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Kovacevic S, Mitovic N, Brkic P, Ivanov M, Zivotic M, Miloradovic Z, Nesovic Ostojic J. Hyperbaric Oxygenation: Can It Be a Novel Supportive Method in Acute Kidney Injury? Data Obtained from Experimental Studies. Cells 2024; 13:1119. [PMID: 38994971 PMCID: PMC11240597 DOI: 10.3390/cells13131119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 06/13/2024] [Accepted: 06/25/2024] [Indexed: 07/13/2024] Open
Abstract
Despite constant achievements in treatment, acute kidney injury (AKI) remains a significant public health problem and a cause of mortality in the human population. In developed countries, AKI is a significant and frequent hospital complication, especially among patients admitted to intensive care units, where mortality rates can reach up to 50%. In addition, AKI has been implicated as an independent risk factor for the development of chronic kidney disease. Hyperbaric oxygenation (HBO) has been used as a primary or adjunctive therapy for the past 50 years, both in experimental and clinical studies. HBO is a treatment in which the patient is occasionally exposed to 100% oxygen at a pressure greater than atmospheric pressure at sea level. However, despite decades of extensive research, the potentially beneficial effects of this therapeutic approach are still not fully understood, although many potential mechanisms have been proposed, such as antioxidative, anti-inflammatory, anti-apoptotic, etc. Furthermore, the low cost and insignificant adverse events make HBO a potentially important strategy in the prevention and treatment of different diseases. Considering all of this, this review highlights the potential role of HBO in maintaining cellular homeostasis disrupted due to AKI, caused in different experimental models.
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Affiliation(s)
- Sanjin Kovacevic
- Department of Pathological Physiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nikola Mitovic
- Department of Pathological Physiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Predrag Brkic
- Department of Medical Physiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milan Ivanov
- Institute for Medical Research, Department of Cardiovascular Physiology, National Institute of Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia
| | - Maja Zivotic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Zoran Miloradovic
- Institute for Medical Research, Department of Cardiovascular Physiology, National Institute of Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia
| | - Jelena Nesovic Ostojic
- Department of Pathological Physiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Ma B, Jin G, Mao F, Zhou M, Li Y, Hu W, Cai X. Development of a nomogram to predict the incidence of acute kidney injury among ischemic stroke individuals during ICU hospitalization. Heliyon 2024; 10:e25566. [PMID: 38352771 PMCID: PMC10862667 DOI: 10.1016/j.heliyon.2024.e25566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/26/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
Background Limited clinical prediction models exist to assess the likelihood of acute kidney injury (AKI) occurrence in ischemic stroke individuals. In this retrospective study, our aim was to construct a nomogram that utilizes commonly available clinical features to predict the occurrence of AKI during intensive care unit hospitalization among this patient population. Methods In this study, the MIMIC-IV database was utilized to investigate potential risk factors associated with the incidence of AKI among ischemic stroke individuals. A predictive nomogram was developed based on these identified risk factors. The discriminative performance of the constructed nomogram was assessed. Calibration analysis was utilized to evaluate the calibration performance of the constructed model, assessing the agreement between predicted probabilities and actual outcomes. Furthermore, decision curve analysis (DCA) was employed to assess the clinical net benefit, taking into account the potential risks and benefits associated with different decision thresholds. Results A total of 2089 ischemic stroke individuals were included and randomly allocated into developing (n = 1452) and verification cohorts (n = 637). Risk factors for AKI incidence in ischemic stroke individuals, determined through LASSO and logistic regression. The constructed nomogram had good performance in predicting the occurrence of AKI among ischemic stroke patients and provided significant improvement compared to existing scoring systems. DCA demonstrated satisfactory clinical net benefit of the constructed nomogram in both the validation and development cohorts. Conclusions The developed nomogram exhibits robust predictive performance in forecasting AKI occurrence in ischemic stroke individuals.
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Affiliation(s)
- Buqing Ma
- Department of Critical Care Medicine, Hangzhou First People's Hospital, Hangzhou, China
| | - Guangyong Jin
- Department of Critical Care Medicine, Hangzhou First People's Hospital, Hangzhou, China
| | - Fengkai Mao
- Affiliated Hospital of Hangzhou Normal University, Hangzhou Normal University, Hangzhou, China
| | - Menglu Zhou
- Department of Neurology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Yiwei Li
- Department of Critical Care Medicine, Hangzhou First People's Hospital, Hangzhou, China
| | - Wei Hu
- Department of Critical Care Medicine, Hangzhou First People's Hospital, Hangzhou, China
| | - Xuwen Cai
- Department of Critical Care Medicine, Hangzhou First People's Hospital, Hangzhou, China
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Yu S, Dong X, Lai W, Lu H, Xie Y, Xu JY, Zeng Y, Han K, Liang J, Liu J, Liu Y, Chen J. Establishment and assessment of a preclinical model of acute kidney injury induced by contrast media combined acute myocardial ischemia reperfusion surgery. Exp Ther Med 2023; 26:321. [PMID: 37346411 PMCID: PMC10280325 DOI: 10.3892/etm.2023.12020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 04/20/2023] [Indexed: 06/23/2023] Open
Abstract
Acute kidney injury (AKI) is a common complication after acute myocardial infarction (AMI) in clinical practice, and the majority of previous preclinical models were induced by a single factor. The objective of the present study was to establish a stable preclinic model of AKI induced by contrast media (CM) with acute myocardial ischemia reperfusion surgery and to identify the effect of oxidative stress on kidney injury. Rats were treated individually or with CM or myocardial ischemia reperfusion surgery. Renal baseline and AKI parameters, the level of oxidative stress and histopathological images were examined along with AKI biomarkers. Results showed the incidence of AKI in the CM group and ischemia reperfusion injury (IRI) group was 40%, χ2 test (P<0.05 vs. CM-IRI) and 35%, χ2 test (P<0.05 vs. CM-IRI) and the combination group had the highest incidence rate 75%. IRI surgery combined with CM diminished kidney function and induced oxidative stress by increasing creatinine, blood urea nitrogen and reactive oxygen species levels. Western blotting showed that the early AKI biomarker of NGAL and KIM-1 increased and that the combination group had the highest value. Pathology damage exhibited severe kidney damage in the combination group compared with other control groups. The present research established a reliable preclinic model of post-AMI AKI with a stable and high postoperative AKI rate. Additionally, CM was demonstrated to exacerbate AKI caused by acute myocardial infarction through oxidative stress and, thus, oxidative stress may be a potential therapeutic target.
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Affiliation(s)
- Sijia Yu
- Department of Cardiology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
| | - Xiaoli Dong
- Department of Cardiology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570102, P.R. China
| | - Wenguang Lai
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Pharmacy, Guangdong Provincial People's Hospital, School of Biology and Biological Engineering, South China University of Technology, Guangzhou, Guangdong 5130006, P.R. China
| | - Hongyu Lu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
| | - Yun Xie
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Pharmacy, Guangdong Provincial People's Hospital, School of Biology and Biological Engineering, South China University of Technology, Guangzhou, Guangdong 5130006, P.R. China
| | - Jun-Yan Xu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Key Laboratory of Hainan Trauma and Disaster Rescue, College of Emergency and Trauma, Hainan Medical University, Ministry of Education, Haikou, Hainan 571199, P.R. China
| | - Yewen Zeng
- Guangdong Provincial Key Laboratory of Laboratory Animals, Guangdong Laboratory Animal Monitoring Institute, Guangzhou, Guangdong 523136, P.R. China
| | - Kedong Han
- Department of Cardiology, Maoming People's Hospital, Maoming, Guangdong 525000, P.R. China
| | - Jinqiang Liang
- Key Laboratory of Tropical Biological Resources of Ministry of Education, School of Pharmaceutical Sciences, Hainan University, Haikou, Hainan 570228, P.R. China
| | - Jin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
| | - Yong Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
| | - Jiyan Chen
- Department of Cardiology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
- Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, P.R. China
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Lu XH, Zhang J, Xiong Q. Suppressive effect erythropoietin on oxidative stress by targeting AMPK/Nox4/ROS pathway in renal ischemia reperfusion injury. Transpl Immunol 2022; 72:101537. [PMID: 35031454 DOI: 10.1016/j.trim.2022.101537] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/09/2022] [Accepted: 01/09/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To explore the effect of erythropoietin (EPO) on the AMP-activated protein kinase (AMPK)/nicotinamide adenine dinucleotide phosphatase oxidase 4 (NOX4) signaling pathway during renal ischemia reperfusion injury (RIRI) in rats. METHODS A rat model of RIRI was established by clamping the left renal pedicle and removing the right kidney. The rats in the sham group did not have their left renal pedicle clamped. Rats with a model of RIRI were randomly divided into RIRI alone (control), erythropoietin treatment (EPO/RIRI), and Compound C treatment (CPC/RIRI) groups. Hematoxylin-eosin (H&E) staining was used to examine pathological kidney damage. Serum creatinine and urea nitrogen levels were measured to evaluate renal function. Western blotting was performed to detect the expression levels of phosphorylated p-AMPK and total AMPK protein in the kidneys. RT-PCR was used to evaluate the mRNA levels of Nox4 and p22 in the kidneys. Oxidative stress-related indices (ROS, CAT, GSH, SOD, and MDA) were also measured. RESULTS EPO treatment improved kidney function by preventing kidney damage induced by the RIRI model. Preventing ischemia/reperfusion injury in the RIRI model was correlated with an increased p-AMPK/AMPK ratio and elevated activity of CAT, GSH, and SOD, which ameliorated the expression of NOX4, p22, ROS, and MDA. Moreover, treatment with CPC (an AMPK inhibitor) reduced the effects of EPO in the RIRI model. CONCLUSION EPO treatment protected rats against RIRI in the RIRI model by alleviating oxidative stress by triggering the AMPK/NOX4/ROS pathway.
