• 제목/요약/키워드: Diabetic Nephropathy

검색결과 155건 처리시간 0.025초

Role of Advanced Glycation End Products in TGF-β1 and Fibronectin Expression in Mesangial Cells Cultured under High Glucose

  • HA Hunjoo;KIM Hwa-Jung;LEE Hi Bahl
    • Biomolecules & Therapeutics
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    • 제13권3호
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    • pp.190-197
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    • 2005
  • Advanced glycation end products (AGE) have been implicated in the pathogenesis of diabetic complications including nephropathy. However, the role of AGE in the activation of mesangial cells cultured under high glucose has not been elucidated. The effects of aminoguanidine, which prevents formation of AGE and protein cross-linking, on the synthesis of $TGF-{\beta}1$ and fibronectin by rat mesangial cells cultured under high glucose for 2 weeks were examined and compared with the effects of $N^G$-nitro-L-arginine methyl ester (NAME), a selective nitric oxide synthase inhibitor, because aminoguanidine also inhibits the inducible nitric oxide synthase. Culture of mesangial cells in 30 mM (high) glucose for 2 weeks induced 1.5-fold (ELISA) and 1.9-fold (Western blot analysis) increase in AGE in the culture media compared to 5.6 mM (control) glucose. Northern blot analysis revealed 1.5-fold increase in $TGF-{\beta}1$ and 1.7-fold increase in fibronectin mRNA expression in cells cultured under high glucose compared to control glucose. Increases in mRNA expression were followed by increased protein synthesis. Mink lung epithelial cell growth inhibition assay revealed 1.4-fold increase in $TGF-{\beta}1$ protein in high glucose media compared to control. Fibronectin protein also increased 2.1-fold that of control glucose by Western blot analysis. Administration of aminoguanidine suppressed AGE formation in a dose dependent manner and at the same time suppressed $TGF-{\beta}1$ and fibronectin synthesis by mesangial cells cultured in both control and high glucose. In contrast, NAME did not affect high glucose-induced changes. These findings support a role for AGE in high glucose-induced upregulation of $TGF-{\beta}1$ and fibronectin synthesis by mesangial cells.

혈액투석 환자에서 메트포르민 복용으로 발생한 급성췌장염과 젖산산증 (Metformin induced acute pancreatitis and lactic acidosis in a patient on hemodialysis)

  • 이연경;임기현;황수현;안영환;신규태;김흥수;박인휘
    • Journal of Yeungnam Medical Science
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    • 제33권1호
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    • pp.33-36
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    • 2016
  • Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.

중심성 뇌교 및 뇌교외 수초용해에 병발된 정신증적 장애 (A Case of Psychotic Disorder as a Sequele of Central Pontine and Extrapontine Myelinolysis)

  • 박시성;유봉구;임학
    • 정신신체의학
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    • 제10권1호
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    • pp.55-60
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    • 2002
  • 중심성 뇌교 수초용해 (CPM) 및 뇌교의 수초용해(EPM) 은 대사 이상을 수반하는 여러 질환에서 뇌 세포 내외의 삼투질농도의 급속한 변화와 관련하여 발생하는 신경학적 질환이다. 저자들은 당뇨병성 신중에 의한 만성 신부전으로 신장이식을 받은 43세 남자 환자에서 발현한 CPM과 EPM 증례를 보고하였다. 환자는 망상, 연상이완, 환각, 부적절한 정동, 공격성, 기억장애 등을 수반한 정산병적 증상과 언어실조를 특징적으로 보인 경우로서, CPM과 EPM에서 비교적 드물게 발생하는 정신증상, 특히 정신병적 증상을 보인 증례이기에, 정선과적으로 중요한 임상적 의의를 가진다고 판단하여 문헌고찰과 함께 보고하는 바이다.

