Zhangxue Hu

Amyloidosis is a group of heterogeneous diseases characterized by the deposition of amyloid fibrils in various organs and tissues. Membranous nephropathy (

Background: Lipoprotein glomerulopathy (LPG) is a rare autosomal dominant inherited kidney disease with incomplete penetrance, characterized by nephrotic-range proteinuria, hypertriglyceridemia, and progressive renal dysfunction with elevated serum apoE level. More than fifteen APOE mutations have been associated with LPG, with APOE Kyoto (Arg43Cys) the leading mutation in about 200 patients. We previously observed clustering of APOE Kyoto-causing LPG in a Han population in China. We now explore the haplotype of the APOE Kyoto heterozygotes and the distribution of LPG patients in China. Methods: 115 APOE Kyoto heterozygotes were enrolled and identified by Sanger sequencing, and in this study, the haplotypes of Kyoto and counterpart alleles were investigated by TA cloning and Sanger sequencing. Results: 114 out of 115 APOE Kyoto alleles shared an identical haplotype, likely from haplotype 1 inε3. Among heterozygotes, the counterpart of APOE Kyoto allele showed haplotype diversity, and the difference in haplotype distribution of the counterpart allele was not observed between LPG patients and asymptomatic carriers. Conclusions: This study provides further evidence for the founder effect of APOE Kyoto may play a critical role in the progression of LPG.

Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden dysfunction of the kidney, which is common worldwide, with a relatively high incidence and mortality rate. Damage to the proximal renal tubule is a pathological hallmark of AKI, and inflammation triggered by the overactivation of the immune system is a common cause of proximal renal tubular injury, which is an important contributing factor in AKI exacerbation. Damage-associated molecular patterns (DAMPs) are endogenous molecules released by cells in response to external stimuli that can trigger an inflammatory response by binding to specific pattern recognition receptors (PRRs). Numerous studies have indicated that when the kidney is exposed to external stress or chemical stimuli, injured cells actively secrete or passively release various DAMPs, which can exacerbate or attenuate kidney injury by stimulating or inhibiting the inflammatory response through binding to the appropriate receptor. Currently, there is a lack of early diagnostic biomarkers and specific therapeutic strategies for AKI in the clinic have been established, and given the important role of the release of DAMPs in the regulation of inflammatory response, they will highly likely become favorable candidate biomarkers and clinical therapeutic targets for AKI. Therefore, a deeper understanding of the types of DAMPs and the specific mechanisms of their actions will provide more possibilities for the specific AKI diagnosis and treatment.

Purpose This study aimed to explore the correlation between hemoglobin levels and albuminuria in US adults. Methods This cross-sectional investigation analyzed the National Health and Nutrition Examination Survey (NHANES) information from 2011 to 2020. Data on hemoglobin, albuminuria, and other variables were collected from all participants. The logistic-regression analyses and smoothed curves were used to substantiate the research objectives. Results The average age of the 8,868 participants was 49.5 ± 17.3 years, and 49.3% were men. The prevalence of albuminuria was 12.1%. After adjusting for potential variables in the logistic-regression analysis models, hemoglobin (per 1 g/dL increase) was inversely associated with the presence of albuminuria (odds ratio [OR], 0.92; 95% confidence interval [95%CI], 0.87–0.97). Compared with participants in quartile 3 (Q3, 14.1–15.0 g/dL) for hemoglobin levels, those in the lowest quartile 1 (Q1, 6.1–13.0 g/dL) and highest quartile 4 (Q4, 15.1–19.6 g/dL) had adjusted ORs for albuminuria of 1.48 (95% CI, 1.19–1.85) and 1.11 (95% CI, 0.9–1.38), respectively. Our observations indicated a U-shaped association between hemoglobin levels and albuminuria, with a point of inflection at approximately 15.5 g/dL. The effect sizes and CIs below and above this point were 0.853 (95% CI, 0.798–0.912) and 1.377 (95% CI, 1.055–1.797), respectively. Conclusion This study indicates that the presence of albuminuria is linked to both low and high hemoglobin levels in US adults. The management of hemoglobin may benefit kidney health.

The interleukin (IL)-17 axis is involved in many inflammatory and autoimmune diseases. Secukinumab, an IL-17 inhibitor, has been approved for psoriasis treatment. There are accumulating cases of lupus erythematosus induced by IL-17 inhibition. Lupus nephritis after IL-17 inhibition has not been reported. We report the case of a 57-year-old man who developed membranous lupus nephritis after secukinumab treatment for psoriasis. Anti-SSA and PM-Scl antibodies were positive. dsDNA, anti-Smith, and anti-histone antibodies were negative, and serum complement was low. Secukinumab was discontinued, while tacrolimus was initiated, subsequently switched to cyclosporin, belimumab, glucocorticosteroid, and hydroxychloroquine with a good response. The relationship between lupus erythematosus and IL-17 inhibition requires further research.