Fenofibrate Pre-treatment Suppressed Inflammation by Activating Phosphoinositide 3 Kinase/Protein Kinase B(PI3K/Akt) Signaling in Renal Ischemia-Reperfusion Injury

The aim of this study was to investigate the possible beneficial effects of Fenofibrate on renal ischemia-reperfusion injury（IRI） in mice and its potential mechanism. IRI was induced by bilateral renal ischemia for 60 min followed by reperfusion for 24 h. Eighteen male C57BL/6 mice were randomly divided into three groups： sham-operated group（sham）, IRI＋saline group（IRI group）, IRI＋Fenofibrate（FEN） group. Normal saline or Fenofibrate（3 mg/kg） was intravenously injected 60 min before renal ischemia in IRI group and FEN group, respectively. Blood samples and renal tissues were collected at the end of reperfusion. The renal function, histopathologic changes, and the expression levels of pro-inflammatory cytokines [interleukin-8（IL-8）, tumor necrosis factor alpha（TNF-α） and IL-6] in serum and renal tissue homogenate were assessed. Moreover, the effects of Fenofibrate on activating phosphoinositide 3 kinase/protein kinase B（PI3K/Akt） signaling and peroxisome proliferator-activated receptor-α（PPAR-α） were also measured in renal IRI. The results showed that plasma levels of blood urea nitrogen and creatinine, histopathologic scores and the expression levels of TNF-α, IL-8 and IL-6 were significantly lower in FEN group than in IRI group. Moreover, Fenofibrate pretreatment could further induce PI3K/Akt signal pathway and PPAR-α activation following renal IRI. These findings indicated PPAR-α activation by Fenofibrate exerts protective effects on renal IRI in mice by suppressing inflammation via PI3K/Akt activation. Thus, Fenofibrate could be a novel therapeutic alternative in renal IRI.

Effects of different periods of renal ischemia on liver as a remote organ

AIM:To assess the hepatic changes after induction of different periods of renal ischemia. METHODS:Rats were subjected to either sham operation or ischemia (30,45 and 60 min) followed by 60 min reperfusion. Liver and renal functional indices were measured. Hepatic glutathione (GSH) and ferric reducing antioxidant power levels and the concentration of interleukin (IL)-10 and tumor necrosis factor (TNF-α) were evaluated. Portions of liver and kidney tissues were fixed for histological evaluation. RESULTS:Forty-five minutes renal ischemia followed by 60 min reperfusion caused significant changes in liver structure and a significant reduction in renalfunction. These rats showed a significant decrease in liver GSH,as well as a significant increase in TNF-α and IL-10 concentrations. These results demonstrated that renal ischemia caused changes in liver histology,function,oxidative stress and inflammatory status,which led to a reduction in hepatic antioxidant capacity. With 30 min ischemia,the magnitude of these changes was less than those with 45 or 60 min ischemia.CONCLUSION:A minimum of 45 min ischemia is needed to study the effects of renal injury on the liver as a remote organ.

Glucose Metabolic Alteration of Cerebral Cortical Subareas in Rats with Renal Ischemia/Reperfusion Based on Small-Animal Positron Emission Tomography

Objective:To investigate glucose metabolic alterations in cerebral cortical subareas using ^(18)F-labeled glucose derivative fluorodeoxyglucose(FDG)micro-positron emission tomography(PET)scanning in a rat renal ischemia/reperfusion(RIR)model.Methods:Small-animal PET imaging in vivo was performed with ^(18)F-labeled FDG as a PET tracer to identify glucose metabolic alterations in cerebral cortical subregions using a rat model of RIR.Results:We found that the average standardized uptake value(SUV_(average))of the cerebral cortical subareas in the RIR group was significantly increased compared to the sham group(P<0.05).We also found that glucose uptake in different cortical subregions including the left auditory cortex,right medial prefrontal cortex,right para cortex,left retrosplenial cortex,right retrosplenial cortex,and right visual cortex was significantly increased in the RIR group(P<0.05),but there was no significant difference in the SUV_(avcrage) of right auditory cortex,left medial prefrontal cortex,left para cortex,and left visual cortex between the two groups.Conclusion:The ^(18)F-FDG PET data suggests that RIR causes a profound shift in the metabolic machinery of cerebral cortex subregions.

