Value of autotaxin in predicting refractory Mycoplasma pneumoniae pneumonia in children and its correlation with inflammatory cytokines / 中国当代儿科杂志

OBJECTIVES@#To study the value of autotaxin (an autocrine motility factor) level in serum and bronchoalveolar lavage fluid (BALF) in predicting refractory Mycoplasma pneumoniae pneumonia (RMPP) in children and its correlation with interleukin-6 (IL-6), interleukin-8 (IL-8), and C-reactive protein (CRP).@*METHODS@#A retrospective analysis was performed on 238 children with Mycoplasma pneumoniae pneumonia who were admitted from January 2019 to December 2021. According to disease severity, they were divided into two groups: RMPP (n=82) and general Mycoplasma pneumoniae pneumonia (GMPP; n=156). The two groups were compared in terms of the levels of autotaxin, IL-6, IL-8, and CRP in serum and BALF to study the value of autotaxin level in serum and BALF in predicting RMPP in children, as well as the correlation of autotaxin level with IL-6, IL-8, and CRP in children with RMPP.@*RESULTS@#Compared with the GMPP group, the RMPP group had significantly higher levels of autotaxin, IL-6, IL-8, and CRP in serum and BALF (P<0.05). For the children with RMPP, the levels of autotaxin, IL-6, IL-8, and CRP in serum and BALF in the acute stage were significantly higher than those in the convalescent stage (P<0.05). The receiver operating characteristic (ROC) curve showed that the level of autotaxin in serum and BALF had a good value in predicting RMPP in children, with an area under the curve of 0.874 (95%CI: 0.816-0.935) and 0.862 (95%CI: 0.802-0.924), respectively. The correlation analysis showed that the level of autotaxin in serum and BALF was positively correlated with IL-6, IL-8, and CRP levels (P<0.001).@*CONCLUSIONS@#The level of autotaxin in serum and BALF increases and is correlated with the degree of disease recovery and inflammatory cytokines in children with RMPP. Autotaxin can be used as a predictive indicator for RMPP in children.

Clinical efficacy and safety of sequential treatment with alprostadil and beraprost sodium for chronic renal failure induced by chronic glomerulonephritis / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of sequential treatment with alprostadil and beraprost sodium for chronic renal failure caused by chronic glomerulonephritis.</p><p><b>METHODS</b>Sixty-three patients with chronic renal failure due to chronic glomerulonephritis, after receiving a 2-week-long conventional treatment, were randomly divided into alprostadil group (n=20, with alprostadil injection at 10 µg/d for 2 weeks), sequential treatment group (n=21, with alprostadil injection at 10 µg/d for 2 weeks and oral beraprost sodium at 20 µg three times a day for 12 weeks), and strengthened sequential treatment group (n=22, with alprostadil injection at 20 µg/d for 2 weeks and a double dose of oral beraprost sodium for 12 weeks). Urinary albumin excretion rate (UAER), cystatin C (Cys C), blood urea nitrogen, creatinine, fibrinogen, D-dimer, prothrombin time (PT), and platelets were tested before and after the treatment, and the changes in urinary albumin discharge rate, serum creatinine, and glomerular filtration rate were determined.</p><p><b>RESULTS</b>The patients in strengthened sequential treatment group showed a significantly decreased change rate of urinary albumin discharge rate (P<0.01) than those in the other two groups. In the two sequential treatment groups, especially the strengthened treatment group, the change rate of glomerular filtration rate increased significantly compared with that in alprostadil group (P<0.01). Strengthened sequential treatment resulted also in significantly decreased increment of serum creatinine compared that in the other 2 groups (P<0.01). After 14 weeks of treatment, fibrinogen and D-dimer were decreased in all the 3 groups (P<0.05) to a comparable level between the 3 groups (P>0.05), and prothrombin time (PT) or platelet showed no significant changes (P>0.05).</p><p><b>CONCLUSION</b>Sequential treatment with alprostadil and beraprost sodium can improve the glomerular filtration rate and decrease urine albumin excretion rate, serum creatinine increase rate, and lower blood fibrinogen and D-dimer levels, thus delaying the progression of chronic renal failure caused by chronic glomerulonephritis. This therapy shows a dose-related effect with good clinical safety.</p>

Effects of erythropoietin on complement 3 and epithelial-to-mesenchymal transition of renal tissue in unilateral uretreal obstructire rats / 中国药学杂志

OBJECTIVE: To investigate the effects of erythropoietin (EPO) on renal fibrosis of unilateral uretreal obstruction (UUO) rats and its mechanism. METHODS: The model of renal fibrosis was established by UUO procedure in rats. Experimental rats were randomly divided into 4 groups: sham operation group (control group), UUO group, 100 u · kg-1 · d-1 EPO treatment group (low dosage group) and 1000 u · kg-1 · d-1 EPO treatment group (high dosage group). The rats in control group and UUO group were given physiological saline, and those in UUO treatment group were given EPO by intraperitoneal injection from 3 to 14 d after establishment of UUO model. All rats were given methane to induce anesthesia and consequently executed. The pathological change of renal tissue was observed, and immunohistochemistry was performed to measure the expressions of α-SMA, E-cadherin and complement 3 (C3) in renal tissue. RESULTS: Compared with UUO group, renal fibrosis were attenuated by EPO treatment, especially in high dosage group. Compared with control group, the expressions of α-SMA and C3 were significantly up-regulated, and the expressions of E-cadherin were significantly down-regulated in UUO group. In contrast, EPO treatment significantly attenuated the up-regula-tion of C3 and α-SMA and the down-regulation of E-cadherin in renal tissue, and these changes were more obvious in UUO rats treated with high dosage of EPO. CONCLUSION: EPO can inhibit EMT and attenuate renal fibrosis in obstructed kidney. It is suggested that the renoprotective effects of EPO are probably related with inhibition of C3 expression in renal tubular epithelial cells. Copyright 2012 by the Chinese Pharmaceutical Association.