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1.
Kidney Blood Press Res ; 47(4): 277-290, 2022.
Article in English | MEDLINE | ID: mdl-35104825

ABSTRACT

INTRODUCTION: In diabetic nephropathy (DN), mitochondrial dysfunction and leakage of mitochondrial DNA (mtDNA) are caused by the downregulation of superoxide dismutase 2 (SOD2). mtDNA induces the activation of Toll-like receptor (TLR) 9, which is present in macrophages (Mφs), and triggers their activation. METHODS: We orally administered L-carnitine, which exerts protective effects on the mitochondria, to obesity-induced DN (db/db) mice for 8 weeks. We then investigated the effects of L-carnitine on kidney mitochondrial reactive oxygen species (mtROS) production, circulating mtDNA content, and kidney CD11bhigh/CD11blow Mφ functions. RESULTS: In db/db mice, mtROS production increased in proximal tubular cells and kidney CD11blow Mφs; both Mφ types showed enhanced TLR9 expression. L-Carnitine treatment suppressed mtROS production in both proximal tubular cells and CD11blow Mφs (p < 0.01), with improved SOD2 expression in the kidney (p < 0.01), decreased circulating mtDNA content, and reduced albuminuria. Moreover, it suppressed Mφ infiltration into kidneys and reduced TLR9 expression in Mφs (p < 0.01), thereby lowering tumor necrosis factor-α production in CD11bhigh Mφs (p < 0.05) and ROS production by CD11blow Mφs (p < 0.01). Collectively, these changes alleviated DN symptoms. CONCLUSION: The positive effects of L-carnitine on DN suggest its potential as a novel therapeutic agent against obesity-linked DN.


Subject(s)
Diabetes Mellitus , Diabetic Nephropathies , Animals , Carnitine/pharmacology , Carnitine/therapeutic use , DNA, Mitochondrial/metabolism , DNA, Mitochondrial/pharmacology , DNA, Mitochondrial/therapeutic use , Diabetes Mellitus/metabolism , Diabetic Nephropathies/pathology , Kidney/pathology , Macrophages/metabolism , Mice , Mitochondria/metabolism , Obesity/metabolism , Toll-Like Receptor 9/metabolism
2.
Am J Physiol Renal Physiol ; 321(6): F757-F770, 2021 12 01.
Article in English | MEDLINE | ID: mdl-34719947

ABSTRACT

The pathogenesis of diabetic nephropathy (DN) is related to macrophage (Mφ) recruitment to the kidneys, tumor necrosis factor-α (TNF-α) production, and oxidative stress. Toll-like receptor 9 (TLR9) activation is reportedly involved in systemic inflammation, and it exacerbates this condition in metabolic syndrome. Therefore, we hypothesized that TLR9 plays a role in the pathogenesis of DN. Two subsets of kidney Mφs in DN model (db/db) mice were analyzed using flow cytometry to evaluate their distribution and TLR9 expression and function. Mice were administered the CCR2 antagonist INCB3344 for 8 wk; changes in Mφ distribution and function and its therapeutic effects on DN pathology were examined. Bone marrow-derived CD11bhigh (BM-Mφ) and tissue-resident CD11blow Mφs (Res-Mφ) were identified in the mouse kidneys. As DN progressed, the BM-Mφ number, TLR9 expression, and TNF-α production increased significantly. In Res-Mφs, reactive oxygen species (ROS) production and phagocytic activity were enhanced. INCB3344 decreased albuminuria, serum creatinine level, BM-Mφ abundance, TLR9 expression, and TNF-α production by BM-Mφs and ROS production by Res-Mφs. Both increased activation of BM-Mφ via TLR9 and TNF-α production and increased ROS production by Res-Mφs were involved in DN progression. Thus, inactivating Mφs and their TLR9 expression by INCB3344 is a potential therapeutic strategy for DN.NEW & NOTEWORTHY We classified kidney macrophages (Mφs) into bone marrow-derived Mφs (BM-Mφs) expressing high CD11b and tissue-specific resident Mφ (Res-Mφs) expressing low CD11b. In diabetic nephropathy (DN) model mice, Toll-like receptor 9 (TLR9) expression and TNF-α production via TLR9 activation in BM-Mφs and ROS production in Res-Mφs were enhanced. Furthermore, CCR2 antagonist suppressed the kidney infiltration of BM-Mφs and their function and the ROS production by Res-Mφs, with concomitant TLR9 suppression. Our study presents a new therapeutic strategy for DN.


