1
|
Arantes VM, Bueno RT, Módolo RP, Domingues MAC, de Carvalho LR, do Nascimento Junior P, Módolo NSP. Effects of Ischemic Preconditioning and Postconditioning in a Renal Ischemia-Reperfusion Injury Model: A Comparative Experimental Study in Rats. Transplant Proc 2018; 50:3811-3815. [PMID: 30501900 DOI: 10.1016/j.transproceed.2018.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 06/27/2018] [Accepted: 07/09/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Ischemia-reperfusion injury is an unavoidable aspect of transplantation, as well as an important cause of acute kidney injury in clinical practice. Pre- and post-ischemic conditioning are strategies that may provide organs with resistance to major ischemic events. This study evaluates the effects of ischemic preconditioning and ischemic postconditioning, either separately or in combination, after an acute ischemia-reperfusion kidney injury. METHODS Forty Wistar rats received isoflurane anesthesia and were randomized into 5 groups: 1. the sham group underwent laparotomy; 2. the control group underwent laparotomy and 30 minutes of renal ischemia followed by reperfusion; 3. the preconditioning group underwent laparotomy, ischemic preconditioning, and 30 minutes of renal ischemia followed by reperfusion; 4. the preconditioning and postconditioning group underwent laparotomy, ischemic preconditioning, 30 minutes of renal ischemia, and ischemic postconditioning followed by reperfusion; and 5. the postconditioning group underwent laparotomy, 30 minutes of renal ischemia, and ischemic postconditioning followed by reperfusion. Serum analyses of creatinine and neutrophil gelatinase-associated lipocalin (NGAL) were performed, and renal histology was examined 24 hours later. RESULTS Severe tubular injury and increases in creatinine were observed in all groups except the sham group. The control group and all ischemic conditioning groups were no different in the degree of renal injury and values of NGAL and creatinine after the injury. CONCLUSIONS Ischemic preconditioning and ischemic postconditioning, together or separately, are unable to preserve kidney function or exert a protective effect against tubular cell injury after an acute ischemia-reperfusion kidney injury.
Collapse
Affiliation(s)
- V M Arantes
- Department of Anesthesiology, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - R T Bueno
- Department of Anesthesiology, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - R P Módolo
- ABC Medical School, Santo André, São Paulo, Brazil
| | - M A C Domingues
- Department of Pathology, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - L R de Carvalho
- Biosciences Institute, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - P do Nascimento Junior
- Department of Anesthesiology, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
| | - N S P Módolo
- Department of Anesthesiology, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| |
Collapse
|
2
|
Fiorentino M, Castellano G, Kellum JA. Differences in acute kidney injury ascertainment for clinical and preclinical studies. Nephrol Dial Transplant 2018; 32:1789-1805. [PMID: 28371878 DOI: 10.1093/ndt/gfx002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 01/03/2017] [Indexed: 12/25/2022] Open
Abstract
Background Acute kidney injury (AKI) is a common clinical condition directly associated with adverse outcomes. Several AKI biomarkers have been discovered, but their use in clinical and preclinical studies has not been well examined. This study aims to investigate the differences between clinical and preclinical studies on AKI biomarkers. Methods We performed a systematic review of clinical and preclinical interventional studies that considered AKI biomarkers in enrollment criteria and/or outcome assessment and described the main differences according to their setting, the inclusion of biomarkers in the definition of AKI and the use of biomarkers as primary or secondary end points. Results In the 151 included studies (76 clinical, 75 preclinical), clinical studies have prevalently focused on cardiac surgery (38.1%) and contrast-associated AKI (17.1%), while the majority of preclinical studies have focused on ether ischemia-reperfusion injury or drug-induced AKI (42.6% each). A total of 57.8% of clinical studies defined AKI using the standard criteria and only 19.7% of these studies used AKI biomarkers in the definition of renal injury. Conversely, the majority of preclinical studies defined AKI according to the increase in serum creatinine and blood urea nitrogen, and 32% included biomarkers in that definition. The percentage of both clinical and preclinical studies with biomarkers as a primary end point has not significantly increased in the last 10 years; however, preclinical studies are more likely to use AKI biomarkers as a primary end point compared with clinical studies [odds ratio 2.31 (95% confidence interval 1.17-4.59); P = 0.016]. Conclusion Differences between clinical and preclinical studies are evident and may affect the translation of preclinical findings in the clinical setting.