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황금탕의 족돌기세포에서의 EMT 억제 효능 (Hwanggeum-tang Water Extracts Suppress TGF-β1 Induced EMT in Podocyte)

  • 신상우;정한솔
    • 동의생리병리학회지
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    • 제34권2호
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    • pp.61-66
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    • 2020
  • Epithelial-mesenchymal transition (EMT) is the process by which epithelial cells lose their characters and acquire the properties of mesenchymal cells. EMT has been reported to exert an essential role in embryonic development. Recently, EMT has emerged as a pivotal mechanism in the metastasis of cancer and the fibrosis of chronic diseases. In particular, EMT is drawing attention as a mechanism of renal fibrosis in chronic kidney diseases such as diabetic nephropathy. In this study, we developed an EMT model by treating TGF-β1 on the podocytes, which play a key role in the renal glomerular filtration. This study explored the effects of Hwanggeum-tang (HGT) recorded in Dongeuibogam as being able to be used for the treatment of Sogal whose concept had been applied to Diabetes Mellitus (DM), on the TGF-β1-induced podocyte EMT. HGT suppressed the expression of vimentin and α-SMA, the EMT marker, in the human podocytes stimulated by TGF-β1. However, HGT increased the expression of ZO-1 and nephrin. Interestingly, HGT selectively inhibited the mTOR pathway rather than the classical Smad pathway. HGT also activated the AMPK signaling. HGT's inhibitory effect on the podocyte EMT through regulation of the mTOR pathway was achieved through the activation of AMPK, which was confirmed by comparison with cells treated with compound C (CC), an inhibitor of AMPK signaling. In conclusion, HGT can be applied to the renal fibrosis by preventing TGF-β1-induced EMT of podocytes through AMPK activation and mTOR inhibition.

대장균에서 isorhamnetin 3-O-glucoside의 생합성 최적화 (Optimization of bioactive isorhamnetin 3-O-glucoside production in Escherichia coli)

  • 김봉규
    • Journal of Applied Biological Chemistry
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    • 제62권4호
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    • pp.361-366
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    • 2019
  • Isorhamnetin 3-O-glucoside는 플라보놀 그룹에 속하는 물질로서 염증이나 궤양에 효과가 있을 뿐만 아니라 신경장해, 신장병증, 망막증과 같은 당뇨합병증을 완화하는 것으로 보고되었다. Isorhamnetin 3-O-glucoside는 Tetraena aegyptia, Salsola oppositifolia, Salicornia herbacea, Sambucus ebulus와 같은 몇몇 식물에서 발견된다. 생물전환은 저렴한 화합물로부터 고부가가치 물질을 생산할 수 있는 유용한 방법이다. 본 연구에서 생물전환을 통해 quercetin으부터 isorhamnetin 3-O-glucoside를 생합성 하기 위해 두 개의 유전자(PGT E82L과, ROMT-9)를 각각의 대장균에 도입하였다. 대장균의 공조배양시스템을 이용하여 isorhamnetin 3-O-glucoside 생산 배양법의 최적화를 위해 생물전환배지, 배양온도, 세포의 혼합비율, 재조합 단백질 유도시간, 기질 공급 농도 등을 테스트하였다. 최적화된 생물전환 조건하에서 생물전환을 실시하였으며, 배양의 12시간 후 181.2 mg/L의 isorhamnetin 3-O-glucoside가 생합성 되었다. 이는 이전의 연구에서 보고된 isorhamnetin 3-O-glucosie (39.6 mg/L)의 생합성보다 4.7배 높았다.

만성 속발성 신질환 모델동물에서 콜라젠 변화의 지표 (Markers of Collagen Change in Chronic Secondary Renal Disease Model in Rat)