Antioxidative effect of peroxiredoxin-3 in the rat myocardium exposed to renal ischemia-reperfusion injury

Background:Peroxiredoxin-3(Prx-3)is known to be involved in the clearance of cellular hydrogen peroxide and plays an important role in protecting the myocardial tissue against damage of oxidative stress.However,the role of Prx-3 in protecting the myocardial tissue against renal ischemia/reperfusion(I/R)-induced myocardial injury(RI/RMI)remains unknown.We aimed to examine the antioxidative effect of Prx-3 using a rat RI/RMI model in an attempt to find a new approach to the prevention and treatment of myocardial injury induced by renal I/R.Methods:A RI/RMI rat model was established to detect the renal histopathology and renal functions by hematoxylin-eosin staining staining and commercially available assay kits.The myocardial antioxidant activity and the expressions of mRNA and protein of Prx-3 in the myocardial tissue were measured by real-time polymerase chain reaction and Western blotting assay,respectively.Results:Compared with the normal and control groups,the serum level of blood urea nitrogen and serum creatinine was significantly increased in the I/R group(P<0.05).Histopathological changes in the kidneys were also more obvious,including glomerular cystic and renal interstitial hemorrhage,renal tubular epithelial cell edema,and tubular type formation.The mRNA and protein expressions of Prx-3 were increased significantly in the RI/MRI rat model as compared with those in the normal and control groups.Conclusion:Oxidative damage occurred in the remote myocardium after renal I/R and Prx-3 was able to enhance the self-regulatory ability of the myocardium against damage from oxidative stress after RI/MRI.

Effect and mechanism of adrenomedullin on apoptosis of renal tubular epithelial cell in rats induced by renal ischemia reperfusion injury

Objective To investigate the effect and mechanism of adrenomedullin ( AM ) on apoptosis of renal tubular epithelial cell in rats induced by renal ischemia reperfusion injury. Methods Thirty-two Wistar rats were randomly divided into 4 groups: control group,IRI group, empty plasmid group and AM group. One week after re-

Expression of Bcl-2 and NF-κB in brain tissue after acute renal ischemia-reperfusion in rats

Objective:To investigate the effect of acute renal ischemia reperfusion on brain tissue.Methods:Fourty eight rats were randomly divided into four groups(n=12):sham operation group,30 min ischemia 60 min reperfusion group,60 min ischemia 60 min reperfusion group,and120 min ischemia 60 min reperfusion group.The brain tissues were taken after the experiment.TUNEL assay was used to detect the brain cell apoptosis,and western blot was used to detect the expression of apoptosis-related proteins and inflammatory factors.Results:Renal ischemiareperiusion induced apoptosis of brain tissues,and the apoptosis increased with prolongation of ischemia time.The detection at the molecular level showed decreased Bcl-2 expression,increased Bax expression,upreguiated expression of NF- κB and its downstream factor COX-2/PGE2.Conclusions:Acute renal ischemia-reperfusion can cause brain tissue damage,manifested as induced brain tissues apoptosis and inflammation activation.

Role of P-selectin and anti-P-selectin monoclonal antibody in apoptosis during hepatic/renal ischemia-reperfusion injury

AIM To evaluale the potential role of P-selectinand anti-P-selectin monoclonal antibody(mAb)in apoptosis during hepatic/renal ischemia-reperfusion injury.METHODS Plasma P-selectin level,hepatic/renal P-selectin expression and cell apoptosiswere detected in rat model of hepatic/ renalischemia-reperfusion injury.ELISA,immunohist-ochemistry and TUNEL were used.Someischemia-reperfusion rats were treated with anti-P-selectin mAb.RESULTS Hepatic/renal function insuffic-iency,up-regulated expression of P-selectin inplasma and hepatic/renal tissue,hepatic/renalhistopathological damages and cell apoptosiswere found in rats with hepatic/renal ischemia-reperfusion injury,while these changes becameless conspicuous in animals treated with anti-P-selectin mAb.CONCLUSION P-selectin might mediateneutrophil infiltration and cell apoptosis andcontribute to hepatic/renal ischemia-reperfusioninjury,anti-P-selectin mAb might be an efficientapproach for the prevention and treatment ofhepatic/renal ischemia-reperfusion injury.

