Exploration of novel predictive markers in rat plasma of the early stages of chronic renal failure

To identify blood markers for early stages of chronic kidney disease (CKD), blood samples were collected from rats with adenine-induced CKD over 28 days. Plasma samples were subjected to metabolomic profiling by liquid chromatography-mass spectrometry, followed by multivariate analyses. In addition to already-identified uremic toxins, we found that plasma concentrations of N6-succinyl adenosine, lysophosphatidylethanolamine 20:4, and glycocholic acid were altered, and that these changes during early CKD were more sensitive markers than creatinine concentration, a universal indicator of renal dysfunction. Moreover, the increase in plasma indoxyl sulfate concentration occurred earlier than increases in phenyl sulfate and p-cresol sulfate. These novel metabolites may serve as biomarkers in identifying early stage CKD.     

Suitability of selected chromatographic columns for analysis of fatty acids in dialyzed patients

Gas chromatography–mass spectrometry is a preferred method for fatty acid (FA) analysis in biofluids from patients with metabolic diseases. Complex characteristics of FAs make their analysis particularly challenging. Selection of an appropriate chromatographic column is particularly important component of the process as it provides optimal separation and detection of possibly all FAs present in the sample. However, no accurate protocol for comparative evaluation of capillary columns for the analysis of whole serum FA profile in patients with chronic kidney disease (CKD) has been developed thus far. Therefore, in the present study four columns were examined to select the one providing optimal separation and determination of FA profiles in this group of patients. Moreover, serum FA profiles obtained with the selected column in CKD patients subjected to peritoneal dialysis and healthy controls were compared. Thirty‐seven component FAME Mix and sera from CKD patients were used to optimize chromatographic conditions and to select the most appropriate column. The ZB‐5 column turned out to be the most appropriate for the analysis of whole FA profile in CKD patients' sera. Then, this column was used to compare FA profiles in patients subjected to peritoneal dialysis and in healthy controls. The analysis demonstrated many abnormalities in the FA profile of CKD patients. Further studies involving larger groups of patients presenting with other stages of CKD are required to explain the impact of the disease progression on composition of serum FAs.     

Spectrally and Time-Resolved Fluorescence Imaging of 22-NBD-Cholesterol in Human Peripheral Blood Mononuclear Cells in Chronic Kidney Disease Patients

The interaction of the fluorescent probe 22-NBD-cholesterol with membranes of human peripheral blood mononuclear cells (PBMC) was tested by time- and spectrally resolved fluorescence imaging to monitor the disturbance of lipid metabolism in chronic kidney disease (CKD) and its treatment with statins. Blood samples from healthy volunteers (HV) and CKD patients, either treated or untreated with statins, were compared. Spectral imaging was done using confocal microscopy at 16 spectral channels in response to 458 nm excitation. Time-resolved imaging was achieved by time-correlated single photon counting (TCSPC) following excitation at 475 nm. The fluorescence of 22-NBD-cholesterol was mostly integrated into plasmatic membrane and/or intracellular membrane but was missing from the nuclear region. The presence of two distinct spectral forms of 22-NBD-cholesterol was uncovered, with significant variations between studied groups. In addition, two fluorescence lifetime components were unmasked, changing in CKD patients treated with statins. The gathered results indicate that 22-NBD-cholesterol may serve as a tool to study changes in the lipid metabolism of patients with CKD to monitor the effect of statin treatment.     

