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Clinical Efficacy and Transcriptomic Analysis of Congrong Shujing Granules () in Patients with Parkinson's Disease and Syndrome of Shen (Kidney) Essence Deficiency.
Chen, SY, Xiao, SJ, Lin, YN, Li, XY, Xu, Q, Yang, SS, Huang, LH, Cai, J
Chinese journal of integrative medicine. 2020;(6):412-419
Abstract
OBJECTIVE To evaluate the clinical efficacy and safety of Congrong Shujing Granules ( , CSGs) in treating patients with Parkinson's disease (PD) and Chinese medicine (CM) syndrome of Shen (Kidney) essence deficiency, and to investigate the potential mechanism involving efficacy through a transcriptome sequencing approach. METHODS Eligible PD patients with syndrome of Shen essence defificiency were randomly assigned to a treatment group or a control group by a random number table, and were treated with CSGs combined with Western medicine (WM), or placebo combined with WM, respectively. Both courses of treatment lasted for 12 weeks. The Unifified Parkinson's Disease Rating Scale (UPDRS) score, the PD Question-39 (PDQ-39) score, CM Syndrome Scale score, and drug usage of all patients were evaluated before and after treatment. Safety was evaluated by clinical laboratory tests and electrocardiographs. Blood samples from 6 patients in each group were collected before and after the trial and used for transcriptomic analysis by gene ontology analysis and Kyoto Encyclopedia of Genes and Genomes pathway analysis. Differentially expressed genes were validated using reverse transcription-polymerase chain reaction. RESULTS A total of 86 PD patients were selected from the Third Affifiliated People's Hospital of Fujian University of Traditional Chinese Medicine between January 2017 and December 2017. Finally, 72 patients completed the trial, including 35 in the treatment group and 37 in the control group. When compared with the control group after treatment, patients in the treatment group showed signifificant decreases in UPDRS sub-II score, PDQ-39 score, CM syndrome score, and Levodopa equivalent dose (P<0.05). During the treatment course, no signifificant changes were observed in safety indicators between the two groups (P>0.05). A possible mechanism of clinical effificacy was proposed that involved regulating cell metabolism-related processes and ribosome-related pathways. Treatment with CSGs had shown to affect relevant gene loci for PD, including AIDA, ANKRD36BP2, BCL2A1, BCL2L11, FTH1P2, GCH1, HPRT1, NFE2L2, RMRP, RPS7, TGFBR1, WIPF2, and COX7B. CONCLUSIONS CSGs combined with WM can be used to treat PD patients with CM syndrome of Shen essence defificiency with a good safety. The possible mechanism of action and relevant gene loci were proposed. (Registration No. ChiCTR-IOR-16008394).
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[Hyperhomocysteinemia and kidney diseases].
Zhou, YF, Guan, YF
Sheng li xue bao : [Acta physiologica Sinica]. 2018;(6):607-611
Abstract
Homocysteine (Hcy) is an intermediate metabolite of methionine metabolism. Hyperhomocysteinemia (HHcy) is defined as a condition characterized by plasma Hcy level above 16 μmol/L which can result from abnormal Hcy metabolism. HHcy has been confirmed to be related to cardio-cerebrovascular disease, peripheral vascular disorders, neurodegenerative diseases, diabetes, pregnancy-induced hypertension syndrome, liver cirrhosis and kidney diseases. In this review, we summarize the correlation between HHcy and kidney diseases. Elucidating the role of HHcy in kidney diseases may provide a new strategy to prevent and treat kidney diseases.
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Renal and Bone Toxicity with the Use of Tenofovir: Understanding at the End.
Casado, JL
AIDS reviews. 2016;(2):59-68
Abstract
The use of tenofovir disoproxil fumarate has been associated with side effects on renal function and bone mineral density, but whether this toxicity is of clinical relevance in the middle or long term is highly debated. Current knowledge supports that the use of and time on tenofovir disoproxil fumarate, modulated by other factors such as age, baseline renal function, or classical risk factors, could led to progressive wasting in the urine of low molecular weight proteins, phosphate, uric acid, or glucose. This "partial" Fanconi syndrome seems to be slowly progressive, with increases in the proportion of patients and in the severity of different tubular abnormalities with the long term use of tenofovir disoproxil fumarate. Although progression to chronic kidney disease is relatively rare in patients on tenofovir disoproxil fumarate, in part attributed to the capacity of kidneys to compensate for loss of functioning nephrons, the severity of tubular dysfunction is associated with greater kidney function decline. In large cohorts, the use of tenofovir disoproxil fumarate is one of the main risk factors associated to chronic kidney disease. In addition, hyperphosphaturia secondary to tubular dysfunction could alter the interplay between bone, kidney, and regulatory hormones, leading to progressive bone loss in a similar manner, but in a lesser extent, to hypophosphatemic osteomalacia observed in the Fanconi syndrome. This component of osteomalacia secondary to altered phosphate metabolism explains the partial improvement observed with vitamin D supplementation, the association with altered bone-specific alkaline phosphatase, and the rapid benefit in terms of bone mineral density after tenofovir disoproxil fumarate discontinuation.
