139 results on '"Eleftheriadis T"'
Search Results
2. APD or CAPD: one glove does not fit all
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Roumeliotis, A. Roumeliotis, S. Leivaditis, K. Salmas, M. Eleftheriadis, T. Liakopoulos, V.
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musculoskeletal, neural, and ocular physiology ,cardiovascular system ,musculoskeletal system ,circulatory and respiratory physiology - Abstract
The use of Automated Peritoneal Dialysis (APD) in its various forms has increased over the past few years mainly in developed countries. This could be attributed to improved cycler design, apparent lifestyle benefits and the ability to achieve adequacy and ultrafiltration targets. However, the dilemma of choosing the superior modality between APD and Continuous Ambulatory Peritoneal Dialysis (CAPD) has not yet been resolved. When it comes to fast transporters and assisted PD, APD is certainly considered the most suitable Peritoneal Dialysis (PD) modality. Improved patients’ compliance, lower intraperitoneal pressure and possibly lower incidence of peritonitis have been also associated with APD. However, concerns regarding increased cost, a more rapid decline in residual renal function, inadequate sodium removal and disturbed sleep are APD’s setbacks. Besides APD superiority over CAPD in fast transporters, the other medical advantages of APD still remain controversial. In any case, APD should be readily available for all patients starting PD and the most important indication for its implementation remains patient’s choice. © 2020, Springer Nature B.V.
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- 2021
3. Mechanisms for cardiorenal protection of sglt-2 inhibitors
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Georgianos, P.I. Vaios, V. Dounousi, E. Salmas, M. Eleftheriadis, T. Liakopoulos, V.
- Abstract
Despite optimal treatment of diabetic kidney disease (DKD) with adequate blood pressure control and agents blocking the renin-angiotensin-system (RAS), the residual cardiorenal risk of these patients remains substantially high. There is, therefore, an unmet need for additional therapies effective to retard the progression of DKD and improve cardiovascular outcomes in this high-risk population. Sodium-glucose co-transporter 2 (SGLT-2) inhibitors represent a novel drug class that received regulatory approval for improving glycemic control in patients with type 2 diabetes and preserved kidney function. Large outcome trials designed to test their cardiovascular safety profile showed an unexpected improvement in cardiovascular outcomes and also suggested a slower progression of DKD with SGLT-2 inhibition. The Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy (CREDENCE), a trial that was designed to specifically investigate the renoprotective properties of SGLT-2 inhibitors in patients with overt DKD already receiving guideline-based therapy with a RAS-blocker, was prematurely terminated due to an impressive benefit of canagliflozin on kidney and cardiovascular outcomes. These impressive results refine the role and the indication of SGLT-2 inhibitors as a cardio-and renoprotective strategy in patients with DKD. In this article, we provide an overview of the available clinical-trial evidence and explore the mechanisms mediating the cardiorenal protection afforded by SGLT-2 inhibitors. We conclude with perspectives for a potential beneficial effect of this novel drug class in patients with non-diabetic kidney disease. © 2021 Bentham Science Publishers.
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- 2021
4. Unfavorable effects of peritoneal dialysis solutions on the peritoneal membrane: The role of oxidative stress
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Roumeliotis, S. Dounousi, E. Salmas, M. Eleftheriadis, T. Liakopoulos, V.
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One of the main limitations to successful long-term use of peritoneal dialysis (PD) as a renal replacement therapy is the harmful effects of PD solutions to the structure and function of the peritoneal membrane (PM). In PD, the PM serves as a semipermeable membrane that, due to exposure to PD solutions, undergoes structural alterations, including peritoneal fibrosis, vasculopathy, and neoangiogenesis. In recent decades, oxidative stress (OS) has emerged as a novel risk factor for mortality and cardiovascular disease in PD patients. Moreover, it has become evident that OS plays a pivotal role in the pathogenesis and development of the chronic, progressive injury of the PM. In this review, we aimed to present several aspects of OS in PD patients, including the pathophysiologic effects on the PM, clinical implications, and possible therapeutic antioxidant strategies that might protect the integrity of PM during PD therapy. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
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- 2020
5. Vascular Calcification in Chronic Kidney Disease: The Role of Vitamin K- Dependent Matrix Gla Protein
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Roumeliotis, S. Dounousi, E. Salmas, M. Eleftheriadis, T. Liakopoulos, V.
- Abstract
Arterial calcification is highly prevalent in chronic kidney disease (CKD) patients and is associated with cardiovascular (CV) morbidity and mortality. Patients at early CKD stages are more likely to suffer a fatal CV event than to develop end-stage renal disease and require hemodialysis treatment. The heavy CV burden of these patients cannot be solely explained by traditional calcification risk factors. Moreover, the pathophysiologic mechanisms underlying this association are complex and yet not fully understood. Although vascular calcification was regarded as a passive degenerative process for over a century, this theory changed by recent evidence that pointed toward an active process, where calcification promoters and inhibitors were involved. Matrix Gla Protein (MGP) has been established as a strong inhibitor of calcification both in vitro and in vivo. Not only it prevents mineralization of the arterial wall, but it is the only factor that can actually reverse it. To become fully active, MGP must undergo carboxylation of specific protein bound glutamate residues, a process fully dependent on the availability of vitamin K. Low vitamin K status leads to inactive, uncarboxylated forms of MGP and has been repeatedly associated with accelerated vascular calcification. Aim of this review is to present the pathophysiologic mechanisms underlying the activation and function of MGP and review the existing, accumulating data regarding the association between vitamin K, MGP and vascular calcification/CV disease in CKD patients. © Copyright © 2020 Roumeliotis, Dounousi, Salmas, Eleftheriadis and Liakopoulos.
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- 2020
6. Expression of circulating micrornas linked to bone metabolism in chronic kidney disease-mineral and bone disorder
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Yavropoulou, M.P. Vaios, V. Makras, P. Georgianos, P. Batas, A. Tsalikakis, D. Tzallas, A. Ntritsos, G. Roumeliotis, S. Eleftheriadis, T. Liakopoulos, V.
- Abstract
The pathophysiology of chronic kidney disease–mineral and bone disorder (CKD-MBD) is complex and multifactorial. Recent studies have identified a link between microRNAs (miRNAs) and bone loss. In this study, we investigated the expression of miRNAs in CKD-MBD. In this case-control study, we included thirty patients with CKD-MBD (cases) and 30 age-and gender-matched healthy individuals (controls). Bone mineral density (BMD) and trabecular bone score (TBS) evaluation was performed with dual X-ray absorptiometry. The selected panel of miRNAs included: hsa-miRNA-21-5p; hsa-miRNA-23a-3p; hsa-miRNA-24-2-5p; hsa-miRNA-26a-5p; hsa-miRNA-29a-3; hsa-miRNA-124-3p; hsa-miRNA-2861. The majority of cases had low BMD values. The relative expression of miRNA-21-5p was 15 times lower [fold regulation (FR): −14.7 ± 8.1, p = 0.034), miRNA-124-3p, 6 times lower (FR: −5.9 ± 4, p = 0.005), and miRNA-23a-3p, 4 times lower (FR: −3.8 ± 2.0, p = 0.036) in cases compared to controls. MiRNA-23a-3p was significantly and inversely correlated with TBS, adjusted for calcium metabolism and BMD values (beta = −0.221, p = 0.003, 95% CI −0.360, −0,081) in cases. In a receiver operating characteristic (ROC) analysis, expression of miRNA-124-3p demonstrated 78% sensitivity and 83% specificity in identifying CKD patents with osteoporosis. Serum expression of miRNAs related to osteoblasts (miRNA-23a-3p) and osteoclasts (miRNA-21-5p, miRNA-124-3p) is significantly altered in patients with CKD-MBD. © 2020 by the authors. Licensee MDPI, Basel, Switzerland. article distributed under the terms and conditions of the Cre.
