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Floyd D, Colbert JF, Feng F, Furgeson SB, Montford JR. Acute and Chronic Kidney Disease Worsen Outcomes in Experimental Sepsis. KIDNEY360 2024; 5:654-670. [PMID: 38353663 PMCID: PMC11146656 DOI: 10.34067/kid.0000000000000391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 02/01/2024] [Indexed: 02/22/2024]
Abstract
Key Points Acute kidney disease (AKD) and CKD are common conditions associated with high rates of incident infection, and poor outcomes once infection have been established. We successfully modeled AKD and CKD in rodents and then administered a cecal slurry solution to create peritonitis and tracked sepsis severity, end organ injury, and inflammatory changes. Our results indicate that AKD mice are more susceptible to infection than CKD mice, developing an aggravated inflammatory response and suggests that this condition predisposes to disparate infection risk. Background Infection is a leading cause of morbidity in individuals with acute kidney disease (AKD) and CKD. However, there is significant difficulty in modeling infection into an animal host with preexisting kidney disease. We report a novel method of peritoneal infection induced via cecal slurry (CS) inoculation deployed into mice with experimental aristolochic acid–induced AKD and CKD. Methods AKD, CKD, and paired control mice were injected with sham, low, or higher doses of donor–recipient matched CS solution. Animal survival, sepsis severity, and change in GFR were tracked longitudinally throughout the study. Histology for kidney injury, flow cytometry, plasma cytokines, and evidence of indirect organ injury from sepsis were also assessed. Results Infected AKD mice experienced significantly heightened sepsis severity, with 100% mortality by 24 hours after high CS doses versus no mortality in control mice. In addition, AKD mice receiving lower CS doses developed dramatically increased proinflammatory cytokines and persistent cytopenias. Infected CKD mice also had worse outcomes than paired CKD controls, although less severe than in AKD mice. Interestingly, animals with AKD had worse outcomes than mice with CKD after any CS dose or time point after inoculation, despite higher baseline kidney function and less uremic sequela. Conclusions These data confirm that acute bacterial infection can be modeled in animals with established kidney disease and suggest that the clinical state of kidney disease (AKD versus CKD) may influence host susceptibility to infection more than the degree of kidney failure alone.
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Affiliation(s)
- Deana Floyd
- Renal Section, Rocky Mountain Regional VA Medical Center, Aurora, Colorado
| | - James F. Colbert
- Infectious Disease Section, Rocky Mountain Regional VA Medical Center, Aurora, Colorado
- Division of Infectious Disease, University of Colorado School of Medicine, Aurora, Colorado
| | - Frances Feng
- Department of Pathology, University of Colorado School of Medicine, Aurora, Colorado
| | - Seth B. Furgeson
- Division of Nephrology and Hypertension, University of Colorado School of Medicine, Aurora, Colorado
| | - John R. Montford
- Renal Section, Rocky Mountain Regional VA Medical Center, Aurora, Colorado
- Division of Nephrology and Hypertension, University of Colorado School of Medicine, Aurora, Colorado
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Fu Y, Xiang Y, Wei Q, Ilatovskaya D, Dong Z. Rodent models of AKI and AKI-CKD transition: an update in 2024. Am J Physiol Renal Physiol 2024; 326:F563-F583. [PMID: 38299215 PMCID: PMC11208034 DOI: 10.1152/ajprenal.00402.2023] [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: 12/13/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/02/2024] Open
Abstract
Despite known drawbacks, rodent models are essential tools in the research of renal development, physiology, and pathogenesis. In the past decade, rodent models have been developed and used to mimic different etiologies of acute kidney injury (AKI), AKI to chronic kidney disease (CKD) transition or progression, and AKI with comorbidities. These models have been applied for both mechanistic research and preclinical drug development. However, current rodent models have their limitations, especially since they often do not fully recapitulate the pathophysiology of AKI in human patients, and thus need further refinement. Here, we discuss the present status of these rodent models, including the pathophysiologic compatibility, clinical translational significance, key factors affecting model consistency, and their main limitations. Future efforts should focus on establishing robust models that simulate the major clinical and molecular phenotypes of human AKI and its progression.
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Affiliation(s)
- Ying Fu
- Department of Nephrology, Institute of Nephrology, The Second Xiangya Hospital at Central South University, Changsha, People's Republic of China
| | - Yu Xiang
- Department of Nephrology, Institute of Nephrology, The Second Xiangya Hospital at Central South University, Changsha, People's Republic of China
| | - Qingqing Wei
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University and Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, United States
| | - Daria Ilatovskaya
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, United States
| | - Zheng Dong
- Department of Nephrology, Institute of Nephrology, The Second Xiangya Hospital at Central South University, Changsha, People's Republic of China
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University and Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, United States
- Research Department, Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, United States
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3
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Xiong L, Zou X, Luo X, Yin S, Huang Y, Ning K, Wen D, Zhou Z, Wang J, Li Z, Chen J, Li J, Peng W, Guo S, Dong P, Zhou F, Han H, Peng Y, Yu C, Zhang Z. Longitudinal changes in renal parenchymal volume and function status after partial nephrectomy: a retrospective cohort study. Int J Surg 2024; 110:984-991. [PMID: 38000077 PMCID: PMC10871623 DOI: 10.1097/js9.0000000000000938] [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: 08/16/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The ipsilateral renal parenchymal volume (RPV) experiences a sharp decrease shortly after partial nephrectomy (PN), mainly due to surgical remove or devascularization of kidney tissue. However, the subsequent change of RPV and its association with glomerular filtration rate (GFR) fast decline remains unknown. Our objective was to investigate the change of ipsilateral RPV and renal function status from new baseline (1-12 months after PN) to latest follow-up (≥1 year) after PN, and to explore factors associated with ipsilateral RPV decrease rate and correlation between RPV decrease and GFR fast decline. MATERIALS AND METHODS A retrospective review of 367 patients with PN was conducted. Three-dimensional reconstruction of computed tomography (CT)/MRI images was performed for RPV calculation. Spectrum score was used to assess the degree of acute kidney injury (AKI) in the operated kidney after PN. GFR decline greater than 3 ml/min/1.73 m 2 /year was defined as GFR fast decline. One hundred fourteen patients underwent abdominal surgery was used as control. Predictive factors for subsequent decrease of RPV rate and GFR fast decline were evaluated by linear and logistic regression, respectively. RESULTS With a median interval time of 21.1 (interquartile range:13.8-35.5) months, median ipsilateral RPV significantly decreased from 118.7 (interquartile range:100.7-137.1) ml at new baseline to 111.8 (IQR: 92.3-131.3) ml at latest follow-up. The interval time [β: 1.36(0.71-2.01), P <0.001] and spectrum score [β: 5.83 (2.92-8.74), P <0.001] were identified as independent predictors of ipsilateral RPV decrease rate. GFR fast decline was observed in 101 (27.5%) patients. Annual ipsilateral RPV decrease rate [odds ratio:1.67 (1.05-2.67), P =0.03] and overweight [odds ratio:1.63 (1.02-2.60), P =0.04] were independent predictors of GFR fast decline. CONCLUSIONS Ipsilateral RPV experienced a moderate but significant decrease during follow-up after PN, especially in those with severer acute kidney injury. The presence of GFR fast decline was found to be associated with reduction of ipsilateral RPV, particularly in overweight individuals.
