Bcl11b (also known as Ctip2) is highly and specifically expressed

Bcl11b (also known as Ctip2) is highly and specifically expressed within T cells, and to a lesser extent in NK cells 20, suggesting that Bcl11b could function

as a T-cell-specific regulator. Bcl11b has been shown to bind to GC-rich target sequences, and is involved mostly in gene repression 21–23. It recruits the class III histone deacetylase SIRT1 22 and/or the class I histone deacetylases to promoters 23, 24. Genetic analyses have shown that Bcl11b is crucial at several stages of T-cell development. Germline deletion of Bcl11b results in a complete block of T-cell differentiation at the DN stage, associated with impaired TCRβ rearrangement 25. Bcl11b inactivation at the DP stage strongly blocks the maturation of DP thymocytes into SP cells and impairs positive selection, possibly through defective

TCR signaling 26. Here, we further investigated Bcl11b PS341 function in T cells by generating new T-cell-specific deletions of this gene. We previously generated a germline deletion of exon 4 of the Bcl11b locus, Bcl11bL−/L−27, which is lethal just after birth 27. These mice exhibited a tenfold decrease in thymic cellularity (0.9±0.2×106 RGFP966 cells for Bcl11bL−/L− versus 9.3±2.3×106 cells for Bcl11bL−/+ or Bcl11b+/+ mice). The majority of Bcl11bL−/L− thymocytes were large cells lacking CD4 and CD8 expression, whereas a smaller proportion expressed CD8 (Supporting Information Fig. 1A). Bcl11bL−/L− thymocytes lacked αβTCR but most expressed γδTCR, including those expressing Neratinib mw CD8 ( Supporting Information Fig. 1A, and data not shown). To circumvent the perinatal lethality and to analyze the role of Bcl11b in adult T cells, we combined the floxed Bcl11b alleles (Bcl11bL2/L2) with a transgenic allele expressing Cre recombinase under the transcriptional control of the Lck promoter, which initiates T-cell-specific expression in DN2 and DN3 cells 28. Bcl11bL2/L2Lckcre/+ mice appeared healthy and indistinguishable from littermates and were analyzed at 6 wk of age. The thymuses from these mice were very small and contained low numbers of thymocytes (an average of 3×105 cells; control

littermates had an average of >108 cells). T cells from Lck-Cre-deleted mice exhibited a phenotype reminiscent of that found in null newborn mice: most cells were large DN (48%) or CD8+ (30%) cells, and few DP cells (10%) were detected (Supporting Information Fig. 1B). In addition, as was observed in Bcl11bL−/L− newborns, a large proportion of cells, including most CD8+ cells, expressed γδTCR ( Supporting Information Fig. 1B; 46% of total thymocytes on average). Although these γδTCR+ cells were present in absolute numbers similar to WT, the phenotype of these cells was clearly abnormal, as CD8-expressing TCRγδ+ cells were not detected in control mice (Supporting Information Figs. 1B and 2). These data confirm that Bcl11b acts early in T cells to promote differentiation toward the αβ lineage.

In vitro experiments have revealed that DMF, as well as its prima

In vitro experiments have revealed that DMF, as well as its primary metabolite monomethyl fumarate (MMF), can exert immunomodulatory effects on T-cell subsets as well as on antigen-presenting cells,[93, 94] and experiments in EAE have demonstrated that DMF is effective in

both preventive check details and therapeutic applications, albeit marginal in chronic EAE, promoting myelin and axonal preservation and reducing astrocyte activation.[95, 96] It has been speculated that part of the effect of DMF could be mediated through modulation of microglia phenotype. Histological studies demonstrated that, during the acute phase of EAE, Mac-3-positive cells (microglia and macrophages) are significantly reduced in the spinal cord of DMF-treated animals.[95] Such an observation is also supported by in vitro studies in which pre-treatment with DMF can inhibit LPS-induced activation of microglial cells by reducing

the expression of NO, TNF-α, IL-1β and IL-6, possibly through an inhibition of the extracellular-signal regulated kinase pathway and an activation of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway.[97] While in vitro data prompted the hypothesis that DMF and MMF could affect microglia activation through Nrf2, Target Selective Inhibitor high throughput screening a pathway involved in the expression of proteins critical in the detoxification of reactive oxygen and reactive nitrogen species,[97, 98] this has not been demonstrated in vivo. Indeed, although Linker et al.[96] showed

