Prediction of treatment response in lupus nephritis using density of tubulointerstitial macrophage infiltration.

Background: Lupus nephritis (LN) is a common disease with diverse clinical and pathological manifestations. A major challenge in the management of LN is the inability to predict its treatment response at an early stage. The objective of this study was to determine whether the density of tubulointerstitial macrophage infiltration can be used to predict treatment response in LN and whether its addition to clinicopathological data at the time of biopsy would improve risk prediction. Methods: In this retrospective cohort study, 430 patients with LN in our hospital from January 2010 to December 2017 were included. We used immunohistochemistry to show macrophage and lymphocyte infiltration in their biopsy specimens, followed by quantification of the infiltration density. The outcome was the treatment response, defined as complete or partial remission at 12 months of immunosuppression. Results: The infiltration of CD68+ macrophages in the interstitium increased in patients with LN. High levels of CD68+ macrophage infiltration in the interstitium were associated with a low probability of treatment response in the adjusted analysis, and verse vice. The density of CD68+ macrophage infiltration in the interstitium alone predicted the response to immunosuppression (area under the curve [AUC], 0.70; 95% CI, 0.63 to 0.76). The addition of CD68+cells/interstitial field to the pathological and clinical data at biopsy in the prediction model resulted in an increased AUC of 0.78 (95% CI, 0.73 to 0.84). Conclusion: The density of tubulointerstitial macrophage infiltration is an independent predictor for treatment response in LN. Adding tubulointerstitial macrophage infiltration density to clinicopathological data at the time of biopsy significantly improves risk prediction of treatment response in LN patients.

ß-Sitosterol Alleviates the Proliferation and Migration of Cystitis Glandularis-Associated Cells by Targeting HMGCR to Induce NLRP3-Dependent Pyroptosis.

BACKGROUND: Cystitis glandularis (CG) is a proliferative lesion of the bladder mucosa, and the incidence rate of CG has increased year by year. Considering the potential function of ß-sitosterol in CG, we aim to fathom its effect and mechanism of CG. METHODS: Primary human cells isolated from CG patients and following transfection as needed, were treated with different concentrations of ß-sitosterol. Cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and transwell assay was used to test the cell migration. Meanwhile, co-immunoprecipitation was employed to evaluate the interaction between 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) and NLR family pyrin domain containing 3 (NLRP3). Additionally, pyroptosis-associated proteins and HMGCR expressions were tested using western blot or quantitative real-time reverse transcription polymerase chain reaction. RESULTS: ß-sitosterol suppressed cell viability and migration, enhanced cell pyroptosis, and upregulated expressions of NLRP3, Cleaved Caspase-1, interleukin-1ß (IL-1ß), gasdermin D-N-terminal domain (GSDMD-N), and HMGCR in CG primary cells (p < 0.05). HMGCR silencing promoted cell viability and migration, inhibited cell pyroptosis, and downregulated expressions of NLRP3, Cleaved Caspase-1, IL-1ß, and GSDMD-N in ß-sitosterol-affected CG primary cells (p < 0.05). HMGCR interacted with NLRP3. CONCLUSIONS: ß-sitosterol alleviates the proliferation and migration of CG-associated cells by targeting HMGCR to induce NLRP3-dependent pyroptosis. These findings confirmed the therapeutic effect of ß-sitosterol on treating CG.

A General Global and Local Pre-Training Framework for 3D Medical Image Segmentation.

Accurate target segmentation from computed tomography (CT) scans is crucial for surgical robots to perform clinical surgeries successfully. However, the lack of medical image data and annotations has been the biggest obstacle to learning robust medical image segmentation models. Self-supervised learning can effectively address this problem by providing a strategy to pre-train a model with unlabeled data, and then fine-tune downstream tasks with limited labeled data. Existing self-supervised methods fail to simultaneously utilize the abundant global anatomical structure information and local feature differences in medical imaging. In this work, we propose a new strategy for the pre-training framework, which uses the three-dimensional anatomical structure of medical images and specific task and background cues to segment volumetric medical images with limited annotations. Specifically, we propose (1) learning intrinsic patterns of volumetric medical image structures through multiple sub-tasks, and (2) designing a multi-level background cube contrastive learning strategy to enhance the target feature representation by exploiting the differences between the specific target and background. We conduct extensive evaluations on two publicly available datasets. Under limited annotation settings, the proposed method yields significant improvements compared to other self-supervised learning techniques. The proposed method achieves within 6% of the baseline performance using only five labeled CT volumes for training. Once the paper is online, the code and dataset will be available at https://github.com/PinkGhost0812/SGL.