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Affiliation(s)
- Xiang-Heng Lu
- Queen Mary School, Nanchang University, Nanchang 330031, China
| | - Jiong Zhang
- Department of Nephrology, University of Electronic Science and Technology, Sichuan Academy of Sciences & Sichuan Provincial People's Hospital, Sichuan Clinical Research Center for Kidney Disease, Chengdu 610072, China
| | - Qin Xiong
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
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Hyperbaric Oxygen Preconditioning Upregulates Heme OxyGenase-1 and Anti-Apoptotic Bcl-2 Protein Expression in Spontaneously Hypertensive Rats with Induced Postischemic Acute Kidney Injury. Int J Mol Sci 2021; 22:ijms22031382. [PMID: 33573145 PMCID: PMC7866496 DOI: 10.3390/ijms22031382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 12/19/2022] Open
Abstract
Renal ischemia and reperfusion (I/R) injury is the most common cause of acute kidney injury (AKI). Pathogenesis of postischemic AKI involves hemodynamic changes, oxidative stress, inflammation process, calcium ion overloading, apoptosis and necrosis. Up to date, therapeutic approaches to treat AKI are extremely limited. Thus, the aim of this study was to evaluate the effects of hyperbaric oxygen (HBO) preconditioning on citoprotective enzyme, heme oxygenase-1 (HO-1), pro-apoptotic Bax and anti-apoptotic Bcl-2 proteins expression, in postischemic AKI induced in normotensive Wistar and spontaneously hypertensive rats (SHR). The animals were randomly divided into six experimental groups: SHAM-operated Wistar rats (W-SHAM), Wistar rats with induced postischemic AKI (W-AKI) and Wistar group with HBO preconditioning before AKI induction (W-AKI + HBO). On the other hand, SHR rats were also divided into same three groups: SHR-SHAM, SHR-AKI and SHR-AKI + HBO. We demonstrated that HBO preconditioning upregulated HO-1 and anti-apoptotic Bcl-2 protein expression, in both Wistar and SH rats. In addition, HBO preconditioning improved glomerular filtration rate, supporting by significant increase in creatinine, urea and phosphate clearances in both rat strains. Considering our results, we can also say that even in hypertensive conditions, we can expect protective effects of HBO preconditioning in experimental model of AKI.
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Wang ZS, Zhou HH, Han Q, Guo YL, Li ZY. Effects of grape seed proanthocyanidin B2 pretreatment on oxidative stress and renal tubular epithelial cell apoptosis after renal ischemia reperfusion in mice. Acta Cir Bras 2020; 35:e202000802. [PMID: 32901679 PMCID: PMC7478463 DOI: 10.1590/s0102-865020200080000002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/08/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To investigate the effects of grape seed proanthocyanidin B2 (GSPB2) preconditioning on oxidative stress and apoptosis of renal tubular epithelial cells in mice after renal ischemia-reperfusion (RIR). METHODS Forty male ICR mice were randomly divided into 4 groups: Group A: mice were treated with right nephrectomy. Group B: right kidney was resected and the left renal vessel was clamped for 45 minutes. Group C: mice were intraperitoneally injected with GSPB2 before RIR established. Group D: mice were intraperitoneally injected with GSPB2 plus brusatol before RIR established. Creatinine and urea nitrogen of mice were determined. Pathological and morphological changes of kidney were checked. Expressions of Nrf-2, HO-1, cleaved-caspase3 were detected by Western-blot. RESULTS Compared to Group B, morphology and pathological damages of renal tissue were less serious in Group C. Western-blot showed that expressions of Nrf-2 and HO-1 in Group C were obviously higher than those in Group B. The expression of cleaved-caspase3 in Group C was significantly lower than that in Group B. CONCLUSION GSPB2 preconditioning could attenuate renal oxidative stress injury and renal tubular epithelial cell apoptosis by up-regulating expressions of Nrf-2 and HO-1 and down-regulating the expression of cleaved-caspase-3, but the protective effect could be reversed by brusatol.
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Affiliation(s)
- Zhi-shun Wang
- Huazhong University of Science and Technology, China
| | - Hai-hong Zhou
- Huazhong University of Science and Technology, China
| | - Qi Han
- The Fifth Hospital of Wuhan, China
| | - Yong-lian Guo
- Huazhong University of Science and Technology, China
| | - Zhong-yuan Li
- Huazhong University of Science and Technology, China
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Açiksari K, Eğin S, Hepgül G, Mirasoğlu B, Tanriverdi G, Kanber DS, Demirci S, Doğan H, Özüçelik DN, Toklu AS, Seçkin İ, Yanar HT. Protective effect of hyperbaric oxygen treatment on rat intestinal mucosa after mesenteric ischaemia and reperfusion. Diving Hyperb Med 2020; 49:253-258. [PMID: 31828743 DOI: 10.28920/dhm49.4.253-258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 07/25/2019] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Mesenteric ischaemia results from a lack of adequate blood flow to and oxygenation of the mesentery and intestines. The aim of the present study was to evaluate the effect of hyperbaric oxygen treatment (HBOT) on the healing process in intestinal mucosa of rats undergoing mesenteric ischaemia and reperfusion. METHODS Thirty-two Wistar-Albino rats were divided into four groups of eight: 1) ischaemia/reperfusion (I/R); 2) sham operation; 3) I/R+HBOT started 6 hours after reperfusion; 4) I/R+HBOT started 12 hours after reperfusion. In the I/R groups, a vascular clamp was placed across the superior mesenteric artery to occlude arterial circulation for 60 minutes, followed by reperfusion. A dose of HBOT consisted of 100% oxygen breathing for 90 minutes at 2.5 atmospheres absolute pressure. Thirteen doses of HBOT were administered after ischaemia. The rats were sacrificed on the eighth day, and their intestinal tissues were harvested for histopathologic analysis. The tissue levels of catalase, malondialdehyde, and glutathione were determined. RESULTS The histopathological scores (HSCORE) were consistent with macroscopic examinations. The scores were significantly higher (worse) in Group 1 compared to Group 2, Group 3, and Group 4 (for all comparisons, P < 0.05). Group 4's HSCORE was significantly higher than those of Group 2 and Group 3 (for both comparisons P < 0.05). Group 3's HSCOREs were only marginally higher than Group 2. Group 3 exhibited higher glutathione levels than Group 1 (P < 0.05). There were no significant differences across the groups with respect to malondialdehyde and catalase levels. CONCLUSION A beneficial effect of HBOT was observed on oxidative stress and inflammation in acute mesenteric ischaemia-reperfusion.