that Nrf2 is required for the therapeutic effect of DMF, double-labelling these of Nrf2 with a marker for microglia did not reveal an increase of its expression in those cells after DMF treatment in EAE-affected mice. Further in vitro and in vivo studies are needed to dissect the pathways through which DMF promote an alternative neuroprotective phenotype in microglia. Mesenchymal stem cells (MSC) are currently being investigated as an alternative therapeutic approach for MS.[99] The potential therapeutic use of MSC for neurodegenerative diseases was originally considered as related to their possible regenerative function through their ability to differentiate into mesodermal tissues and perhaps into other embryonic lineages. However, recent observations have indicated that, upon systemic administration, most MSC are rapidly entrapped in the lungs, and only a few engraft into injured CNS, where they display negligible transdifferentiation capacity.[100-102] In vitro studies demonstrating that MSC can modulate several effector functions of cells of both the adaptive and innate immune systems introduced the possibility that MSC might be effective in EAE. Indeed, Zappia et al.

Because of the known role of Ca2+ in smooth muscle contractile re

Because of the known role of Ca2+ in smooth muscle contractile responses, we investigated how alcohol impacts cyclic BMN 673 purchase Ca2+ and whether changes in RhoA/ROCK-mediated Ca2+ sensitivity underlie the alcohol-induced reduction of myogenic responsiveness. AAI was produced by intragastric administration of 30% alcohol in rats. Mesenteric lymphatics were cannulated and loaded with Fura-2 AM to [Ca2+]i for 30 minutes after AAI. Active GTP-bound RhoA levels were determined by ELISA. To determine

ROCK’s ability to restore myogenic responsiveness following AAI, isolated lymphatics were transfected with constitutively active ca-ROCK protein. Lymphatics from alcohol-treated rats displayed significantly larger Ca2+ transients. Also, step increases in luminal pressure caused a gradual rise in the basal [Ca2+]i between transients that was greater in lymphatics submitted to AAI, compared to vehicle control. RhoA-GTP was significantly reduced in lymphatics from the AAI group, compared

to vehicle control. Transfection with ca-ROCK protein restored the myogenic response of lymphatic vessels isolated from AAI animals. The data strongly suggest that the alcohol-induced inhibition of mesenteric lymphatic myogenic constriction is mediated by reduced RhoA/ROCK-mediated Ca2+ sensitivity. “
“To determine HMV and PS in skeletal muscle of OZR and evaluate the Raf inhibitor impact of increased microvascular perfusion heterogeneity on mass transport/exchange. PAK6 The

in situ gastrocnemius muscle from OZR and LZR was examined under control conditions and following pretreatment with TEMPOL (antioxidant)/SQ-29548 (PGH2/TxA2 receptor antagonist), phentolamine (adrenergic antagonist), or all agents combined. A spike input of a labeled blood tracer cocktail was injected into the perfusing artery. Tracer washout was analyzed using models for HMV and PS. HT was determined in in situ cremaster muscle of OZR and LZR using videomicroscopy. HMV was decreased in OZR versus LZR. While TEMPOL/SQ-29548 or phentolamine had minor effects, treatment with all three agents improved HMV in OZR. HT was not different between strains, although variability was increased in OZR, and normalized following treatment with all three agents. PS was reduced in OZR and was not impacted by intervention. Increased microvascular perfusion heterogeneity in OZR reduces HMV in muscle vascular networks and increases its variability, potentially contributing to premature muscle fatigue.

DCs appear to be important

DCs appear to be important Selleck Olaparib regulators of the bioactivity of IL-22 as, in the gut, activated DCs produce the soluble IL-22R protein IL22BP that may play a role in the control of mucosal regeneration [109]. It is not yet clear if lung DCs

also regulate the bioactivity of IL-22 during allergen challenge. However, in a chronic model of fungal-induced asthma, IL-22 was shown to be mainly proinflammatory [110]. Over the past few years, IL-9-producing CD4+ T (Th9) cells have been identified as a subset distinct from the classical Th2 cells, with Th9 cells requiring the transcription factors IRF4, PU1, STAT6, Smad3, and Notch signaling for development. Th9 cells differentiate in response to IL-4 and TGF-β and are described to promote T-cell proliferation, IgE, and IgG production by B cells, survival and maturation of eosinophils, and mastocytosis [111-115]. Studies in asthmatic patients

have also shown elevated levels of IL-9 in the lungs after allergen challenge; this IL-9 was also demonstrated to be localized to the lymphocyte population in the BAL [116]. Initial mouse studies using transgenic lung-specific overexpression of IL-9 also showed increased airway inflammation, goblet cells metaplasia, and BHR, which were reduced when blocking IL-9 function [117, 118]. Consistent with this observation, later studies using models in which Th9 cells were adoptively transferred showed that these cells can induce allergic airway inflammation, and that this induction can be reversed by neutralization of