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- 2020
7. The contribution of genetic variants of SLC2A1 gene in T2DM and T2DM-nephropathy: association study and meta-analysis
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Stefanidis, I., Tziastoudi, M., Tsironi, E. E., Dardiotis, E., Tachmitzi, S. V., Fotiadou, A., Pissas, G., Kytoudis, K., Sounidaki, M., Ampatzis, G., Mertens, P. R., Liakopoulos, V., Eleftheriadis, T., Hadjigeorgiou, Georgios M., Santos, M., Zintzaras, E., Hadjigeorgiou, Georgios M. [0000-0001-5386-4273], and Dardiotis, E. [0000-0003-2957-641X]
- Subjects
Male ,0301 basic medicine ,Glucose transporter 1 (GLUT1) ,Diabetic nephropathy ,Type 2 diabetes ,Critical Care and Intensive Care Medicine ,Bioinformatics ,lcsh:RC870-923 ,Nephropathy ,03 medical and health sciences ,Diabetes mellitus ,Gene Frequency ,Risk Factors ,Slc2a1 gene ,medicine ,Humans ,Diabetic Nephropathies ,Genetic Predisposition to Disease ,Gene ,Alleles ,Aged ,genetic variants of SLC2A1 ,Aged, 80 and over ,Glucose Transporter Type 1 ,business.industry ,glucose transporter 1 (GLUT1) ,diabetic nephropathy ,Glucose transporter ,Genetic Variation ,Genetic variants of SLC2A1 ,General Medicine ,Middle Aged ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Logistic Models ,030104 developmental biology ,Diabetes Mellitus, Type 2 ,Nephrology ,Case-Control Studies ,Meta-analysis ,Clinical Study ,Female ,business - Abstract
An association study was conducted to investigate the relation between 14 variants of glucose transporter 1 gene (SLC2A1) and the risk of type 2 diabetes (T2DM) leading to nephropathy. We also performed a meta-analysis of 11 studies investigating association between diabetic nephropathy (DN) and SLC2A1 variants. The cohort included 197 cases (T2DM with nephropathy), 155 diseased controls (T2DM without nephropathy) and 246 healthy controls. The association of variants with disease progression was tested using generalized odds ratio (ORG). The risk of type 2 diabetes leading to nephropathy was estimated by the OR of additive and co-dominant models. The mode of inheritance was assessed using the degree of dominance index (h-index). We synthesized results of 11 studies examining association between 5 SLC2A1 variants and DN. ORG was used to assess the association between variants and DN using random effects models. Significant results were derived for co-dominant model of rs12407920 [OR = 2.01 (1.17–3.45)], rs841847 [OR = 1.73 (1.17–2.56)] and rs841853 [OR = 1.74 (1.18–2.55)] and for additive model of rs3729548 [OR = 0.52 (0.29–0.90)]. The mode of inheritance for rs12407920, rs841847 and rs841853 was ‘dominance of each minor allele’ and for rs3729548 ‘non-dominance’. Frequency of one haplotype (C-G-G-A-T-C-C-T-G-T-C-C-A-G) differed significantly between cases and healthy controls [p = .014]. Regarding meta-analysis, rs841853 contributed to an increased risk of DN [(ORG = 1.43 (1.09–1.88) ORG = 1.58 (1.01–2.48)] between diseased controls versus cases and healthy controls versus cases, respectively. Further studies confirm the association of rs12407920, rs841847, rs841853, as well as rs3729548 and the risk of T2DM leading to nephropathy. 40 1 561 576
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- 2018
8. Phosphorus nutritional knowledge among dialysis health care providers and patients: A multicenter observational study
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Pafili, Z. Maridaki, M. Giannaki, C. Karatzaferi, C. Liakopoulos, V. Eleftheriadis, T. Stefanidis, I. Sakkas, G.
- Abstract
Background-aims: Phosphorus nutritional knowledge level of hemodialysis patients and renal nurses has been found to be low, while respective knowledge of nephrologists has not been studied yet. There are equivocal results regarding the association of phosphorus nutritional knowledge level and serum phosphorus values. The aim of this study was to assess phosphorus nutritional knowledge of hemodialysis patients, nephrologists and renal nurses and seek potential interventions to improve patients’ adherence to phosphorus and overall nutritional guidelines. Methods: This cross-sectional observational study was conducted on sixty eight hemodialysis patients, 19 renal nurses and 11 nephrologists who were recruited from 3 hemodialysis units in Greece. Phosphorus nutritional knowledge of the participants was assessed by a 25-item item questionnaire (CKDKAT–N) which included 15 questions on phosphorus and 10 questions on protein, sodium, and potassium knowledge. Results: Nephrologists had higher CKDKAT–N total (19.1 ± 3.6 vs 14.1 ± 2.8 and 13.2 ± 2.8, P < 0.01) and phosphorus knowledge scores (10.6 ± 2.7 vs 7.6 ± 2.2 and 7.3 ± 2.0, P < 0.01) compared to renal nurses and patients respectively. There were no differences in total and phosphorus knowledge scores between nurses and patients. Patients and nurses answered correctly significantly less questions regarding phosphorus compared with the rest of the questions (P < 0.01) while no such difference was found in nephrologists. Serum phosphorus was positively correlated with phosphorus knowledge score (r = 0.31, P = 0.02), and negatively correlated with patient age (r = −0.34, P < 0.05). None of the patients, 11% of the nurses and 27% of the nephrologists answered correctly all three questions regarding P, K and Na dietary recommendations (P < 0.01). Conclusions: The study confirms that hemodialysis patients have low renal nutrition knowledge while higher nutritional phosphorus knowledge does not lead to lower serum phosphorus values. Alarmingly, renal nurses have been found to have a similar level of knowledge with hemodialysis patients, something that needs to be taken into account when training the new dialysis staff. Nephrologists have superior knowledge; however they are still lacking essential nutritional knowledge that could affect patients' and nurses’ overall understanding. Continuing education on nutrition of nephrologists and renal nurses could improve nutrition care of hemodialysis patients. © 2019 European Society for Clinical Nutrition and Metabolism
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- 2019
9. Aquaporin-1 and sodium transport in the peritoneal membrane - need for more research?
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Liakopoulos, V, Zarogiannis, S, Eleftheriadis, T, and Stefanidis, I
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- 2006
10. Is there a link between inflammation, plasma resistin levels, and protein malnutrition in hemodialysis patients?
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Liakopoulos, V, Mertens, P R, Eleftheriadis, T, Koukoulis, G, and Stefanidis, I
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- 2006
11. Peritoneal dialysis-related infections recommendations: 2016 update. What is new?
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Liakopoulos, V. Nikitidou, O. Kalathas, T. Roumeliotis, S. Salmas, M. Eleftheriadis, T.
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In 2016, the International Society of Peritoneal Dialysis (ISPD) published guidelines that focus on the importance of both prevention and treatment of peritonitis. For once more, the need for annual reporting of peritonitis rates and recording of peritonitis and exit-site infections, isolated microorganism and antimicrobial susceptibilities as a central component of a quality improvement program is highlighted. Data on new antibiotic regimens, techniques for microorganism isolation and peritoneal dialysis solutions are included. Training of both peritoneal dialysis nurses and patients seems to be crucial, while the modifiable risk factors for peritonitis seem to be of great interest. In this article, we record the changes in the last ISPD (2016) guidelines compared to the previous ones published in 2010. © 2017, Springer Science+Business Media Dordrecht.
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- 2017
12. Differential diagnosis of hyperkalemia: an update to a complex problem
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Eleftheriadis, T, Leivaditis, K, Antoniadi, G, and Liakopoulos, V
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Review Article - Abstract
Hyperkalemia is a relative common and sometimes life threatening electorlyte disorder. Although its symptomatic treatment is relatively easy, since precise therapeutic algorithms are available, its differential diagnosis is more complicated. The present review aims to unfold the differential diagnosis of hypekalemia using a pathophysiological, albeit clinically useful, approach. The basic elements of potassium homeostasis are provided, the causes of hyperkalemia are categorized and analysed and finally the required for the diferrential diagnosis laboratory tests are mentioned.
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- 2012
13. Ectoparasite infestations of urban stray dogs in Greece and their zoonotic potential.
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Lefkaditis, M. A., Athanasiou, L. V., Ionicã, A. M., Koukeri, S. E., Panorias, A., Eleftheriadis, T. G., and Boutsini, S.
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- 2016
14. About the effect of low-molecular-weight heparin on platelet function in haemodialysis patients
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Eleftheriadis, T., primary, Antoniadi, G., additional, Liakopoulos, V., additional, and Stefanidis, I., additional
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- 2008
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15. Clonal relatedness of methicillin-resistant coagulase-negative staphylococci in the haemodialysis unit of a single university centre in Greece
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Liakopoulos, V., primary, Petinaki, E., additional, Efthimiadi, G., additional, Klapsa, D., additional, Giannopoulou, M., additional, Dovas, S., additional, Eleftheriadis, T., additional, Mertens, P. R., additional, and Stefanidis, I., additional
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- 2008
- Full Text
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16. Urate crystals induce NLRP3 inflammasome-dependent IL-1β secretion and proliferation in isolated primary human T-cells.
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Eleftheriadis, T., Pissas, G., Antoniadi, G., Makri, P., Liakopoulos, V., and Stefanidis, I.
