다중혈관 관상동맥 환자에서 y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적

[신간의 별자리x] 우리/미술, 그리고 ‘슬픔의 박물관’

Diabetic nephropathy (DN) is associated with an increased morbidity and mortality, resulting in elevated cost for public health systems. DN is the main cause of chronic kidney disease (CKD) and its incidence increases the number of patients that develop the end-stage renal disease (ESRD). There are growing epidemiological and preclinical evidence about the close relationship between inflammatory response and the occurrence and progression of DN. Several anti-inflammatory strategies targeting specific inflammatory mediators (cell adhesion molecules, chemokines and cytokines) and intracellular signaling pathways have shown beneficial effects in experimental models of DN, decreasing proteinuria and renal lesions. A number of inflammatory molecules have been shown useful to identify diabetic patients at high risk of developing renal complications. In this review, we focus on the key role of inflammation in the genesis and progression of DN, with a special interest in effector molecules and activated intracellular pathways leading to renal damage, as well as a comprehensive update of new therapeutic strategies targeting inflammation to prevent and/or retard renal injury.

Pathogenic Pathways and Therapeutic Approaches Targeting Inflammation in Diabetic Nephropathy.

Heart failure (HF) is a growing epidemic with high morbidity and mortality at an international scale. The apelin-APJ receptor pathway has been implicated in HF, making it a promising therapeutic target. APJ has been shown to be activated by a novel endogenous peptide ligand known as Elabela (ELA, also called Toddler or Apela), with a critical role in cardiac development and function. Activation of the ELA-APJ receptor axis exerts a wide range of physiological effects, including depressor response, positive inotropic action, diuresis, anti-inflammatory, anti-fibrotic, and anti-remodeling, leading to its cardiovascular protection. The ELA-APJ axis is essential for diverse biological processes and has been shown to regulate fluid homeostasis, myocardial contractility, vasodilation, angiogenesis, cellular differentiation, apoptosis, oxidative stress, cardiorenal fibrosis, and dysfunction. The beneficial effects of the ELA-APJ receptor system are well-established by treating hypertension, myocardial infarction, and HF. Additionally, administration of ELA protects human embryonic stem cells against apoptosis and stress-induced cell death and promotes survival and self-renewal in an APJ-independent manner (X receptor) via the phosphatidylinositol 3-kinase/Akt pathway, which may provide a new therapeutic approach for HF. Thus, targeting the ELA-APJ axis has emerged as a pre-warning biomarker and a novel therapeutic approach against progression of HF. An increased understanding of cardiovascular actions of ELA will help to develop effective interventions. This article gives an overview of the characteristics of the ELA-apelin-APJ axis and summarizes the current knowledge on its cardioprotective roles, potential mechanisms, and prospective application for acute and chronic HF.

https://link.springer.com/content/pdf/10.1007/s10741-020-09957-5.pdf

The Elabela-APJ axis: a promising therapeutic target for heart failure.

Paecilomyces cicadae-fermented Radix astragali activates podocyte autophagy by attenuating PI3K/AKT/mTOR pathways to protect against diabetic nephropathy in mice

Elabela, a newly discovered APJ ligand: Similarities and differences with Apelin.

Elabela protects against podocyte injury in mice with streptozocin-induced diabetes by associating with the PI3K/Akt/mTOR pathway.

Sulforaphane suppresses obesity-related glomerulopathy-induced damage by enhancing autophagy via Nrf2

Pyroptosis, a newly identified type of lytic programmed cell death (PCD), is featured in pore formation in the plasma membrane, swelling, and cell rupture with secretion of cellular contents, especially the inflammatory cytokines. A large number of studies have shown that pyroptosis includes not only the GSDMD involved caspase-1-dependent classical pathway and caspase-11/4/5-dependent non-classical pathway, but also the GSDME involved caspase-3 (Casp3) dependent pathway. Diabetic nephropathy (DN) is one of the most serious microvascular complications in diabetes. Present evidence suggestes that pyroptosis promotes the progression of several diabetic complications including DN. The underlying mechanism mediating renoprotection conferred by GSDME regulation in the diabetic kidney, specifically in human tubular cells has been investigated. Z-DEVD-FMK, the inhibitor of Casp3, ameliorated albuminuria, renal function, and tubulointerstitial fibrosis in diabetic mice. The nephroprotection mediated by Z-DEVDFMK was potentially associated with inhibition of GSDME. In vitro, molecular and morphological features of secondary necrosis were observed in glucose-stimulated HK-2 cells, evidenced by active GSDME cleavage, ballooning of the cell membrane, and release of cellular contents. Based on this, it is not difficult to conclude that therapies targeting Casp3/GSDME dependent pyroptosis show great application prospects in DN, and novel nephroprotective strategy using GSDME-derived peptides directed against Casp3-induced cell death in vitro and in vivo may be a key breakthrough for this goal. Therefore, in the mini-review, we introduced the history of pyroptosis; gasdermin family proteins especially GSDME, and GSDME mediated pyroptosis in DN, expecting this novel mechanism may provide valuable therapeutic insights for the treatment of DN.

Mini-Review: GSDME-Mediated Pyroptosis in Diabetic Nephropathy

The association of serum elabela (ELA) and apelin with the progression of chronic kidney disease (CKD) is unknown. We determined if serum ELA and apelin levels were associated with CKD stage. This ...

Yue Lu

Papers

Elabela, a newly discovered APJ ligand: Similarities and differences with Apelin.

Elabela protects against podocyte injury in mice with streptozocin-induced diabetes by associating with the PI3K/Akt/mTOR pathway.

Sulforaphane suppresses obesity-related glomerulopathy-induced damage by enhancing autophagy via Nrf2

Mini-Review: GSDME-Mediated Pyroptosis in Diabetic Nephropathy

Serum elabela and apelin levels during different stages of chronic kidney disease.