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Philipoff A, Lin Y, Teixeira-Pinto A, Gately R, Craig JC, Opdam H, Chapman JC, Pleass H, Rogers NM, Davies CE, McDonald S, Yang J, Lopez P, Wong G, Lim WH. Antecedent Cardiac Arrest Status of Donation After Circulatory Determination of Death (DCDD) Kidney Donors and the Risk of Delayed Graft Function After Kidney Transplantation: A Cohort Study. Transplantation 2024:00007890-990000000-00741. [PMID: 38685196 DOI: 10.1097/tp.0000000000005022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
BACKGROUND The number of donors from donation after circulatory determination of death (DCDD) has increased by at least 4-fold over the past decade. This study evaluated the association between the antecedent cardiac arrest status of controlled DCDD donors and the risk of delayed graft function (DGF). METHODS Using data from the Australia and New Zealand Dialysis and Transplant, the associations between antecedent cardiac arrest status of DCDD donors before withdrawal of cardiorespiratory support, DGF, posttransplant estimated glomerular filtration rate (eGFR), and allograft loss were examined using adjusted logistic, linear mixed modeling, and cox regression, respectively. Among donors who experienced cardiac arrest, we evaluated the association between duration and unwitnessed status of arrest and DGF. RESULTS A total of 1173 kidney transplant recipients received DCDD kidneys from 646 donors in Australia between 2014 and 2019. Of these, 335 DCDD had antecedent cardiac arrest. Compared with recipients of kidneys from donors without antecedent cardiac arrest, the adjusted odds ratio (95% confidence interval) for DGF was 0.85 (0.65-1.11) among those with kidneys from donors with cardiac arrest. There was no association between antecedent cardiac arrest and posttransplant eGFR or allograft loss. The duration of cardiac arrest and unwitnessed status were not associated with DGF. CONCLUSIONS This focused analysis in an Australian population showed that the allograft outcomes were similar whether DCDD donors had experienced a prior cardiac arrest, with no associations between duration or unwitnessed status of arrest and risk of DGF. This study thus provides important reassurance to transplant programs and the patients they counsel, to accept kidneys from donors through the DCDD pathway irrespective of a prior cardiac arrest.
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Affiliation(s)
- Adam Philipoff
- Department of Transplant Surgery, Western Australian Kidney and Liver Transplant Surgery, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Yingxin Lin
- Public Health, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Sydney Precision Data Science, Faculty of Science, School of Mathematics and Science, University of Sydney, Sydney, NSW, Australia
| | - Armando Teixeira-Pinto
- Public Health, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Ryan Gately
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Helen Opdam
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia
- DonateLife, Organ and Tissue Authority, Canberra, ACT, Australia
| | - Jeremy C Chapman
- The Westmead Institute for Medical Research, Centre for Transplant and Renal Research, Westmead Hospital, Sydney, NSW, Australia
| | - Henry Pleass
- Specialty of Surgery, University of Sydney, Sydney, NSW, Australia
| | - Natasha M Rogers
- The Westmead Institute for Medical Research, Centre for Transplant and Renal Research, Westmead Hospital, Sydney, NSW, Australia
- Department of Renal Medicine, Westmead Hospital, Sydney, NSW, Australia
| | - Christopher E Davies
- Australia and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Stephen McDonald
- Australia and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Department of Renal Medicine, Central Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Jean Yang
- Sydney Precision Data Science, Faculty of Science, School of Mathematics and Science, University of Sydney, Sydney, NSW, Australia
| | - Pedro Lopez
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, WA, Australia
- Grupo de Pesquisa em Exercício para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
| | - Germaine Wong
- Public Health, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Department of Renal Medicine, Westmead Hospital, Sydney, NSW, Australia
| | - Wai H Lim
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
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Dugbartey GJ. Nitric oxide in kidney transplantation. Biomed Pharmacother 2023; 167:115530. [PMID: 37722191 DOI: 10.1016/j.biopha.2023.115530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 09/20/2023] Open
Abstract
Kidney transplantation is the treatment of choice for patients with kidney failure. Compared to dialysis therapy, it provides better quality of life and confers significant survival advantage at a relatively lower cost. However, the long-term success of this life-saving intervention is severely hampered by an inexorable clinical problem referred to as ischemia-reperfusion injury (IRI), and increases the incidence of post-transplant complications including loss of renal graft function and death of transplant recipients. Burgeoning evidence shows that nitric oxide (NO), a poisonous gas at high concentrations, and with a historic negative public image as an environmental pollutant, has emerged as a potential candidate that holds clinical promise in mitigating IRI and preventing acute and chronic graft rejection when it is added to kidney preservation solutions at low concentrations or when administered to the kidney donor prior to kidney procurement and to the recipient or to the reperfusion circuit at the start and during reperfusion after renal graft preservation. Interestingly, dysregulated or abnormal endogenous production and metabolism of NO is associated with IRI in kidney transplantation. From experimental and clinical perspectives, this review presents endogenous enzymatic production of NO as well as its exogenous sources, and then discusses protective effects of constitutive nitric oxide synthase (NOS)-derived NO against IRI in kidney transplantation via several signaling pathways. The review also highlights a few isolated studies of renal graft protection by NO produced by inducible NOS.
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Affiliation(s)
- George J Dugbartey
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Accra College of Medicine, Magnolia St, JVX5+FX9, East Legon, Accra, Ghana.
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3
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Wu J, Yu L, Liu Y, Xiao B, Ye X, Zhao H, Xi Y, Shi Z, Wang W. Hypoxia regulates adipose mesenchymal stem cells proliferation, migration, and nucleus pulposus-like differentiation by regulating endoplasmic reticulum stress via the HIF-1α pathway. J Orthop Surg Res 2023; 18:339. [PMID: 37158945 PMCID: PMC10169485 DOI: 10.1186/s13018-023-03818-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/01/2023] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVE Hypoxia can promote stem cell proliferation and migration through HIF-1α. Hypoxia can regulate cellular endoplasmic reticulum (ER) stress. Some studies have reported the relationship among hypoxia, HIF-α, and ER stress, however, while little is known about HIF-α and ER stress in ADSCs under hypoxic conditions. The purpose of the study was to investigate the role and relationship of hypoxic conditions, HIF-1α and ER stress in regulating adipose mesenchymal stem cells (ADSCs) proliferation, migration, and NPC-like differentiation. METHOD ADSCs were pretreated with hypoxia, HIF-1α gene transfection, and HIF-1α gene silence. The ADSCs proliferation, migration, and NPC-like differentiation were assessed. The expression of HIF-1α in ADSCs was regulated; then, the changes of ER stress level in ADSCs were observed to investigate the relationship between ER stress and HIF-1α in ADSCs under hypoxic conditions. RESULT The cell proliferation and migration assay results show that hypoxia and HIF-1α overexpression can significantly increase the ADSCs proliferation and migration, while HIF-1α inhibition can significantly decrease the ADSCs proliferation and migration. The HIF-1α and co-cultured with NPCs played an important role in the directional differentiation of ADSCs into NPCs. The hypoxia-regulated ER stress in ADSCs through the HIF-1α pathway, thereby regulating the cellular state of ADSCs, was also observed. CONCLUSION Hypoxia and HIF-1α play important roles in proliferation, migration, and NPC-like differentiation of ADSCs. This study provides preliminary evidence that HIF-1α-regulated ER stress thus affects ADSCs proliferation, migration, and differentiation. Therefore, HIF-1α and ER may serve as key points to improve the efficacy of ADSCs in treating disc degeneration.
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Affiliation(s)
- Jianxin Wu
- Department of Orthopaedics, First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Shanghai, People's Republic of China
| | - Lei Yu
- Department of Orthopedic Surgery and Neurosurgery, No. 906 Hospital of the People's Liberation Army, Ningbo, Zhejiang, People's Republic of China
| | - Yi Liu
- Department of Orthopedics, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Kangfu Road, Tianjin, People's Republic of China
| | - Bing Xiao
- Department of Orthopaedics, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, People's Republic of China
| | - Xiaojian Ye
- Department of Orthopaedics, Tongren Hospital of Shanghai Jiaotong University, No. 1111, Xianxia Road, Shanghai, People's Republic of China
| | - Hong Zhao
- Department of Orthopedics, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Kangfu Road, Tianjin, People's Republic of China
| | - Yanhai Xi
- Department of Orthopaedics, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, People's Republic of China
| | - Zhicai Shi
- Department of Orthopaedics, First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Shanghai, People's Republic of China
| | - Weiheng Wang
- Department of Orthopaedics, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Shanghai, People's Republic of China.
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Widjaja G, Jalil AT, Budi HS, Abdelbasset WK, Efendi S, Suksatan W, Rita RS, Satria AP, Aravindhan S, Saleh MM, Shalaby MN, Yumashev AV. Mesenchymal stromal/stem cells and their exosomes application in the treatment of intervertebral disc disease: A promising frontier. Int Immunopharmacol 2022. [DOI: https://doi.org/10.1016/j.intimp.2022.108537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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5
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Widjaja G, Jalil AT, Budi HS, Abdelbasset WK, Efendi S, Suksatan W, Rita RS, Satria AP, Aravindhan S, Saleh MM, Shalaby MN, Yumashev AV. Mesenchymal stromal/stem cells and their exosomes application in the treatment of intervertebral disc disease: A promising frontier. Int Immunopharmacol 2022; 105:108537. [PMID: 35101851 DOI: 10.1016/j.intimp.2022.108537] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/01/2022] [Accepted: 01/07/2022] [Indexed: 02/07/2023]
Abstract
Today, the application of mesenchymal stromal/stem cells (MSCs) and their exosomes to treat degenerative diseases has received attention. Due to the characteristics of these cells, such as self-renewability, differentiative and immunomodulatory effects, their use in laboratory and clinical studies shows promising results. However, the allogeneic transplantation problems of MSCs limit the use of these cells in the clinic. Scientists propose the application of exosomes to use from the therapeutic effect of MSCs and overcome their defects. These vesicles change the target cell behaviour and transcription profile by transferring various cargo such as proteins, mi-RNAs, and lipids. One of the degenerative tissue diseases in which MSCs and their exosomes are used in their treatment is intervertebral disc disease (IDD). Different factors such as genetics, nutrition, ageing, and environmental factors play a significant role in the onset and progression of this disease. These factors affect the cellular and molecular properties of the disc, leading to tissue destruction. Nucleus pulposus cells (NPCs) are among the most important cells involved in the pathogenesis of disc degeneration. MSCs exert their therapeutic effects by differentiating, reducing apoptosis, increasing proliferation, and decreasing senescence in NPCs. In addition, the use of MSCs and their exosomes also affects the annulus fibrosus and cartilaginous endplate cells in disc tissue and prevents disc degeneration progression.
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Affiliation(s)
- Gunawan Widjaja
- Postgraduate Study, Universitas Krisnadwipayana, Bekasi, Indonesia; Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Abduladheem Turki Jalil
- Faculty of Biology and Ecology, Yanka Kupala State University of Grodno, 230023 Grodno, Belarus; College of Technical Engineering, The Islamic University, Najaf, Iraq; Department of Dentistry, Kut University College, Kut, Wasit 52001, Iraq
| | - Hendrik Setia Budi
- Department of Oral Biology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia.
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia; Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Syahril Efendi
- Fasilkom-TI, Universitas Sumatera Utara, Medan, Indonesia.
