601
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Simplified purification approach of urinary neutrophil gelatinase-associated lipocalin by tangential flow filtration and ion exchange chromatography. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1051:68-74. [PMID: 28324833 DOI: 10.1016/j.jchromb.2017.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/01/2017] [Accepted: 03/09/2017] [Indexed: 12/31/2022]
Abstract
This investigation reports a simplified approach for the purification of urinary siderocalin known as neutrophil gelatinase-associated lipocalin (NGAL). Urinary NGAL was purified by tangential flow filtration and ion exchange chromatography. Isolated NGAL was analyzed by SDS-PAGE, immunoblotting and mass spectrometry (MS). The relative molecular mass of NGAL is 23674Da. Peptide mass fingerprinting of the purified NGAL yielded peptides that partially matched with known sequence of P80188 (NGAL_HUMAN). The tryptic digestion profile of isolated NGAL infers that it may be unique and additive molecule in the dictionary of urinary proteins. This is the first report of purification and validation of urinary NGAL from large volume sample by using tangential flow filtration and peptide sequencing respectively. This cost-effective and simplified approach to purification of NGAL, together with the easy availability of urine sample makes the large-scale production of NGAL possible, allowing exploration of various bioclinical as well as biodiagnostic applications.
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602
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Milk fat globule-epidermal growth factor-factor VIII attenuates sepsis-induced acute kidney injury. J Surg Res 2017; 213:281-289. [PMID: 28601327 DOI: 10.1016/j.jss.2017.02.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/20/2016] [Accepted: 02/17/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Acute kidney injury (AKI) is most commonly caused by sepsis in critically ill patients, and it is associated with high morbidity and mortality. The pathophysiology of sepsis-induced AKI is generally accepted to include direct inflammatory injury, endothelial cell dysfunction, and apoptosis. Milk fat globule-epidermal growth factor-factor VIII (MFG-E8) is a secretory glycoprotein with a known role in the enhancement of apoptotic cell clearance and regulation of inflammation. We hypothesize that administration of recombinant mouse MFG-E8 (rmMFG-E8) can protect mice from kidney injuries caused by sepsis. METHODS Sepsis was induced in 8-wk-old male C57BL/6 mice by cecal ligation and puncture (CLP). rmMFG-E8 or phosphate-buffered saline (vehicle) was injected intravenously at a dosage of 20 μg/kg body weight at time of CLP (n = 5-8 mice per group). After 20 h, serum and renal tissue were harvested for various analyses. The renal injury markers blood urea nitrogen (BUN) and creatinine were determined by enzymatic and chemical reactions, respectively. The gene expression analysis was carried out by real-time quantitative polymerase chain reaction. RESULTS At 20 h after CLP, serum levels of BUN and creatinine were both significantly increased in the vehicle group compared with the sham group, whereas the mice treated with rmMFG-E8 had a significant reduction in BUN and creatinine levels by 28% and 24.1%, respectively (BUN: 197.7 ± 23.6 versus 142.3 ± 20.7 mg/dL; creatinine: 0.83 ± 0.12 versus 0.63 ± 0.06 mg/dL; P < 0.05). Expressions of novel biomarkers of renal tissue injury neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 were also significantly downregulated by 58.2% and 95%, respectively, after treatment with rmMFG-E8. Proinflammatory cytokine interleukin-6 and tumor necrosis factor-α messenger RNA (mRNA) were significantly reduced by 50.8% and 50.3%, respectively, in rmMFG-E8-treated mice compared with vehicle-treated mice. The mRNA levels of the chemokines keratinocyte chemoattractant and macrophage inhibitory protein-2 were reduced by 85.1% and 78%, respectively, in mice treated with rmMFG-E8 compared with the vehicle mice. In addition, the expression of intercellular cell adhesion molecule-1 and platelet endothelial cell adhesion molecule-1 (PECAM-1/CD31) mRNA was downregulated by 35.6% and 77.8%, respectively, in rmMFG-E8-treated mice compared with the vehicle animals (P < 0.05). CONCLUSIONS Treatment with rmMFG-E8 reduces renal tissue injury induced by sepsis through inhibiting the production of proinflammatory cytokines and chemokine, as well as through the activation of endothelial cells. Thus, MFG-E8 may have a therapeutic potential for treating AKI induced by sepsis.
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603
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Heidari-Soreshjani S, Asadi-Samani M, Yang Q, Saeedi-Boroujeni A. Phytotherapy of nephrotoxicity-induced by cancer drugs: an updated review. J Nephropathol 2017; 6:254-263. [PMID: 28975109 PMCID: PMC5607991 DOI: 10.15171/jnp.2017.41] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 01/27/2017] [Indexed: 12/15/2022] Open
Abstract
Context:
Kidney is one of the vital organs maintaining homeostasis of body and thus
dysfunction of kidney affects quality of life and health severely. Anticancer drugs,
particularly chemotherapeutic agents, cause high toxicity leading kidney dysfunction
and irreparable kidney injury. Therefore, attention has recently been paid to seeking out
alternatives such as nature-based drugs that are effective but less toxic. In this regard, this
systematic review article is to report and introduce the most important medicinal plants
and their derivatives that are used to reduce anticancer drug-induced nephrotoxicity.
Evidence Acquisitions: The word nephrotoxicity alongside the words cancer or chemotherapy
in combination with some herbal terms such as medicinal plant, plants, herbs, and extracts
were administered to search for relevant publications indexed in PubMed.
Results:
According to this study, 16 medicinal plants, 12 plant-based derivatives, and three
traditional plant-based formulations were found to help control and modulate anticancer
drug-induced nephrotoxicity indices.
Conclusions:
Anticancer drugs cause nephrotoxicity through activating pathways of oxidative
stress, damage-associated molecular patterns (DAMPs) production, inflammatory
processes, and cell apoptosis, while medicinal plants and their derivatives can cause
reduction in nephrotoxicity and anticancer drugs side effects via their antioxidant and
anti-inflammatory properties.
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Affiliation(s)
| | - Majid Asadi-Samani
- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Qian Yang
- Institute of Pharmacy and Molecular Biotechnology, University of Heidelberg, Heidelberg, Germany
| | - Ali Saeedi-Boroujeni
- Department of Immunology, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
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604
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Tsai HH, Yen RF, Lin CL, Kao CH. Increased risk of dementia in patients hospitalized with acute kidney injury: A nationwide population-based cohort study. PLoS One 2017; 12:e0171671. [PMID: 28192452 PMCID: PMC5305096 DOI: 10.1371/journal.pone.0171671] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 01/09/2017] [Indexed: 12/20/2022] Open
Abstract
Purpose To determine whether acute kidney injury (AKI) is a risk factor for dementia. Methods This nationwide population-based cohort study was based on data from the Taiwan National Health Insurance Research Database for 2000–2011. The incidence and relative risk of dementia were assessed in 207788 patients hospitalized for AKI. The comparison control was selected using the propensity score based on age, sex, index year and comorbidities. Results During the 12-year follow-up, patients with AKI had a significantly higher incidence for developing dementia than did the controls (8.84 vs 5.75 per 1000 person-y). A 1.88-fold increased risk of dementia (95% confidence interval, 1.76–2.01) was observed after adjustment for age, sex, and several comorbidities (diabetes, hypertension, hyperlipidemia, head injury, depression, stroke, chronic obstructive pulmonary disease, coronary artery disease, congestive heart failure, atrial fibrillation, cancer, liver disease, chronic infection/inflammation, autoimmune disease, malnutrition). Conclusions We found that patients with AKI exhibited a significantly increased risk of developing dementia. This study provides evidence on the association between AKI and long-term adverse outcomes. Additional clinical studies investigating the related pathways are warranted.
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Affiliation(s)
- Hsin-Hsi Tsai
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- * E-mail:
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605
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Rider SA, Christian HC, Mullins LJ, Howarth AR, MacRae CA, Mullins JJ. Zebrafish mesonephric renin cells are functionally conserved and comprise two distinct morphological populations. Am J Physiol Renal Physiol 2017; 312:F778-F790. [PMID: 28179256 DOI: 10.1152/ajprenal.00608.2016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/17/2017] [Accepted: 02/01/2017] [Indexed: 12/20/2022] Open
Abstract
Zebrafish provide an excellent model in which to assess the role of the renin-angiotensin system in renal development, injury, and repair. In contrast to mammals, zebrafish kidney organogenesis terminates with the mesonephros. Despite this, the basic functional structure of the nephron is conserved across vertebrates. The relevance of teleosts for studies relating to the regulation of the renin-angiotensin system was established by assessing the phenotype and functional regulation of renin-expressing cells in zebrafish. Transgenic fluorescent reporters for renin (ren), smooth muscle actin (acta2), and platelet-derived growth factor receptor-beta (pdgfrb) were studied to determine the phenotype and secretory ultrastructure of perivascular renin-expressing cells. Whole kidney ren transcription responded to altered salinity, pharmacological renin-angiotensin system inhibition, and renal injury. Mesonephric ren-expressing cells occupied niches at the preglomerular arteries and afferent arterioles, forming intermittent epithelioid-like multicellular clusters exhibiting a granular secretory ultrastructure. In contrast, renin cells of the efferent arterioles were thin bodied and lacked secretory granules. Renin cells expressed the perivascular cell markers acta2 and pdgfrb Transcriptional responses of ren to physiological challenge support the presence of a functional renin-angiotensin system and are consistent with the production of active renin. The reparative capability of the zebrafish kidney was harnessed to demonstrate that ren transcription is a marker for renal injury and repair. Our studies demonstrate substantive conservation of renin regulation across vertebrates, and ultrastructural studies of renin cells reveal at least two distinct morphologies of mesonephric perivascular ren-expressing cells.
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Affiliation(s)
- Sebastien A Rider
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, Little France, The University of Edinburgh, Edinburgh, United Kingdom;
| | - Helen C Christian
- Department of Physiology, Anatomy and Genetics, Oxford, United Kingdom; and
| | - Linda J Mullins
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, Little France, The University of Edinburgh, Edinburgh, United Kingdom
| | - Amelia R Howarth
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, Little France, The University of Edinburgh, Edinburgh, United Kingdom
| | - Calum A MacRae
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - John J Mullins
- University/British Heart Foundation Centre for Cardiovascular Science, The Queen's Medical Research Institute, Little France, The University of Edinburgh, Edinburgh, United Kingdom
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606
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Affiliation(s)
- Pedro A Villablanca
- Division of Cardiovascular Diseases Montefiore Medical Center/Albert Einstein College of Medicine New York, NY
| | - Harish Ramakrishna
- Division of Cardiovascular and Thoracic Anesthesiology Mayo Clinic College of Medicine Scottsdale, AZ
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607
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Dickerson VM, Rissi DR, Brown CA, Brown SA, Schmiedt CW. Assessment of Acute Kidney Injury and Renal Fibrosis after Renal Ischemia Protocols in Cats. Comp Med 2017; 67:56-66. [PMID: 28222840 PMCID: PMC5310626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 06/21/2016] [Accepted: 07/14/2016] [Indexed: 06/06/2023]
Abstract
In an attempt to identify a feline model of acute or chronic kidney disease, this study was designed to evaluate the effects of 15 or 30 min of bilateral renal ischemia (RI) and 60 min of unilateral RI with delayed contralateral nephrectomy as models of acute kidney injury and chronic interstitial fibrosis in cats. Adult, purpose-bred, USDA Class A cats (n = 14) were randomly assigned to receive bilateral RI for 15 min (n = 3) or 30 min (n = 3), unilateral RI for 60 min with a delayed (2 wk) contralateral nephrectomy (n = 5), or sham unilateral RI with a delayed contralateral nephrectomy (n = 3). Serum creatinine concentration, urine specific gravity, and plasma clearance of iohexol were assessed at several time points throughout the study. Renal interstitial inflammatory cell counts and descriptive histopathology were acquired in all cats. Histomorphometry was used to quantify renal interstitial fibrosis and collagen at 120 d after RI in cats undergoing unilateral RI. Renal histopathology was evaluated at 21 and 120 d after bilateral and unilateral RI, respectively. Neither duration of bilateral RI resulted in appreciable histologic renal damage at 21 d after ischemia. At 120 d after ischemia, variable amounts of renal fibrosis were noted after 60 min of unilateral RI with delayed contralateral nephrectomy. Neither of the tested methods is a suitable model of consistent renal interstitial fibrosis in cats. Healthy cats appear able to sustain bilateral RI for as long as 30 min with no apparent effects on renal morphology or function at 21 d after ischemia.
