ADPKD: Prototype of Cardiorenal Syndrome Type 4

The cardiorenal syndrome type 4 (Chronic Renocardiac Syndrome) is characterized by a condition of primary chronic kidney disease (CKD) that leads to an impairment of the cardiac function, ventricular hypertrophy, diastolic dysfunction, and/or increased risk of adverse cardiovascular events. Clinically, it is very difficult to distinguish between CRS type 2 (Chronic Cardiorenal Syndrome) and CRS type 4 (Chronic Renocardiac Syndrome) because often it is not clear whether the primary cause of the syndrome depends on the heart or the kidney. Autosomal dominant polycystic kidney disease (ADPKD), a genetic disease that causes CKD, could be viewed as an ideal prototype of CRS type 4 because it is certain that the primary cause of cardiorenal syndrome is the kidney disease. In this paper, we will briefly review the epidemiology of ADPKD, conventional and novel biomarkers which may be useful in following the disease process, and prevention and treatment strategies

Improvement of Fatty Acid Profile in Durum Wheat Breads Supplemented with Portulaca oleracea L. Quality Traits of Purslane-Fortified Bread

The addition of functional ingredients to breads could have effects on preventing cardiovascular diseases, cancers and inflammation. The incorporation of 0–5–10–15% of three populations of dried purslane flour on the rheological, sensorial and nutritional quality of fortified durum wheat breads were evaluated. The increase in dried purslane (up to 15%) caused an increase in the resistance to the mixture and a consequent reduction in its extensibility. The “panel test” gave a largely positive evaluation in 10% of enrichment. The fatty acids in breads resulted higher with the 5% substitution. Contrary to what has been imagined, the increase in percentage of substitution to 10 and 15% did not lead to an increase in linoleic (omega-3) and α-linolenic (omega-6) acid and probably the cause is in the cooking. The total phenols content and the antioxidant potential, evaluated by ferric reducing antioxidant potential (FRAP) and 2,20 -azinobis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays of the enriched breads increased with the percentage of the dry purslane substitution. The enrichment of the durum wheat flour with 5% purslane resulted in a good compromise to obtain good rheological characteristics of loaves and breads with decreased omega-6/omega-3 ratio and good antioxidant properties

Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Peritoneal Dialytic Effluent: Preliminary Results on the Comparison between Two Different Methods in Patients with and without Peritonitis

Neutrophil gelatinase-associated lipocalin (NGAL) is a lipocalin involved in the immune response and is significantly high in the peritoneal dialytic effluent (PDE) of peritoneal dialysis (PD) patients with inflammation of the peritoneum membrane (peritonitis). The focus of this study was to match two different techniques for peritoneal NGAL evaluation: NGAL point-of-care test-POCT (NGAL Dipstick—NGALds) versus the laboratory-based NGAL assay and with the white cell count in PDE. In this study, we included 30 PD patients: 17 with peritonitis and 13 without. Peritoneal NGAL was tested by a turbidimetric immunoassay and by NGALds. We noticed a good positive linear correlation between the POCT results and the laboratory-based test and between the peritoneal NGALds and white cell count in PDE (both, p < 0.01). NGALds values resulted in being elevated in patients with peritonitis (300 ng/mL, IQR 300–600) in comparison to patients without (100 ng/mL, IQR 50–150) (p < 0.01). Furthermore, the NGALds test was performed in a median time of 20 mins (IQR 18–21) in comparison with the median time of 65 mins (IQR 55–69) necessary for the laboratory-based test (p < 0.01). The results of the NGALds were coherent with the laboratory-based NGAL and with the white cell count in PDE; furthermore, it was a user-friendly method with real-time findings. NGALds could be an extra tool for the diagnosis of peritonitis, helpful at the bedside of the patient, shortening the length of diagnosis, and if the laboratory-based NGAL test is not accessible

Novel Clinical Updates in Uremia

The progressive loss of kidney function is responsible for the retention of different metabolites due to a decrease in their renal clearance [...

New Frontiers in Diagnosis and Prevention of Acute Kidney Injury (AKI): The Role of Dendritic Cells and Innovative High-Throughput Techniques

Kidney diseases, including acute kidney injury (AKI) and chronic kidney disease (CKD), represent a general, public health urgency, causing a heavy burden to global health care systems. Moreover, AKI is a frequent complication of hospitalization, and it is associated with short-term morbidity and mortality rate greater than 50%, as a result of its relationship with other severe complications. Furthermore, multiple pathophysiologic processes are involved in AKI, such as cellular death, apoptosis, mesenchymal transition, cellular infiltration, inflammation, cytokines release, coagulation, and complement activation. Since increasing evidence highlighted the central role of the immune system in AKI pathophysiology, several efforts have been made to delineate the link between this disease and the different population of immune cells. This narrative review aims to describe the role played by dendritic cells (DCs) in AKI, with a special focus on recent findings suggesting DCs suppression as a promising strategy to prevent AKI negative side effects and ameliorate renal injury and dysfunction. Furthermore, we briefly summarize the main characteristics of innovative high-throughput techniques, including as genomics, transcriptomics, proteomics, and metabolomics in the context of AKI