Extracellular ascorbic acid fluctuation during the protective process of ischemic preconditioning in rabbit renal ischemia-reperfusion model measured

Background Ascorbic acid has important antioxidant ischemic preconditioning on later ischemia-reperfusion ascorbic acid in ischemic preconditioning in the kidney. properties, and may play a role in the protective effects of Herein, we examined the role of endogenous extracellular Methods We developed a solitary rabbit kidney model where animals received ischemia-reperfusion only （ischemia-reperfusion group, n=-15） or ischemic preconditioning followed by ischemia-reperfusion （ischemic preconditioning group, n=15）. Ischemia-reperfusion was induced by occluding and loosening of the renal pedicle. The process of ischemic preconditioning included 15-minute brief ischemia and 10-minute reperfusion. In vivo microdialysis coupled with online electrochemical detection was used to determine levels of endogenous extracellular ascorbic acid in both groups. The extent of tissue damage was determined in kidney sections stained with hematoxylin and eosin. Serum creatinine and urea nitrogen were also detected to assess renal function. Results During ischemia-reperfusion, the extracellular ascorbic acid concentration during ischemia increased rapidly to the peak level （（130.01±9.98）%）, and then decreased slowly to near basal levels. Similar changes were observed during reperfusion （peak level, （126.78±18.24）%）. In the ischemic preconditioning group there was a similar pattern of extracellular ascorbic acid concentration during ischemic preconditioning. However, the ascorbic acid level was significantly lower during the ischemia and early reperfusion stage compared to the ischemia-reperfusion group. Additionally, the extent of glomerular ischemic collapse, tubular dilation, tubular denudation, and loss of brush border were markedly attenuated in the ischemic preconditioning group. Levels of serum creatinine and urea nitrogen were also decreased significantly in the ischemic preconditioning group. Conclusions Ischemic preconditioning may protect renal tissue against ischemia-reperfusion injury via use of extracellular ascorbic acid. In vivo microdialysis coupled with online electrochemical detection is effective for continuous monitoring extracellular ascorbic acid in the renal cortex.

Assessment of Warm and Cold Ischemia on Functions of the Operated Kidney with ^99mTc-DMSA in Renal Masses: A Prospective and Randomized Study

Objective: To examine the effect of warm and cold ischemia on functions of the operated kidney in cases with a normal contralateral kidney undergoing nephron sparing surgery. Methods: This study enrolled 40 patients with a normal contralateral kidney and without a renal function threatening risk factor, who were operated with NSS. The patients were randomized at admission. They were divided into 2 equal groups as warm and cold ischemia. An ice application for 10 minutes was done to cold ischemia group after clamping renal artery. Renal functions were evaluated with Technesium-99m-Dimercaptosuccinic Acid (DMSA) and serum creatinine at the preoperative and postoperative (day 1, day 15, month 6, and month 12) period. Statistical analysis was done with Mann Whitney U test, Wilcoxon Signed Rank test, and Fredman test. A p value below 0.05 was considered statistically significant. Results: There were no significant differences between the groups in terms of age, body mass index, ischemia time, tumor size, amount of hemorrhage, and procedure time. Both groups had a significantly higher DMSA uptake at the preoperative period compared with the postoperative period (postoperative day 1, day 15, month 6, and month 12) (p 0.001). However, both groups had similar DMSA uptake results at the postoperative period. Preoperative and postoperative creatinine levels were not significantly different from each other in both groups. Conclusion: Based on tumor localization, nephron sparing surgery without use of superficial cooling appears as a viable option for small renal masses.

