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Santana AC, Andraus W, Zimelewicz Oberman D, Rabelo NN, Silva FMO, Dellê H, Pepineli R, de Moraes EL, Scavone C, de Sá Lima L, Degaspari S, Brasil S, Solla DJF, Ruiz LM, de Oliveira-Braga KA, Nepomuceno NA, Pêgo-Fernandes PM, Tullius SG, Figueiredo EG. Immunomodulatory response in an experimental model of brain death. Sci Rep 2023; 13:10524. [PMID: 37386074 PMCID: PMC10310852 DOI: 10.1038/s41598-023-36629-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 06/07/2023] [Indexed: 07/01/2023] Open
Abstract
Liver transplantation has come a long way and is now regarded as the gold standard treatment for end-stage liver failure. The great majority of livers utilized in transplantation come from brain-dead donors. A broad inflammatory response characterizes BD, resulting in multiorgan damage. This process is primarily mediated by cytokines, which increase the immunogenicity of the graft. In male Lewis rats, we evaluated the immune response in a BD liver donor and compared it to that of a control group. We studied two groups: Control and BD (rats subjected to BD by increasing intracranial pressure). After the induction of BD, there was an intense rise in blood pressure followed by a fall. There were no significant differences observed between the groups. Blood tissue and hepatic tissue analyzes showed an increase in plasma concentrations of liver enzymes (AST, ALT, LDH and ALP), in addition to pro-inflammatory cytokines and macrophages in liver tissue in animals submitted to BD. The current study found that BD is a multifaceted process that elicits both a systemic immune response and a local inflammatory response in liver tissue. Our findings strongly suggested that the immunogenicity of plasma and liver increased with time following BD.
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Affiliation(s)
- Alexandre Chagas Santana
- Neurological Surgery Department, University of Sao Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255, 5Th Floor, São Paulo, CEP 05402-000, Brazil
- Organ Procurement Organization Department, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Wellington Andraus
- Gastroenterology Department, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Nícollas Nunes Rabelo
- Neurological Surgery Department, University of Sao Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255, 5Th Floor, São Paulo, CEP 05402-000, Brazil
| | | | - Humberto Dellê
- Medical Science Department, Nove de Julho University, São Paulo, Brazil
| | - Rafael Pepineli
- Medical Science Department, Nove de Julho University, São Paulo, Brazil
| | - Edvaldo Leal de Moraes
- Organ Procurement Organization Department, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Cristoforo Scavone
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of Sao Paulo, São Paulo, Brazil
| | - Larissa de Sá Lima
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of Sao Paulo, São Paulo, Brazil
| | - Sabrina Degaspari
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of Sao Paulo, São Paulo, Brazil
| | - Sérgio Brasil
- Neurological Surgery Department, University of Sao Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255, 5Th Floor, São Paulo, CEP 05402-000, Brazil
| | - Davi Jorge Fontoura Solla
- Neurological Surgery Department, University of Sao Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255, 5Th Floor, São Paulo, CEP 05402-000, Brazil
| | - Liliane Moreira Ruiz
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of Sao Paulo, São Paulo, Brazil
| | | | | | | | - Stefan Gunther Tullius
- Department of Surgery, Division of Transplant Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Eberval Gadelha Figueiredo
- Neurological Surgery Department, University of Sao Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255, 5Th Floor, São Paulo, CEP 05402-000, Brazil.
- Division of Neurosurgery, School of Medicine, University of São Paulo (FMUSP), Hospital das Clínicas/FMUSP - Rua Dr. Enéas de Carvalho Aguiar, 255, São Paulo, SP, 05403-010, Brazil.