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URATES , *INTERLEUKIN-1 , *T cells , *CELL proliferation , *BROMODEOXYURIDINE , *ENZYME-linked immunosorbent assay - Abstract
Background: Urate through NOD-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome-dependent caspase-1 activation stimulates macrophages to secrete inteleukin-1β (IL-1β). Urate also enhances adaptive immunity indirectly through its effect on antigen presenting cells. In this study, the direct effect of urate on isolated primary human T-cells was evaluated. Methods: Isolated T-cells were cultured with or without monosodium urate crystals in the presence or not of the NLRP3 inflammasome inhibitor glyburide. Activated cleaved caspase-1 was assessed by means of western blotting, whereas caspase- 1 activity was measured colorimetrically in the cell lysates. IL-1β was measured in the supernatants by means of enzyme-linked immunosorbent assay. T-cell proliferation was assessed by means of bromodeoxyuridine labelling and immunoenzymatic detection. Results: Urate induced caspase-1 activation and IL-1β release by T-cells. It also induced proliferation of T-cells. Glyburide inhibited urate-induced caspase-1 activation, IL-1β secretion and proliferation. Conclusions: Urate, a well defined danger signal, stimulates directly human T-cells in a NLRP3 infmmasomela-dependent way. The subsequent IL-1β secretion could enhance inflammation, whereas expansion of T-cell clones could facilitate a subsequent adaptive immune response. [ABSTRACT FROM AUTHOR]
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- 2015
17. Body dysmorphic disorder due to hirsutism in a patient treated with cyclosporin
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Vergoulas, G., primary, Eleftheriadis, T., additional, Avdelidou, A., additional, Ioannou, K., additional, Miserlis, G., additional, Solonaki, F., additional, Papagiannis, A., additional, and Takoudas, D., additional
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- 2005
- Full Text
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18. Phenytoin efficacy in treating the diabetic foot ulcer of a haemodialysis patient
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Spaia, S., primary, Eleftheriadis, T., additional, Pazarloglou, M., additional, Askepidis, N., additional, Ioannidis, I., additional, Touboura, A., additional, and Vayonas, G., additional
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- 2004
- Full Text
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19. Uric acid induces caspase-1 activation, IL-1β secretion and P2X7 receptor dependent proliferation in primary human lymphocytes.
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Eleftheriadis, T., Pissas, G., Karioti, A., Antoniadi, G., Golfinopoulos, S., Liakopoulos, V., Mamara, A., Speletas, M. M., Koukoulis, G., and Stefanidis, I.
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URIC acid , *LYMPHOCYTES , *LEUCINE , *PYRIN (Protein) , *CASPASES regulation , *MACROPHAGES , *CYTOMETRY , *PHYSIOLOGY , *THERAPEUTICS - Abstract
Background: Urate through Nacht Domain, Leucine-Rich Repeat, and pyrin domain-containing protein 3 (NALP3) dependent caspase-1 activation stimulates macrophages to secrete inteleukin-1β (IL-1β). Purinergic receptor P2X7 plays a role in the urate induced NALP3 activation. Urate also enhances adaptive immunity indirectly through its effect on antigen presenting cells. In this study, the direct effect of urate on primary human lymphocytes was evaluated. Methods: Lymphocytes were cultured with or without monosodium urate crystals in the presence or not of a P2X7 inhibitor. Caspase-1 activity was assessed colorimetrically in cell lysates and IL-1β was measured in supernatants with ELISA. Whole lymphocyte viability and proliferation, as well as T-cell proliferation were assessed by means of 2,3-bis- (2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) assay and of flow cytometry respectively. Results: Urate induced caspase-1 activation and IL-1β release by lymphocytes. It also induced proliferation of whole lymphocytes and T-cells as well. P2X7 inhibitor abrogated lymphocyte proliferation. Conclusions: Urate, a well defined danger signal, stimulates directly human lymphocytes in a P2X7 dependent way. The subsequent IL-1β secretion could enhance inflammation, whereas expansion of lymphocyte clones could facilitate a subsequent adaptive immune response. [ABSTRACT FROM AUTHOR]
- Published
- 2013
20. Plasma serotonin and markers of bone formation and bone resorption in hemodialysis patients.
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Eleftheriadis T, Antoniadi G, Liakopoulos V, Sparopoulou T, Stefanidis I, and Galaktidou G
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Introduction. Serotonin receptors are present in osteoblasts and osteoclasts, and serotonin affects bone metabolism. The association of plasma serotonin with markers of bone formation and bone resorption in hemodialysis patients was evaluated. Materials and Methods. Twenty-four hemodialysis patients (11 diabetics) and 22 healthy volunteers were enrolled into the study. Serotonin was assessed in platelet-free plasma, whereas the markers of osteoblastic activity N-terminal midfragment osteocalcin and total procollagen type-1 aminoterminal propeptide as well as the marker of osteoclastic activity beta-isomerized C-terminal cross-linked peptide of collagen type I were measured in serum. Serum intact parathyroid hormone was also assessed. Results. Serotonin did not significantly differ between hemodialysis patients and healthy volunteers. All evaluated markers of bone metabolism and intact parathyroid hormone were much higher in hemodialysis patients. Serotonin was significantly correlated with all evaluated markers of bone metabolism in hemodialysis patients. Serotonin was reversely related to the patients' age. Serotonin, osteocalcin, procollagen type-1 aminoterminal propeptide, and beta-isomerized C-terminal cross-linked peptide of collagen type I were much lower in diabetic hemodialysis patients. Conclusions. Serotonin may increase both bone formation and bone resorption in hemodialysis patients. The reverse relation of serotonin to patients' age as well as its lower levels in diabetic hemodialysis patients indicate that low plasma serotonin may contribute to the higher incidence of low-turnover bone disease that characterizes old and diabetic hemodialysis patients. [ABSTRACT FROM AUTHOR]
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- 2013
21. Differential diagnosis of hyperkalemia: an update to a complex problem.
- Author
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Eleftheriadis, T., Leivaditis, K., Antoniadi, G., and Liakopoulos, V.
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DIFFERENTIAL diagnosis , *HYPERKALEMIA , *HOMEOSTASIS , *POTASSIUM in the body , *NEPHRONS , *DIAGNOSIS - Abstract
Hyperkalemia is a relative common and sometimes life threatening electorlyte disorder. Although its symptomatic treatment is relatively easy, since precise therapeutic algorithms are available, its differential diagnosis is more complicated. The present review aims to unfold the differential diagnosis of hypekalemia using a pathophysiological, albeit clinically useful, approach. The basic elements of potassium homeostasis are provided, the causes of hyperkalemia are categorized and analysed and finally the required for the diferrential diagnosis laboratory tests are mentioned. Hippokratia 2012, 16, 4: 294-302 [ABSTRACT FROM AUTHOR]
- Published
- 2012
22. Plasma angiogenin and vascular endothelial growth factor a among hemodialysis patients.
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Eleftheriadis T, Antoniadi G, Liakopoulos V, Pissas G, Stefanidis I, and Galaktidou G
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Introduction. Angiogenesis plays a role in the pathogenesis of coronary heart disease (CHD) and diabetes mellitus (DM) pathology, and certain angiogenic factors are increased by inflammation. The aim of this study was to evaluate plasma angiogenin and vascular endothelial factor A (VEGFA) levels in hemodialysis patients, as well as the effect of CHD, DM, and inflammation on these markers. Materials and Methods. Sixty-six hemodialysis patients were enrolled in the study, of whom 22 (33.3%) suffered from CHD , 22 (33.3%) from DM, and 28 (42.4%) from inflammation. They were compared with 24 healthy volunteers. Plasma angiogenin and VEGFA were assessed by means of enzyme-linked immunosorbent assay, and serum C-reactive protein was measured with an immunoturbidimetric method. These markers were compared between hemodialysis patients with and without CHD, DM, and inflammation. Results. Compared to healthy volunteers, plasma angiogenin was significantly higher in hemodialysis patients (263.57 ± 65.95 ng/mL versus 499.15 ± 175.68 ng/mL; P < .001). Similarly, plasma VEGFA was markedly increased in hemodialysis patients (median, 60.50 pg/mL; range, 280 pg/mL), compared to healthy volunteers (median, 28.84 pg/mL; range, 59.40 pg/mL; P < .001). Neither angiogenin nor VEGFA levels differed significantly between hemodialysis patients with and without CHD, DM, or inflammation. Conclusions. Plasma angiogenin and VEGFA levels are markedly increased in hemodialysis patients, but not associated with CHD, DM, or inflammation among hemodialysis patients. [ABSTRACT FROM AUTHOR]
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- 2012
23. Lipopolysaccharide and hypoxia significantly alters interleukin-8 and macrophage chemoattractant protein-1 production by human fibroblasts but not fibrosis related factors.
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Eleftheriadis, T., Liakopoulos, V., Lawson, B., Antoniadi, G., Stefanidis, I., and Galaktidou, G.
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HYPOXEMIA , *INTERLEUKIN-8 , *MACROPHAGES , *FIBROBLASTS , *FIBROSIS - Abstract
Besides extracellular matrix production, fibroblasts are able to produce various cytokines. Their ubiquitous position makes fibroblasts appropriate cells for sensing various noxious stimuli and for attracting immune cells in the affected area. In the present study the effect of lipopolysaccharide (LPS) and cobalt chloride (CoCl2) on the above fibroblasts functions were evaluated in primary human skin fibroblasts cultures. Collagen, matrix metalloproteinase-1, tissue inhibitor of metalloproteinases-1, transforming growth factor-β1, interleukin-8 (IL-8) and macrophage chemoattractant protein-1 (MCP-1) were measured in fibroblasts culture supernatants. Fibroblasts proliferation and viability were assessed as well. Hypoxia inducible factor-1α and the phosphorylated p65 portion of NF-κB were assessed in fibroblasts protein extracts. LPS and CoCl2 had a minor effect on fibrosis related factors in human primary fibroblasts, possibly due to the absence of interplay with other cell types in the used experimental system. On the contrary both LPS and CoCl2 increased significantly IL-8. LPS also increased considerably MCP-1, but CoCl2 decreased it. Thus LPS and CoCl2 induce a sentinel, nevertheless not identical, phenotype in primary human fibroblasts. The last disparity could result in different body response to infectious or hypoxic noxious stimuli. [ABSTRACT FROM AUTHOR]
- Published
- 2011
24. Suppression of humoral immune response to hepatitis B surface antigen vaccine in BALB/c mice by 1-methyl-tryptophan co-administration.