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Affiliation(s)
- Kurtuluş Açiksari
- Department of Emergency Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.,Corresponding author: Department of Emergency Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey,
| | - Seracettin Eğin
- Department of General Surgery, MoH Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Gülçin Hepgül
- Department of General Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Bengüsu Mirasoğlu
- Department of Underwater and Hyperbaric Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gamze Tanriverdi
- Department of Histology and Embryology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Devrim S Kanber
- Department of Biophysics, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sibel Demirci
- Department of Histology and Embryology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Halil Doğan
- Department of Emergency Medicine, MoH Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | | | - Akın S Toklu
- Department of Underwater and Hyperbaric Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - İsmail Seçkin
- Department of Histology and Embryology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hakan T Yanar
- Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Kovacevic S, Ivanov M, Miloradovic Z, Brkic P, Vajic UJ, Zivotic M, Mihailovic-Stanojevic N, Jovovic D, Karanovic D, Jeremic R, Nesovic-Ostojic J. Hyperbaric oxygen preconditioning and the role of NADPH oxidase inhibition in postischemic acute kidney injury induced in spontaneously hypertensive rats. PLoS One 2020; 15:e0226974. [PMID: 31914135 PMCID: PMC6948727 DOI: 10.1371/journal.pone.0226974] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/09/2019] [Indexed: 12/14/2022] Open
Abstract
Renal ischemia/reperfusion injury is a common cause of acute kidney injury (AKI) and hypertension might contribute to the increased incidence of AKI. The purpose of this study was to investigate the effects of single and combined hyperbaric oxygen (HBO) preconditioning and NADPH oxidase inhibition on oxidative stress, kidney function and structure in spontaneously hypertensive rats (SHR) after renal ischemia reperfusion injury. HBO preconditioning was performed by exposing to pure oxygen (2.026 bar) twice a day for two consecutive days for 60 minutes, and 24h before AKI induction. For AKI induction, the right kidney was removed and ischemia was performed by clamping the left renal artery for 45 minutes. NADPH oxidase inhibition was induced by apocynin (40 mg/kg b.m., intravenously) 5 minutes before reperfusion. AKI significantly increased renal vascular resistance and reduced renal blood flow, which were significantly improved after apocynin treatment. Also, HBO preconditioning, with or without apocynin treatment showed improvement on renal hemodynamics. AKI significantly increased plasma creatinine, urea, phosphate levels and lipid peroxidation in plasma. Remarkable improvement, with decrease in creatinine, urea and phosphate levels was observed in all treated groups. HBO preconditioning, solitary or with apocynin treatment decreased lipid peroxidation in plasma caused by AKI induction. Also, combined with apocynin, it increased catalase activity and solitary, glutathione reductase enzyme activity in erythrocytes. While AKI induction significantly increased plasma KIM– 1 levels, HBO preconditioning, solitary or with apocynin decreased its levels. Considering renal morphology, significant morphological alterations present after AKI induction were significantly improved in all treated groups with reduced tubular dilatation, tubular necrosis in the cortico-medullary zone and PAS positive cast formation. Our results reveal that NADPH oxidase inhibition and hyperbaric oxygen preconditioning, with or without NADPH oxidase inhibition may have beneficial effects, but their protective role should be evaluated in further studies.
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Affiliation(s)
- Sanjin Kovacevic
- Department of Pathophysiology, Medical Faculty, University of Belgrade, Belgrade, Serbia
- * E-mail: (SK); (JNO)
| | - Milan Ivanov
- Institute for Medical Research, Department of Cardiovascular Physiology, University of Belgrade, Belgrade, Serbia
| | - Zoran Miloradovic
- Institute for Medical Research, Department of Cardiovascular Physiology, University of Belgrade, Belgrade, Serbia
| | - Predrag Brkic
- Department of Medical Physiology, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Una Jovana Vajic
- Institute for Medical Research, Department of Cardiovascular Physiology, University of Belgrade, Belgrade, Serbia
| | - Maja Zivotic
- Department of Pathology, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Nevena Mihailovic-Stanojevic
- Institute for Medical Research, Department of Cardiovascular Physiology, University of Belgrade, Belgrade, Serbia
| | - Djurdjica Jovovic
- Institute for Medical Research, Department of Cardiovascular Physiology, University of Belgrade, Belgrade, Serbia
| | - Danijela Karanovic
- Institute for Medical Research, Department of Cardiovascular Physiology, University of Belgrade, Belgrade, Serbia
| | - Rada Jeremic
- Department of Medical Physiology, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Jelena Nesovic-Ostojic
- Department of Pathophysiology, Medical Faculty, University of Belgrade, Belgrade, Serbia
- * E-mail: (SK); (JNO)
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Cury MFR, Olivares EQ, Garcias RC, Toledo GQ, Anselmo NA, Paskakulis LC, Botelho FFR, Carvalho NZ, Silva AAD, Agren C, Carlos CP. Inflammation and kidney injury attenuated by prior intake of Brazil nuts in the process of ischemia and reperfusion. ACTA ACUST UNITED AC 2018; 40:312-318. [PMID: 30118536 PMCID: PMC6533994 DOI: 10.1590/2175-8239-jbn-2018-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 06/11/2018] [Indexed: 12/13/2022]
Abstract
Introduction: Ischemia and reperfusion (IR) is a process inherent to the procedures
involved in the transplantation of organs that causes inflammation, cell
death and cell injury, and may lead to rejection of the graft. It is
possible that the anti-inflammatory properties of the Brazil nuts (BN) can
mitigate the renal injury caused by IR. Objective: To investigate whether the previous intake of BN reduces the expression of
markers of inflammation, injury, and cell death after renal IR. Methods: Male Wistar rats were distributed into six groups (N = 6/group): SHAM
(control), SHAM treated with 75 or 150 mg of BN, IR, and IR treated with 75
or 150 mg of BN. The IR procedure consisted of right nephrectomy and
occlusion of the left renal artery with a non-traumatic vascular clamp for
30 min. BN was given daily from day 1 to 7 before surgery (SHAM or IR), and
maintained until sacrifice (48 h after surgery). Inflammation was evaluated
by renal expression of COX-2 and TGF-β, injury by the expression of
vimentin, and cell death by apoptosis through caspase-3 expression
(immunohistochemistry). Results: Pretreatment with 75 mg of BN reduced renal expression of the COX-2, TGF-β,
vimentin, and caspase-3. The dose of 150 mg caused increased expression of
COX-2. Conclusion: In experimental IR, the damage can be minimized with a prior low-dose intake
of BN, improving inflammation, injury, and cell death.
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Affiliation(s)
| | - Estéfany Queiroz Olivares
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Renata Correia Garcias
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Giovana Queda Toledo
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Natassia Alberici Anselmo
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | | | | | - Natiele Zanardo Carvalho
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Analice Andreoli da Silva
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Camila Agren
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
| | - Carla Patrícia Carlos
- Laboratório de Pesquisa Experimental, FACERES Faculdade de Medicina, São José do Rio Preto, SP, Brasil
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A Pilot Study of Short-Duration Hyperbaric Oxygen Therapy to Improve HbA1c, Leukocyte, and Serum Creatinine in Patients with Diabetic Foot Ulcer Wagner 3-4. ScientificWorldJournal 2018; 2018:6425857. [PMID: 30158840 PMCID: PMC6109474 DOI: 10.1155/2018/6425857] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/09/2018] [Indexed: 12/25/2022] Open
Abstract
Objective To evaluate the short-duration hyperbaric oxygen therapy (HBOT) can improve HbA1c levels, leukocyte count, and serum creatinine levels in patients with diabetic foot ulcer (DFU) Wagner 3-4. Methods Blood samples from all DFU patients at Sanglah General Hospital, Denpasar, were taken for HbA1c, leukocyte, and serum creatinine test before debridement procedure, and the patients were then grouped into either standard therapy or standard therapy with HBOT for 10 sessions (combination therapy). At the end of therapy, all blood tests were resumed. Results Each group consisted of 15 patients. Results of laboratory analysis before and after treatment were significant regarding decrease of HbA1c levels in standard therapy (10.98 ± 2.37 % to 9.70 ± 2.46 %; p = 0.006), HbA1c levels in combination therapy (9.42 ± 1.96 % to 7.07 ± 1.16 %; p < 0.001), and leukocyte count in combination therapy (13.97 ± 6.24 x 103 cells/μL to 8.84 ± 2.88 x 103 cells/μL; p = 0.009). The HbA1c levels at the end of therapy were significantly different between groups (p = 0.001). Serum creatinine level was decreased only in combination therapy but it was not significant. The effect size of all variables was larger in the combination therapy, but it was not significant (p > 0.05). Conclusion The use of short-duration HBOT on DFU reduces HbA1c levels, leukocyte count, and serum creatinine levels better than standard therapy alone. This protocol would save time and effort in future HBOT implementation. This trial is registered with ClinicalTrials.gov Identifier: NCT03615755.