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Rauza Sukma Rita
- Department of Biochemistry, Faculty of Medicine, Universitas Andalas, Indonesia
| | - Andri Praja Satria
- Faculty of Nursing, Universitas Muhammadiyah Kalimantan Timur, Samarinda 75124, Indonesia
| | - Surendar Aravindhan
- Department of Pharmacology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Marwan Mahmood Saleh
- Department of Biophysics, College of Applied Sciences, University Of Anbar, Iraq
| | - Mohammed Nader Shalaby
- Biological Sciences and Sports Health Department, Faculty of Physical Education, Suez Canal University, Egypt
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6
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Groves HK, Lee H. Perioperative Management of Renal Failure and Renal Transplant. Perioper Med (Lond) 2022. [DOI: 10.1016/b978-0-323-56724-4.00019-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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7
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Melis N, Carcy R, Rubera I, Cougnon M, Duranton C, Tauc M, Pisani DF. Akt Inhibition as Preconditioning Treatment to Protect Kidney Cells against Anoxia. Int J Mol Sci 2021; 23:ijms23010152. [PMID: 35008578 PMCID: PMC8745656 DOI: 10.3390/ijms23010152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/15/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
Lesions issued from the ischemia/reperfusion (I/R) stress are a major challenge in human pathophysiology. Of human organs, the kidney is highly sensitive to I/R because of its high oxygen demand and poor regenerative capacity. Previous studies have shown that targeting the hypusination pathway of eIF5A through GC7 greatly improves ischemic tolerance and can be applied successfully to kidney transplants. The protection process correlates with a metabolic shift from oxidative phosphorylation to glycolysis. Because the protein kinase B Akt is involved in ischemic protective mechanisms and glucose metabolism, we looked for a link between the effects of GC7 and Akt in proximal kidney cells exposed to anoxia or the mitotoxic myxothiazol. We found that GC7 treatment resulted in impaired Akt phosphorylation at the Ser473 and Thr308 sites, so the effects of direct Akt inhibition as a preconditioning protocol on ischemic tolerance were investigated. We evidenced that Akt inhibitors provide huge protection for kidney cells against ischemia and myxothiazol. The pro-survival effect of Akt inhibitors, which is reversible, implied a decrease in mitochondrial ROS production but was not related to metabolic changes or an antioxidant defense increase. Therefore, the inhibition of Akt can be considered as a preconditioning treatment against ischemia.
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Affiliation(s)
- Nicolas Melis
- Laboratory of Cellular and Molecular Biology, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA;
| | - Romain Carcy
- Université Côte d’Azur, CNRS, LP2M, 06103 Nice, France; (R.C.); (I.R.); (M.C.); (C.D.); (M.T.)
- CHU Nice, Hôpital Pasteur 2, Service de Réanimation Polyvalente et Service de Réanimation des Urgences Vitales, 06103 Nice, France
- Laboratories of Excellence Ion Channel Science and Therapeutics, 06103 Nice, France
| | - Isabelle Rubera
- Université Côte d’Azur, CNRS, LP2M, 06103 Nice, France; (R.C.); (I.R.); (M.C.); (C.D.); (M.T.)
- Laboratories of Excellence Ion Channel Science and Therapeutics, 06103 Nice, France
| | - Marc Cougnon
- Université Côte d’Azur, CNRS, LP2M, 06103 Nice, France; (R.C.); (I.R.); (M.C.); (C.D.); (M.T.)
- Laboratories of Excellence Ion Channel Science and Therapeutics, 06103 Nice, France
| | - Christophe Duranton
- Université Côte d’Azur, CNRS, LP2M, 06103 Nice, France; (R.C.); (I.R.); (M.C.); (C.D.); (M.T.)
- Laboratories of Excellence Ion Channel Science and Therapeutics, 06103 Nice, France
| | - Michel Tauc
- Université Côte d’Azur, CNRS, LP2M, 06103 Nice, France; (R.C.); (I.R.); (M.C.); (C.D.); (M.T.)
- Laboratories of Excellence Ion Channel Science and Therapeutics, 06103 Nice, France
| | - Didier F. Pisani
- Université Côte d’Azur, CNRS, LP2M, 06103 Nice, France; (R.C.); (I.R.); (M.C.); (C.D.); (M.T.)
- Laboratories of Excellence Ion Channel Science and Therapeutics, 06103 Nice, France
- Correspondence:
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8
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Budhiraja P, Heilman RL, Jadlowiec CC, Smith ML, Ryan MS, Khamash HA, Kodali L, Moss AA, Mathur AK, Reddy KS. Successful outcomes with transplanting kidneys from deceased donors with acute kidney injuryon temporary renal replacement therapy. Clin Transplant 2021; 35:e14465. [PMID: 34514643 DOI: 10.1111/ctr.14465] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND OBJECTIVES We aimed to determine outcomes with transplanting kidneys from deceased donors with severe acute kidney injury requiring acute renal replacement therapy (RRT). MATERIALS AND METHODS A total of 172 recipients received a kidney from donors with acute kidney injury stage 3 (AKIN3) requiring RRT. We compared the study group to 528 recipients who received a kidney from donors with AKIN stage 3 not on RRT and 463 recipients who received < 85% Kidney Donor Profile Index (KDPI) AKIN stage 0 kidney. RESULTS The study group donors were younger compared to the 2 control groups. Despite higher DGF in the study group, the length of hospital stay and acute rejection were similar. Death censored graft survival (96% AKIN3-RRT vs. 97%AKIN3 no RRT vs. 96% KDPI < 85% AKIN0, P = 0.26) and patient survival with functioning graft at 1 year (95% across all groups, P = 0.402) were similar. The estimated glomerular filtration rate were similar across the 3 groups after first month. Interstitial fibrosis and tubular atrophy score ≥ 2 on protocol biopsy at time 0, 4 and 12 months were similar. Primary nonfunction was rare and associated with high KDPI. CONCLUSIONS Transplanting selected kidneys from deceased donors with AKIN3 requiring RRT is safe and has good outcomes.
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Affiliation(s)
- Pooja Budhiraja
- Division of Nephrology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | | | | | - Maxwell L Smith
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, Arizona, USA
| | - Margaret S Ryan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, Arizona, USA
| | - Hasan A Khamash
- Division of Nephrology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Lavanya Kodali
- Division of Nephrology, Mayo Clinic Hospital, Phoenix, Arizona, USA
| | - Adyr A Moss
- Department of Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Amit K Mathur
- Department of Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Kunam S Reddy
- Department of Surgery, Mayo Clinic, Phoenix, Arizona, USA
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9
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Franzin R, Stasi A, Fiorentino M, Simone S, Oberbauer R, Castellano G, Gesualdo L. Renal Delivery of Pharmacologic Agents During Machine Perfusion to Prevent Ischaemia-Reperfusion Injury: From Murine Model to Clinical Trials. Front Immunol 2021; 12:673562. [PMID: 34295329 PMCID: PMC8290413 DOI: 10.3389/fimmu.2021.673562] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/21/2021] [Indexed: 12/12/2022] Open
Abstract
Donor organ shortage still remains a serious obstacle for the access of wait-list patients to kidney transplantation, the best treatment for End-Stage Kidney Disease (ESKD). To expand the number of transplants, the use of lower quality organs from older ECD or DCD donors has become an established routine but at the price of increased incidence of Primary Non-Function, Delay Graft Function and lower-long term graft survival. In the last years, several improvements have been made in the field of renal transplantation from surgical procedure to preservation strategies. To improve renal outcomes, research has focused on development of innovative and dynamic preservation techniques, in order to assess graft function and promote regeneration by pharmacological intervention before transplantation. This review provides an overview of the current knowledge of these new preservation strategies by machine perfusions and pharmacological interventions at different timing possibilities: in the organ donor, ex-vivo during perfusion machine reconditioning or after implementation in the recipient. We will report therapies as anti-oxidant and anti-inflammatory agents, senolytics agents, complement inhibitors, HDL, siRNA and H2S supplementation. Renal delivery of pharmacologic agents during preservation state provides a window of opportunity to treat the organ in an isolated manner and a crucial route of administration. Even if few studies have been reported of transplantation after ex-vivo drugs administration, targeting the biological pathway associated to kidney failure (i.e. oxidative stress, complement system, fibrosis) might be a promising therapeutic strategy to improve the quality of various donor organs and expand organ availability.
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Affiliation(s)
- Rossana Franzin
- Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, Italy
| | - Alessandra Stasi
- Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, Italy
| | - Marco Fiorentino
- Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, Italy
| | - Simona Simone
- Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, Italy
| | - Rainer Oberbauer
- Department of Nephrology and Dialysis, University Clinic for Internal Medicine III, Medical University Vienna, Vienna, Austria
| | - Giuseppe Castellano
- Nephrology, Dialysis and Transplantation Unit, Advanced Research Center on Kidney Aging (A.R.K.A.), Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Loreto Gesualdo
- Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, Italy
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10
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Carcy R, Cougnon M, Poet M, Durandy M, Sicard A, Counillon L, Blondeau N, Hauet T, Tauc M, F Pisani D. Targeting oxidative stress, a crucial challenge in renal transplantation outcome. Free Radic Biol Med 2021; 169:258-270. [PMID: 33892115 DOI: 10.1016/j.freeradbiomed.2021.04.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/31/2021] [Accepted: 04/15/2021] [Indexed: 02/07/2023]
Abstract
Disorders characterized by ischemia/reperfusion (I/R) are the most common causes of debilitating diseases and death in stroke, cardiovascular ischemia, acute kidney injury or organ transplantation. In the latter example the I/R step defines both the amplitude of the damages to the graft and the functional recovery outcome. During transplantation the kidney is subjected to blood flow arrest followed by a sudden increase in oxygen supply at the time of reperfusion. This essential clinical protocol causes massive oxidative stress which is at the basis of cell death and tissue damage. The involvement of both reactive oxygen species (ROS) and nitric oxides (NO) has been shown to be a major cause of these cellular damages. In fact, in non-physiological situations, these species escape endogenous antioxidant control and dangerously accumulate in cells. In recent years, the objective has been to find clinical and pharmacological treatments to reduce or prevent the appearance of oxidative stress in ischemic pathologies. This is very relevant because, due to the increasing success of organ transplantation, clinicians are required to use limit organs, the preservation of which against oxidative stress is crucial for a better outcome. This review highlights the key actors in oxidative stress which could represent new pharmacological targets.
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Affiliation(s)
- Romain Carcy
- Université Côte d'Azur, CNRS, LP2M, Nice, France; CHU Nice, Hôpital Pasteur 2, Service de Réanimation Polyvalente et Service de Réanimation des Urgences Vitales, Nice, France; Laboratories of Excellence Ion Channel Science and Therapeutics, Nice, France
| | - Marc Cougnon
- Université Côte d'Azur, CNRS, LP2M, Nice, France; Laboratories of Excellence Ion Channel Science and Therapeutics, Nice, France
| | - Mallorie Poet
- Université Côte d'Azur, CNRS, LP2M, Nice, France; Laboratories of Excellence Ion Channel Science and Therapeutics, Nice, France
| | - Manon Durandy
- Université Côte d'Azur, CNRS, LP2M, Nice, France; Laboratories of Excellence Ion Channel Science and Therapeutics, Nice, France
| | - Antoine Sicard
- Université Côte d'Azur, CNRS, LP2M, Nice, France; Laboratories of Excellence Ion Channel Science and Therapeutics, Nice, France; CHU Nice, Hôpital Pasteur 2, Service de Néphrologie-Dialyse-Transplantation, Nice, France; Clinical Research Unit of Université Côte d'Azur (UMR2CA), France
| | - Laurent Counillon
- Université Côte d'Azur, CNRS, LP2M, Nice, France; Laboratories of Excellence Ion Channel Science and Therapeutics, Nice, France
| | | | - Thierry Hauet
- Université de Poitiers, INSERM, IRTOMIT, CHU de Poitiers, La Milétrie, Poitiers, France
| | - Michel Tauc
- Université Côte d'Azur, CNRS, LP2M, Nice, France; Laboratories of Excellence Ion Channel Science and Therapeutics, Nice, France
| | - Didier F Pisani
- Université Côte d'Azur, CNRS, LP2M, Nice, France; Laboratories of Excellence Ion Channel Science and Therapeutics, Nice, France.