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Affiliation(s)
- Vanna M Dickerson
- Departments of Small Animal Medicine, Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Daniel R Rissi
- Athens Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Cathy A Brown
- Athens Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Scott A Brown
- Departments of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Chad W Schmiedt
- Departments of Small Animal Medicine, Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia;,
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608
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Bland SK, Schmiedt CW, Clark ME, DeLay J, Bienzle D. Expression of Kidney Injury Molecule-1 in Healthy and Diseased Feline Kidney Tissue. Vet Pathol 2017; 54:490-510. [DOI: 10.1177/0300985817690213] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sensitive markers to detect acute kidney injury (AKI) in cats are lacking. Kidney injury molecule-1 (KIM-1) is a promising marker of acute tubular injury in humans, and sequence and structure of feline KIM-1 have been determined. KIM-1 is shed into urine of cats with natural AKI. The objectives of this study were to characterize temporal and cellular expression of KIM-1 in kidneys from cats without and with experimental and natural AKI using histopathology and immunohistochemistry. Tissue sections from 8 cats without kidney disease, 3 to 4 cats with experimentally induced AKI on each day 1, 3, 6, and 12 after unilateral ischemia/reperfusion, and 9 cats with natural AKI were assessed. In sections from cats without kidney disease, patterns of periodic acid–Schiff and aquaporin-1 staining allowed identification of 3 distinct segments of the proximal tubule. KIM-1 staining was absent in segments 1 (S1) and S2, and faint in S3. Injury of S3 in cats with experimental and natural AKI was characterized by cell loss and necrosis, and remaining intact cells had cytoplasmic blebs and reduced brush borders. In experimental AKI, intensity of KIM-1 expression increased in proportion to the severity of injury and was consistently present in S3 but only transiently in other segments. Vimentin was absent in proximal tubules of healthy cats but expressed in injured S3. These findings indicate that S3 is the proximal tubular segment most susceptible to ischemic injury and that KIM-1 is a sensitive tissue indicator of AKI in cats.
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Affiliation(s)
- S. K. Bland
- Department of Pathobiology, University of Guelph, Guelph, Ontario, Canada
| | - C. W. Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - M. E. Clark
- Department of Pathobiology, University of Guelph, Guelph, Ontario, Canada
| | - J. DeLay
- Animal Health Laboratory, University of Guelph, Guelph, Ontario, Canada
| | - D. Bienzle
- Department of Pathobiology, University of Guelph, Guelph, Ontario, Canada
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609
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Collett JA, Corridon PR, Mehrotra P, Kolb AL, Rhodes GJ, Miller CA, Molitoris BA, Pennington JG, Sandoval RM, Atkinson SJ, Campos-Bilderback SB, Basile DP, Bacallao RL. Hydrodynamic Isotonic Fluid Delivery Ameliorates Moderate-to-Severe Ischemia-Reperfusion Injury in Rat Kidneys. J Am Soc Nephrol 2017; 28:2081-2092. [PMID: 28122967 DOI: 10.1681/asn.2016040404] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 12/17/2016] [Indexed: 01/03/2023] Open
Abstract
Highly aerobic organs like the kidney are innately susceptible to ischemia-reperfusion (I/R) injury, which can originate from sources including myocardial infarction, renal trauma, and transplant. Therapy is mainly supportive and depends on the cause(s) of damage. In the absence of hypervolemia, intravenous fluid delivery is frequently the first course of treatment but does not reverse established AKI. Evidence suggests that disrupting leukocyte adhesion may prevent the impairment of renal microvascular perfusion and the heightened inflammatory response that exacerbate ischemic renal injury. We investigated the therapeutic potential of hydrodynamic isotonic fluid delivery (HIFD) to the left renal vein 24 hours after inducing moderate-to-severe unilateral IRI in rats. HIFD significantly increased hydrostatic pressure within the renal vein. When conducted after established AKI, 24 hours after I/R injury, HIFD produced substantial and statistically significant decreases in serum creatinine levels compared with levels in animals given an equivalent volume of saline via peripheral infusion (P<0.05). Intravital confocal microscopy performed immediately after HIFD showed improved microvascular perfusion. Notably, HIFD also resulted in immediate enhancement of parenchymal labeling with the fluorescent dye Hoechst 33342. HIFD also associated with a significant reduction in the accumulation of renal leukocytes, including proinflammatory T cells. Additionally, HIFD significantly reduced peritubular capillary erythrocyte congestion and improved histologic scores of tubular injury 4 days after IRI. Taken together, these results indicate that HIFD performed after establishment of AKI rapidly restores microvascular perfusion and small molecule accessibility, with improvement in overall renal function.
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Affiliation(s)
| | - Peter R Corridon
- Department of Craniofacial Biology, University of Colorado Denver, Anschutz Campus, Aurora, Colorado
| | | | - Alexander L Kolb
- Department of Biology, Indiana University-Purdue University, Indianapolis, Indiana; and
| | | | | | - Bruce A Molitoris
- Division of Nephrology, Department of Medicine.,Indiana Center for Biological Microscopy, Indiana University School of Medicine, Indianapolis, Indiana
| | | | | | - Simon J Atkinson
- Department of Biology, Indiana University-Purdue University, Indianapolis, Indiana; and
| | | | - David P Basile
- Department of Cellular and Integrative Physiology.,Division of Nephrology, Department of Medicine
| | - Robert L Bacallao
- Division of Nephrology, Department of Medicine, .,Department of Medicine, Division of Nephrology, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana
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610
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611
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Devarajan P, Basu RK. Sepsis-associated acute kidney injury - is it possible to move the needle against this syndrome? J Pediatr (Rio J) 2017; 93:1-3. [PMID: 27746155 PMCID: PMC5656060 DOI: 10.1016/j.jped.2016.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Prasad Devarajan
- University of Cincinnati, Cincinnati Children's Hospital Medical Center, Center for Acute Care Nephrology, Cincinnati, United States
| | - Rajit K Basu
- University of Cincinnati, Cincinnati Children's Hospital Medical Center, Center for Acute Care Nephrology, Cincinnati, United States.
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612
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Dobrek Ł, Skowron B, Baranowska A, Płoszaj K, Bądziul D, Thor P. The influence of oxazaphosphorine agents on kidney function in rats. Medicina (B Aires) 2017; 53:179-189. [DOI: 10.1016/j.medici.2017.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 04/10/2017] [Accepted: 05/02/2017] [Indexed: 02/04/2023] Open
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613
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Sepsis‐associated acute kidney injury – is it possible to move the needle against this syndrome. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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614
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Zhang L, Xu Y, Xue S, Wang X, Dai H, Qian J, Ni Z, Yan Y. Implications of dynamic changes in miR-192 expression in ischemic acute kidney injury. Int Urol Nephrol 2016; 49:541-550. [PMID: 28035621 PMCID: PMC5321705 DOI: 10.1007/s11255-016-1485-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 12/09/2016] [Indexed: 11/23/2022]
Abstract
Purpose Ischemia–reperfusion injury (IRI) is a major cause of acute kidney injury (AKI) with poor outcomes. While many important functions of microRNAs (miRNAs) have been identified in various diseases, few studies reported miRNAs in acute kidney IRI, especially the dynamic changes in their expression and their implications during disease progression. Methods The expression of miR-192, a specific kidney-enriched miRNA, was assessed in both the plasma and kidney of IRI rats at different time points after kidney injury and compared to renal function and kidney histological changes. The results were validated in the plasma of the selected patients with AKI after cardiac surgery compared with those matched patients without AKI. The performance characteristics of miR-192 were summarized using area under the receiver operator characteristic (ROC) curves (AUC-ROC). Results MiRNA profiling in plasma led to the identification of 42 differentially expressed miRNAs in the IRI group compared to the sham group. MiR-192 was kidney-enriched and chosen for further validation. Real-time PCR showed that miR-192 levels increased by fourfold in the plasma and decreased by about 40% in the kidney of IRI rats. Plasma miR-192 expression started increasing at 3 h and peaked at 12 h, while kidney miR-192 expression started decreasing at 6 h and remained at a low level for 7 days after reperfusion. Plasma miR-192 level in patients with AKI increased at the time of ICU admission, was stable for 2 h and decreased after 24 h. AUC-ROC was 0.673 (95% CI: 0.540–0.806, p = 0.014). Conclusions Plasma miR-192 expression was induced in a time-dependent manner after IRI in rats and patients with AKI after cardiac surgery, comparably to the kidney injury development and recovery process, and may be useful for the detection of AKI.
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Affiliation(s)
- Lulu Zhang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China
| | - Yuan Xu
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China
| | - Song Xue
- Department of Cardiac Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China
| | - Xudong Wang
- Department of Cardiac Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China
| | - Huili Dai
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China
| | - Jiaqi Qian
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China
| | - Zhaohui Ni
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China
| | - Yucheng Yan
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
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615
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Xu K, Rosenstiel P, Paragas N, Hinze C, Gao X, Huai Shen T, Werth M, Forster C, Deng R, Bruck E, Boles RW, Tornato A, Gopal T, Jones M, Konig J, Stauber J, D'Agati V, Erdjument-Bromage H, Saggi S, Wagener G, Schmidt-Ott KM, Tatonetti N, Tempst P, Oliver JA, Guarnieri P, Barasch J. Unique Transcriptional Programs Identify Subtypes of AKI. J Am Soc Nephrol 2016; 28:1729-1740. [PMID: 28028135 DOI: 10.1681/asn.2016090974] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 11/12/2016] [Indexed: 01/07/2023] Open
Abstract
Two metrics, a rise in serum creatinine concentration and a decrease in urine output, are considered tantamount to the injury of the kidney tubule and the epithelial cells thereof (AKI). Yet neither criterion emphasizes the etiology or the pathogenetic heterogeneity of acute decreases in kidney excretory function. In fact, whether decreased excretory function due to contraction of the extracellular fluid volume (vAKI) or due to intrinsic kidney injury (iAKI) actually share pathogenesis and should be aggregated in the same diagnostic group remains an open question. To examine this possibility, we created mouse models of iAKI and vAKI that induced a similar increase in serum creatinine concentration. Using laser microdissection to isolate specific domains of the kidney, followed by RNA sequencing, we found that thousands of genes responded specifically to iAKI or to vAKI, but very few responded to both stimuli. In fact, the activated gene sets comprised different, functionally unrelated signal transduction pathways and were expressed in different regions of the kidney. Moreover, we identified distinctive gene expression patterns in human urine as potential biomarkers of either iAKI or vAKI, but not both. Hence, iAKI and vAKI are biologically unrelated, suggesting that molecular analysis should clarify our current definitions of acute changes in kidney excretory function.