聚苯乙烯磺酸钙防治慢性肾脏病(CKD)患者服用RAAS-I致高钾血症的效果

目的 探讨因服用肾素-血管紧张素-醛固酮系统抑制剂(RAAS-I)致高钾血症的慢性肾脏病(CKD)患者应用聚苯乙烯磺酸钙进行防治的临床效果.方法 选取惠州市第三人民医院诊治的CKD患者80例作为研究对象,所有患者均服用RAAS-I 4周以上.将其随机分为观察组和对照组.对照组给予常规治疗,观察组给予聚苯乙烯磺酸钙联合治疗.统计观察组患者治疗前以及治疗2个月后24 h尿蛋白、血肌酐以及血钾变化,并对两组患者不同时段血钾水平进行统计分析.结果 治疗后观察组24 h尿蛋白水平明显高于治疗前(P<0.05),血钾水平明显低于治疗前(P<0.05);观察组治疗1、3以及6个月时血钾水平均低于对照组(P<0.05).结论 聚苯乙烯磺酸钙治疗CKD患者服用RAAS-I所致的高钾血症效果显著,血钾水平控制良好.     

Combination of medical and health care based on digital smartphone-powered photochemical dongle for renal function management

Currently, the global healthcare market is increasing at high speed with the impendent global aging issue. Healthcare Industry 4.0 has emerged as an efficient solution towards the aging issue since it was integrated with ubiquitous medical sensors, big health processing platform, high bandwidth, speed technologies, and medical services, etc. It is believed to fulfil the requirement of the tremendously growing health market. The acquisition of medical data acts as the dominant precondition to implement the Healthcare Industry 4.0. In the same way, the widely available smartphone could serve as the best biomedical information collect station. In this study, a smartphone-powered photochemical dongle is demonstrated to precisely estimate blood creatinine from the fingertip blood, which works as a highly compact reflectance spectral analyzer with an enzymatically dry chemical test strip. Comparing with conventional laboratory facility for the evaluation and treatment of chronic kidney disease (CKD), it implemented the platform of point care with agreed accuracy. In order to estimate the efficiency of treatment and recovery of the CKD, the proposed photochemical dongle would provide a flexible and rapid platform for point of care. Furthermore, the proposed measured technology is very promising method for remote CKD management.     

Capillary electrophoretic analysis of whole blood samples for hemoglobin-based oxygen carriers without the use of immunoprecipitation

Hemoglobin-based oxygen carriers (HBOCs) are blood substitutes, synthesized by polymerizing hemoglobin, which are being developed and investigated as alternatives to blood for medical purposes. However, due to their ability to increase the oxygen carrying capacity when taken by healthy individuals, HBOCs have been used as a doping agent among endurance athletes and are included in the World Anti-Doping Agency's Prohibited List. To maintain the fairness of competitions and continue the battle against doping, it is essential to be able to detect HBOCs if present in an athlete's blood. To achieve this goal, it is necessary to differentiate HBOCs from the native hemoglobin and to do so in a cost and time effective manner. We have developed a rapid capillary zone electrophoresis (CZE), UV absorbance, method capable of detecting HBOCs, in whole blood samples, at levels below those considered necessary to provide a performance enhancement. Our approach to the analysis for HBOCs utilizes the whole blood sample, not just the plasma, and does not require the use of immunoprecipitants to ensure accurate analysis. By lysing the red blood cells and using centrifugal filtration, followed by our CZE separation, we are able to effectively distinguish between native hemoglobin and HBOCs. Through this method, we have been able to reliably detect concentrations of HBOCs at the equivalent of 5.5 g/L, the equivalent to a 3.5% increase in blood hemoglobin concentration for an athlete.     

Determination of selenium in human body fluids by hydride-generation atomic absorption spectrometry : Optimization of sample decomposition

The accuracy of the determination of selenium in human body fluids by hydride-generation a.a.s. depends critically upon the sample decomposition-method used. Digestion with HNO₃ alone gave low selenium recoveries, but with nitric, sulfuric and perchloric acids at a final temperature of 310°C gave results that agreed with those obtained by other techniques. The recovery of selenomethionine added to whole blood and of trimethylselenonium iodide added to urine was 97–104%. The average selenium values found for 6 healthy individuals were 88 μg l^?1 in whole blood, 75 μg l^?1 in blood plasma and 307 μg (kg Hb)^?1 in erythrocytes. A detection limit of 5 μg l^?1 Se in body fluids was found under routine conditions.     