IL-9 [112]. IL-9 is U0126 mw also made by ILC2s and boosts production of IL-5 and IL-13, which may in turn amplify Th2-associated inflammation [23]. In a model of chronic Aspergillus-induced asthma, IL-9 neutralization suppressed the salient features of disease [119]. As for any chronic mucosal disorder, it Phosphoprotein phosphatase has been proposed that asthma might result from a (functional or absolute) deficiency in natural or induced regulatory T (Treg) cells, either through genetic predisposition, or environmental influences on homeostasis in the immune system. Studies using either the model antigen OVA or mice lacking the intronic Foxp3 enhancer CNS1 have shown that tolerance mediated by induced Foxp3+ Treg (iTreg) cells is the usual outcome after inhalation of harmless antigens [120-123]. Just like natural Treg (nTreg) cells, the iTreg cells found in the airways of mice with asthma highly express high levels of neuropilin-1, whereas iTreg cells in the LNs draining the lung of asthmatics remained neuropilin-1 low [124]. Adoptive transfer studies in mice have revealed that IL-10-producing Treg cells are able to suppress all salient features of asthma, including BHR [125, 126]. Treg cells suppress features of asthma by suppressing the activation of airway DCs (through IL-10 and TGF-β) [127], by reducing (lymph-)angiogenesis [128], and by altering the composition of the gut microbiota.

However, it may be that this risk is diminished if other risk fac

However, it may be that this risk is diminished if other risk factors, particularly cardiovascular, are taken into account. Whether or not weight loss diminishes the risk of obesity in renal transplantation is unclear. For the individual patient, a renal transplant is usually better than remaining on dialysis, although this was not true for patients

with a BMI > 40 kg/m2 in their study.[3] However, there appears to be some increased risk with obesity. In relation to age at the time of transplantation we recommend that: There be no lower age limit set for transplantation (1B). In infants under 1 year of age, transplantation should be performed www.selleckchem.com/products/SRT1720.html in highly specialized units with extensive experience in paediatric transplantation (1D). In infants under 1 year of age, adult live

donors should be used in preference to cadaveric donors (1C). In all patients but particularly in adolescents we recommend that: Risk factors for non-adherence are identified prior to transplantation (1D). Specific strategies are implemented to actively manage factors and behaviours that contribute to non-adherence (1D). We recommend that children with urological abnormalities be carefully assessed prior to transplantation and that abnormalities in bladder emptying are corrected Ferroptosis cancer before transplantation (1D). We suggest that asymptomatic vesicouretic reflux does not require correction prior to transplantation (2C). We suggest that children with Wilms tumour wait at least 2 years following completion of chemotherapy Oxalosuccinic acid before undergoing transplantation (2D). We suggest that post-transplant anticoagulation be considered for children with thrombophilic disorders

(2D). We recommend that mental retardation should not preclude an individual from consideration for transplantation (1C). None provided. Renal transplantation is considered the treatment of choice for children with end stage kidney disease with Australasian data showing a four-fold risk of death in children who remain on dialysis compared with those who are transplanted.[1] Kidney transplants are now performed routinely in many paediatric centres around the world with excellent reported graft (1- and 5-year graft survival up to 95%) and patient survival (5- and 10-year patient survival of 70–100% and 75–95%, respectively).[2, 3] A number of studies have shown the important benefits of transplant in improving cognitive development[4-6] and growth[7] of children. In recognition of these unique benefits of transplant to children and adolescents, many countries including Australia give priority to paediatric recipients on deceased donor waiting lists in order to expedite transplantation and keep waiting time short.