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Eleftheriadis, T, Sparopoulou, T, Antoniadi, G, Liakopoulos, V, Stefanidis, I, and Galaktidou, G
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- 2011
25. Infections in hemodialysis: a concise review - Part 1: bacteremia and respiratory infections.
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Eleftheriadis, T., Liakopoulos, V., Leivaditis, K., Antoniadi, G., and Stefanidis, I.
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HEMODIALYSIS patients , *BACTEREMIA , *RESPIRATORY infections , *IMMUNITY , *PNEUMONIA , *VIRUS diseases , *HEPATITIS B virus , *HEPATITIS C virus , *HIV - Abstract
Hemodialysis (HD) patients are particularly predisposed to infections. It seems that the HD procedure per se as well as disturbances in both innate and adaptive immunity significantly contribute to this susceptibility. Infections are the major cause of morbidity and the second cause of death following cardiovascular events in HD patients. Episodes of bacteremia and pneumonia account for the majority of severe infections in this population. In addition to these bacterial infections another common problem in HD units is the blood transmitted viral infections, particularly infections caused by hepatitis B virus, hepatitis C virus and Human immunodeficiency virus. A number of safety concerns exist for limiting the spread of these viral infections among HD patients and the staff of the unit. The aim of the present review is to present in a concise albeit practical form the difficult aspect of infections in HD. For practical reasons the review is separated in two parts. The present first part covers bacteremia and respiratory infections, while the second part will cover blood transmitted viral infections. [ABSTRACT FROM AUTHOR]
- Published
- 2011
26. Uric acid induces caspase-1 activation, IL-1β secretion and P2X7 receptor dependent proliferation in primary human lymphocytes
- Author
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Eleftheriadis, T., Pissas, G., Karioti, A., Antoniadi, G., Golfinopoulos, S., Vassilios Liakopoulos, Mamara, A. M., Speletas, M., Koukoulis, G., and Stefanidis, I.
- Subjects
Original Article - Abstract
Urate through Nacht Domain, Leucine-Rich Repeat, and pyrin domain-containing protein 3 (NALP3) dependent caspase-1 activation stimulates macrophages to secrete inteleukin-1β (IL-1β). Purinergic receptor P2X7 plays a role in the urate induced NALP3 activation. Urate also enhances adaptive immunity indirectly through its effect on antigen presenting cells. In this study, the direct effect of urate on primary human lymphocytes was evaluated.Lymphocytes were cultured with or without monosodium urate crystals in the presence or not of a P2X7 inhibitor. Caspase-1 activity was assessed colorimetrically in cell lysates and IL-1β was measured in supernatants with ELISA. Whole lymphocyte viability and proliferation, as well as T-cell proliferation were assessed by means of 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) assay and of flow cytometry respectively.Urate induced caspase-1 activation and IL-1β release by lymphocytes. It also induced proliferation of whole lymphocytes and T-cells as well. P2X7 inhibitor abrogated lymphocyte proliferation.Urate, a well defined danger signal, stimulates directly human lymphocytes in a P2X7 dependent way. The subsequent IL-1β secretion could enhance inflammation, whereas expansion of lymphocyte clones could facilitate a subsequent adaptive immune response.
27. Infections in hemodialysis: A concise review. Part II: Blood transmitted viral infections
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Eleftheriadis, T., Liakopoulos, V., Leivaditis, K., Antoniadi, G., and Ioannis Stefanidis
- Subjects
Review Article - Abstract
Hemodialysis (HD) patients are particularly predisposed to infections. It seems that the HD procedure per se as well as disturbances in both innate and adaptive immunity significantly contribute to this susceptibility. Infections are the major cause of morbidity and the second cause of death following cardiovascular events in HD patients. Episodes of bacteremia and pneumonia account for the majority of severe infections in this population. In addition to these bacterial infections another common problem in HD units is the blood transmitted viral infections, particularly infections caused by hepatitis B virus, hepatitis C virus and Human immunodeficiency virus. A number of safety concerns exist for limiting the spread of these viral infections among HD patients and the staff of the unit. The aim of the present review is to present in a concise albeit practical form the difficult aspect of infections in HD. For practical reasons the review is separated in two parts. The previous first part covered bacteremia and respiratory infections, while the present second part covers blood transmitted viral infections.
28. Suppression of humoral immune response to hepatitis B surface antigen vaccine in BALB/C mice by 1-methyl-tryptophan co-administration
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Eleftheriadis, T., Sparopoulou, T., Antoniadi, G., Liakopoulos, V., Ioannis Stefanidis, and Galaktidou, G.
- Subjects
Serum anti-HBs ,DL-1-MT ,Original Article ,IDO - Abstract
Background and the purpose of the study Indoleamine 2,3-dioxygenase (IDO) suppresses adaptive immune response. The purpose of this study was to determine the effect of the IDO inhibitor namely 1-methyl-DL-tryptophan (DL-1-MT) on antibody production after vaccination with hepatitis B surface (HBs) antigen. Methods Four groups of BALB/c mice were immunized with a HBs antigen vaccine. In the first group the vaccine had no DL-1-MT, whereas in the other three groups the vaccine contained 1 mg, 10 mg and 20 mg DL-1-MT. Blood samples were collected 5 weeks post-vaccination and anti-HBs antibodies in the serum were measured by ELISA. Results Compared to the three groups of mice that were immunized with the vaccines containing DL-1-MT, serum anti-HBs level was much higher in the mice that were immunized with the vaccine with out DL-1-MT. Conclusions Inhibition of IDO at the time of vaccination decreased humoral immune response to HBs antigen vaccine. The idea that IDO activity is simply immunosuppressive may need to be re-evaluated.
29. Lipopolysaccharide and hypoxia significantly alters interleukin-8 and macrophage chemoattractant protein-1 production by human fibroblasts but not fibrosis related factors
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Eleftheriadis, T., Liakopoulos, V., Lawson, B., Antoniadi, G., Ioannis Stefanidis, and Galaktidou, G.
- Subjects
Review Article - Abstract
Besides extracellular matrix production, fibroblasts are able to produce various cytokines. Their ubiquitous position makes fibroblasts appropriate cells for sensing various noxious stimuli and for attracting immune cells in the affected area. In the present study the effect of lipopolysaccharide (LPS) and cobalt chloride (CoCl(2)) on the above fibroblasts functions were evaluated in primary human skin fibroblasts cultures. Collagen, matrix metalloproteinase-1, tissue inhibitor of metalloproteinases-1, transforming growth factor-β1, interleukin-8 (IL-8) and macrophage chemoattractant protein-1 (MCP-1) were measured in fibroblasts culture supernatants. Fibroblasts proliferation and viability were assessed as well. Hypoxia inducible factor-1α and the phosphorylated p65 portion of NF-κB were assessed in fibroblasts protein extracts. LPS and CoCl(2) had a minor effect on fibrosis related factors in human primary fibroblasts, possibly due to the absence of interplay with other cell types in the used experimental system. On the contrary both LPS and CoCl(2) increased significantly IL-8. LPS also increased considerably MCP-1, but CoCl(2) decreased it. Thus LPS and CoCl(2) induce a sentinel, nevertheless not identical, phenotype in primary human fibroblasts. The last disparity could result in different body response to infectious or hypoxic noxious stimuli.
30. Infections in hemodialysis: A concise review - part 1: Bacteremia and respiratory infections
- Author
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Eleftheriadis, T., Vassilios Liakopoulos, Leivaditis, K., Antoniadi, G., and Stefanidis, I.
- Subjects
Review Article - Abstract
Hemodialysis (HD) patients are particularly predisposed to infections. It seems that the HD procedure per se as well as disturbances in both innate and adaptive immunity significantly contribute to this susceptibility. Infections are the major cause of morbidity and the second cause of death following cardiovascular events in HD patients. Episodes of bacteremia and pneumonia account for the majority of severe infections in this population. In addition to these bacterial infections another common problem in HD units is the blood transmitted viral infections, particularly infections caused by hepatitis B virus, hepatitis C virus and Human immunodeficiency virus. A number of safety concerns exist for limiting the spread of these viral infections among HD patients and the staff of the unit. The aim of the present review is to present in a concise albeit practical form the difficult aspect of infections in HD. For practical reasons the review is separated in two parts. The present first part covers bacteremia and respiratory infections, while the second part will cover blood transmitted viral infections.
