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2016 ; 6
(ä): 36618
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Metabolic alterations by indoxyl sulfate in skeletal muscle induce uremic
sarcopenia in chronic kidney disease
#MMPMID27830716
Sato E
; Mori T
; Mishima E
; Suzuki A
; Sugawara S
; Kurasawa N
; Saigusa D
; Miura D
; Morikawa-Ichinose T
; Saito R
; Oba-Yabana I
; Oe Y
; Kisu K
; Naganuma E
; Koizumi K
; Mokudai T
; Niwano Y
; Kudo T
; Suzuki C
; Takahashi N
; Sato H
; Abe T
; Niwa T
; Ito S
Sci Rep
2016[Nov]; 6
(ä): 36618
PMID27830716
show ga
Sarcopenia is associated with increased morbidity and mortality in chronic kidney
disease (CKD). Pathogenic mechanism of skeletal muscle loss in CKD, which is
defined as uremic sarcopenia, remains unclear. We found that causative
pathological mechanism of uremic sarcopenia is metabolic alterations by uremic
toxin indoxyl sulfate. Imaging mass spectrometry revealed indoxyl sulfate
accumulated in muscle tissue of a mouse model of CKD. Comprehensive metabolomics
revealed that indoxyl sulfate induces metabolic alterations such as upregulation
of glycolysis, including pentose phosphate pathway acceleration as antioxidative
stress response, via nuclear factor (erythroid-2-related factor)-2. The altered
metabolic flow to excess antioxidative response resulted in downregulation of TCA
cycle and its effected mitochondrial dysfunction and ATP shortage in muscle
cells. In clinical research, a significant inverse association between plasma
indoxyl sulfate and skeletal muscle mass in CKD patients was observed. Our
results indicate that indoxyl sulfate is a pathogenic factor for sarcopenia in
CKD.