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Liang J, Liu Y. Animal Models of Kidney Disease: Challenges and Perspectives. KIDNEY360 2023; 4:1479-1493. [PMID: 37526653 PMCID: PMC10617803 DOI: 10.34067/kid.0000000000000227] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/24/2023] [Indexed: 08/02/2023]
Abstract
Kidney disease is highly prevalent and affects approximately 850 million people worldwide. It is also associated with high morbidity and mortality, and current therapies are incurable and often ineffective. Animal models are indispensable for understanding the pathophysiology of various kidney diseases and for preclinically testing novel remedies. In the last two decades, rodents continue to be the most used models for imitating human kidney diseases, largely because of the increasing availability of many unique genetically modified mice. Despite many limitations and pitfalls, animal models play an essential and irreplaceable role in gaining novel insights into the mechanisms, pathologies, and therapeutic targets of kidney disease. In this review, we highlight commonly used animal models of kidney diseases by focusing on experimental AKI, CKD, and diabetic kidney disease. We briefly summarize the pathological characteristics, advantages, and drawbacks of some widely used models. Emerging animal models such as mini pig, salamander, zebrafish, and drosophila, as well as human-derived kidney organoids and kidney-on-a-chip are also discussed. Undoubtedly, careful selection and utilization of appropriate animal models is of vital importance in deciphering the mechanisms underlying nephropathies and evaluating the efficacy of new treatment options. Such studies will provide a solid foundation for future diagnosis, prevention, and treatment of human kidney diseases.
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Affiliation(s)
- Jianqing Liang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangzhou, China
| | - Youhua Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangzhou, China
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Okamura K, Lu S, He Z, Altmann C, Montford JR, Li AS, Lucia MS, Orlicky DJ, Weiser-Evans M, Faubel S. IL-6 mediates the hepatic acute phase response after prerenal azotemia in a clinically defined murine model. Am J Physiol Renal Physiol 2023; 325:F328-F344. [PMID: 37471421 PMCID: PMC10511171 DOI: 10.1152/ajprenal.00267.2022] [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: 10/31/2022] [Revised: 06/09/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023] Open
Abstract
Prerenal azotemia (PRA) is a major cause of acute kidney injury and uncommonly studied in preclinical models. We sought to develop and characterize a novel model of PRA that meets the clinical definition: acute loss of glomerular filtration rate (GFR) that returns to baseline with resuscitation. Adult male C57BL/6J wild-type (WT) and IL-6-/- mice were studied. Intraperitoneal furosemide (4 mg) or vehicle was administered at time = 0 and 3 h to induce PRA from volume loss. Resuscitation began at 6 h with 1 mL intraperitoneal saline for four times for 36 h. Six hours after furosemide administration, measured glomerular filtration rate was 25% of baseline and returned to baseline after saline resuscitation at 48 h. After 6 h of PRA, plasma interleukin (IL)-6 was significantly increased, kidney and liver histology were normal, kidney and liver lactate were normal, and kidney injury molecule-1 immunofluorescence was negative. There were 327 differentially regulated genes upregulated in the liver, and the acute phase response was the most significantly upregulated pathway; 84 of the upregulated genes (25%) were suppressed in IL-6-/- mice, and the acute phase response was the most significantly suppressed pathway. Significantly upregulated genes and their proteins were also investigated and included serum amyloid A2, serum amyloid A1, lipocalin 2, chemokine (C-X-C motif) ligand 1, and haptoglobin; hepatic gene expression and plasma protein levels were all increased in wild-type PRA and were all reduced in IL-6-/- PRA. This work demonstrates previously unknown systemic effects of PRA that includes IL-6-mediated upregulation of the hepatic acute phase response.NEW & NOTEWORTHY Prerenal azotemia (PRA) accounts for a third of acute kidney injury (AKI) cases yet is rarely studied in preclinical models. We developed a clinically defined murine model of prerenal azotemia characterized by a 75% decrease in measured glomerular filtration rate (GFR), return of measured glomerular filtration rate to baseline with resuscitation, and absent tubular injury. Numerous systemic effects were observed, such as increased plasma interleukin-6 (IL-6) and upregulation of the hepatic acute phase response.
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Affiliation(s)
- Kayo Okamura
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Sizhao Lu
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Zhibin He
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Chris Altmann
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - John R Montford
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Renal Section, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, United States
| | - Amy S Li
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - M Scott Lucia
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - David J Orlicky
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Mary Weiser-Evans
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Sarah Faubel
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
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Han DS, Erickson C, Hansen KC, Kirkbride-Romeo L, He Z, Rodell CB, Soranno DE. Mesenchymal Stem Cells Delivered Locally to Ischemia-Reperfused Kidneys via Injectable Hyaluronic Acid Hydrogels Decrease Extracellular Matrix Remodeling 1 Month after Injury in Male Mice. Cells 2023; 12:1771. [PMID: 37443806 PMCID: PMC10340256 DOI: 10.3390/cells12131771] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
The translation of stem cell therapies has been hindered by low cell survival and retention rates. Injectable hydrogels enable the site-specific delivery of therapeutic cargo, including cells, to overcome these challenges. We hypothesized that delivery of mesenchymal stem cells (MSC) via shear-thinning and injectable hyaluronic acid (HA) hydrogels would mitigate renal damage following ischemia-reperfusion acute kidney injury. Acute kidney injury (AKI) was induced in mice by bilateral or unilateral ischemia-reperfusion kidney injury. Three days later, mice were treated with MSCs either suspended in media injected intravenously via the tail vein, or injected under the capsule of the left kidney, or MSCs suspended in HA injected under the capsule of the left kidney. Serial measurements of serum and urine biomarkers of renal function and injury, as well as transcutaneous glomerular filtration rate (tGFR) were performed. In vivo optical imaging showed that MSCs localized to both kidneys in a sustained manner after bilateral ischemia and remained within the ipsilateral treated kidney after unilateral ischemic AKI. One month after injury, MSC/HA treatment significantly reduced urinary NGAL compared to controls; it did not significantly reduce markers of fibrosis compared to untreated controls. An analysis of kidney proteomes revealed decreased extracellular matrix remodeling and high overlap with sham proteomes in MSC/HA-treated animals. Hydrogel-assisted MSC delivery shows promise as a therapeutic treatment following acute kidney injury.
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Affiliation(s)
- Daniel S. Han
- Pediatric Urology, Department of Urology, Stanford University School of Medicine, Palo Alto, CA 94305, USA
| | - Christopher Erickson
- Department of Biochemistry and Molecular Genetics, University of Colorado, Aurora, CO 80045, USA
| | - Kirk C. Hansen
- Department of Biochemistry and Molecular Genetics, University of Colorado, Aurora, CO 80045, USA
| | | | - Zhibin He
- Department of Pediatrics, University of Colorado, Aurora, CO 80045, USA
| | - Christopher B. Rodell
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA
| | - Danielle E. Soranno
- Division of Nephrology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Bioengineering, Purdue University, West Lafayette, IN 47907, USA
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7
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Jensen MS, de Araujo IBBA, Mutsaers HAM, Nørregaard R. Transcutaneous measurement of renal function in two rodent models of obstructive nephropathy. BMC Res Notes 2023; 16:119. [PMID: 37365638 DOI: 10.1186/s13104-023-06387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVE Glomerular filtration rate (GFR) is a key indicator of renal function. In both clinical practice and pre-clinical research, serum levels of endogenous filtration markers, such as creatinine, are often used to estimate GFR. However, these markers often do not reflect minor changes in renal function. In this study, we therefore set out to evaluate the applicability of transcutaneous GFR (tGFR) measurements to monitor the changes in renal function, as compared to plasma creatinine (pCreatinine), in two models of obstructive nephropathy, namely unilateral ureteral obstruction (UUO) or bilateral ureteral obstruction followed by release (BUO-R) in male Wistar rats. RESULTS UUO animals showed a significant reduction in tGFR compared to baseline; whereas pCreatinine levels were not significantly changed. In BUO animals, tGFR drops 24 h post BUO and remains lower upon release of the obstruction until day 11. Concomitantly, pCreatinine levels were also increased 24 h after obstruction and 24 h post release, however after 4 days, pCreatinine returned to baseline levels. In conclusion, this study revealed that the tGFR method is superior at detecting minor changes in renal function as compared to pCreatinine measurements.
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Affiliation(s)
- Michael Schou Jensen
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 11, Aarhus N, DK-8200, Denmark
| | | | - Henricus A M Mutsaers
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 11, Aarhus N, DK-8200, Denmark
| | - Rikke Nørregaard
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 11, Aarhus N, DK-8200, Denmark.