Determination of creatinine-related molecules in saliva by reversed-phase liquid chromatography with tandem mass spectrometry and the evaluation of hemodialysis in chronic kidney disease patients

The serum concentrations of creatinine (Cre) and urea are used for the determination of the renal function. However, the use of blood is not always suitable due to the invasive, hygienic and infection problems during its sample collection and handling. In contrast, saliva is relatively clean and the samples can be quickly and noninvasively collected and easily stored. Therefore, the simultaneous determination of Arginine (Arg), creatine (Cr) and Cre in the saliva of chronic kidney disease (CKD) patients was performed by UPLC-ESI-MS/MS together with the saliva of healthy volunteers. The evaluation of hemodialysis of CKD patients was also carried out by the determinations before and after the dialysis. An HS-F5 column was used for the simultaneous determination of Arg, Cr and Cre in the saliva. These molecules were rapidly separated within 4 min and sensitively determined by the multiple reaction monitoring (MRM) of the precursor ion [M+H]⁺ → product ions (m/z 175.1 → 70.1 for Arg; m/z 132.0 → 44.1 for Cr; m/z 114.0 → 44.1 for Cre). The concentration of Cre in the CKD patients was higher than that in the healthy persons. The concentrations of Cre in the saliva of the patients before hemodialysis were moderately correlated with the serum Cre concentrations (R² = 0.661). Furthermore, the concentration in the saliva obviously decreased after hemodialysis (before 0.73 mg/dL, after 0.25 mg/dL; p < 0.02). Thus, the proposed detection method using saliva by UPLC-MS/MS is useful for the evaluation of the renal function in CKD patients. The present method offers a new option for monitoring the hemodialysis of CKD patients.     

Flavonoids in Treatment of Chronic Kidney Disease

Chronic kidney disease (CKD) is a progressive systemic disease, which changes the function and structure of the kidneys irreversibly over months or years. The final common pathological manifestation of chronic kidney disease is renal fibrosis and is characterized by glomerulosclerosis, tubular atrophy, and interstitial fibrosis. In recent years, numerous studies have reported the therapeutic benefits of natural products against modern diseases. Substantial attention has been focused on the biological role of polyphenols, in particular flavonoids, presenting broadly in plants and diets, referring to thousands of plant compounds with a common basic structure. Evidence-based pharmacological data have shown that flavonoids play an important role in preventing and managing CKD and renal fibrosis. These compounds can prevent renal dysfunction and improve renal function by blocking or suppressing deleterious pathways such as oxidative stress and inflammation. In this review, we summarize the function and beneficial properties of common flavonoids for the treatment of CKD and the relative risk factors of CKD.     

Determination of manganese in urine and whole blood samples by electrothermal atomic absorption spectrometry: comparison of chemical modifiers.

In this work, methodologies to determine manganese (Mn) in urine and whole blood by electrothermal atomic absorption spectrometry were developed. The use of Ru, Rh, and Zr as permanent modifiers, Pd as a modifier in solution, and the condition without modifier were investigated for the direct determination of Mn in urine and whole blood samples. The best results for Mn in urine and in whole blood were obtained without modifier use. The analytical characteristic, such as accuracy, precision and limit of detection of the proposed methodology were adequate.     

Loss of RTN3 phenocopies chronic kidney disease and results in activation of the IGF2-JAK2 pathway in proximal tubular epithelial cells