Mitochondrial metabolism-related signature depicts immunophenotype and predicts therapeutic response in testicular germ cell tumors.

In recent years, there has been growing evidence linking mitochondrial dysfunction to the development and progression of cancer. However, the role of mitochondrial metabolism-related genes (MMRGs) in testicular germ cell tumor (TGCT) remains unclear. We downloaded clinical pathology, transcriptome, and somatic mutation data for TGCT from public databases and conducted univariate Cox regression analysis to investigate prognostic correlations. We also used consensus clustering to identify molecular subtypes, comparing differential expression genes, biological processes, Kyoto Encyclopedia of Genes and Genomes pathways, mutations, prognosis, immune infiltration, drug sensitivity, and immune therapeutic response between these subtypes. We constructed multi-gene risk features and nomograms for TGCT prognosis. Fifteen MMRGs were significantly correlated with progression-free survival in TGCT patients. Based on these genes, we identified 2 molecular subtypes which showed significant differences in somatic mutations, prognosis, and immune cell infiltration. These subtypes could also indicate drug sensitivity and immune therapeutic response; the subtype with poor prognosis showed a higher potential benefit from some drugs and immunotherapy. Abnormalities in immune-related biological processes and extracellular matrix as well as Kyoto Encyclopedia of Genes and Genomes pathways such as PI3K-AKT signaling pathway, pat5hways in cancer, primary immunodeficiency, and neutrophil extracellular trap formation were associated with significant differences in phenotypes among subtypes. Finally, we constructed an 8-gene TGCT risk feature based on differential expression genes between subtypes which performed well in TGCT patient prognostic evaluation. Our study elucidated the prognostic correlation between MMRGs and TGCT and established MMRG-derived molecular subtypes and risk features for personalized treatment of TGCT which have potential clinical application value.

Innovation and Reform of Ideological and Political Course Mode in Colleges and Universities Based on Big Data Network Platform.

With the continuous development of the computer field, the Internet has become the main way of education in today's era. The development of computer technology and big data has brought innovation and opportunities to the teaching mode of ideological and political courses in colleges and universities. Due to the dynamic change of big data, there are many difficulties in the establishment of ideological and political course models in colleges and universities. This paper studies the innovation of ideological and political course modes in colleges and universities on the network platform under the background of big data. This paper mainly compares the traditional teaching mode and explores the formal modeling method of network platform education. The discrete dynamic modeling technology of the complex system is used to model the formal process of online education. Then, it carries out nonlinear prediction modeling for the operation efficiency and traffic change of the network platform under the big data environment and uses dynamic modeling to predict the learning effect of college students' ideological and political course mode. The results show that the formal method of education under dynamic modeling can improve the defects of traditional teaching and give full play to the advantages of network platform teaching. Improving the teaching mode of network platform can improve students' learning efficiency. Finally, in the dynamic model prediction, the problem of big data affecting the model results is improved, and the accuracy of the prediction model is improved.

Prognosis Analysis and Perioperative Research of Elderly Patients with Non-Muscle-Invasive Bladder Cancer under Computed Tomography Image of Three-Dimensional Reconstruction Algorithm.

To analyze the application value of computed tomography (CT) based on a three-dimensional reconstruction algorithm in perioperative nursing research and prognosis analysis of non-muscle-invasive bladder cancer (NMIBC), a retrospective study was performed on 124 patients with NMIBC who underwent surgical treatment in the hospital. All patients underwent CT examination based on the three-dimensional reconstruction algorithm before surgery, and transurethral resection of the bladder tumor was performed. The patients receiving conventional care were classified as the control group, and those receiving comprehensive care were classified as the case group, and the recovery status and recurrence of the two groups were compared. The results showed that the accuracy, specificity, and sensitivity of CT imaging information based on the three-dimensional reconstruction algorithm for NMIBC patients were 89.38, 93.77, and 84.39, respectively. The incidence of bladder spasm (9.68%), bladder flushing time (1.56 d), and retention of drainage tube time (2.68 d) in the case group were obviously lower compared with the control group (30.65%, 2.32 d, and 5.19 d) (P < 0.05). Serum BLCA-1 (3.72 ng/mL) and CYFRA21-1 (5.68 µg/mL) in the case group were significantly lower than those in the control group, with a statistically considerable difference (P < 0.05). Compared with the control group, the scores of role function (89.82 points), emotional function (84.76 points), somatic function (79.23 points), and social function (73.93 points) in the case group were observably higher (P < 0.05). In addition, one year after the operation, CT examination showed that the recurrence rate in the case group (6.45%) was significantly lower than that in the control group (22.58%) (P < 0.05). Therefore, CT detection based on the three-dimensional reconstruction algorithm was particularly important for preoperative diagnosis, prognosis, and recurrence monitoring of NMIBC patients. It could provide great clinical value for the diagnosis and prognosis monitoring of NMIBC.