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8
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Systemic Changes in Endocannabinoids and Endocannabinoid-like Molecules in Response to Partial Nephrectomy-Induced Ischemia in Humans. Int J Mol Sci 2023; 24:ijms24044216. [PMID: 36835635 PMCID: PMC9962891 DOI: 10.3390/ijms24044216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Renal ischemia-reperfusion (IR), a routine feature of partial nephrectomy (PN), can contribute to the development of acute kidney injury (AKI). Rodent studies show that the endocannabinoid system (ECS) is a major regulator of renal hemodynamics and IR injury; however, its clinical relevance remains to be established. Here, we assessed the clinical changes in systemic endocannabinoid (eCB) levels induced by surgical renal IR. Sixteen patients undergoing on-clamp PN were included, with blood samples taken before renal ischemia, after 10 min of ischemia time, and 10 min following blood reperfusion. Kidney function parameters (serum creatinine (sCr), blood urea nitrogen (BUN), and serum glucose) and eCB levels were measured. Baseline levels and individual changes in response to IR were analyzed and correlation analyses were performed. The baseline levels of eCB 2-arachidonoylglycerol (2-AG) were positively correlated with kidney dysfunction biomarkers. Unilateral renal ischemia increased BUN, sCr, and glucose, which remained elevated following renal reperfusion. Renal ischemia did not induce changes in eCB levels for all patients pooled together. Nevertheless, stratifying patients according to their body mass index (BMI) revealed a significant increase in N-acylethanolamines (anandamide, AEA; N-oleoylethanolamine, OEA; and N-palmitoylethanolamine, PEA) in the non-obese patients. No significant changes were found in obese patients who had higher N-acylethanolamines baseline levels, positively correlated with BMI, and more cases of post-surgery AKI. With the inefficiency of 'traditional' IR-injury 'preventive drugs', our data support future research on the role of the ECS and its manipulation in renal IR.
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Chen YL, Li HK, Wang L, Chen JW, Ma X. No safe renal warm ischemia time-The molecular network characteristics and pathological features of mild to severe ischemia reperfusion kidney injury. Front Mol Biosci 2022; 9:1006917. [PMID: 36465563 PMCID: PMC9709142 DOI: 10.3389/fmolb.2022.1006917] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/03/2022] [Indexed: 07/25/2023] Open
Abstract
Ischemic acute kidney injury (AKI) has always been a hot and difficult research topic in the field of renal diseases. This study aims to illustrate the safe warm ischemia time of kidney and the molecular network characteristics and pathological features of mild to severe ischemia reperfusion kidney injury. We established varying degrees of renal injury due to different ischemia time (0 min, 16 min, 18 min, 20 min, 22 min, 24 min, 26 min, 28 min, and 30 min) on unilateral (left kidney) ischemia-reperfusion injury and contralateral (right kidney) resection (uIRIx) mouse model. Mice were sacrificed 24 h after uIRIx, blood samples were harvested to detect serum creatinine (Scr), and kidney tissue samples were harvested to perform Periodic Acid-Schiff (PAS) staining and RNA-Seq. Differentially expressed genes (DEGs) were identificated, time-dependent gene expression patterns and functional enrichment analysis were further performed. Finally, qPCR was performed to validated RNA-Seq results. Our results indicated that there was no absolute safe renal warm ischemia time, and every minute of ischemia increases kidney damage. Warm ischemia 26min or above in mice makes severe kidney injury, renal pathology and SCr were both significantly changed. Warm ischemia between 18 and 26 min makes mild kidney injury, with changes in pathology and renal molecular expression, while SCr did not change. No obvious pathological changes but significant differences in molecular expression were found less than 16min warm ischemia. There are two key time intervals in the process of renal ischemia injury, 0 min-16 min (short-term) and 26 min-28 min (long-term). Gene expression of immune-related pathways were most significantly down-regulated in short-term ischemia, while metabolism-related pathways were the mainly enriched pathway in long-term ischemia. Taken together, this study provides novel insights into safe renal artery occlusion time in partial nephrectomy, and is of great value for elucidating molecular network characteristics and pathological features of mild to severe ischemia reperfusion kidney injury, and key genes related to metabolism and immune found in this study also provide potential diagnostic and therapeutic biomarkers for AKI.
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Affiliation(s)
- Ya-Lei Chen
- Department of Critical Care Medicine, Capital Medical University Electric Power Teaching Hospital/State Grid Beijing Electric Power Hospital, Beijing, China
| | - Huai-Kang Li
- Senior Department of Urology, The Third Medical Centre of PLA General Hospital, Beijing, China
| | - Lei Wang
- Senior Department of Urology, The Third Medical Centre of PLA General Hospital, Beijing, China
| | - Jian-Wen Chen
- Senior Department of Urology, The Third Medical Centre of PLA General Hospital, Beijing, China
- Department of Nephrology, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People’s Liberation Army, National Clinical Research Center for Kidney Diseases, Beijing, China
| | - Xin Ma
- Senior Department of Urology, The Third Medical Centre of PLA General Hospital, Beijing, China
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Freitas F, Attwell D. Pericyte-mediated constriction of renal capillaries evokes no-reflow and kidney injury following ischaemia. eLife 2022; 11:74211. [PMID: 35285797 PMCID: PMC8947765 DOI: 10.7554/elife.74211] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 03/09/2022] [Indexed: 12/12/2022] Open
Abstract
Acute kidney injury is common, with ~13 million cases and 1.7 million deaths/year worldwide. A major cause is renal ischaemia, typically following cardiac surgery, renal transplant or severe haemorrhage. We examined the cause of the sustained reduction in renal blood flow ('no-reflow'), which exacerbates kidney injury even after an initial cause of compromised blood supply is removed. Adult male Sprague-Dawley rats, or NG2-dsRed male mice were used in this study. After 60 min kidney ischaemia and 30-60 min reperfusion, renal blood flow remained reduced, especially in the medulla, and kidney tubule damage was detected as Kim-1 expression. Constriction of the medullary descending vasa recta and cortical peritubular capillaries occurred near pericyte somata, and led to capillary blockages, yet glomerular arterioles and perfusion were unaffected, implying that the long-lasting decrease of renal blood flow contributing to kidney damage was generated by pericytes. Blocking Rho kinase to decrease pericyte contractility from the start of reperfusion increased the post-ischaemic diameter of the descending vasa recta capillaries at pericytes, reduced the percentage of capillaries that remained blocked, increased medullary blood flow and reduced kidney injury. Thus, post-ischaemic renal no-reflow, contributing to acute kidney injury, reflects pericytes constricting the descending vasa recta and peritubular capillaries. Pericytes are therefore an important therapeutic target for treating acute kidney injury.
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Affiliation(s)
- Felipe Freitas
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - David Attwell
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
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Zhou S, Guo J, Liao X, Zhou Q, Qiu X, Jiang S, Xu N, Wang X, Zhao L, Hu W, Xie L, Xie P, Cui Y, Yang Y, Patzak A, Persson PB, Mao J, Lai EY. rhADAMTS13 reduces oxidative stress by cleaving VWF in ischaemia/reperfusion-induced acute kidney injury. Acta Physiol (Oxf) 2022; 234:e13778. [PMID: 34989474 DOI: 10.1111/apha.13778] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/17/2021] [Accepted: 01/03/2022] [Indexed: 12/17/2022]
Abstract
AIMS Acute kidney injury (AKI), a major health burden, lacks effective therapy. Anti-inflammatory actions of a disintegrin and metalloproteinase with a thrombospondin type 1 motif member 13 (ADAMTS13) may provide a new treatment option for AKI. Along with inflammation, oxidative stress is critical for AKI development, yet the impact of ADAMTS13 on oxidative stress in AKI remains to be fully elucidated. METHODS We assess recombinant human ADAMTS13 (rhADAMTS13) actions on oxidative stress in a murine ischaemia/reperfusion (IR) model. Antioxidant stress-enzyme activities, renal morphology, kidney function markers and vascular function of isolated afferent arterioles are quantified. RESULTS rhADAMTS13 provided after IR, reduces blood urea nitrogen (BUN) by 33% and serum creatinine (Scr) by 73% in 24 hours post-IR. rhADAMTS13 reduces BUN (40.03 ± 20.34 mmol/L vs 72.35 ± 18.74 mmol/L, P < .01), Scr (75.67 ± 51.19 μmol/L vs 176.17 ± 55.38 μmol/L, P < .01) and proteinuria by 41% in 48 hours post-IR as well. Moreover, rhADAMTS13 administration decreases malondialdehyde (MDA) and increases the activity of antioxidant stress enzymes, and attenuates reactive oxygen species production. rhADAMTS13 also upregulates nuclear factor-erythroid-2-related factor 2/haem oxygenase-1, enhances antioxidant enzymes activity and alleviates endothelial dysfunction. Finally, treatment with rhADAMTS13 mitigates severe functional and morphological injury present in IR mice. Extracellular signal-regulated kinase (ERK) phosphorylation is limited by rhADAMTS13 and PPARγ expression is partly restored in ischaemic kidneys. Co-administration of von Willebrand factor (VWF) impairs rhADAMTS13's antioxidant capacity and its protective role in IR. CONCLUSION rhADAMTS13 alleviates renal IR injury through antioxidant effects by cleaving VWF.