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Affiliation(s)
- Katherine Xu
- Departments of *Medicine, Division of Nephrology
| | | | - Neal Paragas
- Department of Medicine, Division of Nephrology, University of Washington, Seattle, Washington
| | | | - Xiaobo Gao
- Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Max Werth
- Departments of *Medicine, Division of Nephrology
| | - Catherine Forster
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Rong Deng
- Departments of *Medicine, Division of Nephrology
| | - Efrat Bruck
- Departments of *Medicine, Division of Nephrology
| | | | | | | | | | - Justin Konig
- Departments of *Medicine, Division of Nephrology
| | | | | | - Hediye Erdjument-Bromage
- Department of Biochemistry and Molecular Pharmacology, New York University Langone Medical Center, New York, New York
| | - Subodh Saggi
- Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York
| | | | | | | | - Paul Tempst
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Paolo Guarnieri
- Systems Biology, Columbia University Medical Center, New York, New York;
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616
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Nivy R, Avital Y, Aroch I, Segev G. Utility of urinary alkaline phosphatase and γ-glutamyl transpeptidase in diagnosing acute kidney injury in dogs. Vet J 2016; 220:43-47. [PMID: 28190493 DOI: 10.1016/j.tvjl.2016.12.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/13/2016] [Accepted: 12/15/2016] [Indexed: 11/29/2022]
Abstract
The diagnostic utility of urinary alkaline phosphatase (uALP) and γ-glutamyl transpeptidase (uGGT) activities in naturally occurring acute kidney injury (AKI) was investigated in a heterogeneous group of dogs. The study included client-owned dogs with AKI (n = 32), chronic kidney disease (CKD, n = 13), lower urinary tract infection (LUTI, n = 15) and healthy controls (n = 24). uGGT and uALP activities were normalised to urinary creatinine (uCr) concentrations (uGGT/uCr and uALP/uCr, respectively). uALP/uCr and uGGT/uCr were positively and significantly correlated (r = 0.619, P <0.001), and differed significantly (P ≤ 0.001) among groups, as well as between AKI and LUTI or CKD groups (P < 0.05), but not between the AKI and control groups. Areas under the receiver operator characteristics (ROC) curve for uALP/uCr and uGGT/uCr as predictors of AKI were 0.75 and 0.65, respectively, with optimal cut-off points showing poor to moderate sensitivity (59% for uALP/uCr and 79% for uGGT/uCr) and specificity (59% for uALP/uCr and 75% for uGGT/uCr). Higher cut-off points, with 90% specificity, showed low sensitivity (41% for both uALP/uCr and uGGT/uCr). In conclusion, uALP/uCr is superior to uGGT/uCr as a marker of AKI, but both uGGT/uCr and uALP/uCr have unsatisfactory discriminatory power for diagnosing naturally occurring AKI in dogs and therefore cannot be recommended as sole screening tests for canine AKI. However, both may serve as ancillary, confirmatory, biomarkers for detecting AKI in dogs if appropriate cut-off points with high specificities are used.
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Affiliation(s)
- Ran Nivy
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel.
| | - Yochai Avital
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel
| | - Itamar Aroch
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel
| | - Gilad Segev
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel
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617
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Wigger O, Bloechlinger S, Berger D, Häner J, Zanchin T, Windecker S, Räber L, Schefold JC. Baseline serum bicarbonate levels independently predict short-term mortality in critically ill patients with ischaemic cardiogenic shock. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2016; 7:45-52. [PMID: 28838261 DOI: 10.1177/2048872616683526] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cardiogenic shock is a feared complication of acute myocardial infarction with high mortality rates. Data on the predictive role of acid base dysregulation in this clinical setting are sparse. We therefore embarked on investigating the predictive role of serum bicarbonate in critically ill intensive care unit (ICU) patients with cardiogenic shock. METHODS A total of 165 ischaemic cardiogenic shock patients (118 men, aged 68.4 years (interquartile range 59.0-77.4), APACHE II score 26.0 (interquartile range 21.0-29.0), after percutaneous coronary intervention were included in a single-centre analysis. Percutaneous coronary intervention-related data such as left ventricular ejection fraction and laboratory indices were recorded and routine clinical follow-up was obtained at hospital discharge and at one year. All-cause mortality was assessed and data were analysed using univariate and multivariate models. RESULTS All-cause mortality was highest (17%) during the first 48 hours following ICU admission (28-day mortality rate 43%). In a multiple regression model, age (hazard ratio (HR) 1.035, 95% confidence interval (CI) 1.011-1.059, P=0.004), APACHE II score (HR 1.036, 95% CI 1.002-1.072, P=0.037) and baseline serum bicarbonate levels (HR 0.93, 95% CI 0.866-0.998, P=0.046) independently predicted 28-day mortality (overall model fit χ2 22.9, P<0.0001). The HR for patients in the lowest baseline serum bicarbonate tertile for 365-day mortality was HR 2.06 (95% CI 1.20-3.53). CONCLUSIONS In a large cohort of consecutive cardiogenic shock patients hospitalised in the ICU, low serum bicarbonate levels at admission independently predicted mortality. Given the widespread availability of blood gas analysers in ICUs, we propose baseline serum bicarbonate levels as an additional biomarker for identification and stratification of cardiogenic shock patients at risk.
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Affiliation(s)
- Olivier Wigger
- 1 Department of Cardiology, Bern University Hospital, Switzerland
| | - Stefan Bloechlinger
- 1 Department of Cardiology, Bern University Hospital, Switzerland
- 2 Department of Intensive Care Medicine, Bern University Hospital, Switzerland
| | - David Berger
- 3 Department of Intensive Care Medicine, Bern University Hospital, Switzerland
| | - Jonas Häner
- 1 Department of Cardiology, Bern University Hospital, Switzerland
| | - Thomas Zanchin
- 1 Department of Cardiology, Bern University Hospital, Switzerland
| | | | - Lorenz Räber
- 1 Department of Cardiology, Bern University Hospital, Switzerland
| | - Joerg C Schefold
- 3 Department of Intensive Care Medicine, Bern University Hospital, Switzerland
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618
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Pressly JD, Park F. DNA repair in ischemic acute kidney injury. Am J Physiol Renal Physiol 2016; 312:F551-F555. [PMID: 27927651 DOI: 10.1152/ajprenal.00492.2016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/05/2016] [Accepted: 12/05/2016] [Indexed: 12/11/2022] Open
Abstract
Ischemia-reperfusion injury (IRI) is a common cause of acute kidney injury leading to an induction of oxidative stress, cellular dysfunction, and loss of renal function. DNA damage, including oxidative base modifications and physical DNA strand breaks, is a consequence of renal IRI. Like many other organs in the body, a redundant and highly conserved set of endogenous repair pathways have evolved to selectively recognize the various types of cellular DNA damage and combat its negative effects on cell viability. Severe damage to the DNA, however, can trigger cell death and elimination of the injured tubular epithelial cells. In this minireview, we summarize the state of the current field of DNA damage and repair in the kidney and provide some expected and, in some cases, unexpected effects of IRI on DNA damage and repair in the kidney. These findings may be applicable to other forms of acute kidney injury and could provide new opportunities for renal research.
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Affiliation(s)
- Jeffrey D Pressly
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Frank Park
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee
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619
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Viñas JL, Burger D, Zimpelmann J, Haneef R, Knoll W, Campbell P, Gutsol A, Carter A, Allan DS, Burns KD. Transfer of microRNA-486-5p from human endothelial colony forming cell–derived exosomes reduces ischemic kidney injury. Kidney Int 2016; 90:1238-1250. [DOI: 10.1016/j.kint.2016.07.015] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 06/09/2016] [Accepted: 07/07/2016] [Indexed: 12/24/2022]
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620
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Konno T, Nakano R, Mamiya R, Tsuchiya H, Kitanaka T, Namba S, Kitanaka N, Okabayashi K, Narita T, Sugiya H. Expression and Function of Interleukin-1β-Induced Neutrophil Gelatinase-Associated Lipocalin in Renal Tubular Cells. PLoS One 2016; 11:e0166707. [PMID: 27851800 PMCID: PMC5112913 DOI: 10.1371/journal.pone.0166707] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/02/2016] [Indexed: 01/06/2023] Open
Abstract
Acute kidney injury (AKI) is characterized by a sudden loss of renal function. Early recognition of AKI, especially in critically ill patients, is essential for adequate therapy. Currently, neutrophil gelatinase-associated lipocalin (NGAL) is considered to be an effective biomarker of AKI; however, the regulation of its expression and function in renal tubular cells remains unclear. In this study, we investigated the regulation of the expression and function of NGAL in IL-1β-treated Madin–Darby canine kidney (MDCK) cells as a model of renal tubular cells. IL-1β induced a disturbance in the localization of E-cadherin and zonaoccludin-1 (ZO-1). The transepithelial electrical resistance (TER) also decreased 5 days after IL-1β treatment. IL-1β induced NGAL mRNA expression and protein secretion in a time- and dose-dependent manner, which occurred faster than the decrease in TER. In the presence of ERK1/2 and p38 inhibitors, IL-1β-induced NGAL mRNA expression and protein secretion were significantly attenuated. In the presence of recombinant NGAL, IL-1β-induced disturbance in the localization of E-cadherin and ZO-1 was attenuated, and the decrease in TER was partially maintained. These results suggest that NGAL can be used as a biomarker for AKI and that it functions as a protector from AKI.