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Kidney disease and psoriasis: novel evidences beyond old concepts.
Visconti, L, Leonardi, G, Buemi, M, Santoro, D, Cernaro, V, Ricciardi, CA, Lacquaniti, A, Coppolino, G
Clinical rheumatology. 2016;(2):297-302
Abstract
Psoriasis is an immune-mediated inflammatory disease for a long time considered as a type of pathology characterized by an exclusive skin involvement. Recently it has been shown that patients affected by this disease have a higher risk of developing comorbidities such as cardiovascular diseases, arterial hypertension, diabetes mellitus, and metabolic syndrome. Even the kidneys can be affected by psoriasis through three different mechanisms: immune-mediated renal damage, drug-related renal damage and chronic renal damage. Renal function should be monitored periodically to minimize the risk of renal adverse events.
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[Importance of annexin V in kidney diseases].
Jakubowska, A, Kiliś-Pstrusińska, K
Postepy higieny i medycyny doswiadczalnej (Online). 2015;:153-7
Abstract
Annexin V (AnV) belongs to a cytoplasmic calcium binding protein family found in many body tissues, including distal tubule cells and glomerular epithelial cells. The biological role of this protein discovered so far is connected with apoptosis. AnV is considered as an early marker of that process and is used in one of the most frequently applied apoptosis detection methods, consisting in the detection of biochemical and morphological changes in cells. Measuring the AnV level may help understand many renal processes. Elevated AnV levels have been found in both acute and chronic renal conditions. Applying AnV to identify cells in the early phase of apoptosis in acute pyelonephritis caused by Escherichia coli showed that hemolysins of pathogenic bacteria stimulate the death of tubular cells and that the intensification of the process depends on the level of the toxin and its activity time. Studies on the mechanisms of reperfusion injury in acute renal injury have revealed protective activity of a synthetic AnV homodimer with regard to tubular cells. AnV was also used in diabetic nephropathy to study the influence of metabolic disorders on the intensification of apoptosis in renal tubular cells. Additionally, the suitability of AnV measurement as a biochemical marker of atherosclerosis in patients with a chronic renal condition was evaluated. It was also used to study the causes of immunodeficiency in patients diagnosed with the above-mentioned condition. There have been few papers published so far on the significance of AnV in children with renal conditions. The prognostic value of AnV and T cell apoptosis was evaluated in children with nephrotic syndrome.
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Anti-hypertensive strategies in patients with MEtabolic parameters, DIabetes mellitus and/or NephropAthy (the M E D I N A study).
Spinar, J, Vitovec, J, Soucek, M
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia. 2014;(3):412-21
Abstract
AIMS: The primary questions asked by the MEDINA (MEtabolic parameters, DIabetes mellitus and NephropAthy) study are: 1) Do angiotensin converting enzyme inhibitors (ACE-I) have any advantages over angiotensin receptor blockers (ARB)? 2) Should the other drug for combination be a diuretic or a calcium-channel blocker (CCB)? 3) How are the risks reduced by the co administration of a statin? METHODS A total of 439 hypertensive patients with metabolic syndrome and/or diabetes mellitus were randomized to 2 groups: group 1--ramipril (ACE-I) or perindopril and group 2--losartan (ARB). Hydrochlorothiazide (diuretic) or amlodipine (CCB) were added to both groups. As a third step, a statin was added. RESULTS Blood pressure decreased 24.1/13.3 mmHg in the ACE inhibitor group and 25.9/13.5 in the losartan group. The difference was insignificant. Adding either hydrochlorothiazide or amlodipin was equally effective. There were no significant differences on metabolic parameters in the trial arms. Cholesterol level decreased by 0.95 mmol/L in the ACE-I group and 1.02 mmol/L in the ARB group (ns). CONCLUSION MEDINA has so far confirmed the equivalence of ACE-I and ARB in hypertension treatment. Adding either diuretic or CCB was equally effective. Our data support the current recommendations on adding a statin to reduce cardiovascular risk.
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[Kidney and thyroid dysfunction].
