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Feng S, Ji J, Li H, Zhang X. H 2S alleviates renal ischemia and reperfusion injury by suppressing ERS-induced autophagy. Transpl Immunol 2024; 83:102006. [PMID: 38342329 DOI: 10.1016/j.trim.2024.102006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Ischemia/reperfusion injury (IRI) can lead to acute kidney injury and result in high disability and mortality rates. Cystathionine γ-lyase (CSE)-produced hydrogen sulfide (H2S) has been confirmed to play a protective role in renal IRI. While autophagy is involved in renal IRI, its role in the regulation by endoplasmic reticulum stress (ERS) has not been considered. Our study explored the role of CSE/H2S in protecting against renal IRI by regulating ERS-induced autophagy. METHODS C57/BL6 mice were subjected to 30-min renal ischemia followed by .24-h reperfusion injury (IRI). The H2S donor sodium hydrosulfide hydrate (NaHS) or the CSE inhibitor D,L-propargylglycine (PAG) was injected intraperitoneally (i.p) into the mice. Serum creatinine and urea nitrogen levels were analyzed to evaluate renal function. Renal tubule epithelial cell damage was measured by HE and PAS staining. ERS and microtubule-associated protein light chain 3 (LC3) autophagy (LC3-I to LC3-II conversion) were analyzed by using western blotting. RESULTS In a C57/BL6 mouse model of acute renal IRI, the application of IRI impaired the renal function, which was accompanied by elevated serum creatinine (P < 0.001) and urea nitrogen levels (P < 0.001). While NaHS pretreatment dramatically attenuated renal IRI, PAG administration exacerbated renal IRI (P < 0.001). Furthermore, NaHS treatment inhibited the ERS-induced increased LC3II/I protein ratio (P < 0.001); increased Beclin-1 protein expression (P < 0.001); PAG pretreatment exacerbated the effects of ERS on both the LC3II/I ratio (P < 0.001) and the Beclin-1 protein expression (P < 0.001). CONCLUSIONS Our results suggest that the CSE/H2S system is an important therapeutic target for protecting against renal IRI, and it may protect renal tubule epithelial cells from IRI by suppressing ERS-induced autophagy.
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Affiliation(s)
- Sujuan Feng
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jiawei Ji
- Department of urology, Beijing Haidian Hospital, Beijing 100080, China
| | - Han Li
- Institute of Uro-Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
| | - Xiaodong Zhang
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
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Agius T, Songeon J, Lyon A, Longchamp J, Ruttimann R, Allagnat F, Déglise S, Corpataux JM, Golshayan D, Buhler L, Meier R, Yeh H, Markmann JF, Uygun K, Toso C, Klauser A, Lazeyras F, Longchamp A. Sodium Hydrosulfide Treatment During Porcine Kidney Ex Vivo Perfusion and Transplantation. Transplant Direct 2023; 9:e1508. [PMID: 37915463 PMCID: PMC10617874 DOI: 10.1097/txd.0000000000001508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/01/2023] [Accepted: 05/16/2023] [Indexed: 11/03/2023] Open
Abstract
Background In rodents, hydrogen sulfide (H2S) reduces ischemia-reperfusion injury and improves renal graft function after transplantation. Here, we hypothesized that the benefits of H2S are conserved in pigs, a more clinically relevant model. Methods Adult porcine kidneys retrieved immediately or after 60 min of warm ischemia (WI) were exposed to 100 µM sodium hydrosulfide (NaHS) (1) during the hypothermic ex vivo perfusion only, (2) during WI only, and (3) during both WI and ex vivo perfusion. Kidney perfusion was evaluated with dynamic contrast-enhanced MRI. MRI spectroscopy was further employed to assess energy metabolites including ATP. Renal biopsies were collected at various time points for histopathological analysis. Results Perfusion for 4 h pig kidneys with Belzer MPS UW + NaHS resulted in similar renal perfusion and ATP levels than perfusion with UW alone. Similarly, no difference was observed when NaHS was administered in the renal artery before ischemia. After autotransplantation, no improvement in histologic lesions or cortical/medullary kidney perfusion was observed upon H2S administration. In addition, AMP and ATP levels were identical in both groups. Conclusions In conclusion, treatment of porcine kidney grafts using NaHS did not result in a significant reduction of ischemia-reperfusion injury or improvement of kidney metabolism. Future studies will need to define the benefits of H2S in human, possibly using other molecules as H2S donors.
