Exploring ex vivo modulation of fibrosis in discarded human donor kidneys

Pamplona, C. C.; Bergada, C. B.; Jaynes, C. L.; Hamelink, T. L.; Lantinga, V. A.; Ogurlu, B.; Ottens, P. J.; van Hateren, K.; Hillebrands, J.-L.; Olinga, P.; Touw, D. J.; Leuvenink, H. G. D.; Moers, C.; van Leeuwen, L. L.

doi:10.1101/2025.07.31.667749

bioRxiv · 10.1101/2025.07.31.667749

Exploring ex vivo modulation of fibrosis in discarded human donor kidneys

Pamplona, C. C.·Bergada, C. B.·Jaynes, C. L.·Hamelink, T. L.·Lantinga, V. A.·Ogurlu, B.·Ottens, P. J.·van Hateren, K.·Hillebrands, J.-L.·Olinga, P.·Touw, D. J.·Leuvenink, H. G. D.·Moers, C.·van Leeuwen, L. L.

View original source ↗Export metadata ↓

Abstract

IntroductionEarly-onset fibrosis limits kidney transplant success. Normothermic machine perfusion (NMP) offers a platform for targeted drug delivery directly to isolated organs, minimizing systemic effects. This study evaluated the long-term anti-fibrotic efficacy and safety of galunisertib in discarded human kidneys perfused ex vivo. MethodsTwelve discarded human kidneys underwent 4 hours of oxygenated hypothermic perfusion followed by 6 hours of NMP with galunisertib or vehicle (n=6). Precision-cut kidney slices (PCKS) were then cultured for 48 hours with either continued or discontinued galunisertib exposure. Endpoints included fibrosis-related mRNA expression and pharmacokinetics. ResultsGalunisertib did not negatively affect renal function during NMP. Continued exposure in PCKS significantly attenuated fibrosis-related mRNA expression, including SERPINE1 (p=0.0046), TGF-{beta} (p=0.0168), FN1 (p=0.0269) and ACTA2 (p=0.0014) after 48 hours. The discontinuation of treatment did not exhibit the same anti-fibrotic effects. ConclusionGalunisertib was safely administered during NMP and steadily excreted via the urine. NMP showed to be a promising platform for safe targeted anti-fibrotic therapy delivery, offering potential to improve graft quality. When treatment was sustained, galunisertib induced a modest reduction in fibrosis-related mRNA expression over 48 hours of tissue incubation. Further studies are needed to optimize delivery strategies and evaluate the impact of prolonged therapeutic exposure.

Explore related subjects

pharmacology and toxicology Preprint

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

Pamplona, C. C., Bergada, C. B., Jaynes, C. L., Hamelink, T. L., Lantinga, V. A., Ogurlu, B., Ottens, P. J., van Hateren, K., Hillebrands, J.-L., Olinga, P., Touw, D. J., Leuvenink, H. G. D., Moers, C., van Leeuwen, L. L.. 2025-08-02. Exploring ex vivo modulation of fibrosis in discarded human donor kidneys. https://doi.org/10.1101/2025.07.31.667749

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related preprints

bioRxiv2026

Protective effects of heat shock protein 70 induction against global warming by using oriental bezoar and ginseng

The interest in compounds that protect against heat stress-induced damage has been heightened due to world global warming. We found the protective effects of a Japanese natural drug named BG, containing oriental bezoar and ginseng, against heat stress in Drosophila. BG suppressed the heat-induced shortened lifespan and reduced fertility in Drosophila. Interestingly, the protective effects of BG against heat stress were abolished in heat shock protein 70 (HSP70) mutant flies. To see the protective effects in humans, we applied BG on the cytotoxicity in heat-stressed human hepatic cell line, HepG2. BG suppressed heat stress-induced cytotoxicity at 43{degrees}C, and increased HSP70 and heat shock factor 1 (HSF1) mRNA expression in HepG2 cells. These findings indicate that BG protects against heat stress-induced damage via the HSF1/HSP70 pathway and has potential as a therapeutic agent for heat stress-induced disorders, including heatstroke even in human.