Collapse
Affiliation(s)
- Marco Fiorentino
- Department of Critical Care Medicine, Center for Critical Care Nephrology, CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Center, University of Pittsburgh School of Medicine, Pittsburgh, USA.,Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari, Bari, Italy
| | - Giuseppe Castellano
- Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari, Bari, Italy
| | - John A Kellum
- Department of Critical Care Medicine, Center for Critical Care Nephrology, CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Center, University of Pittsburgh School of Medicine, Pittsburgh, USA
| |
Collapse
|
3
|
Ramos MFDP, Monteiro de Barros ADCM, Razvickas CV, Borges FT, Schor N. Xanthine oxidase inhibitors and sepsis. Int J Immunopathol Pharmacol 2018; 32:2058738418772210. [PMID: 29786457 PMCID: PMC5967155 DOI: 10.1177/2058738418772210] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 03/08/2018] [Indexed: 12/13/2022] Open
Abstract
Xanthine oxidase activation occurs in sepsis and results in the generation of uric acid (UrAc) and reactive oxygen species (ROS). We aimed to evaluate the effect of xanthine oxidase inhibitors (XOis) in rats stimulated with lipopolysaccharide (LPS). LPS (10 mg/kg) was administered intraperitoneally (i.p.) immediately after allopurinol (Alo, 2 mg/kg) or febuxostat (Feb, 1 mg/kg) every 24 h for 3 days. To increase UrAc levels, oxonic acid (Oxo) was administered by gavage (750 mg/kg per day) for 5 days. Animals were divided into the following 10 groups (n = 6 each): (1) Control, (2) Alo, (3) Feb, (4) LPS, (5) LPSAlo, (6) LPSFeb, (7) Oxo, (8) OxoLPS, (9) OxoLPSAlo, and (10) OxoLPSFeb. Feb with or without Oxo did not aggravate sepsis. LPS administration (with or without Oxo) significantly decreased the creatinine clearance (ClCr) in LPSAlo (60%, P < 0.01) versus LPS (44%, P < 0.05) and LPSFeb (35%, P < 0.05). Furthermore, a significant increase in mortality was observed with LPSAlo (28/34, 82%) compared to LPS treatment alone (10/16, 63%) and LPSFeb (11/17, 65%, P < 0.05). In addition, increased levels of thiobarbituric acid reactive substances (TBARS), tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10 were observed at 72 h compared to the groups that received LPS and LPSFeb with or without Oxo. In this study, coadministration of Alo in LPS-induced experimental sepsis aggravated septic shock, leading to mortality, renal function impairment, and high ROS and proinflammatory IL levels. In contrast, administration of Feb did not potentiate sepsis, probably because it did not interfere with other metabolic events.
Collapse
Affiliation(s)
- Maria Fátima de Paula Ramos
- Division of Nephrology, Department of
Medicine, Escola Paulista De Medicina (EPM), Universidade Federal de São Paulo
(UNIFESP), São Paulo, Brazil
| | | | - Clara Versolato Razvickas
- Division of Nephrology, Department of
Medicine, Escola Paulista De Medicina (EPM), Universidade Federal de São Paulo
(UNIFESP), São Paulo, Brazil
| | - Fernanda T Borges
- Division of Nephrology, Department of
Medicine, Escola Paulista De Medicina (EPM), Universidade Federal de São Paulo
(UNIFESP), São Paulo, Brazil
- Universidade Cruzeiro do Sul, São Paulo,
Brazil
| | - Nestor Schor
- Division of Nephrology, Department of
Medicine, Escola Paulista De Medicina (EPM), Universidade Federal de São Paulo
(UNIFESP), São Paulo, Brazil
| |
Collapse
|
4
|
Fahmy SR, Soliman AM, El Ansary M, Elhamid SA, Mohsen H. Therapeutic efficacy of human umbilical cord mesenchymal stem cells transplantation against renal ischemia/reperfusion injury in rats. Tissue Cell 2017; 49:369-375. [PMID: 28476205 DOI: 10.1016/j.tice.2017.04.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 04/21/2017] [Accepted: 04/24/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Acute kidney injury (AKI) is a common clinical problem raising the urgent needs to develop new strategies for treatment. The present study investigated the therapeutic potential of human umbilical cord - mesenchymal stem cells (HUC-MSCs) transplantation against renal ischemia/reperfusion injury (IRI) in rats. METHODS Twenty four male Wistar rats were assigned into two main groups, sham group (control group) and I/R group. I/R group was injected in the tail vein with either phosphate buffer saline (PBS) or HUC-MSCs. RESULTS The HUC-MSCs improved kidney injury induced by I/R as demonstrated by enhancement of the kidney function via decreasing serum levels of creatinine, urea and uric acid. The therapeutic efficacy of HUC-MSCs were found to be mediated through anti-oxidant activity as indicated by significant reduction in total malondialdehyde (MDA) and significant increment in the levels of reduced glutathione (GSH), catalase (CAT) and glutathione-S-transferase (GST). CONCLUSION The present work suggests that HUC-MSCs may be an effective therapeutic agent against renal IRI. The recorded data showed improvement of renal functions and urine albumin in HUC-MSCs than IRI group with positive antioxidant efficacy of HUC-MSCs through scavenging free radicals and supporting the antioxidant enzymes.