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Affiliation(s)
- Thomas Agius
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Surgery, Transplant Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Julien Songeon
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Arnaud Lyon
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Medicine, Transplantation Centre, Lausanne University Hospital, Lausanne, Switzerland
| | - Justine Longchamp
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Raphael Ruttimann
- Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - Florent Allagnat
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Sébastien Déglise
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Jean-Marc Corpataux
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Déla Golshayan
- Department of Medicine, Transplantation Centre, Lausanne University Hospital, Lausanne, Switzerland
| | - Léo Buhler
- Section of Medicine, Faculty of Science and Medicine, University of Fribourg, Switzerland
| | - Raphael Meier
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD
| | - Heidi Yeh
- Department of Surgery, Transplant Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - James F. Markmann
- Department of Surgery, Transplant Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Korkut Uygun
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Christian Toso
- Visceral and Transplant Surgery, Department of Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - Antoine Klauser
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- CIBM Center for Biomedical Imaging, Geneva, Switzerland
| | - Francois Lazeyras
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- CIBM Center for Biomedical Imaging, Geneva, Switzerland
| | - Alban Longchamp
- Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Surgery, Transplant Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Xing D, Ma Y, Lu M, Liu W, Zhou H. Paeoniflorin alleviates hypoxia/reoxygenation injury in HK-2 cells by inhibiting apoptosis and repressing oxidative damage via Keap1/Nrf2/HO-1 pathway. BMC Nephrol 2023; 24:314. [PMID: 37884904 PMCID: PMC10601317 DOI: 10.1186/s12882-023-03366-0] [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: 03/05/2022] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
Acute kidney injury (AKI) is a serious disorder associated with significant morbidity and mortality. AKI and ischemia/reperfusion (hypoxia/reoxygenation, H/R) injury can be induced due to several reasons. Paeoniflorin (PF) is a traditional herbal medicine derived from Paeonia lactiflora Pall. It exerts diverse therapeutic effects, including anti-inflammatory, antioxidative, antiapoptotic, and immunomodulatory properties; thus, it is considered valuable for treating several diseases. However, the effects of PF on H/R injury-induced AKI remain unknown. In this study, we established an in vitro H/R model using COCL2 and investigated the functions and underlying mechanisms of PF on H/R injury in HK-2 cells. The cell vitality was evaluated using the cell count kit-8 assay. The DCFH-DA fluorescence probe was used to measure the levels of reactive oxygen species (ROS). Oxidative damage was detected using superoxide dismutase (SOD) and malondialdehyde (MDA) assay kits. Apoptotic relative protein and Keap1/Nrf2/HO-1 signaling were evaluated by Western blotting. Our results indicated that PF increased cell viability and SOD activity and decreased the ROS and MDA levels in HK-2 cells with H/R injury. PF inhibits apoptosis by increasing Bcl-2 and decreasing Bax. Furthermore, PF significantly upregulated the expression of HO-1 and Nrf2, but downregulated the expression of HIF-1α and Keap1. PF considerably increased Nrf2 nuclear translocation and unregulated the HO-1 expression. The Nrf2 inhibitor (ML385) could reverse the abovementioned protective effects of PF, suggesting that Nrf2 can be a critical target of PF. To conclude, we found that PF attenuates H/R injury-induced AKI by decreasing the oxidative damage via the Nrf2/HO-1 pathway and inhibiting apoptosis.
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Affiliation(s)
- Di Xing
- Department of Nephrology, The First Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Yihua Ma
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Miaomiao Lu
- Department of Nephrology, The First Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Wenlin Liu
- Department of Nephrology, The First Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Hongli Zhou
- Department of Nephrology, The First Affiliated Hospital of Jinzhou Medical University, Liaoning, China.
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Min J, Chen Q, Pan M, Liu T, Gu Q, Zhang D, Sun R. Butylphthalide improves brain damage induced by renal ischemia-reperfusion injury rats through Nrf2/HO-1 and NOD2/MAPK/NF-κB pathways. Ren Fail 2023; 45:2259234. [PMID: 37732403 PMCID: PMC10515692 DOI: 10.1080/0886022x.2023.2259234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
Renal ischemia-reperfusion (I/R) injury leads to irreversible brain damage with serious consequences. Activation of oxidative stress and release of inflammatory mediators are considered potential pathological mechanisms. Butylphthalide (NBP) has anti-inflammatory and antioxidant effects on I/R injuries. However, it is unclear whether NBP can effectively mitigate renal I/R secondary to brain injury as well as its mechanism, which are the aims of this study. Both renal I/R injury rats and oxygen and glucose deprivation cell models were established and pre-intervened NBP. The Morris water maze assay was used to detect behavior. Hippocampal histopathology and function were examined after renal I/R. Apoptosis and tube-forming capacity of brain microvascular endothelial cells (BMVECs) were tested. Immunohistochemistry and Western blot were used to measure protein expression of nuclear factor erythroid 2-related factor 2 (Nrf2)/Heme Oxygenase-1 (HO-1) pathway and NOD-like receptor C2 (NOD2)/Mitogen-activated protein kinases (MAPK)/Nuclear factor kappa-B (NF-κB) pathway. NBP treatment attenuated renal I/R-induced brain tissue damage and learning and memory dysfunction. NBP treatment inhibited apoptosis and promoted blood-brain barrier restoration and microangiogenesis. Also, it decreased oxidative stress levels and pro-inflammatory factor expression in renal I/R rats. Furthermore, NBP enhanced BMVECs' viability and tube-forming capacity while inhibiting apoptosis and oxidative stress. Notably, the alleviating effects of NBP were attributed to Nrf2/HO-1 pathway activation and NOD2/MAPK/NF-κB inhibition. This study demonstrates that NBP maintains BBB function by activating the Nrf2/HO-1 pathway and inhibiting the NOD2/MAPK/NF-κB pathway to suppress inflammation and oxidative stress, thereby alleviating renal I/R-induced brain injury.
