Clinical and pathological correlation between urinary exosome miR-223 and IgAN patients.

OBJECTIVE: To investigate the association between urine exosome miR-223 and clinical markers with pathological severity of IgA nephropathy (IgAN) in order to offer a new perspective for the evaluation of IgAN patients. MATERIALS AND METHODS: Western blotting and transmission electron microscopy were used to identify the exosomes collected and isolated from subjects' urine. qRT-PCR was then performed to determine the expression level of miR-223. Following that, the relationship between miR-223 expression, clinical markers, and the severity of pathology in IgAN patients was examined. RESULTS: (1) Urine can be used to isolate exosomes since its marker protein was visible by Western blotting, and its size and structure were observable using transmission electron microscopy. (2) Expression levels of miR-223 in urinary exosomes were much higher in IgAN patients than in healthy subjects, and these were also positively correlated with creatinine (Cr) (rho = 0.396; p = 0.006), blood urea nitrogen (BUN) (rho = 0.371; p = 0.011), 24-hour urinary microalbumin (24hU-mALB) (rho = 0.341; p = 0.036), mesangial cell proliferation (rho = 0.359; p = 0.014), glomerular segmental sclerosis (rho = 0.417; p = 0.004), cell/fibroblast crescents (rho = 0.612; p = 0.000), glomerulosclerosis, and renal interstitial fibrosis (rho = 0.331; p = 0.025). CONCLUSION: In urine exosomes, miR-223 might be considered a non-invasive biomarker for the assessment of IgAN disease progression.

Evaluation of variation in D-dimer levels among COVID-19 and bacterial pneumonia: a retrospective analysis.

In the recent outbreak of novel coronavirus infection worldwide, the risk of thrombosis and bleeding should be concerned. We aimed to observe the dynamic changes of D-dimer levels during disease progression to evaluate their value for thrombosis. In this study, we report the clinical and laboratory results of 57 patients with confirmed COVID-19 pneumonia and 46 patients with confirmed community-acquired bacterial pneumonia (CAP). And their concentrations of D-dimer, infection-related biomarkers, and conventional coagulation were retrospectively analyzed. The Padua prediction score is used to identify patients at high risk for venous thromboembolism (VTE). The results found that, on admission, both in COVID-19 patients and CAP patients, D-dimer levels were significantly increased, and compared with CAP patients, D-dimer levels were higher in COVID-19 patients (P < 0.05). Besides, we found that in COVID-19 patients, D-dimer were related with markers of inflammation, especially with hsCRP (R = 0.426, P < 0.05). However, there was low correlation between VTE score and D-dimer levels (Spearman's R = 0.264, P > 0.05) weakened the role of D-dimer in the prediction of thrombosis. After treatments, D-dimer levels decreased which was synchronous with hsCRP levels in patients with good clinical prognosis, but there were still some patients with anomalous increasing D-dimer levels after therapy. In conclusion, elevated baseline D-dimer levels are associated with inflammation but not with VTE score in COVID-19 patients, suggesting that it is unreasonable to judge whether anticoagulation is needed only according to D-dimer levels. However, the abnormal changes of D-dimer and inflammatory factors suggest that anticoagulant therapy might be needed.

LncRNA MALAT1 promoted high glucose-induced pyroptosis of renal tubular epithelial cell by sponging miR-30c targeting for NLRP3.

Diabetic nephropathy (DN), characterized by the chronic loss of kidney function during diabetes, is a long-term kidney disease that affects millions of populations. However, the etiology of DN remains unclear. DN cell model was established by treating HK-2 cells with high glucose (HG) in vitro. Expression of metastasis-associated lung adenocarcinoma transcript-1 (MALAT1), miR-30c, nucleotide binding and oligomerization domain-like receptor protein 3 (NLRP3), caspase-1, IL-1ß, and IL-18 in treated HK-2 cells were tested by quantitative polymerase chain reaction. HK-2 cell pyroptosis was assessed using flow cytometry analysis. Lactate dehydrogenase (LDH) activity was examined with a LDH assay kit. Correlation among MALAT1, miR-30c, and NLRP3 was examined via dual-luciferase reporter assay. Here, we revealed that MALAT1 was upregulated, but miR-30c was downregulated in HG-treated HK-2 cells, leading to upregulation of NLRP3 expression and cell pyroptosis. Knockdown of MALAT1 or overexpression of miR-30c protected HK-2 cells from HG-induced pyroptosis. Meanwhile, we found that MALAT1 promoted NLRP3 expression by sponging miR-30c through dual-luciferase reporter assay. Moreover, the co-transfection of sh-MALAT1 and miR-30c inhibitor could reverse the protective effects of the sh-MALAT1 on the HG-induced pyroptosis. These results confirmed that MALAT1 regulated HK-2 cell pyroptosis by inhibiting miR-30c targeting for NLRP3, contributing to a better understanding of DN pathogenesis and help to find out the effective treatment for DN.

High Glucose Enhances oxLDL-Induced Apoptosis in Human Renal Proximal Tubular Epithelial Cells Largely via Inducing Lectin-Like ox-LDL Receptor-1.