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Santana AC, Andraus W, Silva FMO, Dellê H, Pepineli R, de Moraes EL, Scavone C, de Sá Lima L, Degaspari S, Brasil S, Solla DJF, Ruiz LM, de Oliveira-Braga KA, Nepomuceno NA, Pêgo-Fernandes PM, Tullius SG, Figueiredo EG. Immunomodulatory effects of thalidomide in an experimental brain death liver donor model. Sci Rep 2021; 11:19221. [PMID: 34584130 PMCID: PMC8479052 DOI: 10.1038/s41598-021-98538-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/07/2021] [Indexed: 12/17/2022] Open
Abstract
Brain death is characterized by a generalized inflammatory response that results in multiorgan damage. This process is mainly mediated through cytokines, which amplify graft immunogenicity. We investigated the immunological response in a brain death liver donor model and analysed the effects of thalidomide, a drug with powerful immunomodulatory properties. Brain death was induced in male Lewis rats. We studied three groups: Control (sham-operated rats in which trepanation was performed without inserting the balloon catheter), BD (rats subjected to brain death by increasing intracranial pressure) and BD + Thalid (BD rats receiving thalidomide after brain death). After 6 h, serum levels of AST, ALT, LDH, and ALP as well as systemic and hepatic levels of TNF-α, IL1-β, IL-6, and IL-10 were analysed. We also determined the mRNA expression of MHC Class I and Class II, NF-κB, and macrophage infiltration. NF-κB was also examined by electrophoretic mobility shift assay. Thalidomide treatment significantly reduced serum levels of hepatic enzymes and TNF-α, IL-1-β, and IL-6. These cytokines were evaluated at either the mRNA expression or protein level in liver tissue. In addition, thalidomide administration resulted in a significant reduction in macrophages, MHC Class I and Class II, and NF-κB activation. This study reveals that thalidomide significantly inhibited the immunologic response and graft immunogenicity, possibly through suppression of NF-κB activation.
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Affiliation(s)
- Alexandre Chagas Santana
- Neurological Surgery Department, University of Sao Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255, 5th Floor, São Paulo, CEP: 05402-000, Brazil. .,Organ Procurement Organization Department, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
| | - Wellington Andraus
- Gastroenterology Department, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Humberto Dellê
- Medical Science Department, Nove de Julho University, São Paulo, Brazil
| | - Rafael Pepineli
- Medical Science Department, Nove de Julho University, São Paulo, Brazil
| | - Edvaldo Leal de Moraes
- Organ Procurement Organization Department, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Cristoforo Scavone
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of Sao Paulo, Sao Paulo, Brazil
| | - Larissa de Sá Lima
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of Sao Paulo, Sao Paulo, Brazil
| | - Sabrina Degaspari
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of Sao Paulo, Sao Paulo, Brazil
| | - Sergio Brasil
- Neurological Surgery Department, University of Sao Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255, 5th Floor, São Paulo, CEP: 05402-000, Brazil
| | - Davi Jorge Fontoura Solla
- Neurological Surgery Department, University of Sao Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255, 5th Floor, São Paulo, CEP: 05402-000, Brazil
| | - Liliane Moreira Ruiz
- Cardiopneumology Department, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | | | | | | | - Stefan Gunther Tullius
- Department of Surgery, Division of Transplant Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Eberval Gadelha Figueiredo
- Neurological Surgery Department, University of Sao Paulo School of Medicine, Av. Dr. Enéas Carvalho de Aguiar, 255, 5th Floor, São Paulo, CEP: 05402-000, Brazil
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Degaspari S, Orellana AMM, Tzanno-Martins CB, Fujihara CK, Zatz R, Viel TA, Böhmer AE, Scavone C, Kawamoto EM. MP013CHANGES INWNT/Β-CATENIN SIGNALING IN COGNITIVE DEFICIT LINKED TO CHRONIC KIDNEY DISEASE (CKD) ON ANIMAL MODELOF CKD (5/6NEPHRECTOMY). Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw181.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Degaspari S, Tzanno-Martins CB, Fujihara CK, Zatz R, Branco-Martins JP, Viel TA, Buck HDS, Orellana AMM, Böhmer AE, de Sá Lima L, Andreotti DZ, Munhoz CD, Scavone C, Kawamoto EM. Altered KLOTHO and NF-κB-TNF-α Signaling Are Correlated with Nephrectomy-Induced Cognitive Impairment in Rats. PLoS One 2015; 10:e0125271. [PMID: 25961830 PMCID: PMC4427267 DOI: 10.1371/journal.pone.0125271] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 03/23/2015] [Indexed: 12/23/2022] Open
Abstract