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Affiliation(s)
- Jingjing Min
- Department of Neurology, The First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Qi Chen
- Department of Nephrology, The First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Mengxiong Pan
- Department of Neurology, The First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Tan Liu
- Department of Neurology, The First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Qun Gu
- Department of Neurology, The First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Dongwei Zhang
- Department of Neurology, The First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
| | - Ru Sun
- Department of Neurology, The First People’s Hospital of Huzhou, First affiliated Hospital of Huzhou University, Huzhou, China
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Pre-Treatment of Transplant Donors with Hydrogen Sulfide to Protect against Warm and Cold Ischemia-Reperfusion Injury in Kidney and Other Transplantable Solid Organs. Int J Mol Sci 2023; 24:ijms24043518. [PMID: 36834928 PMCID: PMC9963309 DOI: 10.3390/ijms24043518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Ischemia-reperfusion injury (IRI), a pathological condition resulting from prolonged cessation and subsequent restoration of blood flow to a tissue, is an inevitable consequence of solid organ transplantation. Current organ preservation strategies, such as static cold storage (SCS), are aimed at reducing IRI. However, prolonged SCS exacerbates IRI. Recent research has examined pre-treatment approaches to more effectively attenuate IRI. Hydrogen sulfide (H2S), the third established member of a family of gaseous signaling molecules, has been shown to target the pathophysiology of IRI and thus appears to be a viable candidate that can overcome the transplant surgeon's enemy. This review discusses pre-treatment of renal grafts and other transplantable organs with H2S to mitigate transplantation-induced IRI in animal models of transplantation. In addition, ethical principles of pre-treatment and potential applications of H2S pre-treatment in the prevention of other IRI-associated conditions are discussed.
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Wetzel C, Pfeffer T, Bulkescher R, Zemva J, Modafferi S, Polimeni A, Salinaro AT, Calabrese V, Schmitt CP, Peters V. Anserine and Carnosine Induce HSP70-Dependent H 2S Formation in Endothelial Cells and Murine Kidney. Antioxidants (Basel) 2022; 12:antiox12010066. [PMID: 36670928 PMCID: PMC9855136 DOI: 10.3390/antiox12010066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/19/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022] Open
Abstract
Anserine and carnosine have nephroprotective actions; hydrogen sulfide (H2S) protects from ischemic tissue damage, and the underlying mechanisms are debated. In view of their common interaction with HSP70, we studied possible interactions of both dipeptides with H2S. H2S formation was measured in human proximal tubular epithelial cells (HK-2); three endothelial cell lines (HUVEC, HUAEC, MCEC); and in renal murine tissue of wild-type (WT), carnosinase-1 knockout (Cndp1-KO) and Hsp70-KO mice. Diabetes was induced by streptozocin. Incubation with carnosine increased H2S synthesis capacity in tubular cells, as well as with anserine in all three endothelial cell lines. H2S dose-dependently reduced anserine/carnosine degradation rate by serum and recombinant carnosinase-1 (CN1). Endothelial Hsp70-KO reduced H2S formation and abolished the stimulation by anserine and could be restored by Hsp70 transfection. In female Hsp70-KO mice, kidney H2S formation was halved. In Cndp1-KO mice, kidney anserine concentrations were several-fold and sex-specifically increased. Kidney H2S formation capacity was increased 2-3-fold in female mice and correlated with anserine and carnosine concentrations. In diabetic Cndp1-KO mice, renal anserine and carnosine concentrations as well as H2S formation capacity were markedly reduced compared to non-diabetic Cndp1-KO littermates. Anserine and carnosine induce H2S formation in a cell-type and Hsp70-specific manner within a positive feedback loop with CN1.
