Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan.
Mackay Junior College of Medicine, Nursing and Management, 11260 Taipei, Taiwan.
Int J Mol Sci. 2020 Feb 13;21(4):1257. doi: 10.3390/ijms21041257.
Indoxyl sulphate (IS) and p-cresyl sulphate (PCS) are two protein bound uraemic toxins accumulated in chronic kidney disease (CKD) and associated with adverse outcomes. The purpose of this study isto evaluate the effect of the new activated charcoal, CharXgen, on renal function protection and lowering serum uraemic toxins in CKD animal model. The physical character of CharXgen was analyzed before and after activation procedure by Scanning Electron Microscope (SEM) and X-ray diffractometer (XRD). The effect of CharXgen on biochemistry and lowering uremic toxins was evaluated by in vitro binding assay and CKD animal model. CharXgen have high interior surface area analyzed by SEM and XRD and have been produced from local bamboo after an activation process. CharXgen was able to effectively absorb IS, p-cresol and phosphate in an in vitro gastrointestinal tract simulation study. The animal study showed that CharXgen did not cause intestine blackening. Serum albuminand liver function did not change after feeding with CharXgen. Moreover, renal function was improved in CKD rats fed with CharXgen as compared to the CKD group, and there were no significant differences in the CKD and the CKD + AST-120 groups. Serum IS and PCS were higher in the CKD group and lower in rats treated with CharXgen and AST-120. In rats treated with CharXgen, Fibroblast growth factor 23 was significantly decreased as compared to the CKD group. This change cannot be found in rats fed with AST-120.It indicates that CharXgen is a new safe and non-toxic activated charcoal having potential in attenuating renal function deterioration and lowering protein-bound uraemic toxins. Whether the introduction of this new charcoal could further have renal protection in CKD patients will need to be investigated further.
硫酸吲哚酚（IS）和对甲酚硫酸盐（PCS）是两种在慢性肾脏病（CKD）中蓄积的蛋白结合尿毒症毒素，与不良结局相关。本研究旨在评估新型活性炭 CharXgen 对 CKD 动物模型肾功能保护和降低血清尿毒症毒素的作用。通过扫描电子显微镜（SEM）和 X 射线衍射仪（XRD）分析 CharXgen 活化前后的物理特性。通过体外结合试验和 CKD 动物模型评估 CharXgen 对生化和降低尿毒症毒素的作用。CharXgen 的 SEM 和 XRD 分析结果表明其具有较高的内表面积，且经过活化过程后由当地竹子制成。CharXgen 能够在体外胃肠道模拟研究中有效吸附 IS、对甲酚和磷酸盐。动物研究表明，CharXgen 不会导致肠道变黑。给予 CharXgen 后血清白蛋白和肝功能没有变化。此外，与 CKD 组相比，给予 CharXgen 的 CKD 大鼠肾功能得到改善，而 CKD 组和 CKD+AST-120 组之间没有显著差异。与 CKD 组相比，CharXgen 治疗组大鼠血清 IS 和 PCS 升高，而 AST-120 治疗组大鼠血清 IS 和 PCS 降低。与 CKD 组相比，CharXgen 治疗组大鼠成纤维细胞生长因子 23 显著降低，而 AST-120 治疗组大鼠未发现此变化。这表明 CharXgen 是一种新型安全无毒的活性炭，具有减轻肾功能恶化和降低蛋白结合尿毒症毒素的潜力。这种新型活性炭的引入是否能进一步在 CKD 患者中发挥肾脏保护作用，还需要进一步研究。
