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Giraud S, Kerforne T, Zely J, Ameteau V, Couturier P, Tauc M, Hauet T. The inhibition of eIF5A hypusination by GC7, a preconditioning protocol to prevent brain death-induced renal injuries in a preclinical porcine kidney transplantation model. Am J Transplant 2020; 20:3326-3340. [PMID: 32400964 DOI: 10.1111/ajt.15994] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/07/2020] [Accepted: 04/29/2020] [Indexed: 01/25/2023]
Abstract
The eIF5A hypusination inhibitor GC7 (N1-guanyl-1,7-diaminoheptane) was shown to protect from ischemic injuries. We hypothesized that GC7 could be useful for preconditioning kidneys from donors before transplantation. Using a preclinical porcine brain death (BD) donation model, we carried out in vivo evaluation of GC7 pretreatment (3 mg/kg iv, 5 minutes after BD) at the beginning of the 4h-donor management, after which kidneys were collected and cold-stored (18h in University of Wisconsin solution) and 1 was allotransplanted. Groups were defined as following (n = 6 per group): healthy (CTL), untreated BD (Vehicle), and GC7-treated BD (Vehicle + GC7). At the end of 4h-management, GC7 treatment decreased BD-induced markers, as radical oxygen species markers. In addition, GC7 increased expression of mitochondrial protective peroxisome proliferator-activated receptor-gamma coactivator-1-alpha (PGC1α) and antioxidant proteins (superoxyde-dismutase-2, heme oxygenase-1, nuclear factor [erythroid-derived 2]-like 2 [NRF2], and sirtuins). At the end of cold storage, GC7 treatment induced an increase of NRF2 and PGC1α mRNA and a better mitochondrial integrity/homeostasis with a decrease of dynamin- related protein-1 activation and increase of mitofusin-2. Moreover, GC7 treatment significantly improved kidney outcome during 90 days follow-up after transplantation (fewer creatininemia and fibrosis). Overall, GC7 treatment was shown to be protective for kidneys against BD-induced injuries during donor management and subsequently appeared to preserve antioxidant defenses and mitochondria homeostasis; these protective effects being accompanied by a better transplantation outcome.
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Affiliation(s)
- Sebastien Giraud
- INSERM UMR-1082 IRTOMIT, Poitiers, France.,Service de Biochimie, CHU de Poitiers, Poitiers, France
| | - Thomas Kerforne
- INSERM UMR-1082 IRTOMIT, Poitiers, France.,Faculté de Médecine et de Pharmacie, Université de Poitiers, Poitiers, France.,Service d'Anesthésie-Réanimation, CHU de Poitiers, Poitiers, France
| | - Jeremy Zely
- INSERM UMR-1082 IRTOMIT, Poitiers, France.,Faculté de Médecine et de Pharmacie, Université de Poitiers, Poitiers, France.,Service d'Anesthésie-Réanimation, CHU de Poitiers, Poitiers, France
| | - Virginie Ameteau
- INSERM UMR-1082 IRTOMIT, Poitiers, France.,Faculté de Médecine et de Pharmacie, Université de Poitiers, Poitiers, France
| | - Pierre Couturier
- INSERM UMR-1082 IRTOMIT, Poitiers, France.,Service de Biochimie, CHU de Poitiers, Poitiers, France.,MOPICT 'plate-forme MOdélisation Préclinique - Innovations Chirurgicale et Technologique', Domaine Expérimental du Magneraud, Surgères, France
| | - Michel Tauc
- Université Cote d'Azur, LP2M, CNRS-7370, Nice, France
| | - Thierry Hauet
- INSERM UMR-1082 IRTOMIT, Poitiers, France.,Service de Biochimie, CHU de Poitiers, Poitiers, France.,Faculté de Médecine et de Pharmacie, Université de Poitiers, Poitiers, France.,MOPICT 'plate-forme MOdélisation Préclinique - Innovations Chirurgicale et Technologique', Domaine Expérimental du Magneraud, Surgères, France.,FHU SUPORT 'SUrvival oPtimization in ORgan Transplantation', Poitiers, France
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Kerforne T, Allain G, Giraud S, Bon D, Ameteau V, Couturier P, Hebrard W, Danion J, Goujon JM, Thuillier R, Hauet T, Barrou B, Jayle C. Defining the optimal duration for normothermic regional perfusion in the kidney donor: A porcine preclinical study. Am J Transplant 2019; 19:737-751. [PMID: 30091857 DOI: 10.1111/ajt.15063] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 01/25/2023]
Abstract