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Affiliation(s)
- Suhan Zhou
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Jie Guo
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Xinxin Liao
- Department of Anesthesiology Nanfang Hospital Southern Medical University Guangzhou China
| | - Qin Zhou
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Xingyu Qiu
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Shan Jiang
- Department of Nephrology Center of Kidney and Urology the Seventh Affiliated Hospital Sun Yat‐sen University Shenzhen China
| | - Nan Xu
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
- Department of Pathophysiology School of Basic Medical Sciences Henan University Kaifeng China
| | - Xiaohua Wang
- Department of Nephrology Center of Kidney and Urology the Seventh Affiliated Hospital Sun Yat‐sen University Shenzhen China
| | - Liang Zhao
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Weipeng Hu
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Lanyu Xie
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Peng Xie
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Yu Cui
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Yi Yang
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
| | - Andreas Patzak
- Charité–Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institute of Vegetative Physiology Berlin Germany
| | - Pontus B. Persson
- Charité–Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institute of Vegetative Physiology Berlin Germany
| | - Jianhua Mao
- Department of Nephrology the Children's Hospital of Zhejiang University School of Medicine Hangzhou China
| | - En Yin Lai
- Kidney Disease Center of the First Affiliated Hospital and Department of Physiology School of Basic Medical Sciences Zhejiang University School of Medicine Hangzhou China
- Department of Nephrology Center of Kidney and Urology the Seventh Affiliated Hospital Sun Yat‐sen University Shenzhen China
- Charité–Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Institute of Vegetative Physiology Berlin Germany
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12
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Experimental models of acute kidney injury for translational research. Nat Rev Nephrol 2022; 18:277-293. [PMID: 35173348 DOI: 10.1038/s41581-022-00539-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 12/20/2022]
Abstract
Preclinical models of human disease provide powerful tools for therapeutic discovery but have limitations. This problem is especially apparent in the field of acute kidney injury (AKI), in which clinical trial failures have been attributed to inaccurate modelling performed largely in rodents. Multidisciplinary efforts such as the Kidney Precision Medicine Project are now starting to identify molecular subtypes of human AKI. In addition, over the past decade, there have been developments in human pluripotent stem cell-derived kidney organoids as well as zebrafish, rodent and large animal models of AKI. These organoid and AKI models are being deployed at different stages of preclinical therapeutic development. However, the traditionally siloed, preclinical investigator-driven approaches that have been used to evaluate AKI therapeutics to date rarely account for the limitations of the model systems used and have given rise to false expectations of clinical efficacy in patients with different AKI pathophysiologies. To address this problem, there is a need to develop more flexible and integrated approaches, involving teams of investigators with expertise in a range of different model systems, working closely with clinical investigators, to develop robust preclinical evidence to support more focused interventions in patients with AKI.
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13
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Soranno DE, Baker P, Kirkbride-Romeo L, Wennersten SA, Ding K, Keith B, Cavasin MA, Altmann C, Bagchi RA, Haefner KR, Montford J, Gist KM, Vergnes L, Reue K, He Z, Elajaili H, Okamura K, Nozik E, McKinsey TA, Faubel S. Female and male mice have differential longterm cardiorenal outcomes following a matched degree of ischemia-reperfusion acute kidney injury. Sci Rep 2022; 12:643. [PMID: 35022484 PMCID: PMC8755805 DOI: 10.1038/s41598-021-04701-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/29/2021] [Indexed: 12/13/2022] Open
Abstract
Acute kidney injury (AKI) is common in patients, causes systemic sequelae, and predisposes patients to long-term cardiovascular disease. To date, studies of the effects of AKI on cardiovascular outcomes have only been performed in male mice. We recently demonstrated that male mice developed diastolic dysfunction, hypertension and reduced cardiac ATP levels versus sham 1 year after AKI. The effects of female sex on long-term cardiac outcomes after AKI are unknown. Therefore, we examined the 1-year cardiorenal outcomes following a single episode of bilateral renal ischemia-reperfusion injury in female C57BL/6 mice using a model with similar severity of AKI and performed concomitantly to recently published male cohorts. To match the severity of AKI between male and female mice, females received 34 min of ischemia time compared to 25 min in males. Serial renal function, echocardiograms and blood pressure assessments were performed throughout the 1-year study. Renal histology, and cardiac and plasma metabolomics and mitochondrial function in the heart and kidney were evaluated at 1 year. Measured glomerular filtration rates (GFR) were similar between male and female mice throughout the 1-year study period. One year after AKI, female mice had preserved diastolic function, normal blood pressure, and preserved levels of cardiac ATP. Compared to males, females demonstrated pathway enrichment in arginine metabolism and amino acid related energy production in both the heart and plasma, and glutathione in the plasma. Cardiac mitochondrial respiration in Complex I of the electron transport chain demonstrated improved mitochondrial function in females compared to males, regardless of AKI or sham. This is the first study to examine the long-term cardiac effects of AKI on female mice and indicate that there are important sex-related cardiorenal differences. The role of female sex in cardiovascular outcomes after AKI merits further investigation.
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Affiliation(s)
- Danielle E Soranno
- Department of Pediatrics, Pediatric Nephrology, University of Colorado, 13123 E. 16th Ave, Box #328, Aurora, CO, 80045, USA. .,Division of Renal Disease and Hypertension, Department of Medicine, University of Colorado, Aurora, CO, USA. .,Consortium for Fibrosis Research & Translation, University of Colorado, Aurora, CO, USA. .,Department of Bioengineering, University of Colorado, Aurora, CO, USA.