Collapse
Affiliation(s)
- Sohair R Fahmy
- Department of Zoology, Faculty of Science, Cairo University, Egypt
| | - Amel M Soliman
- Department of Zoology, Faculty of Science, Cairo University, Egypt
| | - Mervat El Ansary
- Department of Clinical and Chemical Pathological, Faculty of Medicine, Cairo University, Kasr Al-Ainy, Egypt
| | - Samah Abd Elhamid
- Department of Clinical and Chemical Pathological, Faculty of Medicine, Cairo University, Kasr Al-Ainy, Egypt.
| | - Heba Mohsen
- Department of Zoology, Faculty of Science, Cairo University, Egypt
| |
Collapse
|
5
|
Sampaio TL, Menezes RRPPBD, da Costa MFB, Meneses GC, Arrieta MCV, Chaves Filho AJM, de Morais GB, Libório AB, Alves RS, Evangelista JSAM, Martins AMC. Nephroprotective effects of (-)-α-bisabolol against ischemic-reperfusion acute kidney injury. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:1843-1852. [PMID: 27912887 DOI: 10.1016/j.phymed.2016.11.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 10/28/2016] [Accepted: 11/10/2016] [Indexed: 05/14/2023]
Abstract
BACKGROUND Ischemia/reperfusion (I/R) in kidney is commonly related to acute kidney injury (AKI), essentially through oxidative stress. (-)-α-Bisabolol is a sesquiterpene isolated from the essential oil of a variety of plants, including chamomile, which has important antioxidant activity. STUDY DESIGN This study intends to evaluate the nephroprotective activity of (-)-α-bisabolol (Bis) in both in vivo and in vitro models of kidney I/R. METHODS Male Wistar rats were submitted to right nephrectomy, followed by ischemia by clamping of the renal artery in the left kidney for 60min. and 48h of reperfusion. The animals were treated orally with Bis (100mg/kg) or vehicle for 24h after reperfusion, and placed in metabolic cages, to evaluate water consumption, diuresis, urinary osmolality, classic biochemical markers and urinary KIM-1 (kidney injury molecule-1). Additionally, the left kidney was collected for histological evaluation and determination of glutathione (GSH) and Thiobarbituric Acid Reactive Substances (TBARS) levels. Tubular epithelial cells LLC-MK2 were used to assess Bis effect on in vitro I/R, by MTT assay. It was performed the cellular respiration tests by flow cytometry: evaluation of the production of cytoplasmic reactive oxygen species by DCFH-DA assay and mitochondrial transmembrane potential analysis with the dye rhodamine 123. RESULTS I/R caused alterations in diuresis, water intake, urinary osmolality, plasmatic creatinine, urea and uric acid, creatinine clearance, proteinuria and microalbuminuria. Treatment with Bis ameliorated all of these parameters. Also, KIM-1 level enhanced by I/R was also diminished in groups treated with Bis. The histological examination showed that Bis attenuated the morphological changes caused by I/R, markedly vascular congestion and intratubular deposits of proteinaceous material. Additionally, Bis was able to reduce the changes observed in TBARS and GSH levels in kidney tissue. In in vitro assay, Bis was capable to partially protect the cell lineage against cell damage induced by I/R. CONCLUSION (-)-α-Bisabolol has a nephroprotective effect in kidney I/R, with antioxidant effect. Moreover, this result seems to be associated to a direct protective effect on tubular epithelia.