Subject(s)
Diabetic Nephropathies/drug therapy , Kidney/drug effects , Macrophages/drug effects , Pyrrolidines/pharmacology , Receptors, CCR2/antagonists & inhibitors , Toll-Like Receptor 9/metabolism , Animals , Diabetic Nephropathies/genetics , Diabetic Nephropathies/immunology , Diabetic Nephropathies/metabolism , Disease Models, Animal , Kidney/immunology , Kidney/metabolism , Macrophages/immunology , Macrophages/metabolism , Male , Mice, Inbred C57BL , Mice, Knockout , Phagocytosis/drug effects , Phenotype , Reactive Oxygen Species/metabolism , Receptors, CCR2/metabolism , Receptors, Leptin/genetics , Signal Transduction , Tumor Necrosis Factor-alpha/metabolism
3.
Sci Rep ; 11(1): 19304, 2021 09 29.
Article in English | MEDLINE | ID: mdl-34588546

ABSTRACT

Epitranscriptomics is the study of RNA base modifications involving functionally relevant changes to the transcriptome. In recent years, epitranscriptomics has been an active area of research. However, a major issue has been the development of sequencing methods to map transcriptome-wide RNA base modifications. We have proposed a single-molecule quantum sequencer for mapping RNA base modifications in microRNAs (miRNAs), such as N6-methyladenosine (m6A) or 5-methylcytidine (5mC), which are related to cancer cell propagation and suppression. Here, we investigated 5mC and m6A in hsa-miR-200c-5p extracted from colorectal cancer cells and determined their methylation sites and rates; the data were comparable to those determined by mass spectrometry. Furthermore, we evaluated the methylation ratio of cytidine and adenosine at each site in the sequences and its relationship. These results suggest that the methylation ratio of cytidine and adenosine is facilitated by the presence of vicinal methylation. Our work provides a robust new tool for sequencing various types of RNA base modifications in their RNA context.


Subject(s)
Gene Expression Profiling/methods , Sequence Analysis, RNA/methods , Single Molecule Imaging/methods , Adenosine/analogs & derivatives , Adenosine/isolation & purification , Adenosine/metabolism , Cell Line, Tumor , Colorectal Neoplasms/genetics , Colorectal Neoplasms/pathology , Cytidine/analogs & derivatives , Cytidine/isolation & purification , Cytidine/metabolism , Epigenesis, Genetic , Gene Expression Regulation, Neoplastic , Humans , Methylation , MicroRNAs/chemistry , MicroRNAs/genetics , MicroRNAs/metabolism
4.
Respir Med Case Rep ; 33: 101440, 2021.
Article in English | MEDLINE | ID: mdl-34401280

ABSTRACT

Small cell lung cancer (SCLC) transformation is a rare resistance mechanism to anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs), for which cytotoxic chemotherapy is often initiated. However, no case has been reported so far in which the SCLC component disappeared after chemotherapy and the tumor responded to ALK-TKI treatment again. A 41-year-old, never-smoker man was diagnosed with multiple metastatic lung adenocarcinoma harboring ALK gene rearrangements. After tumor re-growth was treated with alectinib, histological analysis of re-biopsy of the primary lesion showed combined small cell carcinoma, and cytotoxic chemotherapy was administered. After resistance to chemotherapy developed, the third biopsy of the primary lesion showed the original ALK gene rearrangements without the SCLC component. Alectinib was re-administered, and partial response was obtained. Biopsy for ALK-positive lung cancer that progressed after chemotherapy for SCLC transformation might be useful for decision-making regarding the therapeutic strategy.

5.
Respir Res ; 22(1): 115, 2021 Apr 20.
Article in English | MEDLINE | ID: mdl-33879137

ABSTRACT

BACKGROUND: Idiopathic non-specific interstitial pneumonia (iNSIP), idiopathic pleuroparenchymal fibroelastosis (iPPFE), and unclassifiable idiopathic interstitial pneumonia (IIP) are IIPs with chronic fibrotic phenotypes, and unlike idiopathic pulmonary fibrosis, they have often been treated with anti-inflammatory drugs, including corticosteroids and immunosuppressants. However, the impact of bronchoalveolar lavage (BAL) lymphocytosis on the effects of anti-inflammatory therapy has never been evaluated. This study aimed to elucidate whether BAL lymphocytosis can be used to predict the efficacy of anti-inflammatory drugs for iNSIP, iPPFE, and unclassifiable IIP. METHODS: Japanese patients diagnosed with iNSIP, iPPFE, and unclassifiable IIP by multidisciplinary discussion were identified using the nationwide registry. Eligible patients were stratified into four groups with and without BAL lymphocytosis and anti-inflammatory therapy to compare overall survival (OS) and changes in lung function. BAL lymphocytosis was defined as a lymphocyte differential count > 15%, and the cut-off was corroborated by survival classification and regression tree analysis. RESULTS: Overall, 186 patients (37 iNSIP, 16 iPPFE, and 133 unclassifiable IIP) were analyzed. Limited to patients treated with anti-inflammatory drugs (n = 123), patients with BAL lymphocytosis had a better prognosis [hazard ratio (HR), 0.26; 95% confidence interval (CI), 0.11-0.63; P = 0.003], higher slope of forced vital capacity (FVC) % predicted for 2 years, and longer OS (log-rank test, P = 0.012) than those without BAL lymphocytosis. On multivariate analysis, BAL lymphocytosis (HR 0.31; 95% CI 0.13-0.75; P = 0.009) was a prognostic factor for OS, along with age and FVC % predicted. Conversely, for patients managed without anti-inflammatory therapy (n = 63), the presence or absence of BAL lymphocytosis had no prognostic value. CONCLUSIONS: BAL lymphocytosis is associated with good outcomes in patients treated with anti-inflammatory drugs, but has no prognostic value when anti-inflammatory drugs are not used. BAL lymphocytosis may provide a predictive biomarker for identifying patients with iNSIP, iPPFE and unclassifiable IIP who are likely to benefit from anti-inflammatory drugs.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Idiopathic Interstitial Pneumonias/drug therapy , Idiopathic Pulmonary Fibrosis/drug therapy , Lung/drug effects , Lymphocytosis/immunology , Aged , Anti-Inflammatory Agents/adverse effects , Bronchoalveolar Lavage Fluid/immunology , Female , Humans , Idiopathic Interstitial Pneumonias/immunology , Idiopathic Interstitial Pneumonias/mortality , Idiopathic Interstitial Pneumonias/physiopathology , Idiopathic Pulmonary Fibrosis/immunology , Idiopathic Pulmonary Fibrosis/mortality , Idiopathic Pulmonary Fibrosis/physiopathology , Japan , Lung/immunology , Lung/physiopathology , Male , Middle Aged , Registries , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome , Vital Capacity
6.
Cancer Chemother Pharmacol ; 87(2): 251-258, 2021 02.
Article in English | MEDLINE | ID: mdl-33394102