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Affiliation(s)
- Tadayoshi Konno
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
| | - Rei Nakano
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
| | - Ryo Mamiya
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
| | - Hisashi Tsuchiya
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
| | - Taku Kitanaka
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
| | - Shinichi Namba
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
| | - Nanako Kitanaka
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
| | - Ken Okabayashi
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
| | - Takanori Narita
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
| | - Hiroshi Sugiya
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, Nihon University College of Bioresource Sciences, 1866 Kameino, Fujisawa, Kanagawa, 252–0880, Japan
- * E-mail:
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621
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Mehrotra P, Collett JA, McKinney SD, Stevens J, Ivancic CM, Basile DP. IL-17 mediates neutrophil infiltration and renal fibrosis following recovery from ischemia reperfusion: compensatory role of natural killer cells in athymic rats. Am J Physiol Renal Physiol 2016; 312:F385-F397. [PMID: 27852609 DOI: 10.1152/ajprenal.00462.2016] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 12/19/2022] Open
Abstract
T cells have been implicated in the pathogenesis of acute kidney injury (AKI) and its progression to chronic kidney disease (CKD). Previous studies suggest that Th17 cells participate during the AKI-to-CKD transition, and inhibition of T cell activity by mycophenolate mofetil (MMF) or losartan attenuates the development of fibrosis following AKI. We hypothesized that T cell-deficient rats may have reduced levels of IL-17 cytokine leading to decreased fibrosis following AKI. Renal ischemis-reperfusion (I/R) was performed on T cell-deficient athymic rats (Foxn1rnu-/rnu-) and control euthymic rats (Foxn1rnu-/+), and CKD progression was hastened by unilateral nephrectomy at day 33 and subsequent exposure to 4.0% sodium diet. Renal fibrosis developed in euthymic rats and was reduced by MMF treatment. Athymic rats exhibited a similar degree of fibrosis, but this was unaffected by MMF treatment. FACS analysis demonstrated that the number of IL-17+ cells was similar between postischemic athymic vs. euthymic rats. The source of IL-17 production in euthymic rats was predominately from conventional T cells (CD3+/CD161-). In the absence of conventional T cells in athymic rats, a compensatory pathway involving natural killer cells (CD3-/CD161+) was the primary source of IL-17. Blockade of IL-17 activity using IL-17Rc receptor significantly decreased fibrosis and neutrophil recruitment in both euthymic and athymic rats compared with vehicle-treated controls. Taken together, these data suggest that IL-17 secretion participates in the pathogenesis of AKI-induced fibrosis possibly via the recruitment of neutrophils and that the source of IL-17 may be from either conventional T cells or NK cells.
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Affiliation(s)
- Purvi Mehrotra
- Department of Cellular and Integrative Physiology, Indiana University of Medicine, Indianapolis, Indiana
| | - Jason A Collett
- Department of Cellular and Integrative Physiology, Indiana University of Medicine, Indianapolis, Indiana
| | - Seth D McKinney
- Department of Cellular and Integrative Physiology, Indiana University of Medicine, Indianapolis, Indiana
| | - Jackson Stevens
- Department of Cellular and Integrative Physiology, Indiana University of Medicine, Indianapolis, Indiana
| | - Carlie M Ivancic
- Department of Cellular and Integrative Physiology, Indiana University of Medicine, Indianapolis, Indiana
| | - David P Basile
- Department of Cellular and Integrative Physiology, Indiana University of Medicine, Indianapolis, Indiana
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622
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Acute Kidney Injury in Diabetes Mellitus. Int J Nephrol 2016; 2016:6232909. [PMID: 27974972 PMCID: PMC5126418 DOI: 10.1155/2016/6232909] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/27/2016] [Accepted: 10/20/2016] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) significantly increases the overall morbidity and mortality, particularly by elevating the cardiovascular risk. The kidneys are severely affected as well, partly as a result of intrarenal athero- and arteriosclerosis but also due to noninflammatory glomerular damage (diabetic nephropathy). DM is the most frequent cause of end-stage renal disease in our society. Acute kidney injury (AKI) remains a clinical and prognostic problem of fundamental importance since incidences have been increased in recent years while mortality has not substantially been improved. As a matter of fact, not many studies particularly addressed the topic “AKI in diabetes mellitus.” Aim of this article is to summarize AKI epidemiology and outcomes in DM and current recommendations on blood glucose control in the intensive care unit with regard to the risk for acquiring AKI, and finally several aspects related to postischemic microvasculopathy in AKI of diabetic patients shall be discussed. We intend to deal with this relevant topic, last but not least with regard to increasing incidences and prevalences of both disorders, AKI and DM.
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623
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Brakeman P, Miao S, Cheng J, Lee CZ, Roy S, Fissell WH, Ferrell N. A modular microfluidic bioreactor with improved throughput for evaluation of polarized renal epithelial cells. BIOMICROFLUIDICS 2016; 10:064106. [PMID: 27917253 PMCID: PMC5116024 DOI: 10.1063/1.4966986] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 10/23/2016] [Indexed: 05/16/2023]
Abstract
Most current microfluidic cell culture systems are integrated single use devices. This can limit throughput and experimental design options, particularly for epithelial cells, which require significant time in culture to obtain a fully differentiated phenotype. In addition, epithelial cells require a porous growth substrate in order to fully polarize their distinct apical and basolateral membranes. We have developed a modular microfluidic system using commercially available porous culture inserts to evaluate polarized epithelial cells under physiologically relevant fluid flow conditions. The cell-support for the bioreactor is a commercially available microporous membrane that is ready to use in a 6-well format, allowing for cells to be seeded in advance in replicates and evaluated for polarization and barrier function prior to experimentation. The reusable modular system can be easily assembled and disassembled using these mature cells, thus improving experimental throughput and minimizing fabrication requirements. The bioreactor consists of an apical microfluidic flow path and a static basolateral chamber that is easily accessible from the outside of the device. The basolateral chamber acts as a reservoir for transport across the cell layer. We evaluated the effect of initiation of apical shear flow on short-term intracellular signaling and mRNA expression using primary human renal epithelial cells (HRECs). Ten min and 5 h after initiation of apical fluid flow over a stable monolayer of HRECs, cells demonstrated increased phosphorylation of extracellular signal-related kinase and increased expression of interleukin 6 (IL-6) mRNA, respectively. This bioreactor design provides a modular platform with rapid experimental turn-around time to study various epithelial cell functions under physiologically meaningful flow conditions.
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Affiliation(s)
- Paul Brakeman
- Department of Pediatrics, University of California , San Francisco, San Francisco, California 94143, USA
| | - Simeng Miao
- Department of Biomedical Engineering, Vanderbilt University , Nashville, Tennessee 37232, USA
| | - Jin Cheng
- Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center , Nashville, Tennessee 37232, USA
| | - Chao-Zong Lee
- Department of Pediatrics, University of California , San Francisco, San Francisco, California 94143, USA
| | - Shuvo Roy
- Department of Bioengineering and Therapeutic Sciences, University of California , San Francisco, San Francisco, California 94143, USA
| | - William H Fissell
- Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center , Nashville, Tennessee 37232, USA
| | - Nicholas Ferrell
- Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center , Nashville, Tennessee 37232, USA
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624
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Aldahmash BA, El-Nagar DM, Ibrahim KE. Reno-protective effects of propolis on gentamicin-induced acute renal toxicity in swiss albino mice. Nefrologia 2016; 36:643-652. [DOI: 10.1016/j.nefro.2016.06.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 05/02/2016] [Accepted: 06/13/2016] [Indexed: 12/19/2022] Open
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625
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DNA damage response in nephrotoxic and ischemic kidney injury. Toxicol Appl Pharmacol 2016; 313:104-108. [PMID: 27984128 DOI: 10.1016/j.taap.2016.10.022] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 01/01/2023]
Abstract
DNA damage activates specific cell signaling cascades for DNA repair, cell cycle arrest, senescence, and/or cell death. Recent studies have demonstrated DNA damage response (DDR) in experimental models of acute kidney injury (AKI). In cisplatin-induced AKI or nephrotoxicity, the DDR pathway of ATR/Chk2/p53 is activated and contributes to renal tubular cell apoptosis. In ischemic AKI, DDR seems more complex and involves at least the ataxia telangiectasia mutated (ATM), a member of the phosphatidylinositol 3-kinase-related kinase (PIKK) family, and p53; however, while ATM may promote DNA repair, p53 may trigger cell death. Targeting DDR for kidney protection in AKI therefore relies on a thorough elucidation of the DDR pathways in various forms of AKI.
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626
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Thioredoxin-Interacting Protein Mediates NLRP3 Inflammasome Activation Involved in the Susceptibility to Ischemic Acute Kidney Injury in Diabetes. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:2386068. [PMID: 27867451 PMCID: PMC5102753 DOI: 10.1155/2016/2386068] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/10/2016] [Accepted: 09/19/2016] [Indexed: 12/14/2022]
Abstract
Kidney in diabetic state is more sensitive to ischemic acute kidney injury (AKI). However, the underlying mechanisms remain unclear. Herein, we examined the impact of diabetes mellitus on thioredoxin-interacting protein (TXNIP) expression and whether mediated NLRP3 activation was associated with renal ischemia/reperfusion- (I/R-) induced AKI. In an in vivo model, streptozotocin-induced diabetic rats showed higher susceptibility to I/R injury with increased TXNIP expression, which was significantly attenuated by resveratrol (RES) treatment (10 mg/kg intraperitoneal daily injection for 7 consecutive days prior to I/R induction). RES treatment significantly inhibited TXNIP binding to NLRP3 in diabetic rats subjected to renal I/R injury. Furthermore, RES treatment significantly reduced cleaved caspase-1 expression and production of IL-1β and IL-18. In an in vitro study using cultured human kidney proximal tubular cell (HK-2 cells) in high glucose condition (HG, 30 mM) subjected to hypoxia/reoxygenation (H/R), HG combined H/R (HH/R) stimulated TXNIP expression which was accompanied by increased NLRP3 expression, ROS generation, caspase-1 activity and IL-1β levels, and aggravated HK-2 cells apoptosis. All these changes were significantly attenuated by TXNIP RNAi and RES treatment. In conclusion, our results demonstrate that TXNIP-mediated NLRP3 activation through oxidative stress is a key signaling mechanism in the susceptibility to AKI in diabetic models.
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627
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Martínez-Lara E, Peña A, Calahorra J, Cañuelo A, Siles E. Hydroxytyrosol decreases the oxidative and nitrosative stress levels and promotes angiogenesis through HIF-1 independent mechanisms in renal hypoxic cells. Food Funct 2016; 7:540-8. [PMID: 26608793 DOI: 10.1039/c5fo00928f] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In the kidney, tissue oxygen tension is comparatively low and this renders this organ more prone to hypoxic injury. In fact, hypoxia has a central role in the development and progression of renal disease. The recovery from this situation is dependent on the degree to which sublethally damaged cells restore normal function. The master regulator of the hypoxic response is hypoxia-inducible factor-1 (HIF-1). HIF-1 activity depends on the HIF-1α subunit level which is regulated by oxygen, nitric oxide (NO), reactive oxygen species and mTOR. Given the antioxidant and antinitrosative properties ascribed to hydroxytyrosol (HT), this study evaluates the impact of this olive oil polyphenol on the response to hypoxia in kidney cells. For this purpose, the human embryonic kidney HEK293T cell line was treated with HT and cultured under sublethal hypoxic conditions. Our results demonstrate that HT treatment decreases both, post-hypoxic reactive oxygen species and NO levels and, consequently, HIF-1α accumulation. However, HT does not affect mTOR activation or the factor inhibiting HIF level but promotes the expression of angiogenic proteins, suggesting that HT activates an adaptive response to hypoxia in a HIF-1α-independent pathway. In fact, this effect could be ascribed to the up-regulation of estrogen-related receptor α. In conclusion, our results suggest that in renal hypoxia, HT treatment might act as an effective preventive therapeutic approach to decrease stress and to improve the adaptive response to this pathological situation.
