Insights into the possible mechanism of cyclosporine-induced chronic nephrotoxicity; arteriolopathy

Palliative Role of Zamzam Water against Cyclosporine-Induced Nephrotoxicity through Modulating Autophagy and Apoptosis Crosstalk

Cyclosporine (CsA) is considered one of the main components of treatment protocols for organ transplantation owing to its immunosuppressive effect. However, its use is very restricted due to its nephrotoxic effect. ZW is an alkaline fluid rich in various trace elements and has a great ability to stimulate antioxidant processes. This study aimed to investigate the possible mitigating effect of ZW on CsA-induced nephrotoxicity and its underlying mechanisms. Forty rats were allocated into four groups (n = 10): a control group, ZW group, cyclosporine A group (injected subcutaneously (SC) with CsA (20 mg/kg/day)), and cyclosporine A+ Zamzam water group (administered CsA (SC) and ZW as their only drinking water (100 mL/cage/day) for 21 days). Exposure to CsA significantly (p < 0.001) increased the serum creatinine level, lipid peroxidation marker level (malondialdehyde; MDA), and the expression of apoptotic markers procaspase-8, caspase-8, caspase- 9, calpain, cytochrome c, caspas-3, P62, and mTOR in renal tissues. Meanwhile, it markedly decreased (p< 0.001) the autophagic markers (AMPK, ULK-I, ATag5, LC3, and Beclin-1), antiapoptotic Bcl-2, and antioxidant enzymes. Moreover, the administration of CsA caused histological alterations in renal tissues. ZW significantly (p < 0.001) reversed all the changes caused by CsA and conclusively achieved a positive outcome in restraining CsA-induced nephrotoxicity, as indicated by the restoration of the histological architecture, improvement of renal function, inhibition of apoptosis, and enhancement of autophagy via the AMPK/mTOR pathway.

A modified approach to establish a murine model of hypoxic renal interstitial fibrosis

Modelling methods that are commonly used to establish a murine model of hypoxic renal interstitial fibrosis mainly includes 5/6 nephrectomy, unilateral ureteral obstruction and cyclosporin A (CsA)-induced renal interstitial fibrosis. The first two methods are technically challenging and unsuitable for clinical practice; thus, CsA induction is more promising. A previously introduced model of CsA-induced renal interstitial fibrosis involves the subcutaneous injection of CsA combined with a 0.01% low-sodium diet. The aim of this study was to provide a modified approach to this model by replacing the subcutaneous injection with gavage and the low-sodium diet with furosemide. From the gross morphology of kidney; the micro-specimens which were stained with haematoxylin-eosin (H&E), Masson-trichrome (Masson), periodic acid-Schiff (PAS); the renal function determination; and the expression of Vimentin protein. Our findings indicate that the combined administration of CsA every day and furosemide every other day by gavage at 80 mg/kg and 60 mg/kg, respectively, for 28 days can be used to successfully establish a murine model of renal interstitial fibrosis. Immunohistochemistry was used to show the expression of renin, the initiator of renin angiotensin aldosterone system (RAAS), while Western blotting was used to show the expression of hypoxia-inducible factor-1α (HIF-1α), a sensitive indicator of hypoxia. The expression levels of renin and HIF-1α revealed that RAAS activation and hypoxia are important mechanisms of this the model. Altogether, the data suggest that our modified approach is also an effective, alternative way to establish this model.

Altered oxidative status and integrin expression in cyclosporine A-treated oral epithelial cells

BACKGROUND AND OBJECTIVE

Cyclosporine A (CsA) is an immunosuppressive agent administered to transplant patients. A well-known reported oral side effect of CsA consumption is gingival overgrowth (GO). Changes in the expression of integrins occurring in the gingiva following CsA treatment have been reported but these reports are mainly concerned with the connective tissue of the gingiva. In this study we targeted the alterations in the oral epithelium using KB cells, an oral epithelial cell line.

METHODS

Cultured oral epithelial cells were treated with increasing concentrations of CsA (0.1, 1 and 10 µg/mL) and the molecular changes involving antioxidant enzymes [glutathione peroxidase (GPx) and glutathione reductase (GR)] and the level of reactive oxygen species (ROS) were measured. Quantitative real-time PCR was used to assess the expression of selected integrins (α2, α5 and β1).

RESULTS

At CsA concentration above 0.1 µg/mL GPx demonstrated an increase in activity while GR activity and the level of reduced glutathione were diminished (p < 0.05). α5 and β1 integrin were downregulated at all treatment concentrations of CsA while α2 integrin presented this effect at concentrations above 1 µg/mL (p < 0.05).

CONCLUSION

The results suggest a possible role for oxidative stress and the altered expression of integrins in the pathology of CsA-induced gingival overgrowth.

Sodium tanshinone IIA sulfonate prolongs the survival of skin allografts by inhibiting inflammatory cell infiltration and T cell proliferation

Acute rejection is a major problem for allograft transplantation in the clinic. Classic immunosuppressive drug therapy is accompanied by a variety of side effects. Therefore, safe and effective immunosuppressive drugs remain in demand. In this study, the effect of sodium tanshinone IIA sulfonate (STS) on prolonging the allogeneic skin graft survival was determined using a rat skin transplantation model. Rat recipients were divided into four groups that received different treatments: physiological saline, STS, CsA, or STS+CsA. The results indicated that the administration of STS alone, CsA alone or combined STS and CsA all significantly promoted skin allograft survival as demonstrated by a longer mean survival time (MST) compared with the control group. This effect was due to the reductions in the infiltration of inflammatory cells into allograft and the percentages of CD4+ T cells and CD8+ T cells in the peripheral blood of rat recipients. The injection of STS could also downregulate the expression of RANTES, IP-10 as well as IL-2, IFN-γ and TNF-α in allograft tissue. STS markedly inhibited the proliferation of mouse spleen T lymphocytes stimulated by mitogen and alloantigen in vitro. Taken together, these results suggest that STS is a widely applicable drug with few complications that may serve as a new therapeutic alternative for allograft rejection or even other Th1 cell-dominated immune diseases.