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Biomedical subjects

G Deschênes

Publications and source records attributed to G Deschênes.

At least 19 recordsLinked to original sources
PubMed2002

[Primary molecular changes and secondary biological problems in Bartter and Gitelman syndrome].

Bartter syndrome and Gitelman syndrome are primary hereditary diseases characterized by hypokaliemia, alkalosis, hypertrophy of the juxtaglomerular complex with secondary hyperaldoteronism and normal blood pressure. They result from molecular disorders leading to a defect of sodium reabsorption in respectively the Henle's loop and the distal convoluted tubule. Biological adaptations of downstream tubular segments, i.e. distal convoluted tubule and collecting duct, are responsible for hypokaliemia, alkalosis, renin-aldosterone activation, prostaglandins hypersecretion and dysregulation of the urinary excretion of calcium and magnesium, illustrating the close integration of the regulation of different solutes in the distal tubular structures.

Bartter Syndrome↗
PubMed2002

[Urinary antimicrobial prophylaxis].

Antibiotics are usually used to prevent childhood recurrent urinary tract infections: cystitis or pyelonephritis. The mechanism of action of these antibiotics, although imperfectly known, seems to be double: the antibiotic acts by its bactericidal effect, but also probably for minimal concentrations by reducing adhesion capability of bacteria to the urothelium. The most commonly used molecules are cotrimoxazole, trimethoprime, pivmecillinam, cefaclor and nalidixic acid. However all have not been studied rigorously as for their prophylactic capacity, and in particular very little is known for patients presenting with vesico-ureteral reflux.

Amdinocillin Pivoxil↗
PubMed2001

Prognosis of Streptococcus pneumoniae-induced hemolytic uremic syndrome.

Streptococcus pneumoniae-induced hemolytic uremic syndrome (HUS) is known to be a severe acute disease leading to death in one-third of cases, but data regarding the long-term follow-up are lacking. A new series of 11 patients with Streptococcus pneumoniae-induced HUS associated with meningitis and pneumonia constituted a multi-center review. Among 9 patients with a severe acute infectious disease, 3 died from meningitis and 1 from neurological sequelae after a partial recovery of renal function. The mean duration of dialysis was 32 days in patients with acute renal failure who survived the acute infectious period. Cortical necrosis was documented in five of six kidney specimens. Among the 7 surviving patients, 5 developed end-stage renal failure 4-17 years later.

Child, Preschool↗
PubMed2001

Successful plasma therapy in hemolytic uremic syndrome with factor H deficiency.

A patient with homozygous factor H deficiency presented with hemolytic uremic syndrome (HUS) at the age of 7 months. After a 2-year period of stability, renal failure and erythrocyte fragmentation recurred between the age of 3 and 4 years. Fresh frozen plasma infusions allowed renal function to be improved and erythrocyte fragmentation to be stopped. Withdrawal of plasma therapy led to a relapse of the biological signs of HUS.

Complement Factor H↗
PubMed2001

Cyclic AMP increases cell surface expression of functional Na,K-ATPase units in mammalian cortical collecting duct principal cells.

Cyclic AMP (cAMP) stimulates the transport of Na(+) and Na,K-ATPase activity in the renal cortical collecting duct (CCD). The aim of this study was to investigate the mechanism whereby cAMP stimulates the Na,K-ATPase activity in microdissected rat CCDs and cultured mouse mpkCCD(c14) collecting duct cells. db-cAMP (10(-3) M) stimulated by 2-fold the activity of Na,K-ATPase from rat CCDs as well as the ouabain-sensitive component of (86)Rb(+) uptake by rat CCDs (1.7-fold) and cultured mouse CCD cells (1.5-fold). Pretreatment of rat CCDs with saponin increased the total Na,K-ATPase activity without further stimulation by db-cAMP. Western blotting performed after a biotinylation procedure revealed that db-cAMP increased the amount of Na,K-ATPase at the cell surface in both intact rat CCDs (1.7-fold) and cultured cells (1.3-fold), and that this increase was not related to changes in Na,K-ATPase internalization. Brefeldin A and low temperature (20 degrees C) prevented both the db-cAMP-dependent increase in cell surface expression and activity of Na,K-ATPase in both intact rat CCDs and cultured cells. Pretreatment with the intracellular Ca(2+) chelator bis-(o-aminophenoxy)-N,N,N',N'-tetraacetic acid also blunted the increment in cell surface expression and activity of Na,K-ATPase caused by db-cAMP. In conclusion, these results strongly suggest that the cAMP-dependent stimulation of Na,K-ATPase activity in CCD results from the translocation of active pump units from an intracellular compartment to the plasma membrane.