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Affiliation(s)
- Esther Martínez-Lara
- Department of Experimental Biology, University of Jaén, Paraje Las Lagunillas s/n, 23071-Jaén, Spain.
| | - Ana Peña
- Department of Experimental Biology, University of Jaén, Paraje Las Lagunillas s/n, 23071-Jaén, Spain.
| | - Jesús Calahorra
- Department of Experimental Biology, University of Jaén, Paraje Las Lagunillas s/n, 23071-Jaén, Spain.
| | - Ana Cañuelo
- Department of Experimental Biology, University of Jaén, Paraje Las Lagunillas s/n, 23071-Jaén, Spain.
| | - Eva Siles
- Department of Experimental Biology, University of Jaén, Paraje Las Lagunillas s/n, 23071-Jaén, Spain.
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628
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Shen J, Wang L, Jiang N, Mou S, Zhang M, Gu L, Shao X, Wang Q, Qi C, Li S, Wang W, Che X, Ni Z. NLRP3 inflammasome mediates contrast media-induced acute kidney injury by regulating cell apoptosis. Sci Rep 2016; 6:34682. [PMID: 27721494 PMCID: PMC5056378 DOI: 10.1038/srep34682] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 09/16/2016] [Indexed: 12/20/2022] Open
Abstract
Iodinated contrast media serves as a direct causative factor of acute kidney injury (AKI) and is involved in the progression of cellular dysfunction and apoptosis. Emerging evidence indicates that NLRP3 inflammasome triggers inflammation, apoptosis and tissue injury during AKI. Nevertheless, the underlying renoprotection mechanism of NLRP3 inflammasome against contrast-induced AKI (CI-AKI) was still uncertain. This study investigated the role of NLRP3 inflammasome in CI-AKI both in vitro and in vivo. In HK-2 cells and unilateral nephrectomy model, NLRP3 and NLRP3 inflammasome member ASC were significantly augmented with the treatment of contrast media. Moreover, genetic disruption of NLRP3 notably reversed contrast-induced expression of apoptosis related proteins and secretion of proinflammatory factors, similarly to the effects of ASC deletion. Consistent with above results, absence of NLRP3 in mice undergoing unilateral nephrectomy also protected against contrast media-induced renal cells phenotypic alteration and cell apoptosis via modulating expression level of apoptotic proteins. Collectively, we demonstrated that NLRP3 inflammasome mediated CI-AKI through modulating the apoptotic pathway, which provided a potential therapeutic target for the treatment of contrast media induced acute kidney injury.
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Affiliation(s)
- Jianxiao Shen
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Ling Wang
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Na Jiang
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Shan Mou
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Minfang Zhang
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Leyi Gu
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Xinghua Shao
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Qin Wang
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Chaojun Qi
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Shu Li
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Wanpeng Wang
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Xiajing Che
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
| | - Zhaohui Ni
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, Shanghai, 200127, China
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629
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Jerome NP, Boult JKR, Orton MR, d’Arcy J, Collins DJ, Leach MO, Koh DM, Robinson SP. Modulation of renal oxygenation and perfusion in rat kidney monitored by quantitative diffusion and blood oxygen level dependent magnetic resonance imaging on a clinical 1.5T platform. BMC Nephrol 2016; 17:142. [PMID: 27716094 PMCID: PMC5048450 DOI: 10.1186/s12882-016-0356-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 09/26/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND To investigate the combined use of intravoxel incoherent motion (IVIM) diffusion-weighted (DW) and blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) to assess rat renal function using a 1.5T clinical platform. METHODS Multiple b-value DW and BOLD MR images were acquired from adult rats using a parallel clinical coil arrangement, enabling quantitation of the apparent diffusion coefficient (ADC), IVIM-derived diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f), and the transverse relaxation time T2*, for whole kidney, renal cortex, and medulla. Following the acquisition of two baseline datasets to assess measurement repeatability, images were acquired following i.v. administration of hydralazine, furosemide, or angiotensin II for up to 40 min. RESULTS Excellent repeatability (CoV <10 %) was observed for ADC, D, f and T2* measured over the whole kidney. Hydralazine induced a marked and significant (p < 0.05) reduction in whole kidney ADC, D, and T2*, and a significant (p < 0.05) increase in D* and f. Furosemide significantly (p < 0.05) increased whole kidney ADC, D, and T2*. A more variable response to angiotensin II was determined, with a significant (p < 0.05) increase in medulla D* and significant (p < 0.05) reduction in whole kidney T2* established. CONCLUSIONS Multiparametric MRI, incorporating quantitation of IVIM DWI and BOLD biomarkers and performed on a clinical platform, can be used to monitor the acute effects of vascular and tubular modulating drugs on rat kidney function in vivo. Clinical adoption of such functional imaging biomarkers can potentially inform on treatment effects in patients with renal dysfunction.
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Affiliation(s)
- Neil P. Jerome
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG UK
| | - Jessica K. R. Boult
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG UK
| | - Matthew R. Orton
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG UK
| | - James d’Arcy
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG UK
| | - David J. Collins
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG UK
| | - Martin O. Leach
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG UK
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey SM2 5PT UK
| | - Simon P. Robinson
- Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, SM2 5NG UK
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630
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Habedank D, Schefold JC, Bernhardt C, Karhausen T, Doehner W, Anker SD, Reinke P. Vasodilation and Exercise Capacity in Patients with End-Stage Renal Disease: A Prospective Proof-of-Concept Study. Cardiorenal Med 2016; 7:50-59. [PMID: 27994602 DOI: 10.1159/000449174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/06/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Previous data have pointed to the fact that vascular function is significantly impaired in patients with end-stage renal disease (ESRD). We aimed to better characterise vasodilation and exercise capacity in both ESRD and chronic heart failure (CHF) patients. METHODS A total of 30 ESRD patients (23 male; mean age 45.7 ± 9.9 years) were included in a prospective proof-of-concept study at a tertiary care academic centre. The patients underwent forearm venous plethysmography with post-ischaemic peak blood flow (PF) and flow-dependent flow (FDF) testing as well as cardiopulmonary exercise testing during the morning of the day following the last haemodialysis. After matching for age, gender, and body mass index, the data were compared to 30 patients with CHF and 20 age-matched healthy controls. RESULTS PF in ESRD patients was reduced when compared to that in CHF patients (12.5 ± 4.2 vs. 15.6 ± 6.9 ml/100 ml/min; p = 0.048) and healthy controls (26.4 ± 9.3 ml/100 ml/min; p < 0.001). When compared to controls, FDF was significantly reduced in ESRD patients (7.6 ± 3.1 vs. 6.0 ± 2.5 ml/100 ml/min; p = 0.03), but not in CHF patients, whereas resting blood flow did not differ between the ESRD, CHF, and healthy control groups. In contrast to indices of vasodilative capacity, maximum exercise capacity (peakVO2) was higher in ESRD when compared to CHF patients (23.8 ± 7.3 vs. 18.8 ± 5.2 ml/min/kg), but significantly impaired when compared to controls (32.8 ± 6.7 ml/min/kg; p < 0.001). CONCLUSION In this proof-of-concept study, exercise capacity was relatively preserved, while vasodilative capacity was substantially impaired in ESRD patients. Additional studies are warranted to examine the underlying mechanisms and potential clinical implications of our findings.
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Affiliation(s)
- Dirk Habedank
- Medizinische Klinik Kardiologie, DRK-Kliniken Berlin-Köpenick, Berlin, Germany
| | - Joerg C Schefold
- Department of Nephrology and Intensive Care Medicine, Berlin, Germany; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Carolin Bernhardt
- Department of Cardiology, Applied Cachexia Research, Berlin, Germany
| | - Tim Karhausen
- Department of Cardiology, Applied Cachexia Research, Berlin, Germany
| | - Wolfram Doehner
- Department of Cardiology, Applied Cachexia Research, Berlin, Germany; Stroke Research Centre, Charité Campus Virchow-Klinikum, Berlin, Germany
| | - Stefan D Anker
- Department of Cardiology, Applied Cachexia Research, Berlin, Germany; Department of Cardiology and Pneumology, Innovative Clinical Trials, University of Göttingen, Göttingen, Germany
| | - Petra Reinke
- Department of Nephrology and Intensive Care Medicine, Berlin, Germany
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631
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Guo J, Guan Q, Liu X, Wang H, Gleave ME, Nguan CYC, Du C. Relationship of clusterin with renal inflammation and fibrosis after the recovery phase of ischemia-reperfusion injury. BMC Nephrol 2016; 17:133. [PMID: 27649757 PMCID: PMC5028988 DOI: 10.1186/s12882-016-0348-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 09/12/2016] [Indexed: 01/10/2023] Open
Abstract
Background Long-term outcomes after acute kidney injury (AKI) include incremental loss of function and progression towards chronic kidney disease (CKD); however, the pathogenesis of AKI to CKD remains largely unknown. Clusterin (CLU) is a chaperone-like protein that reduces ischemia-reperfusion injury (IRI) and enhances tissue repair after IRI in the kidney. This study investigated the role of CLU in the transition of IRI to renal fibrosis. Methods IRI was induced in the left kidneys of wild type (WT) C57BL/6J (B6) versus CLU knockout (KO) B6 mice by clamping the renal pedicles for 28 min at the body temperature of 32 °C. Tissue damage was examined by histology, infiltrate phenotypes by flow cytometry analysis, and fibrosis-related gene expression by PCR array. Results Reduction of kidney weight was induced by IRI, but was not affected by CLU KO. Both WT and KO kidneys had similar function with minimal cellular infiltration and fibrosis at day 14 of reperfusion. After 30 days, KO kidneys had greater loss in function than WT, indicated by the higher levels of both serum creatinine and BUN in KO mice, and exhibited more cellular infiltration (CD8 cells and macrophages), more tubular damage and more severe tissue fibrosis (glomerulopathy, interstitial fibrosis and vascular fibrosis). PCR array showed the association of CLU deficiency with up-regulation of CCL12, Col3a1, MMP9 and TIMP1 and down-regulation of EGF in these kidneys. Conclusion Our data suggest that CLU deficiency worsens renal inflammation and tissue fibrosis after IRI in the kidney, which may be mediated through multiple pathways. Electronic supplementary material The online version of this article (doi:10.1186/s12882-016-0348-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jia Guo
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.,Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Qiunong Guan
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Xiuheng Liu
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hao Wang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Martin E Gleave
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.,Vancouver Prostate Centre, Vancouver, BC, Canada
| | - Christopher Y C Nguan
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Caigan Du
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada. .,Department of Urologic Sciences, The University of British Columbia, VGH-Jack Bell Research Centre, 2660 Oak St, Vancouver, BC, V6H 3Z6, Canada.
