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Correction of hyperoxaluria by liver repopulation with hepatocytes in a mouse model of primary hyperoxaluria type-1.
[primary hyperoxaluria type 1]
Primary
hyperoxaluria
type
-
1
(
PH
1
)
is
an
autosomal
recessive
disease
characterized
by
excessive
oxalate
production
by
hepatocytes
caused
by
the
deficiency
of
peroxisomal
alanine-glyoxylate
aminotransferase
(
AGT
)
activity
.
Persistent
hyperoxaluria
causes
nephrocalcinosis
and
urolithiasis
,
leading
to
renal
failure
,
followed
by
tissue
oxalosis
with
life-threatening
complications
.
Combined
liver
-kidney
transplantation
is
the
only
definitive
treatment
of
PH
1
.
Hepatocyte
transplantation
,
which
is
much
less
invasive
,
could
have
offered
an
attractive
alternative
.
However
,
because
the
AGT
-
deficient
hepatocytes
overproduce
oxalate
,
a
large
fraction
of
the
mutant
host
hepatocytes
must
be
replaced
by
AGT
-competent
cells
,
which
is
beyond
the
capacity
of
current
hepatocyte
transplantation
procedures
.
Here
,
we
have
evaluated
a
preparative
irradiation-based
method
of
liver
repopulation
in
an
Agxt-deleted
mouse
model
of
PH
1
(
Agxt-
/
-
)
.
Hepatocytes
(
10
(
6
)
viable
cells
)
isolated
from
congeneic
mice
(
[
ROSA
]
26
C
5
7
BL
/
6
J
)
expressing
Escherichia
coli
beta
-galactosidase
were
transplanted
into
Agxt-
/
-
mice
by
intrasplenic
injection
.
The
preparative
regimen
consisted
of
X-
irradiation
of
the
host
liver
and
mitotic
stimulation
of
the
hepatocytes
by
adenovector-based
expression
of
hepatocyte
growth
factor
.
T
he
procedure
resulted
in
progressive
replacement
of
the
mutant
host
hepatocytes
with
the
AGT
-competent
hepatocytes
,
leading
to
correction
of
urinary
oxalate
excretion
.
Oral
ethylene
glycol
challenge
(
0
.
7
%
for
1
week
)
resulted
in
nephrocalcinosis
and
microlithiasis
in
untreated
Agxt-
/
-
mice
,
but
not
in
the
mice
after
hepatic
repopulation
.
The
results
indicate
that
hepatocyte
transplantation
after
appropriate
preparative
regimens
may
permit
sufficient
repopulation
of
the
liver
to
ameliorate
hyperoxaluria
,
and
therefore
should
be
evaluated
further
as
a
potential
treatment
of
PH
1
.
Diseases
Validation
Diseases presenting
"nephrocalcinosis"
symptom
cystinuria
familial hypocalciuric hypercalcemia
primary hyperoxaluria type 1
This symptom has already been validated