Renal insufficiency can have a negative impact on cognitive function. Neuroinflammation and changes in klotho levels associate with chronic kidney disease (CKD) and may play a role in the development of cognitive impairment (CI). The present study evaluates the correlation of cognitive deficits with neuroinflammation and soluble KLOTHO in the cerebral spinal fluid (CSF) and brain tissue of nephrectomized rats (Nx), with 5/6 renal mass ablation. Nx and sham Munich Wistar rats were tested over 4 months for locomotor activity, as well as inhibitory avoidance or novel object recognition, which started 30 days after the surgery. EMSA for Nuclear factor-κB and MILLIPLEXMAP or ELISA kit were used to evaluate cytokines, glucocorticoid and KLOTHO levels. Nx animals that showed a loss in aversive-related memory and attention were included in the CI group (Nx-CI) (n=14) and compared to animals with intact learning (Nx-M n=12 and Sham n=20 groups). CSF and tissue samples were collected 24 hours after the last behavioral test. The results show that the Nx-groups have increased NF-κB binding activity and tumor necrosis factor-alpha (TNF-α) levels in the hippocampus and frontal cortex, with these changes more pronounced in the Nx-CI group frontal cortex. In addition, the Nx-CI group showed significantly increased CSF glucocorticoid levels and TNF-α /IL-10 ratio compared to the Sham group. Klotho levels were decreased in Nx-CI frontal cortex but not in hippocampus, when compared to Nx-M and Sham groups. Overall, these results suggest that neuroinflammation mediated by frontal cortex NF-κB, TNF-α and KLOTHO signaling may contribute to Nx-induced CI in rats.
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Affiliation(s)
- Sabrina Degaspari
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | | | - Clarice Kazue Fujihara
- Renal Division, Department of Clinical Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roberto Zatz
- Renal Division, Department of Clinical Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Tania Araujo Viel
- School of Arts, Sciences and Humanities, Universidade de São Paulo, São Paulo, Brazil
| | - Hudson de Souza Buck
- Department of Physiological Sciences, Santa Casa de São Paulo Medical School, São Paulo 01221–020, Brazil
| | - Ana Maria Marques Orellana
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Ana Elisa Böhmer
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Larissa de Sá Lima
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Diana Zukas Andreotti
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Carolina Demarchi Munhoz
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Cristoforo Scavone
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
- * E-mail:
| | - Elisa Mitiko Kawamoto
- Molecular Neuropharmacology Laboratory, Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
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Tzanno-Martins C, Biavo BMM, Ferreira-Filho O, Ribeiro-Junior E, João-Luiz MVS, Degaspari S, Scavone C, Kawamoto E. Clinical efficacy, safety and anti-inflammatory activity of two sevelamer tablet forms in patients on low-flux hemodialysis. Int J Immunopathol Pharmacol 2014; 27:25-35. [PMID: 24674676 DOI: 10.1177/039463201402700105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Sevelamer hydrochloride is an ionic exchange resin with high affinity for phosphate. This phosphate-binding agent has few serious adverse reactions with the advantage of reducing total and low density lipoprotein (LDL) cholesterol levels. However, it is controversial as to whether sevelamer hydrochloride can modulate the inflammatory response via endotoxin reduction. Therefore, a single-center, open-label, prospective and randomized study was performed to compare the clinical efficacy, safety and anti-inflammatory activity of two sevelamer hydrochloride tablet forms a branded tablet form, Renagel (Genzyme manufacturer) and its generic equivalent (EMS manufacturer). Twenty-eight chronic kidney disease volunteer patients at stage 5 (CDK 5D), on chronic low-flux hemodialysis carried out in 4-hour sessions, three times a week, were studied. The serum phosphorus, ionic calcium, total cholesterol and fractions, bicarbonate, blood pH, interleukin (IL)-6, IL-10, IL-1 beta and tumor necrosis factor-alpha (TNF-alpha) levels were collected prior to dialysis at mid-week. The incidence of gastrointestinal adverse effects were determined at the end of the phosphate-binder washout period as well as at the end of the fourth and eighth weeks of use of both tablet forms. The same magnitude of reduction in serum phosphorus was observed with both sevelamer tablet forms. Only the Renagel group showed lower total cholesterol and lower LDL cholesterol levels at the fourth and eighth week versus baseline. No significant differences in serum cytokine levels were identified in either drug group. However, the incidence of intestinal obstipation was higher among patients who used the generic equivalent form. In conclusion, Renagel and its EMS generic equivalent tablet forms have a similar clinical efficacy in reducing phosphorus in CKD 5D patients on low-flux hemodialysis and a similar safety profile.
