Pre-Interventional Kynurenine Predicts Medium-Term Outcome after Contrast Media Exposure Due to Coronary Angiography

Reichetzeder, Christoph; Heunisch, Fabian; Einem, Gina von; Tsuprykov, Oleg; Kellner, Karl-Heinz; Dschietzig, Thomas; Kretschmer, Axel; Hocher, Berthold

doi:10.1159/000477222

Cited by 10 publications

(6 citation statements)

References 35 publications

(69 reference statements)

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“…Contrary to animal studies, data on the significance of the KYN pathway in AKI in humans are limited due to ethical considerations. Interesting results concerning the KYN pathway in a contrast nephropathy were published by Reichetzeder et al [ 66 ]. In a prospective cohort study, 245 patients were followed for 120 days after contrast media administration during coronary angiography.…”

Section: Kidney Diseasesmentioning

confidence: 99%

Kynurenine pathway in kidney diseases

Zakrocka

Załuska

2021

Pharmacol. Rep

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Kidney diseases have become one of the most common health care problems. Due to a growing number of advanced aged patients with concomitant disorders the prevalence of these diseases will increase over the coming decades. Despite available laboratory tests, accurate and rapid diagnosis of renal dysfunction has yet to be realized, and prognosis is uncertain. Moreover, data on diagnostic and prognostic markers in kidney diseases are lacking. The kynurenine (KYN) pathway is one of the routes of tryptophan (Trp) degradation, with biologically active substances presenting ambiguous properties. The KYN pathway is known to be highly dependent on immunological system activity. As the kidneys are one of the main organs involved in the formation, degradation and excretion of Trp end products, pathologies involving the kidneys result in KYN pathway activity disturbances. This review aims to summarize changes in the KYN pathway observed in the most common kidney disease, chronic kidney disease (CKD), with a special focus on diabetic kidney disease, acute kidney injury (AKI), glomerulonephritis and kidney graft function monitoring. Additionally, the importance of KYN pathway activity in kidney cancer pathogenesis is discussed, as are available pharmacological agents affecting KYN pathway activity in the kidney. Despite limited clinical data, the KYN pathway appears to be a promising target in the diagnosis and prognosis of kidney diseases. Modulation of KYN pathway activity by pharmacological agents should be considered in the treatment of kidney diseases.

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Section: Kidney Diseasesmentioning

confidence: 99%

Kynurenine pathway in kidney diseases

Zakrocka

Załuska

2021

Pharmacol. Rep

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“…All of these treatments prevented renal fibrosis. Besides that, Kynorenin as an important immune modulator was found highly predictive for “major adverse kidney events” of contrast induced AKI (Reichetzeder et al, 2017 ). These data suggest how to expand beneficial T cells and reduce pathogenic ones in vivo is the focus issue.…”

Section: Potential Therapies Targeting Lymphocytes Of Aki and Ckdmentioning

confidence: 99%

Lymphocytes: Versatile Participants in Acute Kidney Injury and Progression to Chronic Kidney Disease

2021

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Background: Acute kidney injury (AKI) remains a major global public health concern due to its high morbidity and mortality. The progression from AKI to chronic kidney disease (CKD) makes it a scientific problem to be solved. However, it is with lack of effective treatments.Summary: Both innate and adaptive immune systems participate in the inflammatory process during AKI, and excessive or dysregulated immune responses play a pathogenic role in renal fibrosis, which is an important hallmark of CKD. Studies on the pathogenesis of AKI and CKD have clarified that renal injury induces the production of various chemokines by renal parenchyma cells or resident immune cells, which recruits multiple-subtype lymphocytes in circulation. Some infiltrated lymphocytes exacerbate injury by proinflammatory cytokine production, cytotoxicity, and interaction with renal resident cells, which constructs the inflammatory environment and induces further injury, even death of renal parenchyma cells. Others promote tissue repair by producing protective cytokines. In this review, we outline the diversity of these lymphocytes and their mechanisms to regulate the whole pathogenic stages of AKI and CKD; discuss the chronological responses and the plasticity of lymphocytes related to AKI and CKD progression; and introduce the potential therapies targeting lymphocytes of AKI and CKD, including the interventions of chemokines, cytokines, and lymphocyte frequency regulation in vivo, adaptive transfer of ex-expanded lymphocytes, and the treatments of gut microbiota or metabolite regulations based on gut-kidney axis.Key Message: In the process of AKI and CKD, T helper (Th) cells, innate, and innate-like lymphocytes exert mainly pathogenic roles, while double-negative T (DNT) cells and regulatory T cells (Tregs) are confirmed to be protective. Understanding the mechanisms by which lymphocytes mediate renal injury and renal fibrosis is necessary to promote the development of specific therapeutic strategies to protect from AKI and prevent the progression of CKD.

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“…It is important to predict CIN and necessary to predict adverse events in CIN patients. Some new markers have been able to predict CIN-related renal adverse events, such as pre-interventional kynurenine, 68 which predicts adverse renal events in 120 days (AUC = 0.838).…”

mentioning

confidence: 99%

Biomarkers for the early prediction of contrast-induced nephropathy after percutaneous coronary intervention in adults: A systematic review and meta-analysis

Lin

Chen

et al. 2021

Angiology

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Contrast-induced nephropathy (CIN) is a complication of patients undergoing percutaneous coronary intervention (PCI). Promising biomarkers for the early prediction of CIN can significantly improve outcomes of these patients. We searched PubMed, EMBASE, Web of Science, and Cochrane Library for studies. Trials reporting an area under the curve (AUC) for the utility of novel biomarkers in the early prediction of CIN in adults after PCI were included. In total, 42 studies comprising 11,984 adult patients undergoing PCI met the criteria. Four urinary biomarkers and four blood biomarkers were included. For urine biomarkers, the pooled AUCs for neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), liver-type fatty acid-binding protein (L-FABP), and kidney injury molecule-1 (KIM-1) were 0.91 (95% CI 0.89–0.94), 0.79 (0.75–0.82), 0.78 (0.74–0.82), and 0.79 (0.76–0.83), respectively. The blood biomarkers NGAL, cystatin C, brain natriuretic peptide (BNP), and C-reactive protein (CRP) had pooled AUCs of 0.93 (0.91–0.95), 0.92 (0.89–0.94), 0.78 (0.74–0.81), and 0.75 (0.71–0.79), respectively. Subgroup analysis showed that blood NGAL in early CIN predictive time (<6 h) was more effective in predicting CIN. The efficiency of cystatin C in predicting CIN was reduced, whereas that of L-FABP was increased among chronic kidney disease (CKD) patients.

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Pre-Interventional Kynurenine Predicts Medium-Term Outcome after Contrast Media Exposure Due to Coronary Angiography

Cited by 10 publications

References 35 publications

Kynurenine pathway in kidney diseases

Kynurenine pathway in kidney diseases

Lymphocytes: Versatile Participants in Acute Kidney Injury and Progression to Chronic Kidney Disease

Biomarkers for the early prediction of contrast-induced nephropathy after percutaneous coronary intervention in adults: A systematic review and meta-analysis

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