Collapse
Affiliation(s)
- Tiago Lima Sampaio
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Ceará, Brazil
| | | | | | | | | | | | | | - Alexandre Braga Libório
- Department of Clinical Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceara, Brazil
| | - Renata Sousa Alves
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Alice Maria Costa Martins
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
| |
Collapse
|
6
|
Zhou JQ, Qiu T, Zhang L, Chen ZB, Wang ZS, Ma XX, Li D. Allopurinol preconditioning attenuates renal ischemia/reperfusion injury by inhibiting HMGB1 expression in a rat model. Acta Cir Bras 2016; 31:176-82. [PMID: 27050788 DOI: 10.1590/s0102-865020160030000005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/15/2016] [Indexed: 01/15/2023] Open
Abstract
PURPOSE To investigate the potential effects of pretreatment with allopurinol on renal ischemia/reperfusion injury (IRI) in a rat model. METHODS Twenty four rats were subjected to right kidney uninephrectomy were randomly distributed into the following three groups (n=8): Group A (sham-operated group); Group B (ischemic group) with 30 min of renal ischemia after surgery; and Group C (allopurinol + ischemia group) pretreated with allopurinol at 50 mg/kg for 14 days. At 72 h after renal reperfusion, the kidney was harvested to assess inflammation and apoptosis. RESULTS Pretreatment with allopurinol significantly improved renal functional and histological grade scores following I/R injury (p<0.05). Compared with Group B, the expression levels of caspase-3 and Bax were markedly reduced in Group C, meanwhile, whereas expression of bcl-2 was clearly increased (p<0.05). A newly described marker of inflammation, High Mobility Group Box 1(HMGB1), showed reduced expression in Group C (p<0.05). CONCLUSION Pretreatment with allopurinol had a protective effect on kidney ischemia/reperfusion injury, which might be related to the inhibition of HMGB1 expression.
Collapse
Affiliation(s)
- Jiang-qiao Zhou
- Department of Organ Transplantation, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Tao Qiu
- Department of Organ Transplantation, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Lu Zhang
- Department of Urology, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Zhong-bao Chen
- Department of Organ Transplantation, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Zhi-shun Wang
- Department of Urology, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Xiao-xiong Ma
- Department of Organ Transplantation, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Dongyu Li
- Intensive Care Unit, PuAi Hospital, Anlu, Hubei, China
| |
Collapse
|
7
|
Bazzano T, Restel TI, Porfirio LC, Souza ASD, Silva IS. Renal biomarkers of male and female Wistar rats (Rattus norvegicus) undergoing renal ischemia and reperfusion. Acta Cir Bras 2015; 30:277-88. [PMID: 25923261 DOI: 10.1590/s0102-865020150040000007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/18/2015] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To investigate biomarkers of acute renal injury in Wistar rats, subjected to left renal ischemia for 10 minutes, and then compare reperfusion at 24 hours, and at 5, 7, 14 and 21 days after the procedure. METHODS Eight female and male rats between 60 and 81 days old were used in the Central Animal Facility of the UFMS. Assessed biomarkers included urine protein, urea, creatinine, glucose, sodium, potassium, urine alkaline phosphatase and gamma-glutamyl transferase activities, and protein-to-creatinine ratio; and in serum: urea, creatinine, sodium and potassium, fractional excretion of sodium, potassium, urine flow and creatinine clearance. RESULTS Greater variance was observed in the parameters at 24 hours and at five days (p<0.05) after reperfusion. On the 21st day, these parameters approximated those obtained for the control group. CONCLUSIONS Renal ischemia for 10 minutes was sufficient to raise urine levels of protein, glucose, fractional excretion of potassium, urea, creatinine clearance, urine activity of gamma-glutamyltransferase and alkaline phosphatase enzymes in the first 24 hours, up to five days after reperfusion, which may indicate risk of acute kidney injury, according to the RIFLE classification.
Collapse
|