sPLA2-IB Level Correlates with Hyperlipidemia and the Prognosis of Idiopathic Membranous Nephropathy

Summary:Recent studies suggested that serum secretory phospholipase A2 group IB(sPLA2-IB)was increased in idiopathic membranous nephropathy(IMN).However,the interference of high lipemia on the sPL.A2-IB levels was not taken into account in these studies.The present study aimed to investigate the correlation between sPLA2-IB and lipemia,and the clinical merit of sPLA2-IB in the prediction of prognosis of IMN patients.A total of 64 IMN patients,39 immunoglobulin A nephropathy(IgAN)patients and 64 healthy controls were included in the study.The levels of serum sPLA2-IB,lipemia and proteinuria were measured.Fifty IMN patients were followed up for 6 months.Pathologic stages were made for all IgAN and IMN patients.The results showed that the levels of serum sPLA2-IB,cholesterol and low-density lipoprotein cholesterol(LDL-C)were significantly higher,and the levels of albumin and high-density lipoprotein cholesterol(HDL-C)were significantly lower in IMN patients than in healthy controls and IgAN patients.Serum sPLA2-IB levels were also found to be higher in IgAN patients than in heathy controls,but the association of serum sPLA2-IB levels with proteinuria,cholesterol and albumin was only shown in IMN patients.Antibody against M-type receptor for secretory phospholipase A2(PLA2R1)was positive in 813%IMN patients.Glomerular sPLA2-IB deposition,podocyte fused processes,and density deposition on thickened basement membrane were seen in IMN patients,but not in IgAN patients.IMN patients with lower sPLA2-IB and proteinuria levels were found to have better outcome after the 6-month follow-up.In IMN patients,sPLA2-IB levels were significantly increased in both serum and renal tissue.In conclusion,serum sPLA2-IB was closely correlated with proteinuria,albumin and cholesterol,and IMN patients with lower sPLA2-IB levels were more likely to achieve a better outcome.

Novel conservative treatment for peritoneal dialysis-related hydrothorax:Two case reports

BACKGROUND Peritoneal dialysis (PD) is an important renal replacement therapy for patientswith end-stage renal disease. PD-related hydrothorax is a rare but seriouscomplication in PD patients, produced by the movement of peritoneal dialysatethrough pleuroperitoneal fistulas. In previous reports, patients with hydrothoraxsecondary to PD were usually recommended to discontinue PD and transfer tohemodialysis (HD). Herein, we describe another method of managing thiscomplication—with an adjusted PD prescription and continuous drainage ofpleural effusion, patients could continue PD without recurrence of hydrothorax.CASE SUMMARY In this report, we present the medical records of 2 patients with hydrothoraxsecondary to PD. We recommended intermittent PD with continuous drainage ofpleural effusion. A type 18Ga soft catheter was placed to drain pleural effusion.Ultrasound-guided thoracentesis was performed, and the soft catheter was placedin the pleural cavity for a long period (3 mo and 2 mo, respectively). The pleuralcatheter was removed when no fluid was drained from the pleural cavity. Afterseveral months, pleuroperitoneal fistulas were closed in both patients and PD wascontinued. These patients did not transfer to HD, had no recurrence ofhydrothorax and were still treated with PD after 1 year.CONCLUSION These 2 case reports show that continuous drainage of pleural effusion with an18Ga soft catheter is a useful method for hydrothorax secondary to PD.

Potentials of marine natural products against malaria, leishmaniasis, and trypanosomiasis parasites: a review of recent articles

Background:Malaria and neglected communicable protozoa parasitic diseases,such as leishmaniasis,and trypanosomiasis,are among the otherwise called diseases for neglected communities,which are habitual in underprivileged populations in developing tropical and subtropical regions of Africa,Asia,and the Americas.Some of the currently available therapeutic drugs have some limitations such as toxicity and questionable efficacy and long treatment period,which have encouraged resistance.These have prompted many researchers to focus on fin ding new drugs that are safe,effective,and affordable from marine environ merits.The aim of this review was to show the diversity,structural scaffolds,in-vitro or in-vivo efficacy,and recent progress made in the discovery/isolation of marine natural products(MNPs)with potent bioactivity against malaria,leishmaniasis,and trypanosomiasis.Main text:We searched PubMed and Google scholar using Boolean Operators(AND,OR,and NOT)and the combination of related terms for articles on marine natural products(MNPs)discovery published only in English language from January 2016 to June 2020.Twenty nine articles reported the isolation,identification and antiparasitic activity of the isolated compounds from marine environment.A total of 125 compounds were reported to have been isolated,out of which 45 were newly isolated compounds.These compounds were all isolated from bacteria,a fungus,sponges,algae,a bryozoan,cnidarians and soft corals.In recent years,great progress is being made on anti-malarial drug discovery from marine organisms with the isolation of these potent compounds.Comparably,some of these promising antikinetoplastid MNPs have potency better or similar to conventional drugs and could be developed as both antileishmanial and antitrypanosomal drugs.However,very few of these MNPs have a pharmaceutical destiny due to lack of the following:sustainable production of the bioactive compounds,stan da rd efficient screening methods,knowledge of the mechanism of action,partnerships between researchers and pharmaceutical industries.Conclusions:It is crystal clear that marine organisms are a rich source of antiparasitic compounds,such as alkaloids,terpenoids,peptides,polyketides,terpene,coumarins,steroids,fatty acid derivatives,and lactones.The current and future technological innovation in natural products drug discovery will bolster the drug armamentarium for malaria and neglected tropical diseases.