Identification of SEC14 like lipid binding 2(SEC14L2) sequence and expression profiles in the Chinese tree shrew (Tupaia belangeri chinensis).

BACKGROUND: The product of the SEC14L2 (SEC14 Like Lipid Binding 2) gene belongs to a family of lipid-binding proteins including Sec14p, alpha-tocopherol transfer protein, and cellular retinol-binding protein. SEC14L2 expression enables replication of clinical hepatitis C virus (HCV) isolates in several hepatoma cell lines, and mutations in SEC14L2 may enhance HCV replication in vitro. The Chinese tree shrew (Tupaia belangeri chinensis) is a potential animal model for studying HCV replication, however, the cDNA sequence, protein structure, and expression of the Chinese tree shrew SEC14L2 gene have yet to be characterized. METHODS AND RESULTS: In the present study, we cloned the full-length cDNA sequence of the SEC14L2 in the Chinese tree shrew by using rapid amplification of cDNA ends technology. This led us to determine that, this is 2539 base pairs (bp) in length, the open reading frame sequence is 1212 bp, and encodes 403 amino acids. Following this, we constructed a phylogenetic tree based on SEC14L2 molecules from various species and compared SEC14L2 amino acid sequence with other species. This analysis indicated that the Chinese tree shrew SEC14L2 protein (tsSEC14L2) has 96.28% amino acid similarity to the human protein, and is more closely related to the human protein than either mouse or rat protein. The Chinese tree shrew SEC14L2 mRNA was detected in all tissues, and showed highest expression levels in the pancreas, small intestine and trachea, however the tsSEC14L2 protein abundance was highest in the liver and small intestine. CONCLUSION: The Chinese tree shrew SEC14L2 gene was closer in evolutionary relation to humans and non-human primates and expression of the tsSEC14L2 protein was highest in the liver and small intestine. These results may provide useful information for tsSEC14L2 function in HCV infection.

Value of ST-T changes and heart rate variability in pulmonary heart disease during 24 h dynamic electrocardiography examination.

PURPOSE: This study was designed to analyze the value of 24 h dynamic electrocardiography (DCG) examination in the diagnosis of pulmonary heart disease (PHD). METHODS: Ninety cases of patients with PHD were included as the observation group, and 50 cases of healthy patients were enrolled as the healthy group. Both groups received DCG examination. RESULTS: The proportion of ST depression and elevation as well as the magnitude and duration of ST depression differed significantly between the observation and healthy group (P < 0.05), and the magnitude of ST elevation in patients of the observation group with decompensated heart failure was greater than that of patients with compensated cardiac function and the healthy group (P < 0.05). The incidence rates of sinus bradycardia (SB), ventricular premature beats (VPB), paroxysmal ventricular tachycardia (PVT), and ventricular fibrillation (VF) in patients in the observation group with decompensated heart failure were higher than those of patients with compensated cardiac function and the healthy group (P < 0.05). The differences in standard deviation of the NN (R-R) intervals (SDNN) and standard deviation of average NN intervals (SDANN) between the three groups were significant, and the root mean square of successive RR intervals (RMSSD) of patients in the observation group with decompensated heart failure were lower than those of the healthy group (P < 0.05). The differences in deceleration capacity (DC), left ventricular ejection fraction (LVEF), and heart rate variability (HRV) between the three groups were significant (P < 0.05). CONCLUSION: The results obtained by DCG examination can help clinical assessment of cardiac function in the decompensated or compensated stage, which can assist in judging the condition of PHD and guide clinical treatment.

Molecular cloning and characterization of NPC1L1 in the Chinese tree shrew (Tupaia belangeri chinensis).

