Publications by authors named "Tetsuro Kusaba"

Anorexia nervosa (AN) is an eating disorder characterized by restriction of energy intake leading to a significantly low body weight, and intense fear of gaining weight. Severe electrolyte changes such as hypokalemia and hypophosphatemia; and alterations in water metabolism such as hyponatremia and edema, can occur in patients with AN. Hypokalemia and chronic volume depletion may lead to acute kidney injury (AKI) and chronic kidney disease (CKD).

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Introduction: A reduced salt intake is a vital lifestyle modification in the management of hypertension. Initiatives aimed at decreasing the intake of salt are based on the preference by humans for a salt taste. Salt intake behavior appears to be affected by the balance between attraction to a low salt taste and aversion to a high salt taste.

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  • * Researchers created a mouse model that mimics advanced DKD and found significant tissue damage, inflammation, and high levels of VCAM1 in the kidneys, which reflects the condition in humans.
  • * The drug luseogliflozin was shown to improve kidney health by reducing tissue hypoxia and inflammation, highlighting the potential of VCAM1 as a marker and SGLT2 inhibitors as a treatment option for advanced DKD.
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  • Streptozotocin (STZ) is mainly used as an anti-cancer drug for treating neuroendocrine tumors (NETs) but can also cause DNA damage in kidney cells, leading to injury.
  • Research showed that this kidney damage is linked to the activation of the p53 signaling pathway and reduced membrane transporters in tubular epithelial cells.
  • Treatment with an SGLT2 inhibitor can help protect kidney cells from STZ-induced damage without affecting the drug's effectiveness on pancreatic β-cells, suggesting its potential as a preventative treatment for kidney injury in NET patients.
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  • Cell-based therapies, specifically using human Muse cells, show potential in treating peripheral arterial disease (PAD) in severe limb ischemia cases, though the best methods are still being researched.
  • In a mouse model of hindlimb ischemia, Muse cells led to improved blood flow, increased microvascular density, and less fibrosis compared to other treatment groups.
  • Muse cells also produced more vascular endothelial growth factor (VEGF) and promoted anti-inflammatory responses, indicating they could be a promising new therapy for PAD patients.
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Based on recent clinical trials using sodium-glucose co-transporter 2 inhibitor (SGLT2i) demonstrating the significant improvement of outcomes of diabetic kidney disease (DKD), the paradigm shift from "glomerulocentric" to "tubule centric" pathophysiology in DKD progression has been highlighted. Several responsible mechanisms for renoprotective effects by SGLT2i have been proposed recently, but the changes in proximal tubule-specific gene expression by SGLT2i in diabetic mice have not been elucidated. We report the analysis of the proximal tubular-specific pathway, demonstrating the downregulation of oxidative phosphorylation in dapagliflozin-treated mice, a type 2 diabetic model.

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  • ALK-TKIs are effective for ALK-rearranged lung cancer, but complete responses are uncommon, prompting investigation into how some cancer cells become drug-tolerant.
  • Research found that activation of HER3 and a process called mesenchymal-to-epithelial transition, regulated by ZEB1 proteins, helps these drug-tolerant cells survive.
  • Combining pan-HER inhibitor afatinib with ALK-TKIs significantly improves treatment results and prevents tumor regrowth in patients with specific cancer characteristics, showing HER3's critical role in treatment resistance.
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Kidney hypertrophy is a common clinical feature in patients with diabetes and is associated with poor renal outcomes. Initial cell proliferation followed by cellular hypertrophy are considered the responsible mechanisms for diabetic kidney hypertrophy. However, whether similar responses against hyperglycemia continue in the chronic phase in diabetes is unclear.