31. Simultaneous clinical resolution of focal segmental glomerulosclerosis associated with chronic lymphocytic leukaemia treated with fludarabine, cyclophosphamide and rituximab
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Karasavvidou Foteini, Kourti Panagiota, Eleftheriadis Theodoros, Liakopoulos Vassilios, Giannakoulas Nikolaos, Arampatzis Spyridon, Matsouka Panagiota, and Stefanidis Ioannis
- Subjects
chronic lymphocytic leukemia ,focal segmental glomerulosclerosis ,nephrotic syndrome ,fludarabine ,cyclophosphamide ,rituximab ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Although renal involvement in advanced haematological malignancies is common, glomerulonephritis associated with lymphoproliferative disorders is rare, and the related pathogenetic mechanisms are still poorly understood. We present a rare case of chronic lymphocytic leukaemia(CLL)-associated focal segmental glomerulosclerosis with nephrotic-range proteinuria. Case presentation A 53-year-old Caucasian man, previously healthy, with no history of hypertension, alcohol use or smoking presented with rapid weight gain, massive peripheral oedema, and hypertension. Laboratory findings included a white blood cell count of 49,800 cells/mm3 with an absolute lymphocyte count of 47,000 cells/mm3, serum albumin of 2.3 g/dL, urea 65 mg/dL, and creatinine 1.5 mg/dL. A 24-hour urine collection contained 7.1 g protein and significant haematuria. A peripheral blood smear showed mature lymphocytosis and smudge cells. Diagnostic imaging showed mild paraaortic lymphadenopathy with no renal abnormalities. Bone marrow aspiration and trephine biopsy showed diffuse and focal infiltration with B-CLL lymphocytes. Percutaneous renal biopsy revealed total sclerosis in 3/21(14%) of the glomeruli and focal and segmental solidification and sclerosis in 4/21 (19%) glomeruli. A regimen of fludarabine, cyclophosphamide and rituximab was successful in inducing remission of the CLL and clinical resolution of the nephritic-range proteinuria. Conclusions A multidisciplinary approach to monitor both the malignancy and the glomerular lesions is crucial for the optimal management of paraneoplastic glomerulonephritis. Although chemotherapy with fludarabine, cyclophosphamide and rituximab successfully treated CLL-associated nephrotic syndrome in our patient, further studies are required to confirm efficacy in this setting.
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- 2011
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32. Sex hormone binding globulin (SHBG) serum levels and insulin resistance in men on chronic hemodialysis.
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Nikolaou E, Tziastoudi M, Gougoura SG, Filippidis G, Dousdampanis P, Bargiota A, Mertens PR, Eleftheriadis T, Hadjigeorgiou GM, Koukoulis GN, and Stefanidis I
- Abstract
Background: In males with end stage renal disease biochemical hypogonadism is a frequent finding. Testosterone and sex hormone binding globulin (SHBG) have been associated with insulin resistance, a well-known condition in uremia. The aim of the present study was to investigate in males on chronic hemodialysis the relationship of testosterone and SHBG serum levels with insulin resistance., Methods: In a cross-sectional study we enrolled men treated with chronic hemodialysis who did not suffer from an acute illness or other endocrinopathy, as well as primary hypogonadism, and were not hospitalised. Diabetes mellitus, diabetic nephropathy or previous transplantation were not exclusion criteria. As controls we used a community-based group of healthy males matched for age and Body Mass Index (BMI). We assessed the BMI (kg/m
2 ) from body weight and height, the body fat content (%) by bioelectrical impedance and serum testosterone (ng/ml), SHBG (nmol/L) and estradiol (pg/ml) by standard methods. Testosterone < 3.25 ng/ml defined biochemical hypogonadism. In non-diabetic males, we calculated the homeostasis model assessment index (HOMA-R), an estimate of insulin resistance, from serum fasting insulin and glucose., Results: 27 men (age 54.4 ± 19 years) on chronic hemodialysis (treatment duration 29.1 ± 14.4 months) and 51 healthy men (age 47.1 ± 9.6 years) were included. In men on hemodialysis vs. healthy men there were increased serum levels of SHBG (40.9 ± 26.9 vs. 27.6 ± 11.9 nmol/L; p = 0.031) and a significantly enhanced frequency of biochemical hypogonadism (22.2 vs. 3.9%; p = 0.011). In cases without diabetes (n = 22) a significant correlation was observed between the HOMA-R (r = -0.586, p = 0.004) and the fasting insulin levels (r = -0.650, p = 0.001) on the one hand and the serum SHBG levels on the other., Conclusions: Our findings confirm enhanced prevalence of biochemical hypogonadism in males on chronic hemodialysis. In non-diabetic cases the serum levels of SHBG correlated with serum insulin and insulin resistance., (© 2024. The Author(s).)- Published
- 2024
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33. Sodium-Glucose Transporter 2 (SGLT2) Inhibitors and Iron Deficiency in Heart Failure and Chronic Kidney Disease: A Literature Review.
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Tziastoudi M, Pissas G, Golfinopoulos S, Filippidis G, Dousdampanis P, Eleftheriadis T, and Stefanidis I
- Abstract
Heart failure (HF) and chronic kidney disease (CKD) are associated with high mortality. In both disorders, impaired iron homeostasis, mostly in the form of a functional iron deficiency, is a frequent co-morbidity. In HF, functional iron deficiency and management by i.v. iron supplementation have been proven to affect both prognosis and functional capacity. In the same context, iron supplementation is routine for the adequate management of renal anemia in CKD. In numerous recent studies in HF and in CKD, sodium-glucose transporter 2 (SGLT2) inhibitor treatment has been proven to significantly reduce mortality. Furthermore, the same trials showed that these drugs alleviate iron deficiency and anemia. These effects of SGLT2 inhibitors may be due to an amelioration of inflammation with reduced interleukin-6 (IL-6) and to an enhancement of autophagy with increased sirtuin 1 (SIRT1), both associated with modified production of hepcidin and enhanced ferritinophagy. However, the exact pathogenic basis of the beneficial SGLT2 inhibitor action is not fully elucidated. Nevertheless, effects on iron homeostasis might be a potential explanatory mechanism for the powerful SGLT2 inhibitors' cardiovascular and renal outcome benefits. In addition, the interaction between iron supplementation and SGLT2 inhibitors and its potential impact on prognosis remains to be clarified by future studies. This review represents a significant effort to explore the complex relationships involved, seeking to elucidate the intricate mechanisms by which SGLT2 inhibitors influence iron homeostasis.
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- 2023
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34. Interleukin Variants Are Associated with the Development and Progression of IgA Nephropathy: A Candidate-Gene Association Study and Meta-Analysis.
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Chronopoulou I, Tziastoudi M, Pissas G, Dardiotis E, Dardioti M, Golfinopoulos S, Filippidis G, Mertens PR, Tsironi EE, Liakopoulos V, Eleftheriadis T, and Stefanidis I
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- Humans, Case-Control Studies, Interleukin-10 genetics, Genetic Predisposition to Disease, Genotype, Interleukins genetics, Polymorphism, Single Nucleotide, Interleukin-1 genetics, Interleukin-1beta genetics, Glomerulonephritis, IGA genetics, Glomerulonephritis, IGA pathology
- Abstract
The interleukin-1 gene cluster encodes cytokines, which modulate mesangial cell proliferation and matrix expansion, both constituting central factors in the development and progression of immunoglobulin A nephropathy (IgAN). A candidate-gene study was performed to examine the association of polymorphisms of the interleukin-1 gene cluster with the risk of progressive IgAN. To gain deeper insights into the involvement of interleukin genes in IgAN, a meta-analysis of genetic association studies (GAS) that examine the association between interleukin variants and IgAN was conducted. Association study: The case-control study consisted of 121 unrelated Caucasians with sporadic, histologically diagnosed IgAN and of 246 age- and sex-matched healthy controls. Persistent proteinuria (>2 g/24 h) and/or impaired kidney function (serum creatinine > 1.5 mg/dL) defined progressive (n = 67) vs. non-progressive (n = 54) IgAN cases. Genotypes were assessed for two promoter-region single-nucleotide polymorphisms, C-899T (rs1800587) in IL1A and C-511T (rs16944) in IL1B , and for one penta-allelic variable-length tandem repeat polymorphism (VNTR 86 bp intron 2) in IL1RN . The association of these variants with the susceptibility of IgAN and the development of progressive IgAN (healthy status, IgAN, progressive IgAN) was tested using the generalized odds ratio (OR
G ) metric. Linkage disequilibrium and haplotype analysis were also performed. Meta-analysis: We included in the meta-analysis 15 studies investigating association between 14 interleukin variants harbored in eight different genes and IgAN. The ORG was used to evaluate the association between interleukin variants and IgAN using random effects models. The present case-control study revealed association of IL1B C-511T (rs16944) with the progression of IgAN ( p = 0.041; ORG = 2.11 (1.09-4.07)). On haplotype analysis, significant results were derived for the haplotypes C-C-1 ( p = 0.005; OR = 0.456 (0.261~0.797)) and C-T-2 ( p = 0.003; OR = 4.208 (1.545-11.50)). Regarding association and meta-analysis results, variants in IL1B (rs1143627 and rs16944), IL1RN (rs928940, rs439154, and rs315951) and IL10 (rs1800871) were associated with IgAN based on either genotype or allele counts. Genetic variants and haplotypes in the IL1B , IL1RN, and IL10 genes might contribute to an increased risk for development and progression of IgAN.- Published
- 2023
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35. Tumor Necrosis Factor-α G-308A Polymorphism and Sporadic IgA Nephropathy: A Meta-Analysis Using a Genetic Model-Free Approach.