Animals↗
PubMed2000

Cellular adaptation of the mouse cortical thick ascending limb of Henle's loop (CTAL) to dietary magnesium restriction: enhanced transepithelial Mg2+ and Ca2+ transport.

Mice aged 4 or 8 weeks were fed with a low-Mg2+ diet for 1, 2, 3 or 4 days. After 1 day of diet, the urinary excretion of Mg2+ and Ca2+ was strongly reduced in both animal groups (4 and 8 weeks), accompanied by a significant fall in plasma Mg2+ concentration and an increase in urinary volume. This profile persisted after 2, 3 or 4 days of dietary Mg2+ restriction. After 1 day of diet, transepithelial ion net fluxes of Na+, Cl-, Ca2+ and Mg2+ (JNa' JCI, JCl, JMg) measured in vitro from isolated perfused cortical thick ascending limbs (CTALs) of these animals remained unchanged. After 2 days of diet, measurements of J(Ca) and J(Mg) in isolated perfused CTALs showed that transepithelial Mg2+ and Ca2+ reabsorption were enhanced in CTALs from Mg(2+)-depleted, 8-week-old animals, whereas transepithelial Mg2+ and Ca2+ transport were not altered in 4-week-old mice. JNa and JCl and the transepithelial potential (PDte) were not modified in CTALs from either animal group. Our results suggest that a low-Mg2+ diet leads to urinary retention of Mg2+ and Ca2+ which is most likely due to increased Mg2+ and Ca2+ transport in the CTAL. Furthermore, in response to dietary Mg2+ restriction, the reabsorption of divalent cations in the CTAL of adult, but not of young, mice undergoes cellular adaptation.

Adaptation, Physiological↗
PubMed2000

[Molecular mechanisms of idiopathic nephrotic syndrome].

Steroid-sensitive idiopathic nephrotic syndrome is a T-cell disorder associated with a functional renal impairment. The molecular mechanisms leading from the stimulation of the immune system to the clinical expression of the renal disease can be analyzed according to five biological events: 1) a Th2 activation of T-cells by interleukin-13; 2) a yet unidentified glomerular permeability factor from immune origin; 3) a molecular disorientation of slit diaphragms or glomerular basement membrane responsible for proteinuria; 4) a podocyte cytoskeleton rearrangement responsible for foot process effacement; and 5) renal avidity for sodium and edema formation resulting from a primary stimulation of tubular Na,K-ATPase and an increase of endothelial permeability.

Cytoskeleton↗
PubMed1999

[The biochemical and hematological assessment of iron metabolism].

Despite the progress in the knowledge of iron metabolism, its precise assessment remains uneasy. Serum ferritin assesses the extent of storage iron. Serum iron and the percentage of transferrin saturation evaluate the tissues' iron supply. But these parameters are indirect measurements and they do not reflect marrow iron supply. Serum transferrin receptors, red cell ferritin and red cell zinc protoporphyrin are good indicators of this iron supply to the erythroid marrow for erythropoiesis. Since the introduction of recombinant human erythropoietin, it has become apparent that an adequate iron supply to the bone marrow is essential for a satisfactory hematopoietic response. In some cases, despite a high baseline ferritin, iron may not be sufficiently released from reserves in the bone marrow, resulting in a functional iron deficiency. The percentage of hypochromic red cells and reticulocyte haemoglobin content tends to reflect direct marrow iron status.

Anemia, Iron-Deficiency↗
PubMed1999

[Renal K-ATPases: structure, function and dysfunction].

Na,K-ATPase and H,K-ATPase consist of two transmembrane proteins, the larger of which (catalytic subunit) exchanges extracellular K+ against intracellular Na+ or proton, at the expense of ATP hydrolysis. Cloning of four isoforms of Na,K-ATPase and two isoforms of H,K-ATPase has provided a molecular basis to the functional heterogeneity of these ATPases. Besides its house keeping functions, renal Na,K-ATPase energizes most solute and water transports along the whole nephron. For this purpose, it utilizes about 80% of renal metabolic energy. H,K-ATPase, which is restricted to the renal collecting duct, has a more limited role: it energizes K+ reabsorption during hypokalemia and, along with H-ATPase, participates to acid/base homeostasis. Dysregulation of tubular Na,K-ATPase and H,K-ATPase are involved in physiopathological alterations. For examples, results are presented which show the relationships that exist between a) Na+ retention during experimental nephrotic syndrome and stimulation of collecting duct Na,K-ATPase, and b) kaliuretic effect of loop diuretics and inhibition of collecting duct H,K-ATPase.