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11
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Abstract
Although over 90 000 people are on the kidney transplant waitlist in the United States, some kidneys that are viable for transplantation are discarded. Transplant surgeons are more likely to discard deceased donors with acute kidney injury (AKI) versus without AKI (30% versus 18%). AKI is defined using changes in creatinine from baseline. Transplant surgeons can use DonorNet data, including admission, peak, and terminal serum creatinine, and biopsy data when available to differentiate kidneys with AKI from those with chronic injury. Although chronic kidney disease is associated with reduced graft survival, an abundance of literature has demonstrated similar graft survival for deceased donors with AKI versus donors without AKI. Donors with AKI are more likely to undergo delayed graft function but have similar long-term outcomes as donors without AKI. The mechanism for similar graft survival is unclear. Some hypothesized mechanisms include (1) ischemic preconditioning; (2) posttransplant and host factors playing a greater role in long-term survival than donor factors; and (3) selection bias of transplanting only relatively healthy donor kidneys with AKI. Existing literature suggests transplanting more donor kidneys with stage 1 and 2 AKI, and cautious utilization of stage 3 AKI donors, may increase the pool of viable kidneys. Doing so can reduce the number of people who die on the waitlist by over 500 every year.
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Affiliation(s)
- Neel Koyawala
- School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Chirag R Parikh
- Division of Nephrology, School of Medicine, Johns Hopkins University, Baltimore, MD
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Tavares-da-Silva E, Figueiredo A. Renal Procurement: Techniques for Optimizing the Quality of the Graft in the Cadaveric Setting. Curr Urol Rep 2020; 21:12. [PMID: 32166407 DOI: 10.1007/s11934-020-0963-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW Kidney transplantation is the best treatment for end-stage renal disease. However, due to organ shortage, suboptimal grafts are increasingly being used. RECENT FINDINGS We carried out a review on the methods and techniques of organ optimization in the cadaveric setting. Donor care is the first link in a chain of care. Right after brain death, there is a set of changes, of which hormonal and hemodynamic changes are the most relevant. Several studies have been conducted to determine which drugs to administer, although in most cases, the results are not definitive. The main goal seems rather achieve a set of biochemical and hemodynamic objectives. The ischemia-reperfusion injury is a critical factor for kidney damage in transplantation. One of the ways found to deal with this type of injury is preconditioning. Local and remote ischemic preconditioning has been studied for various organs, but studies on the kidney are scarce. A new promising area is pharmacological preconditioning, which is taking its first steps. Main surgical techniques were established in the late twentieth century. Some minor new features have been introduced to deal with anatomical variations or the emergence of donation after circulatory death. Finally, after harvesting, it is necessary to ensure the best conditions for the kidneys until the time of transplantation. Much has evolved since static cold preservation, but the best preservation conditions are yet to be determined. Conservation in the cold has come to be questioned, and great results have appeared at temperatures closer to physiological.
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Affiliation(s)
- Edgar Tavares-da-Silva
- Urology and Renal Transplantation Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal.,Centro de Investigação em Meio Ambiente, Genética e Oncobiologia (CIMAGO), Coimbra, Portugal
| | - Arnaldo Figueiredo
- Urology and Renal Transplantation Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal. .,Faculty of Medicine, University of Coimbra, Coimbra, Portugal. .,Coimbra Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal. .,Centro de Investigação em Meio Ambiente, Genética e Oncobiologia (CIMAGO), Coimbra, Portugal.
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Russ M, Ott S, Bedarf JR, Kirschfink M, Hiebl B, Unger JK. Increased compensatory kidney workload results in cellular damage in a short time porcine model of mixed acidemia - Is acidemia a 'first hit' in acute kidney injury? PLoS One 2019; 14:e0218308. [PMID: 31206554 PMCID: PMC6576776 DOI: 10.1371/journal.pone.0218308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 05/30/2019] [Indexed: 12/20/2022] Open
Abstract
Acute kidney injury (AKI) corrupts the outcome of about 50% of all critically ill patients. We investigated the possible contribution of the pathology acidemia on the development of AKI. Pigs were exposed to acidemia, acidemia plus hypoxemia or a normal acid-base balance in an experimental setup, which included mechanical ventilation and renal replacement therapy to facilitate biotrauma caused by extracorporeal therapies. Interestingly, extensive histomorphological changes like a tubular loss of cell barriers occurred in the kidneys after just 5 hours exposure to acidemia. The additional exposure to hypoxemia aggravated these findings. These ‘early’ microscopic pathologies opposed intra vitam data of kidney function. They did not mirror cellular or systemic patterns of proinflammatory molecules (like TNF-α or IL 18) nor were they detectable by new, sensitive markers of AKI like Neutrophil gelatinase-associated lipocalin. Instead, the data suggest that the increased renal proton excretion during acidemia could be an ‘early’ first hit in the multifactorial pathogenesis of AKI.
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Affiliation(s)
- Martin Russ
- Department of Anesthesiology and Operative Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
- * E-mail:
| | - Sascha Ott
- Department of Experimental Medicine, Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Janis R. Bedarf
- Department of Neurology, University of Bonn, Bonn, Germany
- German Centre for Neurodegenerative Disease Research (DZNE), Bonn, Germany
| | - Michael Kirschfink
- Institute for Clinical Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Bernhard Hiebl
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviour and Virtual Center for Replacement–Complementary Methods to Animal Testing, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Juliane K. Unger
- Department of Experimental Medicine, Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Berlin, Germany
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O'Kane D, Baldwin GS, Bolton DM, Ischia JJ, Patel O. Preconditioning against renal ischaemia reperfusion injury: the failure to translate to the clinic. J Nephrol 2019; 32:539-547. [PMID: 30635875 DOI: 10.1007/s40620-019-00582-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 01/03/2019] [Indexed: 12/22/2022]
Abstract
Acute kidney injury (AKI) as a result of ischaemia-reperfusion represents a major healthcare burden worldwide. Mortality rates from AKI in hospitalized patients are extremely high and have changed little despite decades of research and medical advances. In 1986, Murry et al. demonstrated for the first time the phenomenon of ischaemic preconditioning to protect against ischaemia-reperfusion injury (IRI). This seminal finding paved the way for a broad body of research, which attempted to understand and ultimately harness this phenomenon for human application. The ability of preconditioning to limit renal IRI has now been demonstrated in multiple different animal models. However, more than 30 years later, a safe and consistent method of protecting human organs, including the kidneys, against IRI is still not available. This review highlights agents which, despite strong preclinical data, have recently failed to reduce AKI in human trials. The multiple reasons which may have contributed to the failure to translate some of the promising findings to clinical therapies are discussed. Agents which hold promise in the clinic because of their recent efficacy in preclinical large animal models are also reviewed.
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Affiliation(s)
- Dermot O'Kane
- Department of Surgery, Austin Health, The University of Melbourne, Studley Rd., Heidelberg, VIC, 3084, Australia
- Department of Urology, Austin Health, Heidelberg, VIC, Australia
| | - Graham S Baldwin
- Department of Surgery, Austin Health, The University of Melbourne, Studley Rd., Heidelberg, VIC, 3084, Australia
| | - Damien M Bolton
- Department of Surgery, Austin Health, The University of Melbourne, Studley Rd., Heidelberg, VIC, 3084, Australia
- Department of Urology, Austin Health, Heidelberg, VIC, Australia
| | - Joseph J Ischia
- Department of Surgery, Austin Health, The University of Melbourne, Studley Rd., Heidelberg, VIC, 3084, Australia
- Department of Urology, Austin Health, Heidelberg, VIC, Australia
| | - Oneel Patel
- Department of Surgery, Austin Health, The University of Melbourne, Studley Rd., Heidelberg, VIC, 3084, Australia.
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15
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Sethi K, Rao K, Bolton D, Patel O, Ischia J. Targeting HIF-1 α to Prevent Renal Ischemia-Reperfusion Injury: Does It Work? Int J Cell Biol 2018; 2018:9852791. [PMID: 30595695 PMCID: PMC6286753 DOI: 10.1155/2018/9852791] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 11/14/2018] [Indexed: 12/26/2022] Open
Abstract
Partial nephrectomy (open or minimally invasive) usually requires temporary renal arterial occlusion to limit intraoperative bleeding and improve access to intrarenal structures. This is a time-critical step due to the critical ischemia period of renal tissue. Prolonged renal ischemia may lead to irreversible nephron damage in the remaining tissue and, ultimately, chronic kidney disease. This is potentiated by the incompletely understood ischemia-reperfusion injury (IRI). A key mechanism in IRI prevention appears to be the upregulation of an intracellular transcription protein, Hypoxia-Inducible Factor (HIF). HIF mediates metabolic adaptation, angiogenesis, erythropoiesis, cell growth, survival, and apoptosis. Upregulating HIF-1α via ischemic preconditioning (IPC) or drugs that simulate hypoxia (hypoxia-mimetics) has been investigated as a method to reduce IRI. While many promising chemical agents have been trialed for the prevention of IRI in small animal studies, all have failed in human trials. The aim of this review is to highlight the techniques and drugs that target HIF-1α and ameliorate IRI associated with renal ischemia. Developing a technique or drug that could reduce the risk of acute kidney injury associated with renal IRI would have an immediate worldwide impact on multisystem surgeries that would otherwise risk ischemic tissue injury.