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11
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Carlos CP, Silva AA, Gil CD, Oliani SM. Pharmacological treatment with galectin-1 protects against renal ischaemia-reperfusion injury. Sci Rep 2018; 8:9568. [PMID: 29934646 PMCID: PMC6015078 DOI: 10.1038/s41598-018-27907-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 06/07/2018] [Indexed: 11/21/2022] Open
Abstract
Galectin-1 protein (GAL-1) has important anti-inflammatory properties, but related pharmacologic approaches to effectively treat or prevent renal ischaemia and reperfusion injury are highly limited. Here, we investigated the effect of GAL-1 in a renal ischaemia-reperfusion injury rat model and an in vitro hypoxia-reoxygenation model with a proximal renal tubular epithelial cell line. In vivo, pretreatment with GAL-1 attenuated the renal parameters changed by ischaemia-reperfusion/hypoxia-reoxygenation, with recovery of renal function, protecting against influx of leukocytes, cell death and oxidative stress. Ischaemia-reperfusion/hypoxia-reoxygenation was also associated with increased renal endogenous expression of GAL-1 and intercellular adhesion molecule 1 (ICAM-1) plus augmented levels of proinflammatory cytokines IL-1β, TNF-α and MCP-1 and decreased anti-inflammatory IL-10 in urine, all of which were abrogated by GAL-1 treatment. In vitro studies demonstrated renal tubular epithelial cells as an important source of GAL-1 during hypoxia-reoxygenation and confirmed the protective effects of exogenous GAL-1 through downregulation of proinflammatory cytokine release by proximal renal tubular epithelial cells. Collectively, our findings confirm the important anti-inflammatory role of GAL-1 in kidney ischaemia and reperfusion injury and indicate its promising use as a therapeutic approach.
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Affiliation(s)
- Carla P Carlos
- Department of Biology, Instituto de Biociências, Letras e Ciências Exatas, Sao Paulo State University, UNESP, São José do Rio Preto, SP, Brazil.,Department of Medicine, FACERES School of Medicine, São José do Rio Preto, SP, Brazil
| | - Analice A Silva
- Department of Biology, Instituto de Biociências, Letras e Ciências Exatas, Sao Paulo State University, UNESP, São José do Rio Preto, SP, Brazil
| | - Cristiane D Gil
- Department of Morphology and Genetics, Federal University of Sao Paulo, UNIFESP, São Paulo, SP, Brazil
| | - Sonia M Oliani
- Department of Biology, Instituto de Biociências, Letras e Ciências Exatas, Sao Paulo State University, UNESP, São José do Rio Preto, SP, Brazil. .,Department of Morphology and Genetics, Federal University of Sao Paulo, UNIFESP, São Paulo, SP, Brazil.
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12
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Anselmo NA, Paskakulis LC, Garcias RC, Botelho FFR, Toledo GQ, Cury MFR, Carvalho NZ, Mendes GEF, Iembo T, Bizotto TSG, Cury PM, Chies AB, Carlos CP. Prior intake of Brazil nuts attenuates renal injury induced by ischemia and reperfusion. ACTA ACUST UNITED AC 2018; 40:10-17. [PMID: 29796584 PMCID: PMC6533976 DOI: 10.1590/1678-46a85-jbn-3819] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/30/2017] [Indexed: 12/13/2022]
Abstract
Introduction: Ischemia-reperfusion (IR) injury results from inflammation and oxidative
stress, among other factors. Because of its anti-inflammatory and
antioxidant properties, the Brazil nut (BN) might attenuate IR renal
injury. Objective: The aim of the present study was to investigate whether the intake of BN
prevents or reduces IR kidney injury and inflammation, improving renal
function and decreasing oxidative stress. Methods: Male Wistar rats were distributed into six groups (N=6/group): SHAM
(control), SHAM treated with 75 or 150 mg of BN, IR, and IR treated with 75
or 150 mg of BN. The IR procedure consisted of right nephrectomy and
occlusion of the left renal artery with a non-traumatic vascular clamp for
30 min. BN was given daily and individually for 7 days before surgery (SHAM
or IR) and maintained until animal sacrifice (48h after surgery). We
evaluated the following parameters: plasma creatinine, urea, and phosphorus;
proteinuria, urinary output, and creatinine clearance; plasmatic TBARS and
TEAC; kidney expression of iNOS and nitrotyrosine, and macrophage
influx. Results: Pre-treatment with 75 mg of BN attenuated IR-induced renal changes, with
elevation of creatinine clearance and urinary output, reducing proteinuria,
urea, and plasmatic phosphorus as well as reducing kidney expression of
iNOS, nitrotyrosine, and macrophage influx. Conclusion: Low intake of BN prior to IR-induced kidney injury improves renal function by
inhibition of macrophage infiltration and oxidative stress.
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Affiliation(s)
- Natassia Alberici Anselmo
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Leticia Colombo Paskakulis
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Renata Correia Garcias
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Fernanda Fortuci Resende Botelho
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Giovana Queda Toledo
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Maria Fernanda Ribeiro Cury
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Natiele Zanardo Carvalho
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Glória Elisa Florido Mendes
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Tatiane Iembo
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Thaís Santana Gastardelo Bizotto
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Patricia Maluf Cury
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
| | - Agnaldo Bruno Chies
- Faculdade de Medicina de Marília, Laboratório de Farmacologia, Marília, SP, Brasil
| | - Carla Patrícia Carlos
- Faculdade de Medicina de São José do Rio Preto - FACERES, Laboratório de Pesquisa Experimental, São José do Rio Preto, SP, Brasil
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13
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Sekiguchi H, Ajiro Y, Uchida Y, Jujo K, Iwade K, Tanaka N, Shimamoto K, Tsurumi Y, Kawana M, Hagiwara N. Contrast-Induced Nephropathy and Oxygen Pretreatment in Patients With Impaired Renal Function. Kidney Int Rep 2018; 3:65-72. [PMID: 29340315 PMCID: PMC5762947 DOI: 10.1016/j.ekir.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 08/01/2017] [Accepted: 08/07/2017] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Contrast-induced nephropathy is a complication following coronary angiography and percutaneous coronary intervention. Because contrast-induced nephropathy is a predictor of long-term mortality in patients with ischemic heart disease undergoing percutaneous coronary intervention, preventive strategies are required. We assessed the effects of periprocedural oxygenation on contrast-induced nephropathy among patients with pre-existing renal dysfunction. METHODS A total of 200 consecutive patients with impaired renal function (estimated glomerular filtration < 60 ml/min per 1.73 m2) undergoing elective cardiovascular angiography were randomly assigned to an oxygenation treatment (n = 100) or control group (n = 100). In oxygenation treatment, pure oxygen (2 L/min) was administered for 10 minutes before exposure to contrast medium. The primary endpoint was the incidence of contrast-induced nephropathy, defined as a ≥ 25% increase in serum creatinine levels from baseline within 48 hours of exposure. RESULTS In the oxygenation treatment group, partial pressure of arterial oxygen was higher (135 ± 25 mm Hg vs. 84 ± 10 mm Hg, P < 0.001); contrast-induced nephropathy incidence was lower (1% vs. 8%, odds ratio [OR] = 0.12, 95% confidence interval [CI] = 0.01-0.95, P = 0.02); and partial pressure of arterial carbon dioxide and bicarbonate base lactate levels were similar compared with those in the control group. Upon univariate analysis, excess and absence of oxygenation treatment (OR = 9.18, CI = 1.13-74.86, P = 0.03) and anemia (OR = 4.30, CI = 1.04-17.78, P = 0.04) were shown to be associated with contrast-induced nephropathy incidence. CONCLUSION Oxygenation, a simple, nonpharmacological strategy, may be beneficial when using contrast media in patients with impaired renal function from noninvasive angiography to emergency catheterization.
