe M, Watanabe M, Ito K, Abe Y, Ogahara S, Nakashima H, Sato T, Saito T, Shin YT, Choi DE, Na KR, Chang YK, Kim SS, Lee KW, Mace C, Chugh S, Clement L, Tomochika M, Seiji H, Toshio M, Tetsuya K, Takao K, Jaen JC, Sullivan TJ, Miao Z, Zhao N, Berahovich R, Krasinski A, Powers JP, Ertl L, Schall TJ, Han SY, Sun HK, Han KH, Kim HS, Ahn SH, Kokeny G, Gasparics A, Fang L, Rosivall L, Sebe A, Banki NF, Fekete A, Wagner L, Ver A, Degrell P, Prokai A, George R, Szabo A, Baylis C, Vannay A, Tulassay T, Chollet C, Hus-Citharel A, Caron N, Bouby N, Silva K, Rampaso R, Luiz R, De Angelis K, Mostarda CT, Abreu N, Irigoyen MC, Schor N, Rampaso R, Luiz R, Silva K, Montemor J, Higa EMS, Schor N, Nagasu H, Satoh M, Kidokoro K, Kashihara N, Nakayama Y, Fukami K, Obara N, Ando R, Kaida Y, Ueda S, Yamagishi SI, Okuda S, Qin Q, Wang Z, Niu J, Xu W, Qiao Z, Qi W, Gu Y, Zitman-Gal T, Golan E, Green J, Pasmanik-Chor M, Oron-Karni V, Bernheim J, Benchetrit S, Tang RN, Tang RN, Wu M, Gao M, Liu H, Zhang XL, Liu BC. Diabetes - Experimental. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs220] [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: 11/15/2022] Open
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Zitman-Gal T, Green J. Vitamin D and Vascular Smooth Muscle Cells: Gene Modulation Following Exposure to a Diabetic-Like Environment. ACTA ACUST UNITED AC 2012. [DOI: 10.4172/2155-6156.1000218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lopez-Parra V, Mallavia B, Oguiza A, Recio C, Egido J, Gomez-Guerrero C, Ito M, Nishio S, Koike T, Takayanagi K, Hasegawa H, Shimizu T, Asakura J, Iwashita T, Tayama Y, Hara H, Inamura M, Kanozawa K, Kato H, Mitarai T, Sanchez-Nino MD, Sanchez-Lopez E, Sanz AB, Ruiz-Ortega M, Saleem MA, Mathieson PW, Mezzano S, Egido J, Ortiz A, Liu L, Hu X, Cai GY, Lv Y, Zhuo L, Gao JJ, Cui SY, Feng Z, Fu B, Chen XM, Zaladek Gil F, Costa MC, Hirata AE, Camara NO, Chen JS, Chang LC, Shieh YS, Wu CC, Zhang L, Gu Y, Lin S, Buraczynska M, Zukowski P, Kuczmaszewska A, Ksiazek A, Kimachi M, Ito M, Sato A, Nakagaki T, Nakazawa D, Ishikawa Y, Shibasaki S, Nishio S, Koike T, Ahn EM, Choi JY, Shin JI, Ha TS, Buraczynska M, Zukowski P, Mozul S, Dragan M, Lumi Z, Liu J, Xiufen Z, Jun Q, Changying X, Zitman-Gal T, Green J, Bernheim J, Benchetrit S, Watanabe M, Nakashima H, Abe Y, Ito K, Sato T, Saito T, Riera M, Marquez E, Rigol J, Roca H, Pascual J, Soler MJ, Aizawa K, Hirata M, Moriguchi Y, Iehara N, Terada M, Matsubara T, Araki M, Torikoshi K, Doi T, Fukatsu A. Diabetes - Basic research. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.34] [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: 11/15/2022] Open
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Zitman-Gal T, Green J, Pasmanik-Chor M, Oron-Karni V, Bernheim J. Endothelial pro-atherosclerotic response to extracellular diabetic-like environment: Possible role of thioredoxin-interacting protein. Nephrol Dial Transplant 2010; 25:2141-9. [DOI: 10.1093/ndt/gfp768] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [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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