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mofetil and diabetic nephropathy

Abraham Said Arellano-Buendía, Montserrat Tostado-González, Fernando Enrique García-Arroyo, Magdalena Cristóbal-García, María Lilia Loredo-Mendoza, Edilia Tapia, Laura-Gabriela Sánchez-Lozada, Horacio Osorio-Alonso
This study addressed the relationship of proinflammatory cytokines and Nrf2-Keap1 system in diabetic nephropathy. The experimental groups were control, diabetic, and diabetic treated with mycophenolate mofetil (MMF). The renal function, proinflammatory and profibrotic cytokines, oxidative stress, morphology, and nephrin expression were assessed. Diabetic group showed impaired renal function in association with oxidative stress and decreased Nrf2 nuclear translocation. These results were associated with increased mesangial matrix index, interstitial fibrosis, and increased nephrin expression in cortex and urine excretion...
2016: Oxidative Medicine and Cellular Longevity
Medhat A Halim, Torki Al-Otaibi, Osama Gheith, Ahmed Mosaad, Zakaria Zakaria, Tarek Said, Prasad Nair, Narayanan M R Nampoory
OBJECTIVES: There is no active treatment for postrenal transplant BK virus-associated nephropathy proven to be effective so far. We assessed the effectiveness of actively treating this condition with combined leflunomide, intravenous immunoglobulin, and ciprofloxacin on long-term graft outcome compared with minimization of immunosuppressive drugs. MATERIALS AND METHODS: Kidney transplant recipients were screened for BK virus-associated nephropathy. Group 1 comprised 22 kidney trans plant recipients with twice-positive BK virus polymerase chain reaction results in urine and blood...
February 2016: Experimental and Clinical Transplantation
Jung-Woo Seo, Yang Gyun Kim, Sang Ho Lee, Arah Lee, Dong-Jin Kim, Kyung-Hwan Jeong, Kyung Hye Lee, Seung Joon Hwang, Jong Shin Woo, Sung Jig Lim, Weon Kim, Ju-Young Moon
Chronic low-grade inflammation is an important factor in the pathogenesis of diabetic complication. Mycophenolate mofetil (MMF) has an anti-inflammatory effect, inhibiting lymphocyte proliferation. Previous studies showed attenuation of diabetic nephropathy with MMF, but the underlying mechanisms were unclear. This study aimed to identify the effect of MMF on diabetic nephropathy and investigate its action mechanisms in type 2 diabetic mice model. Eight-week-old db/db and control mice (db/m mice) received vehicle or MMF at a dose of 30 mg/kg/day for 12 weeks...
2015: BioMed Research International
Xiaoyan Xiao, Jie Wang, Xiangdi Chang, Junhui Zhen, Gengyin Zhou, Zhao Hu
Recent studies in animal models have revealed that mycophenolate mofetil (MMF) has certain protective effects against experimental diabetic nephropathy. The present study therefore aimed to investigate the hypothesis that diabetic nephropathy may be ameliorated by mycophenolate mofetil and benazepril treatment alone or in combination, and identify the potential underlying mechanisms in a rat model. Diabetes was induced in rats by a single intraperitoneal injection of streptozotocin. Rats were subsequently treated with benazepril, MMF or a combination of the two drugs, and blood glucose, normalized kidney weight, urine protein and serum creatinine were determined...
September 2015: Molecular Medicine Reports
Izumi Nyumura, Kazuho Honda, Tetsuya Babazono, Shigeru Horita, Toru Murakami, Shohei Fuchinoue, Yasuko Uchigata
Post-transplant hyperglycaemia of diabetic patients may cause recurrent diabetic kidney disease (DKD) in kidney allografts. We report a patient with slowly progressive DKD with calcineurin inhibitor toxicity (CNI) toxicity after the kidney transplantation. A 28-year-old female with type 1 diabetes mellitus underwent successful kidney transplantation from her mother in April 2003, and the kidney graft survived for more than 10 years. She was treated with combined immunosuppressive therapy consisting of cyclosporine and mycophenolate mofetil...