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Affiliation(s)
- Haruki Sekiguchi
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Aoyama Hospital Tokyo Women’s Medical University, Tokyo, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Yoichi Ajiro
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Yoshie Uchida
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | | | - Kazunori Iwade
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Naohide Tanaka
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Ken Shimamoto
- Aoyama Hospital Tokyo Women’s Medical University, Tokyo, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Yukio Tsurumi
- Aoyama Hospital Tokyo Women’s Medical University, Tokyo, Japan
- You Heart Clinic, Tokyo, Tokyo, Japan
| | - Masatoshi Kawana
- Aoyama Hospital Tokyo Women’s Medical University, Tokyo, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
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14
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Berkovitch M, Shain Y, Kozer E, Goldman M, Abu-Kishk I. Hyperbaric oxygen treatment and nephrotoxicity induced by gentamicin in rats. BMC Nephrol 2017; 18:347. [PMID: 29197348 PMCID: PMC5712188 DOI: 10.1186/s12882-017-0768-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 11/20/2017] [Indexed: 11/14/2022] Open
Abstract
Background Nephrotoxicity is a significant adverse side effect of gentamicin. Previous preclinical studies showed that hyperbaric oxygen treatment (HBOT) may have beneficial effects by attenuating renal damage in rats subjected to renal injury. We evaluated the effect of HBOT on acute renal failure caused by gentamicin. Methods Thirty-six rats were divided into four groups. Gentamicin (150 mg/kg for 5 consecutive days) was administered in 30 rats, 10 rats received only gentamicin, 10 rats received 100% oxygen therapy on days 1-5 of the experiment, 10 received daily HBOT on days 1-5 of the experiment, and the remaining six served as a control group. On day 6, renal function tests and renal pathological examinations were performed. Results Body weight and biochemical parameters were similar in all groups except for higher plasma levels of calcium in the 100% oxygen group (P = 0.03). All the rats in the experimental group showed biochemical parameters compatible with renal failure (high serum levels of urea and creatinine). All the rats in the control group had normal renal function tests. Two rats from the HBOT group died on the fifth day of the experiment. All rats in the control group demonstrated normal renal morphology. All 28 intoxicated rats showed moderate to severe histopathological changes without significant differences between the groups. Conclusions Treatment of gentamicin-induced nephrotoxicity with either HBOT or 100% oxygen for 5 days had no beneficial renal effect. Mortality was observed only in the HBOT group.
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Affiliation(s)
- Matitiahu Berkovitch
- Pediatric Division, Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Shain
- Pediatric Division, Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Kozer
- Pediatric Division, Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Goldman
- Pediatric Division, Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ibrahim Abu-Kishk
- Pediatric Division, Assaf Harofeh Medical Center, 70300, Zerifin, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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15
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Sancak EB, Tan YZ, Turkon H, Silan C. Attenuation of partial unilateral ureteral obstruction - induced renal damage with hyperbaric oxygen therapy in a rat model. Int Braz J Urol 2017; 43:946-956. [PMID: 28191789 PMCID: PMC5678529 DOI: 10.1590/s1677-5538.ibju.2016.0565] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/03/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The objective of the present study was to evaluate the effectiveness of HBO therapy on biochemical parameters, renal morphology and renal scintigraphy in rats undergoing chronic unilateral partial ureteral obstruction (UPUO). MATERIAL AND METHODS Thirty-five rats were divided into five equal groups: Control group; Sham group; HBO group; UPUO group and UPUO/HBO group. The effects of HBO therapy were examined using biochemical parameters and histopathological changes. After calculating the score for each histopathological change, the total histopathological score was obtained by adding all the scores. In addition, dynamic renal scintigraphy findings were evaluated. RESULTS Serum parameters indicating inflammation, serum tumor necrosis factoralpha, ischemia modified-albumin, IMA/albumin ratio and Pentraxin-3 levels, were observed to be high in the UPUO group and low in the UPUO/HBO treatment group. Similarly, in the treatment group, the reduction in malondialdehyde, total oxidant status and oxidative stress index levels and increase in total antioxidant capacity values were observed to be statistically significant compared to the UPUO group (p<0.001, p=0.007, p<0.001, p=0.001, respectively). The total score and apoptosis index significantly decreased after administration of HBO treatment. Dynamic 99mTc-MAG3 renal scintigraphy also showed convincing evidence regarding the protective nature of HBO against kidney injury. In the UPUO/HBO therapy group, the percentage contribution of each operated kidney increased significantly compared to the UPUO group (41.73% versus 32.72%). CONCLUSION The findings of this study indicate that HBO therapy had a reno-protective effect by reducing inflammation and oxidative stress, and preserving renal function after renal tissue damage due to induction of UPUO.
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Affiliation(s)
- Eyup Burak Sancak
- Department of Urology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
| | - Yusuf Ziya Tan
- Department of Nuclear Medicine, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
| | - Hakan Turkon
- Department of Biochemistry, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
| | - Coskun Silan
- Department of Pharmacology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey
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16
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Yamashita T, Noiri E, Hamasaki Y, Matsubara T, Ishii T, Yahagi N, Nangaku M, Doi K. Erythropoietin concentration in acute kidney injury is associated with insulin-like growth factor-binding protein-1. Nephrology (Carlton) 2017; 21:693-9. [PMID: 26479890 DOI: 10.1111/nep.12656] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 12/19/2022]
Abstract
AIM Erythropoietin (EPO) production is stimulated by hypoxia in the kidney. Ischaemic injury plays a crucial role in the pathogenesis of acute kidney injury (AKI). However, EPO concentrations in critically ill patients complicated with AKI have not been evaluated sufficiently. This study was conducted to clarify the factors associated with plasma EPO concentrations in AKI. METHODS This study prospectively enrolled 98 critically ill adult patients treated at the adult mixed ICU. Plasma EPO, insulin-like growth factor-binding protein-1 (IGFBP-1), neutrophil gelatinase-associated lipocalin (NGAL), interleukin-6 (IL-6) and urinary N-acetyl-β-D-glucosaminidase (NAG) were measured on ICU admission. RESULTS Acute kidney injury occurred in 42 (42.9%) patients. Significantly higher plasma EPO in the AKI group was detected than in the non-AKI group (16.13 (9.87-28.47) mIU/mL versus 27.81 (10.16-106.02) mIU/mL, P < 0.05). Plasma IGFBP-1 in the AKI group was also significantly higher than in the non-AKI group (19 208 (8820-50 780) pg/mL versus 63 199 (25 289-147 489) pg/mL, P < 0.05). Plasma EPO concentration was negatively correlated with haemoglobin in the non-AKI group with statistical significance, but not in the AKI group. Multiple logistic regression analysis revealed that plasma EPO in the AKI group was associated significantly with plasma IGFBP-1 and complication of diabetes mellitus, but not the haemoglobin concentration, partial pressure of arterial oxygen (PaO2 ), and IL-6. CONCLUSIONS Not low arterial oxygen tension, haemoglobin concentration, and inflammation evaluated by IL-6 but plasma IGFBP-1 was significantly associated with plasma EPO concentration in AKI, suggesting an unknown mechanism related to systemic stress conditions for EPO regulation in AKI.
