Renal Disposition in NASH

项目摘要 肝脏疾病和肾功能之间的相互关系越来越多地被研究，因为肝- 衍生的全身性炎症可对肾脏的生理学产生深远的影响。这是至关重要的因素 因为这些变化会破坏正常的新陈代谢， 消除了32%依赖肾功能排泄的市售治疗药物。在肝脏中 影响肾脏生理学的疾病是非酒精性脂肪性肝病（NAFLD），其特征在于一系列 介导从单纯性脂肪变性转变为非酒精性脂肪性肝炎（NASH）的机制事件， 包括炎症事件。我们的实验室已经鉴定了NASH诱导的几种药物的表型转化， 显著改变某些药物药代动力学特征的代谢酶和转运蛋白 和异生物质。有趣的是，在对各种啮齿动物NASH模型的分析研究中，我们也发现了 NASH诱导的肾转运蛋白表型转化，这种现象也有助于改变 异生物质底物在体内的药代动力学。到目前为止，还没有研究发表检查人类 NASH相关的肾脏药物转运蛋白的表型转换，这将是我们在这篇文章中讨论的第一个问题。 应用程序.我们的中心假设是NASH改变了主要肾脏药物的表达和功能， 转运蛋白，从而增加药物不良反应和环境毒性的风险， NASH患者我们的研究设计不仅旨在确定特定肾脏转运蛋白的表型转化， 在NASH中，还可以确定相关的分泌途径，以更好地缩小改变的机制。 某些治疗剂和环境污染物的药代动力学。我们的目标是：1）确定 在人类NASH患者中肾转运蛋白的表达和定位的变化，2）确定 啮齿动物个体分泌途径的功能变化及其导致环境毒性的可能性 3）确定NASH对GFR的影响并选择人类患者的分泌途径。 通过实现这些目标，我们将能够确定存在更大不良药物风险的药物类别。 对于NASH患者来说。

PROJECT SUMMARY The interrelation between liver disease and kidney function is becoming increasingly researched, as hepatic- derived systemic inflammation can have a profound effect on the physiology of the kidney. This is a vital factor to consider with respect to precision medicine, as these changes can disrupt the proper metabolism and elimination of the 32% of marketed therapeutics that rely upon renal function for excretion. Among the liver diseases that affect renal physiology is nonalcoholic fatty liver disease (NAFLD), characterized by a series of mechanistic events that mediate the transition from simple steatosis to nonalcoholic steatohepatitis (NASH), which include inflammatory events. Our lab has identified NASH-induced phenotypic conversions of several drug metabolizing enzyme and transport proteins that significantly alter the pharmacokinetic profiles of certain drugs and xenobiotics. Interestingly, in a profiling study of various rodent models of NASH, we have also identified NASH-induced phenoconversion of renal transport proteins, a phenomenon that also contributes to altered pharmacokinetics of xenobiotic substrates in vivo. To date, no studies have been published examining human NASH-related phenoconversion of renal drug transporters, and that will be the first item we address in this application. Our central hypothesis is that NASH alters the expression and function of major renal drug transporters, thereby increasing the risk of adverse drug reactions and environmental toxicities in patients with NASH. Our study design seeks not only to identify phenoconversion of specific renal transporters in NASH, but also to pinpoint the associated secretory pathways to better narrow down mechanisms of altered pharmacokinetics for certain therapeutics and environmental contaminants. Our aims are to: 1) Determine the changes in expression and localization of renal transporters in human NASH patients, 2) Determine the functional changes in individual secretion pathways and resulting potential for environmental toxicity in a rodent model of NASH, and 3) Determine the impact of NASH on GFR and select secretion pathways in human patients. By completing these aims, we will be able to identify classes of drugs that present a greater risk of adverse drug events for NASH patients.