A growing body of research showed that diet management, such as promoting protein and vitamin intake and food restriction play a crucial role in extending time to morbidity and mortality in patients undergoing hemodialysis. However, the current dietary recommendations in nutrition guidelines lack examination of cultural factors. The study aimed to understand the diet influenced by culture in Chinese patients undergoing hemodialysis. Semi-structured interviews were conducted for 23 patients, aged 23-75 years, undergoing hemodialysis in a local tertiary hospital. Interview questions mainly focused on patients' real experience about diet, and their perceptions and attitudes toward diet. Each interview was digitally recorded, and conventional content analysis was used to attain information. The majority of patients reserved Chinese traditional dietary habits about salt and calcium intake. Although Chinese herbal medicine was not consumed, dietary therapy including brown sugar and dates was included in the participants' diet. Eggs, broth, and seafood were three prominent preferences and taboos profoundly impacted by culture. Additionally, Chinese social culture influenced patients' dietary behavior of eating at home and knowledge attainment. Diet in Chinese patients undergoing hemodialysis was still strongly influenced by culture. Culturally sensitive interventions regarding the improvement of diet intake are urgently needed.

OBJECTIVE This study aimed to investigate the effects of prostaglandin E2 receptor subtypes 1 (EP1) and 2 (EP2) on endoplasmic reticulum (ER) stress induced by TGF-β1 in mouse mesangial cells (MCs) and to explore its potential mechanisms. MATERIALS AND METHODS Mouse mesangial cells were isolated and cultured. EP-siRNAs were transfected into mesangial cells for silencing EP1 and EP2. Mesangial cell proliferation was assessed by the CCK-8 method. Expression of PGE2 was measured by enzyme-linked immunosorbent assay (ELISA). GRP78, TRPC1, ERK1/2, and phospho-ERK1/2 levels were examined by Western blot. RESULTS TGF-β1 induced mesangial cell proliferation and increased PGE2 secretion. Besides, TGF-β1 significantly upregulated GRP78 and TRPC1 expression at the protein level. Phospho-ERK1/2 protein amounts were also increased (p<0.05). Compared with the TGF-β1 group, cell proliferation in the EP1-siRNA+TGF-β1 group was reduced, while GRP78, TRPC1, and ERK1/2 protein amounts were downregulated (p<0.05). EP1 agonist significantly enhanced above changes and their activities (p<0.05). EP1 antagonist significantly attenuated the above changes (p<0.05). Compared with TGF-β1 group, cell proliferation in EP2-siRNA+TGF-β1 group was increased, while GRP78, TRPC1, and ERK1/2 protein amounts were increased (p<0.05). EP2 agonist significantly attenuated the above changes (p<0.05). CONCLUSIONS EP1 receptor may increase TGF-β1-induced cell damage by increasing the activities of GRP78, TRPC1, and ERK1/2 via ER stress. Meanwhile, the EP2 receptor may reduce TGF-β1-induced cell damage by suppressing GRP78, TRPC1, and ERK1/2 activities, also via ER stress. EP1 inhibition and EP2 stimulation may be a therapeutic option for delaying renal fibrosis.

The article "Lixisenatide protects doxorubicin-induced renal fibrosis by activating wNF-κB/TNF-α and TGF-β/Smad pathways", by N.-F. Guo, Y.-J. Cao, X. Chen, Y. Zhang, Y.-P. Fan, J. Liu, X.-L. Chen published in Eur Rev Med Pharmacol Sci 2019; 23 (9): 4017-4026. DOI: 10.26355/eurrev_201905_17832-PMID: 31115031 has been retracted by the Editor in Chief for the following reasons: This paper has been questioned on PubPeer (https://pubpeer.com/publications/983F02C9C18817139AE18497C359FA). In particular, concerns were raised about Figures 2A and 5A as the figures result to overlap with previously published papers. The Editorial Office has contacted the corresponding author of the article to provide a reply to the comments on PubPeer and check the raw data. Still, the journal has yet to receive a reply. Therefore, considering the comments released on PubPeer and the lack of response from authors, the Editor in Chief no longer relies on the data presented and decided to withdraw the manuscript. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/17832.

Introduction: Exercise is recommended for patients undergoing hemodialysis to decrease morbidity and mortality. However, their exercise level is lower than healthy people. Understanding reasons behind their sedentary lifestyle is required. Traditional Chinese culture may have a profound impact on patients' perceptions of exercise, particularly with regard to the relationship of overwork and kidney function and family members' attitudes toward patients' participation in exercise. Therefore, we sought to explore the facilitators and barriers to exercise influenced by traditional Chinese culture. Methods: We conducted semistructured interviews with 44 Chinese patients residing in Nantong of Jiangsu Province undergoing hemodialysis, aged 25 to 77 years. Interview questions focused on their perceptions of, attitudes to, and experiences with exercise. Each interview was digitally recorded and lasted from 40 to 60 minutes. Conventional content analysis was used to understand facilitators and barriers to exercise within their experience and perceptions. Findings: We found that specific Chinese cultural health beliefs informed by traditional Chinese medicine strongly affected patients' attitudes and behaviors toward exercise. Participants in this study tended to believe that overwork impairs kidney functions and viewed strenuous exercise as overwork. Although participants admitted the benefits of exercise, they rejected strenuous exercise and regarded nearly all modalities of exercise with or without facilities (except walking) as strenuous exercise. The most common barriers to exercise were lack of motivation, bad weather, negative attitudes of family members toward patients' doing exercise, and insufficient exercise information resources. The most common facilitators found in this study were their increased physical well-being and confidence from exercise. Group exercise supported by family members and positive attitudes toward obtaining exercise information were also motivators. Discussion: Chinese patients undergoing hemodialysis reported more barriers than facilitators to exercise. Perceptions and attitudes toward exercise informed by traditional Chinese culture may be hidden barriers to exercising. Our findings indicated that culturally sensitive and patient-centered exercise interventions for Chinese patients are urgently needed.

Background: The prostaglandin E2 (PGE2) and its receptor subtypes 2 and 4 (EP2 and EP4) in mesangial cells (MCs) proliferation and glomerulosclerosis hasn’t been elaborated in detailed. Methods: We cultured EP2-/-, EP4flox/flox, and WT mice mesangial cells to detect the relevant indicators and downstream signalling. Additionally, 5/6 nephrectomy were introduced to confirm the in vitro outcomes. Results: We found that the expression of fibronectin (FN), COX-2 and the phosphorylation level of Smad3 in group EP2-/- obviously increased, with the falling of cyclic adenosine monophosphate (cAMP) level and no protein kinase (PKA) activity. While the relevant genes decreased in EP4 knock out (EP4flox/flox + AD-CRE) group, which represent no significant change in the level of cAMP, although with high level of PKA activity and extracellular signal transduction kinase (ERK) phosphorylation. In vivo study, 24-hour proteinuria, serum creatinine and urea nitrogen in EP4+/- group obviously declined, and the degree of glomerular sclerosis and the density of FN and COX-2 in glomerulus reduced significantly. EP2-/- show a totally opposite event to EP4+/- . Conclusion: EP2 receptor mainly depends on cAMP/PKA to inhibit effect of PGE2 induced by TGF-β1/Smad3 pathway and further alleviate the damage of MCs. While EP4 may coordinate the effect of MCs injury through ERK phosphorylation. Our finding suggests the pleiotropic functions of PGE2, and thus explores a potential therapy on the level of gene mediation.