BACKGROUND: The Niemann-Pick C1-Like 1 protein, a multi-transmembrane domain molecule, is critical for intestinal cholesterol absorption, and is the entry factor for hepatitis C virus (HCV). The Chinese tree shrew (Tupaia belangeri chinensis) is closer to primates in terms of genetic evolution than rodents. Previous studies indicated that the tree shrew was suitable for HCV research; however, little is known about tree shrew NPC1L1. METHODS AND RESULTS: TsNPC1L1 cDNA was amplified by rapid amplification of cDNA ends (RACE) technology. The cDNA sequence, its encoded protein structure, and expression profile were analyzed. Results indicated that the tsNPC1L1 mRNA is 4948 bp in length and encodes a 1326 amino acid protein. TsNPC1L1 possesses 84.97% identity in homology to human NPC1L1 which is higher than both mouse (80.37%) and rat (81.80%). The protein structure was also similar to human with 13 conserved transmembrane helices, and a sterol-sensing domain (SSD). Like human NPC1L1, the tsNPC1L1 mRNA transcript is highly expressed in small intestine, but it was also well-expressed in the lung and pancreas of the tree shrew. CONCLUSION: The homology of tree shrew NPC1L1 was closer to human than that of rodent NPC1L1. The expression of tsNPC1L1 was the highest in small intestine, and was detectable in lung and pancreas. These results may be useful in the study of tsNPC1L1 function in cholesterol absorption and HCV infection.

Transcriptome Analysis of Choroid and Retina From Tree Shrew With Choroidal Neovascularization Reveals Key Signaling Moieties.

Pathological neovascularization in choroid, a leading cause of blindness, is a characteristic of many fundus diseases, such as diabetic retinopathy and age-related macular degeneration. The present study aimed to elucidate the key signaling pathways in choroidal neovascularization (CNV) by analyzing the mRNA profiles of choroid and retina in tree shrews with CNV. We induced choroidal angiogenesis by laser photocoagulation in 15 tree shrews and obtained mRNA profiles of their choroids and retinas by high-throughput transcriptome sequencing. Hierarchical cluster analysis, weighted gene co-expression network analysis (WGCNA), protein-protein interaction (PPI) network analysis, hematoxylin and eosin (HE) staining, CD31 immunohistochemistry (IHC), and reverse transcription quantitative PCR (RT-qPCR) were performed. After laser photocoagulation, we obtained a total of 350 differentially expressed genes (DEGs) in the choroid, including 59 genes in Module-FASN ("ME-FASN") module and 28 genes in Module-RPL ("ME-RPL") module. A total of 69 DEGs in retina, including 20 genes in Module-SLC ("ME-SLC") module. Bioinformatics analysis demonstrated that DEGs in choroid were mainly involved in membrane transport; DEGs in "ME-RPL" were prominent in pathways associated with IgA production, antigen presentation, and cell adhesion molecules (CAMs) signaling. DEGs in "ME-FASN" were involved in fatty acid metabolism and PPAR signaling pathway, while DEGs in "ME-SLC" were involved in GABAergic synapse, neuroactive life receptor interaction, cholinergic synapse, and retrograde endocannabinoid signaling pathway. PPI network analysis demonstrated that the ribosomal protein family genes (RPL31, RPL7, RPL26L1, and RPL19) are key factors of "ME-RPL," acyl-CoA superfamily genes (ACACA, ACAT1, ACAA2, and ACACB) and FASN are key factors of "ME-FASN" and superfamily of solid carrier genes (SLC17A6, SLC32A1, SLC12A5, and SLC6A1) and complement genes (C4A, C3, and C2) are key factors of "ME-SLC." In conclusion, the present study discovered the important signal transductions (fatty acid metabolic pathway and CAMs signaling) and genes (ribosomal protein family and the complement system) in tree shrew CNV. We consider that our findings hold implications in unraveling molecular mechanisms that underlie occurrence and development of CNV.

YAP Triggers Bladder Cancer Proliferation by Affecting the MAPK Pathway.

BACKGROUND: The transcriptional regulator YAP is frequently overexpressed in human cancers, such as breast and pancreatic cancers, plays an important role in tumorigenesis and can regulate many factors affecting cancer progression. These observations encouraged us to investigate the effect of YAP expression on bladder cancer. METHODS: The changes in multiple cellular functions associated with tumor progression including cell proliferation, cell migration, cell cycle, and cell apoptosis were assessed after YAP knockdown/overexpression in bladder cancer cell lines. Additionally, Western blot was developed to verify the change of proteins caused by YAP knockdown/overexpression. RESULTS: YAP had relatively higher expression in bladder cancer tissues than in normal tissues. The proliferation and migration of bladder cancer cells were inhibited by YAP knockdown but were promoted by its overexpression. This promoting effect was accompanied by the increased activity of MAPK/ERK pathway. CONCLUSION: Our data established that YAP is an oncogene involved in bladder cancer and thus can be a potential target for treatment.

