Effects of hormonal changes on sarcopenia in chronic kidney disease: where are we now and what can we do?

Sarcopenia or muscle wasting is a progressive and generalized skeletal muscle disorder involving the accelerated loss of muscle mass and function, often associated with muscle weakness (dynapenia) and frailty. Whereas primary sarcopenia is related to ageing, secondary sarcopenia happens independent of age in the context of chronic disease states such as chronic kidney disease (CKD). Sarcopenia has become a major focus of research and public policy debate due to its impact on patient's health-related quality of life, health-care expenditure, morbidity, and mortality. The development of sarcopenia in patients with CKD is multifactorial and it may occur independently of weight loss or cachexia including under obese sarcopenia. Hormonal imbalances can facilitate the development of sarcopenia in the general population and is a common finding in CKD. Hormones that may influence the development of sarcopenia are testosterone, growth hormone, insulin, thyroid hormones, and vitamin D. Although the relationship between free testosterone level that is low in uraemic patients and sarcopenia in CKD is not well-defined, functional improvement may be seen. Unlike testosterone, it is known that vitamin D is associated with muscle strength, muscle size, and physical performance in patients with CKD. Outcomes after vitamin D replacement therapy are still controversial. The half-life of growth hormone (GH) is prolonged in patients with CKD. Besides, IGF-1 levels are normal in patients with Stage 4 CKD-a minimal reduction is seen in the end-stage renal disease. Unresponsiveness or resistance of IGF-1 and changes in the GH/IGF-1 axis are the main causes of sarcopenia in CKD. Low serum T3 level is frequent in CKD, but the net effect on sarcopenia is not well-studied. CKD patients develop insulin resistance (IR) from the earliest period even before GFR decline begins. IR reduces glucose utilization as an energy source by hepatic gluconeogenesis, decreasing muscle glucose uptake, impairing intracellular glucose metabolism. This cascade results in muscle protein breakdown. IR and sarcopenia might also be a new pathway for targeting. Ghrelin, oestrogen, cortisol, and dehydroepiandrosterone may be other players in the setting of sarcopenia. In this review, we mainly examine the effects of hormonal changes on the occurrence of sarcopenia in patients with CKD via the available data

The Mitochondrion: A Promising Target for Kidney Disease

Acute kidney injury; Chronic kidney disease; Mitochondrial dysfunctionLesión renal aguda; Enfermedad renal crónica; Disfunción mitocondrialLesió renal aguda; Malaltia renal crònica; Disfunció mitocondrialMitochondrial dysfunction is important in the pathogenesis of various kidney diseases and the mitochondria potentially serve as therapeutic targets necessitating further investigation. Alterations in mitochondrial biogenesis, imbalance between fusion and fission processes leading to mitochondrial fragmentation, oxidative stress, release of cytochrome c and mitochondrial DNA resulting in apoptosis, mitophagy, and defects in energy metabolism are the key pathophysiological mechanisms underlying the role of mitochondrial dysfunction in kidney diseases. Currently, various strategies target the mitochondria to improve kidney function and kidney treatment. The agents used in these strategies can be classified as biogenesis activators, fission inhibitors, antioxidants, mPTP inhibitors, and agents which enhance mitophagy and cardiolipin-protective drugs. Several glucose-lowering drugs, such as glucagon-like peptide-1 receptor agonists (GLP-1-RA) and sodium glucose co-transporter-2 (SGLT-2) inhibitors are also known to have influences on these mechanisms. In this review, we delineate the role of mitochondrial dysfunction in kidney disease, the current mitochondria-targeting treatment options affecting the kidneys and the future role of mitochondria in kidney pathology

Desensitization in HLA-incompatible kidney transplant recipients:current strategies and emerging perspectives

Despite development of kidney paired donation programs and prioritization in kidney allocation schemes, transplantation rates are still low and waiting times remain prolonged for highly sensitized kidney transplant recipients with broad human leukocyte antigen antibody reactivity. Desensitization confers an invaluable option improving access to kidney transplantation for sensitized patients who could not benefit from kidney paired donation programs and kidney allocation schemes. Conventional desensitization strategies use intravenous immunoglobulin combined with either plasmapheresis or monoclonal anti-CD20 antibodies. Imlifidase, IL-6 targeting agents, plasma cell-directed therapies, complement inhibitors, chimeric antigen receptor T-cell therapies, and B cell-activating factor inhibitors are emerging new options in the hope of enhancing and sustaining the efficacy of desensitization to improve allograft longevity. In this review, we discuss the rationale and outcome of desensitization with various strategies alone or in combination. Our aim is also to provide some insight for decision when pursuing desensitization might be successful or futile in sensitized patients

CLINICAL MANIFESTATIONS RISK FACTORS AND PROGNOSIS OF ENCAPSULATED PERITONEAL SCLEROSIS

55th Congress of the European-Renal-Association (ERA) and European-Dialysis-and-Transplantation-Association (EDTA) -- MAY 24-27, 2018 -- Copenhagen, DENMARK[Abstract Not Available]European Renal Assoc,European Dialysis & Transplant Asso

Pleomorphic Carcinoma of the Lung with High Serum Beta-human Chorionic Gonadotropin Level and Gynecomastia

Although gynecomastia is a well-defined paraneoplastic syndrome in patients with non-small cell lung cancer, the association with pleomorphic carcinoma has not been reported. A 50-yr-old man presented with bilateral gynecomastia and elevated serum beta-human chorionic gonadotropin (βhCG) level. Chest tomography showed a mass in the right middle lobe. Right middle lobectomy and mediastinal lymph node dissection were performed. βhCG levels decreased rapidly after surgery. Histological examination revealed pleomorphic carcinoma with positive immunostaining for βhCG. Serum βhCG levels began to increase gradually on postoperatively 4th month. Computed tomography detected recurrence and chemotherapy was started. After second cycle of chemotherapy, βhCG levels decreased dramatically again and tomography showed regression in mass. Patient died 6 months later due to brain metastasis. βhCG expression may be associated with aggressive clinical course and increased risk of recurrence, also βhCG levels may be used to evaluate therapy response in patients with pleomorphic carcinoma