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Affiliation(s)
- Tetsushi Yamashita
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
| | - Eisei Noiri
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
| | - Yoshifumi Hamasaki
- 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan
| | - Takehiro Matsubara
- Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeshi Ishii
- Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoki Yahagi
- Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaomi Nangaku
- Department of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan
| | - Kent Doi
- Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan
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17
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Cebi G, Yildiz Ş, Uzun G, Oztas Y, Sabuncuoglu S, Kutlu A, Ilgaz Y, Karatop-Cesur I, Dogan E, Oztas E. The effect of hyperbaric oxygen therapy on rhabdomyolysis-induced myoglobinuric acute renal failure in rats. Ren Fail 2016; 38:1554-1559. [DOI: 10.1080/0886022x.2016.1227925] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Migita H, Yoshitake S, Tange Y, Choijookhuu N, Hishikawa Y. Hyperbaric Oxygen Therapy Suppresses Apoptosis and Promotes Renal Tubular Regeneration After Renal Ischemia/Reperfusion Injury in Rats. Nephrourol Mon 2016; 8:e34421. [PMID: 26981502 PMCID: PMC4780282 DOI: 10.5812/numonthly.34421] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 11/24/2015] [Accepted: 11/28/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Renal ischemia/reperfusion (I/R) injury remains a major cause of acute kidney injury (AKI), in addition to I/R injury-induced tissue inflammation, necrosis and apoptosis. Hyperbaric oxygen therapy (HBO) is defined as a treatment in which a patient is intermittently exposed to 100% oxygen pressurized to a pressure above sea level (> 2.0 atmospheres absolute (ATA), 1.0 ATA = 760 mmHg). It has been used in a number of medical conditions with a proven efficacy in a limited number of disorders. However, the effects of HBO therapy on apoptosis and proliferative activity after I/R injury have not been fully understood. OBJECTIVES We studied the possible beneficial effects of HBO therapy on apoptosis and tubular cell regeneration after renal I/R injury in rats. MATERIALS AND METHODS Sprague-Dawley (SD) rats were randomized into three groups: Sham (Sham-operated rats); I/R (animals submitted to I/R); and I/R + HBO (I/R rats exposed to HBO). Tubular cell apoptosis was confirmed by DNA laddering and the terminal deoxynucleotidyl transferase-mediated uridine triphosphate nick end labeling (TUNEL) assay. Cellular proliferation activity was determined using the anti-Ki-67 antibody. RESULTS A significant decrease in apoptotic cells and increase in proliferative reaction were observed in the I/R + HBO group compared to the I/R group. CONCLUSIONS We demonstrated that HBO suppressed apoptosis, which caused inflammation after renal I/R, and promoted tubular cell regeneration. HBO has protective effects against AKI caused by renal I/R through the inhibition of apoptosis.
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Affiliation(s)
- Heihachi Migita
- Department of Medical Engineering, Faculty of Health Sciences, Kyushu University of Health and Welfare, Yoshinomachi, Nobeoka, Japan
- Corresponding author: Heihachi Migita, Department of Medical Engineering, Faculty of Health Sciences, Kyushu University of Health and Welfare, Yoshinomachi, Nobeoka, Japan. Tel: +81-982235555, Fax: +81-9825618, E-mail:
| | - Shigenori Yoshitake
- Department of Medical Engineering, Faculty of Health Sciences, Kyushu University of Health and Welfare, Yoshinomachi, Nobeoka, Japan
| | - Yoshihiro Tange
- Department of Medical Engineering, Faculty of Health Sciences, Kyushu University of Health and Welfare, Yoshinomachi, Nobeoka, Japan
| | - Narantsog Choijookhuu
- Department of Anatomy, Faculty of Medicine, Division of Histochemistry and Cell Biology, University of Miyazaki, Kyotake, Miyazaki, Japan
| | - Yoshitaka Hishikawa
- Department of Anatomy, Faculty of Medicine, Division of Histochemistry and Cell Biology, University of Miyazaki, Kyotake, Miyazaki, Japan
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19
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The effect of hyperbaric oxygen therapy on kidneys in a rat model. ScientificWorldJournal 2014; 2014:105069. [PMID: 25177712 PMCID: PMC4142719 DOI: 10.1155/2014/105069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 07/30/2014] [Indexed: 11/17/2022] Open
Abstract
Background. Hyperbaric oxygen therapy (HBOT) is used for treating various medical conditions. As far as known yet, HBOT is safe with few major side effects that are easy to avoid using a proper protocol. Renal tubular damage was observed in rats exposed to HBOT in a preliminary study conducted in our institution. Aim. We aim to assess whether HBOT causes renal damage and, if so, whether this is dose dependent. Methods. Thirty-one rats were randomly assigned to three groups. The first group received 10-days HBOT, 100% oxygen at a pressure of 2 atmospheres absolute (2 ATA) for 60 minutes/day, the second received the same treatment for 5 days and the third served as the control. Rat weight, survival, renal function tests, and renal histopathology were analyzed. Results. There were no significant changes in renal function tests in the plasma (cystatin C, urea, creatinine, and electrolytes) between the groups. No significant differences were observed in weight gain or renal histopathological evaluation between all groups. Conclusion. HBOT in this protocol does not cause renal impairment in a rat model, which reinforces the assumption that HBOT is safe in healthy rats, regarding renal function. Further research should be focused on the effect/safety of HBOT on nonhealthy kidneys.
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20
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Saadat A, Shariat Maghani SS, Rostami Z, Davoudi A, Davoudi F, Shafie A, Eynollahi B. Normobaric hyperoxia preconditioning ameliorates cisplatin nephrotoxicity. Ren Fail 2013; 36:5-8. [PMID: 24059271 DOI: 10.3109/0886022x.2013.832604] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cisplatin is a potent anticancer drug, but its nephrotoxicity limits the clinical use of it. To reduce the Cisplatin-induced nephrotoxicity, various interventions have been implicated. The aim of this study was to examine whether preconditioning with normobaric hyperoxia would prevent Cisplatin-induced nephrotoxicity in patient with solid tumor. METHODS In a prospective study, 80 adult patients with solid tumor who were treated with Cisplatin between February 2011 and December 2011 were included. Forty-three patients were exposed to pure oxygen via non-rebreathing reservoir mask which increased the provided oxygen rate to 60% oxygen for 2 hours at 48, 24, and 6 hours before intravenous administration of Cisplatin and 37 patients received only Cisplatin as a control group. Estimated glomerular filtration rate (eGFR) calculated in all patients on day 1 before and on days 1, 3, 6, 30 after Cisplatin exposures. RESULTS Patients treated with Cisplatin and 60% oxygen showed a mild improvement in eGFR and mild reduction of serum creatinine after 30 days with statistically mild significant differences (p = 0.048). CONCLUSION This study showed that normobaric and intermittent precondition of 60% oxygen prior to Cisplatin treatment had an acute transient adverse effect on renal function; however, the improvement of renal function will be seen after 30 days. Thus, it may help to prevent Cisplatin nephrotoxicity.
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Affiliation(s)
- Alireza Saadat
- Department of Hematology & Oncology, Baghiyatallah University of Medical Sciences , Tehran , Iran
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Hammad FT, Al-Salam S, Lubbad L. Does aliskiren protect the kidney following ischemia reperfusion injury? Physiol Res 2013; 62:681-90. [PMID: 23869885 DOI: 10.33549/physiolres.932485] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The effect of blocking the first and rate-limiting step in renin-angiotensin cascade on the renal function in ischemia reperfusion injury has not been previously investigated. We investigated the effect of aliskiren, the first approved direct oral renin inhibitor, on the alterations in renal functional parameters in this condition. Wistar rats underwent left renal ischemia for 40 min. Group-1 received normal saline whereas Group-2 received aliskiren (30 mg/kg/day) by gavage for 6 days commencing one day before IRI. The hemodynamic and tubular functions and gene expression of neutrophil gelatinase-associated lipocalin (NGAL) and plasminogen activating inhibitor (PAI-1) in the right and left kidneys were measured five days following the IRI. Comparing Group-1 and Group-2, the left renal blood flow was significantly higher in Group-2 (1.28+/-0.36 vs. 0.39+/-0.05, P=0.007). Left kidney glomerular filtration rate was also higher in Group-2 but did not reach statistical significance (0.18+/-0.05 vs. 0.10+/-0.02, P=0.07). The left renal FE(Na) was significantly lower in Group-2 (29.9+/-6.4 vs. 49.7+/-7.8, P=0.03). Aliskiren also caused a significant decrease in the gene expression of both NGAL and PAI-1 in the left ischemic kidney. In conclusions, the administration of aliskiren before and after IRI appears to have ameliorated the IRI effect on the total renal artery blood flow, fractional excretion of sodium and gene expression of both NGAL and PAI-1 indicating a renoprotective effects in IRI.
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Affiliation(s)
- F T Hammad
- Department of Surgery, College of Medicine and Health Sciences, Al Ain, United Arab Emirates.