ABSTRACT

PURPOSE: Immune checkpoint inhibitor-associated interstitial lung disease (ICI-ILD) is a serious immune-related adverse event. We aimed to evaluate the impact of ICI-ILD severity and imaging patterns or post-ILD cancer therapy on prognosis in patients with non-small-cell lung cancer (NSCLC). METHODS: We retrospectively analysed NSCLC patients who developed ICI-ILD in our institution between January 2016 and March 2019. The primary objective was to report prognosis following onset of ICI-ILD, stratified by severity grade or imaging pattern. The secondary objective was the analysis of cancer therapy after ICI-ILD. RESULTS: Among 222 patients treated with ICI, 27 (12.2%) developed ICI-ILD. No trend for different prognosis depending on severity grade was seen unless ICI-ILD was fatal. Most patients (91.3%) with organising pneumonia (OP) or nonspecific interstitial pneumonia pattern on imaging showed grade 1 or 2, while all patients with a diffuse alveolar damage (DAD) pattern showed grade 3 or higher, and one reached grade 5. Among patients who overcame ICI-ILD, eight patients (30.8%) have been followed up without chemotherapy because of long-term disease control and seven had shown an OP pattern on imaging at onset of ICI-ILD. Three patients underwent ICI rechallenge, but two showed ICI-ILD recurrence and no patient achieved response to rechallenge treatment. CONCLUSION: The DAD pattern may predict short-term adverse prognosis for ICI-ILD. Once ICI-ILD is overcome, severity grade is not associated with prognosis. Even if initial immunotherapy proves effective, ICI rechallenge requires careful consideration.


Subject(s)
Carcinoma, Non-Small-Cell Lung/drug therapy , Immune Checkpoint Inhibitors/adverse effects , Lung Diseases, Interstitial/chemically induced , Lung Neoplasms/drug therapy , Aged , Female , Humans , Immune Checkpoint Inhibitors/administration & dosage , Lung Diseases, Interstitial/physiopathology , Male , Pneumonia/chemically induced , Prognosis , Pulmonary Alveoli/pathology , Retrospective Studies , Severity of Illness Index
7.
J Clin Apher ; 35(5): 435-443, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32810902

ABSTRACT

BACKGROUND: Patients with clinically amyopathic dermatomyositis (CADM) with anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab) frequently develop rapidly progressive interstitial pneumonia (RPIP), often with fatal outcomes. Therapeutic plasma exchange (TPE) has been reported as effective against CADM-RPIP refractory to conventional immunosuppressive therapy. However, the detailed mechanisms by which TPE improves disease activity of CADM-RPIP remain unclear. AIM: To elucidate the clinical and demographic characteristics of patients with anti-MDA5 Ab-positive CADM-RPIP treated with TPE and to analyze changes in laboratory findings before, during, and after TPE. MATERIALS & METHODS: Patients hospitalized for CADM-RPIP and treated with TPE in 2017 and 2018 were analyzed retrospectively. RESULTS: Three patients were successfully treated with TPE, with good tolerance. Anti-MDA5 Ab titers decreased significantly over the course of TPE. CONCLUSION: We emphasize that TPE could represent an effective treatment option for CADM-RPIP refractory to traditional therapy. Removal of anti-MDA5 Ab and other pathogenic factors may facilitate favorable outcomes.


Subject(s)
Dermatomyositis/complications , Lung Diseases, Interstitial/therapy , Plasma Exchange/methods , Autoantibodies/blood , Female , Hemoperfusion , Humans , Interferon-Induced Helicase, IFIH1/immunology , Male , Middle Aged , Polymyxin B/administration & dosage , Retrospective Studies
8.
Sci Rep ; 10(1): 4923, 2020 03 18.
Article in English | MEDLINE | ID: mdl-32188922

ABSTRACT

Recently, attempts to reveal the structures of autoantibodies comprehensively using improved proteogenomics technology, have become popular. This technology identifies peptides in highly purified antibodies by using an Orbitrap device to compare spectra from liquid chromatography-tandem mass spectrometry against a cDNA database obtained through next-generation sequencing. In this study, we first analyzed granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies in a patient with autoimmune pulmonary alveolar proteinosis, using the trapped ion mobility spectrometry coupled with quadrupole time-of-flight (TIMS-TOF) instrument. The TIMS-TOF instrument identified peptides that partially matched sequences in up to 156 out of 162 cDNA clones. Complementarity-determining region 3 (CDR3) was fully and partially detected in nine and 132 clones, respectively. Moreover, we confirmed one unique framework region 4 (FR4) and at least three unique across CDR3 to FR4 peptides via de novo peptide sequencing. This new technology may thus permit the comprehensive identification of autoantibody structure.


