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Zhao HY, Li HY, Jin J, Jin JZ, Zhang LY, Xuan MY, Jin XM, Jiang YJ, Zheng HL, Jin YS, Jin YJ, Choi BS, Yang CW, Piao SG, Li C. L-carnitine treatment attenuates renal tubulointerstitial fibrosis induced by unilateral ureteral obstruction. Korean J Intern Med 2021; 36:S180-S195. [PMID: 32942841 PMCID: PMC8009152 DOI: 10.3904/kjim.2019.413] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/05/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND/AIMS Accumulating evidence indicates that L-carnitine (LC) protects against multiorgan damage through its antioxidant properties and preservation of the mitochondria. Little information is available about the effects of LC on renal fibrosis. This study examined whether LC treatment would provide renoprotection in a rat model of unilateral ureteral obstruction (UUO) and in vitro. METHODS Sprague-Dawley rats that underwent UUO were treated daily with LC for 7 or 14 days. The influence of LC on renal injury caused by UUO was evaluated by histopathology, and analysis of gene expression, oxidative stress, mitochondrial function, programmed cell death, and phosphatidylinositol 3-kinase (PI3K)/ AKT/forkhead box protein O 1a (FoxO1a) signaling. In addition, H2O2-exposed human kidney cells (HK-2) were treated with LC. RESULTS LC treatment inhibited expression of proinflammatory and profibrotic cytokines, and was followed by a significant attenuation of tubulointerstitial inflammation and fibrosis. The increased oxidative stress caused by UUO was associated with mitochondrial dysfunction and excessive apoptosis and autophagy via PI3K/AKT/FoxO1a-dependent signaling, and this was abrogated by administration of LC. In H2O2-exposed HK-2 cells, LC decreased intracellular production of reactive oxygen species, and suppressed expression of profibrotic cytokines and reduced the number of apoptotic cells. CONCLUSION LC protects against the progression of tubulointerstitial fibrosis in an obstructed kidney.
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Affiliation(s)
- Hai Yan Zhao
- Department of Nephrology, Yanbian University Hospital, Yanji, China
- Health Examination Center, Yanbian University Hospital, Yanji, China
- Postdoctoral Research Institute, Yanbian University Hospital, Yanji, China
| | - Hui Ying Li
- Department of Nephrology, Yanbian University Hospital, Yanji, China
- Postdoctoral Research Institute, Yanbian University Hospital, Yanji, China
| | - Jian Jin
- Department of Nephrology, Yanbian University Hospital, Yanji, China
| | - Ji Zhe Jin
- Department of Nephrology, Yanbian University Hospital, Yanji, China
| | - Long Ye Zhang
- Department of Nephrology, Yanbian University Hospital, Yanji, China
| | - Mei Ying Xuan
- Health Examination Center, Yanbian University Hospital, Yanji, China
| | - Xue Mei Jin
- Department of Pathology, Yanbian University Hospital, Yanji, China
| | - Yu Ji Jiang
- Department of Nephrology, Yanbian University Hospital, Yanji, China
| | - Hai Lan Zheng
- Department of Nephrology, Yanbian University Hospital, Yanji, China
| | - Ying Shun Jin
- Department of Nephrology, Yanbian University Hospital, Yanji, China
| | - Yong Jie Jin
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bum Soon Choi
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chul Woo Yang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Shang Guo Piao
- Department of Nephrology, Yanbian University Hospital, Yanji, China
- Correspondence to Shang Guo Piao, M.D. Department of Nephrology, Yanbian University Hospital, #1327 Juzi St., Yanji 133000, China Tel: +86-155-2677-0987 Fax: +86-433-251-3610 E-mail:
| | - Can Li
- Department of Nephrology, Yanbian University Hospital, Yanji, China
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Review Article: Is There a Role for Antifibrotics in the Treatment of Urological Disease? A Systematic Review of the Literature. UROLOGY PRACTICE 2018. [DOI: 10.1016/j.urpr.2016.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Shirazi M, Soltani MR, Jahanabadi Z, Abdollahifar MA, Tanideh N, Noorafshan A. Stereological comparison of the effects of pentoxifylline, captopril, simvastatin, and tamoxifen on kidney and bladder structure after partial urethral obstruction in rats. Korean J Urol 2014; 55:756-63. [PMID: 25405019 PMCID: PMC4231154 DOI: 10.4111/kju.2014.55.11.756] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 09/11/2014] [Indexed: 01/09/2023] Open