Kidneys from donation after circulatory death (DCD) are highly sensitive to ischemia-reperfusion injury and thus require careful reconditioning, such as normothermic regional perfusion (NRP). However, the optimal NRP protocol remains to be characterized. NRP was modeled in a DCD porcine model (30 minutes of cardiac arrest) for 2, 4, or 6 hours compared to a control group (No-NRP); kidneys were machine-preserved and allotransplanted. NRP appeared to permit recovery from warm ischemia, possibly due to an increased expression of HIF1α-dependent survival pathway. At 2 hours, blood levels of ischemic injury biomarkers increased: creatinine, lactate/pyruvate ratio, LDH, AST, NGAL, KIM-1, CD40 ligand, and soluble-tissue-factor. All these markers then decreased with time; however, AST, NGAL, and KIM-1 increased again at 6 hours. Hemoglobin and platelets decreased at 6 hours, after which the procedure became difficult to maintain. Regarding inflammation, active tissue-factor, cleaved PAR-2 and MCP-1 increased by 4-6 hours, but not TNF-α and iNOS. Compared to No-NRP, NRP kidneys showed lower resistance during hypothermic machine perfusion (HMP), likely associated with pe-NRP eNOS activation. Kidneys transplanted after 4 and 6 hours of NRP showed better function and outcome, compared to No-NRP. In conclusion, our results confirm the mechanistic benefits of NRP and highlight 4 hours as its optimal duration, after which injury markers appear.
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Affiliation(s)
- Thomas Kerforne
- INSERM U1082, (IRTOMIT), Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France.,Anesthesia and Intensive Care Department, Poitiers Regional and Academic Teaching Hospital Center, Poitiers, France
| | - Geraldine Allain
- INSERM U1082, (IRTOMIT), Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France.,CardioVascular Surgery Division, Poitiers Regional and Academic Teaching Hospital Center, Poitiers, France
| | - Sebastien Giraud
- INSERM U1082, (IRTOMIT), Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France.,Biochemistry Department, Poitiers Regional and Academic Teaching Hospital Center, Poitiers, France
| | - Delphine Bon
- INSERM U1082, (IRTOMIT), Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France
| | - Virginie Ameteau
- INSERM U1082, (IRTOMIT), Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France
| | - Pierre Couturier
- INSERM U1082, (IRTOMIT), Poitiers, France.,Biochemistry Department, Poitiers Regional and Academic Teaching Hospital Center, Poitiers, France.,IBiSA 'plate-forme MOdélisation Préclinique - Innovations Chirurgicale et Technologique (MOPICT)', Domaine Expérimental du Magneraud, Surgères, France
| | - William Hebrard
- Unité expérimentale Génétique, Expérimentations et systèmes innovants (GENESI), INRA, Domaine Expérimental du Magneraud, Surgères, France
| | - Jerome Danion
- INSERM U1082, (IRTOMIT), Poitiers, France.,Visceral Surgery Department, Poitiers Regional and Academic Teaching Hospital Center, Poitiers, France
| | - Jean-Michel Goujon
- INSERM U1082, (IRTOMIT), Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France.,Pathology Department, Poitiers Regional and Academic Teaching Hospital Center, Poitiers, France
| | - Raphael Thuillier
- INSERM U1082, (IRTOMIT), Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France.,Biochemistry Department, Poitiers Regional and Academic Teaching Hospital Center, Poitiers, France
| | - Thierry Hauet
- INSERM U1082, (IRTOMIT), Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France.,Biochemistry Department, Poitiers Regional and Academic Teaching Hospital Center, Poitiers, France.,IBiSA 'plate-forme MOdélisation Préclinique - Innovations Chirurgicale et Technologique (MOPICT)', Domaine Expérimental du Magneraud, Surgères, France.,FHU SUPORT 'SUrvival oPtimization in ORgan Transplantation', Poitiers, France
| | - Benoit Barrou
- INSERM U1082, (IRTOMIT), Poitiers, France.,Service d'Urologie et de transplantation rénale, AP-HP, GH Pitié-Salpêtrière, Paris, France.,Pierre and Marie Curie Paris VI University, Paris, France
| | - Christophe Jayle
- INSERM U1082, (IRTOMIT), Poitiers, France.,Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France.,CardioVascular Surgery Division, Poitiers Regional and Academic Teaching Hospital Center, Poitiers, France.,IBiSA 'plate-forme MOdélisation Préclinique - Innovations Chirurgicale et Technologique (MOPICT)', Domaine Expérimental du Magneraud, Surgères, France
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Thuillier R, Renard C, Rogel-Gaillard C, Demars J, Milan D, Forestier L, Ouldmoulene A, Goujon JM, Badet L, Hauet T. Effect of polyethylene glycol-based preservation solutions on graft injury in experimental kidney transplantation. Br J Surg 2010; 98:368-78. [DOI: 10.1002/bjs.7332] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2010] [Indexed: 12/12/2022]
Abstract
Abstract
Background
New preservation solutions are emerging, of various ionic compositions and with hydroxyethyl starch replaced by polymers such as polyethylene glycols (PEGs), offering the potential for ‘immunocamouflage’. This experimental study investigated which of three clinically available preservation protocols offered the best graft protection, based on epithelial-to-mesenchymal transition (EMT) and fibrosis.