UNEXPECTEDLY HIGH PREVALENCE OF LOW ALPHA GALACTOSIDASE A ENZYME ACTIVITY IN PATIENTS WITH FSGS

55th Congress of the European-Renal-Association (ERA) and European-Dialysis-and-Transplantation-Association (EDTA) -- MAY 24-27, 2018 -- Copenhagen, DENMARK[Abstract Not Available]European Renal Assoc,European Dialysis & Transplant Asso

In vitro mechanistic studies and potential health benefits of a standardized bilberry extract in low mood and cognitive enhancement

Background: Low mood and cognitive impairments are multifactorial conditions often linked to oxidative stress, neurotransmitter imbalances, and neuroinflammation. Bilberry (Vaccinium myrtillus L.) extract, particularly rich in anthocyanins, has shown promising neuropharmacological properties in recent studies. Aims of the study: This study aimed to comprehensively evaluate the biochemical, antioxidant, and neuroprotective properties of a standardized bilberry extract (Mirtoselect™), alongside assessing its potential health benefits on mood and cognitive enhancement in a clinical setting. Methods: In vitro assays were conducted to explore the neuromodulatory, antioxidant, and cytoprotective properties of Bilberry extract. Enzyme inhibition assays targeted γ-Aminobutyric acid transaminase (GABA-T), monoamine oxidase A (MAO-A), and acetylcholinesterase (AChE), while GABAA receptor binding was also evaluated. Antioxidant capacity was assessed using DPPH, ABTS, FRAP, ORAC, HORAC, and TAS assays. Neuroprotection was investigated using SH-SY5Y cells exposed to H2O2, assessing cell viability (MTT), membrane integrity (LDH release), and BDNF expression. Cytotoxicity was determined through the MTT assay in SH-SY5Y cells. A randomized, double-blind, placebo-controlled pilot clinical study was conducted on healthy adult subjects (n = 33) (aged 25–55 years) to evaluate the effects of Bilberry extract on mood (POMS) and cognitive function. Results: Bilberry extract demonstrated significant inhibition of GABA-T, MAO-A, and AChE, alongside moderate GABAA receptor binding. It exhibited robust antioxidant activity in DPPH (EC50: 9.24 ± 0.22 μg/mL), ABTS (EC50: 12.70 ± 0.11 μg/mL), FRAP, ORAC, HORAC, and TAS assays. Neuroprotective effects included enhanced cell viability, reduced LDH release, and upregulation of BDNF in SH-SY5Y cells under oxidative stress. Cytotoxicity tests confirmed a favorable safety profile. In the pilot study, Bilberry extract supplementation significantly improved mood parameters, including reduced tension, depression, and confusion scores (p < 0.05) compared to placebo, with minimal adverse effects. Conclusion: Bilberry extract exhibits potent antioxidant, neuromodulatory, and neuroprotective properties, supporting its potential as a natural intervention for managing low mood and cognitive health. The favorable safety profile and preliminary clinical benefits warrant further research

Biological Flora of the British Isles: Sorbus torminalis

1.This account presents information on all aspects of the biology of Sorbus torminalis (L.) Crantz (Wild Service-tree) that are relevant to understanding its ecological characteristics and behaviour. The main topics are presented within the standard framework of the Biological Flora of the British Isles: distribution, habitat, communities, responses to biotic factors, responses to environment, structure and physiology, phenology, floral and seed characters, herbivores and disease, history, and conservation.2.Sorbus torminalis is an uncommon, mostly small tree (but can reach 33 m) native to lowland England and Wales, and temperate and Mediterranean regions of mainland Europe. It is the most shade-tolerant member of the genus in the British Isles and as a result it is more closely associated with woodland than any other British species. Like other British Sorbus species, however, it grows best where competition for space and sunlight is limited. Seedlings are shade tolerant but adults are only moderately so. This, combined with its low competitive ability, restricts the best growth to open areas. In shade, saplings and young adults form a sapling bank, showing reproduction and extensive growth only when released. Sorbus torminalis tolerates a wide range of soil reaction (pH 3.5-8.0) but grows best on calcareous clays and thin soils over limestone.3.Sorbus torminalis is a sexual, diploid, non-apomictic species that has hybridised with a number of other Sorbus species to form microspecies. The hermaphrodite flowers are primarily insect pollinated. Seed production is reliable only in warm years, especially at the edge of its range, although even then seed viability is low. The fruits are primarily dispersed by carnivorous mammals. Seeds display embryo dormancy but most will germinate the first spring after falling.4.This tree is very tolerant of short droughts but only moderately tolerant of frost, hence its southerly and lowland distribution. It faces no particular individual threats although the small size of most populations makes it susceptible to habitat loss and fragmentation, particularly through the loss of open coppiced areas. As a consequence it appears to be declining throughout Britain and Europe despite its wide range of historical uses and the high value of its timber. The extent to which these losses will be offset by increases due to climate change is unknown.This article is protected by copyright. All rights reserved

Kuşanlar Dönemi’ nden Selçuklular Dönemi’ nin sonuna Afganistan şehirleri

Tez (Yüksek Lisans) -- Mimar Sinan Güzel Sanatlar Üniversitesi Sosyal Bilimler Enstitüsü, 2010.Kaynakça var.[Abstract Not Available