Corticotropin-releasing factor (CRF) and the urocortins (UCN1, UCN2, and UCN3) belong to the CRF family of peptides and are the major regulators of the adaptive response to internal and external stresses. The actions of CRF and UCNs are mediated through two receptor subtypes: CRF receptor 1 (CRFR1) and CRFR2. Their physiological roles, among other functions, include the regulation of food intake and anxiety-like behavior. In this review, we describe the progress that has been made towards understanding how anxiety-and depression-like behavior and food intake are regulated by CRF, UCN1, UCN2, and UCN3.
Here we report a 75-year-old man with multiple myeloma who developed acute deterioration of renal function. Systemic AL amyloid deposition was found in the stomach, duodenum and brachial artery. A small amount of proteinuria without significant abnormal urinary sediments, increased excretion of urinary low-molecular-weight proteins and Bence Jones protein were observed. Significant renal Ga-67 uptake suggested acute tubulointerstitial lesions. Renal necropsy after sudden death 40 days after introduction of hemodialysis revealed mesangial expansion with glomerular basement membrane thickening, tubular basement membrane thickening with or without tubular atrophy and massive tubulointerstitial fibrosis. Slight amyloid depositions in the mesangium and vessels, and massive granular electron-dense deposits and deposition of monoclonal light chain lambda in renal basement membranes and vessels were found, indicating the rare condition of coexistence of amyloidosis and light chain deposition disease(LCDD). The rapid progression of renal failure may have been caused by massive deposition of monoclonal light chains in our patient.
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