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Affiliation(s)
- Kapil Sethi
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, VIC, Australia
- Urology Unit, Austin Health, Heidelberg, VIC, Australia
| | - Kenny Rao
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, VIC, Australia
- Urology Unit, Austin Health, Heidelberg, VIC, Australia
| | - Damien Bolton
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, VIC, Australia
- Urology Unit, Austin Health, Heidelberg, VIC, Australia
| | - Oneel Patel
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, VIC, Australia
| | - Joseph Ischia
- Department of Surgery, Austin Health, University of Melbourne, Heidelberg, VIC, Australia
- Urology Unit, Austin Health, Heidelberg, VIC, Australia
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Didar G, Delpazir F, Kaviani M, Azarpira N, Sepehrara L, Ebadi P, Koohpeyma F. Influence of mesenchymal stem cells and royal jelly on kidney damage triggered by ischemia-reperfusion injury: comparison with ischemic preconditioning in an animal model. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s00580-018-2842-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Baban B, Marchetti C, Khodadadi H, Malik A, Emami G, Lin PC, Arbab AS, Riccardi C, Mozaffari MS. Glucocorticoid-Induced Leucine Zipper Promotes Neutrophil and T-Cell Polarization with Protective Effects in Acute Kidney Injury. J Pharmacol Exp Ther 2018; 367:483-493. [PMID: 30301736 DOI: 10.1124/jpet.118.251371] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/01/2018] [Indexed: 12/11/2022] Open
Abstract
The glucocorticoid-induced leucine zipper (GILZ) mediates anti-inflammatory effects of glucocorticoids. Acute kidney injury (AKI) mobilizes immune/inflammatory mechanisms, causing tissue injury, but the impact of GILZ in AKI is not known. Neutrophils play context-specific proinflammatory [type 1 neutrophil (N1)] and anti-inflammatory [type 2 neutrophil (N2)] functional roles. Also, regulatory T lymphocytes (Tregs) and regulatory T-17 (Treg17) cells exert counterinflammatory effects, including the suppression of effector T lymphocytes [e.g., T-helper (Th) 17 cells]. Thus, utilizing cell preparations of mice kidneys subjected to AKI or sham operation, we determined the effects of GILZ on T cells and neutrophil subtypes in the context of its renoprotective effect; these studies used the transactivator of transcription (TAT)-GILZ or the TAT peptide. AKI increased N1 and Th-17 cells but reduced N2, Tregs, and Treg17 cells in association with increased interleukin (IL)-17+ but reduced IL-10+ cells accompanied with the disruption of mitochondrial membrane potential (ψ m) and increased apoptosis/necrosis compared with sham kidneys. TAT-GILZ, compared with TAT, treatment reduced N1 and Th-17 cells but increased N2 and Tregs, without affecting Treg17 cells, in association with a reduction in IL-17+ cells but an increase in IL-10+ cells; TAT-GILZ caused less disruption of ψ m and reduced cell death in AKI. Importantly, TAT-GILZ increased perfusion of the ischemic-reperfused kidney but reduced tissue edema compared with TAT. Utilizing splenic T cells and bone marrow-derived neutrophils, we further showed marked reduction in the proliferation of Th cells in response to TAT-GILZ compared with response to TAT. Collectively, the results indicate that GILZ exerts renoprotection accompanied by the upregulation of the regulatory/suppressive arm of immunity in AKI, likely via regulating cross talk between T cells and neutrophils.
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Affiliation(s)
- Babak Baban
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia (B.B., H.K., A.M., G.E., M.S.M.) and Georgia Cancer Center (P.-C.L., A.S.A.), Augusta University, Augusta, Georgia; and Department of Medicine, University of Perugia, Perugia, Italy (C.M., C.R.)
| | - Cristina Marchetti
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia (B.B., H.K., A.M., G.E., M.S.M.) and Georgia Cancer Center (P.-C.L., A.S.A.), Augusta University, Augusta, Georgia; and Department of Medicine, University of Perugia, Perugia, Italy (C.M., C.R.)
| | - Hesam Khodadadi
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia (B.B., H.K., A.M., G.E., M.S.M.) and Georgia Cancer Center (P.-C.L., A.S.A.), Augusta University, Augusta, Georgia; and Department of Medicine, University of Perugia, Perugia, Italy (C.M., C.R.)
| | - Aneeq Malik
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia (B.B., H.K., A.M., G.E., M.S.M.) and Georgia Cancer Center (P.-C.L., A.S.A.), Augusta University, Augusta, Georgia; and Department of Medicine, University of Perugia, Perugia, Italy (C.M., C.R.)
| | - Golnaz Emami
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia (B.B., H.K., A.M., G.E., M.S.M.) and Georgia Cancer Center (P.-C.L., A.S.A.), Augusta University, Augusta, Georgia; and Department of Medicine, University of Perugia, Perugia, Italy (C.M., C.R.)
| | - Ping-Chang Lin
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia (B.B., H.K., A.M., G.E., M.S.M.) and Georgia Cancer Center (P.-C.L., A.S.A.), Augusta University, Augusta, Georgia; and Department of Medicine, University of Perugia, Perugia, Italy (C.M., C.R.)
| | - Ali S Arbab
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia (B.B., H.K., A.M., G.E., M.S.M.) and Georgia Cancer Center (P.-C.L., A.S.A.), Augusta University, Augusta, Georgia; and Department of Medicine, University of Perugia, Perugia, Italy (C.M., C.R.)
| | - Carlo Riccardi
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia (B.B., H.K., A.M., G.E., M.S.M.) and Georgia Cancer Center (P.-C.L., A.S.A.), Augusta University, Augusta, Georgia; and Department of Medicine, University of Perugia, Perugia, Italy (C.M., C.R.)
| | - Mahmood S Mozaffari
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia (B.B., H.K., A.M., G.E., M.S.M.) and Georgia Cancer Center (P.-C.L., A.S.A.), Augusta University, Augusta, Georgia; and Department of Medicine, University of Perugia, Perugia, Italy (C.M., C.R.)
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18
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Wang W, Huang X, Lin W, Qiu Y, He Y, Yu J, Xi Y, Ye X. Hypoxic preconditioned bone mesenchymal stem cells ameliorate spinal cord injury in rats via improved survival and migration. Int J Mol Med 2018; 42:2538-2550. [PMID: 30106084 PMCID: PMC6192716 DOI: 10.3892/ijmm.2018.3810] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/06/2018] [Indexed: 12/20/2022] Open
Abstract
The unique hypoxic inflammatory microenvironment observed in the spinal cord following spinal cord injury (SCI) limits the survival and efficacy of transplanted bone mesenchymal stem cells (BMSCs). The aim of the present study was to determine whether hypoxic preconditioning (HP) increased the therapeutic effects of BMSC on SCI. BMSCs were pretreated with cobalt chloride (CoCl2) in vitro, and the proliferative apoptotic and migratory abilities of these hypoxic BMSCs (H‑BMSCs) were assessed. BMSCs and H‑BMSCs derived from green fluorescent protein (GFP) rats were transplanted into SCI rats in vivo. The neurological function, histopathology, inflammation, and number and migration of transplanted cells were examined. HP significantly enhanced BMSC migration (increased hypoxia inducible factor 1α and C‑X‑C motif chemokine receptor 4 expression) and tolerance to apoptotic conditions (decreased caspase‑3 and increased B‑cell lymphoma 2 expression) in vitro. In vivo, H‑BMSC transplantation significantly improved neurological function, decreased spinal cord damage and suppressed the inflammatory response associated with microglial activation. The number of GFP‑positive cells in the SCI core and peripheral region of H‑BMSC animals was increased compared with that in those of BMSC animals, suggesting that HP may increase the survival and migratory abilities of BMSCs and highlights their therapeutic potential for SCI.
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Affiliation(s)
- Weiheng Wang
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, P.R. China
| | - Xiaodong Huang
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, P.R. China
| | - Wenbo Lin
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, P.R. China
| | - Yuanyuan Qiu
- Department of Respiration, Shanghai Electric Power Hospital, Shanghai 200050, P.R. China
| | - Yunfei He
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, P.R. China
| | - Jiangming Yu
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, P.R. China
| | - Yanhai Xi
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, P.R. China
| | - Xiaojian Ye
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, P.R. China
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19
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Motta GL, Souza PC, Santos EBD, Bona SR, Schaefer PG, Lima CAT, Marroni NAP, Corso CO. Effects of remote ischemic preconditioning and topical hypothermia in renal ischemia-reperfusion injury in rats. Acta Cir Bras 2018; 33:396-407. [DOI: 10.1590/s0102-865020180050000001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/12/2018] [Indexed: 11/22/2022] Open
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Transplantation of Hypoxic-Preconditioned Bone Mesenchymal Stem Cells Retards Intervertebral Disc Degeneration via Enhancing Implanted Cell Survival and Migration in Rats. Stem Cells Int 2018. [PMID: 29535780 PMCID: PMC5832130 DOI: 10.1155/2018/7564159] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective Special hypoxic and hypertonic microenvironment in intervertebral discs (IVDs) decreases the treatment effect of cell transplantation. We investigated the hypothesis that hypoxic preconditioning (HP) could improve the therapeutic effect of bone mesenchymal stem cells (BMSCs) to IVD degeneration. Methods BMSCs from green fluorescent protein-transgenic rats were pretreated with cobalt chloride (CoCl2, 100 μM, 24 h) for hypoxic conditions in vitro. Apoptosis (related pathways of caspase-3 and bcl-2) and migration (related pathways of HIF-1α and CXCR4) were detected in BMSCs. In vivo, BMSCs and HP BMSCs (H-BMSCs) were injected into the rat model of IVD degeneration. The IVD height, survival, migration, and differentiation of transplanted BMSCs and matrix protein expression (collagen II, aggrecan, and MMP-13) were tested. Results H-BMSCs could extensively decrease IVD degeneration by increasing IVD height and collagen II and aggrecan expressions when compared with BMSCs. Significantly, more GFP-positive BMSCs were observed in the nucleus pulposus and annulus fibrosus regions of IVD. HP could significantly decrease BMSC apoptosis (activating bcl-2 and inhibiting caspase-3) and improve BMSC migration (increasing HIF-1α and CXCR4) in vitro. Conclusion HP could significantly enhance the capacity of BMSCs to repair DDD by increasing the survival and migration of implanted cells and increasing matrix protein expression.
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21
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Jung H. Kidney transplantation and ischemic conditioning: past, present and future perspectives. Anesth Pain Med (Seoul) 2018. [DOI: 10.17085/apm.2018.13.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hoon Jung
- Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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Ribeiro GB, Santos EBD, Bona SR, Schaefer PG, Garcez TA, Rabolini EB, Smaniotto GP, Marroni NP, Corso CO. The effects of local ischemic preconditioning and topical hypothermia in renal ischemia/reperfusion injury in rats. Acta Cir Bras 2017; 32:816-826. [PMID: 29160368 DOI: 10.1590/s0102-865020170100000003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/29/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Topical hypothermia and local ischemic preconditioning have been shown to reduce renal ischemia-reperfusion (I/R) injury individually. We examined whether combination of both strategies lessens renal I/R injury. METHODS Post right nephrectomy, 40 male Wistar rats were randomly assigned to five experimental protocols performed in the left kidney: topical hypothermia without ischemia (TH), warm ischemia (IR), ischemic preconditioning followed by warm ischemia (IPC+IR), cold ischemia (TH+IR), and ischemic preconditioning followed by cold ischemia (IPC+TH+IR). Eight randomly assigned right kidneys constituted the control group. After 240 min of reperfusion, the left kidney was retrieved to evaluate histological changes, lipid peroxidation and antioxidant enzymes activity. Serum was collected to evaluate urea and creatinine. RESULTS IPC+TH+IR group revealed no difference to any other group subjected to ischemia in relation to histological changes, lipid peroxidation and antioxidant enzymes activity. Creatinine was lower in IPC+TH+IR group compared with IPC+IR, but showed no difference compared to TH+IR group. CONCLUSIONS Combination of local ischemic preconditioning (IPC) and topical hypothermia conferred no protection in renal I/R injury. Moreover, local IPC solely followed by warm ischemia impaired renal function more than warm ischemia alone.