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Tziastoudi M, Chronopoulou I, Pissas G, Cholevas C, Eleftheriadis T, and Stefanidis I
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- Humans, Genetic Association Studies, Polymorphism, Genetic, Glomerulonephritis, IGA genetics, Tumor Necrosis Factor-alpha genetics
- Abstract
Tumor necrosis factor-α (TNF-α) is a potent pro-inflammatory cytokine, involved in the pathogenesis and progression of immunoglobulin A nephropathy (IgAN). A bi-allelic polymorphism in the promoter region, at position -308 (G/A) of the TNF - α gene (rs1800629) is associated with an increased TNF-a production. However, several previous association studies of TNF - α G-308A polymorphism and IgAN rendered contradictory findings. The objective of the present study is to shed light on these inconclusive results and clarify the role of TNF-α and any possible contribution of this factor in the development and progression of sporadic IgAN. Therefore, a meta-analysis of all available genetic association studies relating the TNF-α G-308A polymorphism to the risk for development and/or progression of IgAN was conducted. Seven studies were included in the meta-analysis. Three of them included populations of European descent (Caucasians) and four involved Asians. The generalized odds ratio (OR
G ) was used to estimate the risk for the development and/or progression of the disease. Overall, the meta-analysis did not detect any significant association between the G-308A variant and both the risk of developing IgAN and the risk for progression of IgAN. In conclusion, these results suggest that TNF-α does not constitute a key component in the genetic architecture of sporadic IgAN. However, further evidence deciphering the influence of TNF-α on IgAN is still needed.- Published
- 2023
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36. Remedies for Kidney Ailments in Physica by Hildegard von Bingen (1098-1179).
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Stefanidis I, Eleftheriadis T, Efthymiadi M, Kalientzidou M, and Valiakos E
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- Animals, Female, Dysuria, Kidney, Materia Medica therapeutic use
- Abstract
Objectives: Hildegard von Bingen (Hildegardis Bingensis; Saint Hildegard), the Sibyl of the Rhine (AD 1098-1179), was a Benedictine abbess, musician, poet, writer, counselor, and healer. As an influential personality of the 12th century, she was advisor of kings, princes, and bishops. Her medical work is collected in 2 books (AD 1152-1163): Physica and Causae et Curae. We aimed to investigate the characteristics of the nephrology-oriented remedies in Physica and compare these with the respective remedies in De Materia Medica (AD 1st century) by Dioscorides Pedanios Anazarbeus., Materials and Methods: Physica is a collection of 9 volumes with an inventory of plants, trees, elements, stones, animals, and metals and describes the associated natural therapeutic properties. We studied all 293 plants (230 herbaceous plants, and 63 trees) in this treatise and recorded all nephrology-related remedies. In addition, we recorded the treatment indications of the same remedies in De Materia Medica. Nephrology-oriented material was defined as any item with nephrology-related pharmacological action (diuretic) or indication (eg, dysuria, nephritis, stones, sand, dropsy). Our findings are presented as simple descriptive statistics., Results: Among all plants, there were 15 (5.1%) of nephrological interest (11 herbaceous plants and 4 trees). Only some of the natural ingredients mentioned in Physica were found with the same indication in the ancient text, De Materia Medica (9 of 15). The nephrological treatment indications described in Physica included dysuria, nephritic pain, and lithiasis in 87% and dropsy (edema) in 13.0%, which is comparable with 10% in De Materia Medica., Conclusions: Physica provides a reliable account of medicine in the 12th century as it was practiced by the clergy for generations. It also incorporates Hildegard's personal observations and contemporary folk remedies. This fact is supported by the limited similarity of nephrological remedies in Hildegard's Physica with the respective remedies in De Materia Medica.
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- 2023
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37. Publications With Nephrological Themes Appearing Diachronically in the PubMed Bibliographical Database.
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Stefanidis I, Eleftheriadis T, Nikolaou E, Valiakos E, Kalientzidou M, and Diamandopoulos A
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- Humans, Renal Dialysis, PubMed, Kidney Transplantation adverse effects, Nephrology, Renal Insufficiency
- Abstract
Objectives: Nephrology in the last 50 years has undergone important scientific developments, which have formally revolutionized clinical practice, including renal biopsy, renal replacement therapy, and transplantation. The understanding of the pathogenesis and the clinical course of renal disease has also steadily improved, resulting in renewal of definitions, classifications, and therapeutics in nephrology. In this context, publications with nephrological content are also expanding. The aim of this bibliographic study was to analyze publications related to nephrology-specific key words in the PubMed database., Materials and Methods: We included the key words "nephrology," "acute renal failure," "renal biopsy," "hemodialysis," "peritoneal dialysis," and "renal transplantation" as search terms in PubMed in May 2022. We also used the term "kidney" as an alternative to "renal.", Results: "Nephrology" appeared 185 545 times in searches, with its appearance expanding in the past 3 decades since 1948. The term "acute renal failure" was found in 1932 in 1 publication and in a total number of 92 278 publications. Renal biopsy appeared since 1943 in 18 048 publications. "Hemodialysis" appeared in 182 730 citations, with the first in 1915. "Peritoneal dialysis" appeared in 32 266 citations for the first time in 1901 and in 1946 in human application. One publication on "renal transplantation" appeared in 1946, with 106 075 total publications related to renal transplantation., Conclusions: We viewed a clear expansion of nephro-logical publications in the past decades. Hemodialysis remains the most frequently used term in nephrology-related publications. Historical analysis of the PubMed database is useful as a tool to understand the research and publication trends in nephrology, as we approach the new era of precision medicine.
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- 2023
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38. Successful Shrinkage of a Giant Cutaneous Squamous Cell Carcinoma with Immunotherapy in a Kidney Transplant Recipient.
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Eleftheriadis T, Samaras I, Spanos A, Kotsakis A, and Stefanidis I
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- Male, Humans, Middle Aged, Immune Checkpoint Inhibitors therapeutic use, Creatinine, Quality of Life, Methylprednisolone therapeutic use, Immunotherapy adverse effects, Graft Rejection prevention & control, Carcinoma, Squamous Cell therapy, Kidney Transplantation adverse effects, Skin Neoplasms drug therapy, Skin Neoplasms pathology
- Abstract
A 56-year-old male living donor kidney transplant recipient presented with a giant cutaneous squamous cell carcinoma in his right parotid region. Programmed radiotherapy had been previously terminated due to lesion ulceration and bleeding. He was characterized as a terminal case. We applied cemiplimab, which is an immune checkpoint inhibitor against the pro-grammed cell death receptor PD-1. After 6 months, the cutaneous squamous cell carcinoma had shrunk and had stopped bleeding. The patient was treated with methylprednisolone, cyclosporine, and mycophenolate mofetil during this period. He had 2 rejection episodes defined as doubling baseline serum creatinine with no other explanation. Both episodes were successfully treated with intravenous methylprednisolone, while immunotherapy was postponed for 10 days. In both cases, serum creatinine returned to baseline within 1 week. Immune checkpoint inhibitors are indicated for invasive cutaneous squamous cell carcinoma therapy, and the risk of acute rejection should not prevent the use of these agents in kidney transplant recipients, because immune checkpoint inhibitors may enhance the quantity and quality of life of such patients.
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- 2023
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39. Routes of Albumin Overload Toxicity in Renal Tubular Epithelial Cells.
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Eleftheriadis T, Pissas G, Golfinopoulos S, Efthymiadi M, Poulianiti C, Polyzou Konsta MA, Liakopoulos V, and Stefanidis I
- Subjects
- Albumins metabolism, Albumins toxicity, Cell Line, Epithelial Cells metabolism, Epithelial-Mesenchymal Transition, Reactive Oxygen Species metabolism, Humans, Kidney Tubules, Proximal metabolism, Signal Transduction
- Abstract
Besides being a marker of kidney disease severity, albuminuria exerts a toxic effect on renal proximal tubular epithelial cells (RPTECs). We evaluated whether an unfolded protein response (UPR) or DNA damage response (DDR) is elicited in RPTECs exposed to high albumin concentration. The deleterious outcomes of the above pathways, apoptosis, senescence, or epithelial-to-mesenchymal transition (EMT) were evaluated. Albumin caused reactive oxygen species (ROS) overproduction and protein modification, and a UPR assessed the level of crucial molecules involved in this pathway. ROS also induced a DDR evaluated by critical molecules involved in this pathway. Apoptosis ensued through the extrinsic pathway. Senescence also occurred, and the RPTECs acquired a senescence-associated secretory phenotype since they overproduced IL-1β and TGF-β1. The latter may contribute to the observed EMT. Agents against endoplasmic reticulum stress (ERS) only partially alleviated the above changes, while the inhibition of ROS upregulation prevented both UPR and DDR and all the subsequent harmful effects. Briefly, albumin overload causes cellular apoptosis, senescence, and EMT in RPTECs by triggering UPR and DDR. Promising anti-ERS factors are beneficial but cannot eliminate the albumin-induced deleterious effects because DDR also occurs. Factors that suppress ROS overproduction may be more effective since they could halt UPR and DDR.