维生素D通过抑制NLRP3炎症小体的活化改善肾脏缺血再灌注损伤

目的:探讨维生素D(VD)在肾脏缺血再灌注(I/R)损伤中的作用及相关机制。方法:将48只雄性C57BL/6J小鼠分为4组:假手术组(Sham组)、活性VD类似物阿法骨化醇处理组(VD组)、肾缺血再灌注损伤组(I/R组)、阿法骨化醇处理的I/R组(I/R+VD组)。I/R损伤造模24 h后处死各组小鼠,收集外周血,检测血尿素氮(BUN)、血清肌酐(SCr)和炎症因子IL-1β、IL-18、肿瘤坏死因子-α(TNF-α)含量;收集各组小鼠肾组织,TUNEL染色法检测各组小鼠肾组织细胞凋亡水平,免疫组织化学检测肾组织中NOD样受体蛋白3(NLRP3)的表达阳性率;Western blot检测各组小鼠肾组织中NLRP3炎症小体相关因子NLRP3、GSDMD-N、cleaved Caspase-1及NF-κB p65、IκBα的蛋白表达水平。结果:与Sham组比较,VD组血清中BUN、SCr和IL-1β、IL-18及TNF-α水平差异无统计学意义(P>0.05),I/R组与I/R+VD组明显升高(P<0.05);与I/R组比较,I/R+VD组BUN、SCr和IL-1β、IL-18及TNF-α水平显著降低(P<0.05);与Sham组比较,VD组小鼠肾组织中TUNEL阳性率与NLRP3表达差异无统计学意义(P>0.05),I/R组与I/R+VD组明显升高(P<0.01),与I/R组比较,I/R+VD组的TUNEL阳性率与NLRP3表达均显著降低(P<0.05);Western blot检测结果显示,与Sham组相比,VD组小鼠肾组织中NLRP3、GSDMD-N、cleaved Caspase-1、IL-1β和NF-κB p65、IκBα的蛋白表达水平差异无统计学意义(P>0.05),I/R组与I/R+VD组除IκBα蛋白表达明显降低外(P<0.05),其他蛋白表达水平均明显升高(P<0.05);与I/R组比较,I/R+VD组中NLRP3、GSDMD-N、cleaved Caspase-1和IL-1β和NF-κB p65蛋白表达水平均明显降低(P<0.05),IκBα蛋白表达水平明显降低(P<0.05)。结论:VD可通过抑制NF-κB途径介导的NLRP3炎症小体激活,减轻I/R损伤的炎症反应,发挥肾脏保护作用。

PI3K抑制剂LY294002对急性肾损伤大鼠肾功能及细胞自噬的影响

目的探究LY294002对急性肾损伤(AKI)大鼠肾功能及细胞自噬的影响。方法将36只SD大鼠采用随机单位组设计分组法分为对照(control)组、假手术(sham)组、模型(model)组、LY294002预处理(I/R+LY294002)组,每组9只。LY294002预处理组连续腹腔注射LY294002(40μl/d),模型组腹腔注射等量无菌生理盐水,干预时间为14 d。14 d后除对照组外,其余大鼠均行手术,假手术组仅暴露双侧肾脏及肾蒂,模型组及LY294002预处理组进一步建立大鼠肾缺血再灌注损伤(RIRI)模型(缺血45 min,再灌注24 h)模拟AKI。建模成功后收集各组血液和肾脏,检测血清中肾损伤相关指标,观察肾脏组织病理改变,检测PI3K/AKT信号通路和自噬相关蛋白的表达情况。结果模型组血清肌酐(SCr)、尿素氮(BUN)及肾损伤分子1(Kim-1)的浓度高于对照组及假手术组,差异有统计学意义(P<0.05)。LY294002预处理组SCr、BUN及Kim-1的浓度低于模型组,差异有统计学意义(P<0.05)。LY294002预处理组可观察到RIRI大鼠肾脏组织病理改变如肾小管梗阻扩张、血管扩张充血、间质水肿得到减轻。模型组p-AKT/AKT和p-PI3K/PI3K的相对表达量和LC3Ⅱ、Beclin-1的表达高于对照组、假手术组,差异有统计学意义(P<0.05)。LY294002预处理组p-AKT/AKT和p-PI3K/PI3K的相对表达量和LC3Ⅱ、Beclin-1的表达低于模型组,差异有统计学意义(P<0.05)。结论LY294002通过抑制PI3K/AKT信号通路,抑制了细胞自噬,肾脏损伤得到改善。这将为防治AKI提供一个新的思路。