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Affiliation(s)
- Guilherme Behrend Ribeiro
- Fellow Master degree, Postgraduate Program in Medicine: Surgical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre-RS, Brazil. Conception and design of the study; technical procedures; acquisition, interpretation and analysis of data; manuscript writing
| | - Emanuel Burck Dos Santos
- MSc, PhD, Department of Urology, Hospital de Clínicas de Porto Alegre (HCPA), Brazil. Conception and design of the study, critical revision
| | - Silvia Regina Bona
- PhD, Laboratory of Experimental Gastroenterology and Hepatology, HCPA, Brazil. Acquisition and interpretation of data, technical procedures
| | - Pedro Guilherme Schaefer
- MD, Department of Pathology, HCPA, Porto Alegre-RS, Brazil. Histopathological examinations, acquisition of data
| | - Tuane Alves Garcez
- MSc, Animal Experimentation Unit, HCPA, Porto Alegre-RS, Brazil. Technical procedures
| | - Eduardo Brasil Rabolini
- Graduate student, School of Medicine, UFRGS, Porto Alegre-RS, Brazil. Acquisition of data, technical procedures
| | - Guilherme Pereira Smaniotto
- Graduate student, School of Medicine, UFRGS, Porto Alegre-RS, Brazil. Acquisition of data, technical procedures
| | - Norma Possa Marroni
- MSc, Full Professor, Physiologist, Laboratory of Experimental Gastroenterology and Hepatology, UFRGS, Porto Alegre-RS, and Laboratory of Oxidative Stress and Antioxidants, Universidade Luterana do Brasil (ULBRA), Canoas-RS, Brazil. Acquisition and interpretation of data, technical procedures
| | - Carlos Otávio Corso
- MSc, Associate Professor of Surgery, Digestive Surgery Unit, HCPA, and Department of Surgery, UFRGS, Porto Alegre-RS, Brazil. Conception and design of the study, interpretation of data, manuscript writing, critical revision, final approval
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Xue Y, Xu Z, Chen H, Gan W, Chong T. Low-energy shock wave preconditioning reduces renal ischemic reperfusion injury caused by renal artery occlusion. Acta Cir Bras 2017; 32:550-558. [PMID: 28793039 DOI: 10.1590/s0102-865020170070000006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/05/2017] [Indexed: 01/19/2023] Open
Abstract
Purpose: To evaluate whether low energy shock wave preconditioning could reduce renal ischemic reperfusion injury caused by renal artery occlusion. Methods: The right kidneys of 64 male Sprague Dawley rats were removed to establish an isolated kidney model. The rats were then divided into four treatment groups: Group 1 was the sham treatment group; Group 2, received only low-energy (12 kv, 1 Hz, 200 times) shock wave preconditioning; Group 3 received the same low-energy shock wave preconditioning as Group 2, and then the left renal artery was occluded for 45 minutes; and Group 4 had the left renal artery occluded for 45 minutes. At 24 hours and one-week time points after reperfusion, serum inducible nitric oxide synthase (iNOS), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), creatinine (Cr), and cystatin C (Cys C) levels were measured, malondialdehyde (MDA) in kidney tissue was detected, and changes in nephric morphology were evaluated by light and electron microscopy. Results: Twenty-four hours after reperfusion, serum iNOS, NGAL, Cr, Cys C, and MDA levels in Group 3 were significantly lower than those in Group 4; light and electron microscopy showed that the renal tissue injury in Group 3 was significantly lighter than that in Group 4. One week after reperfusion, serum NGAL, KIM-1, and Cys C levels in Group 3 were significantly lower than those in Group 4. Conclusion: Low-energy shock wave preconditioning can reduce renal ischemic reperfusion injury caused by renal artery occlusion in an isolated kidney rat model.
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Affiliation(s)
- Yuquan Xue
- PhD, Department of Urology, the Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi Province, China. Conception and design of the study, intellectual content of the study, analysis and interpretation of data, drafting of the manuscript, critical revision, supervised all phases of the study
| | - Zhibin Xu
- MD, Department of Urology, the Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi Province, China. Acquisition, analysis and interpretation of data; statistical analysis
| | - Haiwen Chen
- PhD, Department of Urology, the Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi Province, China. Conception and design of the study, intellectual content of the study, analysis and interpretation of data, drafting of the manuscript, critical revision, supervised all phases of the study
| | - Weimin Gan
- MD, Department of Urology, the Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi Province, China. Acquisition, analysis and interpretation of data; statistical analysis
| | - Tie Chong
- PhD, Department of Urology, the Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi Province, China. Conception and design of the study, intellectual content of the study, analysis and interpretation of data, drafting of the manuscript, critical revision, supervised all phases of the study
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Zapata-Chavira H, Hernández-Guedea M, Jiménez-Pérez JC, Pérez-Rodríguez E, Muñoz-Espinosa L, Muñoz-Maldonado G, Cordero-Pérez P. Modulation of Remote Ischemic Preconditioning by Proinflammatory Cytokines in Renal Transplant Recipients. J INVEST SURG 2017; 32:63-71. [PMID: 29083941 DOI: 10.1080/08941939.2017.1375052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM Remote ischemic preconditioning (RIPC) has been used as a strategy to reduce acute renal injury and ischemia-reperfusion injury (IRI) in renal transplantation (RT) with controversial results. OBJECTIVE To determine if RIPC modifies IRI in cadaveric RT recipients through inflammatory mediators and graft function. METHODS Twenty-nine RT recipients were studied, 12 in the control group (CG) and 17 in the RIPC group. RIPC which was performed on donors using a pneumatic tourniquet placed on both thighs for 10 min followed by the determination of IL-1, IL-6, TNF-α, VEGF, and ICAM-1, and hematological and biochemical parameters in different phases of RT. RESULTS Serum creatinine levels were significantly lower in the RIPC group versus the CG at 15 and 30 days; however, the estimated glomerular filtration rate (eGFR) showed no significant difference in any phase between either group, only TNF-α showed significantly higher values in the RIPC group versus the CG in almost all phases of the study, meanwhile IL6 was increased at 72 hours (hr) and 30 days, IL1 at 72 hr and 15 days and ICAM-1 post reperfusion, contrary to this VEGF showed a decrease at 7 and 15 days. CONCLUSION RIPC did not improve eGFR or serum creatinine; however, it modifies the inflammatory response in RT recipients.
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Affiliation(s)
- Homero Zapata-Chavira
- a Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González" Servicio de Trasplantes , Monterrey , Nuevo León , México
| | - Marco Hernández-Guedea
- a Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González" Servicio de Trasplantes , Monterrey , Nuevo León , México
| | - Julio César Jiménez-Pérez
- b Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González" Departamento de Medicina Interna, Unidad de Hígado , Monterrey , Nuevo León , México
| | - Edelmiro Pérez-Rodríguez
- a Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González" Servicio de Trasplantes , Monterrey , Nuevo León , México
| | - Linda Muñoz-Espinosa
- b Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González" Departamento de Medicina Interna, Unidad de Hígado , Monterrey , Nuevo León , México
| | - Gerardo Muñoz-Maldonado
- c Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González" Servicio de Cirugía General , Monterrey , Nuevo León , México
| | - Paula Cordero-Pérez
- a Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José E. González" Servicio de Trasplantes , Monterrey , Nuevo León , México
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Choi HS, Hwang JK, Kim JG, Hwang HS, Lee SJ, Chang YK, Kim JI, Moon IS. The optimal duration of ischemic preconditioning for renal ischemia-reperfusion injury in mice. Ann Surg Treat Res 2017; 93:209-216. [PMID: 29094031 PMCID: PMC5658303 DOI: 10.4174/astr.2017.93.4.209] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 06/12/2017] [Accepted: 06/27/2017] [Indexed: 12/20/2022] Open
Abstract
Purpose The aim of the present study was to investigate the protective effects of ischemic preconditioning for different periods of time and to elucidate the optimal safe ischemic preconditioning time for renal ischemia-reperfusion (I/R) injury in mice. Methods A total of 25 male C57BL/6 mice were randomly divided into 5 groups (sham, I/R, ischemic preconditioning [IP]-3, IP-5, and IP-7 groups), in which the kidney was preconditioned with IP of various durations and then subjected to I/R injury (the last 3 groups). To induce renal ischemia, the left renal pedicle was occluded with a nontraumatic microaneurysm clamp for 30 minutes followed by reperfusion for 24 hours. The effects of IP on renal I/R injury were evaluated in terms of renal function, tubular necrosis, apoptotic cell death and inflammatory cytokines. Results Results indicated that BUN and creatinine (Cr) levels increased significantly in the I/R group, but the elevations were significantly lower in IP groups, especially in the IP-5 group. Histological analysis revealed that kidney injury was markedly decreased in the IP-5 group compared with the I/R group, as evidenced by reduced renal necrosis/apoptosis. In addition, IP significantly inhibited gene expression of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) and chemokines (monocyte chemoattractant protein-1). Western blot analysis indicated that the expression levels of Toll-like receptor 4 (TLR4) and nuclear factor-kappa B (NF-κB) were upregulated in the I/R group, while expression was inhibited in the IP groups. Conclusion Five-minute IP had the greatest protective effect against I/R injury.
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Affiliation(s)
- Hyun Su Choi
- Department of Clinical Research, Daejeon St. Mary's Hospital, Daejeon, Korea
| | - Jeong Kye Hwang
- Department of Surgery, Daejeon St. Mary's Hospital, Daejeon, Korea
| | - Jeong Goo Kim
- Department of Surgery, Daejeon St. Mary's Hospital, Daejeon, Korea
| | - Hyeon Seok Hwang
- Department of Internal Medicine, Daejeon St. Mary's Hospital, Daejeon, Korea
| | - Sang Ju Lee
- Department of Internal Medicine, Daejeon St. Mary's Hospital, Daejeon, Korea
| | - Yoon Kyung Chang
- Department of Internal Medicine, Daejeon St. Mary's Hospital, Daejeon, Korea
| | - Ji Il Kim
- Department of Surgery, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
| | - In Sung Moon
- Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Abstract
Ischemia–reperfusion injury is a composite of the injury sustained during a period of reduced or absent blood flow to a tissue or organ and the additional insult sustained on reperfusion, which limits the amount of tissue that can be salvaged. Ischemia–reperfusion injury is the predominant insult during kidney transplantation, contributing to graft dysfunction, increased rates of acute rejection, and reduced rejection-free graft survival. In this review, we discuss the potential therapeutic benefits of a cost-effective and low-risk intervention, ischemic preconditioning, and its potential for improving kidney function following transplantation.
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Affiliation(s)
- Kristin Veighey
- Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
- Research & Development, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Raymond MacAllister
- Clinical Pharmacology, Centre for Clinical Pharmacology, University College London, London, United Kingdom
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Mansour SG, Puthumana J, Reese PP, Hall IE, Doshi MD, Weng FL, Schröppel B, Thiessen-Philbrook H, Bimali M, Parikh CR. Associations between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes. Kidney Int Rep 2017; 2:749-758. [PMID: 28730184 PMCID: PMC5512592 DOI: 10.1016/j.ekir.2017.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Introduction Existing methods to predict recipient allograft function during deceased-donor kidney procurement are imprecise. Understanding the potential renal reparative role for monocyte chemoattractant protein-1 (MCP-1), a cytokine involved in macrophage recruitment after injury, might help to predict allograft outcomes. Methods We conducted a substudy of the multicenter prospective Deceased Donor Study cohort that evaluated deceased kidney donors from 5 organ procurement organizations from May 2010 to December 2013. We measured urine MCP-1 (uMCP-1) concentrations from donor samples collected at nephrectomy to determine associations with donor acute kidney injury (AKI), recipient delayed graft function (DGF), 6-month estimated glomerular filtration rate (eGFR), and graft failure. We also assessed perfusate MCP-1 concentrations from pumped kidneys for associations with DGF and 6-month eGFR. Results AKI occurred in 111 donors (9%). The median (interquartile range) uMCP-1 concentration was higher in donors with AKI compared with donors without AKI (1.35 [0.41–3.93] ng/ml vs. 0.32 [0.11–0.80] ng/ml, P < 0.001). DGF occurred in 756 recipients (31%), but uMCP-1 was not independently associated with DGF. Higher donor uMCP-1 concentrations were independently associated with a higher 6-month eGFR in those without DGF (0.77 [0.10–1.45] ml/min per 1.73 m2 per doubling of uMCP1). However, there were no independent associations between uMCP-1 and graft failure over a median follow-up of ∼2 years. Lastly, perfusate MCP-1 concentrations significantly increased during pump perfusion but were not associated with DGF or 6-month eGFR. Discussion Donor uMCP-1 concentrations were modestly associated with higher recipient 6-month eGFR in those without DGF. However, the results suggest that donor uMCP-1 has minimal clinical utility given no associations with graft failure.