Animals↗
PubMed1998

Novel molecular variants of the Na-K-2Cl cotransporter gene are responsible for antenatal Bartter syndrome.

Antenatal Bartter syndrome is a variant of inherited renal-tubular disorders associated with hypokalemic alkalosis. This disorder typically presents as a life-threatening condition beginning in utero, with marked fetal polyuria that leads to polyhydramnios and premature delivery. Another hallmark of this variant is a marked hypercalciuria and, as a secondary consequence, the development of nephrocalcinosis and osteopenia. We have analyzed 15 probands belonging to 13 families and have performed SSCP analysis of the coding sequence and the exon-intron boundaries of the NKCC2 gene; and we report 14 novel mutations in patients with antenatal Bartter syndrome, as well as the identification of three isoforms of human NKCC2 that arise from alternative splicing.

Amino Acid Sequence↗
PubMed1998

Large deletion of the 5' end of the ROMK1 gene causes antenatal Bartter syndrome.

Mutations in exon 5 of the ROMK1 gene (KCNJ1) have recently been observed in antenatal Bartter syndrome patients. This study describes a homozygous deletion removing KCNJ1 exons 1 and 2 observed in a consanguineous family with antenatal Bartter syndrome. Absence of the untranslated exon 1 led to the deletion of transcription elements located in this exon that may cause the disease. Deletion of exon 1 transcription elements should lead to the absence of hROMK2-K5 transcripts, whereas hROMK1 transcripts should normally be transcripted. Consequently, probably only hROMK2-K5 transcripts are expressed in the medullary thick ascending limb of Henle.

Bartter Syndrome↗
PubMed1997

Nephrotic syndrome and Hodgkin disease in children: a report of five cases.

UNLABELLED: This report documents the occurrence of a nephrotic syndrome in five children with Hodgkin disease. In two cases the nephrotic syndrome predated the diagnosis of lymphoma by 6 months and 12 months respectively, while in the other three, the two disorders occurred simultaneously. The nephrotic syndrome resolved in four cases during effective treatment for active Hodgkin disease, while proteinuria remained unchanged in the fifth case with partial control of the lymphoma. The occurrence of a nephrotic syndrome as a manifestation of active Hodgkin disease suggests that some immunological abnormalities play a role in the pathogenesis of the association. CONCLUSION: The possibility of glomerular dysfunction although rare must be considered and actively looked for in all cases of Hodgkin disease. Similarly, any unusual sign or symptom noted in patients with nephrotic syndrome, particularly receiving or having received immunosuppressants, requires thorough investigation to determine the presence or absence of lymphoma.

Adolescent↗
PubMed1996

Cluster of cases of haemolytic uraemic syndrome due to unpasteurised cheese.

A cluster of four patients (1 girl, 3 boys) from a French village (2,000 inhabitants) had acute haemolytic uraemic syndrome (HUS) between March 1992 and May 1993. All had prodromes with fever and diarrhoea, then acute renal failure, anaemia, schistocytosis and thrombocytopenia. Peritoneal dialysis was carried out in three children (duration 3-12 days). The verotoxin VT2 gene was identified by polymerase chain reaction in the stools of two children. Some days prior to the diarrhoea, all children had eaten a cheese made with unpasteurised mixed cows' and goats' milk from the same farm. A case control study showed that the occurrence of HUS was linked to the consumption of this milk product (P = 0.006). The VT 2 gene was isolated from the cheese and from the stools of goats and cows from the farm, but not from the stools of farm employees.

Acute Disease↗
PubMed1996

Spectrum of mutations in the COL4A5 collagen gene in X-linked Alport syndrome.

Alport syndrome is a mainly X-linked hereditary disease of basement membranes that is characterized by progressive renal failure, deafness, and ocular lesions. It is associated with mutations of the COL4A5 gene located at Xq22 and encoding the alpha5 chain of type IV collagen. We have screened 48 of the 51 exons of the COL4A5 gene by SSCP analysis and have identified 64 mutations and 10 sequence variants among 131 unrelated Alport syndrome patients. This represents a mutation-detection rate of 50%. There were no hot-spot mutations and no recurrent mutations in our population. The identified mutations were 6 nonsense mutations, 12 frameshift mutations, 17 splice-site mutations, and 29 missense mutations, 27 of the latter being glycine substitutions in the collagenous domain. Two of these occurred on the same allele in one patient and segregated with the disease in the family. We showed that some of the glycine substitutions could be associated with the lack of immunological expression of the alpha3(IV)-alpha5(IV) collagen chains in the glomerular basement membrane.

Adolescent↗