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Chronic kidney disease (CKD) is characterized by progressive reduction in kidney function over time. CKD affects greater than 10% of the population and its incidence is on the rise due to the growing prevalence of its risk factors. Previous studies demonstrated CKD alters nonrenal clearance of drugs in addition to reducing renal clearance. We assessed the function and expression of hepatic CYP2B enzymes using a rat model of CKD. CKD was induced in Wistar rats by supplementing their chow with adenine and confirmed through the detection of elevated uremic toxins in plasma. Liver enzymes AST and ALT were unchanged by the adenine diet. Bupropion was used as a probe substrate for hepatic CYP2B function using rat liver microsomes. The resulting metabolite, hydroxy-bupropion, and bupropion were quantified by ultra-performance liquid chromatography coupled to time-of- flight mass spectrometry. Level of mRNA and protein were determined by RT-PCR and Western blot, respectively. The results of our study demonstrate that CYP2B1 is downregulated in a rat model of CKD. CYP2B1 mRNA level was significantly decreased (88%, P < 0.001) in CKD relative to control. Similarly, maximal enzymatic velocity (Vmax) for CYP2B was decreased by 46% in CKD relative to control (P < 0.0001). Previous studies involving patients with CKD demonstrated altered bupropion pharmacokinetics compared to control. Hence, our results suggest that these alterations may be mediated by attenuated CYP2B hepatic metabolism. This finding may partially explain the alterations in pharmacokinetics and nonrenal drug clearance frequently observed in patients with CKD. [ABSTRACT FROM AUTHOR]

Decision‐making in the somatosensory domain has been intensively studied using vibrotactile frequency discrimination tasks. Results from human and monkey electrophysiological studies from this line of research suggest that perceptual choices are encoded within a sensorimotor network. These findings, however, rely on experimental settings in which perceptual choices are inextricably linked to sensory and motor components of the task. Here, we devised a novel version of the vibrotactile frequency discrimination task with saccade responses which has the crucial advantage of decoupling perceptual choices from sensory and motor processes. We recorded human fMRI data from 32 participants while they performed the task. Using a whole‐brain searchlight multivariate classification technique, we identify the left lateral prefrontal cortex and the oculomotor system, including the bilateral frontal eye fields (FEF) and intraparietal sulci, as representing vibrotactile choices. Moreover, we show that the decoding accuracy of choice information in the right FEF correlates with behavioral performance. Not only are these findings in remarkable agreement with previous work, they also provide novel fMRI evidence for choice coding in human oculomotor regions, which is not limited to saccadic decisions, but pertains to contexts where choices are made in a more abstract form. [ABSTRACT FROM AUTHOR]

Background and Purpose Erythropoietin ( EPO) is used to treat anaemia associated with chronic kidney disease ( CKD). Hypoxia is associated with anaemia and is known to cause a decrease in cytochrome P450 ( P450) expression. As EPO production is regulated by hypoxia, we investigated the role of EPO on P450 expression and function. Experimental Approach Male Wistar rats were subjected to a 0.7% adenine diet for 4 weeks to induce CKD. The diet continued for an additional 2 weeks while rats received EPO by i.p. injection every other day. Following euthanasia, hepatic P450 mRNA and protein expression were determined. Hepatic enzyme activity of selected P450s was determined and chromatin immunoprecipitation was used to characterize binding of nuclear receptors involved in the transcriptional regulation of CYP2 C and CYP3 A. Key Results EPO administration decreased hepatic mRNA and protein expression of CYP3 A2 ( P < 0.05), but not CYP2 C11. Similarly, EPO administration decreased CYP3 A2 protein expression by 81% ( P < 0.001). A 32% decrease ( P < 0.05) in hepatic CYP3 A enzymatic activity ( Vmax) was observed for the formation of 6 βOH-testosterone in the EPO-treated group. Decreases in RNA pol II recruitment ( P < 0.01), hepatocyte nuclear factor 4 α binding ( P < 0.05) and pregnane X receptor binding ( P < 0.01) to the promoter region of CYP3 A were also observed in EPO-treated rats. Conclusions and Implications Our data show that EPO decreases the expression and function of CYP3 A, but not CYP2 C in rat liver. [ABSTRACT FROM AUTHOR]