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Affiliation(s)
- S G Mansour
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT.,Section of Nephrology, Yale University School of Medicine, New Haven, CT
| | - J Puthumana
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT
| | - P P Reese
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - I E Hall
- Division of Nephrology, Hypertension and Renal Transplantation, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | | | - F L Weng
- Saint Barnabas Medical Center, Livingston, NJ
| | - B Schröppel
- Section of Nephrology, University Hospital, Ulm, Germany
| | - H Thiessen-Philbrook
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT
| | - M Bimali
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT
| | - C R Parikh
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT.,Section of Nephrology, Yale University School of Medicine, New Haven, CT.,Veterans Affairs Connecticut Healthcare System, New Haven, CT
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Kristensen MLV, Kierulf-Lassen C, Nielsen PM, Krag S, Birn H, Nejsum LN, Nørregaard R. Remote ischemic perconditioning attenuates ischemia/reperfusion-induced downregulation of AQP2 in rat kidney. Physiol Rep 2016; 4:4/13/e12865. [PMID: 27405971 PMCID: PMC4945844 DOI: 10.14814/phy2.12865] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 06/21/2016] [Indexed: 12/28/2022] Open
Abstract
Renal ischemia/reperfusion (I/R) can lead to impaired urine concentration ability and increased fractional excretion of sodium (FeNa). Local ischemic preconditioning improves renal water and sodium handling after I/R injury. Here, we investigate whether remote ischemic perconditioning (rIPeC) prevents dysregulation of renal water and salt handling in response to I/R injury and mechanisms that may be involved. Rats were subjected to right nephrectomy and randomized into a sham group or an I/R group. In the I/R group, rats were subjected to 37 min of renal ischemia and 3 days of reperfusion. rIPeC was applied to the abdominal aorta. Blood and urine were collected on day 3 postoperatively for clearance studies. The expression of aquaporins (AQPs) and the sodium transporter Na-K-ATPase were analyzed using immunoblotting and immunohistochemistry. I/R injury resulted in polyuria, increased FeNa, and decreased urine osmolality compared to sham rats. rIPeC attenuated the increase in FeNa and the decrease in urine osmolality. Expression of AQP1, AQP2, phosphorylated AQP2 (pAQP2), and Na-K-ATPase was downregulated in I/R rats. rIPeC attenuated the reductions in AQP2 and pAQP2 expression. Immunohistochemistry revealed decreased labeling of Na-K-ATPase in the outer medulla in I/R kidneys compared to kidneys from sham and I/R + rIPeC rats. After renal ischemia, the expression of Na-K-ATPase was substantially reduced in the outer medullary thick ascending limb. In conclusion, our data suggest that rIPeC might prevent dysregulation of renal water and salt handling via regulation of AQP2 expression and phosphorylation as well as via regulation of Na-K-ATPase expression in I/R rat kidneys.
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Affiliation(s)
| | | | - Per Mose Nielsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren Krag
- Department of Pathology, Aarhus University, Aarhus, Denmark
| | - Henrik Birn
- Department of Biomedicine, Aarhus University, Aarhus, Denmark Department of Renal Medicine, Aarhus University, Aarhus, Denmark
| | - Lene N Nejsum
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Rikke Nørregaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Preconditioning is hormesis part I: Documentation, dose-response features and mechanistic foundations. Pharmacol Res 2016; 110:242-264. [DOI: 10.1016/j.phrs.2015.12.021] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 12/18/2015] [Accepted: 12/19/2015] [Indexed: 12/16/2022]
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Kierulf-Lassen C, Nieuwenhuijs-Moeke GJ, Krogstrup NV, Oltean M, Jespersen B, Dor FJMF. Molecular Mechanisms of Renal Ischemic Conditioning Strategies. Eur Surg Res 2015; 55:151-83. [PMID: 26330099 DOI: 10.1159/000437352] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/02/2015] [Indexed: 11/19/2022]
Abstract
Ischemia-reperfusion injury is the leading cause of acute kidney injury in a variety of clinical settings such as renal transplantation and hypovolemic and/or septic shock. Strategies to reduce ischemia-reperfusion injury are obviously clinically relevant. Ischemic conditioning is an inherent part of the renal defense mechanism against ischemia and can be triggered by short periods of intermittent ischemia and reperfusion. Understanding the signaling transduction pathways of renal ischemic conditioning can promote further clinical translation and pharmacological advancements in this era. This review summarizes research on the molecular mechanisms underlying both local and remote ischemic pre-, per- and postconditioning of the kidney. The different types of conditioning strategies in the kidney recruit similar powerful pro-survival mechanisms. Likewise, renal ischemic conditioning mobilizes many of the same protective signaling pathways as in other organs, but differences are recognized.
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Hypoxia and Complement-and-Coagulation Pathways in the Deceased Organ Donor as the Major Target for Intervention to Improve Renal Allograft Outcome. Transplantation 2015; 99:1293-300. [PMID: 25427168 DOI: 10.1097/tp.0000000000000500] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND In the last few decades, strategies to improve allograft survival after kidney transplantation have been directed to recipient-dependent mechanisms of renal injury. In contrast, no such efforts have been made to optimize organ quality in the donor. Optimizing deceased donor kidney quality opens new possibilities to improve renal allograft outcome. METHODS A total of 554 kidney biopsies were taken from donation after brain death (DBD) and donation after cardiac death (DCD) kidneys before donation, after cold ischemia and after reperfusion. Healthy living donor kidney biopsies served as controls. Transcriptomics was performed by whole genome microarray analyses followed by functional pathway analyses. RESULTS Before organ retrieval and before cessation of blood circulation, metabolic pathways related to hypoxia and complement-and-coagulation cascades were the major pathways enhanced in DBD donors. Similar pathways were also enriched in DCD donors after the first warm ischemia time. Shortly after reperfusion of DCD grafts, pathways related to prolonged and worsening deprivation of oxygen were associated with delayed graft function in the recipient. CONCLUSION In conclusion, this large deceased donor study shows enrichment of hypoxia and complement-and-coagulation pathways already in DBD donors before cessation of blood flow, before organ retrieval. Therefore, future intervention therapies should target hypoxia and complement-and-coagulation cascades in the donor to improve renal allograft outcome in the recipient.
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Dodecafluoropentane emulsion elicits cardiac protection against myocardial infarction through an ATP-Sensitive K+ channel dependent mechanism. Cardiovasc Drugs Ther 2015; 28:541-7. [PMID: 25319313 PMCID: PMC4260113 DOI: 10.1007/s10557-014-6557-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Purpose Dodecafluoropentane emulsion (DDFPe) is a perfluorocarbon with high oxygen dissolving, transport, and delivery capacity that may offer the potential to limit ischemic injury prior to clinical reperfusion. Here we investigated the cardiac protective potential of DDFPe in a mouse model of myocardial infarction. Methods Myocardial infarction was initiated by permanent ligation of the left anterior descending (LAD) coronary artery. Mice were administered vehicle or 5-hydroxydecanoate (5-HD) intravenously 10 min before LAD occlusion followed by a single intravenous administration of vehicle or DDFPe immediately after occlusion. Heart tissue and serum samples were collected 24 after LAD occlusion for measurement of infarct size and cardiac troponin I (cTnI) levels, respectively. Results DDFPe treatment reduced infarct size by approximately 72 % (36.9 ± 4.2 % for vehicle vs 10.4 ± 2.3 % for DDFPe; p < 0.01; n = 6–8) at 24 h. Serum cTnI levels were similarly reduced by DDFPe (35.0 ± 4.6 ng/ml for vehicle vs 15.8 ± 1.6 ng/ml for DDFPe; p < 0.01; n = 6–8). Pretreatment with 5-HD, a mitochondrial ATP-sensitive potassium channel (mitoKATP) inhibitor, blocked the reduction in infarct size (29.2 ± 4.4 % for 5-HD vs 35.4 ± 7.4 % for 5-HD+DDFPe; p = 0.48; n = 6–8) and serum cTnI levels (27.4 ± 5.1 ng/ml for 5-HD vs 34.6 ± 5.3 ng/ml for 5-HD+DDFPe; p = 0.86; n = 6–8) by DDFPe. Conclusion Our data indicate a cardiac protective role of DDFPe that persists beyond its retention time in the body and is dependent on mitoKATP, an important mediator of ischemic preconditioning induced cardiac protection.
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Vafapour M, Nematbakhsh M, Monajemi R, Mazaheri S, Talebi A, Talebi N, Shirdavani S. Effect of Γ-aminobutyric acid on kidney injury induced by renal ischemia-reperfusion in male and female rats: Gender-related difference. Adv Biomed Res 2015; 4:158. [PMID: 26380243 PMCID: PMC4550949 DOI: 10.4103/2277-9175.161585] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/17/2015] [Indexed: 11/25/2022] Open
Abstract
Background: The most important cause of kidney injury is renal ischemia/reperfusion injury (IRI), which is gender-related. This study was designed to investigate the protective role of Γ-aminobutyric acid (GABA (against IRI in male and female rats. Materials and Methods: Thirty-six female and male wistar rats were assigned to six experimental groups. The IRI was induced by clamping renal vessels for 45 min then was performed reperfusion for 24 h. The group sex posed to IRI were pretreated with GABA and were compared with the control groups. Results: Serum levels of creatinine and blood urea nitrogen, kidney weight, and kidney tissue damage score increased in the IRI alone groups, (P < 0.05), while GABA decreased these parameters in female significantly (P < 0.05), but not in male rats. Uterus weight decreased significantly in female rats treated with GABA. Testis weight did not alter in male rats. Serum level of nitrite and kidney level of malondialdehyde (MDA) had no significant change in both female and male rats. Kidney level of nitrite increased significantly in female rats experienced IRI and serum level of MDA increased significantly in males that were exposed to IRI (P < 0.05). Conclusion: GABA could ameliorate kidney injury induced by renal IRI in a gender dependent manner.
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Affiliation(s)
- Marzieh Vafapour
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Mehdi Nematbakhsh
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran ; Isfahan-MN Institute of Basic and Applied Sciences Research, Isfahan, Iran
| | - Ramesh Monajemi
- Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Safoora Mazaheri
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ardeshir Talebi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Clinical Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Talebi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Soheyla Shirdavani
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Ischemic postconditioning inhibits apoptosis of renal cells following reperfusion: a novel in vitro model. Int Urol Nephrol 2015; 47:1067-74. [DOI: 10.1007/s11255-015-0997-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 04/21/2015] [Indexed: 11/26/2022]
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Minor T, Paul A, Efferz P, Wohlschlaeger J, Rauen U, Gallinat A. Kidney transplantation after oxygenated machine perfusion preservation with Custodiol-N solution. Transpl Int 2015; 28:1102-8. [PMID: 25882869 DOI: 10.1111/tri.12593] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 03/27/2015] [Accepted: 04/15/2015] [Indexed: 11/28/2022]
Abstract
Custodiol-N, a new preservation solution, has been shown particularly suitable for hypothermic machine perfusion preservation (HMP) in isolated porcine kidneys. These preliminary results should be confirmed in an actual transplant model in vivo. Kidney function after 21 h of HMP was studied in an autotransplant model using Landrace pigs (25-30 kg; n = 6 per group). Perfusion was performed with oxygenated perfusate, using either Custodiol-N solution including 50 g/l dextran 40 (CND) or kidney perfusion solution 1 (KPS-1) as gold standard. Viability of the grafts was followed for 1 week after bilateral nephrectomy in the recipient pigs. HMP with CND resulted in less acute tubular injury, evaluated by levels of fatty acid-binding protein and better clearance function during the first 24 h after Tx than with KPS-1 (P < 0.05, resp.). Serum creatinine tended to be lower in the CND group during the whole observation period. Histological tissue scores one week after Tx were similar in both groups. Expression of endothelin-1 as well as of Toll-like receptor 4 15 min after reperfusion was lower in the CND group (P < 0.05), suggesting less endothelial stress response. The data provide first in vivo evidence for the suitability of Custodiol-N as an effective perfusate for renal machine perfusion.
