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BACKGROUND: Cutaneous diseases are observed with increasing duration and severity of renal disease in patients with chronic kidney disease (CKD). This study aimed to elucidate dermatological manifestations at different stages of CKD and determine their relationship with interleukin 31 (IL-31), a T-cell cytokine that induces severe pruritus, and uridine diphosphate (UDP)-glucose ceramide glucosyltransferase (UGCG), an enzyme that metabolizes ceramide, which plays an important role in moisturizing epidermis. METHODS: In this retrospective cohort study 145 patients with a mean age of 46 ± 17 years were categorized into hemodialysis (group 1), peritoneal dialysis (group 2), kidney transplant (group 3), CKD (group 4), and healthy control (group 5) groups. Serum IL-31 and UGCG levels were measured using enzyme-linked immunosorbent assay, and clinical dermatologists evaluated dermatological manifestations. RESULTS: In the overall cohort, pruritus was significantly and inversely correlated with glomerular filtration rate and serum hemoglobin and albumin levels (p <0.005). Additionally, pruritus was significantly more frequent in group 2 than in group 5; and significantly less frequent in group 3 than in groups 1, 2, and 4 (p =0.01). In group 4, the patients with longitudinal nail ridges had significantly higher serum IL-31 levels than those without longitudinal nail ridges in their nails (p =0.02). Furthermore, in group 2, the patients with pruritus had significantly lower UGCG levels than those without pruritus (p =0.045). CONCLUSION: IL-31 might play a role in the development of longitudinal nail ridges, whereas UGCG might provide protection from pruritus and xerosis in patients with CKD. HIPPOKRATIA 2019, 23(2): 75-80.
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AIM: To investigate the prognostic role of nuclear factor-kappa B (NF-κB) activity in peripheral blood mononuclear cells (PBMNCs) during acute necrotizing pancreatitis (ANP) in rats. METHODS: ANP was induced by an intravenous infusion of cerulein over 6 h superimposed on glycodeoxycholic acid (10 mmol/l) into the biliary-pancreatic duct for 10 min. The rats were divided into five groups and the first group served as the control. ANP was induced in the remaining groups, which were followed for 6, 12, 24 and 48 h. The mortality rate, serum amylase, alanine transferase (ALT), urea, creatinine and calcium, pancreatic histology, and NF-κB activity in PBMNCs were investigated. The NF-κB activity in PBMNCs was measured as two subunits of NF-κB, p50 and p65. RESULTS: A significant increase in mortality rate, pancreatic damage, serum activity of amylase and ALT, urea and NF-κB p65 activity in PBMNCs were observed. There was a significant correlation between the mortality rate and pancreatic damage in conjunction with time, but there was no correlation between NF-κB p65 activity in PBMNCs and the mortality rate. CONCLUSION: The measurement of p65 levels of NF-kB in PBMNCs has no prognostic role during ANP in rats.
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Leucocitos Mononucleares/metabolismo , Pancreatitis Aguda Necrotizante/metabolismo , Factor de Transcripción ReIA/metabolismo , Animales , Modelos Animales de Enfermedad , Masculino , Pancreatitis Aguda Necrotizante/patología , Pancreatitis Aguda Necrotizante/fisiopatología , Pronóstico , Ratas , Ratas Sprague-DawleyRESUMEN
The aim of this study was to investigate the influence of omega-3 fatty acids (omega3FA) on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. The induction of ANP resulted in significant increases in mortality rate, intestinal permeability, bacterial infection in pancreas and extrapancreatic organs, and serum activity of urea and amylase, alanine transferase (ALT), interleukin (IL)-6, tumor necrotizing factor-alpha (TNF-alpha), lactate dehydrogenase (LDH) in bronchoalveolar lavage (BAL) fluid, tissue activity of myeloperoxidase (MPO) and malondialdehyde (MDA) in the pancreas and lung, and a considerable decrease of concentrations of calcium, protein and albumin. The use of omega3FA reduced mortality, phenol sulfophthalein excretion in urine, bacterial infection in pancreas, liver, spleen, MPO and MDA levels in pancreatic and lung tissue, LDH level in BAL fluid and serum IL-6 and TNF-alpha values. Serum triglyceride increased only in the omega3FA groups. Serum amylase, ALT, calcium, urea, protein, IL-1, and degree of pancreatic damage indicated no difference between the pancreatitis groups. Increased intestinal permeability and cytokine levels, and free radical damage play an important role during the course of acute pancreatitis. The treatment with omega3FA improves these effects. omega3FA may be useful in the treatment during ANP in rats. Therefore, it can be beneficial in patients with pancreatitis.