| | - Peter Baker
- Department of Pediatrics, Clinical Genetics & Metabolism, University of Colorado, Aurora, CO, USA
| | - Lara Kirkbride-Romeo
- Department of Pediatrics, Pediatric Nephrology, University of Colorado, 13123 E. 16th Ave, Box #328, Aurora, CO, 80045, USA
| | - Sara A Wennersten
- Consortium for Fibrosis Research & Translation, University of Colorado, Aurora, CO, USA.,Division of Cardiology, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Kathy Ding
- School of Medicine, University of Colorado, Aurora, CO, USA
| | - Brysen Keith
- Department of Bioengineering, University of Colorado, Aurora, CO, USA
| | - Maria A Cavasin
- Consortium for Fibrosis Research & Translation, University of Colorado, Aurora, CO, USA.,Division of Cardiology, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Christopher Altmann
- Division of Renal Disease and Hypertension, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Rushita A Bagchi
- Consortium for Fibrosis Research & Translation, University of Colorado, Aurora, CO, USA.,Division of Cardiology, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Korey R Haefner
- Consortium for Fibrosis Research & Translation, University of Colorado, Aurora, CO, USA.,Division of Cardiology, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - John Montford
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - Katja M Gist
- Department of Pediatrics, Pediatric Cardiology, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, OH, USA
| | - Laurent Vergnes
- Department of Human Genetics and Metabolism Theme Area, University of California Los Angeles, Los Angeles, CA, USA
| | - Karen Reue
- Department of Human Genetics and Metabolism Theme Area, University of California Los Angeles, Los Angeles, CA, USA
| | - Zhibin He
- Department of Pediatrics, Pediatric Nephrology, University of Colorado, 13123 E. 16th Ave, Box #328, Aurora, CO, 80045, USA
| | - Hanan Elajaili
- Department of Pediatrics, Critical Care Medicine, University of Colorado, Aurora, CO, USA
| | - Kayo Okamura
- Division of Renal Disease and Hypertension, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Eva Nozik
- Department of Pediatrics, Critical Care Medicine, University of Colorado, Aurora, CO, USA
| | - Timothy A McKinsey
- Consortium for Fibrosis Research & Translation, University of Colorado, Aurora, CO, USA.,Division of Cardiology, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Sarah Faubel
- Division of Renal Disease and Hypertension, Department of Medicine, University of Colorado, Aurora, CO, USA
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14
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What Happens to the Preserved Renal Parenchyma After Clamped Partial Nephrectomy? Eur Urol 2022; 81:492-500. [DOI: 10.1016/j.eururo.2021.12.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/05/2021] [Accepted: 12/30/2021] [Indexed: 12/11/2022]
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15
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Kitani T, Kidokoro K, Nakata T, Kirita Y, Nakamura I, Nakai K, Yagi-Tomita A, Ida T, Uehara-Watanabe N, Ikeda K, Yamashita N, Humphreys BD, Kashihara N, Matoba S, Tamagaki K, Kusaba T. Kidney vascular congestion exacerbates acute kidney injury in mice. Kidney Int 2021; 101:551-562. [PMID: 34843756 DOI: 10.1016/j.kint.2021.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/01/2021] [Accepted: 11/09/2021] [Indexed: 01/15/2023]
Abstract
Heart failure is frequently accompanied by kidney failure and co-incidence of these organ failures worsens the mortality in patients with heart failure. Recent clinical observations revealed that increased kidney venous pressure, rather than decreased cardiac output, causes the deterioration of kidney function in patients with heart failure. However, the underlying pathophysiology is unknown. Here, we found that decreased blood flow velocity in peritubular capillaries by kidney congestion and upregulation of endothelial nuclear factor-κB (NF-κB) signaling synergistically exacerbate kidney injury. We generated a novel mouse model with unilateral kidney congestion by constriction of the inferior vena cava between kidney veins. Intravital imaging highlighted the notable dilatation of peritubular capillaries and decreased kidney blood flow velocity in the congestive kidney. Damage after ischemia reperfusion injury was exacerbated in the congestive kidney and accumulation of polymorphonuclear leukocytes within peritubular capillaries was noted at the acute phase after injury. Similar results were obtained in vitro, in which polymorphonuclear leukocytes adhesion on activated endothelial cells was decreased in flow velocity-dependent manner but cancelled by inhibition of NF-κB signaling. Pharmacological inhibition of NF-κB for the mice subjected by both kidney congestion and ischemia reperfusion injury ameliorated the accumulation of polymorphonuclear leukocytes and subsequent exacerbation of kidney injury. Thus, our study demonstrates the importance of decreased blood flow velocity accompanying activated NF-κB signaling in aggravation of kidney injury. Hence, inhibition of NF-κB signaling may be a therapeutic candidate for the vicious cycle between heart and kidney failure with increased kidney venous pressure.
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Affiliation(s)
- Takashi Kitani
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kengo Kidokoro
- Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Tomohiro Nakata
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuhei Kirita
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Itaru Nakamura
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kunihiro Nakai
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Aya Yagi-Tomita
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomoharu Ida
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Noriko Uehara-Watanabe
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kisho Ikeda
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Noriyuki Yamashita
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Benjamin D Humphreys
- Division of Nephrology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Naoki Kashihara
- Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keiichi Tamagaki
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tetsuro Kusaba
- Department of Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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16
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Wei J, Zhang J, Jiang S, Xu L, Qu L, Pang B, Jiang K, Wang L, Intapad S, Buggs J, Cheng F, Mohapatra S, Juncos LA, Osborn JL, Granger JP, Liu R. Macula Densa NOS1β Modulates Renal Hemodynamics and Blood Pressure during Pregnancy: Role in Gestational Hypertension. J Am Soc Nephrol 2021; 32:2485-2500. [PMID: 34127535 PMCID: PMC8722793 DOI: 10.1681/asn.2020070969] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 05/08/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Regulation of renal hemodynamics and BP via tubuloglomerular feedback (TGF) may be an important adaptive mechanism during pregnancy. Because the β-splice variant of nitric oxide synthase 1 (NOS1β) in the macula densa is a primary modulator of TGF, we evaluated its role in normal pregnancy and gestational hypertension in a mouse model. We hypothesized that pregnancy upregulates NOS1β in the macula densa, thus blunting TGF, allowing the GFR to increase and BP to decrease. METHODS We used sophisticated techniques, including microperfusion of juxtaglomerular apparatus in vitro, micropuncture of renal tubules in vivo, clearance kinetics of plasma FITC-sinistrin, and radiotelemetry BP monitoring, to determine the effects of normal pregnancy or reduced uterine perfusion pressure (RUPP) on macula densa NOS1β/NO levels, TGF responsiveness, GFR, and BP in wild-type and macula densa-specific NOS1 knockout (MD-NOS1KO) mice. RESULTS Macula densa NOS1β was upregulated during pregnancy, resulting in blunted TGF, increased GFR, and decreased BP. These pregnancy-induced changes in TGF and GFR were largely diminished, with a significant rise in BP, in MD-NOS1KO mice. In addition, RUPP resulted in a downregulation in macula densa NOS1β, enhanced TGF, decreased GFR, and hypertension. The superimposition of RUPP into MD-NOS1KO mice only caused a modest further alteration in TGF and its associated changes in GFR and BP. Finally, in African green monkeys, renal cortical NOS1β expression increased in normotensive pregnancies, but decreased in spontaneous gestational hypertensive pregnancies. CONCLUSIONS Macula densa NOS1β plays a critical role in the control of renal hemodynamics and BP during pregnancy.
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Affiliation(s)
- Jin Wei
- Department of Molecular Pharmacology & Physiology, University of South Florida, Tampa, Florida,Correspondence: Jin Wei, Department of Molecular Pharmacology & Physiology, University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Boulevard MDC 8, Tampa, Florida 33612.
| | - Jie Zhang
- Department of Molecular Pharmacology & Physiology, University of South Florida, Tampa, Florida
| | - Shan Jiang
- Department of Molecular Pharmacology & Physiology, University of South Florida, Tampa, Florida
| | - Lan Xu
- College of Public Health, University of South Florida, Tampa, Florida
| | - Larry Qu
- Department of Molecular Pharmacology & Physiology, University of South Florida, Tampa, Florida
| | - Bo Pang
- Department of Internal Medicine, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
| | - Kun Jiang
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Lei Wang
- Department of Molecular Pharmacology & Physiology, University of South Florida, Tampa, Florida
| | - Suttira Intapad
- Department of Pharmacology, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Jacentha Buggs
- Advanced Organ Disease & Transplantation Institute, Tampa, Florida
| | - Feng Cheng
- Department of Pharmaceutical Science, University of South Florida, Tampa, Florida
| | - Shyam Mohapatra
- Department of Pharmaceutical Science, University of South Florida, Tampa, Florida
| | - Luis A. Juncos
- Department of Internal Medicine, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
| | | | - Joey P. Granger
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Ruisheng Liu
- Department of Molecular Pharmacology & Physiology, University of South Florida, Tampa, Florida
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17
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Soranno DE, Kirkbride-Romeo L, Han D, Altmann C, Rodell CB. Measurement of glomerular filtration rate reveals that subcapsular injection of shear-thinning hyaluronic acid hydrogels does not impair kidney function in mice. J Biomed Mater Res A 2021; 110:652-658. [PMID: 34590787 PMCID: PMC9292789 DOI: 10.1002/jbm.a.37317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/07/2022]
Abstract
The continued development of minimally invasive therapeutic implants, such as injectable hydrogels, necessitates the concurrent advancement of methods to best assess their biocompatibility via functional outcomes in vivo. Biomaterial implants have been studied to treat kidney disease; however, assessment of biocompatibility has been limited to biomarker and histological assessments. Techniques now exist to measure kidney function serially in vivo in murine studies via transcutaneous measurements of glomerular filtration rate (tGFR). In this study, adult male and female wild-type BalbC mice underwent right unilateral nephrectomy. The remaining solitary left kidney was allowed 4 weeks to recover via compensatory hypertrophy, after which subcapsular injection of either saline or shear-thinning hyaluronic acid hydrogel was performed. Serial tGFR measurements before and after treatment were used to assess the effect of hydrogel injection on kidney filtration. Urine and serum biomarkers of kidney function, and kidney histology were also quantified. Hydrogel injection did not affect kidney function, as assessed by tGFR. Results were in agreement with standard metrics of serum and urine biomarkers of injury as well as histological assessment of inflammation. The model developed provides a direct functional assessment of implant compatibility for the treatment of kidney disease and impact on kidney function.