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Affiliation(s)
- Thomas Minor
- Surgical Research Division, University Clinic of Surgery, Bonn, Germany
| | - Andreas Paul
- Clinic of General, Visceral and Transplantation Surgery, University Hospital of Essen, Essen, Germany
| | - Patrik Efferz
- Surgical Research Division, University Clinic of Surgery, Bonn, Germany
| | | | - Ursula Rauen
- Institute of Physiological Chemistry, University Hospital Essen, Essen, Germany
| | - Anja Gallinat
- Clinic of General, Visceral and Transplantation Surgery, University Hospital of Essen, Essen, Germany
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Abstract
INTRODUCTION Cold storage of organs for preservation and transplantation is reaching its limits especially with extended criteria for heart beating donors and donation after cardiac death. We will discuss recent findings and perspectives in normothermic kidney preservation. METHODS A literature review was performed from original articles and syntheses selected by the search engine PubMed. Keywords used were: cold ischemia; warm ischemia, normothermic, organ preservation, preconditioning, organ perfusion. RESULTS We identified several ways to improve kidney preservation: Ischemic normothermic preconditioning; Pharmacologic normothermic preconditioning; Ex vivo normothermic reperfusion; Remote ischemic transplantation preconditioning; Ischemic postconditioning. In clinical practice, only uses of ECMO for organ preconditioning or ex vivo normothermic organ perfusion were used. CONCLUSION Promising experimental and clinical results make challenge cold preservation. The most suitable and physiological method seems to be a normothermic perfusion and conservation with autologous oxygenated blood using Extra Corporeal Membrane Oxygenation or Regional Normothermic Circulation.
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Affiliation(s)
- X Tillou
- Urology and Transplantation department, University Hospital, Caen, France.
| | - R Thuret
- Urology and Transplantation department, University Hospital, Montpellier, France
| | - A Doerfler
- Urology and Transplantation department, University Hospital, Caen, France
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A nitric oxide-donor furoxan moiety improves the efficacy of edaravone against early renal dysfunction and injury evoked by ischemia/reperfusion. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2015:804659. [PMID: 25834700 PMCID: PMC4365375 DOI: 10.1155/2015/804659] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 02/13/2015] [Indexed: 12/31/2022]
Abstract
Edaravone (5-methyl-2-phenyl-2,4-dihydro-3H-pyrazol-3-one, EDV) is a free-radical scavenger reduces organ ischemic injury. Here we investigated whether the protective effects of EDV in renal ischemia/reperfusion (I/R) injury may be enhanced by an EDV derivative bearing a nitric oxide- (NO-) donor furoxan moiety (NO-EDV). Male Wistar rats were subjected to renal ischemia (45 minutes), followed by reperfusion (6 hours). Administration of either EDV (1.2–6–30 µmol/kg, i.v.) or NO-EDV (0.3–1.2–6 µmol/kg, i.v.) dose-dependently attenuated markers of renal dysfunction (serum urea and creatinine, creatinine clearance, urine flow, urinary N-acetyl-β-D-glucosaminidase, and neutrophil gelatinase-associated lipocalin/lipocalin-2). NO-EDV exerted protective effects in the dose-range 1.2–6 µmol/kg, while a higher dose (30 µmol/kg) was needed to obtain protection by EDV. Both EDV and NO-EDV modulated tissue markers of oxidative stress and lipid peroxidation. NO-EDV, but not EDV, activated endothelial NO synthase (NOS) and blunted I/R-induced upregulation of inducible NOS, secondary to modulation of Akt and NF-κB activation, respectively. Besides NO-EDV administration inhibited I/R-induced IL-1β, IL-18, IL-6, and TNF-α overproduction. Overall, these findings demonstrate that the NO-donor moiety contributes to the protection against early renal I/R injury and suggest that NO-donor EDV codrugs are worthy of additional study as innovative pharmacological tools.
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Kirchner C, Lüer B, Efferz P, Wohlschlaeger J, Paul A, Minor T. Ex vivo use of a Rho-kinase inhibitor during renal preservation improves graft function upon reperfusion. Cryobiology 2015; 70:71-5. [DOI: 10.1016/j.cryobiol.2014.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 12/21/2014] [Accepted: 12/22/2014] [Indexed: 10/24/2022]
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Tofangchiha S, Moazen Jamshidi SMM, Emami H, Dormanesh B. Investigating Antithyroid Effects of Propylthiouracil on the Ischemia and Reperfusion Injury in Rat' Kidney and Determining the Role of Nitric Oxide in Mediating this Effect. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e15605. [PMID: 25763197 PMCID: PMC4329750 DOI: 10.5812/ircmj.15605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/28/2014] [Accepted: 02/22/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Renal ischemia/reperfusion injury (IRI) is a major problem in renal transplantation, which occurs during the process of organ retrieval and storage, and is closely associated with acute rejection episodes and late allograft failure. Recent studies have revealed a new phenomenon called "chemical preconditioning" that can induce tolerance against the ischemic stress via a variety of proposed pathways especially nitric oxide (NO) system. Propylthiouracil (PTU) is suggested to modulate the intracellular NO signaling. OBJECTIVES In this study, we investigated the preconditioning properties of chronic pretreatment with PTU in preventing renal IRI. In addition, we evaluated the involvement of NO pathway. MATERIALS AND METHODS Sixty adult male Wistar rats were allocated into six groups. All groups underwent right nephrectomy 15 days before intervention. In groups 1 (Chronic PTU + L-NG-nitro arginine methyl ester [L-NAME]) and 2 (Chronic PTU) oral PTU (500 mg/L in water) treatment was started 15 days before right nephrectomy to achieve the therapeutic plasma level of PTU. Fourteen days after nephrectomy, animals received either L-NAME (10 mg/kg) or its vehicle and renal IRI was induced 45 minutes later. Groups 3 and 4 (Control) received respectively L-NAME (10 mg/kg) and its vehicle 45 minutes before IRI. The last two groups were normal sham operated rats and PTU + sham. Rats were killed 24 hours after IRI. The blood samples were collected and assessed for serum blood urea nitrogen (BUN) and creatinine (Cr) level, and tissue samples were fixed in formalin for histopathologic scoring of tubular damage (H-score). RESULTS The mean BUN, Cr, and H-score of control group were 176.66 ± 12.24 mmol/L, 4.45 ± 0.44 μmol/L, and 83.5% ± 3.5%, respectively. Chronic pretreatment with PTU significantly improved BUN (40.4 ± 6.1 mmol/L), Cr (0.96 ± 0.068 μmol/L), and H-score (7.83% ± 4.02%) in IRI animals in comparison to those that were not treated with chronic PTU (P < 0.001) and L-NAME; however, it did not completely reversed the chronic PTU-induced protection (BUN, 93.33 ± 12.22 mmol/L; Cr, 2.7 ± 1.15 μmol/L, and H-score, 24.83% ± 3.5%). There was no significant difference between rats that were treated with L-NAME alone (group 5) and the control group. CONCLUSIONS Our study demonstrates that preconditioning of kidney with chronic PTU administration protects renal tissue against IRI and this phenomenon was mediated through NO system. The results suggest a potential indication for using PTU to protect the kidney before transplantations and to reduce the risk of tissue rejection afterwards.
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Affiliation(s)
- Shahnaz Tofangchiha
- Department of Internal Medicine, AJA University of Medical Sciences, Tehran, IR Iran
| | | | - Hamed Emami
- Tehran University of Medical Sciences, Tehran, IR Iran
| | - Banafshe Dormanesh
- Department of Pediatric Nephrology, AJA University of Medical Sciences, Tehran, IR Iran
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Hoyer DP, Gallinat A, Swoboda S, Wohlschläger J, Rauen U, Paul A, Minor T. Subnormothermic machine perfusion for preservation of porcine kidneys in a donation after circulatory death model. Transpl Int 2014; 27:1097-106. [PMID: 24963744 DOI: 10.1111/tri.12389] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 05/12/2014] [Accepted: 06/23/2014] [Indexed: 01/26/2023]
Abstract
Machine perfusion for preservation led to compelling success for the outcome of renal transplantation. Further refinements of methods to decrease preservation injury remain an issue of high interest. This study investigates functional and morphological aspects of kidneys preserved by subnormothermic (20 °C) machine perfusion (SNTM) compared with oxygenated hypothermic machine perfusion (HMPox) and cold storage (CS) in a donation after circulatory death (DCD) model. After 30 min of warm ischaemia, porcine kidneys were randomly assigned to preservation for 7 h by CS, HMPox or SNTM. Afterwards, kidneys were reperfused for 2 h with autologous blood in vitro for assessment of function and integrity. Application of SNTM for preservation led to significantly higher blood flow and urine output compared with both other groups. SNTM led to a twofold increased creatinine clearance compared with HMPox and 10-fold increased creatinine clearance compared with CS. Structural integrity was best preserved by SNTM. In conclusion, this is the first study on SNTM for kidneys from DCD donors. SNTM seems to be a promising preservation method with the potential to improve functional parameters of kidneys during reperfusion.
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Affiliation(s)
- Dieter P Hoyer
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
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Hwang JK, Kim JM, Kim YK, Kim SD, Park SC, Kim JI, Nam HW, Kim J, Moon IS. The early protective effect of glutamine pretreatment and ischemia preconditioning in renal ischemia-reperfusion injury of rat. Transplant Proc 2014; 45:3203-8. [PMID: 24182785 DOI: 10.1016/j.transproceed.2013.08.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 07/13/2013] [Accepted: 08/16/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Heat shock proteins (HSP) play an important role in protecting cells against stress. METHODS Using a rat model, we tested the hypothesis that pretreatment with glutamine (Gln) and ischemia preconditioning (IPC) increase the expression of HSP resulting in attenuation of renal ischemia/reperfusion (I/R) injury. Sprague-Dawley rats were randomized into 4 groups [group I, Gln injection (+), IPC (+); group II, Gln injection (+), IPC (-); group III, saline injection (+), IPC (+); group IV, saline injection (+), IPC (-)]. Renal HSP70 expression was determined by Western blotting and kidney function was assessed by blood urea nitrogen and serum creatinine. Renal cross-sections were microscopically examined for tubular necrosis, exfoliation of tubular epithelial cells, cast formation, and monocyte infiltration. RESULTS Gln pretreatment increased intrarenal HSP expression (P = .031). In group I, tubulointerstitial abnormalities were clearly slighter compared with the other groups (P < .001). CONCLUSION Our experiments suggest that (1) a single dose of Gln could induce HSP expression and (2) IPC could relieve renal I/R injury. In addition, IPC combined with Gln pretreatment had a synergic protective effect against renal I/R injury.
