Abstract:Oxidative stress is an imbalance between pro- and antioxidants that adversely influences the organism in various mechanisms and on many levels. Oxidative damage occurring concomitantly in many cellular structures may cause a deterioration of function, including apoptosis and necrosis. The damage leaves a molecular “footprint”, which can be detected by specific methodology, using certain oxidative stress biomarkers. There is an intimate relationship between oxidative stress, inflammation, and functional impairm… Show more
“…Further reactions lead to aldehydes syntheses such as MDA or HNE. Lipid peroxidation affects all cell membranes inducing damage and loss of function [ 30 ]. MDA is commonly considered a marker of ferroptosis [ 31 ].…”
“…Further reactions lead to aldehydes syntheses such as MDA or HNE. Lipid peroxidation affects all cell membranes inducing damage and loss of function [ 30 ]. MDA is commonly considered a marker of ferroptosis [ 31 ].…”
“…This injury process leaves marks, e.g., representing epithelial cell disruption and tubular injury that might be detected as biomarkers in the perfusate ( 22 , 23 ).…”
Predicting organ viability before transplantation remains one of the most challenging and ambitious objectives in transplant surgery. Waitlist mortality is high while transplantable organs are discarded. Currently, around 20% of deceased donor kidneys and livers are discarded because of “poor organ quality”, Decisions to discard are still mainly a subjective judgement since there are only limited reliable tools predictive of outcome available. Organ perfusion technology has been posed as a platform for pre-transplant organ viability assessment. Markers of graft injury and function as well as perfusion parameters have been investigated as possible viability markers during ex-situ hypothermic and normothermic perfusion. We provide an overview of the available evidence for the use of kidney and liver perfusion as a tool to predict posttransplant outcomes. Although evidence shows post-transplant outcomes can be predicted by both injury markers and perfusion parameters during hypothermic kidney perfusion, the predictive accuracy is too low to warrant clinical decision making based upon these parameters alone. In liver, further evidence on the usefulness of hypothermic perfusion as a predictive tool is needed. Normothermic perfusion, during which the organ remains fully metabolically active, seems a more promising platform for true viability assessment. Although we do not yet fully understand “on-pump” organ behaviour at normothermia, initial data in kidney and liver are promising. Besides the need for well-designed (registry) studies to advance the field, the catch-22 of selection bias in clinical studies needs addressing.
“…Reactive oxygen species (ROS) can be divided into free radicals and non-free radicals. Although they play an important role in signal transduction, they have a strong binding capacity that can cause injuries to cellular components, such as lipids, proteins, and DNA ( Tejchman et al, 2021 ). Oxidative stress is an important factor in inducing the progression of kidney diseases ( Coppolino et al, 2018 ).…”
Section: Clinical Applications and Mechanisms Of Twhf And Its Prepara...mentioning
Tripterygium wilfordii Hook. f. (TwHF) is a Chinese botanical drug containing a large number of metabolites. The discovered and recognized anti-inflammatory and immune-regulating effects have made it attract more and more attentions in trials and clinical researches. The extraction and processing of TwHF for pharmaceuticals is a manifestation of the role of traditional Chinese medicine. However, TwHF is toxic. Optimization of TwHF preparations has become a requirement for the development of TwHF pharmaceuticals. Our article introduces the main preparations of TwHF on the Chinese market and their characteristics. In particular, we summarize the clinical applications and influential mechanisms of TwHF and its preparations in kidney diseases. Considering that nephropathy is closely related to immune inflammation and TwHF is a botanical drug with a high number of metabolites, the application of TwHF in kidney diseases may be much more complicated. By revealing the role and mechanisms of TwHF in kidney diseases, this study aims to provide more insights to basic and clinical studies about nephropathy.
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