Association between Acrylamide Metabolites and Cardiovascular Risk in Children With Early Stages of Chronic Kidney Disease
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Authors: Hsu, Chien-Ning; Hou, Chih-Yao; Lu, Pei-Chen; Chang-Chien, Guo-Ping; Lin, Sufan; Tain, You-Lin
Abstract
Cardiovascular disease (CVD) begins early in children with chronic kidney disease (CKD). Reduced nitric oxide (NO) bioavailability has been associated with increased CVD in CKD patients. Children tend to have more exposure to acrylamide, one of the most common toxins in food. We aimed to determine whether urinary levels of acrylamide metabolites N-acetyl-S-(2-carbamoylethyl)-cysteine (AAMA) and N-acetyl-S-(2-carbamoyl-2-hydroxyethyl)-cysteine (GAMA) are associated with CV risk markers in children with CKD. Data on 112 children and adolescents ages three to 18 years old with CKD stage G1-G4 are reported. We observed that 24 h ambulatory blood pressure monitoring (ABPM) abnormalities were greater, and left ventricular (LV) mass and ambulatory arterial stiffness index (AASI) were higher in children with CKD stage G2-G4 versus G1. Patients with CKD stage G2-G4 had a lower urinary acrylamide level, but a higher AAMA-to-GAMA ratio than those with CKD stage G1. Urinary acrylamide level was negatively associated with high systolic blood pressure (SBP) and diastolic BP (DBP) load on 24 h ABPM. Lower urinary levels of acrylamide, AAMA, and GAMA were correlated with LV mass. Additionally, GAMA are superior to AAMA related to NO-related parameters, namely citrulline and symmetric dimethylarginine (SDMA). This study suggests that determinations of urinary acrylamide level and its metabolites in the early stages of pediatric CKD may identify patients at risk of CVD. Further studies should clarify mechanisms underlying acrylamide exposure to define the treatment for protection against CVD.
Engineering transplantable jejunal mucosal grafts using patient-derived organoids from children with intestinal failure
NATURE MEDICINE
Authors: Meran, Laween; Massie, Isobel; Campinoti, Sara; Weston, Anne E.; Gaifulina, Riana; Tullie, Lucinda; Faull, Peter; Orford, Michael; Kucharska, Anna; Baulies, Anna; Novellasdemunt, Laura; Angelis, Nikolaos; Hirst, Elizabeth; Konig, Julia; Tedeschi, Alfonso Maria; Pellegata, Alessandro Filippo; Eli, Susanna; Snijders, Ambrosius P.; Collinson, Lucy; Thapar, Nikhil; Thomas, Geraint M. H.; Eaton, Simon; Bonfanti, Paola; De Coppi, Paolo; Li, Vivian S. W.
Abstract
In a first step toward developing autologous tissue grafts for the treatment of children with intestinal failure, patient-derived jejunal organoids seeded on scaffolds of decellularized human intestinal matrix formed grafts that had jejunal properties and formed luminal structures when transplanted into mice. Intestinal failure, following extensive anatomical or functional loss of small intestine, has debilitating long-term consequences for children(1). The priority of patient care is to increase the length of functional intestine, particularly the jejunum, to promote nutritional independence(2). Here we construct autologous jejunal mucosal grafts using biomaterials from pediatric patients and show that patient-derived organoids can be expanded efficiently in vitro. In parallel, we generate decellularized human intestinal matrix with intact nanotopography, which forms biological scaffolds. Proteomic and Raman spectroscopy analyses reveal highly analogous biochemical profiles of human small intestine and colon scaffolds, indicating that they can be used interchangeably as platforms for intestinal engineering. Indeed, seeding of jejunal organoids onto either type of scaffold reliably reconstructs grafts that exhibit several aspects of physiological jejunal function and that survive to form luminal structures after transplantation into the kidney capsule or subcutaneous pockets of mice for up to 2 weeks. Our findings provide proof-of-concept data for engineering patient-specific jejunal grafts for children with intestinal failure, ultimately aiding in the restoration of nutritional autonomy.