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632
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Zhao WY, Zhang L, Sui MX, Zhu YH, Zeng L. Protective effects of sirtuin 3 in a murine model of sepsis-induced acute kidney injury. Sci Rep 2016; 6:33201. [PMID: 27620507 PMCID: PMC5020492 DOI: 10.1038/srep33201] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 08/22/2016] [Indexed: 02/07/2023] Open
Abstract
Acute kidney injury (AKI) is a rapid loss of kidney function characterized by damage to renal tubular cells driven by mitochondrial dysregulation and oxidative stress. Here, we used a murine caecal ligation and puncture (CLP) model of sepsis-induced AKI to study the role of sirtuin 3 (SIRT3), a NAD+ dependent deacetylase critical for the maintenance of mitochondrial viability, in AKI-related renal tubular cell damage and explored the underlying mechanisms. CLP induced alterations in kidney function and morphology were associated with SIRT3 downregulation, and SIRT3 deletion exacerbated CLP-induced kidney dysfunction, renal tubular cell injury and apoptosis, mitochondrial alterations, and ROS production in a knockout mouse model. SIRT3 deletion increased the CLP-induced upregulation of the NLRP3 inflammasome and apoptosis-associated speck-like protein, resulting in the activation of oxidative stress, increased production of the proinflammatory cytokines interleukin (IL)-1β and IL-18, and the enhancement of apoptosis, and these effects were reversed by antioxidant NAC. Our results suggest that SIRT3 plays a protective role against mitochondrial damage in the kidney by attenuating ROS production, inhibiting the NRLP3 inflammasome, attenuating oxidative stress, and downregulating IL-1β and IL-18.
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Affiliation(s)
- Wen-Yu Zhao
- Department of Organ Transplantation, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Lei Zhang
- Department of Organ Transplantation, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Ming-Xing Sui
- Department of Organ Transplantation, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - You-Hua Zhu
- Department of Organ Transplantation, Changhai Hospital, Second Military Medical University, Shanghai, PR China
| | - Li Zeng
- Department of Organ Transplantation, Changhai Hospital, Second Military Medical University, Shanghai, PR China
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633
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634
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Graw JA, Mayeur C, Rosales I, Liu Y, Sabbisetti VS, Riley FE, Rechester O, Malhotra R, Warren HS, Colvin RB, Bonventre JV, Bloch DB, Zapol WM. Haptoglobin or Hemopexin Therapy Prevents Acute Adverse Effects of Resuscitation After Prolonged Storage of Red Cells. Circulation 2016; 134:945-60. [PMID: 27515135 DOI: 10.1161/circulationaha.115.019955] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 06/30/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Extracellular hemoglobin and cell-free heme are toxic breakdown products of hemolyzed erythrocytes. Mammals synthesize the scavenger proteins haptoglobin and hemopexin, which bind extracellular hemoglobin and heme, respectively. Transfusion of packed red blood cells is a lifesaving therapy for patients with hemorrhagic shock. Because erythrocytes undergo progressive deleterious morphological and biochemical changes during storage, transfusion of packed red blood cells that have been stored for prolonged intervals (SRBCs; stored for 35-40 days in humans or 14 days in mice) increases plasma levels of cell-free hemoglobin and heme. Therefore, in patients with hemorrhagic shock, perfusion-sensitive organs such as the kidneys are challenged not only by hypoperfusion but also by the high concentrations of plasma hemoglobin and heme that are associated with the transfusion of SRBCs. METHODS To test whether treatment with exogenous human haptoglobin or hemopexin can ameliorate adverse effects of resuscitation with SRBCs after 2 hours of hemorrhagic shock, mice that received SRBCs were given a coinfusion of haptoglobin, hemopexin, or albumin. RESULTS Treatment with haptoglobin or hemopexin but not albumin improved the survival rate and attenuated SRBC-induced inflammation. Treatment with haptoglobin retained free hemoglobin in the plasma and prevented SRBC-induced hemoglobinuria and kidney injury. In mice resuscitated with fresh packed red blood cells, treatment with haptoglobin, hemopexin, or albumin did not cause harmful effects. CONCLUSIONS In mice, the adverse effects of transfusion with SRBCs after hemorrhagic shock are ameliorated by treatment with either haptoglobin or hemopexin. Haptoglobin infusion prevents kidney injury associated with high plasma hemoglobin concentrations after resuscitation with SRBCs. Treatment with the naturally occurring human plasma proteins haptoglobin or hemopexin may have beneficial effects in conditions of severe hemolysis after prolonged hypotension.
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Affiliation(s)
- Jan A Graw
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Claire Mayeur
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Ivy Rosales
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Yumin Liu
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Venkata S Sabbisetti
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Frank E Riley
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Osher Rechester
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Rajeev Malhotra
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - H Shaw Warren
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Robert B Colvin
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Joseph V Bonventre
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Donald B Bloch
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.)
| | - Warren M Zapol
- From Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine (J.A.G., C.M., D.B.B., W.M.Z.), Department of Pathology (I.R., R.B.C.), Department of Pediatrics (F.E.R., O.R., H.S.W.), Cardiovascular Research Center and Cardiology Division, Department of Medicine (R.M.), and Division of Rheumatology, Allergy and Immunology, Department of Medicine (D.B.B.), Massachusetts General Hospital, Harvard Medical School, Boston; and Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Y.L., V.S.S., H.S.W.).
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635
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Chandrashekar KB, Lopez-Ruiz A, Juncos LA. The Promise of Mineralocorticoid Antagonism in Acute Kidney Injury. Nephron Clin Pract 2016; 134:154-159. [DOI: 10.1159/000448224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/05/2016] [Indexed: 11/19/2022] Open
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636
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Stone JP, Ball AL, Critchley WR, Major T, Edge RJ, Amin K, Clancy MJ, Fildes JE. Ex Vivo Normothermic Perfusion Induces Donor-Derived Leukocyte Mobilization and Removal Prior to Renal Transplantation. Kidney Int Rep 2016; 1:230-239. [PMID: 29142927 PMCID: PMC5678860 DOI: 10.1016/j.ekir.2016.07.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/12/2016] [Accepted: 07/30/2016] [Indexed: 12/18/2022] Open
Abstract
Introduction Ex vivo normothermic perfusion offers an alternative method of organ preservation, allowing donor kidneys to be reanimated and evaluated prior to transplantation. Beyond preservation, it can be used to characterize the immunological contribution of the donor kidney in isolation. Furthermore, it has the potential to be used as an immunomodulatory strategy to manipulate donor kidneys prior to transplantation. Methods Explanted porcine kidneys underwent 6 hours of perfusion. Sequential perfusate samples were collected and leukocytes characterized via flow cytometry. An inflammatory profile was generated via cytokine quantification. Cell-free DNA was also determined as markers of cell death. Results All kidneys functioned within normal parameters and met the criteria for transplantation at the end of perfusion. Throughout perfusion there were continuous increases in pro-inflammatory cytokines, including large concentrations of interferon-γ, suggesting that perfusion drives a significant inflammatory response. Increasing concentrations in cell-free DNA were also observed, suggesting cell death. During perfusion there was a marked cellular diapedesis of T cells, B cells, natural killer (NK) cells, and monocytes from the kidney into the circuit. Minor populations of granulocytes and macrophages were also detected. Discussion We demonstrate that ex vivo normothermic perfusion initiates an inflammatory cytokine storm and release of mitochondrial and genomic DNA. This is likely to be responsible for immune cell activation and mobilization into the circuit prior to transplantation. Interestingly this did not have an impact on renal function. These data therefore suggest that normothermic perfusion can be used to immunodeplete and to saturate the pro-inflammatory capacity of donor kidneys prior to transplantation.
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Affiliation(s)
- John P Stone
- Manchester Collaborative Centre for Inflammation Research (MCCIR), University of Manchester, Manchester, UK.,The Transplant Centre, University Hospital of South Manchester, Manchester, UK
| | - Alexandra L Ball
- Manchester Collaborative Centre for Inflammation Research (MCCIR), University of Manchester, Manchester, UK.,The Transplant Centre, University Hospital of South Manchester, Manchester, UK
| | - William R Critchley
- Manchester Collaborative Centre for Inflammation Research (MCCIR), University of Manchester, Manchester, UK.,The Transplant Centre, University Hospital of South Manchester, Manchester, UK
| | - Triin Major
- Manchester Collaborative Centre for Inflammation Research (MCCIR), University of Manchester, Manchester, UK.,The Transplant Centre, University Hospital of South Manchester, Manchester, UK
| | - Rebecca J Edge
- Manchester Collaborative Centre for Inflammation Research (MCCIR), University of Manchester, Manchester, UK.,The Transplant Centre, University Hospital of South Manchester, Manchester, UK
| | - Kavit Amin
- Manchester Collaborative Centre for Inflammation Research (MCCIR), University of Manchester, Manchester, UK.,The Transplant Centre, University Hospital of South Manchester, Manchester, UK
| | - Marc J Clancy
- The Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - James E Fildes
- Manchester Collaborative Centre for Inflammation Research (MCCIR), University of Manchester, Manchester, UK.,The Transplant Centre, University Hospital of South Manchester, Manchester, UK
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637
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Chatterjee D. Understanding the Exacerbating Role of the Metalloproteinase Meprin during AKI, an <i>In Silico</i> Approach. INTERNATIONAL LETTERS OF NATURAL SCIENCES 2016. [DOI: 10.18052/www.scipress.com/ilns.57.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Acute kidney injury (AKI) is a syndrome characterised by the rapid loss of the kidney’s excretory function and is typically diagnosed by the accumulation of end products of nitrogen metabolism (urea and creatinine) or decreased urine output, or both. It is the clinical manifestation of several disorders that affect the kidney acutely. No specific therapies have yet emerged that can attenuate AKI or expedite recovery; thus, the only treatment is supportive therapies and intensive care. The present study was aimed to provide an insight into the importance of a metalloproteinase involved in the pathological conditions of AKI and potentially is a unique target for therapeutic intervention during the disease; Meprin. The data obtained using literature search from PubMed and interaction networks analysis software STRING strongly support the concept that meprin acts as a major matrix degrading enzyme in the kidney, and thus creating an environment that leads to impairment in cellular function rather than cellular stability in response to AKI. The present study discerns the structure of meprin alpha subunit usingin silicotools SWISS-MODE, Phyre2 web server and identify the active site and critical amino acid residues in the active site using AADS (IIT Delhi), 3DLigandSite and DoGSiteScorer. Further it is documented that actinonin, a naturally occurring antibacterial agent as a pharmacologically active intervention for the metalloproteinase’s α subunit by blocking its active sites from the environment which was validated using molecular docking algorithms of SWISS-DOCK and FlexX.
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638
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Maringer K, Sims-Lucas S. The multifaceted role of the renal microvasculature during acute kidney injury. Pediatr Nephrol 2016; 31:1231-40. [PMID: 26493067 PMCID: PMC4841763 DOI: 10.1007/s00467-015-3231-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 09/28/2015] [Accepted: 09/29/2015] [Indexed: 12/20/2022]
Abstract
Pediatric acute kidney injury (AKI) represents a complex disease process for clinicians as it is multifactorial in cause and only limited treatment or preventatives are available. The renal microvasculature has recently been implicated in AKI as a strong therapeutic candidate involved in both injury and recovery. Significant progress has been made in the ability to study the renal microvasculature following ischemic AKI and its role in repair. Advances have also been made in elucidating cell-cell interactions and the molecular mechanisms involved in these interactions. The ability of the kidney to repair post AKI is closely linked to alterations in hypoxia, and these studies are elucidated in this review. Injury to the microvasculature following AKI plays an integral role in mediating the inflammatory response, thereby complicating potential therapeutics. However, recent work with experimental animal models suggests that the endothelium and its cellular and molecular interactions are attractive targets to prevent injury or hasten repair following AKI. Here, we review the cellular and molecular mechanisms of the renal endothelium in AKI, as well as repair and recovery, and potential therapeutics to prevent or ameliorate injury and hasten repair.