Clinicopathological and prognostic value of SNHG6 in cancers: a systematic review and a meta-analysis.

BACKGROUND: Dysregulation of the long non-coding RNA small nucleolar RNA host gene 16 (lncRNA SNHG6) has been found in multiple cancers. However, a definite conclusion on the clinical value of lncRNA SNHG6 expression in human cancers has not been determined. The purpose of the present meta-analysis was to comprehensively elucidate the association between SNHG6 expression and clinical outcomes in cancers. METHODS: A systematic search was performed through the PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Wangfang databases for relevant studies. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were collected to estimate the prognostic value, and the odds ratios (ORs) with 95% CIs were used to evaluate the relationship between lncRNA SNHG6 expression and clinicopathological features, including tumor invasion depth, lymph node metastasis (LNM), distance metastasis (DM), and TNM stage. RESULTS: In total, 914 patients from 13 studies were included in this meta-analysis. The pooled results suggested that evaluated SNHG6 expression could predict an unfavorable overall survival (OS) (HR = 2.04, 95% CI:1.56-2.52) with no heterogeneity (I2 = 0.0%, p = 0.996). Subgroup analysis indicated a significant association between high SNHG6 expression and shorter OS in those studies with digestive system cancers (HR = 2.05, 95% CI: 1.47-2.62), or with sample size < 70 (HR = 2.70, 95% CI: 1.29-4.11), or with multivariate analysis (HR = 2.04, 95% CI: 1.44-2.64). Moreover, elevated SNHG6 expression was positively associated with tumor invasion depth (OR = 1.76, 95% CI: 1.18-2.63), LNM (OR = 1.60, 95% CI: 1.18-2.17), DM (OR = 1.90, 95% CI: 1.37-2.64) and advanced TNM stage (OR = 1.88, 95% CI: 1.36-2.60) in patients with cancers. CONCLUSIONS: High lncRNA SNHG6 expression was correlated with tumor invasion depth, LNM, DM, and advanced TNM stage, suggesting that SNHG6 may serve as a promising prognostic biomarker of human cancers.

Renoprotection Provided by Dipeptidyl Peptidase-4 Inhibitors in Combination with Angiotensin Receptor Blockers in Patients with Type 2 Diabetic Nephropathy.

BACKGROUND: Treatment with the dipeptidyl peptidase-4 inhibitors (DPP4i) and angiotensin receptor blockers (ARBs) in patients with type 2 diabetic nephropathy (DN) has not been well characterized. This study aimed to assess the renoprotection of this combined treatment in DN patients. METHODS: A total of 159 type 2 DN patients from 2013 to 2015 were enrolled retrospectively from a prospective DN cohort at the National Clinical Research Center of Kidney Diseases, Jinling Hospital (China). Fifty-seven patients received DPP4i and ARB treatment, and 102 patients were treated with ARBs alone. All patients were followed up for at least 12 months. Statistical analyses were performed using Stata version 12.0. RESULTS: There were no significant differences at baseline for age, sex, body mass index, duration of diabetes, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR) between the two groups. Antihypertensive and antidiabetic medication use was similar in each group except calcium channel antagonists (P = 0.032). No significant changes in FBG and HbA1c were observed in the two groups after treatment. The eGFR decreased slower in the DPP4i + ARB group than in the ARB group at 12 months (Δ12 months: -2.48 ± 13.86 vs. -6.81 ± 12.52 ml·min-1·1.73m-2, P = 0.044). In addition, proteinuria was decreased further in the DPP4i + ARB group than in the ARB group after 24 months of treatment (Δ24 months: -0.18 [-1.00, 0.17] vs. 0.32 [-0.35, 0.88], P = 0.031). There were 36 patients with an eGFR decrease of more than 30% over 24 months. After adjusting for FBG, HbA1c, and other risk factors, DPP4i + ARB treatment was still associated with a reduced incidence of an eGFR decrease of 20% or 30%. CONCLUSIONS: The combined treatment of DPP4i and ARBs is superior to ARBs alone, as evidenced by the greater proteinuria reduction and lower eGFR decline. In addition, the renoprotection of DPP4i combined with ARBs was independent of glycemic control.

Dissection of Glomerular Transcriptional Profile in Patients With Diabetic Nephropathy: SRGAP2a Protects Podocyte Structure and Function.