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Affiliation(s)
- Danielle E Soranno
- Department of Pediatrics, University of Colorado, Aurora, Colorado, USA.,Department of Bioengineering, University of Colorado, Aurora, Colorado, USA.,Department of Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - Daniel Han
- Department of Urology, Stanford University, CA, USA
| | | | - Christopher B Rodell
- School of Biomedical Engineering, Science and Health SystemsScience and Health Systems, Drexel University, Philadelphia, Pennsylvania, USA
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18
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Matsuura R, Yamashita T, Hayase N, Hamasaki Y, Noiri E, Numata G, Takimoto E, Nangaku M, Doi K. Preexisting heart failure with reduced ejection fraction attenuates renal fibrosis after ischemia reperfusion via sympathetic activation. Sci Rep 2021; 11:15091. [PMID: 34302012 PMCID: PMC8302613 DOI: 10.1038/s41598-021-94617-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
Although chronic heart failure is clinically associated with acute kidney injury (AKI), the precise mechanism that connects kidney and heart remains unknown. Here, we elucidate the effect of pre-existing heart failure with reduced ejection fraction (HFrEF) on kidney via sympathetic activity, using the combining models of transverse aortic constriction (TAC) and unilateral renal ischemia reperfusion (IR). The evaluation of acute (24 h) and chronic (2 weeks) phases of renal injury following IR 8 weeks after TAC in C57BL/6 mice revealed that the development of renal fibrosis in chronic phase was significantly attenuated in TAC mice, but not in non-TAC mice, whereas no impact of pre-existing heart failure was observed in acute phase of renal IR. Expression of transforming growth factor-β, monocyte chemoattractant protein-1, and macrophage infiltration were significantly reduced in TAC mice. Lastly, to investigate the effect of sympathetic nerve activity, we performed renal sympathetic denervation two days prior to renal IR, which abrogated attenuation of renal fibrosis in TAC mice. Collectively, we demonstrate the protective effect of pre-existing HFrEF on long-term renal ischemic injury. Renal sympathetic nerve may contribute to this protection; however, further studies are needed to fully clarify the comprehensive mechanisms associated with attenuated renal fibrosis and pre-existing HFrEF.
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Affiliation(s)
- Ryo Matsuura
- Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsushi Yamashita
- Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoki Hayase
- Department of Acute Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Yoshifumi Hamasaki
- Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eisei Noiri
- Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Genri Numata
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eiki Takimoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaomi Nangaku
- Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kent Doi
- Department of Acute Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan.
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19
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Siwinska N, Zak A, Slowikowska M, Paslawska U. Renal Resistive Index as A Potential Indicator of Acute Kidney Injury in Horses. J Equine Vet Sci 2021; 103:103662. [PMID: 34281637 DOI: 10.1016/j.jevs.2021.103662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/19/2022]
Abstract
Reliable and simple tests are constantly being sought to enable the quick detection of acute kidney injury in humans and animals. Diagnosis of subclinical AKI in horses, mainly in field practice, is difficult. An ultrasound scan is a routine test performed when kidney disease is suspected. The aim of the study was to establish the value of the renal resistive index (RRI) in intrarenal arteries in horses with clinical AKI and compare it to that of healthy horses. The second goal was to determine whether potentially nephrotoxic agents can influence RRI. The kidney ultrasonography examination was performed in 30 healthy horses, 11 horses with AKI and 30 horses at risk for AKI (10 colic horses, 10 horses receiving gentamicin and 10 horses receiving NSAIDs). RRI values were measured using pulsed-wave Doppler. Differences in RRI between groups were observed only in the right kidney. Horses with AKI had significantly higher RRI values compared to healthy horses. In the risk group, there was no effect of potentially nephrotoxic agents on the RRI value. RRI value in horses seem to be lower than in other species. The increase in this parameter in horses with AKI affected only one kidney and these values did not reach values obtained in other species. The clinical application of this method in non-cooperating animals remains questionable, and therefore RRI Doppler ultrasonography of blood flow in the intrarenal arteries may have poor clinical utility as a diagnostic tool in the diagnosis of AKI in horses.
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Affiliation(s)
- Natalia Siwinska
- Department of Internal Diseases with Clinic for Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.
| | - Agnieszka Zak
- Department of Immunology, Pathophysiology and Veterinary Preventive Medicine, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Malwina Slowikowska
- Department of Internal Diseases with Clinic for Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Urszula Paslawska
- Department of Internal Diseases with Clinic for Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland; Veterinary Institute, Faculty of Biological and Veterinary Sciences Nicolaus Copernicus University Toruń ul. Toruń, Poland
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20
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Soranno DE, Kirkbride-Romeo L, Wennersten SA, Ding K, Cavasin MA, Baker P, Altmann C, Bagchi RA, Haefner KR, Steinkühler C, Montford JR, Keith B, Gist KM, McKinsey TA, Faubel S. Acute Kidney Injury Results in Long-Term Diastolic Dysfunction That Is Prevented by Histone Deacetylase Inhibition. ACTA ACUST UNITED AC 2021; 6:119-133. [PMID: 33665513 PMCID: PMC7907538 DOI: 10.1016/j.jacbts.2020.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 01/06/2023]
Abstract
This is the first long-term (1-year) study to evaluate both the kidney and systemic sequelae of acute kidney injury in mice. Serial kidney function was measured via transcutaneous glomerular filtration rate. AKI resulted in diastolic dysfunction, followed by hypertension. Ejection fraction was preserved. One year after AKI, cardiac ATP levels were reduced compared with sham controls. Mice treated with the histone deacetylase inhibitor, ITF2357, maintained normal diastolic function normal blood pressure, and normal cardiac ATP after AKI. Metabolomics data suggest that treatment with ITF2357 preserves pathways related to energy metabolism.
Growing epidemiological data demonstrate that acute kidney injury (AKI) is associated with long-term cardiovascular morbidity and mortality. Here, the authors present a 1-year study of cardiorenal outcomes following bilateral ischemia-reperfusion injury in male mice. These data suggest that AKI causes long-term dysfunction in the cardiac metabolome, which is associated with diastolic dysfunction and hypertension. Mice treated with the histone deacetylase inhibitor, ITF2357, had preservation of cardiac function and remained normotensive throughout the study. ITF2357 did not protect against the development of kidney fibrosis after AKI.