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Affiliation(s)
- Charlotte Wetzel
- Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Tilman Pfeffer
- Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Ruben Bulkescher
- Department of Medicine I and Clinical Chemistry, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Johanna Zemva
- Department of Medicine I and Clinical Chemistry, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Sergio Modafferi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95125 Catania, Italy
| | - Alessandra Polimeni
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95125 Catania, Italy
| | - Angela Trovato Salinaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95125 Catania, Italy
| | - Vittorio Calabrese
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95125 Catania, Italy
| | - Claus Peter Schmitt
- Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Verena Peters
- Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
- Correspondence:
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de Mello AH, Liu T, Garofalo RP, Casola A. Hydrogen Sulfide Donor GYY4137 Rescues NRF2 Activation in Respiratory Syncytial Virus Infection. Antioxidants (Basel) 2022; 11:1410. [PMID: 35883901 PMCID: PMC9311616 DOI: 10.3390/antiox11071410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022] Open
Abstract
Respiratory syncytial virus (RSV) can cause severe respiratory illness in infants, immunocompromised, and older adults. Despite its burden, no vaccine or specific treatment is available. RSV infection is associated with increased reactive oxygen species (ROS) production, degradation of the transcription factor nuclear factor erythroid 2-related factor 2 (NRF2), and decreased antioxidant enzymes (AOEs), leading to oxidative damage and lung injury. Hydrogen sulfide (H2S) is an endogenous gaseous molecule that plays a physiological role in numerous cellular processes and a protective role in multiple pathological conditions, displaying vasoactive, cytoprotective, anti-inflammatory, and antioxidant activities. H2S can promote NRF2 activation through the sulfhydration of Kelch-like ECH-associated protein 1, the cytoplasmic repressor of NRF2. Here we investigated whether increasing cellular H2S levels could rescue NRF2 and NRF2-dependent gene expression in RSV-infected primary airway epithelial cells. We found that treatment with the H2S donor GYY4137 significantly increased NRF2 levels and AOEs gene expression by decreasing KEAP1 levels, and by modulating pathways involved in RSV-induced NRF2 degradation, such as NRF2 ubiquitination, and promyelocytic leukemia (PML) protein levels. These results suggest that the administration of exogenous H2S can positively impact the altered redox balance associated with RSV infection, which represents an important determinant of RSV-induced lung disease.
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Affiliation(s)
- Aline Haas de Mello
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX 77555, USA; (A.H.d.M.); (T.L.); (R.P.G.)
| | - Tianshuang Liu
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX 77555, USA; (A.H.d.M.); (T.L.); (R.P.G.)
| | - Roberto P. Garofalo
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX 77555, USA; (A.H.d.M.); (T.L.); (R.P.G.)
- Department of Microbiology and Immunology, The University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Antonella Casola
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX 77555, USA; (A.H.d.M.); (T.L.); (R.P.G.)
- Department of Microbiology and Immunology, The University of Texas Medical Branch, Galveston, TX 77555, USA
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Oxidative Stress and Ischemia/Reperfusion Injury in Kidney Transplantation: Focus on Ferroptosis, Mitophagy and New Antioxidants. Antioxidants (Basel) 2022; 11:antiox11040769. [PMID: 35453454 PMCID: PMC9024672 DOI: 10.3390/antiox11040769] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 12/11/2022] Open
Abstract
Although there has been technical and pharmacological progress in kidney transplant medicine, some patients may experience acute post-transplant complications. Among the mechanisms involved in these conditions, ischemia/reperfusion (I/R) injury may have a primary pathophysiological role since it is one of the leading causes of delayed graft function (DGF), a slow recovery of the renal function with the need for dialysis (generally during the first week after transplantation). DGF has a significant social and economic impact as it is associated with prolonged hospitalization and the development of severe complications (including acute rejection). During I/R injury, oxidative stress plays a major role activating several pathways including ferroptosis, an iron-driven cell death characterized by iron accumulation and excessive lipid peroxidation, and mitophagy, a selective degradation of damaged mitochondria by autophagy. Ferroptosis may contribute to the renal damage, while mitophagy can have a protective role by reducing the release of reactive oxygen species from dysfunctional mitochondria. Deep comprehension of both pathways may offer the possibility of identifying new early diagnostic noninvasive biomarkers of DGF and introducing new clinically employable pharmacological strategies. In this review we summarize all relevant knowledge in this field and discuss current antioxidant pharmacological strategies that could represent, in the next future, potential treatments for I/R injury.
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