We show that the two-stage activation process that was previously

We show that the two-stage activation process that was previously described only in vitro26 can adequately explain the situation in vivo. However, tumor escape seems to be more complex than might be suggested by definitions in terms of type 1 or type 2 resistance. λ-myc transgenic mice express the myc oncogene under the control of Ig-λ chain regulatory sequences and spontaneously develop tumors of the B-cell lineage that share multiple features of human Burkitt lymphoma 29. Animals with lymphadenopathy were sacrificed and NK cells from spleens and lymph nodes were phenotypically analyzed. The absolute number of NK cells was strongly increased in tumor lymph nodes.

The highest numbers were found in cervical and mandibular lymph nodes, Deforolimus the primary site of lymphoma growth (Fig. 1A). Inguinal and axillary lymph nodes and other lymphoid organs are infiltrated by tumor cells later during disease progression. Obviously, there is either an active migration of NK cells into the developing lymphomas or an enhanced proliferation in the tumor lymph nodes.

Most activating receptors including NKG2D and the inhibitory receptors tested were diminished, and expression of typical activation markers, such as CD45R and CD69, was enhanced (Fig. 1B). We assume that interaction of NK cells with tumor cells gave rise to NK-cell activation entailing up- or down-regulation of several surface receptors. A correlation between NK-receptor levels and NK/tumor-cell ratios in the different compartments was not seen in mice with visible tumor burdens suggesting strong activating signals as soon as visible tumor Selleck 17-AAG growth has started. To obtain more information on NK-cell activation in vivo, we also analyzed transgenic mice prior to macroscopic

tumor manifestation. NK cells from these animals already showed slight alterations of the surface molecules (data not shown), which might be due to incipient, yet undetectable lymphomas. To investigate effector functions, NK cells were tested for cytotoxicity by chromium release assay and for IFN-γ expression by RT-PCR and protein staining. In contrast to normal NK cells, highly enriched NK cells from tumor-bearing animals did not exert any cytotoxicity against the NK-sensitive Flucloronide YAC-1 target (Fig. 2A). Lytic activity of NK cells from clinically unapparent λ-myc transgenic mice (before manifestation of visible tumors) was also impaired but its decrease was often less pronounced than in tumor-bearing mice. For IFN-γ mRNA expression, a clear hierarchy was observed in NK cells derived from WT, clinically unapparent λ-myc transgenic and lymphoma-bearing animals, respectively (Fig. 2B). These differences were confirmed at the protein level by IFN-γ capture assays and intracellular IFN-γ staining (Fig. 2C). As in T lymphocytes activation-induced anergy may be overcome by stimulation of TLR, we treated freshly isolated NK cells with CpG-oligonucleotide (CpG-ODN) 1668, a stimulatory TLR9 ligand.

Further, we point out that apoptosis is also observed in the earl

Further, we point out that apoptosis is also observed in the early phase of endotoxin stimulation. Therefore, apoptosis seems to be present independently of the time of LPS stimulation. This statement can also be applied to tracheobronchial epithelial cells. In a previous work from our group, we were able to demonstrate that the intrinsic apoptosis pathway is activated at 24 h of LPS stimulation [10]. Results

of the current study show that the process of apoptosis is already initiated at earlier time-points upon stimulation with LPS. In accordance with epithelial cells, alveolar macrophages experience the same process of apoptosis, with increased activity of caspase-3 in acute and subacute situations of LPS exposure. Another study underlining these findings was performed by Bingisser et al. [17]. This group showed that LPS induced selleck chemicals llc the apoptosis rate only of human alveolar macrophages,

but not cytokines. An important aspect of apoptosis in epithelial cells of the respiratory compartment, and in alveolar macrophages is the cellular signalling pathway. While tracheobronchial epithelial cells undergo apoptosis over the intrinsic pathway, intrinsic and extrinsic signalling is activated in alveolar macrophages. For alveolar epithelial cells the pathway is not clear, as neither caspases-8 nor find more -9, respectively, are involved. Further experiments need to be performed to determine the exact pathway in these cells. A possible explanation might be the modification of the cell line compared to primary culture of alveolar epithelial cells. Interestingly, while no change in caspase-3 activity of neutrophils was detected at 4 h of LPS stimulation, it decreased significantly