Ponsoye, M, Paule, R, Gueutin, V, Deray, G, Izzedine, H
Nephrologie & therapeutique. 2013;(1):13-20
Abstract
Thyroid hormones influence renal development, kidney structure, renal hemodynamics, glomerular filtration rate, the function of many transport systems along the nephron, and sodium and water homeostasis. Effects of hypothyroidism and hyperthyroidism on kidney function are the result of direct renal effects, as well as systemic hemodynamic, metabolic, and cardiovascular effects. Most of the renal manifestations of thyroid disorders, which are clinically most significant with hypothyroidism, are reversible with treatment. Patients with hypothyroidism can have clinically important reductions in GFR, so screening for hypothyroidism should be considered in patients with unexplained elevations in serum creatinine. Patients with thyroid disorders are also at risk for immune-mediated glomerular diseases. Finally, patients with nephrotic syndrome, as well as acute and chronic kidney injury, have alterations in thyroid gland physiology that can impact thyroid function and the testing of thyroid function status. Dialysis patients have frequently hypothyroidism whose biological diagnosis must be careful.
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[Lifestyle-related disease and fracture risk].
Fujiwara, S
Clinical calcium. 2011;(5):649-53
Abstract
Meta analysis of fracture risk in diabetes indicates that the risk of proximal femoral fracture in type-2 diabetes is increased 1.4-1.7 times. It is well known that increased fracture risk is observed in serious kidney disease. However, it has recently been reported that increased fracture risk is also observed in the early stages of chronic kidney disease (CKD) . The risk of proximal femoral fracture increases in early stages after stroke, but gradually decreases in subsequent stages. Some reports indicate decreased fracture risk in metabolic syndrome and hyperlipidemia and increased fracture risk in hypertension, arterial calcification and ischemic heart disease, while other reports indicate contradictory results.
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9.
Epidemiology of hypertension and chronic kidney disease in China.
Chen, J
Current opinion in nephrology and hypertension. 2010;(3):278-82
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Abstract
PURPOSE OF REVIEW Hypertension and chronic kidney disease have become major public health challenges in China. RECENT FINDINGS It is estimated that approximately 153 million Chinese adults had hypertension in 2002. It is also estimated that 2.33 million total cardiovascular deaths and 1.27 million premature cardiovascular deaths were attributable to increased blood pressure in 2005 in China. Approximately 39% of Chinese adult populations are highly sensitive to dietary sodium intake, a risk factor for hypertension and cardiovascular disease. The prevalence of chronic kidney disease varied greatly among studies due to differences in study populations and definitions of chronic kidney disease. A large prospective cohort study estimates that incidence and mortality of end-stage renal disease was 30.7 and 20.9 per 100,000 person-years among Chinese adults aged 40 years and older. Hypertension and the metabolic syndrome have been documented as risk factors for chronic kidney disease. In addition, a J-shaped association between body weight and incidence of end-stage renal disease and an inverse association between alcohol consumption and risk of end-stage renal disease were documented. SUMMARY These results underscore the urgent need to develop national strategies for the prevention, detection, and treatment of hypertension and chronic kidney disease.
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Antenatal micronutrient supplementation reduces metabolic syndrome in 6- to 8-year-old children in rural Nepal.
Stewart, CP, Christian, P, Schulze, KJ, Leclerq, SC, West, KP, Khatry, SK
The Journal of nutrition. 2009;(8):1575-81
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Abstract
Previously, we showed that antenatal micronutrient supplementation increases birth weight in a malnourished rural South Asian setting, but the long-term effects are unknown. Between 1999 and 2001, pregnant women were sector-randomized to receive from early pregnancy through 3 mo postpartum daily micronutrient supplements containing either vitamin A alone as the control or with folic acid; folic acid+iron; folic acid+iron+zinc; or a multiple micronutrient supplement that included the above nutrients plus 11 others. From 2006 to 2008, 3524 children (93% of surviving children) were revisited between the ages of 6 and 8 y. Blood pressure, BMI, waist circumference, glycated hemoglobin, cholesterol, triglycerides, glucose, insulin, and the urinary microalbumin:creatinine ratio were assessed among children. Insulin resistance was estimated using the homeostasis model assessment (HOMA) and metabolic syndrome was defined using a modified National Cholesterol Education Program definition. None of the micronutrient supplement combinations affected blood pressure, cholesterol, triglycerides, glucose, insulin, or HOMA. There was a reduced risk of microalbuminuria (> or =3.40 mg/mmol creatinine) in the folic acid [odds ratio (OR), 0.56; 95%CI, 0.33-0.93; P = 0.02) and folic acid+iron+zinc (OR, 0.53; CI, 0.32-0.89; P = 0.02) groups and a reduced risk of metabolic syndrome in the folic acid group (OR, 0.63; CI, 0.41-0.97; P = 0.03). Maternal supplementation with folic acid or folic acid+iron+zinc reduced the risk of kidney dysfunction and, to some extent, metabolic syndrome among children at 6-8 y of age. Supplementation with multiple micronutrients had no such affect. Future follow-up studies are needed to examine long-term supplementation effects on risk of chronic diseases in adults.