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Affiliation(s)
- J K Hwang
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Timsit MO, Kleinclauss F. Ischemia-reperfusion in the renal allograft: new clues in a cold-case. Prog Urol 2014; 24 Suppl 1:S1-3. [DOI: 10.1016/s1166-7087(14)70056-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thuret R, Saint Yves T, Tillou X, Chatauret N, Thuillier R, Barrou B, Billault C. Ischemic pre- and post-conditioning: current clinical applications. Prog Urol 2014; 24 Suppl 1:S56-61. [DOI: 10.1016/s1166-7087(14)70065-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Camarço JPF, Morais LK, Moreno JD, Rassi MC, Camarço MNDCR, Guimarães PF, Quireze Júnior C. The feasibility of an experimental model of donors after cardiac death in remote ischemic preconditioning studies for renal transplantation in porcine. Acta Cir Bras 2014; 29:82-6. [PMID: 24604310 DOI: 10.1590/s0102-86502014000200002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 01/21/2014] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate the feasibility of an experimental model of donors after cardiac death in remote ischemic preconditioning studies. METHODS Twelve Landrace pigs were used as organ donors. They underwent cardiac arrest by coronary en block suture and interruption of ventilatory support. Haemodynamic data regarding the donor surgical protocol were evaluated. Studies variables included mean heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, central venous pressure and oxygen saturation and the time to death. RESULTS Haemodynamic parameter indicated that the circulatory failure occurred after nine minutes of en block coronary suture and respiratory support interruption. The circulatory collapse occurred evenly across all groups. The heart rate and central venous pressure were statistically different between groups (p=0.023 and p=0.04), respectively. The remote preconditioning resulted in delayed time of death. CONCLUSIONS The model is feasible, and was easily reproduced. The ischemic remote preconditioning tends to a slight increase in circulatory failure time.
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Affiliation(s)
- João Paulo Figueiredo Camarço
- Federal University of Goias, GoianiaGO, Brazil, Fellow Master degree, Postgraduate Program in Health Sciences, Federal University of Goias (UFG), Goiania-GO, Brazil. Intellectual and scientific contents of the study, technical procedures, manuscript writing
| | - Lucio Kenny Morais
- UFG, GoianiaGO, Brazil, Fellow Master degree, Postgraduate Program in Health Sciences, UFG, Goiania-GO, Brazil. Acquisition and interpretation of data, manuscript writing
| | - Juan Duque Moreno
- UFG, School of Veterinary and Animal Science, GoianiaGO, Brazil, PhD, Associate Professor, Anesthesiology, School of Veterinary and Animal Science (EVZ), UFG, Goiania-GO, Brazil. Intellectual and scientific content of the study, technical procedures, manuscript writing
| | - Matheus Castrillon Rassi
- UFG, GoianiaGO, Brazil, Fellow Master degree, Postgraduate Program in Health Sciences, UFG, Goiania-GO, Brazil. Acquisition and interpretation of data, manuscript writing
| | - Mylena Naves de Castro Rocha Camarço
- Pontifical Catholic University of Goias, Department of Obstetrics/Gynecology, GoianiaGO, Brazil, Assistant Professor, Department of Obstetrics/Gynecology, Pontifical Catholic University of Goias (UCG), Goiania-GO, Brazil. Critical revision
| | - Pedro Figueiredo Guimarães
- Catholic University of Brasilia, Departament of Surgery, BrasiliaDF, Graduate student, Departament of Surgery, Catholic University of Brasilia (UCB), Brasilia-DF. Acquisition of data, technical procedures
| | - Claudemiro Quireze Júnior
- UFG, GoianiaGO, Brazil, PhD, Associate Professor, Surgical Clinics, UFG, Goiania-GO, Brazil. Intellectual and scientific contents of the study, technical procedures, manuscript writing
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Desai KK, Mora-Esteves C, Holland BK, Dikdan G, Fisher A, Wilson DJ, Koneru B. Does Liver Ischemic Preconditioning in Brain Death Donors Induce Kidney Preconditioning? A Retrospective Analysis. Transplantation 2014; 97:337-43. [DOI: 10.1097/01.tp.0000436926.30897.56] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Shokeir AA, Hussein AM, Barakat N, Abdelaziz A, Elgarba M, Awadalla A. Activation of nuclear factor erythroid 2-related factor 2 (Nrf2) and Nrf-2-dependent genes by ischaemic pre-conditioning and post-conditioning: new adaptive endogenous protective responses against renal ischaemia/reperfusion injury. Acta Physiol (Oxf) 2014; 210:342-53. [PMID: 24010821 DOI: 10.1111/apha.12164] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 02/25/2013] [Accepted: 09/02/2013] [Indexed: 12/12/2022]
Abstract
AIM To investigate the impact of ischaemic pre-conditioning (Ipre) and post-conditioning (Ipost) on expression of nuclear factor erythroid 2-related factor 2 (Nrf2) gene and its dependent genes, haem oxygenase-1 (HO-1) and NADPH-quinone oxidoreductase-1 (NQO-1); inflammatory cytokines TNF-α, IL1β and ICAM-1; and apoptotic markers such as caspase-3 in renal ischaemia/reperfusion (I/R) injury. METHODS One hundred and fifty male Sprague Dawley rats were classified into five groups (each consisted of 30 rats): sham, control (I/R), Ipre + I/R, Ipre without I/R and Ipost + I/R. Serum creatinine and blood urea nitrogen (BUN) were measured at 2, 24 and 48 h after ischaemia. In kidney tissues, mRNA of Nrf2, HO-1, NQO-1, TNF-α, IL-1β and ICAM-1 and immunohistochemical expression of Nrf2 and caspase-3 were assessed. RESULTS Serum creatinine and BUN improved significantly in Pre + I/R group; however, they did not show any significant improvement in Post + I/R group. Also, Ipre-I/R group showed non-significant change in serum creatinine and BUN. The expression of Nrf2, HO-1 and NQO-1 is increased significantly in Pre + I/R and Pre - I/R groups, while the enhancement in Post + I/R group was non-significant. Moreover, the expression of proinflammatory cytokines (TNF-α, IL-1 and ICAM-1) and apoptotic (caspase-3) markers showed high significant attenuation in Pre + I/R group, but slight significant attenuation in Pre + I/R group. CONCLUSION The renoprotective action of Ipre might include early activation and enhanced expression of Nrf2 gene and its dependent antioxidant genes, HO-1 and NOQ1, as endogenous adaptive renoprotective genes, as well as reduction in TNF-α, IL-1β, ICAM-1 and caspase-3.
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Affiliation(s)
- A. A. Shokeir
- Urology and Nephrology Center; Faculty of Medicine; Mansoura University; Mansoura Egypt
| | - A. M. Hussein
- Physiology Department; Faculty of Medicine; Mansoura University; Mansoura Egypt
| | - N. Barakat
- Urology and Nephrology Center; Faculty of Medicine; Mansoura University; Mansoura Egypt
| | - A. Abdelaziz
- Pathology Department; Faculty of Medicine; Mansoura University; Mansoura Egypt
| | - M. Elgarba
- Urology Department; Faculty of Medicine; Omar ElMokhtar University; Bida Libya
| | - A. Awadalla
- Urology and Nephrology Center; Faculty of Medicine; Mansoura University; Mansoura Egypt
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Ponticelli C. Ischaemia-reperfusion injury: a major protagonist in kidney transplantation. Nephrol Dial Transplant 2013; 29:1134-40. [PMID: 24335382 DOI: 10.1093/ndt/gft488] [Citation(s) in RCA: 194] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Ischaemia-reperfusion injury (IRI) is a frequent event in kidney transplantation, particularly when the kidney comes from a deceased donor. The brain death is usually associated with generalized ischaemia due to a hyperactivity of the sympathetic system. In spite of this, most donors have profound hypotension and require administration of vasoconstrictor agents. Warm ischaemia after kidney vessels clamping and the cold ischaemia after refrigeration also reduce oxygen and nutrients supply to tissues. The reperfusion further aggravates the state of oxidation and inflammation created by ischaemia. IRI first attacks endothelial cells and tubular epithelial cells. The lesions may be so severe that they lead to acute kidney injury (AKI) and delayed graft function (DGF), which can impair the graft survival. The unfavourable impact of DGF is worse when DGF is associated with acute rejection. Another consequence of IRI is the activation of the innate immunity. Danger signals released by dying cells alarm Toll-like receptors that, through adapter molecules and a chain of kinases, transmit the signal to transcription factors which encode the genes regulating inflammatory cells and mediators. In the inflammatory environment, dendritic cells (DCs) intercept the antigen, migrate to lymph nodes and present the antigen to immunocompetent cells, so activating the adaptive immunity and favouring rejection. Attempts to prevent IRI include optimal management of donor and recipient. Calcium-channel blockers, l-arginine and N-acetylcysteine could obtain a small reduction in the incidence of post-transplant DGF. Fenoldopam, Atrial Natriuretic Peptide, Brain Natriuretic Peptide and Dopamine proved to be helpful in reducing the risk of AKI in experimental models, but there is no controlled evidence that these agents may be of benefit in preventing DGF in kidney transplant recipients. Other antioxidants have been successfully used in experimental models of AKI but only a few studies of poor quality have been made in clinical transplantation with a few of these agents and we still lack of unambiguous demonstration that pre-treatment with these antioxidants can attenuate the impact of IRI in kidney transplantation. Interference with the signals leading to activation of innate immunity, inactivation of complement or manipulation of DCs is a promising therapeutic option for the near future.
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Kaeidi A, Rasoulian B, Hajializadeh Z, Pourkhodadad S, Rezaei M. Cisplatin toxicity reduced in human cultured renal tubular cells by oxygen pretreatment. Ren Fail 2013; 35:1382-6. [PMID: 24001324 DOI: 10.3109/0886022x.2013.829406] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Cisplatin is an effective and widely used chemotherapy agent and its side effects, particularly nephrotoxicity, limit its usage and related platinum-based drugs. Cisplatin nephrotoxicity is mainly due to extremely increase in reactive oxygen species (ROS) generation leading to kidney tubular cell death. Preconditioning with oxidative stress has been demonstrated to stimulate the cellular adaptation to subsequent severe oxidative stress. Short term oxygen pre-exposure as a mild oxidative stress may enhance some endogenous defense mechanisms, so its effect on Cisplatin induced cell death was investigated in present research. We studied the effects of hyperoxic environment pre-exposure on Cisplatin toxicity in an in-vitro model of cultured human embryonic tubular epithelial cells (AD293). Viability of AD293 cells, as evaluated by MTT-assay, was affected by Cisplatin in a time (1-4 h) dependent model. Biochemical markers of cell apoptosis were evaluated using immunoblotting. Pretreatment with nearly pure oxygen (≥90%) for 2 h significantly reduced the level of cell damage. Activated caspase 3 and Bax/Bcl-2 ratio were significantly increased in Cisplatin-treated cells. Oxygen pretreatment inhibited caspase 3 activation and decreased Bax/Bcl-2 ratio. Oxygen pre-treatment itself not showed any cytotoxicity in exposure times up to 3 h. Our data indicate that hyperoxic preconditioning reduces Cisplatin toxicity in cultured human tubular epithelial cells. The exact mechanism of protection is unclear, though enhancement of some endogenous defense mechanisms and subsequently scavenging of free oxygen radicals may play an important role.
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Affiliation(s)
- Ayat Kaeidi
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences , Khorramabad , Iran
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