  • 남정석;김기영;이영순
    • Toxicological Research
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    • 제12권2호
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    • pp.213-221
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    • 1996
  • In order to develop a suitable secondary renal disease model and diagnostic markers of renal disease in the rat, the change of PIIIP (aminoterminal procollagen III peptide) in serum and hydroxyproline levels in the renal tissue that reflect the synthesis of extracellular matrix (ECM) during development of experimental renal diseases were observed. Two types of experimental primary diseases, diabetes mellitus administrated by streptozotocin (STZ, 75 mg/kg, i.p.) and liver cirrhosis produced by bile duct ligation/scission (BDL/s) operation, were induced. The hydroxyproline level increased according to the high PIIIP and NCl(carboxyterminal procollagen IV peptide) in Western blot analysis as early as 1 week in the STZ treated-rat kidney. Increased renal ECM was observed at 15 weeks in STZ and BDL/s model under the microscopic examination. High PAS positive reaction was found in capillary basement membrane in STZ treated-rats and mesangium in BDL/s operated rats at this time, showing the histological characteristics of diabetic nephropathy and cirrhotic glomerulonephritis in human, respectively. Such secondary renal failure were supported by additional tests including urinalysis and renal function test. The serum PIIIP detected by ELISA was a useful parameter to estimate synthesis rate of renal ECM during development of renal disease without extrarenal fibrosis i.e. liver cirrhosis in rats. This study is proposed that STZ treatment or BDL/s operation may be a suitable experimental animal model for the induction and development of chronic secondary renal diseases. Morover, it was found that hydroxyproline level in renal tissues was a good parameter of the change of renal ECM at the early stage of the diseases without apparent histological changes. Especially, serum PIIIP could be a choice as a diagnostic or prognostic marker during the development of renal diseases in rats.

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Successful Treatment of Invasive Gastric Mucormycosis in a Kidney Transplant Recipient

  • Kim, Hyung Nam;Han, Sun Ae;Park, Ha Yeol;Kim, Hyun Woo;Hong, Ran;Choi, Nam Gyu;Shin, Min Ho;Yoon, Na Ra;Kim, Hyun Lee;Chung, Jong Hoon;Shin, Byung Chul
    • 대한이식학회지
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    • 제32권4호
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    • pp.104-107
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    • 2018
  • Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Gastrointestinal (GI) mucormycosis is very rare and occurs primarily in highly malnourished patients, especially in infants and children. A 55-year-old man with end-stage renal disease due to diabetic nephropathy, who had undergone deceased donor kidney transplantation 2 years prior, complained of abdominal pain and distension with a 3-day duration. Computed tomography revealed diffuse gastric wall thickening, and a huge amount of grey colored necrotic debris surrounded by erythematous erosive mucosa was observed at the antrum to upper body by GI endoscopy. The microscopic examination obtained from a GI endoscopic specimen demonstrated peptic detritus with numerous non-septate mucor hyphae in the mucosa and submucosa. Mucormycosis was diagnosed based on the clinical findings and morphological features. A total gastrectomy was performed and an antifungal agent was administered. A microscopic examination of the surgical specimen demonstrated invasive mucormycosis with numerous fungal hyphae with invasion into the mucosa to subserosa. The patient and graft were treated successfully by total gastrectomy and antifungal therapy.

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD): A Korean Chronic Kidney Disease Cohort

  • Oh, Kook-Hwan;Park, Sue K.;Kim, Jayoun;Ahn, Curie
    • Journal of Preventive Medicine and Public Health
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    • 제55권4호
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    • pp.313-320
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    • 2022
  • The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was launched in 2011 with the support of the Korea Disease Control and Prevention Agency. The study was designed with the aim of exploring the various clinical features and characteristics of chronic kidney disease (CKD) in Koreans, and elucidating the risk factors for CKD progression and adverse outcomes of CKD. For the cohort study, nephrologists at 9 tertiary university-affiliated hospitals participated in patient recruitment and follow-up. Biostatisticians and epidemiologists also participated in the basic design and structuring of the study. From 2011 until 2016, the KNOW-CKD Phase I recruited 2238 adult patients with CKD from stages G1 to G5, who were not receiving renal replacement therapy. The KNOW-CKD Phase II recruitment was started in 2019, with an enrollment target of 1500 subjects, focused on diabetic nephropathy and hypertensive kidney diseases in patients with reduced kidney function who are presumed to be at a higher risk of adverse outcomes. As of 2021, the KNOW-CKD investigators have published articles in the fields of socioeconomics, quality of life, nutrition, physical activity, renal progression, cardiovascular disease and outcomes, anemia, mineral bone disease, serum and urine biomarkers, and international and inter-ethnic comparisons. The KNOW-CKD researchers will elaborate a prediction model for various outcomes of CKD such as the development of end-stage kidney disease, major adverse cardiovascular events, and death.