July 2015: Nephrology
Su-Mi Kim, Sang-Ho Lee, Arah Lee, Dong-Jin Kim, Yang-Gyun Kim, Se-Yun Kim, Kyung-Hwan Jeong, Tae-Won Lee, Chun-Gyoo Ihm, Sung-Jig Lim, Ju-Young Moon
Proinflammatory T helper 1 (Th1) and T helper 17 (Th17) cell subsets have been reported to have an immunopathogenic role in metabolic disease. We previously demonstrated that CD4(+) T cells are increased in kidneys in type 2 diabetic patients. However, the role of Th1 and Th17 cells in the development and progression of diabetic nephropathy is unclear. In this study, we examined the hypothesis that mycophenolate mofetil (MMF) attenuates diabetic kidney injury by the suppression of renal T-cell proliferation and related cytokines...
October 2015: Translational Research: the Journal of Laboratory and Clinical Medicine
Tarek Fayad, Emad William, Nasr Tawfik, Boulos Habashy, Hazem S Abou-Youssef, Sameh Shokry, Soha Khalil, Ahmed Morsy, Rashad Barsoum
OBJECTIVES: To describe the long-term results of a previously developed a sirolimus-based sequential immunosuppression protocol for kidney transplant comprising 2 phases: sirolimus + cyclosporine + prednisolone for 3 months followed by sirolimus + prednisolone + mycophenolate mofetil with steroid minimization the first year. Two-year outcomes of patients on this protocol (group A) showed equivalent patient and graft survival, yet with significantly better function, compared with those on cyclosporine + mycophenolate mofetil + prednisolone (group B)...
April 2015: Experimental and Clinical Transplantation
Medhat Abdel Halim, Torki Al-Otaibi, Osama Gheith, Zakaria Zkaria, Ahmed Mosaad, Tarek Said, Prasad Nair, Narayanan Nampoory
OBJECTIVES: Thus far, there is no active treatment for BK virus-associated nephropathy after a kidney transplant that has proven to be effective. We sought to assess the effectiveness of treatment with leflunomide, intravenous immunoglobulin, and ciprofloxacin on graft outcome after 1 year compared with a historical group treated with reduced immunosuppressive medications strategy. MATERIALS AND METHODS: Group 1 (n = 19) was composed of kidney transplant recipients with twice positive BK virus-polymerase chain reaction in urine and blood who underwent graft biopsy to confirm BK virus-associated nephropathy...
December 2014: Experimental and Clinical Transplantation
M Kamran Mirza, Lisa Kim, Pradeep V Kadambi, Anthony Chang, Shane M Meehan
We report a case of idiopathic, PLA2R-negative membranous nephropathy (MN) transplanted via a deceased donor kidney. Changes in glomerular immune deposits were followed in serial biopsies. The allograft recipient had end-stage disease without significant proteinuria from ischemic nephropathy due to chronic heart failure, hypertension, atherosclerosis and presumed diabetic nephropathy. Combined cardiac and renal transplants were performed. Maintenance immunosuppression consisted of prednisone, a calcineurin inhibitor and mycophenolate mofetil...
December 2014: Nephrology, Dialysis, Transplantation
Shotaro Kuramitsu, Tomohiro Iguchi, Mizuki Ninomiya, Yo-ichi Yamashita, Norifumi Harimoto, Toru Ikegami, Hideaki Uchiyama, Tomoharu Yoshizumi, Yuji Soejima, Ken Shirabe, Hirofumi Kawanaka, Tetsuo Ikeda, Toshiya Furuta, Ryuichiro Tamada, Yoshihiko Maehara
Calcineurin inhibitor (CNI) combined with mycophenolate mofetil (MMF) and steroid is mainly used as immunosuppressive therapy after the living-donor liver transplantation (LDLT). However, the nephrotoxicity caused by CNI remains a critical problem for patients with chronic renal failure, especially on early postoperative period. A 62-year-old woman with decompensated liver cirrhosis secondary to hepatitis B (Child-Pugh C, MELD score 11 points) and chronic renal failure due to diabetic nephropathy (Cr 1.56 mg/dl, GFR 27 ml/min/1...