Reticulon 3 (RTN3) is an endoplasmic reticulum protein that has previously been shown to play roles in neurodegenerative diseases, but little is known about its function in the kidneys. The aim of the present study was to clarify the roles of RTN3 in chronic kidney disease (CKD) and kidney fibrosis. In this study, RTN3 levels were measured in kidney tissues from healthy controls and CKD or kidney fibrosis patients. An RTN3-null mouse model was generated to explore the pathophysiological roles of RTN3 in the kidneys. The underlying mechanisms were studied in primary proximal tubular epithelial cells and HEK293 cells in vitro. The results showed that (1) a reduction in RTN3 in mice induces CKD and kidney fibrosis; (2) decreased RTN3 expression is found in patients with CKD; (3) RTN3 plays critical roles in regulating collagen biosynthesis and mitochondrial function; and (4) mechanistically, RTN3 regulates these phenotypes by interacting with GC-Rich Promoter Binding Protein 1 (GPBP1), which activates the IGF2-JAK2-STAT3 pathway. Our study indicates that RTN3 might play crucial roles in CKD and kidney fibrosis and that a reduction in RTN3 in the kidneys might be a risk factor for CKD and kidney fibrosis.Subject terms: Chronic kidney disease, Experimental models of disease     

The advantages of cell lysis before blood sample preparation by extraction for HPLC propofol analysis

Propofol (2,6-diisopropylphenol) is a short-acting drug with a large volume of distribution and high body clearance. It is suitable both for the induction of anaesthesia by bolus injection and the maintenance of anaesthesia by repeated injections or a continuous infusion. Examining the drug concentration its analysis in whole blood is recommended. This results from the fact that propofol molecules strongly bind with plasma proteins and cellular blood constituents and blood composition variations are observed between individuals or in different disease states or resulting from transfusion etc. In most cases the HPLC analysis follows the extraction of samples. The degree of propofol binding with blood cells can be different, depending on the blood type, and it can change in time, which may affect the results of the analysis. The paper discusses and shows the necessity of blood cell lysis before the extraction procedure. The cell lysis makes possible to determine the total amount of propofol in blood independently of the degree of propofol binding with cellular blood constituents and its changes.     

Studies of luminol-dependent whole-blood chemiluminescence induced by platelet-activating factor (PAF)

A whole-blood luminol-dependent chemiluminescence (CL) assay stimulated by platelet-activating factor (PAF) is reported. Factors investigated using this assay were dilution of blood, dose responsiveness of PAF, and inactivation of PAF. The final conditions chosen for the assay were a 1:10 dilution of whole blood and 2 × 10^?4M luminol. Nordihydroguaiaretic acid (NDGA) and indomethacin (INDO), which inhibit lipoxygenase and cyclooxygenase, decreased luminol-dependent whole-blood chemiluminescence by 59 and 17%, respectively. Superoxide dismutase and catalase were relatively ineffective inhibitors of CL (28 and 22%, respectively) while sodium azide was most inhibitory (84%). Although these studies were not entirely conclusive, lipoxygenase and myeloperoxidase appear to be important in CL elicited by PAF in this whole-blood CL assay. This system may serve as a useful screening system for measuring the effect of PAF in the blood of different individuals without extensive separation of cell types. It has the distinct advantage of being closer to in situ Conditions.     

Metabolic profiles of the Flos Abelmoschus manihot extract by intestinal bacteria from the normal and CKD model rats based on UPLC‐Q‐TOF/MS

Flos Abelmoschus manihot is a traditional herbal medicine widely used in clinical practice to tackle chronic kidney disease (CKD) for thousands of years. Nowadays, many studies indicate that gut bacteria are closely related to the progression of CKD and CKD‐related complications. In this study, a UPLC‐Q‐TOF/MS method coupled with the MetaboLynx™ software was established and successfully applied to investigate the metabolites and metabolic profile of Flos A. manihot extract by intestinal bacteria from normal and CKD rats. Eight parent components and eight metabolites were characterized by their protonated ions. Among these compounds, 15 were detected in the two group samples while M16 was only determined in the CKD model samples. Compared with the quercetin‐type glycosides, fewer myricetin‐type and gossypetin‐type metabolites were obtained in the two group samples. These metabolites suggested that deglycosylation and methylation are the major metabolic pathways of Flos A. manihot extract. Few differences of metabolite classes were observed in the two group samples. However, the concentrations of aglycones such as quercetin, myricetin and gossypetin in the normal samples were notably higher than those in the CKD model samples. The results are important in unravelling the pharmacological effects of A. manihot and clarifying its mechanism of action in vivo .     