Subject(s)
Autoantibodies/immunology , Autoantigens/immunology , Granulocyte-Macrophage Colony-Stimulating Factor/immunology , Proteogenomics , Pulmonary Alveolar Proteinosis/etiology , Pulmonary Alveolar Proteinosis/metabolism , Autoantibodies/blood , Autoimmunity , Chromatography, Liquid , Disease Susceptibility , Humans , Proteogenomics/methods , Pulmonary Alveolar Proteinosis/blood , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Tandem Mass Spectrometry
9.
J Immunol ; 204(8): 2043-2052, 2020 04 15.
Article in English | MEDLINE | ID: mdl-32169847

ABSTRACT

Control of lymphocyte infiltration in kidney is a potential therapeutic strategy for lupus nephritis, considering that control of lymphocyte migration by sphingosine 1 phosphate has been implicated in inflammation-related pathology. The peptide inhibitor of the transendothelial migration (PEPITEM)/cadherin (CDH) 15 axis was recently reported to promote sphingosine 1 phosphate secretion. In this study, we investigated whether CDH15 is expressed in the kidney of MRL/lpr mice and whether lymphocyte infiltration is suppressed by exogenously administered PEPITEM. Mice (18 wk old) were randomized into 4-wk treatment groups that received PEPITEM or PBS encapsulated in dipalmitoylphosphatidylcholine liposomes. Enlargement of the kidney, spleen, and axillary lymph nodes was suppressed by PEPITEM treatment, which also blocked infiltration of double-negative T lymphocytes into the kidney and glomerular IgG/C3 deposition, reduced proteinuria, and increased podocyte density. Immunohistochemical analysis revealed that the PEPITEM receptor CDH15 was expressed on vascular endothelial cells of glomeruli and kidney arterioles, skin, and peritoneum in lupus mice at 22 wk of age but not in 4-wk-old mice. These results suggest that PEPITEM inhibits lymphocyte migration and infiltration into the kidney, thereby preserving the kidney structure and reducing proteinuria. Thus, PEPITEM administration may be considered as a potential therapeutic tool for systemic lupus erythematosus.


Subject(s)
Cadherins/metabolism , Glomerulonephritis/drug therapy , Lupus Erythematosus, Systemic/drug therapy , Peptides/pharmacology , T-Lymphocytes/drug effects , Animals , Disease Models, Animal , Female , Glomerulonephritis/immunology , Injections, Subcutaneous , Lupus Erythematosus, Systemic/immunology , Mice , Mice, Inbred MRL lpr , Peptides/administration & dosage , T-Lymphocytes/immunology , Transendothelial and Transepithelial Migration/drug effects , Transendothelial and Transepithelial Migration/immunology
10.
J Infect Chemother ; 26(6): 563-569, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32067902

ABSTRACT

BACKGROUND AND OBJECTIVE: Nursing and healthcare-associated pneumonia (NHCAP) is a category of healthcare-associated pneumonia modified for the healthcare system in Japan. To date, only a few studies have examined the prognostic factors of NHCAP in a prospective cohort. This study aimed to investigate the prognostic factors related to 30-day mortality in patients with NHCAP by analyzing prospective data. METHODS: We analyzed patients hospitalized for NHCAP who were enrolled between October 2010 and February 2017. Age, sex, comorbidities, vital signs and laboratory findings were used as prognostic variables. The primary outcome was 30-day mortality. RESULTS: Of 817 NHCAP patients identified, the mean age was 78.0 ± 11.1 years, 580 (71.0%) were men and 30-day mortality was 13.1% (107/817). On multivariate analysis, male sex (odds ratio [OR]: 2.07, 95% confidence interval [CI]: 1.18-3.63), malignancy (OR: 2.35, 95%CI: 1.38-4.01), performance status (PS) (OR: 1.55, 95%CI: 1.23-1.96), body temperature (OR: 0.77, 95%CI: 0.61-0.97), heart rate (OR: 1.02, 95%CI: 1.01-1.03), respiratory rate (OR: 1.04, 95%CI: 1.01-1.08), serum albumin (Alb) (OR: 0.45, 95%CI: 0.30-0.66) and blood urea nitrogen (BUN) (OR: 1.02, 95%CI: 1.01-1.03) were significantly related to 30-day mortality. On the other hand, the risk factors for involvement by drug-resistant pathogens predicted a better prognosis (OR: 0.39, 95%CI: 0.19-0.82). CONCLUSIONS: Male sex, malignancy, poor PS, hypothermia, tachycardia, tachypnea, low serum Alb and high BUN are worse prognostic factors. Thus, the risk of drug-resistant pathogens is not necessarily related to poor prognosis.