pharmacology and toxicology↗

bioRxiv2026

Replacing In Vivo Experiments for PK/PD Target Determination Through In Vitro Time-Kill Experiments and PK/PD Modelling Incorporating Inter-strain Variability: Application to Meropenem Against Pseudomonas aeruginosa

Background. Optimal antibiotic dosing regimens depend on the pharmacokinetic/pharmacodynamic (PK/PD) index that best predicts antibacterial efficacy. PK/PD targets are traditionally determined using murine infection models based on a limited number of bacterial isolates. Objective. This study aimed to investigate whether animal experiments could be replaced by in vitro time-kill experiments performed on a large collection of clinical isolates and analyzed using a modelling approach accounting for inter-strain variability. The proposed framework was evaluated using meropenem against Pseudomonas aeruginosa. Materials and Methods. In vitro time-kill experiments were performed on 66 clinical isolates of P. aeruginosa. A population pharmacodynamic model was developed from experimental data. A murine pharmacokinetic model was reproduced from literature and combined with the pharmacodynamic model to simulate in vivo bacterial burden over time. The relationships between simulated bacterial counts at 24 h and the three main PK/PD indices (fCmax/MIC, fAUC/MIC and %fT>MIC) were characterized using nonlinear mixed-effects Imax models. Results. The PK/PD index showing the strongest correlation with meropenem efficacy at 24 h was %fT>MIC (R2 = 0.989), compared with fAUC/MIC (R2 = 0.373) and fCmax/MIC (R2 = 0.284). These findings are consistent with previous studies using murine thigh infection models. The %fT>MIC target required to achieve a 2-log CFU reduction was estimated at 44%, with substantial inter-strain variability (10th and 90th percentiles: 27% and 71%, respectively). Conclusions. Using meropenem against P. aeruginosa as a proof of concept, we demonstrate that in vitro time-kill experiments combined with pharmacometric modelling can identify the same PK/PD efficacy targets as animal infection models. Moreover, performing experiments on a large panel of clinical isolates enables the quantification of inter-strain variability in PK/PD targets, providing information that may improve their translation to clinical dosing optimization.

pharmacology and toxicology↗

bioRxiv2026

Physicochemical compatibility and stability of urapidil-propofol admixtures during simulated Y-site Administration

Background/Objectives: Urapidil with propofol is clinically efficient against elevated blood pressure during sedation. However, their physicochemical compatibility and emulsion stability upon continuous infusion remain unclear. This study aimed to evaluate different mixing ratios and diluents, thereby proving the safety limits for their co-administration. Methods: Urapidil solutions prepared with either sodium chloride (NS) or glucose injection (GS), and emulsified with propofol at different ratios (v/v), were stored for 12 h. Physical compatibility was assessed by visual inspection, pH, osmolality, mean droplet diameter (MDD), polydispersity index (PDI), zeta potential, and percentage of fat globules larger than 5 m (PFAT5). Chemical stability was quantified using high-performance liquid chromatography. Results: pH and osmolality stabilized. Urapidil hydrochloride and propofol contents remained pure at > 95%, MDD was < 500 nm, and PDI was < 0.2. Urapidil proportion in NS was significantly negatively correlated with the zeta potential. PFAT5 was > 0.05% after 2-8 h. In contrast, in GS at a 1:2 ratio, PFAT5 remained < 0.05%, which increased slightly in the 1:1 group at 8 h. PFAT5 stabilized in the high-propofol group (10:1) under all conditions. Conclusions: The chemical compatibility of the admixture was acceptable after 12 h of storage. However, physical compatibility was influenced by the mixing ratio, diluent type, and storage time. For clinical Y-site co-administration, a 10:1 mixing ratio or dilution in 5% GS is recommended. Enhanced proportions must be mixed with NS, while continuous infusion time must be < 2 h to mitigate fat embolism risk.

pharmacology and toxicology↗