Osmotic nephrosis with mannitol: review article

Nomani, Ali Zohair; Nabi, Zahid; Rashid, Humayun; Janjua, J.; Nomani, Hanna; Majeed, Azer; Chaudry, Sohail Raza; Mazhar, Ayesha Saad

doi:10.3109/0886022x.2014.926758

Cited by 55 publications

(69 citation statements)

References 31 publications

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“…Frequently used tests are based on the plasma concentration of fatty acid-binding proteins, citrulline or tight junction proteins, such as zonulin and claudin-3. In contrast, the currently available functional tests evaluating permeability of the GBB use orally administered exogenous, radio-labelled, highly osmotic markers, such as polysaccharides or dextrans, and their safety is uncertain, especially for paediatric patients and those with concomitant kidney and cardiovascular diseases (Nomani et al, 2014). This is because the GBB is a complex multilayer system, the functioning of which depends on numerous factors, such as intestinal perfusion, immunological and neurohormonal activity, mucous secretion and the composition of microbiota (Farhadi et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…This is because the GBB is a complex multilayer system, the functioning of which depends on numerous factors, such as intestinal perfusion, immunological and neurohormonal activity, mucous secretion and the composition of microbiota (Farhadi et al, 2003). In contrast, the currently available functional tests evaluating permeability of the GBB use orally administered exogenous, radio-labelled, highly osmotic markers, such as polysaccharides or dextrans, and their safety is uncertain, especially for paediatric patients and those with concomitant kidney and cardiovascular diseases (Nomani et al, 2014). Moreover, the blood concentration of orally administered agents varies in time depending on concomitant diet or duration of fasting and gastrointestinal motility.…”

Section: Discussionmentioning

confidence: 99%

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Inflammatory bowel disease is associated with increased gut‐to‐blood penetration of short‐chain fatty acids: A new, non‐invasive marker of a functional intestinal lesion

Jaworska

Konop

Bielinska

et al. 2019

Experimental Physiology

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New Findings What is the central question of this study?‘Leaky gut’ has been found in intestinal and extra‐intestinal diseases. However, functional evaluation of intestinal permeability is not widely used as a diagnostic marker, possibly owing to significant limitations of currently used permeability assays. There is an unmet need for development of a new, non‐invasive test to assess intestinal function. What is the main finding and its importance?We show that an increased blood‐to‐stool ratio of the concentration of gut bacteria‐produced short‐chain fatty acids may be used as a marker of gut permeability. Our findings lay the groundwork for establishing a new, non‐invasive, risk‐free diagnostic tool in diseases associated with intestinal barrier malfunction, such as inflammatory bowel disease. Abstract Intestinal diseases, such as inflammatory bowel disease (IBD), are characterized by an impaired gut–blood barrier commonly referred to as ‘leaky gut’. Therefore, functional evaluation of the gut–blood barrier is a promising diagnostic marker. We hypothesized that short‐chain fatty acids (SCFAs) produced by gut bacteria might serve as a marker in IBD. Animal experiments were performed on male Sprague–Dawley rats with acetic acid‐induced colitis and in sham control animals. The gut–blood barrier permeability was determined by assessing the ratios of the following: (i) portal blood concentration of SCFAs (Cp) to faecal concentration of SCFAs (Cf); (ii) systemic blood concentration of SCFAs (Cs) to faecal concentration of SCFAs (Cf); and (iii) Cp and Cs of fluorescein isothiocyanate (FITC)–dextran administered into the colon. As a clinical study, we evaluated Cs, Cf and the Cs/Cf ratio of SCFAs in six paediatric patients with IBD, assessed as mild/moderate/severe by the Paediatric Ulcerative Colitis Activity Index (PUCAI) and the Paediatric Crohn's Disease Activity Index (PCDAI) at the time of sample collection, and nine age‐matched healthy control subjects. Rats with histologically confirmed IBD had significantly increased ratios of Cp/Cf and Cs/Cf for SCFAs. This was positively correlated with the plasma FITC–dextran concentration. Likewise, IBD patients showed a significantly higher Cs/Cf ratio for SCFAs, including acetic, valeric, isocaproic, caproic and propionic acids, in comparison to control subjects. In conclusion, in the rats and in paediatric patients with IBD we found an increased blood‐to‐stool ratio of SCFAs, suggesting an increased gut‐to‐blood penetration of SCFAs. These findings pave the way for a new, non‐invasive diagnostic tool in IBD and other diseases accompanied by intestinal barrier malfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease is associated with increased gut‐to‐blood penetration of short‐chain fatty acids: A new, non‐invasive marker of a functional intestinal lesion