Methods
Kidneys were preserved for 24 h at 4 °C with University of Wisconsin solution (UW) as standard, compared with solutions containing either 1 g/l PEG 35 kDa (Institute Georges Lopez solution, IGL) or 30g/l PEG 20 kDa (solution de conservation des organes et des tissus, SCOT). Animals were followed for up to 3 months and development of EMT, tubular atrophy and fibrosis was evaluated in comparison with sham-operated animals.
Results
Functional recovery was better in the SCOT group compared with the other groups. Chronic fibrosis, EMT and inflammation were observed in the UW and IGL groups, but limited in the SCOT group. Levels of profibrosis markers such as transforming growth factor β1, plasminogen activator inhibitor 1 and connective tissue growth factor were increased in IGL and UW groups compared with the SCOT group. Hypoxia-inducible factor (HIF) 1α and 2α expression was increased at 3 months in grafts preserved in UW and IGL, but detected transiently on day 14 when SCOT was used. Expression of HIF-regulated genes vascular endothelial growth factor and erythropoietin was increased in UW and IGL groups.
Conclusion
The choice of colloid and ionic content is paramount in providing long-term protection against chronic graft injury after renal transplantation. Preservation solutions based on PEGs may optimize graft quality.
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Affiliation(s)
- R Thuillier
- Institut National de la Santé et de la Recherche Médicale (INSERM) U927 and Université de Poitiers, Poitiers, France
- Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- Fédération pour l'Étude de l'Ischémie Reperfusion en Transplantation (FLIRT), Poitiers, France
| | - C Renard
- Laboratoire de Radiobiologie et d'Étude du Génome, Unité Mixte de Recherche (UMR) 1061, Commissariat à l'Énergie Atomique-Institut National de la Recherche Agronomique (INRA), Jouy-en-Josas, France
| | - C Rogel-Gaillard
- Laboratoire de Radiobiologie et d'Étude du Génome, Unité Mixte de Recherche (UMR) 1061, Commissariat à l'Énergie Atomique-Institut National de la Recherche Agronomique (INRA), Jouy-en-Josas, France
| | - J Demars
- Laboratoire de Génétique Cellulaire, UMR 444, INRA, Castanet Tolosan, Limoges, France
| | - D Milan
- Laboratoire de Génétique Cellulaire, UMR 444, INRA, Castanet Tolosan, Limoges, France
| | - L Forestier
- Laboratoire de Génétique Moléculaire Animale, UMR 1061, Limoges, France
| | - A Ouldmoulene
- Laboratoire de Génétique Moléculaire Animale, UMR 1061, Limoges, France
| | - J M Goujon
- Institut National de la Santé et de la Recherche Médicale (INSERM) U927 and Université de Poitiers, Poitiers, France
| | - L Badet
- Institut National de la Santé et de la Recherche Médicale (INSERM) U927 and Université de Poitiers, Poitiers, France
- Fédération pour l'Étude de l'Ischémie Reperfusion en Transplantation (FLIRT), Poitiers, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- CENTAURE Network, Nantes, France
| | - T Hauet
- Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- Fédération pour l'Étude de l'Ischémie Reperfusion en Transplantation (FLIRT), Poitiers, France
- Plateforme IBiSA, Génétique et Expérimentation en Productions Animales, INRA, Domaine du Magneraud, Surgères, France
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