at 8 h. At the time-point of subacute injury at 24 h, however, a fivefold increase of apoptosis rate was detected. These results are in accordance with previous studies. Upon stimulation with various concentrations of LPS (1–100 ng/ml), apoptosis rate decreased concentration-dependently after 12 h of stimulation [18]. Hirata et al. also found a depressed apoptosis rate in neutrophils upon LPS stimulation [19]. A study performed in patients with severe sepsis showed Farnesyltransferase that spontaneous neutrophil apoptosis seemed to be inhibited in these patients compared to healthy volunteers [20]. Keel et al. isolated neutrophils from healthy humans and patients with severe sepsis and stimulated them with LPS for 16 h, showing a decrease in apoptosis rate in neutrophils from healthy individuals, while apoptosis did not change upon stimulation in neutrophils from septic patients. In a model of ALI, induced by intravascular injection of oleic acid to simulate pulmonary fat embolism-induced ALI, a massive neutrophil response at 1 and 4 h following oleic acid injection was found in the lung, without any evidence of apoptosis [21].

Despite the large geographic distance between Angola and the othe

Despite the large geographic distance between Angola and the other known locations of MVD, phylogenetic analysis using the complete viral genome sequences put Angolan strains within the same clade as the majority of east African isolates [22]. Whereas CFR for MVD are variable (Table 2), the MARV-Angola strain is thought to be more pathogenic than other MARV strains such as the Musoke strain [23-25]. There has been an increase in EVD outbreaks in Africa, probably as result of increased contact between humans and wildlife because of extensive deforestation, hunting and mining [14]. Ebolavirus species have complete genome sequence divergence of 30–45% [7]. The

CFRs of the different ebolavirus species causing these EVD outbreaks have Ibrutinib nmr also varied (Table 3). Ebola virus representing the species Zaire ebolavirus can cause sporadic infections in humans, usually resulting in self-limiting outbreaks [26]. The genetic diversity between EBOV strains so far isolated is low [27]. For instance, two separate outbreaks caused by EBOV occurred in Luebo in the DRC in 2007 and 2008: the sequences of the viruses in these two outbreaks were almost identical and related to previously isolated strains, including the one causing the first reported outbreak in Yambuku in the DRC in 1976 [28]. Most recently, there was an outbreak of hemorrhagic fever

caused SCH772984 chemical structure by EBOV in the West African countries of Guinea, Liberia and Sierra Leone. Full genome sequences of EBOV from three patients showed 97% nucleotide

sequence identity to DRC and Gabon strains of EBOV [29, 30]. TAFV, an ebolavirus belonging to a different species (namely, Taï Forest ebolavirus) FER has been found in the Taï Forest, Côte d’Ivoire [6]; however, the outbreak in West Africa was the first ever reported incidence of EBOV infection in this region [31]. In the 2001–2004 EVD outbreaks in the RC and Gabon, nonhuman primates were also affected by EBOV infections, a large decline occurring in their populations just before and during the outbreaks in humans in the same area [10, 32]. A large serological survey during the 2001–2002 outbreak in Gabon found that dogs might be asymptomatically infected with EBOV, probably as a result of eating infected carcasses or licking body fluids from infected patients, and might potentially transmit EBOV infections [33]. As opposed to EBOV, SUDV, representing the species Sudan ebolavirus, is much more confined geographically, all outbreaks having occurred within a 640 km range [27]. Genetic diversity between the different SUDV strains is very low [27]. In 2011, 7 years after its last appearance, there was a fatal case of SUDV infection in Uganda; the full-length genome sequence of the isolate showed 99.3% identity to the one that caused the Gulu outbreak in 2000 [34].

Results:  The percentage of CD4+CD25+Foxp3+ cells within the CD4+

Results:  The percentage of CD4+CD25+Foxp3+ cells within the CD4+ cell population did not significantly alter at different time points post-transplant. However, the percentage of

CD4+CD25+Foxp3+ cells within the CD4+ population was significantly lower in RTR compared with patients with ESRF. In contrast, RTR and ESRF had a similar percentage of CD4+CD25+ cells expressing Foxp3. Multivariate analysis of PBL and clinical parameters demonstrated (i) a positive linear relationship https://www.selleckchem.com/autophagy.html between the percentage CD4+CD25+ cells expressing Foxp3 and estimated glomerular filtration rate and (ii) a higher percentage of CD4+CD25+ cells in the CD4+ cell population in patients with malignancy (the majority were skin cancers). Malignancy also correlated strongly with time post-transplant and age of the RTR. Conclusion:  Immune monitoring of the PBL phenotype in RTR using CD4, CD25 and Foxp3 may stratify RTR and predict graft outcome and function, and risk of complications from immunosuppression. Longitudinal and functional studies of Tregs are essential to extend the findings of the present study. “
“Chronic kidney disease (CKD) has emerged as a global public health burden. Taiwan has Palbociclib the highest incidence and prevalence rates of end-stage renal disease (ESRD)