Novel pressurized solvent extraction vessels for the analysis of polychlorinated biphenyl congeners in avian whole blood

Persistent organic pollutants remain a serious threat to many food-chain systems. New pollutants continue to emerge. The present study has created novel extraction vessels which are compatible with readily available commercial instrumentation to validate the analysis of one class of persistent organic pollutants, polychlorinated biphenyls (PCBs), in avian blood. The volumes used can be reasonably sampled without sacrificing individuals, or comprising breeding or migratorial success. The procedure consists of the pressurized solvent extraction (PSE) of analytes in a novel PSE extraction vessel. The new extraction cell contains a 38-cm long, coiled, re-packable, in situ clean-up column. Lipid elimination, using Florisil, occurs within the coiled region of the extraction vessel, eliminating the requirement for post extraction clean-up. For development, 0.2 g samples of chicken whole blood have been used. Extract volumes are reduced from (30 to 10) cm³, compared to unmodified systems. The new PSE vessel with its integrated clean-up method showed satisfactory performance for the analysis of ten environmentally relevant PCB congeners in chicken whole blood samples with recoveries in the range of (70-130)%. Detection limits using gas chromatography coupled with large volume injection ion-trap mass spectrometry (GC-LVI-ITMS-MS) were in the range of (0.05-0.5) ng g⁻¹. The relative standard deviations for all congeners investigated were better than 5%. This is the first PSE validation to have been conducted on unaltered whole blood samples.     

Visualization of microscale particle focusing in diluted and whole blood using particle trajectory analysis

Inertial microfluidics has demonstrated the potential to provide a rich range of capabilities to manipulate biological fluids and particles to address various challenges in biomedical science and clinical medicine. Various microchannel geometries have been used to study the inertial focusing behavior of particles suspended in simple buffer solutions or in highly diluted blood. One aspect of inertial focusing that has not been studied is how particles suspended in whole or minimally diluted blood respond to inertial forces in microchannels. The utility of imaging techniques (i.e., high-speed bright-field imaging and long exposure fluorescence (streak) imaging) primarily used to observe particle focusing in microchannels is limited in complex fluids such as whole blood due to interference from the large numbers of red blood cells (RBCs). In this study, we used particle trajectory analysis (PTA) to observe the inertial focusing behavior of polystyrene beads, white blood cells, and PC-3 prostate cancer cells in physiological saline and blood. Identification of in-focus (fluorescently labeled) particles was achieved at mean particle velocities of up to 1.85 m s(-1). Quantitative measurements of in-focus particles were used to construct intensity maps of particle frequency in the channel cross-section and scatter plots of particle centroid coordinates vs. particle diameter. PC-3 cells spiked into whole blood (HCT = 45%) demonstrated a novel focusing mode not observed in physiological saline or diluted blood. PTA can be used as an experimental frame of reference for understanding the physical basis of inertial lift forces in whole blood and discover inertial focusing modes that can be used to enable particle separation in whole blood.     

Trace analysis of total fluorine in human blood using combustion ion chromatography for fluorine: a mass balance approach for the determination of known and unknown organofluorine compounds

The number of perfluorochemicals (PFCs) that have been found in biological and environmental matrices is increasing as analytical standards and methods evolve. Perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) constitute only a fraction of the total suite of PFCs found in environmental and biological matrices. A robust method and approach is needed to evaluate the mass of fluorinated compounds in biological matrices. In this study, we developed a method to measure total fluorine (TF) and organic fluorine (TOF) in human blood matrices using combustion ion chromatography (CIC). Blood matrices (whole blood, serum, and plasma) were analyzed in bulk to determine TF. An aliquot of the blood was also extracted with organic solvents such as methyl-tert-butyl ether (MTBE) and hexane, and organic and aqueous extracts were separated, to fractionate organofluorines from inorganic fluorine. The organic layer was analyzed for TF by CIC, and for known PFCs by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). PFCs measured by HPLC-MS/MS accounted for >80% of the TF in the organic fraction. The aqueous fraction contained inorganic fluorine and other non-extractable organofluorines. However, in the bulk sample, fluoride and non-extractable organofluorines accounted for >70% of the TF in blood samples from the general population. In occupationally exposed individuals, known organofluorines accounted for a major proportion of the TF. These results suggest the existence of yet uncharacterized fluorine fraction in human blood. Further studies are needed to characterize the aqueous fraction that contains inorganic fluorine and non-extractable forms of fluorine.     