Subject(s)
Healthcare-Associated Pneumonia/microbiology , Healthcare-Associated Pneumonia/mortality , Pneumonia, Bacterial/microbiology , Pneumonia, Bacterial/mortality , Aged , Aged, 80 and over , Anti-Bacterial Agents/pharmacology , Comorbidity , Drug Resistance, Bacterial , Female , Healthcare-Associated Pneumonia/diagnosis , Hospital Mortality , Humans , Japan , Klebsiella pneumoniae/pathogenicity , Male , Pneumonia, Bacterial/diagnosis , Prognosis , Prospective Studies , Risk Factors , Staphylococcus aureus/pathogenicity
11.
Auton Neurosci ; 224: 102640, 2020 03.
Article in English | MEDLINE | ID: mdl-32036244

ABSTRACT

Hypertension often occurs in patients with chronic kidney disease (CKD). Considering the decrease in serum Klotho and increase in serum FGF23 levels in such patients, decreased Klotho and increased FGF23 levels were thought to be associated with hypertension. Presympathetic neurons at the rostral ventrolateral medulla (RVLM) contribute to sympathetic activity and regulation of blood pressure. Therefore, we hypothesized that Klotho would reduce the activities of RVLM neurons and FGF23 would stimulate them. Accordingly, this study examined the effects of Klotho and FGF23 on bulbospinal neurons in the RVLM. We used a brainstem-spinal cord preparation to record from RVLM presympathetic neurons and to evaluate the effects of Klotho and FGF23 on firing rate and membrane potentials of these neurons. Our results showed that Klotho-induced RVLM neuron hyperpolarization, while ouabain, a Na+/K+-ATPase inhibitor, suppressed the effects of Klotho on such neurons. Moreover, FGF23 induced RVLM neuron depolarization, while SU5402, an FGF23 receptor (FGFR1) antagonist, induced RVLM neuron hyperpolarization. Histological examinations revealed that Klotho, Na+/K+-ATPase, FGF23, and FGFR1 were present in RVLM neurons and that Klotho was localized in the same neurons as FGFR1. These results suggest that Klotho and FG23 regulate the activity of RVLM neurons. Klotho may reduce the activity of RVLM neurons via stimulating Na+/K+-ATPase on those neurons while FGF23 may activate those neurons via FGFR1.


Subject(s)
Fibroblast Growth Factors/pharmacology , Glucuronidase/pharmacology , Medulla Oblongata/drug effects , Neurons/drug effects , Action Potentials/physiology , Animals , Animals, Newborn , Hypertension/physiopathology , Klotho Proteins , Membrane Potentials/drug effects , Neurons/physiology , Rats, Wistar , Spinal Cord/drug effects , Spinal Cord/physiopathology , Sympathetic Nervous System/physiopathology
12.
Nat Commun ; 10(1): 3888, 2019 08 29.
Article in English | MEDLINE | ID: mdl-31467274

ABSTRACT

The biological significance of micro (mi)RNAs has traditionally been evaluated according to their RNA expression levels based on the assumption that miRNAs recognize and regulate their targets in an unvarying fashion. Here we show that a fraction of mature miRNAs including miR-17-5p, -21-5p, and -200c-3p and let-7a-5p harbor methyl marks that potentially alter their stability and target recognition. Importantly, methylation of these miRNAs was significantly increased in cancer tissues as compared to paired normal tissues. Furthermore, miR-17-5p methylation level in serum samples distinguished early pancreatic cancer patients from healthy controls with extremely high sensitivity and specificity. These findings provide a basis for diagnostic strategies for early-stage cancer and add a dimension to our understanding of miRNA biology.


Subject(s)
Gastrointestinal Neoplasms/genetics , Gastrointestinal Neoplasms/metabolism , MicroRNAs/genetics , MicroRNAs/metabolism , Biomarkers, Tumor/blood , Biomarkers, Tumor/genetics , Cell Line, Tumor , Epigenomics , Gene Expression Profiling , Gene Expression Regulation, Neoplastic , Humans , Methylation , MicroRNAs/blood , Molecular Dynamics Simulation , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
13.
Intern Med ; 57(21): 3129-3133, 2018 Nov 01.
Article in English | MEDLINE | ID: mdl-29877281

ABSTRACT

A 76-year-old woman suddenly developed anasarca and a fever, and an examination revealed thrombocytopenia, reticulin fibrosis, and acute kidney injury, yielding the diagnosis of thrombocytopenia, anasarca, fever, reticulin fibrosis, organomegaly (TAFRO) syndrome. Renal replacement therapy and steroid treatment were soon started. Her proteinuria was minor at first; however, once the kidney function improved, nephrotic syndrome occurred. A kidney biopsy showed membranoproliferative glomerulonephritis-like glomerulopathy with massive macrophage infiltration. Although kidney dysfunction is often observed in TAFRO syndrome patients, its detailed mechanism is unclear. This case suggests that TAFRO syndrome involves both acute kidney injury with minor proteinuria and nephrotic syndrome, and these disorders can develop serially in the same patient.