Abstract
Purpose Limited studies have shown antifibrotic effects of pentoxifylline, captopril, simvastatin, and tamoxifen. No comparisons are available of the effects of these drugs on prevention of renal and bladder changes in partial urethral obstruction (PUO). Materials and Methods The rats were divided into six groups (n=7). The sham-operated rats (group I) only underwent laparotomy and did not receive any treatments. The PUO groups (group II-VI) received normal saline (PUO+NS), pentoxifylline (100 mg/kg/d; PUO+PEN), captopril (35 mg/kg/d; PUO+CAP), simvastatin (15 mg/kg/d; PUO+SIM), or tamoxifen (10 mg/kg/d; PUO+TAM) by gavage for 28 days. Then, the volume and/or length of the kidney components (tubules, vessels, and fibrous tissue) and the bladder components (epithelial and muscular layers, fibrous tissue, fibroblast and fibrocyte number) were quantitatively evaluated on the microscopic sections by use of stereological techniques. Results The volume of renal and bladder fibrosis was significantly ameliorated in the PUO+PEN group, followed by the PUO+CAP, PUO+SIM, and PUO+TAM groups. Also, the volume and length of the renal tubules and vessels and bladder layers were more significantly protected in the PUO+PEN group, followed by the PUO+CAP, PUO+SIM, and PUO+TAM groups. Conclusions Treatment of PUO with PEN was more effective in the prevention of renal and bladder fibrosis and in the preservation of renal and bladder structures.
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Affiliation(s)
- Mehdi Shirazi
- Histomorphometry and Stereology Research Centre, Shiraz University of Medical Sciences, Shiraz Iran. ; Department of Urology, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad-Reza Soltani
- Department of Urology, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Jahanabadi
- Department of Urology, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad-Amin Abdollahifar
- Histomorphometry and Stereology Research Centre, Shiraz University of Medical Sciences, Shiraz Iran. ; Anatomy Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Tanideh
- Stem Cell and Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Noorafshan
- Histomorphometry and Stereology Research Centre, Shiraz University of Medical Sciences, Shiraz Iran. ; Anatomy Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Dellê H, Rocha JRC, Cavaglieri RC, Vieira JM, Malheiros DMAC, Noronha IL. Antifibrotic effect of tamoxifen in a model of progressive renal disease. J Am Soc Nephrol 2011; 23:37-48. [PMID: 22052053 DOI: 10.1681/asn.2011010046] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Tamoxifen, a selective estrogen receptor modulator, has antifibrotic properties; however, whether it can attenuate renal fibrosis is unknown. In this study, we tested the effects of tamoxifen in a model of hypertensive nephrosclerosis (chronic inhibition of nitric oxide synthesis with L-NAME). After 30 days, treated rats had significantly lower levels of albuminuria as well as lower histologic scores for glomerulosclerosis and interstitial fibrosis than untreated controls. Tamoxifen was renoprotective despite having no effect on the sustained, severe hypertension induced by L-NAME. Tamoxifen prevented the accumulation of extracellular matrix by decreasing the expression of collagen I, collagen III, and fibronectin mRNA and protein. These renoprotective effects associated with inhibition of TGF-β1 and plasminogen activator inhibitor-1, and with a significant reduction in α-smooth muscle actin-positive cells in the renal interstitium. Furthermore, tamoxifen abrogated IL-1β- and angiotensin-II-induced proliferation of fibroblasts from both kidney explants and from the NRK-49F cell line. Tamoxifen also inhibited the expression of extracellular matrix components and the production and release of TGF-β1 into the supernatant of these cells. In summary, tamoxifen exhibits antifibrotic effects in the L-NAME model of hypertensive nephrosclerosis, likely through the inhibition of TGF-β1, suggesting that it may have therapeutic use in CKD treatment.