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Affiliation(s)
- C Tzanno-Martins
- Home Dialysis Center (HDC), Center of Study for Social and Health Humaniztion (CEHUS), São Paulo, Brazil
| | - B M M Biavo
- Home Dialysis Center (HDC), Center of Study for Social and Health Humaniztion (CEHUS), São Paulo, Brazil
| | - O Ferreira-Filho
- Home Dialysis Center (HDC), Center of Study for Social and Health Humaniztion (CEHUS), São Paulo, Brazil
| | - E Ribeiro-Junior
- Home Dialysis Center (HDC), Center of Study for Social and Health Humaniztion (CEHUS), São Paulo, Brazil
| | - M V S João-Luiz
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, Brazil
| | - S Degaspari
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, Brazil
| | - C Scavone
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, Brazil
| | - E Kawamoto
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, Brazil
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Kawamoto EM, Vasconcelos AR, Degaspari S, Böhmer AE, Scavone C, Marcourakis T. Age-related changes in nitric oxide activity, cyclic GMP, and TBARS levels in platelets and erythrocytes reflect the oxidative status in central nervous system. Age (Dordr) 2013; 35:331-342. [PMID: 22278206 PMCID: PMC3592952 DOI: 10.1007/s11357-011-9365-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 12/05/2011] [Indexed: 05/31/2023]
Abstract
Aging is associated with an increased susceptibility to neurodegenerative disorders which has been linked to chronic inflammation. This process generates oxygen-reactive species, ultimately responsible for a process known as oxidative stress, leading to changes in nitric oxide (NO), and cyclic guanosine monophosphate (cyclic GMP) signaling pathway. In previous studies, we showed that human aging was associated with an increase in NO Synthase (NOS) activity, a decrease in basal cyclic GMP levels in human platelets, and an increase in thiobarbituric acid-reactant substances (TBARS) in erythrocytes. The aim of the present work was to evaluate NOS activity, TBARS and cyclic GMP levels in hippocampus and frontal cortex and its correlation to platelets and erythrocytes of 4-, 12-, and 24-month-old rats. The result showed an age-related decrease in cyclic GMP levels which was linked to an increase in NOS activity and TBARS in both central areas as well as in platelets and erythrocytes of rats. The present data confirmed our previous studies performed in human platelets and erythrocytes and validate NOS activity and cyclic GMP in human platelet as well as TBARS in erythrocytes as biomarkers to study age-related disorders and new anti-aging therapies.