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Salmanoglu M, Önem Y. Role of NO in Ischemia/Reperfusion Injury. Ren Fail 2013; 35:433. [DOI: 10.3109/0886022x.2012.758577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hyperbaric oxygen therapy induces kidney protection in an ischemia/reperfusion model in rats. Transplant Proc 2013; 44:2333-6. [PMID: 23026586 DOI: 10.1016/j.transproceed.2012.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Ischemia/reperfusion (I/R) injury remains a major cause of graft dysfunction, which impacts short- and long-term follow-up. Hyperbaric oxygen therapy (HBO), through plasma oxygen transport, has been currently used as an alternative treatment for ischemic tissues. The aim of this study was to analyze the effects of HBO on kidney I/R injury model in rats, in reducing the harmful effect of I/R. The renal I/R model was obtained by occluding bilateral renal pedicles with nontraumatic vascular clamps for 45 minutes, followed by 48 hours of reperfusion. HBO therapy was delivered an hypebaric chamber (2.5 atmospheres absolute). Animals underwent two sessions of 60 minutes each at 6 hours and 20 hours after initiation of reperfusion. Male Wistar rats (n = 38) were randomized into four groups: sham, sham operated rats; Sham+HBO, sham operated rats exposed to HBO; I/R, animals submitted to I/R; and I/R+HBO, I/R rats exposed to HBO. Blood, urine, and kidney tissue were collected for biochemical, histologic, and immunohistochemical analyses. The histopathological evaluation of the ischemic injury used a grading scale of 0 to 4. HBO attenuated renal dysfunction after ischemia characterized by a significant decrease in blood urea nitrogen (BUN), serum creatinine, and proteinuria in the I/R+HBO group compared with I/R alone. In parallel, tubular function was improved resulting in significantly lower fractional excretions of sodium and potassium. Kidney sections from the I/R plus HBO group showed significantly lower acute kidney injury scores compared with the I/R group. HBO treatment significantly diminished proliferative activity in I/R (P < .05). There was no significant difference in macrophage infiltration or hemoxygenase-1 expression. In conclusion, HBO attenuated renal dysfunction in a kidney I/R injury model with a decrease in BUN, serum creatinine, proteinuria, and fractional excretion of sodium and potassium, associated with reduced histological damage.
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Ilhan H, Eroglu M, Inal V, Eyi YE, Arziman I, Yildirim AO, Tansel A, Uzun G, Yamanel L. Hyperbaric oxygen therapy alleviates oxidative stress and tissue injury in renal ischemia/reperfusion injury in rats. Ren Fail 2012; 34:1305-8. [PMID: 23009323 DOI: 10.3109/0886022x.2012.723776] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Hyperbaric oxygen (HBO) therapy has been shown to attenuate renal ischemia/reperfusion (I/R) injury in rats, when applied in the early reperfusion period. The aim of this study was to elucidate possible beneficial effects of HBO therapy on renal I/R injury, when applied 24 h after ischemia. Rats were randomized into three groups: (1) control group (n = 20), (2) I/R group (n = 20), and (3) I/R + HBO group (n = 20). Renal I/R injury was created by interrupting renal blood flow for 30 min with a non-traumatic vascular clamp. HBO therapy was administered 24 h after I/R injury and continued for 5 days. At the end of the study, rats were sacrificed under anesthesia, blood was drawn, and right kidneys were harvested for analysis. Renal I/R injury increased serum and tissue malondialdehyde (MDA) levels and reduced superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels. HBO therapy attenuated MDA levels by increasing SOD and GPx activities. HBO therapy also prevented neutrophil infiltration and tissue injury in kidneys. Taken together, HBO therapy has been found to be effective in the delayed period of I/R injury.
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Affiliation(s)
- Haluk Ilhan
- Department of Emergency Medicine, Gulhane Military Medical Academy, Ankara, Turkey
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25
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Hammad FT, Al-Salam S, Lubbad L. Curcumin provides incomplete protection of the kidney in ischemia reperfusion injury. Physiol Res 2012; 61:503-11. [PMID: 22881234 DOI: 10.33549/physiolres.932376] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Curcumin, a component of the spice turmeric, was shown to have a protective effect on acute kidney injury markers following ischemia-reperfusion injury (IRI). However, its effect on glomerular and tubular renal functions following IRI is not known and this data is probably of more clinical relevance. In this study, curcumin was tested for its effect on renal functional parameters following two different periods of warm IRI in the rat. Groups V-30 (n=10) and C-30 (n=10) underwent ischemia for 30 minutes whereas groups V-45 (n=8) and C-45 (n=8) underwent ischemia for 45 minutes. C-30 and C-45 received oral curcumin (200 mg/kg/day) whereas V-30 and V-45 received a vehicle. The left renal artery blood flow was measured by a flowmeter before and 15 minutes after reperfusion. Serum TNF-alpha was measured before and 2 days after ischemia. The function of both kidneys was measured 2 days following ischemia using clearance technique. IRI caused significant increase in TNF-alpha in all groups. Curcumin significantly ameliorated the ischemia-induced alterations in serum TNF-alpha and associated histological changes but did not affect the alterations in renal artery blood flow, glomerular (glomerular filtration rate, renal blood flow) or tubular (urinary volume, urinary sodium and fractional excretion of sodium) functions following 30 or 45 min of IRI.
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Affiliation(s)
- F T Hammad
- Department of Surgery, Faculty of Medicine and Health Sciences, Al Ain, United Arab Emirates.
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Ayvaz S, Aksu B, Kanter M, Uzun H, Erboga M, Colak A, Basaran UN, Pul M. Preventive effects of hyperbaric oxygen treatment on glycerol-induced myoglobinuric acute renal failure in rats. J Mol Histol 2012; 43:161-70. [PMID: 22311626 DOI: 10.1007/s10735-012-9391-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 01/21/2012] [Indexed: 12/21/2022]
Abstract
Myoglobinuric acute renal failure (ARF) is a uremic syndrome caused by traumatic or non-traumatic skeletal muscle breakdown and intracellular elements that are released into the bloodstream. We hypothesized that hyperbaric oxygen (HBO) therapy could be beneficial in the treatment of myoglobinuric ARF caused by rhabdomyolysis. A total of 32 rats were used in the study. The rats were divided into four groups: control, control+hyperbaric oxygen (control+HBO), ARF, and ARF+hyperbaric oxygen (ARF+HBO). Glycerol (8 ml/kg) was injected into the hind legs of each of the rats in ARF and ARF+HBO groups. 2.5 atmospheric absolute HBO was applied to the rats in the control+HBO and ARF+HBO groups for 90 min on two consecutive days. Plasma urea, creatinine, sodium, potassium, calcium, aspartate aminotransferase, alanine aminotransferase, lactic dehydrogenase, creatinine kinase and urine creatinine and sodium were examined. Creatinine clearance and fractional sodium excretion could then be calculated. Superoxide dismutase, catalase, glutathione and malondialdehyde (MDA) levels were assessed in renal tissue. Tissue samples were evaluated by Hematoxylin-eosin, PCNA and TUNEL staining histopathologically. MDA levels were found to be significantly decreased whereas SOD and CAT were twofold higher in the ARF+HBO group compared to the ARF group. Renal function tests were ameliorated by HBO therapy. Semiquantitative evaluation of histopathological findings indicated that necrosis and cast formation was decreased by HBO therapy and TUNEL staining showed that apoptosis was inhibited. PCNA staining showed that HBO therapy did not increase regeneration. Ultimately, we conclude that, in accordance with our hypothesis, HBO could be beneficial in the treatment of myoglobinuric ARF.
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Affiliation(s)
- Suleyman Ayvaz
- Department of Pediatric Surgery, Faculty of Medicine, Trakya University, Cocuk Cerrahisi AD, 22030, Edirne, Turkey.