Subject(s)
Acute Kidney Injury/etiology , Edema/diagnosis , Fever/diagnosis , Nephrotic Syndrome/etiology , Thrombocytopenia/diagnosis , Aged , Edema/complications , Female , Fever/complications , Fibrosis/complications , Fibrosis/diagnosis , Glomerulonephritis, Membranoproliferative/etiology , Glomerulonephritis, Membranoproliferative/pathology , Humans , Kidney/pathology , Proteinuria/etiology , Syndrome
14.
Sci Rep ; 8(1): 8225, 2018 05 29.
Article in English | MEDLINE | ID: mdl-29844470

ABSTRACT

Lupus nephritis is a crucial complication of systemic lupus erythematosus. In this study, we investigated the roles of mouse natural killer T (NKT) cells in lupus nephritis. From 24 weeks of age, NZB/NZW F1 mice were injected with alpha-galactosylceramide (α-GalCer) or vehicle once a week for four weeks. In the α-GalCer group, the levels of proteinuria and blood urea nitrogen were significantly lower than those in the vehicle group. The histological evaluation showed a decrease in glomerular immune complex deposits and an alleviation of podocyte injury. The proportion of NKT cells in the mononuclear cell (MNC) fraction in the α-GalCer group was significantly decreased in the liver, kidney, and spleen. The proliferation and cytokine production in α-GalCer-stimulated liver MNCs were markedly diminished in the α-GalCer group (anergy). The IFN-γ production in liver MNCs stimulated by concanavalin A or an anti-CD3 antibody did not differ between the two groups, whereas the IL-4 production was significantly lower in the α-GalCer group. In addition, the IgM production in CpG-oligodeoxynucleotide-stimulated spleen MNCs was significantly lower in the α-GalCer group. These results suggest that α-GalCer suppressed Th2 immune responses in NKT cells and B cell function, thereby slowing the progression of lupus nephritis.


Subject(s)
Galactosylceramides/administration & dosage , Lupus Nephritis/drug therapy , Animals , B-Lymphocytes/immunology , Disease Progression , Drug Administration Schedule , Female , Galactosylceramides/therapeutic use , Immunoglobulin G/metabolism , Interleukin-4/biosynthesis , Kidney/physiopathology , Lupus Nephritis/immunology , Lupus Nephritis/physiopathology , Mice , Natural Killer T-Cells/immunology
15.
Am J Physiol Regul Integr Comp Physiol ; 314(5): R700-R708, 2018 05 01.
Article in English | MEDLINE | ID: mdl-29443550

ABSTRACT

Recent studies indicate that erythropoietin (EPO) is present in many areas of the brain and is active in the restoration of impaired neurons. In this study, we examined the presence of EPO and its role in bulbospinal neurons in the rostral ventrolateral medulla (RVLM). Hypoxia is often accompanied by a high blood pressure (BP). We hypothesized that EPO is produced in response to hypoxia in RVLM neurons and then activates them. To investigate whether RVLM neurons are sensitive to EPO, we examined the changes in the membrane potentials (MPs) of bulbospinal RVLM neurons using the whole cell patch-clamp technique during superfusion with EPO. A brainstem-spinal cord preparation was used for the experiments. EPO depolarized the RVLM neurons, and soluble erythropoietin receptor (SEPOR), an antagonist of EPO, hyperpolarized them. Furthermore, hypoxia-depolarized RVLM neurons were significantly hyperpolarized by SEPOR. In histological examinations, the EPO-depolarized RVLM neurons showed the presence of EPO receptor (EPOR). The RVLM neurons that possessed EPORs showed the presence of EPO and hypoxia-inducible factor (HIF)-2α. We also examined the levels of HIF-2α and EPO messenger RNA (mRNA) in the ventral sites of the medullas (containing RVLM areas) in response to hypoxia. The levels of HIF-2α and EPO mRNA in the hypoxia group were significantly greater than those in the control group. These results suggest that EPO is produced in response to hypoxia in RVLM neurons and causes a high BP via the stimulation of those neurons. EPO may be one of the neurotransmitters produced by RVLM neurons during hypoxia.


Subject(s)
Erythropoietin/metabolism , Medulla Oblongata/metabolism , Neurons/metabolism , Action Potentials , Animals , Animals, Newborn , Basic Helix-Loop-Helix Transcription Factors/genetics , Basic Helix-Loop-Helix Transcription Factors/metabolism , Blood Pressure , Cell Hypoxia , Erythropoietin/genetics , Erythropoietin/pharmacology , Hypertension/etiology , Hypertension/metabolism , Hypertension/physiopathology , Hypoxia/complications , Hypoxia/metabolism , Hypoxia/physiopathology , In Vitro Techniques , Medulla Oblongata/drug effects , Medulla Oblongata/physiopathology , Neurons/drug effects , Rats, Wistar , Receptors, Erythropoietin/agonists , Receptors, Erythropoietin/metabolism , Up-Regulation
16.
BMC Nephrol ; 18(1): 377, 2017 12 29.
Article in English | MEDLINE | ID: mdl-29287589