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Affiliation(s)
- Danielle E Soranno
- Department of Pediatrics, Pediatric Nephrology, University of Colorado, Aurora, Colorado, USA.,Department of Medicine, Division of Renal Disease and Hypertension, University of Colorado, Aurora, Colorado, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Lara Kirkbride-Romeo
- Department of Pediatrics, Pediatric Nephrology, University of Colorado, Aurora, Colorado, USA
| | - Sara A Wennersten
- Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Medicine, Division of Cardiology, University of Colorado, Aurora, Colorado, USA
| | - Kathy Ding
- Department of Pediatrics, Pediatric Nephrology, University of Colorado, Aurora, Colorado, USA
| | - Maria A Cavasin
- Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Medicine, Division of Cardiology, University of Colorado, Aurora, Colorado, USA
| | - Peter Baker
- Department of Pediatrics, Clinical Genetics and Metabolism, University of Colorado, Aurora, Colorado, USA
| | - Christopher Altmann
- Department of Medicine, Division of Renal Disease and Hypertension, University of Colorado, Aurora, Colorado, USA
| | - Rushita A Bagchi
- Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Medicine, Division of Cardiology, University of Colorado, Aurora, Colorado, USA
| | - Korey R Haefner
- Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Medicine, Division of Cardiology, University of Colorado, Aurora, Colorado, USA
| | | | - John R Montford
- Department of Medicine, Division of Renal Disease and Hypertension, University of Colorado, Aurora, Colorado, USA.,Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Brysen Keith
- Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Katja M Gist
- Department of Pediatrics, Pediatric Cardiology, University of Colorado, Aurora, Colorado, USA
| | - Timothy A McKinsey
- Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Medicine, Division of Cardiology, University of Colorado, Aurora, Colorado, USA
| | - Sarah Faubel
- Department of Medicine, Division of Renal Disease and Hypertension, University of Colorado, Aurora, Colorado, USA
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21
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Park M, Kwon CH, Ha HK, Han M, Song SH. RNA-Seq identifies condition-specific biological signatures of ischemia-reperfusion injury in the human kidney. BMC Nephrol 2020; 21:398. [PMID: 32977749 PMCID: PMC7517631 DOI: 10.1186/s12882-020-02025-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022] Open
Abstract
Background Acute kidney injury (AKI) is defined as a sudden event of kidney failure or kidney damage within a short period. Ischemia-reperfusion injury (IRI) is a critical factor associated with severe AKI and end-stage kidney disease (ESKD). However, the biological mechanisms underlying ischemia and reperfusion are incompletely understood, owing to the complexity of these pathophysiological processes. We aimed to investigate the key biological pathways individually affected by ischemia and reperfusion at the transcriptome level. Results We analyzed the steady-state gene expression pattern of human kidney tissues from normal (pre-ischemia), ischemia, and reperfusion conditions using RNA-sequencing. Conventional differential expression and self-organizing map (SOM) clustering analyses followed by pathway analysis were performed. Differential expression analysis revealed the metabolic pathways dysregulated in ischemia. Cellular assembly, development and migration, and immune response-related pathways were dysregulated in reperfusion. SOM clustering analysis highlighted the ischemia-mediated significant dysregulation in metabolism, apoptosis, and fibrosis-related pathways, while cell growth, migration, and immune response-related pathways were highly dysregulated by reperfusion after ischemia. The expression of pro-apoptotic genes and death receptors was downregulated during ischemia, indicating the existence of a protective mechanism against ischemic injury. Reperfusion induced alterations in the expression of the genes associated with immune response such as inflammasome and antigen representing genes. Further, the genes related to cell growth and migration, such as AKT, KRAS, and those related to Rho signaling, were downregulated, suggestive of injury responses during reperfusion. Semaphorin 4D and plexin B1 levels were also downregulated. Conclusions We show that specific biological pathways were distinctively involved in ischemia and reperfusion during IRI, indicating that condition-specific therapeutic strategies may be imperative to prevent severe kidney damage after IRI in the clinical setting.
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Affiliation(s)
- Meeyoung Park
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Chae Hwa Kwon
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Hong Koo Ha
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Miyeun Han
- Department of Urology, Pusan National University Hospital, Busan, South Korea
| | - Sang Heon Song
- Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
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22
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Wang J, Zhu P, Toan S, Li R, Ren J, Zhou H. Pum2-Mff axis fine-tunes mitochondrial quality control in acute ischemic kidney injury. Cell Biol Toxicol 2020; 36:365-378. [PMID: 31993882 DOI: 10.1007/s10565-020-09513-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 01/24/2020] [Indexed: 12/31/2022]
Abstract
Mitochondrial fission factor (Mff) has been demonstrated to play a role in the activation of mitochondrial cleavage and mitochondrial death, denoting its role in the regulation of mitochondrial quality control. Recent evidence suggested that the mRNA translation of Mff is under the negative regulation by the RNA-binding protein Pumilio2 (Pum2). This study was designed to examine the role of Pum2 and Mff in the governance of mitochondrial quality control in a murine model of acute ischemic kidney injury. Our results indicated that genetic deletion of Mff overtly attenuated ischemic acute kidney injury (AKI)-induced renal failure through inhibition of pro-inflammatory response, tubular oxidative stress, and ultimately cell death in the kidney. Furthermore, Mff inhibition effectively preserved mitochondrial homeostasis through amelioration of mitochondrial mitosis, restoration of Sirt1/3 expression, and boost of mitochondrial respiration. Western blot analysis revealed that levels of Pum2 were significantly downregulated by ischemic AKI, inversely coinciding with levels of Mff. Overexpression of Pum2 reduced ischemic AKI-mediated Mff upregulation and offered protection on renal tubules through modulation of mitochondrial quality control. Taken together, our data have unveiled the molecular mechanism of the Pum2-Mff axis in mitochondrial quality control in a mouse model of ischemic AKI. These data indicated the therapeutic potential of Pum2 activation and Mff inhibition in the management of ischemic AKI.
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Affiliation(s)
- Jin Wang
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Pingjun Zhu
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Sam Toan
- Department of Chemical Engineering, University of Minnesota-Duluth, Duluth, MN, 55812, USA
| | - Ruibing Li
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Jun Ren
- Center for Cardiovascular Research and Alternative Medicine, University of Wyoming, Laramie, WY, 82071, USA.
| | - Hao Zhou
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China.
- Center for Cardiovascular Research and Alternative Medicine, University of Wyoming, Laramie, WY, 82071, USA.
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23
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Faubel S. The author replies. Kidney Int 2020; 97:1301-1302. [PMID: 32444098 DOI: 10.1016/j.kint.2020.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/26/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Sarah Faubel
- Department of Renal Medicine, University of Colorado Denver, Denver, Colorado.
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24
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Intracellular Reactive Oxygen Species Mediate the Therapeutic Effect of Induced Pluripotent Stem Cells for Acute Kidney Injury. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:1609638. [PMID: 32308798 PMCID: PMC7136790 DOI: 10.1155/2020/1609638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/03/2020] [Accepted: 02/19/2020] [Indexed: 11/17/2022]
Abstract
Aims Treatment for acute kidney injury (AKI) is challenging. Induced pluripotent stem cells (iPSCs) have great therapeutic potential. This study sought to determine whether iPSCs attenuate AKI and the role of reactive oxygen species (ROS). Results We intravenously injected isogenic iPSCs into mice 2 h after renal ischemia-reperfusion injury (IRI). The cells were selectively trafficked to ischemia/reperfusion-injured kidney where they decreased kidney ROS and inflammatory cytokines and improved kidney function and morphology. Pretreating the cells with ROS inhibitors before administration decreased iPSC engraftment and abolished the protective effect of iPSCs. In contrast, pretreating iPSCs with hydrogen peroxide increased iPSC engraftment and therapeutic effect. Although the intravenously administered iPSCs trafficked to the IRI kidney, the cells did not differentiate into proximal or distal tubular epithelial cells. In vitro, the capabilities of the iPSC-released substances to promote proliferation and decrease apoptosis of renal epithelial cells were increased by ROS pretreatment of iPSCs. Moreover, pretreatment of the iPSCs with ROS inhibitor had the opposite effect. Similarly, moderate concentrations of ROS increased while ROS inhibitors decreased iPSC mobility, adhesion to the extracellular matrix, and mitochondrial metabolism. Innovation and Conclusion. iPSCs decreased renal ischemia/reperfusion injury mainly through iPSC-released substances. The therapeutic effect, mitochondrial metabolism, mobility, and kidney trafficking of iPSCs were ROS dependent.