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  • Heart failure often leads to kidney failure, and when both occur together, they significantly increase mortality rates in patients.
  • Recent research indicates that kidney injury in heart failure patients is primarily due to increased kidney venous pressure rather than just reduced blood flow from the heart.
  • A new mouse model study found that decreased blood flow in kidney capillaries, caused by kidney congestion and activated NF-κB signaling, worsens kidney damage, suggesting that targeting NF-κB could be a promising treatment for paired heart and kidney failures.
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Cisplatin is a commonly used anticancer drug, but nephrotoxicity is a dose-limiting adverse effect. Recent experimental and clinical observations have demonstrated that multiple injections of cisplatin induce the transition to chronic kidney disease; however, the underlying mechanisms remain unclear. We found that multiple injections of higher doses of cisplatin in a shorter interval affected the severity of kidney injury, causing kidney fibrosis to develop at a later time point.

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A 75-year-old man with fever was diagnosed with alveolar hemorrhage. Antineutrophil cytoplasmic antibodies for myeloperoxidase and proteinase 3 were absent. He received corticosteroid therapy, which immediately improved his symptoms and chest radiological findings.

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Glomerulopathy with fibronectin deposits (GFND) is a rare hereditary kidney disease with autosomal dominant inheritance. A 21-year-old woman who had been diagnosed with GFND 10 years ago was admitted for investigation of a rapid decline in her renal function, hemolytic anemia, and cardiac dysfunction. A renal biopsy showed GFND accompanied by extraglomerular vascular lesions.

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Purpose: To report the endovascular treatment for acute progressive and very-late-onset multiple segmental small-artery stenoses in transplanted kidney parenchyma presenting with rapidly deteriorating renal function and refractory hypertension in a 65-year-old man.

Case Report: Nineteen years ago, the patient received a living renal transplant via end-to-end anastomosis of the right internal iliac artery for kidney failure caused by chronic glomerulonephritis. His transplant renal function (creatinine: 0.

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  • IgA nephropathy is the most common form of glomerulonephritis and can be triggered by systemic diseases like psoriasis; in this case, a patient experienced worsening IgA nephropathy after starting infliximab treatment for generalized pustular psoriasis.
  • The 28-year-old woman presented with kidney issues, including hematuria and proteinuria, which developed after her psoriasis treatment was resumed postpartum, leading to a renal biopsy that confirmed active IgA nephropathy.
  • Treatment involved stopping infliximab and using corticosteroids, tonsillectomy, and secukinumab, resulting in improvements in both kidney function and psoriasis symptoms, highlighting the need for more research on the link between targeted therapies and Ig
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Tubular atrophy is a common pathological feature of kidney fibrosis. Although fibroblasts play a predominant role in tissue fibrosis, the role of repairing tubular epithelia in tubular atrophy is unclear. We demonstrated the essential role of focal adhesion kinase (FAK)-mediated intratubular epithelial-mesenchymal transition (EMT) in the pathogenesis of tubular atrophy after severe ischemia-reperfusion injury (IRI).

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Backgrounds: The clinical features of autosomal dominant polycystic kidney disease (ADPKD) differ among patients even if they have the same gene mutation in PKD1 or PKD2. This suggests that there is diversity in the expression of other modifier genes or in the underlying molecular mechanisms of ADPKD, but these are not well understood.

Methods: We primarily cultured solute carrier family 12 member 3 (SLC12A3)-positive urine-derived distal tubular epithelial cells from 6 ADPKD patients and 4 healthy volunteers and established immortalized cell lines.

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The DNA damage response after kidney injury induces cell cycle arrest in renal tubular epithelial cells, resulting in the secretion of pro-fibrotic cytokines, thereby promoting interstitial fibrosis in a paracrine manner. Phosphorylation of ataxia-telangiectasia mutated (ATM) is the initial step in the DNA damage response and subsequent cell cycle arrest; however, the effects of ATM inhibition on the injured kidney have not been explored. Pharmacological ATM inhibition by KU55933 in cisplatin-treated mice did not ameliorate, but instead exacerbated cisplatin-induced DNA damage and tubular injury, thereby increasing mortality.