ABSTRACT

BACKGROUND: Amyloid A amyloidosis is one of the most common forms of amyloidosis. It is secondary to rheumatoid arthritis, which is difficult to manage and has a poor prognosis. We present a patient with rheumatoid arthritis and amyloid A amyloidosis who was treated with tocilizumab, a humanized monoclonal antibody against interleukin 6 receptor, resulting in improvement in both proteinuria and gastrointestinal symptoms; however, amyloid deposition remained. CASE PRESENTATION: A 67-year-old woman who had previously been treated for rheumatoid arthritis presented with abdominal pain and diarrhea. Right renal cell carcinoma was found, and amyloid A amyloidosis was diagnosed concomitantly based on colon biopsy. The renal cell carcinoma was resected, and the non-cancerous part of the renal tissue also showed amyloid A deposition. Following surgery, protein levels in the urine increased to the nephrotic range, and administration of tocilizumab was initiated, which resulted in resolution of the proteinuria. The patient's gastrointestinal symptoms were also alleviated. However, repeat colon biopsy showed amyloid deposition. CONCLUSIONS: This case of amyloid A amyloidosis suggests that amyloid deposition indicates only structural change of the affected tissue, and that it is not amyloid deposition per se that causes the clinical symptoms of amyloidosis.


Subject(s)
Amyloidosis/diagnosis , Amyloidosis/drug therapy , Antibodies, Monoclonal, Humanized/therapeutic use , Colon/pathology , Kidney/pathology , Serum Amyloid A Protein , Aged , Female , Humans , Treatment Outcome
17.
J Periodontol ; 85(11): 1480-8, 2014 Nov.
Article in English | MEDLINE | ID: mdl-24857321

ABSTRACT

BACKGROUND: Tumor necrosis factor (TNF)-α inhibitor has been shown to affect the periodontal condition of patients with rheumatoid arthritis (RA). The aim of the present study is to assess the effect of a fully humanized anti-TNF-α monoclonal antibody, adalimumab (ADA), on the periodontal condition of patients with RA and to compare serum protein profiles before and after ADA therapy. METHODS: The study participants consisted of 20 patients with RA treated with ADA. Clinical periodontal and rheumatologic parameters and serum cytokine levels were evaluated at baseline and 3 months later. Serum protein spot volume was examined with two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis. Proteins with significant difference in abundance before and after ADA therapy were found and identified using mass spectrometry and protein databases. RESULTS: The patients showed a significant decrease in gingival index (P = 0.002), bleeding on probing (P = 0.003), probing depth (P = 0.002), disease activity score including 28 joints using C-reactive protein (P <0.001), and serum levels of TNF-α (P <0.001) and interleukin-6 (P <0.001) after ADA medication, although plaque levels were comparable. Among a total of 495 protein spots obtained, nine spots were significantly decreased in abundance at reassessment, corresponding to complement factor H, phospholipase D, serum amyloid A, complement component 4, and α-1-acid glycoprotein (P <0.01). CONCLUSION: These results suggest a beneficial effect of ADA therapy on the periodontal condition of patients with RA, which might be related to differences in serum protein profiles before and after ADA therapy.


Subject(s)
Adalimumab/therapeutic use , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Blood Proteins/drug effects , Periodontitis/prevention & control , Adult , Aged , Arthritis, Rheumatoid/blood , Blood Proteins/analysis , C-Reactive Protein/drug effects , Complement C4/analysis , Complement C4/drug effects , Complement Factor H/analysis , Complement Factor H/drug effects , Cytokines/blood , Dental Plaque Index , Female , Follow-Up Studies , Humans , Interleukin-6/blood , Male , Middle Aged , Orosomucoid/analysis , Orosomucoid/drug effects , Periodontal Attachment Loss/prevention & control , Periodontal Index , Periodontal Pocket/prevention & control , Periodontitis/blood , Phospholipase D/blood , Phospholipase D/drug effects , Serum Amyloid A Protein/analysis , Serum Amyloid A Protein/drug effects , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Tumor Necrosis Factor-alpha/blood
18.
Cytokine ; 68(2): 118-26, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24813650

ABSTRACT

To date, the biological activity of granulocyte macrophage-colony stimulating factor (GM-CSF) has been investigated by using mostly Escherichia coli- or yeast cell-derived recombinant human GM-CSF (erhGM-CSF and yrhGM-CSF, respectively). However, Chinese hamster ovary cell-derived recombinant human GM-CSF (crhGM-CSF), as well as natural human GM-CSF, is a distinct molecule that includes modifications by complicated oligosaccharide moieties. In the present study, we reevaluated the bioactivity of crhGM-CSF by comparing it with those of erhGM-CSF and yrhGM-CSF. The effect of short-term stimulation (0.5h) on the activation of neutrophils/monocytes or peripheral blood mononuclear cells (PBMCs) by crhGM-CSF was lower than those with erhGM-CSF or yrhGM-CSF at low concentrations (under 60pM). Intermediate-term stimulation (24h) among the different rhGM-CSFs with respect to its effect on the activation of TF-1 cells, a GM-CSF-dependent cell line, or PBMCs was not significantly different. In contrast, the proliferation/survival of TF-1 cells or PBMCs after long-term stimulation (72-168h) was higher at low concentrations of crhGM-CSF (15-30pM) than that of cells treated with other GM-CSFs. The proportion of apoptotic TF-1 cells after incubation with crhGM-CSF for 72h was lower than that of cells incubated with other rhGM-CSFs. These effects were attenuated by desialylation of crhGM-CSF. Clearance of crhGM-CSF but not desialylated-crhGM-CSF by both TF-1 cells and PBMCs was delayed compared with that of erhGM-CSF or yrhGM-CSF. These results suggest that sialylation of oligosaccharide moieties delayed the clearance of GM-CSF, thus eliciting increased long-term bioactivity in vitro.