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Kazancioglu R, Gulgun C, Aydin S, Aysuna N, Bozfakioglu S, Sever MS. Hyperbaric-oxygen treatment: An adjunctive therapy in acute renal failure due to crush injury. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ns.2012.428092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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28
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Vega J, Goecke H, Manriquez F, Escobar C, Escobar M, Videla C, Santamarina M, Echeverria C, Guarda FJ. Hyperbaric oxygen therapy in a patient with autosomal dominant polycystic kidney disease with a perinephritic abscess. Clin Exp Nephrol 2010; 15:141-6. [PMID: 20886361 DOI: 10.1007/s10157-010-0348-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Accepted: 08/23/2010] [Indexed: 12/01/2022]
Abstract
A 68-year-old female in hemodialysis due to autosomal dominant polycystic kidney disease underwent resection of cysts in her right kidney via a laparoscopic approach due to abdominal pain. Three weeks after surgery, she was admitted with sepsis. A CT scan showed a large abscess around the right kidney. Percutaneous drainage of abscess was performed. The pus smear showed Gram-positive cocci and the culture contained methicillin-resistant Staphylococcus aureus. Ciprofloxacin, clindamycin and vancomycin were given. In the 3 weeks following admission, she remained febrile and septic and showed a progressive deterioration in her general condition, along with malnutrition and persistent drainage of purulent material from her right flank. The antibiotic therapy was changed to vancomycin, metronidazole and meropenem, but no improvement was observed. Because of the high risk associated with carrying out an open nephrectomy, we decided to use hyperbaric oxygen therapy (HBOT) as a potentially useful measure to control her infection. The patient underwent 26 daily sessions of 100% hyperbaric oxygen (2.5 atm). The use of HBOT induced a notable break in the clinical course of this patient's retroperitoneal infection. She was discharged after day 58 without any signs of inflammatory activity, and she has not presented reactivation of infection since then. We think that this case suggests that this therapy could be a new therapeutic tool in the management of patients with similar clinical features when all other therapeutic measures have failed. We did not find any other reports of the use of HBOT in infections of renal cysts.
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Affiliation(s)
- Jorge Vega
- Departamento de Medicina, Escuela de Medicina, Universidad de Valparaíso, 5 Norte 1035, Quinta Región, Viña del Mar, Chile.
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Abstract
Chronic kidney disease (CKD) is characterized by irreversible pathological processes that result in the development of end-stage renal disease (ESRD). Accumulating evidence has emphasized the important role of chronic hypoxia in the tubulointerstitium in the final common pathway that leads to development of ESRD. The causes of chronic hypoxia in the tubulointerstitium are multifactorial and include mechanisms such as hemodynamic changes and disturbed oxygen metabolism of resident kidney cells. Epidemiological studies have revealed an association between CKD and systemically hypoxic conditions, such as chronic obstructive pulmonary disease and sleep apnea syndrome. In addition to tubulointerstitial hypoxia, glomerular hypoxia can occur and is a crucial factor in the development of glomerular disorders. Chemical compounds, polarographic sensors, and radiographical methods can be used to detect hypoxia. Therapeutic approaches that target chronic hypoxia in the kidney should be effective against a broad range of kidney diseases. Amelioration of hypoxia is one mechanism of inhibiting the renin-angiotensin system, the current gold standard of CKD therapy. Future therapeutic approaches include protection of the vascular endothelium and appropriate activation of hypoxia-inducible factor, a key transcription factor involved in adaptive responses against hypoxia.
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Youngster I, Abu-Kishk I, Kozer E, Braunstein R, Bar-Haim A, Berkovitch M. Hyperbaric Oxygen Treatment Reduces Mortality in Acute Iron Intoxication in Rats. Basic Clin Pharmacol Toxicol 2010; 107:737-41. [DOI: 10.1111/j.1742-7843.2010.00569.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Protective role of extracellular superoxide dismutase in renal ischemia/reperfusion injury. Kidney Int 2010; 78:374-81. [PMID: 20505656 DOI: 10.1038/ki.2010.141] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Extracellular superoxide dismutase (SOD3) is highly expressed in renal tissues and a critical regulator of vascular function. We hypothesized that deletion of SOD3 would attenuate recovery of renal blood flow (RBF) and increase oxidative stress and injury following renal ischemia/reperfusion (I/R). To test this, we evaluated SOD expression and activity, basal superoxide production, and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity in kidneys from male and female wild-type (WT) and SOD3-knockout mice. RBF, measured using an ultrasonic flow probe, and histological indices of oxidative stress and injury were assessed after 1 h of ischemia. Following ischemia, RBF was attenuated in kidneys from male, but not female, knockout mice compared with their WT counterparts. Total SOD activity was significantly reduced in male knockout compared with WT male mice but was similar in female mice of both genotypes, suggesting upregulated SOD1 activity. Basal superoxide production and NADPH oxidase activity were unrelated to the differences in RBF. After 24 h, kidneys from both genders of knockout mice were found to have more oxidative stress (3-nitrotyrosine immunohistochemistry) and renal cast formation than those from WT mice. Thus, our study found a key role for SOD3 in regulating renal I/R injury.
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Yousefipour Z, Oyekan A, Newaz M. Interaction of oxidative stress, nitric oxide and peroxisome proliferator activated receptor gamma in acute renal failure. Pharmacol Ther 2010; 125:436-45. [PMID: 20117134 DOI: 10.1016/j.pharmthera.2009.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Accepted: 12/24/2009] [Indexed: 01/23/2023]
Abstract
Oxidative stress has been reported to play a critical role in the pathology of acute renal failure (ARF). An interaction between different reactive species and/or their sources have been the focus of extensive studies. The exact sources of reactive species generated in biological systems under different disease states are always elusive because they are also a part of physiological processes. Exaggerated involvement of different oxidation pathways including NAD(P)H oxidase has been proposed in different models of ARF. An interaction between oxygen species and nitrogen species has drawn extensive attention because of the deleterious effects of peroxynitrite and their possible effects on antioxidant systems. Recent advances in molecular biology have allowed us to understand glomerular function more precisely, especially the organization and importance of the slit diaphragm. Identification of slit diaphragm proteins came as a breakthrough and a possibility of therapeutic manipulation in ARF is encouraging. Transcriptional regulation of the expression of slit diaphragm protein is of particular importance because their presence is crucial in the maintenance of glomerular function. This review highlights the involvement of oxidative stress in ARF, sources of these reactive species, a possible interaction between different reactive species, and involvement of PPARgamma, a nuclear transcription factor in this process.
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Affiliation(s)
- Zivar Yousefipour
- Center for Cardiovascular Diseases, Texas Southern University, Houston, Texas, United States
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Zager RA. Uremia induces proximal tubular cytoresistance and heme oxygenase-1 expression in the absence of acute kidney injury. Am J Physiol Renal Physiol 2008; 296:F362-8. [PMID: 19036845 DOI: 10.1152/ajprenal.90645.2008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Acute kidney injury (AKI) induces adaptive responses within proximal tubular (PT) cells that serve to protect them from further ischemic or toxic damage. However, it is not known whether uremia, a potential consequence of AKI, independently alters susceptibility to tubular injury. To address this issue, we subjected CD-1 mice to bilateral ureteral transection (BUTx), which produces uremia (blood urea nitrogen approximately 150 mg/dl) in the absence of direct renal damage. PT segments were then isolated from BUTx and control mice and subjected to in vitro hypoxic injury. Additionally, "in vitro uremia" was modeled in isolated tubules or in cultured PT (HK-2) cells by addition of 1) peritoneal dialysate (obtained from mice with bilateral ureteral obstruction), 2) peritoneal fluid (from BUTx mice), or 3) normal human urine (pH 7.4, with and without boiling). Effects on injury severity (lactate dehydrogenase release) were assessed. Finally, because uremia is a prooxidant state, it was hypothesized that BUTx would increase renal lipid peroxidation (malondialdehyde) and induce heme oxygenase-1 (HO-1), a redox-sensitive cytoprotective protein. BUTx conferred striking protection against hypoxic damage. This could be partially modeled in tubules and HK-2 cells by induction of in vitro uremia. Urine's protective action was heat labile (largely destroyed by boiling). BUTx caused a tripling of renal malondialdehyde and HO-1 protein levels. Increased HO-1 transcription was likely involved, as indicated by a tripling of HO-1 mRNA and RNA polymerase II binding along the HO-1 gene (chromatin immunoprecipitation assay). "Gene-activating" histone modifications [H3K4 trimethylation (H3K4m3) and histone 2 variant (H2A.Z)] at HO-1 gene loci were also observed. Uremia, per se, can contribute to the AKI-induced cytoresistance. Low-molecular-weight, heat-labile, cytoprotective factor(s) and uremia-induced renal stress responses (e.g., HO-1 gene activation) are likely involved. Finally, renal HO-1 induction following AKI may reflect direct cell injury effects and adaptations to uremia.
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Affiliation(s)
- Richard A Zager
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N, Rm. D2-190, Seattle, WA 98109, USA.
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