BACKGROUND: High blood glucose is characteristic of diabetic nephropathy (DN). Both lectin-like ox-LDL receptor-1 (LOX-1) and renal tubular epithelial cells apoptosis reportedly are important for the pathogenesis and progression of DN. In this study, we explored the regulatory effects of high glucose on the expression of LOX-1 and its impact on oxLDL-induced apoptosis in human renal proximal tubular epithelial cells (HRPTEpCs). METHODS: Primary HRPTEpCs were treated with high glucose with or without concurrent treatment with selective p38 mitogen-activated protein kinase (MAPK) inhibitor PD169316 or lentiviral knockdown of LOX-1. HRPTEpCs cultured in normal glucose concentration (5.5 mmol/l) was used as a control. RESULTS AND CONCLUSION: High glucose concentration dependency increased the expression of LOX-1, which led to increased ox-LDL binding in HRPTEpCs. In addition, high glucose upregulated the LOX-1 gene promoter activity but not its mRNA stability in HRPTEpCs; the effect was abolished by PD169316. Furthermore, high glucose markedly enhanced oxLDL-induced apoptosis in HRPTEpCs, which was largely abolished by knockdown of LOX-1. This study demonstrates that high glucose induces the expression of LOX-1 at the gene promoter/transcription level mainly by a p38 MAPK-dependent mechanism, which enhances oxLDL-induced apoptosis in renal tubular epithelial cells. It adds new insights into the molecular mechanisms underlying DN.

Positive association of pro-inflammatory biomarkers and increased oxidative stress in the healthy elderly.

To investigate the relationship between oxidative stress and pro-inflammatory status in healthy elderly people. A total of 1205 healthy elderly Chinese people (age: 65-83 years old; 861 males, 344 females) who visited the Geriatric Department for a thorough physical examination between May 20 and July 23, 2008 were screened and 118 of them were recruited for further evaluation of oxidative stress (total antioxidation capacity, superoxide dismutase (SOD) activity, xanthine oxidase (XO) activity and serum hydrogen peroxide (H(2)O(2)) level) and pro-inflammatory status (serum C-reactive protein (CRP) and interleukin-6 (IL-6) level). The total anti-oxidation capacity and SOD activity were decreased while the serum H(2)O(2) level and XO activity were elevated in groups with higher CRP or IL-6 level. Linear stepwise regression showed that body mass index (BMI), total antioxidation capacity, SOD activity, H(2)O(2) level and XO activity were predictors for CRP level, while age, BMI, H(2)O(2) level and XO activity were predictors for IL-6 level. Pro-inflammatory status is associated with increased oxidative stress in healthy elderly population.

Nondiabetic renal disease in type 2 diabetic patients: a review of our experience in 220 cases.

BACKGROUND: The purpose of this retrospective study was to evaluate the renal biopsies performed on type 2 diabetic patients for suspicion of nondiabetic renal disease (NDRD) and to correlate the pathological finding with the clinical and laboratory findings. METHODS: From January 1999 to December 2009, 220 people with type 2 diabetes for clinically suspected NDRD underwent renal biopsy. The case records of these patients were retrospectively analyzed. Based on the biopsy findings, patients were divided into two groups: Group I, isolated diabetic glomerulosclerosis (DGS), and Group II, NDRD with underlying DGS. Clinical and laboratory data were analyzed in relation to the histopathological findings. RESULTS: Of the 220 patients studied, 153 were males and 67 were females. The average age was 51.35 years (30-79). Renal biopsy showed that 100 patients (45.5%) had NDRD with underlying DGS. Group II had a significantly higher level of proteinuria and hematuria but less frequent diabetic retinopathy. There was no significant difference between the two groups in age, duration of diabetes, presence of hypertension, serum creatinine, and glomerular filtration rate. IgA nephropathy was the most common, accounting for 34% of Group II, membranous nephropathy ranked second accounting for 22.0%, followed by mesangial proliferative nephritis for 14%. CONCLUSION: This study showed that IgA nephropathy is the commonest NDRD among diabetics. The absence of retinopathy, especially when associated with nephritic proteinuria and hematuria, strongly predicts NDRD superimposed on DGS. Renal biopsy should be performed in diabetics when the clinical scenario is atypical.

[Phosphorylation of glycogen synthase kinase-3beta induces epithelial mesenchymal transition in human peritoneal mesothelial cells].

OBJECTIVE: To investigate the role of phosphorylation of glycogen synthase kinase-3beta (GSK-3beta) inducing epithelial mesenchymal transition in human peritoneal mesothelial cells (HPMC). METHODS: Primary HPMC was harvested from human omental tissue and maintained under defined in vitro conditions. The expression of p-GSK-3beta and total GSK-3beta in HMPC was detected by Western blot after incubation with different concentrations (0, 5, 10, 20, and 40 mmol/L)of LiCl at different time points (0, 1, 3, 6, and 12 h). The protein expression of E-cadherin and alpha-SMA was also examined after treatment with 20 mmol/L LiCl according to different time courses. The intracellular distribution and expression of alpha-SMA were determined by indirect immunofluorescence. RESULTS: LiCl stimulated phosphorylation of GSK-3beta and the effect was time-dependent and concentration-dependent to limited extent (P<0.05). The expression of alpha-SMA increased (P<0.05) and the expression of E-cadherin decreased significantly (P<0.05) after 24 h stimulation by 20 mmol/L LiCl. The indirect immunoflurescence showed that the expression of alpha-SMA in HPMC increased significantly after 24 h incubation with 20 mmol/L LiCl. CONCLUSION: The phosphorylation of GSK-3beta leads HMPC to epithelial mesenchymal transition and provides new clue for the treatment of peritoneal fibrosis.