March 2014: Fukuoka Igaku Zasshi, Hukuoka Acta Medica
Mohamed M Elseweidy, Sahar E Elswefy, Abd Elmoniem Ali, Mohamed Shawky
BACKGROUND: Renal injury may develop in uncontrolled chronic hyperglycemia due to increased oxidative stress and release of pro-inflammatory mediators, leading to diabetic complications. METHODS: Mycophenolate Mofetil (MMF) is an immunosuppressant drug, an inhibitor of inosine monophosphate dehydrogenase (IMPDH), relevant to inflammation processes. MMF effect was tested in alloxan-diabetic rats on selected parameters like oxidative stress, gene expression of tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1), in relation to microalbuminuria and renal function...
December 2014: Pathology, Research and Practice
F Q Chen, Q Y Wang, G Z Wei, X Y Ma, D W Ma, W W Deng, W B Sun
The effects of high glucose on the expression of monocyte chemoattractant protein-1 (MCP-1) and the main component of the extracellular matrix, fibronectin (FN), were explored in human mesangial cells (HMCs), along with the intervention effects of mycophenolate mofetil (MMF) on these indicators. Cultured HMCs were divided into five groups: 1) normal control group (5 mM glucose); 2) high glucose group (30 mM glucose); 3) mannitol osmotic pressure control group (5 mM glucose + 25 mM mannitol); 4) high glucose + MMF-10 group (30 mM glucose + 10 μg/mL MMF); 5) high glucose + MMF-100 group (30 mM glucose + 100 μg/mL MMF)...
2014: Genetics and Molecular Research: GMR
Julie Belliere, Laure Esposito, Peggy Gandia, Jean Pierre Duffas, Federico Sallusto, Isabelle Cardeau-Desangles, Arnaud Del Bello, Lionel Rostaing, Nassim Kamar
BACKGROUND: Patients with a simultaneous pancreas-kidney transplant (SPKT), especially those with gastroparesis, often have gastro-intestinal (GI) disorders that can modify immunosuppressant pharmacokinetics. We compared the MPA 12-hours area under the curve (AUC(0-12)) in SKPT patients with severe gastroparesis receiving mycophenolate mofetil (MMF) or enteric-coated mycophenolate sodium (EC-MPS). MATERIAL/METHODS: Fifteen SKPT patients having a severe gastroparesis were switched, at 182 (69-1523) days post-transplantation, from MMF to EC-MPS because of GI disorders...
2014: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Wei Lv, Yan Zhang, Guangju Guan, Peng Li, Jianping Wang, Dong Qi
AIM: To investigate the effects of mycophenolate mofetil on apoptosis and the expression of Bax and Bcl-2 of podocytes in rats with diabetic nephropathy. METHODS: A total of 40 male rats were randomly divided into two groups: healthy control group (NC, n = 8) and diabetic nephropathy group (DN, n = 32). The diabetic rat models were induced by streptozotocin, which was injected intraperitoneally. After the DN model was established successfully, the DN group was subdivided into four groups: (1) group treated with the dissolvent (DN), (2) group treated with mycophenolate mofetil (DN + M), (3) group treated with valsartan (DN + V) and (4) group treated with mycophenolate mofetil and valsartan (DN + MV)...