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- 2023
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40. Therapeutic Advances in Diabetic Kidney Disease.
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Georgianos PI, Vaios V, Eleftheriadis T, Papachristou E, and Liakopoulos V
- Subjects
- Humans, Glucose therapeutic use, Diabetic Nephropathies complications, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Sodium-Glucose Transporter 2 Inhibitors pharmacology, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic drug therapy
- Abstract
Although sodium glucose co-transporter type 2 (SGLT-2) inhibitors were initially introduced as glucose-lowering medications, it was later discovered that cardiorenal protection is the most important treatment effect of these agents. A triad of landmark trials consistently showed the benefits of SGLT-2 inhibitors on kidney and cardiovascular outcomes in patients with chronic kidney disease (CKD), irrespective of the presence or absence of Type 2 diabetes (T2D). Furthermore, finerenone is a novel, selective, nonsteroidal mineralocorticoid receptor antagonist (MRA) that safely and effectively improved cardiorenal outcomes in a large Phase 3 clinical trial program that included >13,000 patients with T2D and a wide spectrum of CKD. These two drug categories have shared and distinct mechanisms of action, generating the hypothesis that an overadditive cardiorenal benefit with their combined use may be biologically plausible. In this article, we describe the mechanism of action, and we provide an overview of the evidence for cardiorenal protection with SGLT-2 inhibitors and the nonsteroidal MRA finerenone in patients with CKD associated with T2D.
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- 2023
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41. Dapagliflozin Prevents High-Glucose-Induced Cellular Senescence in Renal Tubular Epithelial Cells.
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Eleftheriadis T, Pissas G, Filippidis G, Efthymiadi M, Liakopoulos V, and Stefanidis I
- Subjects
- Humans, Glucose metabolism, Cellular Senescence physiology, Epithelial Cells metabolism, Tumor Suppressor Protein p53 metabolism, Sodium-Glucose Transporter 2 Inhibitors pharmacology, Sodium-Glucose Transporter 2 Inhibitors metabolism
- Abstract
Gliflozins are a new class of antidiabetic drugs with renoprotective properties. In cultures of primary human renal tubular epithelial cells (RPTECs) subjected to high-glucose conditions in the presence or absence of dapagliflozin, we evaluated cellular senescence pathways. High glucose increased sodium-glucose cotransporter-2 (SGLT-2) expression and glucose consumption, enhancing reactive oxygen species production. The latter induced DNA damage, ataxia telangiectasia mutated kinase (ATM), and p53 phosphorylation. Stabilized p53 increased the cell cycle inhibitor p21, resulting in cell cycle arrest and increasing the cellular senescence marker beta-galactosidase (GLB-1). RPTECs under high glucose acquired a senescence-associated secretory phenotype, which was detected by the production of IL-1β, IL-8, and TGF-β1. By decreasing SGLT-2 expression and glucose consumption, dapagliflozin inhibited the above pathway and prevented RPTEC senescence. In addition, dapagliflozin reduced the cell cycle inhibitor p16 independently of the glucose conditions. Neither glucose concentration nor dapagliflozin affected the epithelial-to-mesenchymal transition when assessed with α-smooth muscle actin (α-SMA). Thus, high glucose induces p21-dependent RPTEC senescence, whereas dapagliflozin prevents it. Since cellular senescence contributes to the pathogenesis of diabetic nephropathy, delineating the related molecular mechanisms and the effects of the widely used gliflozins on them is of particular interest and may lead to novel therapeutic approaches.
- Published
- 2022
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42. Key Genetic Components of Fibrosis in Diabetic Nephropathy: An Updated Systematic Review and Meta-Analysis.
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Tziastoudi M, Theoharides TC, Nikolaou E, Efthymiadi M, Eleftheriadis T, and Stefanidis I
- Subjects
- Humans, Fibrosis, Genetic Association Studies, Signal Transduction, Diabetic Nephropathies genetics, Renal Insufficiency, Chronic, Diabetes Mellitus
- Abstract
Renal fibrosis (RF) constitutes the common end-point of all kinds of chronic kidney disease (CKD), regardless of the initial cause of disease. The aim of the present study was to identify the key players of fibrosis in the context of diabetic nephropathy (DN). A systematic review and meta-analysis of all available genetic association studies regarding the genes that are included in signaling pathways related to RF were performed. The evaluated studies were published in English and they were included in PubMed and the GWAS Catalog. After an extensive literature review and search of the Kyoto Encyclopedia of Genes and Genomes (KEGG) database, eight signaling pathways related to RF were selected and all available genetic association studies of these genes were meta-analyzed. ACE , AGT , EDN1 , EPO , FLT4 , GREM1 , IL1B , IL6 , IL10 , IL12RB1 , NOS3 , TGFB1 , IGF2/INS/TH cluster , and VEGFA were highlighted as the key genetic components driving the fibrosis process in DN. The present systematic review and meta-analysis indicate, as key players of fibrosis in DN, sixteen genes. However, the results should be interpreted with caution because the number of studies was relatively small.
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- 2022
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43. Cellular communication network 2 (connective tissue growth factor) aggravates acute DNA damage and subsequent DNA damage response-senescence-fibrosis following kidney ischemia reperfusion injury.
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Valentijn FA, Knoppert SN, Marquez-Exposito L, Rodrigues-Diez RR, Pissas G, Tang J, Tejedor-Santamaria L, Broekhuizen R, Samarakoon R, Eleftheriadis T, Goldschmeding R, Nguyen TQ, Ruiz-Ortega M, and Falke LL
- Subjects
- Animals, Humans, Mice, Fibrosis, Kidney pathology, Mice, Inbred C57BL, Acute Kidney Injury genetics, Acute Kidney Injury metabolism, Connective Tissue Growth Factor genetics, Connective Tissue Growth Factor metabolism, DNA Damage, Reperfusion Injury pathology
- Abstract
Chronic allograft dysfunction with progressive fibrosis of unknown cause remains a major issue after kidney transplantation, characterized by ischemia-reperfusion injury (IRI). One hypothesis to account for this is that spontaneous progressive tubulointerstitial fibrosis following IRI is driven by cellular senescence evolving from a prolonged, unresolved DNA damage response (DDR). Since cellular communication network factor 2 ((CCN2), formerly called connective tissue growth factor), an established mediator of kidney fibrosis, is also involved in senescence-associated pathways, we investigated the relation between CCN2 and cellular senescence following kidney transplantation. Tubular CCN2 overexpression was found to be associated with DDR, loss of kidney function and tubulointerstitial fibrosis in both the early and the late phase in human kidney allograft biopsies. Consistently, CCN2 deficient mice developed reduced senescence and tubulointerstitial fibrosis in the late phase; six weeks after experimental IRI. Moreover, tubular DDR markers and plasma urea were less elevated in CCN2 knockout than in wild-type mice. Finally, CCN2 administration or overexpression in epithelial cells induced upregulation of tubular senescence-associated genes including p21, while silencing of CCN2 alleviated DDR induced by anoxia-reoxygenation injury in cultured proximal tubule epithelial cells. Thus, our observations indicate that inhibition of CCN2 can mitigate IRI-induced acute kidney injury, DNA damage, and the subsequent DDR-senescence-fibrosis sequence. Hence, targeting CCN2 might help to protect the kidney from transplantation-associated post-IRI chronic kidney dysfunction., (Copyright © 2022 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)
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- 2022
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44. Hypertension in Dialysis Patients: Diagnostic Approaches and Evaluation of Epidemiology.
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Georgianos PI, Vaios V, Sgouropoulou V, Eleftheriadis T, Tsalikakis DG, and Liakopoulos V
- Abstract
Whereas hypertension is an established cardiovascular risk factor in the general population, the contribution of increased blood pressure (BP) to the huge burden of cardiovascular morbidity and mortality in patients receiving dialysis continues to be debated. In a large part, this controversy is attributable to particular difficulties in the accurate diagnosis of hypertension. The reverse epidemiology of hypertension in dialysis patients is based on evidence from large cohort studies showing that routine predialysis or postdialysis BP measurements exhibit a U-shaped or J-shaped association with cardiovascular or all-cause mortality. However, substantial evidence supports the notion that home or ambulatory BP measurements are superior to dialysis-unit BP recordings in diagnosing hypertension, in detecting evidence of target-organ damage and in prognosticating the all-cause death risk. In the first part of this article, we explore the accuracy of different methods of BP measurement in diagnosing hypertension among patients on dialysis. In the second part, we describe how the epidemiology of hypertension is modified when the assessment of BP is based on dialysis-unit versus home or ambulatory recordings.