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Affiliation(s)
- Elisa Mitiko Kawamoto
- />Department of Pharmacology, Institute of Biomedical Science—ICB-1, University of São Paulo, Avenida Professor Lineu Prestes, 1524, 05508-900 São Paulo, Brazil
- />Laboratory of Neurosciences, NIA, NIH, Baltimore, MD USA
| | - Andrea Rodrigues Vasconcelos
- />Department of Pharmacology, Institute of Biomedical Science—ICB-1, University of São Paulo, Avenida Professor Lineu Prestes, 1524, 05508-900 São Paulo, Brazil
| | - Sabrina Degaspari
- />Department of Pharmacology, Institute of Biomedical Science—ICB-1, University of São Paulo, Avenida Professor Lineu Prestes, 1524, 05508-900 São Paulo, Brazil
| | - Ana Elisa Böhmer
- />Department of Pharmacology, Institute of Biomedical Science—ICB-1, University of São Paulo, Avenida Professor Lineu Prestes, 1524, 05508-900 São Paulo, Brazil
| | - Cristoforo Scavone
- />Department of Pharmacology, Institute of Biomedical Science—ICB-1, University of São Paulo, Avenida Professor Lineu Prestes, 1524, 05508-900 São Paulo, Brazil
| | - Tania Marcourakis
- />Department of Clinical Chemistry and Toxicology, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
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Santana AC, Degaspari S, Catanozi S, Dellê H, de Sá Lima L, Silva C, Blanco P, Solez K, Scavone C, Noronha IL. Thalidomide suppresses inflammation in adenine-induced CKD with uraemia in mice. Nephrol Dial Transplant 2013; 28:1140-9. [PMID: 23345625 DOI: 10.1093/ndt/gfs569] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Persistent systemic inflammation has been widely recognized in patients with chronic kidney disease (CKD), and is associated with increased risk of morbidity and mortality. Intervention therapies aiming for the blockade of inflammatory cytokines are considered attractive approaches for CKD patients with signs of chronic inflammation. In this context, thalidomide, due to its potent anti-inflammatory and immunomodulatory properties, may represent an alternative strategy of treatment. In the present study, we developed an experimental model of CKD with uraemia in mice, induced by a diet rich in adenine, which causes progressive renal dysfunction, resembling the human uraemic features. Inflammatory parameters were analysed in this model of CKD and the potential beneficial effects of thalidomide as an anti-inflammatory drug was also investigated. METHODS C57/BL-6 mice were fed with an adenine-containing diet during a period of 6 weeks. Thirty mice were divided into three groups: Control group (animals receiving normal diet), ADE group (mice receiving adenine-containing diet) and ADE + TLD group (CKD mice receiving thalidomide, 30 mg/kg/day, by gavage). Besides biochemical and histopathological changes, local and systemic inflammatory parameters were also analysed, including expression of cytokines interleukin (IL)-1β, tumour necrosis factor-α, IL-6, IL-4 and IL-10 in kidney samples by real-time RT-PCR and quantification of serum levels of cytokines. Finally, the electrophoretic mobility shift assay (EMSA) for NF-κB was also examined. RESULTS Adenine-fed mice developed advanced CKD characterized by a marked increase in serum urea, creatinine, phosphorus and intact parathyroid hormone (iPTH) levels. In addition, histological changes of tubulointerstitial injury, characterized by deposition of crystals in the kidney, accompanied by tubular dilatation, degeneration of proximal tubular epithelium with loss of the brush border, inflammatory cellular infiltration, foreign-body granuloma formation and interstitial fibrosis were also evident. By immunohistochemistry, Mac-2- and α-SMA-positive cells were identified in the tubulointerstitial compartment. Treatment with thalidomide significantly reduced serum urea, creatinine, phosphorus and iPTH levels and protected against tubulointerstitial injury. Local and systemic inflammation in the mice model of adenine-induced CKD was confirmed by the findings of significantly high expression of cytokine mRNA levels and NF-κB activation in the kidney tissue as well as marked increased serum levels of inflammatory cytokines. Thalidomide treatment significantly reduced gene expression of these cytokines and the activation of the NF-κB in the renal tissue and the circulating levels of cytokines. CONCLUSIONS Dietary adenine caused advanced CKD with uraemia in mice providing a useful experimental model to study molecular and morphological changes associated with this disease. The negative impact of inflammation in this CKD model was overcome by the marked anti-inflammatory effects of thalidomide, promoting renal protection.
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Affiliation(s)
- Alexandre C Santana
- Laboratory of Cellular and Molecular Nephrology, Division of Nephrology, University of São Paulo, São Paulo, Brazil
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