Podocytes play a pivotal role in maintaining glomerular filtration function through their interdigitated foot processes. However, the mechanisms that govern the podocyte cytoskeletal rearrangement remain unclear. Through analyzing the transcriptional profile of renal biopsy specimens from patients with diabetic nephropathy (DN) and control donors, we identify SLIT-ROBO ρGTPase-activating protein 2a (SRGAP2a) as one of the main hub genes strongly associated with proteinuria and glomerular filtration in type 2 DN. Immunofluorescence staining and Western blot analysis revealed that human and mouse SRGAP2a is primarily localized at podocytes and largely colocalized with synaptopodin. Moreover, podocyte SRGAP2a is downregulated in patients with DN and db/db mice at both the mRNA and the protein level. SRGAP2a reduction is observed in cultured podocytes treated with tumor growth factor-ß or high concentrations of glucose. Functional and mechanistic studies show that SRGAP2a suppresses podocyte motility through inactivating RhoA/Cdc42 but not Rac1. The protective role of SRGAP2a in podocyte function also is confirmed in zebrafish, in which knockdown of SRGAP2a, a SRGAP2 ortholog in zebrafish, recapitulates podocyte foot process effacement. Finally, increasing podocyte SRGAP2a levels in db/db mice through administration of adenovirus-expressing SRGAP2a significantly mitigates podocyte injury and proteinuria. The results demonstrate that SRGAP2a protects podocytes by suppressing podocyte migration.

Comparing the GFR estimation equations using both creatinine and cystatin c to predict the long-term renal outcome in type 2 diabetic nephropathy patients.

AIMS: This study aimed to determine whether eGFRcre-cys and its slope could improve the prediction of the long-term renal outcome in patients with type 2 diabetic nephropathy (DN). METHODS: The cross-sectional and longitudinal analyses included 501 type 2DN patients from 2003 to 2009. GFR was estimated using either eGFRcre-cys or the serum creatinine-based equation (eGFRcre) or the cystatin C-based equation (eGFRcys), and was classified into 3 categories (≥90, 60-90, ≤60ml/min per 1.73m2). The proportion of patients was evaluated in each creatinine-calculated eGFR category for which the category was reclassified based on either cystatin C or the combined measurement. Long-term changes in eGFRcre-cys, eGFRcys and eGFRcre were estimated using linear mixed effect models. The receiver operating characteristic (ROC) curves was applied to study the sensitivity and specificity of different eGFR slopes for predicting the renal endpoint. RESULTS: In the cross-sectional analyses, eGFRcre was overestimated compared to eGFRcre-cys [median bias -8.5 (95% CI: -25.01, 1.21)]. The reclassification of eGFRcre to a higher value was associated with an increased risk of ESRD [OR: 4.01 (95% CI: 2.36 to 6.82)]. In the longitudinal analyses for predicting end-stage renal disease (ERSD), the ROC curves for eGFRcre-cys (AUC=0.86±0.03) over 24months were increased compared with the ROC curves for eGFRcre and eGFRcys (p<0.05). CONCLUSIONS: The study suggests that the eGFRcre-cys equation may be more precise and sensitive for predicting the renal outcome in T2DN patients. Tracking renal decline using eGFRcre-cys may be used as a surrogate for determining the renal endpoint in a clinical setting.

Rapid Identification of Potential Drugs for Diabetic Nephropathy Using Whole-Genome Expression Profiles of Glomeruli.

OBJECTIVE: To investigate potential drugs for diabetic nephropathy (DN) using whole-genome expression profiles and the Connectivity Map (CMAP). METHODOLOGY: Eighteen Chinese Han DN patients and six normal controls were included in this study. Whole-genome expression profiles of microdissected glomeruli were measured using the Affymetrix human U133 plus 2.0 chip. Differentially expressed genes (DEGs) between late stage and early stage DN samples and the CMAP database were used to identify potential drugs for DN using bioinformatics methods. RESULTS: (1) A total of 1065 DEGs (FDR < 0.05 and fold change > 1.5) were found in late stage DN patients compared with early stage DN patients. (2) Piperlongumine, 15d-PGJ2 (15-delta prostaglandin J2), vorinostat, and trichostatin A were predicted to be the most promising potential drugs for DN, acting as NF-κB inhibitors, histone deacetylase inhibitors (HDACIs), PI3K pathway inhibitors, or PPARγ agonists, respectively. CONCLUSION: Using whole-genome expression profiles and the CMAP database, we rapidly predicted potential DN drugs, and therapeutic potential was confirmed by previously published studies. Animal experiments and clinical trials are needed to confirm both the safety and efficacy of these drugs in the treatment of DN.