Endotoxin in Sepsis: Methods for LPS Detection and the Use of Omics Techniques

Lipopolysaccharide (LPS) or endotoxin, the major cell wall component of Gram-negative bacteria, plays a pivotal role in the pathogenesis of sepsis. It is able to activate the host defense system through interaction with Toll-like receptor 4, thus triggering pro-inflammatory mechanisms. A large amount of LPS induces inappropriate activation of the immune system, triggering an exaggerated inflammatory response and consequent extensive organ injury, providing the basis of sepsis damage. In this review, we will briefly describe endotoxin’s molecular structure and its main pathogenetic action during sepsis. In addition, we will summarize the main different available methods for endotoxin detection with a special focus on the wider spectrum offered by omics technologies (genomics, transcriptomics, proteomics, and metabolomics) and promising applications of these in the identification of specific biomarkers for sepsis

Rheological and nutritional profile of spaghetti and bread fortified with hemp flours

In recent years, the demands of food consumers have changed considerably. Food today is not only intended to satisfy hunger and provide the necessary nutrients, but also to prevent food-related diseases and improve the physical and mental well-being of consumers. Functional foods are formulated to contain healthy components, which when consumed daily as part of the diet, can have beneficial health effects. Cereal-based products, especially pasta and bread, are well suited for adding nutrients. Both bread and pasta, traditionally produced using durum wheat flour, can be prepared also using "non-wheat flours" in variable percentages or by incorporating food by-products, capable of increasing their nutritional value [1]. Unfortunately, fortification often affects the quality of cereal-based products, in terms of texture, color, cooking quality and sensory properties. Therefore, one of the main challenges of the food industry is to increase the healthiness of foods without sacrificing sensory attributes. In this study the rheological and chemical qualities of spaghetti and bread samples were evaluated, obtained by using a durum wheat cultivar, called "Ciclope", fortified with different percentages of hemp flour, called "Futura 75". The hemp flours, obtained after grinding the seeds and the subsequent separation of the oil, were sieved at 0.530 mm (Hemp -1) and 0.236 mm (Hemp -2)

In Vitro Induction of Eryptosis by Uremic Toxins and Inflammation Mediators in Healthy Red Blood Cells

Eryptosis is the stress-induced RBC (red blood cell) death mechanism. It is known that eryptosis is largely influenced by plasma and blood composition, and that it is accelerated in patients affected by chronic kidney disease (CKD). The aim of this study is to evaluate the eryptosis rate in healthy RBCs treated with different concentration of IL-6, IL-1β, urea and p-cresol, comparable to plasmatic level of CKD patients, at different time points. We exposed healthy RBCs to increasing concentrations of IL-6, IL-1β, urea and p-cresol. Morphological markers of eryptosis (cell membrane scrambling, cell shrinkage and PS exposure at RBC surface) were evaluated by flow cytometric analyses. The cytotoxic effect of cytokines and uremic toxins were analyzed in vitro on healthy RBCs at 4, 8 and 24 h. Morphology of treated RBCs was dramatically deranged, and the average cell volume was significantly higher in RBCs exposed to higher concentration of all molecules (all, p p < 0.05). In conclusion, our data show that cytokines and uremic toxins have a harmful effect on RBCs viability and trigger eryptosis. Further studies are necessary to validate these results in vivo and to associate abnormal eryptosis with cytokine levels in CKD patients. The eryptosis pathway could, moreover, become a new promising target for anemia management in CKD patients

Eryptosis in Patients with Chronic Kidney Disease: A Possible Relationship with Oxidative Stress and Inflammatory Markers

Background. Eryptosis is the programmed death of red blood cells; it may contribute to worsening anemia in chronic kidney disease (CKD). In this clinical condition, different factors induce eryptosis, such as oxidative stress, energy depletion and uremic toxins. In our study, we investigated if the progression of CKD may influence erythrocyte death levels and its relationship with oxidative stress and inflammation. Methods. We evaluated eryptosis levels in 25 CKD patients (five for each stage), as well as markers of oxidative stress and inflammation: myeloperoxidase (MPO), copper/zinc superoxide dismutase (Cu/Zn SOD) and interleukin-6 (IL-6) were evaluated in plasma samples. Results. Higher cell death rate was reported in the highest CKD stages (p 2). Patients with eGFR 2 had higher eryptosis levels (p p p = 0.01) and IL-6 (Spearman’s rho = 0.52, p = 0.05) and Cu/Zn SOD. Spearman’s rho = 0.6, p = 0.03). Conclusions. In patients with CKD, different factors are involved in the pathogenesis of eryptosis, in particular uremic toxins and oxidative stress and inflammatory markers. The progressive impairment of renal function may be associated with the increase in eryptosis levels, probably due to the accumulation of oxidative stress factors, inflammatory cytokines and uremic toxins