중추신경계 질환자에게 이환된 난치성 딸꾹질의 한방치험1례 (A Case Report of Central Nervous System Disorder Induced Intractable Hiccups Treated with Korean Medicine)

  • 문지성;민선우;김예슬;박지윤;홍정화;최동준
    • 대한한방내과학회지
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    • 제43권2호
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    • pp.191-200
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    • 2022
  • Intractable hiccups are those which persist for more than one month and can often occur in patients with disorders of the central nervous system, such as stroke, epilepsy, or brain tumor. An 80-year-old male patient undergoing conservative hemodialysis for diabetic nephropathy, recently developed paralysis and dysphagia due to central nervous system complications including stroke and epilepsy. He was admitted to the ◯◯ Oriental Medicine Hospital, and treated with herbal medicine (Gyulpijugyeo-tang, Jeonssiigong-san, and Ijin-tang) and electrical acupuncture for 30 days. No side effects were observed during hospitalization. The frequency and duration of hiccups were measured daily and found to reduce, and the effect persisted during his admission. The patient took no other nervous system drugs. In conclusion, Korean medicine like gyulpijugyeo-tang and acupuncture can be effective for patients with intractable hiccups who cannot use alternative drugs or treatment, because of other complications.

한국인 신생아 황달과 안지오텐신 전환효소 유전자의 다형성 (The relation between angiotensin converting enzyme (ACE) gene polymorphism and neonatal hyperbilirubinemia in Korea)

  • 김미연;이재명;김지숙;김은령;이희제;윤서현;정주호
    • Clinical and Experimental Pediatrics
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    • 제50권1호
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    • pp.28-32
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    • 2007
  • 목 적 : ACE 유전자에 인트론 16의 287 bp 삽입(I) 혹은 결손(D)에 의한 다형성이 존재하고, 그 중 DD 유전형은 ACE 활성도가 높은 것으로 보고 되었으며 ID 다형성은 고혈압 또는 관상동맥 질환, 당뇨병성 신증, IgA 신장염 등 만성 신질환, 만성 B형 간염, 간경변증, 급성간염에서 위험인자로 알려졌다. 신생아 황달은 동아시아인이 서양인보다 2배 이상 높은 것으로 보여 유전적 연관성이 있을 것으로 사료되어 본 연구에서는 ACE 다형성과 한국인 신생아 황달과의 관계를 알아보고자 하였다. 방 법 : 혈중 빌리루빈 수치가 12 mg/dL 이상의 건강하고, 위험인자가 없는 만삭아 중 신생아 황달 환자 110명과 대조군 164명을 대상으로 하였다. 혈액을 0.5 cc를 채취하여 DNA를 분리하였고 ACE 유전자 다형성은 중합효소 연쇄반응을 이용하여 결정하였다. 1.5% agarose gel에서 전기 영동시켜 ethidium bromide로 염색한 후 유전자형을 확인하였다. 결 과 : ACE 유전자 다형성은 신생아 고빌리루빈혈증군 110명중 59명(53.6%)에서 DI 유전형을 보였고, 29명(26.4%)에서 II 유전형, 22명(20%)에서, DD 유전형을 나타냈다. 대조군 164명에서는 85명(51.8%)이 DI 유전형을 보였고, 40명(24.4%)에서 II 유전형을 보였으며, DD 유전형은 39명(23.4%)에서 나타났다. 대립유전자 빈도는 신생아 고빌리루빈혈증군에서 I 0.532, D 0.468의 분포를 보였고, 정상 대조군에서는 I 0.503, D 0.497로 비슷하였다. 결 론 : 한국 신생아에서 ACE 유전자 다형성은 DI 유전형이 많았으나, 대립유전자의 빈도는 차이가 없어 한국인 신생아 황달의 발생과 연관이 없었다.