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25
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Polichnowski AJ, Griffin KA, Licea-Vargas H, Lan R, Picken MM, Long J, Williamson GA, Rosenberger C, Mathia S, Venkatachalam MA, Bidani AK. Pathophysiology of unilateral ischemia-reperfusion injury: importance of renal counterbalance and implications for the AKI-CKD transition. Am J Physiol Renal Physiol 2020; 318:F1086-F1099. [PMID: 32174143 DOI: 10.1152/ajprenal.00590.2019] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Unilateral ischemia-reperfusion (UIR) injury leads to progressive renal atrophy and tubulointerstitial fibrosis (TIF) and is commonly used to investigate the pathogenesis of the acute kidney injury-chronic kidney disease transition. Although it is well known that contralateral nephrectomy (CNX), even 2 wk post-UIR injury, can improve recovery, the physiological mechanisms and tubular signaling pathways mediating such improved recovery remain poorly defined. Here, we examined the renal hemodynamic and tubular signaling pathways associated with UIR injury and its reversal by CNX. Male Sprague-Dawley rats underwent left UIR or sham UIR and 2 wk later CNX or sham CNX. Blood pressure, left renal blood flow (RBF), and total glomerular filtration rate were assessed in conscious rats for 3 days before and over 2 wk after CNX or sham CNX. In the presence of a contralateral uninjured kidney, left RBF was lower (P < 0.05) from 2 to 4 wk following UIR (3.6 ± 0.3 mL/min) versus sham UIR (9.6 ± 0.3 mL/min). Without CNX, extensive renal atrophy, TIF, and tubule dedifferentiation, but minimal pimonidazole and hypoxia-inducible factor-1α positivity in tubules, were present at 4 wk post-UIR injury. Conversely, CNX led (P < 0.05) to sustained increases in left RBF (6.2 ± 0.6 mL/min) that preceded the increases in glomerular filtration rate. The CNX-induced improvement in renal function was associated with renal hypertrophy, more redifferentiated tubules, less TIF, and robust pimonidazole and hypoxia-inducible factor-1α staining in UIR injured kidneys. Thus, contrary to expectations, indexes of hypoxia are not observed with the extensive TIF at 4 wk post-UIR injury in the absence of CNX but are rather associated with the improved recovery of renal function and structure following CNX.
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Affiliation(s)
- Aaron J Polichnowski
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.,Center of Excellence in Inflammation, Infectious Disease and Immunity, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.,Renal Section, Department of Medicine, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois.,Division of Nephrology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Karen A Griffin
- Renal Section, Department of Medicine, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois.,Division of Nephrology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Hector Licea-Vargas
- Renal Section, Department of Medicine, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois.,Division of Nephrology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Rongpei Lan
- Department of Pathology, University of Texas Health Science Center, San Antonio, Texas
| | - Maria M Picken
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Jainrui Long
- Department of Electrical and Computer Engineering, Illinois Institute of Technology, Chicago, Illinois
| | - Geoffrey A Williamson
- Department of Electrical and Computer Engineering, Illinois Institute of Technology, Chicago, Illinois
| | - Christian Rosenberger
- Department of Nephrology and Medical Intensive Care, Charité Universitaetsmedizin, Berlin, Germany
| | - Susanne Mathia
- Department of Nephrology and Medical Intensive Care, Charité Universitaetsmedizin, Berlin, Germany
| | | | - Anil K Bidani
- Renal Section, Department of Medicine, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois.,Division of Nephrology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
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26
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Grisk O. The sympathetic nervous system in acute kidney injury. Acta Physiol (Oxf) 2020; 228:e13404. [PMID: 31610091 DOI: 10.1111/apha.13404] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/23/2019] [Accepted: 10/10/2019] [Indexed: 12/18/2022]
Abstract
Acute kidney injury (AKI) is frequently accompanied by activation of the sympathetic nervous system (SNS). This may result from pre-exisiting chronic diseases associated with sympathetic activation prior to AKI or it may be induced by stressors that ultimately lead to AKI such as endotoxins and arterial hypotension in circulatory shock. Conversely, sympathetic activation may also result from acute renal injury. Focusing on studies in experimental renal ischaemia and reperfusion (IR), this review summarizes the current knowledge on how the SNS is activated in IR-induced AKI and on the consequences of sympathetic activation for the development of acute renal damage. Experimental studies show beneficial effects of sympathoinhibitory interventions on renal structure and function in response to IR. However, few clinical trials obtained in scenarios that correspond to experimental IR, namely major elective surgery, showed that peri-operative treatment with centrally acting sympatholytics reduced the incidence of AKI. Apparently, discrepant findings on how sympathetic activation influences renal responses to acute IR-induced injury are discussed and future areas of research in this field are identified.
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Affiliation(s)
- Olaf Grisk
- Institute of Physiology University of Greifswald Greifswald Germany
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27
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Skrypnyk NI, Gist KM, Okamura K, Montford JR, You Z, Yang H, Moldovan R, Bodoni E, Blaine JT, Edelstein CL, Soranno DE, Kirkbride-Romeo LA, Griffin BR, Altmann C, Faubel S. IL-6-mediated hepatocyte production is the primary source of plasma and urine neutrophil gelatinase-associated lipocalin during acute kidney injury. Kidney Int 2019; 97:966-979. [PMID: 32081304 DOI: 10.1016/j.kint.2019.11.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 10/09/2019] [Accepted: 11/01/2019] [Indexed: 10/25/2022]
Abstract
Neutrophil gelatinase associated lipocalin (NGAL, Lcn2) is the most widely studied biomarker of acute kidney injury (AKI). Previous studies have demonstrated that NGAL is produced by the kidney and released into the urine and plasma. Consequently, NGAL is currently considered a tubule specific injury marker of AKI. However, the utility of NGAL to predict AKI has been variable suggesting that other mechanisms of production are present. IL-6 is a proinflammatory cytokine increased in plasma by two hours of AKI and mediates distant organ effects. Herein, we investigated the role of IL-6 in renal and extra-renal NGAL production. Wild type mice with ischemic AKI had increased plasma IL-6, increased hepatic NGAL mRNA, increased plasma NGAL, and increased urine NGAL; all reduced in IL-6 knockout mice. Intravenous IL-6 in normal mice increased hepatic NGAL mRNA, plasma NGAL and urine NGAL. In mice with hepatocyte specific NGAL deletion (Lcn2hep-/-) and ischemic AKI, hepatic NGAL mRNA was absent, and plasma and urine NGAL were reduced. Since urine NGAL levels appear to be dependent on plasma levels, the renal handling of circulating NGAL was examined using recombinant human NGAL. After intravenous recombinant human NGAL administration to mice, human NGAL in mouse urine was detected by ELISA during proximal tubular dysfunction, but not in pre-renal azotemia. Thus, during AKI, IL-6 mediates hepatic NGAL production, hepatocytes are the primary source of plasma and urine NGAL, and plasma NGAL appears in the urine during proximal tubule dysfunction. Hence, our data change the paradigm by which NGAL should be interpreted as a biomarker of AKI.
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Affiliation(s)
- Nataliya I Skrypnyk
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA
| | - Katja M Gist
- Department of Cardiology, The Heart Institute, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Kayo Okamura
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA
| | - John R Montford
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA; Renal Section, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | - Zhiying You
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA
| | - Haichun Yang
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Radu Moldovan
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA; Advanced Light Microscopy Core Facility, Aurora, Colorado, USA
| | - Evelyn Bodoni
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA; Advanced Light Microscopy Core Facility, Aurora, Colorado, USA
| | - Judith T Blaine
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA
| | - Charles L Edelstein
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA
| | - Danielle E Soranno
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA; Department of Pediatrics and Bioengineering, University of Colorado, Aurora, Colorado, USA
| | - Lara A Kirkbride-Romeo
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA
| | - Benjamin R Griffin
- Department of Medicine, Division of Nephrology, University of Iowa, Iowa City, Iowa, USA
| | - Chris Altmann
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA
| | - Sarah Faubel
- Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA; Renal Section, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA.
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