Subject(s)
Granulocyte-Macrophage Colony-Stimulating Factor/pharmacology , Recombinant Proteins/pharmacology , Animals , Apoptosis/drug effects , CHO Cells , Cell Proliferation/drug effects , Cell Survival/drug effects , Cricetinae , Cricetulus , Escherichia coli/metabolism , Granulocyte-Macrophage Colony-Stimulating Factor/chemistry , Humans , Leukocytes, Mononuclear/cytology , Leukocytes, Mononuclear/drug effects , Mass Spectrometry , Molecular Weight , Neuraminidase/pharmacology , Saccharomyces cerevisiae/metabolism
19.
J Periodontol ; 85(1): 103-12, 2014 Jan.
Article in English | MEDLINE | ID: mdl-23646852

ABSTRACT

BACKGROUND: Rheumatoid arthritis (RA) and chronic periodontitis (CP) are chronic inflammatory conditions and share many pathologic features. The common molecular pathogenesis of the two inflammatory diseases is unclear. The aim of the present study is to evaluate serum protein profiles specific for patients with RA and CP by a comprehensive proteomic analysis. METHODS: The study participants were: 10 patients with RA, 10 patients with CP, 10 patients with RA and CP, and 10 healthy controls. All groups were balanced for age, sex, and smoking status. Serum protein spot volume was examined with two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis. Proteins with significant differences in abundance among the four groups were determined with computer image analysis and identified with mass spectrometry and protein databases. RESULTS: A total of 1,694 protein spots were obtained in sera of the four groups. Seven spots were significantly different in abundance among the four groups. Of these, three spots (complement component 3, complement factor H, and ceruloplasmin) were significantly different in the RA+CP group compared with the other three groups (P <0.05). The similar profiles of complement component 3, complement factor H, and ceruloplasmin were observed by enzyme-linked immunosorbent assay. CONCLUSION: These results suggest that patients with RA and CP may exhibit three serum proteins with different abundance compared with healthy controls and patients with RA only or CP only.


Subject(s)
Arthritis, Rheumatoid/blood , Blood Proteins/analysis , Chronic Periodontitis/blood , Case-Control Studies , Ceruloplasmin/analysis , Chronic Periodontitis/classification , Complement C3/analysis , Complement Factor H/analysis , Complement Inactivating Agents/blood , Dental Plaque Index , Electrophoresis, Gel, Two-Dimensional/methods , Female , Humans , Image Processing, Computer-Assisted/methods , Immunologic Factors/blood , Isoelectric Focusing/methods , Male , Mass Spectrometry , Middle Aged , Periodontal Attachment Loss/classification , Periodontal Index , Periodontal Pocket/classification
20.
Proteomics ; 7(12): 2000-8, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17514680

ABSTRACT

Recently (Cytometry 2003, 56A, 71-80), we reported that direct cell-to-cell contact is required for stimulating proliferation of bystander rat liver cells (WB-F344) cocultured with irradiated cells, and neither functional gap junction intercellular communication nor long-range extracellular factors appear to be involved in this proliferative bystander response (PBR). The molecular basis for this response is unknown. Confluent monolayers of WB-F344 cells were exposed to 5-Gray (Gy) of gamma-rays. Irradiated cells were mixed with unirradiated cells and co-cultured for 24 h. Cells were harvested and protein expression was examined using 2-DE. Protein expression was also determined in cultures of unirradiated and 5-Gy irradiated cells. Proteins were identified by MS. Nucleophosmin (NPM)-1, a multifunctional nucleolar protein, was more highly expressed in bystander cells than in either unirradiated or 5-Gy irradiated cells. Enolase-alpha, a glycolytic enzyme, was present in acidic and basic variants in unirradiated cells. In bystander and 5-Gy irradiated cells, the basic variant was weakly expressed, whereas the acidic variant was overwhelmingly present. These data indicate that the presence of irradiated cells can affect NPM-1 and enolase-alpha in adjacent bystander cells. These proteins appear to participate in molecular events related to the PBR and suggest that this response may involve cellular defense, proliferation, and metabolism.


Subject(s)
Cell Communication/drug effects , Cell Proliferation , Proteome/metabolism , Amino Acid Sequence , Cells, Cultured , Coculture Techniques , Electrophoresis, Gel, Two-Dimensional , Epithelial Cells/metabolism , Gamma Rays/adverse effects , Molecular Sequence Data , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
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