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Affiliation(s)
- Humberto Dellê
- Laboratory of Cellular, Genetic, and Molecular Nephrology, University of São Paulo, Av. Dr. Arnaldo, 455, 4th Floor, Lab 4304, São Paulo, CEP 01246-903, Brazil
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Shirazi M, Noorafshan A, Farrokhi A. Effects of pentoxifylline on renal structure after urethral obstruction in rat: A stereological study. Cent European J Urol 2011; 64:30-3. [PMID: 24578857 PMCID: PMC3921697 DOI: 10.5173/ceju.2011.01.art6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 01/30/2011] [Accepted: 02/04/2011] [Indexed: 11/22/2022] Open
Abstract
Objective Chronic renal failure due to tubulointerstitial fibrosis is one of complications of lower urinary tract obstruction. Since pentoxifylline is a xanthine derivative that inhibits some inflammatory mediators, we conducted this study to investigate whether pentoxifylline inhibits renal fibrosis in a rat model of partial urethral obstruction (PUO). Methods All the rats underwent experimental PUO. Then, the animals were divided randomly into two groups: positive control group and experimental group. The experimental group received pentoxifylline 100 mg/kg per day via oral gavages for 4-weeks. The control group received the same dose of normal saline. After 4-weeks, all the rats underwent left nephrectomy. Kidney volume and weight and fractional and absolute volumes of the glomeruli, tubules, interstitium and vessels were determined with stereological methods. To reduce the workload of reference (kidney) volume estimation, the total kidney volume was determined after estimation of tissue shrinkage on isotropic uniform random histological sections. The total volume (amount) of each renal structure including fibrosis was estimated to avoid the bias conclusion due to relying on volume density alone. Results The absolute volume of interstitial fibrosis was lower in the experimental group (PUO with pentoxifylline treatment) (~84%; p ≤0.006) in comparison with the control group (PUO with no treatment). Conclusion Pentoxifylline reduces interstitial renal fibrosis after partial urethral obstruction in rats.
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Affiliation(s)
- Mehdi Shirazi
- Histomorphometry & Stereology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Noorafshan
- Histomorphometry & Stereology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Farrokhi
- Department of Urology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Orlin JR, Klevmark B, Bjørnsen L, Hermansen P, Sanchez M. Two screening tests for urinary voiding dysfunction used in 209 consecutive patients undergoing lumbar spine operations. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 2010; 44:106-112. [PMID: 20095869 DOI: 10.3109/00365590903544223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE A study of the prevalence of urinary voiding dysfunction was carried out preoperatively in 209 patients undergoing lumbar spine operations, using two non-invasive screening tests: free uroflowmetry and ultrasound measurement of residual urine. The value of using the two urodynamic screening tests in the evaluation of a larger group of patients with sciatica from disc lesions or spinal stenosis has not been published as an article before. MATERIAL AND METHODS In 209 consecutive patients, 159 with lumbar disc lesions and 50 with lumbar spinal stenosis, the main indications for operative treatment were pain and/or somatic paresis. In preoperative interviews, information about voiding, anal and sexual functions were obtained. Then uroflowmetry was performed and the volume of residual urine was measured. In this study, the definition of normal bladder function is based on normal flow rates, the shape of the curves, normal voided volumes and the absence of significant residual urine. Bladder dysfunction differs from normal function by one, two, three or all four of these parameters. RESULTS Normal bladder function was found in 66 patients (31.6%). The other 143 (68.4%) had signs that could indicate sensory paresis and/or neurogenic detrusor underactivity. Seventy-nine of the 143 were also tested 3 months postoperatively. In 58% the bladder function had improved. CONCLUSIONS The very high prevalence of abnormal uroflowmetry and/or postvoiding residual urine suggestive of possible bladder dysfunction (68.4%) indicates that the two tests should be used routinely in cases of lumbar disc lesions and spinal stenosis. The two tests provide documentation of preoperative voiding function and a possibility of comparison with postoperative findings.
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Affiliation(s)
- Jan Roar Orlin
- Department of Orthopaedics, Central Hospital (FSS), Førde, Norway.
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