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Ácidos Grasos Omega-3/farmacología , Pancreatitis Aguda Necrotizante/tratamiento farmacológico , Pancreatitis Aguda Necrotizante/patología , Alanina Transaminasa/sangre , Amilasas/sangre , Animales , Traslocación Bacteriana , Líquido del Lavado Bronquioalveolar , Permeabilidad Capilar , Interleucina-6/sangre , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiología , Riñón/fisiología , Hígado/fisiología , Masculino , Pancreatitis Aguda Necrotizante/mortalidad , Ratas , Ratas Sprague-Dawley , Tasa de Supervivencia , Factor de Necrosis Tumoral alfa/metabolismo , Urea/sangreRESUMEN
The aim of this study was to investigate the influence of U-74389G on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. The induction of ANP resulted in a significant increase in mortality rate, pancreatic necrosis, and serum levels of amylase, alanine aminotransferase, interleukin-6, tumor necrosis factor alpha, and urea, in lactate dehydrogenase levels in bronchoalveolar lavage fluid, and in the activities of myeloperoxidase and malondialdehyde in pancreas and lung tissue; a significant decrease was observed in serum calcium levels, blood pressure, urine output, and pO(2). The use of U-74389G inhibited the changes in serum urea, pO(2), and tissue levels of myeloperoxidase and malondialdehyde in pancreas and lungs. Moreover, it indicated a limited effect on the course of ANP in the rats and did not reduce mortality and pancreatic damage. Therefore, it may be used in the treatment of lung injury during acute pancreatitis.
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Antioxidantes/farmacología , Pancreatitis Aguda Necrotizante/tratamiento farmacológico , Pancreatitis Aguda Necrotizante/metabolismo , Pregnatrienos/farmacología , Animales , Pulmón/efectos de los fármacos , Pulmón/patología , Masculino , Microcirculación/efectos de los fármacos , Páncreas/efectos de los fármacos , Páncreas/patología , Pancreatitis Aguda Necrotizante/mortalidad , Ratas , Ratas Sprague-Dawley , Tasa de SupervivenciaRESUMEN
The aim of this study was to investigate the influence of N-acetylcysteine (NAC) on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. The induction of ANP resulted in significant increase in mortality rate, pancreatic necrosis and serum activity of amylase, alanine aspartate transferase (ALT), interleukin-6 (IL-6), lactate dehydrogenase (LDH) in bronchoalveolar lavage (BAL) fluid, serum concentration of urea, tissue activity of myeloperoxidase (MPO) and malondialdehyde (MDA) in the pancreas and lung, and significant decrease of concentrations of calcium, blood pressure, urine output and pO(2). The use of NAC inhibited the changes in urine output, pO(2), tissue activity of MPO and MDA in pancreas and lungs, and the serum activity of IL-6, ALT, and serum concentrations of urea and calcium. NAC reduced the mortality and pancreatic damage. The use of NAC has a beneficial effect on the course of ANP in rats. It may be used in the treatment of acute pancreatitis.
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Acetilcisteína/farmacología , Pancreatitis Aguda Necrotizante/metabolismo , Pancreatitis Aguda Necrotizante/patología , Animales , Líquido del Lavado Bronquioalveolar/química , Detergentes , Ácido Glicodesoxicólico , Pulmón/metabolismo , Masculino , Necrosis , Páncreas/efectos de los fármacos , Páncreas/metabolismo , Páncreas/patología , Pancreatitis Aguda Necrotizante/inducido químicamente , Pancreatitis Aguda Necrotizante/mortalidad , Ratas , Ratas Sprague-DawleyRESUMEN
The aim of this study was to investigate the influence of melatonin on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. The induction of ANP resulted in significant increases in mortality rate, pancreatic necrosis and increased serum activity of amylase, alanine aspartate transferase (ALT), interleukin 6 (IL-6), lactate dehydrogenase (LDH) in bronchoalveolar lavage (BAL) fluid, serum concentration of urea, tissue activity of myeloperoxidase (MPO) and malondialdehyde (MDA) in the pancreas and lung, and significant decrease of concentrations of calcium, blood pressure, urine output and pO (2). Melatonin inhibited the changes in blood pressure, urine output, pO (2), serum concentration of urea, and calcium, tissue activity of MPO and MDA in the pancreas and lung, LDH level in BAL fluid, and partially reduced serum activity of IL-6. Melatonin did not change serum activity of amylase, ALT, pancreatic damage and the mortality rate. The use of melatonin has a limited value on the course of ANP. It may be useful as a supportive treatment during ANP.