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Affiliation(s)
- Katherine Maringer
- Rangos Research Center, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
- Division of Nephrology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sunder Sims-Lucas
- Rangos Research Center, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
- Division of Nephrology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA.
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639
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Atilano-Roque A, Aleksunes LM, Joy MS. Bardoxolone methyl modulates efflux transporter and detoxifying enzyme expression in cisplatin-induced kidney cell injury. Toxicol Lett 2016; 259:52-59. [PMID: 27480280 DOI: 10.1016/j.toxlet.2016.07.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/05/2016] [Accepted: 07/18/2016] [Indexed: 12/12/2022]
Abstract
Cisplatin is prescribed for the treatment of solid tumors and elicits toxicity to kidney tubules, which limits its clinical use. Nuclear factor erythroid 2-related factor 2 (Nrf2, NFE2L2) is a critical transcription factor that has been shown to protect against kidney injury through activation of antioxidant mechanisms. We aimed to evaluate the ability of short-term treatment with the Nrf2 activator bardoxolone methyl (CDDO-Me) to protect against cisplatin-induced kidney cell toxicity. Cell viability was assessed in human kidney proximal tubule epithelial cells (hPTCs) exposed to low, intermediate, and high cisplatin concentrations in the presence and absence of CDDO-Me, administered either prior to or after cisplatin. Treatment with cisplatin alone resulted in reductions in hPTC viability, while CDDO-Me administered prior to or after cisplatin exposure yielded significantly higher cell viability (17%-71%). Gene regulation (mRNA expression) studies revealed the ability of CDDO-Me to modify protective pathways including Nrf2 induced detoxifying genes [GCLC (increased 1.9-fold), NQO1 (increased 9.3-fold)], and an efflux transporter [SLC47A1 (increased 4.5-fold)] at 12h. Protein assessments were in agreement with gene expression. Immunofluorescence revealed localization of GCLC and NQO1 to the nucleus and cytosol, respectively, with CDDO-Me administered prior to or after cisplatin exposure. The findings of enhanced cell viability and increased expression of detoxifying enzymes (GCLC and NQO1) and the multidrug and toxin extrusion protein 1 (MATE1) efflux transporter (SLC47A1) in hPTCs exposed to CDDO-Me, suggest that intermittent treatment with CDDO-Me prior to or after cisplatin exposure may be a promising approach to mitigate acute kidney injury.
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Affiliation(s)
- Amandla Atilano-Roque
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, United States
| | - Lauren M Aleksunes
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, United States
| | - Melanie S Joy
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, United States; Division of Renal Diseases and Hypertension, University of Colorado School of Medicine, Aurora, CO, United States.
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640
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Chen YC, Tseng YC, Huang WH, Hsu CW, Weng CH, Liu SH, Yang HY, Chen KH, Chen HL, Fu JF, Lin WR, Wang IK, Yen TH. Acute Kidney Injury Predicts Mortality after Charcoal Burning Suicide. Sci Rep 2016; 6:29656. [PMID: 27430168 PMCID: PMC4949594 DOI: 10.1038/srep29656] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/21/2016] [Indexed: 11/10/2022] Open
Abstract
A paucity of literature exists on risk factors for mortality in charcoal burning suicide. In this observational study, we analyzed the data of 126 patients with charcoal burning suicide that seen between 2002 and 2013. Patients were grouped according to status of renal damage as acute kidney injury (N = 49) or non-acute kidney injury (N = 77). It was found that patients with acute kidney injury suffered severer complications such as respiratory failure (P = 0.002), myocardial injury (P = 0.049), hepatic injury (P < 0.001), rhabdomyolysis (P = 0.045) and out-of-hospital cardiac arrest (P = 0.028) than patients without acute kidney injury. Moreover, patients with acute kidney injury suffered longer hospitalization duration (16.9 ± 18.3 versus 10.7 ± 10.9, P = 0.002) and had higher mortality rate (8.2% versus 0%, P = 0.011) than patients without injury. In a multivariate Cox regression model, it was demonstrated that serum creatinine level (P = 0.019) and heart rate (P = 0.022) were significant risk factors for mortality. Finally, Kaplan-Meier analysis revealed that patients with acute kidney injury suffered lower cumulative survival than without injury (P = 0.016). In summary, the overall mortality rate of charcoal burning suicide population was 3.2%, and acute kidney injury was a powerful predictor of mortality. Further studies are warranted.
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Affiliation(s)
- Yu-Chin Chen
- Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Chia Tseng
- Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Hung Huang
- Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan.,Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-Wei Hsu
- Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan.,Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Cheng-Hao Weng
- Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan.,Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Shou-Hsuan Liu
- Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan.,Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Huang-Yu Yang
- Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan.,Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Kuan-Hsin Chen
- Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan.,Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hui-Ling Chen
- Department of Dentistry and Craniofacial Orthodontics, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jen-Fen Fu
- Department of Medical Research, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan
| | - Wey-Ran Lin
- Department of Gastroenterology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan
| | - I-Kuan Wang
- Department of Nephrology, China Medical University Hospital and College of Medicine, China Medical University, Taichung, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Linkou, Taiwan.,Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan
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641
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McKee RA, Wingert RA. Nephrotoxin Microinjection in Zebrafish to Model Acute Kidney Injury. J Vis Exp 2016. [PMID: 27500823 DOI: 10.3791/54241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The kidneys are susceptible to harm from exposure to chemicals they filter from the bloodstream. This can lead to organ injury associated with a rapid decline in renal function and development of the clinical syndrome known as acute kidney injury (AKI). Pharmacological agents used to treat medical circumstances ranging from bacterial infection to cancer, when administered individually or in combination with other drugs, can initiate AKI. Zebrafish are a useful animal model to study the chemical effects on renal function in vivo, as they form an embryonic kidney comprised of nephron functional units that are conserved with higher vertebrates, including humans. Further, zebrafish can be utilized to perform genetic and chemical screens, which provide opportunities to elucidate the cellular and molecular facets of AKI and develop therapeutic strategies such as the identification of nephroprotective molecules. Here, we demonstrate how microinjection into the zebrafish embryo can be utilized as a paradigm for nephrotoxin studies.
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Affiliation(s)
- Robert A McKee
- Center for Zebrafish Research, Department of Biological Sciences, University of Notre Dame; Center for Stem Cells and Regenerative Medicine, Department of Biological Sciences, University of Notre Dame
| | - Rebecca A Wingert
- Center for Zebrafish Research, Department of Biological Sciences, University of Notre Dame; Center for Stem Cells and Regenerative Medicine, Department of Biological Sciences, University of Notre Dame;
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642
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Seller-Pérez G, Más-Font S, Pérez-Calvo C, Villa-Díaz P, Celaya-López M, Herrera-Gutiérrez ME. Acute kidney injury: Renal disease in the ICU. Med Intensiva 2016; 40:374-82. [PMID: 27388683 DOI: 10.1016/j.medin.2016.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 04/21/2016] [Accepted: 05/01/2016] [Indexed: 12/26/2022]
Abstract
Acute kidney injury (AKI) in the ICU frequently requires costly supportive therapies, has high morbidity, and its long-term prognosis is not as good as it has been presumed so far. Consequently, AKI generates a significant burden for the healthcare system. The problem is that AKI lacks an effective treatment and the best approach relies on early secondary prevention. Therefore, to facilitate early diagnosis, a broader definition of AKI should be established, and a marker with more sensitivity and early-detection capacity than serum creatinine - the most common marker of AKI - should be identified. Fortunately, new classification systems (RIFLE, AKIN or KDIGO) have been developed to solve these problems, and the discovery of new biomarkers for kidney injury will hopefully change the way we approach renal patients. As a first step, the concept of renal failure has changed from being a "static" disease to being a "dynamic process" that requires continuous evaluation of kidney function adapted to the reality of the ICU patient.
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Affiliation(s)
- G Seller-Pérez
- Intensive Care Medicine, Complejo Hospitalario Universitario Carlos Haya, Málaga, Spain
| | - S Más-Font
- Intensive Care Medicine, Hospital General Universitario de Castellón, Spain
| | - C Pérez-Calvo
- Intensive Care Medicine, HU Fundación Jiménez Díaz, Madrid, Spain
| | - P Villa-Díaz
- Intensive Care Medicine, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain
| | - M Celaya-López
- Intensive Care Medicine, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - M E Herrera-Gutiérrez
- Intensive Care Medicine, Complejo Hospitalario Universitario Carlos Haya, Málaga, Spain.
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643
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Determinant Variables of Resistive Index in Early Renal Transplant Recipients. Transplant Proc 2016; 48:1955-61. [DOI: 10.1016/j.transproceed.2016.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/25/2016] [Indexed: 12/25/2022]
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644
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Dobronravov VA, Smirnov KA, Afanasiev BV, Galkina OV, Smirnov AV. [Acute kidney injury and tubular biomarkers after hematopoietic stem cell transplantation]. TERAPEVT ARKH 2016; 88:14-20. [PMID: 27296256 DOI: 10.17116/terarkh201688614-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AIM To determine the value of molecular biomarkers (BMs) associated with tubular epithelial damage in developing and predicting acute kidney injury (AKI) after hematopoietic stem cell transplantation (HSCT). SUBJECTS AND METHODS The open-label observational prospective study enrolled 90 patients (46 males and 44 females) who had undergone HSCT. The concentrations of BMs (calbindin, clusterin, interleukin-18 (IL-18), kidney injury molecules-1 (KIM-1), glutathione S-transferase-π (GST-π), and monocyte chemoattractant protein-1 (MCP-1) were measured in urinary samples 7 days before HSCT (week 0) and at weeks 1, 2, 3, 4, and 5. Main clinical parameters were simultaneously monitored. AKI was diagnosed and stratified according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. RESULTS At weeks 1, 2, 3, 4, and 5 after HSCT, the proportion of AKI cases was 7.8, 8.9, 12.5, 27.3, and 35.9%, respectively. The elevated urinary levels of BMs (above the median) were found to be substantially more common than AKI cases. The urinary excretion of the majority of BMs dramatically increased in the early HSCT period. The median number of simultaneously elevated BMs was 3 (2; 5) during the entire follow-up period. Clusterin, MCP-1 and KIM-1 positively and significantly correlated with serum creatinine at the week following the determination of BMs in the multivariate linear regression models adjusted for other confounders. The higher urinary KIM-1 and/or MCP-1 excretion regardless of other clinical indicators was associated with the higher relative risk (RR) of AKI, which increased by 2.3 times with a rise in one of these indicators and by 3.4 times with a rise in both indicators. CONCLUSION Multiple renal toxic effects after HSCT result in a substantial and simultaneous elevation of urinary excretion of BMs for tubular damage. Among the BMs studied, KIM-1 and MCP-1 seem to be the most suitable molecules for assessing the risk of AKI in this cohort of patient within the predictive diagnostic approach.