in the world. In this review, the following key issues of CKD in Taiwan are addressed: epidemiological data, underlying diseases patterns, risk factors, public health concerns and a preventive project. Prevalence of CKD are reported to be 6.9% for CKD stage 3–5, 9.83% L-NAME HCl for clinically recognized CKD and 11.9% for CKD stage 1–5. However, overall awareness of CKD is low, 9.7% for CKD stage 1–3 and 3.5% for stage 1–5. Diabetes mellitus (43.2%), chronic glomerulonephritis

(25.1%), hypertension (8.3%) and chronic interstitial nephritis (2.8%) are four major underlying renal diseases of ESRD. Older age, diabetes, hypertension, smoking, obesity, regular use of herbal medicine, family members (both relatives and spouses), chronic lead exposure and hepatitis C are associated with higher risk for CKD. Impact of CKD increases risk of all-cause mortality and cardiovascular diseases, especially in those with overt proteinuria and advanced CKD stages. These impacts lead to increased medical costs. The nationwide CKD Preventive Project with multidisciplinary care program has proved its effectiveness in decreasing dialysis incidence, mortality and medical costs. It is crucially significant from Taiwan experience on CKD survey and preliminary outcome of the preventive project. Provision of a more comprehensive public health strategy and better care plan for CKD should be achieved by future international collaborative efforts and research.

These circulating AGE can deposit in the kidney and cause cellula

These circulating AGE can deposit in the kidney and cause cellular dysfunction and renal damage. Elevated serum and urine levels of the AGE pentosidine can be detected

by HPLC or ELISA and help to predict the development of diabetic nephropathy.17 In addition, plasma levels of pentosidine have been shown to increase with loss of residual renal function in patients on peritoneal dialysis and to decrease with patients recovering renal function after transplantation.19,20 The excretion rate of albumin is the most commonly used biomarker of renal injury. Albumin is the most abundant protein in the circulation and during normal kidney function very little intact albumin is excreted by the kidney (<30 mg/day in humans). However, following renal injury, glomerular filtration of albumin is increased and the selleck chemicals llc reabsorption and degradation of albumin by tubules are decreased, resulting check details in increased levels of intact albumin in the urine (i.e. albuminuria). Patient albuminuria is usually classified by ranges of severity, which are: microalbuminuria (30–300 mg/day), macroalbuminuria (300 mg–3 g/day) and nephritic range albuminuria (>3 g/day). Albuminuria is commonly used as

an early marker of renal injury because it often precedes a decline in renal function. However, it cannot distinguish different types of proteinuric kidney disease and has a limited ability to predict disease progression and determine therapeutic efficacy. Albuminuria is commonly measured by immunological

techniques, which include: immunonephelometry, immunoturbidimetry, radioimmunoassay and ELISA.21 These techniques are good for assessing albumin excretion, which is distinctly higher than normal. However, newer HPLC-based methods (e.g. the Accumin Test) can identify both immunoreactive and non-immunoreactive albumin providing greater sensitivity than conventional immunological methods for distinguishing microalbuminuria from normal PAK5 albumin excretion.22,23 Podocyte injury is a feature of many kidney diseases that is postulated to increase glomerular filtration of albumin. Severely damaged podocytes can detach from the glomerular basement membrane and be collected in the urine sediment. Analysis of the urine sediment by quantitative PCR or ELISA can determine mRNA or protein levels of podocyte-specific molecules (e.g. nephrin, podocin, podocalyxin) as markers of podocyte injury. Increased urine sediment levels of nephrin and podocin have been detected in patients with diabetic nephropathy and active lupus nephritis.24,25 Similarly, increased levels of podocalyxin have been found in the urine sediment of patients with IgA nephropathy, lupus nephritis and post-streptococcal glomerulonephritis.26 Sensitive markers of tubular injury have been identified in acute and CKD. N-acetyl-beta-D-glucosaminidase is a proximal tubular lysosomal enzyme, which is released during damage to proximal tubules.