Hao Wu

Objective. To investigate the association between immunogobulin G (IgG) in urine and serum, and disease severity in patients with idiopathic membranous nephropathy (IMN). Methods. A total of 280 patients with IMN were enrolled in this study. Serum and urine IgG levels were measured, and the relationship between IgG levels and parameters suggestive of disease severity in these patients were explored. Patients were placed into one of three groups based on urine protein levels. Results. Urine IgG levels in most patients (99%) increased, while serum IgG in 74% patients decreased. Higher urine and lower serum IgG levels were associated with a more advanced-stage disease, based on the pathology assessment. Urine IgG positively correlated with 24-h urinary albumin, urinary alpha 1- and 2-microglobulin, serum anti-phospholipase A2 receptor (PLA2R) antibody, and erythrocyte sedimentation rate (ESR). However, urine IgG negatively correlated with serum albumin and the estimated glomerular filtration rate (eGFR). Serum IgG positively correlated with serum albumin, but negatively correlated with 24-h urine protein, albumin, urinary a1- and 2-microglobulin, and anti-PLA2R antibody levels. Multivariate regression analyses showed that the 24-h urine protein, urinary alpha 1-microglobulin, eGFR, and ESR were associated with urine IgG levels, independent of age, sex, urinary albumin, urinary 2-microglobulin, or serum anti-PLA2R antibody levels. In addition, serum albumin and age were significant determinants of serum IgG levels. Conclusions. Serum and urine IgG levels are significantly associated with disease severity in patients with IMN and can be useful indicators of IMN incidence.

(1) Background: 12-lipoxygenase (12-LO) is involved in the development of diabetic nephropathy (DN). In the present study, we investigated whether 12-LO inhibition may ameliorate type-2 DN (T2DN) by interfering with insulin resistance (IR); (2) Methods: Rat glomerular mesangial cells, glomeruli and skeletal muscles were isolated and used in this study. Kidney histological changes were confirmed by periodic-acid Schiff staining; mRNA expression was detected by competitive reverse transcription polymerase chain reaction; and the protein level was determined by Western blot and the enzyme-linked immunosorbent assay, respectively; (3) Results: The inhibition of 12-LO attenuated microalbuminuria (MAU) increases in type-2 diabetic rats, but not in type-1 diabetic rats. Infusion of 12(S)-hydroxyeicosatetraenoic acid (12(S)-HETE) significantly increased the expression of angiotensin II (Ang II) and Ang II type 1 receptor (AT1R), but decreased the expression of AT1R-associated protein (ATRAP) in rat glomeruli, compared to the control. An in vitro study revealed that both 12(S)-HETE and insulin upregulated AT1R expression in rat mesangial cells. In the presence of p38 mitogen-activated protein kinase (MAPK) inhibitor, SB202190, the 12(S)-HETE-induced ATRAP reduction was significantly abolished. Interestingly, 12-LO inhibition did not influence AT1R expression in type-1 diabetic rats, but significantly abolished the increased AT1R and Ang II expression in glomeruli of type-2 diabetic rats. Furthermore, the inhibition of 12-LO significantly corrected impaired insulin sensitivity and fast serum insulin level, as well as the p-AMP-activated protein kinase (AMPK) reduction in skeletal muscle of type-2 diabetic rats; (4) Conclusion: The inhibition of 12-LO potentially ameliorated MAU by preventing IR through the downregulation of glomerular AT1R expression in T2DN.

Esophageal duplication cyst (EDC) is a congenital malformation of the posterior primitive foregut, which mainly occurs in the thoracic esophagus. Here, we describe a 3-year-old Han Chinese boy afflicted with intermittent fever of acute onset and dry cough. Thoracic computed tomography revealed an 10 cm × 5.4 cm × 5.8 cm oval-shaped, cyst-like tumor located in the extrapleural space, extending along the right paravertebral gutter and compressing the trachea forward. An additional small-sized, oval-shaped cyst was identified in the posterior mediastinum, between the esophagus and the spinal column, at the T1 level. During open thoracotomy, under general anesthesia, an opaque, thick-walled, esophageal cyst was revealed not to be in communication with the esophageal lumen or the trachea. This cyst was subsequently resected in an en bloc manner. The small (1-cm) esophageal cyst was left untreated based on a “wait-and-see” policy. Histological analysis showed that the resected cyst was walled by hyperplastic, fibrous tissues and locally lined with gastric mucosa inherent glands. This finding was consistent with a diagnosis of EDC, with ectopic gastric mucosa. The respiratory tract symptoms resolved immediately after the operation. Computed tomography obtained at the 6-month follow-up showed that no disease, residual or recurrence, was present after the resection of the large-sized cyst, and the small-sized cyst remained unchanged in size.