IntroductionPathophysiological changes associated with chronic kidney disease impair angiogenic processes and increase renal fibrosis. Progenitor-like cells derived from adult kidney have been previously used to promote regeneration in acute kidney injury, even though it remained unclear whether the cells could be beneficial in chronic kidney disease (CKD).MethodsIn this study, we established a CKD model by five-sixths nephrectomy and mouse kidney progenitor-like cells (MKPCs) were intravenously administered weekly for 5 weeks after establishing CKD. We examined the impact of MKPCs on the progression of renal fibrosis and the potential of MKPCs to preserve the angiogenic process and prevent endothelial mesenchymal transition in vivo and in vitro.ResultsOur results demonstrate that the MKPCs delayed interstitial fibrosis and the progression of glomerular sclerosis and ameliorated the decline of kidney function. At 17 weeks, the treated mice exhibited lower blood pressures, higher hematocrit levels, and larger kidney sizes than the control mice. In addition, the MKPC treatment prolonged the survival of the mice with chronic kidney injuries. We observed a decreased recruitment of macrophages and myofibroblasts in the interstitium and the increased tubular proliferation. Notably, MKPC both decreased the level of vascular rarefaction and prevented endothelial mesenchymal transition (EndoMT) in the remnant kidneys. Moreover, the conditioned medium from the MKPCs ameliorated endothelial cell death under hypoxic culture conditions and prevented TGF-β-induced EndoMT through downregulation of phosphorylated Smad 3 in vitro.ConclusionsMKPCs may be a beneficial treatment for kidney diseases characterized by progressive renal fibrosis. The enhanced preservation of angiogenic processes following MKPC injections may be associated with decreased fibrosis in the remnant kidney. These findings provide further understanding of the mechanisms involved in these processes and will help develop new cell-based therapeutic strategies for regenerative medicine in renal fibrosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13287-015-0241-8) contains supplementary material, which is available to authorized users.
Burnout comprises three interrelated dimensions: emotional exhaustion (EE), depersonalisation (DP) and low personal accomplishment (PA). (2) The Maslach Burnout Inventory (MBI) is the most frequently used questionnaire and includes 22 items that measure all three burnout dimensions (seven-item EE subscale, eight-item PA subscale and seven-item DP subscale). Although several studies focus on the presence of high levels of EE or DP alone, other burnout studies have also included all three components in their measurement of burnout. (3,4) Furthermore, even if burnout prevalence is defined as high EE or DP in our study instead of the current definition of high EE, high DP or low PA, the difference is small (354/446, 79.4% vs. 360/446, 80.7%, respectively) and does not change the conclusion of our paper. At the time of writing, our study was the first in Singapore to evaluate empathy and burnout among residents. (5) We acknowledge that burnout studies have been performed in other medical cohorts, such as nurses and medical students. The other local burnout study by See et al, (6) which involved 64 trainees, was published in October 2016 and our manuscript was submitted prior to that. While there are 34 different residency programmes in our institution, numbers of residents within each programme vary greatly, from as low as one (hand surgery) to as high as 153 (internal medicine). Without grouping similar programmes together, a meaningful comparison would not have been possible and may have revealed the identity of the programmes and participants. The Jefferson Scale of Physician Empathy for students (JSPE-S) and JSPE for physicians and health professionals are similar in content, differing only in the wording of the questions, which address the population they are targeted at. The website for the Jefferson Center for Research in Medical Education and Health Care states, "Both are similar in content with minor modifications in wording to avoid confusion. For example, an item beginning 'Physicians' understanding…' in the medical student version may begin 'Health care providers' understanding…' in the health professions student version". (7) Testing for internal consistency in our sample revealed a Cronbach's alpha of 0.87, which indicates good internal consistency and is indeed similar to what some of our authors have previously reported for the JSPE-S (0.83). (8) The statement that "Medical students in Singapore have been shown to be less empathetic than their counterparts from the US, although they were relatively more empathetic compared to counterparts from East Asia" is also attributable to the same cited paper. (8) We agree that more data could have been reported in that paper. Student's t-test comparing mean scores from a Japanese study (9) with those reported in Singapore students showed that Singapore students had a significantly higher mean JSPE-S score (112.18 vs. 104.30, p < 0.001). Similarly, a significant difference in mean scores between a cohort of US students (10) and Singapore students was also observe...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.