An indirect spectrophotometric method for the determination of silicon in serum, whole blood and erythrocytes.

An indirect method for the determination of silicon in blood samples has been developed. The proposed method overcame interference from a large amount of salts and phosphate in blood samples, and enabled us to determine the silicon contents in serum and whole blood by the same operation. After blood samples were digested by microwave heating, silicon, present as silicate in the sample solution, was reacted with molybdate to form a silicomolybdate complex. The complex was then separated from unreacted molybdate by a cation-exchange resin column. The molybdate liberated from the complex was spectrophotometrically determined in place of silicon. Since the method is not affected the composition of matrices between serum and whole blood, it could achieve good precision and accuracy, and could also estimate the silicon contents in erythrocytes from those in serum and whole blood. The sensitivity of the method was almost equal to that of the conventional silicomolybdenum blue method, and the calibration curve was linear up to 50 micromol l(-1) of silicon with a detection limit of 1.1 micromol l(-1) in whole blood. The mean concentrations of silicon in five healthy subjects were 11 micromol l(-1) for serum, 28 micromol l(-1) for whole blood and 50 micromol l(-1) for erythrocytes. Thus, the obtained distribution ratio between serum and erythrocytes was in the range of 0.15-0.39, and was found to be included in a narrow range.     

Influence of parenteral fat emulsion Intralipos and citric acid on blood viscosity and erythrocyte morphology in vitro

In most studies fat emulsion had been administered by enteral route. Recently a parenteral soybean-oil emulsion has been developed. In this study we assessed the effects of a parenteral soybean-oil emulsion (Intralipos((R))) and citric acid on blood rheology and erythrocyte morphology in vitro. Porcine blood was incubated in vitro with increasing concentrations of fat emulsion Intralipos((R)) and citric acid at 37 degrees C for 1h. Viscosity of plasma and whole blood was measured using a FASCO-2050 digital viscometer. Red blood cell morphology was examined by light microscopy. The viscosity of whole blood represented an ascending dose-dependence for different Intralipos((R)) concentrations at high shear rate of 90 and 225s(-1), however, it decreased with citric acid concentrations. On the other hand, the whole blood viscosity also declined with citric acid concentrations in presence of 30% Intralipos((R)) (v/v), and there is a minimal viscosity at 0.67% citric acid (v/v). There are some thorns on the blood membrane at 40% Intralipos((R)) as compared with control (no Intralipos((R)) addition), which indicates the Intralipos((R)) compound may affect blood cell membranes, and resulted in whole blood viscosity increase. We concluded that the intravenous soybean-oil preparation Intralipos((R)) interacts with the erythrocyte membrane, and citric acid could alleviate the whole blood viscosity.     

轮状病毒感染性腹泻患儿的微量元素锌检测结果分析

目的：检测轮状病毒感染性腹泻患儿的全血微量元素锌的水平,探讨轮状病毒感染性腹泻患儿全血微量元素锌的变化。方法对186例轮状病毒感染性腹泻患儿和675例健康对照组儿童进行全血微量元素锌测定。结果轮状病毒感染性腹泻患儿全血微量元素锌含量明显低于健康对照组儿童,差异有统计学意义（ P＜0.05）。结论轮状病毒感染性腹泻患儿全血微量元素锌水平明显下降,需要及时补充微量元素锌。