2013: Pharmacology
Uttara Das, Kaligotla Venkata Dakshinamurty
Chronic allograft nephropathy (CAN) is a major cause of late kidney allograft loss. Everolimus, a novel proliferation signal inhibitor, ameliorates CAN by its antiproliferative or apoptosis-enhancing effects. This study aims to evaluate the safety and efficacy of everolimus in renal transplant recipients with calcineurin inhibitor (CNI) withdrawal either due to CAN or cal-cineurin inhibitor toxicity (CNIT). A total 21 patients with CAN or CNIT converted from CNI to everolimus were prospectively studied from 2006 to 2009...
September 2013: Saudi Journal of Kidney Diseases and Transplantation
A Ingsathit, S Kantachuvesiri, S Rattanasiri, Y Avihingsanon, N Premasathian, C Pongskul, S Jittikanont, A Lumpaopong, V Sumethkul
INTRODUCTION: Kidney retransplantation is a high-risk procedure that is increasingly performed because of previous graft failure. The aim of this study was to determine the long-term outcomes of kidney retransplantations compared with first kidney transplantations under the current era of immunosuppression. METHODS: Since the first retransplantation in Thailand was performed in 1993, this study included all consecutive cases registered in the Thai Transplantation Registry database from January 1993 to December 2011...
May 2013: Transplantation Proceedings
Rosanna Coppo
The term 'legacy effect'--a memory of a treatment which produces benefits long after the cessation of the intervention--was adopted for the first time to describe the benefits of early and strict control of diabetes on cardiovascular complications. The search for a similar effect for early treatment of immune-mediated renal diseases, interrupting some self-amplification loops of the pathogenetical immunological mechanisms and leaving a permanent memory, is fascinating. Some recent reports suggest a long-term beneficial or legacy effect of early treatment of IgA nephropathy after a randomized controlled trial (RCT) using mycophenolate mofetil, methylprednisolone pulses or steroid/immunosuppressive multiple therapy, or prolonged steroid doses associated with tonsillectomy...
July 2013: Nephrology, Dialysis, Transplantation
Ryo Fukumoto, Tetsuji Soda, Tetsuya Hayashi, Daizo Oka, Nobumasa Fujimoto, Takuo Koide, Eriko Mabuchi, Ryuta Ikegami, Masashi Nishio, Tetsuya Matsushita
The patient was a 67-year-old man who was started on peritoneal dialysis for treatment of diabetic nephropathy in March 2010. He received an ABO-compatible living-donor kidney transplant from his wife in October 2010. The immunosuppressive regimen consisted of tacrolimus, mycophenolate mofetil, steroid and basiliximab. Before the operation, a bump on his forehead/temple region that was increasing in size for years was noted. The bump had a scaly surface and the top of the bump was sloughed on postoperative day 14...
September 2012: Hinyokika Kiyo. Acta Urologica Japonica
Eduardo Mancilla-Urrea, Salvador Aburto-Morales, Jorge Kasep-Bahena, Francisco Rodríguez-Castellanos
The first renal transplant was done on July 22, 1968 and until December, 2010 a total of 865 procedures have been performed. Immunosuppressive protocols have changing with time: from 1968 to 1984 azathioprine + prednisone plus total radiation in some cases; from 1985 to 1998 cyclosporine + azathioprine + prednisone; in 1998 tacrolimus is used for first time; Mofetil micofenolate was available at 2005 and practically has displaced to azathioprine. As far as possible we use some induction therapy. Primary ESRD etiologies were: unknown (74...
September 2011: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
P Saudan, P-Y Martin
Several landmark studies have recently been published in nephrology. In summary, mycophenolate mofetil is superior to azathioprine in maintaining remission and preventing relapse in lupus nephritis. For patients with type I diabetes, long-term renal function is better preserved when optimal glycaemic control is obtained with intensive diabetes therapy from the onset of disease, and in patients with type 2 diabetes treatment with bardexolone may increase renal function. With respect to chronic kidney disease, the association of simvastatine and ezetimibe is effective in improving cardiovascular outcomes...
January 11, 2012: Revue Médicale Suisse
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