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Non-dipping nocturnal blood pressure (BP) pattern is a predictor of the future decline of renal function; however, it is unclear whether it is still a risk for chronic kidney disease (CKD) patients with normal BP. To solve this question, a retrospective cohort study was conducted, and 1107 CKD patients who underwent ambulatory blood pressure monitoring (ABPM) were enrolled. We divided patients into 4 groups based on their nocturnal BP dipping pattern (dipper or non-dipper) and average 24-hour BP (hypertension or normotension).

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  • - Dietary salt restriction is crucial for managing fluid retention in chronic kidney disease (CKD) patients, as shown in a 7-day study where patients consumed a low-salt diet of 5g/day.
  • - Among 311 patients studied, significant weight loss was noted on Day 4 (0.7 kg) and Day 7 (1.0 kg), with increased weight loss observed in patients with higher urinary salt excretion.
  • - The study found that higher body mass index (BMI) and urinary salt excretion correlated with greater initial weight loss, indicating that dietary changes can impact fluid retention in CKD patients, but further long-term studies are necessary.
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The lack of a decrease in nocturnal blood pressure is a risk factor for the progression of chronic kidney disease (CKD); however, it currently remains unknown whether it is a risk factor in normotensive CKD patients. We conducted a retrospective cohort study and enrolled 676 CKD patients who underwent ambulatory blood pressure monitoring (ABPM). According to their nocturnal blood pressure dipping pattern (>10%: dipper or <10%: non-dipper) and average 24-h systolic blood pressure (>130/80 mmHg: hypertension or <130/80 mmHg: normotension), patients were divided into four groups.

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Fibrosis is the common final pathway of virtually all chronic injury to the kidney. While it is well accepted that myofibroblasts are the scar-producing cells in the kidney, their cellular origin is still hotly debated. The relative contribution of proximal tubular epithelium and circulating cells, including mesenchymal stem cells, macrophages, and fibrocytes, to the myofibroblast pool remains highly controversial.

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  • Sodium glucose co-transporter 2 inhibitors (SGLT2i), particularly ipragliflozin, are effective in slowing down the progression of diabetic kidney disease, as seen in various studies.
  • Administering ipragliflozin to both type 2 and type 1 diabetic mice showed that it lowered blood glucose and urinary albumin levels, while also inhibiting kidney enlargement and reducing oxidative stress.
  • The study highlighted that both high- and low doses of ipragliflozin protect kidney function by improving podocyte integrity and reducing renal tissue hypoxia, with dose-dependent effects particularly noted in the early stages of diabetic nephropathy.
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Circadian clocks in mammals function in most organs and tissues throughout the body. Various renal functions such as the glomerular filtration and excretion of electrolytes exhibit circadian rhythms. Although it has been reported that the expression of the clock genes composing molecular oscillators show apparent daily rhythms in rodent kidneys, functional variations of regional clocks are not yet fully understood.

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A 62-year-old man exhibiting nasal obstruction and glomerulonephritis with proteinase 3-antineutrophil cytoplasmic antibodies (PR3-ANCAs) was diagnosed with extranodal NK/T-cell lymphoma, nasal type (ENKL) with infiltration of neutrophils with apoptosis. Chemoradiotherapy reduced the tumor, improved the renal function, and decreased the PR3-ANCA levels. ANCA-positivity is observed in immunoinsufficient diseases, in which neutrophils lead to apoptosis and translocate intracellular granules, such as PR3, to the cell surface, triggering the production of ANCAs.

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  • HDR syndrome is a rare genetic disorder linked to mutations in the GATA3 gene, characterized by hypoparathyroidism, sensorineural deafness, and renal dysplasia.
  • A new case of HDR syndrome was reported in an adult with a specific mutation (p.C288W) in GATA3, revealing unusual kidney histology similar to membranoproliferative glomerulonephritis.
  • Further studies on kidney histology in HDR syndrome patients are essential to understand how GATA3 affects kidney development and function in adults.
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