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Affiliation(s)
- V A Dobronravov
- I.P. Pavlov First Saint Petersburg Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
| | - K A Smirnov
- I.P. Pavlov First Saint Petersburg Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
| | - B V Afanasiev
- I.P. Pavlov First Saint Petersburg Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
| | - O V Galkina
- I.P. Pavlov First Saint Petersburg Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
| | - A V Smirnov
- I.P. Pavlov First Saint Petersburg Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
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645
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Cocchiaro P, Fox C, Tregidgo NW, Howarth R, Wood KM, Situmorang GR, Pavone LM, Sheerin NS, Moles A. Lysosomal protease cathepsin D; a new driver of apoptosis during acute kidney injury. Sci Rep 2016; 6:27112. [PMID: 27271556 PMCID: PMC4895243 DOI: 10.1038/srep27112] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/13/2016] [Indexed: 12/19/2022] Open
Abstract
Acute kidney injury (AKI) is an abrupt reduction in kidney function caused by different pathological processes. It is associated with a significant morbidity and mortality in the acute phase and an increased risk of developing End Stage Renal Disease. Despite the progress in the management of the disease, mortality rates in the last five decades remain unchanged at around 50%. Therefore there is an urgent need to find new therapeutic strategies to treat AKI. Lysosomal proteases, particularly Cathepsin D (CtsD), play multiple roles in apoptosis however, their role in AKI is still unknown. Here we describe a novel role for CtsD in AKI. CtsD expression was upregulated in damaged tubular cells in nephrotoxic and ischemia reperfusion (IRI) induced AKI. CtsD inhibition using Pepstatin A led to an improvement in kidney function, a reduction in apoptosis and a decrease in tubular cell damage in kidneys with nephrotoxic or IRI induced AKI. Pepstatin A treatment slowed interstitial fibrosis progression following IRI induced AKI. Renal transplant biopsies with acute tubular necrosis demonstrated high levels of CtsD in damaged tubular cells. These results support a role for CtsD in apoptosis during AKI opening new avenues for the treatment of AKI by targeting lysosomal proteases.
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Affiliation(s)
- Pasquale Cocchiaro
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, Federico II, Italy
| | - Christopher Fox
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Nicholas W Tregidgo
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Rachel Howarth
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Katrina M Wood
- Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
| | - Gerhard R Situmorang
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
- Urology Department, Cipto Mangunkusumo National Referral Hospital/Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Luigi M Pavone
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, Federico II, Italy
| | - Neil S Sheerin
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Anna Moles
- Fibrosis Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
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646
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Zhang L, Nie Y, Zheng Y, Ke L, Tong Z, Li W, Li J. Esmolol attenuates lung injury and inflammation in severe acute pancreatitis rats. Pancreatology 2016; 16:726-32. [PMID: 27269252 DOI: 10.1016/j.pan.2016.05.395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 05/18/2016] [Accepted: 05/29/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Recent studies suggest that beta-adrenergic blockers attenuate systemic inflammation and improve survival in sepsis. We investigated whether esmolol can reduce lung injury and modulate inflammatory response in a rat model of severe acute pancreatitis (SAP). METHODS A taurocholate-induced SAP was used, with or without continuously intravenous pumping of esmolol (15 mg/kg/h). Heart rate and arterial pressure were monitored. Nine hrs after esmolol administration, blood was drawn for blood gas analyses and cytokine (interleukin(IL)-6, tumor necrosis factor (TNF)-α) detections, lungs and pancreata were isolated for measurements of myeloperoxidase (MPO) activity and histological damage. In an additional 20 animals, rats were randomized into SAP or SAP + esmolol groups to assess effects of esmolol on survival time. RESULTS Treatment with esmolol was associated with improved survival time (11.1 ± 1.6 h vs. 9.2 ± 2.0 h, p = 0.044) and less severe disease, as assessed by lung and pancreas histology. Blood gas analyses were ameliorated in esmolol group. Arterial PO2 increased (109.7 ± 12.4 mmHg vs 93.9 ± 4.1 mmHg, p = 0.008) while lactate levels (2.1 ± 0.5 vs 3.1 ± 0.7 mmol/L, p = 0.001) decreased in SAP + esmolol group as compared with SAP group. Esmolol treatment also abated the increase in bronchoalveolar lavage fluid protein and proinflammatory cytokines. Furthermore, esmolol reduced SAP-induced plasma amylase activity (p = 0.02), blunted the expression of TNF-α (p = 0.003) and IL-6 (p < 0.001), and decreased pancreas/lung MPO activities. CONCLUSIONS Continuous infusion of esmolol, a selective beta-1 adrenergic blocker, improves outcome, reduces inflammatory responses and also offers lung and pancreas protective effects in SAP rats. This may offer novel therapeutic strategies in treating patients suffering from SAP.
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Affiliation(s)
- Luyao Zhang
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China; School of Basic Medical Science, Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Yao Nie
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yishan Zheng
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lu Ke
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhihui Tong
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Weiqin Li
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Jieshou Li
- Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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647
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Patschan D, Kribben A, Müller GA. Postischemic microvasculopathy and endothelial progenitor cell-based therapy in ischemic AKI: update and perspectives. Am J Physiol Renal Physiol 2016; 311:F382-94. [PMID: 27194716 DOI: 10.1152/ajprenal.00232.2016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 05/15/2016] [Indexed: 02/07/2023] Open
Abstract
Acute kidney injury (AKI) dramatically increases mortality of hospitalized patients. Incidences have been increased in recent years. The most frequent cause is transient renal hypoperfusion or ischemia which induces significant tubular cell dysfunction/damage. In addition, two further events take place: interstitial inflammation and microvasculopathy (MV). The latter evolves within minutes to hours postischemia and may result in permanent deterioration of the peritubular capillary network, ultimately increasing the risk for chronic kidney disease (CKD) in the long term. In recent years, our understanding of the molecular/cellular processes responsible for acute and sustained microvasculopathy has increasingly been expanded. The methodical approaches for visualizing impaired peritubular blood flow and increased vascular permeability have been optimized, even allowing the depiction of tissue abnormalities in a three-dimensional manner. In addition, endothelial dysfunction, a hallmark of MV, has increasingly been recognized as an inductor of both vascular malfunction and interstitial inflammation. In this regard, so-called regulated necrosis of the endothelium could potentially play a role in postischemic inflammation. Endothelial progenitor cells (EPCs), represented by at least two major subpopulations, have been shown to promote vascular repair in experimental AKI, not only in the short but also in the long term. The discussion about the true biology of the cells continues. It has been proposed that early EPCs are most likely myelomonocytic in nature, and thus they may simply be termed proangiogenic cells (PACs). Nevertheless, they reliably protect certain types of tissues/organs from ischemia-induced damage, mostly by modulating the perivascular microenvironment in an indirect manner. The aim of the present review is to summarize the current knowledge on postischemic MV and EPC-mediated renal repair.
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Affiliation(s)
- D Patschan
- Clinic of Nephrology and Rheumatology, University Hospital of Göttingen, Georg-August-University, Göttingen, Germany; and
| | - A Kribben
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - G A Müller
- Clinic of Nephrology and Rheumatology, University Hospital of Göttingen, Georg-August-University, Göttingen, Germany; and
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648
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Makris K, Spanou L. Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes. Clin Biochem Rev 2016; 37:85-98. [PMID: 28303073 PMCID: PMC5198510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Acute kidney injury (AKI) is a clinical syndrome that complicates the course and worsens the outcome in a significant number of hospitalised patients. Recent advances in clinical and basic research will help with a more accurate definition of this syndrome and in the elucidation of its pathogenesis. With this knowledge we will be able to conduct more accurate epidemiologic studies in an effort to gain a better understanding of the impact of this syndrome. AKI is a syndrome that rarely has a sole and distinct pathophysiology. Recent evidence, in both basic science and clinical research, is beginning to change our view for AKI from a single organ failure syndrome to a syndrome where the kidney plays an active role in the progress of multi-organ dysfunction. Accurate and prompt recognition of AKI and better understanding of the pathophysiologic mechanisms underlying the various clinical phenotypes are of great importance to research for effective therapeutic interventions. In this review we provide the most recent updates in the definition, epidemiology and pathophysiology of AKI.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, Kifissia, Athens, 14561, Greece
| | - Loukia Spanou
- Clinical Biochemistry Department, KAT General Hospital, Kifissia, Athens, 14561, Greece
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649
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Davis J, Raisis AL, Cianciolo RE, Miller DW, Shiel RE, Nabity MB, Hosgood GL. Urinary neutrophil gelatinase-associated lipocalin concentration changes after acute haemorrhage and colloid-mediated reperfusion in anaesthetized dogs. Vet Anaesth Analg 2016; 43:262-70. [DOI: 10.1111/vaa.12311] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 06/27/2015] [Indexed: 11/30/2022]
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650
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Dagher PC, Hato T, Mang HE, Plotkin Z, Richardson QV, Massad M, Mai E, Kuehl SE, Graham P, Kumar R, Sutton TA. Inhibition of Toll-Like Receptor 4 Signaling Mitigates Microvascular Loss but Not Fibrosis in a Model of Ischemic Acute Kidney Injury. Int J Mol Sci 2016; 17:ijms17050647. [PMID: 27136544 PMCID: PMC4881473 DOI: 10.3390/ijms17050647] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 04/19/2016] [Accepted: 04/25/2016] [Indexed: 01/22/2023] Open
Abstract
The development of chronic kidney disease (CKD) following an episode of acute kidney injury (AKI) is an increasingly recognized clinical problem. Inhibition of toll-like receptor 4 (TLR4) protects renal function in animal models of AKI and has become a viable therapeutic strategy in AKI. However, the impact of TLR4 inhibition on the chronic sequelae of AKI is unknown. Consequently, we examined the chronic effects of TLR4 inhibition in a model of ischemic AKI. Mice with a TLR4-deletion on a C57BL/6 background and wild-type (WT) background control mice (C57BL/6) were subjected to bilateral renal artery clamping for 19 min and reperfusion for up to 6 weeks. Despite the acute protective effect of TLR4 inhibition on renal function (serum creatinine 1.6 ± 0.4 mg/dL TLR4-deletion vs. 2.8 ± 0.3 mg/dL·WT) and rates of tubular apoptosis following ischemic AKI, we found no difference in neutrophil or macrophage infiltration. Furthermore, we observed significant protection from microvascular rarefaction at six weeks following injury with TLR4-deletion, but this did not alter development of fibrosis. In conclusion, we validate the acute protective effect of TLR4 signal inhibition in AKI but demonstrate that this protective effect does not mitigate the sequential fibrogenic response in this model of ischemic AKI.
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Affiliation(s)
- Pierre C Dagher
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Takashi Hato
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Henry E Mang
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Zoya Plotkin
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Quentin V Richardson
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Michael Massad
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Erik Mai
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Sarah E Kuehl
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Paige Graham
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Rakesh Kumar
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Timothy A Sutton
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, R2-202, 950 West Walnut Street, Indianapolis, IN 46202, USA.
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