Patients with chronic kidney disease (CKD) require many medications. CYP2C and CYP3A drug-metabolizing enzymes play a critical role in determining the pharmacokinetics of the majority of prescribed medications. These enzymes are transcriptionally regulated by the nuclear receptors pregnane X receptor (PXR) and hepatic nuclear factor 4α (HNF-4α). Expression of CYP2C and CYP3A is decreased in CKD; however, the mechanisms by which this occurs is unknown. We induced CKD in rats by 5/6 nephrectomy and used chromatin immunoprecipitation (ChIP) to determine nuclear receptor- and epigenetic alteration-mediated differences in the promoter region of the CYP2C and CYP3A genes. RNA polymerase II and HNF-4α binding was decreased 76 and 57% in the CYP2C11 promotor and 71 and 77% in the CYP3A2 promoter, respectively (P<0.05). ChIP also revealed a 57% decrease in PXR binding to the CYP3A2 promoter in CKD rats (P<0.05). The decrease in PXR and HNF-4α binding was accompanied by diminished histone 4 acetylation in the CYP3A2 promoter (48%) and histone 3 acetylation in the CYP2C11 (77%) and CYP3A2 (77%) promoter loci for nuclear receptor activation (P<0.05). This study suggests that decreased nuclear receptor binding and histone acetylation may contribute to the mechanism of drug-metabolizing enzyme down-regulation and altered pharmacokinetics in CKD. [ABSTRACT FROM AUTHOR]

Cancer immunotherapeutic agents (vaccines) in the form of antigen-loaded dendritic cells (DCs) reached an important milestone with the recent approval of Provenge, the first DC vaccine for treatment of prostate cancer. Although this heralds a new era of tumor immunotherapy, it also highlights the compelling need to optimize such DC-based therapies as they are increasingly tested and used to treat human patients. In this study we sought to augment and enhance the antitumor activity of a DC-based vaccine using siRNA to silence expression of immunosuppressive enzyme indoleamine 2,3-dioxygenase (IDO) in DCs. We report here that DCs loaded with tumor antigens, but with siRNA-silenced IDO expression, were introduced into 4T1 breast tumor-bearing mice, the treatment: ( i) lengthened the time required for tumor onset, ( ii) decreased tumor size compared to tumors grown for equal lengths of time in mice treated with antigen-loaded DCs without IDO silencing and ( iii) reduced CD4+ and CD8+ T cell apoptosis. Furthermore, immunization with IDO-silenced DCs enhanced tumor antigen-specific T cell proliferation and CTL activity, and decreased numbers of CD4+CD25+Foxp3+ Treg. This study provides evidence to support silencing of immunosuppressive genes (IDO) as an effective strategy to enhance the efficacy of DC-based cancer immunotherapeutic. [ABSTRACT FROM AUTHOR]

Mesna and its dimer, dimesna, are coadministered for mitigation of ifosfamide- and cisplatin-induced toxicities, respectively. Dimesna is selectively reduced to mesna in the kidney, producing its protective effects. In vitro screens of uptake and efflux transporters revealed saturable uptake by renal organic anion transporters OAT1, OAT3, and OAT4. Efflux transporters breast cancer resistance protein; multidrug and toxin extrusion 1 (MATE1); multidrug resistance proteins MRP1, MRP2, MRP4, and MRP5; and P-glycoprotein (Pgp) significantly reduced dimesna accumulation. Further investigation demonstrated that renal apical efflux transporters MATE1, MRP2, and Pgp were also capable of mesna efflux. Administration of OAT inhibitor probenecid to healthy subjects significantly increased combined mesna and dimesna plasma exposure (91% ± 34%) while decreasing the renal clearance due to net secretion (67.0% ± 12.7%) and steady-state volume of distribution (45.2% ± 13.4%). Thus, the kidney represents a significant sink of total mesna, whereas function of renal drug transporters facilitates clearance in excess of glomerular filtration rate and likely the presence of active mesna in the urine. Loss of renal transporter function due to genetic variability or drug–drug interactions may decrease the efficacy of chemoprotectants, increasing the risk of ifosfamide- and cisplatin-induced toxicities. [ABSTRACT FROM PUBLISHER]