Jaworska

Konop

Bielinska

et al. 2019

Experimental Physiology

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“…He observed large vacuoles in tubular epithelial cells following hypertonic sucrose infusion in rabbits [113] and humans [114, 115] and interpreted the vacuolization as the result of an osmotic gradient between the tubular lumen and tubular cells [116]. Hydropic vacuolization develops after intravenous injection of substances eliminated by the kidney, such as RCM [72, 114], polyethylene-glycol- (PEG-) conjugated proteins [117], hydroxy-ethyl-starch (HES) [118–120], dextran [121, 122], sucrose [43], mannitol [123], glucose [124], glycerol [125], sorbitol [126], inulin [127], or sugar (sucrose [128–130] or maltose [131]) stabilized intravenous immunoglobulin (IVIG) solutions. According to our experience (Figures 3(c) and 3(d)) different concentrations and repeated intraperitoneal doses of sucrose or maltose induced tubular vacuolization dose dependently.…”

Section: Characteristic Histopathological Changes In Ci-akimentioning

confidence: 99%

Histopathological Evaluation of Contrast-Induced Acute Kidney Injury Rodent Models

Kiss

Hamar

2016

BioMed Research International

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Contrast-induced acute kidney injury (CI-AKI) can occur in 3–25% of patients receiving radiocontrast material (RCM) despite appropriate preventive measures. Often patients with an atherosclerotic vasculature have to receive large doses of RCM. Thus, animal studies to uncover the exact pathomechanism of CI-AKI are needed. Sensitive and specific histologic end-points are lacking; thus in the present review we summarize the histologic appearance of different rodent models of CI-AKI. Single injection of RCM causes overt renal damage only in rabbits. Rats and mice need an additional insult to the kidney to establish a clinically manifest CI-AKI. In this review we demonstrate that the concentrating ability of the kidney may be responsible for species differences in sensitivity to CI-AKI. The most commonly held theory about the pathomechanism of CI-AKI is tubular cell injury due to medullary hypoxia. Thus, the most common additional insult in rats and mice is some kind of ischemia. The histologic appearance is tubular epithelial cell (TEC) damage; however severe TEC damage is only seen if RCM is combined by additional ischemia. TEC vacuolization is the first sign of CI-AKI, as it is a consequence of RCM pinocytosis and lysosomal fusion; however it is not sensitive as it does not correlate with renal function and is not specific as other forms of TEC damage also cause vacuolization. In conclusion, histopathology alone is insufficient and functional parameters and molecular biomarkers are needed to closely monitor CI-AKI in rodent experiments.

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“…Mannitol can promote the secretion of prostaglandin, expand renal blood vessels and increase blood flow. However, renal tubular has a limited absorptive capacity of mannitol; renal tubular can keep a rather high concentration of mannitol, decrease the back absorption of moisture and promote the discharge of urine (9). The above mechanisms promote and cooperate with each other to facilitate the dehydration and diuretic function of mannitol.…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of joint application of β-sodium aescinate and mannitol in treating early swelling after upper limb trauma surgery

Wang

Yang

Qing

et al. 2016

Experimental and Therapeutic Medicine

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The aim of the present study was to examine the clinical merits of joint application of β-sodium aescinate and mannitol for the treatment of early swelling of upper limb trauma after surgery. We verified whether the expression of serum aquaporin 1 (AQP-1) was involved in swelling mechanism. A total of 102 patients with swelling after upper limb trauma surgery were enrolled into the study and divided randomly into 3 groups (n=34 cases per group). Group A was treated with β-sodium aescinate; group B was treated with with mannitol and group C was treated with both β-sodium aescinate and mannitol. The expression level of AQP-1, and clinical effects and complications before and after treatment were compared§. The time of swelling subsidence in group C was significantly shorter than that of the other two groups and differences were statistically significant (P<0.05). The recovery ratio and total efficiency in group C were significantly higher than those in other two groups and differences were statistically significant (P<0.05). Three and seven days after treatment, the AQP-1 levels in group A and group C were decreased and AQP-1 level decreased further with time. Differences of comparison within groups were statistically significant (P<0.05), although the differences of comparison between the groups showed no statistical significance (P>0.05). We also compared the AQP-1 level in group B before and after treatment, and the differences were not statistically significant (P>0.05). When the complication incidence in the 3 groups was compared, no statistical significance was detected (P>0.05). We concluded that the joint use of β-sodium aescinate and mannitol in treating early swelling after upper limb trauma surgery produced satisfactory outcomes. This might be related to reduction of the AQP-1 level.

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Osmotic nephrosis with mannitol: review article

Cited by 55 publications

References 31 publications

Inflammatory bowel disease is associated with increased gut‐to‐blood penetration of short‐chain fatty acids: A new, non‐invasive marker of a functional intestinal lesion

Inflammatory bowel disease is associated with increased gut‐to‐blood penetration of short‐chain fatty acids: A new, non‐invasive marker of a functional intestinal lesion

Histopathological Evaluation of Contrast-Induced Acute Kidney Injury Rodent Models

Clinical effects of joint application of β-sodium aescinate and mannitol in treating early swelling after upper limb trauma surgery

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