MDPI - Publisher of Open Access Journals

10 pages, 2286 KiB

Open AccessArticle

Adsorption of Phenazines Produced by Pseudomonas aeruginosa Using AST-120 Decreases Pyocyanin-Associated Cytotoxicity

by Hidetada Hirakawa, Ayako Takita, Motoyuki Uchida, Yuka Kaneko, Yuto Kakishima, Koichi Tanimoto, Wataru Kamitani and Haruyoshi Tomita

Antibiotics 2021, 10(4), 434; https://doi.org/10.3390/antibiotics10040434 - 13 Apr 2021

Cited by 13 | Viewed by 3388

Abstract

AST-120 (Kremezin) is used to treat progressive chronic kidney disease by adsorbing uremic toxin precursors produced by the gut microbiota, such as indole and phenols. Previously, we found that AST-120 decreased drug tolerance and virulence in Escherichia coli by adsorbing indole. Here, we show that AST-120 adsorbs phenazine compounds, such as pyocyanin, produced by Pseudomonas aeruginosa including multidrug-resistant P. aeruginosa strains, and suppresses pyocyanin-associated toxicity in A-549 (alveolar adenocarcinoma) and Caco-2 (colon adenocarcinoma) cells. Addition of fosfomycin, colistin and amikacin, which are often used to treat P. aeruginosa, inhibited the bacterial growth, regardless of the presence or absence of AST-120. These results suggest a further benefit of AST-120 that supports anti-Pseudomonas chemotherapy in addition to that of E. coli and propose a novel method to treat P. aeruginosa infection. Full article

(This article belongs to the Special Issue Interference of Bacterial Signaling as a New Strategy for Treatment of AMR Pathogens)

► Show Figures

Figure 1

13 pages, 11074 KiB

Open AccessArticle

Effects and Safety of an Oral Adsorbent on Chronic Kidney Disease Progression: A Systematic Review and Meta-Analysis

by Ying-Chun Chen, Mei-Yi Wu, Ping-Jen Hu, Tzu-Ting Chen, Wan-Chen Shen, Wei-Chiao Chang and Mai-Szu Wu

J. Clin. Med. 2019, 8(10), 1718; https://doi.org/10.3390/jcm8101718 - 17 Oct 2019

Cited by 27 | Viewed by 6210

Abstract

Background: AST-120 (Kremezin), which is an oral spherical carbon adsorbent, has been reported to have the potential for retarding disease progression in patients with chronic kidney disease. We aimed to evaluate its efficacy and safety in this study. Methods: We systematically searched for randomized controlled trials published in PubMed, Embase, and Cochrane databases. The primary outcomes were the renal outcome and all-cause mortality, and the change in serum indoxyl sulfate (IS) levels. The safety outcome was also evaluated in terms of reported major adverse events. A random-effects model was used when heterogeneity was expected. Results: Eight studies providing data for 3349 patients were included in the meta-analysis. The risk ratio of renal outcome and all-cause mortality were 0.97 (95% CI: 0.88–1.07; 6 trials) and 0.94 (0.73–1.20; 5 trials), respectively. Furthermore, the weighted mean change in IS levels from baseline to the end of the study was −0.28 mg/dL (95% CI: −0.46 to −0.11; 4 trials). Conclusions: This study provides evidence that AST-120 can effectively lower IS levels but still controversial in terms of slowing disease progression and all-cause mortality. Except for dermatological events, the incidence of adverse events did not differ significantly between the AST-120 and placebo groups. Full article

(This article belongs to the Section Nephrology & Urology)

► Show Figures

Figure 1

Search Results (2)

Further Information

Guidelines

MDPI Initiatives

Follow MDPI

Saved Queries

Search Filter Reset All

Years

Feature Papers

Subjects

Journals

Article Types

Countries / Regions

Search Results (2)

Further Information

Guidelines

MDPI Initiatives

Follow MDPI