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- 2022
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45. Inhibition of Malate Dehydrogenase-2 Protects Renal Tubular Epithelial Cells from Anoxia-Reoxygenation-Induced Death or Senescence.
- Author
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Eleftheriadis T, Pissas G, Golfinopoulos S, Efthymiadi M, Liakopoulos V, and Stefanidis I
- Subjects
- Humans, Adenosine Triphosphate metabolism, Apoptosis, beta-Galactosidase metabolism, Epithelial Cells metabolism, Hypoxia metabolism, Interleukin-1beta metabolism, Ki-67 Antigen metabolism, Pharmaceutical Preparations metabolism, Reactive Oxygen Species metabolism, Tumor Suppressor Protein p53 metabolism, Hypoxia-Inducible Factor 1, alpha Subunit metabolism, Malate Dehydrogenase antagonists & inhibitors, Reperfusion Injury metabolism
- Abstract
Ischemia-reperfusion injury is the leading cause of acute kidney injury. Reactive oxygen species (ROS) production causes cell death or senescence. In cultures of primary human renal tubular epithelial cells (RPTECs) subjected to anoxia-reoxygenation, inhibition of the Krebs cycle at the level of malate dehydrogenase-2 (MDH-2) decreases hypoxia-inducible factor-1α and oxidative stress and protects from apoptotic or ferroptotic cell death. Inhibition of MDH-2 decreased reoxygenation-induced upregulation of p53 and p21, restored the levels of the proliferation marker Ki-67, and prevented the upregulation of the senescence marker beta-galactosidase and interleukin-1β production. MDH-2 inhibition reduced the reoxygenation-induced upregulation of ATP, but the alterations of critical cell metabolism enzymes allowed enough ATP production to prevent cell energy collapse. Thus, inhibition of the Krebs cycle at the level of MDH-2 protects RPTECs from anoxia-reoxygenation-induced death or senescence. MDH-2 may be a promising pharmaceutical target against ischemia-reperfusion injury.
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- 2022
- Full Text
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46. Fatigue and Quality of Life in Children with Chronic Kidney Disease.
- Author
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Karava V, Goutou S, Dotis J, Kondou A, Charela E, Dadoudi O, Eleftheriadis T, Stefanidis I, and Printza N
- Abstract
Background: This study investigates the effect of chronic kidney disease (CKD) stage on fatigue and health-related quality of life (HRQoL) in the pediatric population. Material and Methods: The PedsQL (Pediatric Quality of Life Inventory) Multidimensional Fatigue Scale (subcategories: general, sleep/rest, and cognitive fatigue) and HRQoL Generic Core Scales (subcategories: physical, emotional, social, and school functioning) questionnaires were completed by 30 patients aged from 7 to 18 years old with CKD stage 2−4, CKD stage 5 on dialysis (CKD 5D), and kidney transplantation (KTx), as well as their parents. Results: Both low “Total Fatigue” and “Total HRQoL” scores were reported in 16.7% of patients. “Sleep/Rest Fatigue”, “Emotional Functioning”, and “School functioning” were the lowest scored subcategories. CKD 5D/KTx patients presented lower “Sleep/Rest Fatigue” (p = 0.022) and, more frequently, low “School Functioning” scores (p = 0.029). The “Total HRQoL” score was correlated to the “Total Fatigue” score (rs = 0.625, p < 0.001). A low “Sleep/Rest Fatigue” score was associated with low “Physical Functioning”, “School Functioning”, and “Total HRQoL” scores (p = 0.016, p = 0.001, and p = 0.047 respectively). Parents’ HRQoL score was lower than patients’ score on “Physical Functioning” (p = 0.040) and “School Functioning” subcategories (p = 0.045). Conclusions: Fatigue and disturbed HRQoL are mostly observed in CKD 5D and KTx pediatric patients, and are associated with sleep disorders and school dysfunction. Fatigue affects HRQoL, which is perceived as more deteriorated by the patients’ parents.
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- 2022
- Full Text
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47. VItamin K In PEritonial DIAlysis (VIKIPEDIA): Rationale and study protocol for a randomized controlled trial.
- Author
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Roumeliotis S, Roumeliotis A, Georgianos PI, Thodis E, Schurgers LJ, Maresz K, Eleftheriadis T, Dounousi E, Tripepi G, Mallamaci F, and Liakopoulos V
- Subjects
- Biomarkers, Blood Pressure Monitoring, Ambulatory, Calcium, Calcium-Binding Proteins, Extracellular Matrix Proteins, Humans, Phosphorus, Prospective Studies, Randomized Controlled Trials as Topic, Vascular Calcification, Kidney Failure, Chronic therapy, Renal Dialysis, Vitamin K 2 adverse effects
- Abstract
Vascular calcification (VC) is an active process, resulting from the disturbance of balance between inhibitors and promoters of calcification, in favor of the latter. Matrix Gla Protein, a powerful inhibitor of VC, needs vitamin K to become active. In vitamin K depletion, plasma levels of the inactive form of MGP, dephosphorylated, uncarboxylated MGP (dp-ucMGP) are increased and associated with VC and cardiovascular (CV) outcomes. End Stage Renal Disease (ESRD) patients have increased circulating dp-ucMGP levels and accelerated VC. VItamin K In PEritoneal DIAlysis (VIKIPEDIA) is a prospective, randomized, open label, placebo-controlled trial, evaluating the effect of vitamin K2 supplementation on arterial stiffness and CV events in ESRD patients undergoing peritoneal dialysis (PD). Forty-four PD patients will be included in the study. At baseline, dp-ucMGP and pulse-wave velocity (PWV) will be assessed and then patients will be randomized (1:1 ratio) to vitamin K (1000 μg MK-7/day) or placebo for 1.5 years. The primary endpoint of this trial is the change in PWV in the placebo group as compared to the treatment group. Secondary endpoints are the occurrence of CV events, mortality, changes in PD adequacy, change in 24-hour ambulatory blood pressure indexes and aortic systolic blood pressure and changes in calcium/phosphorus/parathormone metabolism. VIKIPEDIA is a new superiority randomized, open label, placebo-controlled trial aiming to determine the effect of vitamin K2 supplementation on VC, CV disease and calcium/phosphorus metabolism, in PD patients. Trial registration: The protocol of this study is registered at ClinicalTrials.gov with identification number NCT04900610 (25 May 2021)., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Leon J. Schurgers received institutional grants from Bayer, Boehringer Ingelheim, NattoPharma, and Immuno Diagnostic Systems (IDS, but this does not alter our adherence to PLOS ONE policies on sharing data and materials.
- Published
- 2022
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48. Rituximab Administered for Recurrent Membranous Nephropathy in a Kidney Transplant Recipient Did Not Eliminate Donor-Specific Antibodies.
- Author
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Giannopoulou M, Tarassi K, Tsouka G, Christodoulidou C, Stefanidis I, and Eleftheriadis T
- Subjects
- Antibodies, Graft Rejection drug therapy, Graft Rejection etiology, Graft Rejection prevention & control, Humans, Male, Treatment Outcome, Glomerulonephritis, Membranous diagnosis, Glomerulonephritis, Membranous drug therapy, Glomerulonephritis, Membranous pathology, Immunosuppressive Agents adverse effects, Kidney Transplantation adverse effects, Rituximab therapeutic use
- Abstract
Chronic active antibody-mediated rejection is the leading cause of kidney transplant failure. Although various immunosuppressive agents have been tested, rituximab included, presently there is no effective treatment. There are reports about the beneficial role of certain immunosuppressive protocols that include rituximab to reduce donor-specific antibodies, the cause of chronic active antibody-mediated rejection. If an immunosuppressive agent reduces donor-specific antibodies, its administration before the occurrence of chronic active antibody-mediated rejection may be beneficial. We describe a case of a renaltransplantrecipient with recurrent membranous nephropathy and recent development of donor-specific antibodies but without histological evidence of active antibody-mediated rejection. The patient received 3 weekly doses of rituximab for recurrent membranous nephropathy, and complete remission was achieved. One year after, he has preserved an excellentrenal function without proteinuria. However, repeated measurements of donor-specific antibodies revealed that rituximab only modestly reduced donor-specific antibodies. Donor-specific antibody levels remained considerably higher than the laboratory reference value. Thus,rituximab alone may not have a role to prevent chronic active antibody- mediated rejection in patients with donor-specific antibodies.
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- 2022
- Full Text
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49. Should We Use Dialyzable β-Blockers in Hemodialysis?
- Author
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Georgianos PI, Eleftheriadis T, and Liakopoulos V
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- 2022
- Full Text
- View/download PDF
50. Molecular Aspects of Renal Immunology: Current Status and Future Perspectives.
- Author
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Eleftheriadis T and Crespo M
- Subjects
- Forecasting, Humans, Kidney Failure, Chronic therapy, Kidney Transplantation
- Abstract
Kidney transplantation is the most promising treatment available for patients with end-stage kidney disease [...].
- Published
- 2022
- Full Text
- View/download PDF
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