肾部分切除术后急性肾损伤及其对手术侧肾脏的远期影响

肾部分切除术是治疗局限性小肾癌的首选方法,但手术过程中通常需要暂时阻断肾动脉,不可避免地引发缺血再灌注损伤,严重者甚至发生急性肾损伤。肾部分切除术后急性肾损伤的诊断常采用急性肾损伤网络标准(AKIN)和风险、损伤、失败、损失、终末期肾脏疾病标准(RIFLE),但使用总肌酐升高水平来评估单侧肾损伤显然不够准确;另外,肾部分切除术中会丢失部分正常肾组织,也导致血肌酐升高。为避免上述因素对诊断造成干扰,笔者首先改良了孤立肾肾部分切除术后急性肾损伤诊断分级方法,提出了诊断肾部分切除术后的急性肾损伤需要考虑到正常肾组织丢失引起的血肌酐升高。接着采用“极端值法”量化了非孤立肾患者手术侧肾脏急性肾损伤的程度。最后还探讨了急性肾损伤对手术侧肾脏的远期影响以及减轻肾部分切除术中缺血再灌注肾损伤的潜在方法。

细胞焦亡在肾缺血再灌注损伤中的研究进展

缺血再灌注损伤(ischemia-reperfusion injury,IRI)是导致急性肾损伤的主要原因之一,目前尚无有效的治疗方法。探索肾IRI的发生机制及开发减轻肾IRI的有效靶向药物具有重要意义。细胞焦亡是一种新发现的炎症性程序性细胞死亡方式。研究发现细胞焦亡与肾IRI的发生发展密切相关。该文对细胞焦亡在肾IRI中的作用及机制进行综述,并讨论影响细胞焦亡的相关药物在肾IRI保护作用中的研究新进展,为肾IRI的治疗提供新思路。

右美托咪定对急性肾损伤继发肺损伤的修复功用

目的探讨右美托咪定(Dexmedetomidine,Dex)对急性肾损伤(acute kidney injury,AKI)继发肺损伤的修复功用。方法将75只6~8周龄健康SPF级雄性C57BL/6J小鼠(体质量20~22 g)随机分为:假手术(Sham)组,常规行开腹关腹手术;肾缺血再灌注(RIR)组,双侧肾蒂夹闭50 min后再灌注;Dex预处理(Dex+RIR)组,双侧肾蒂夹闭前15 min经腹腔注射Dex(25μg/kg)。各组于造模后24、48、72、96、120 h(n=5),收集肺组织、肺泡灌洗液(bronchoalveolar lavage fluid,BALF)、颈动脉血。观察并比较各组不同时间点肺组织损伤程度及修复情况、动脉血氧分压(PaO_(2))、肺泡灌洗液转化生长因子β1(transforming growth factorβ1,TGF-β1)和结缔组织生长因子(connective tissue growth factor,CTGF)含量。反转录实时定量聚合酶链式反应(quantitative real-time RT-PCR,RT-qPCR)检测肺组织白细胞介素-6(IL-6)、肺表面活性蛋白C(surfactant protein C,SP-C)转录水平。结果与Sham组比较,AKI后48 h内,RIR组和Dex+RIR组肺损伤评分升高、PaO_(2)降低,但Dex+RIR组肺损伤评分及PaO_(2)水平均优于RIR组;AKI后96 h内RIR组肺损伤评分维持高水平,PaO_(2)维持低水平,而Dex+RIR组肺损伤评分和PaO_(2)于48 h后出现持续好转。AKI后RIR组肺泡灌洗液TGF-β1和CTGF以及肺组织IL-6转录水平呈现出由高水平向低水平变化的趋势,但均显著高于Sham组(P<0.05),Dex干预使24~120 h时间点TGF-β1显著降低(P<0.01),24~72 h IL-6转录水平显著降低(P<0.05),而CTGF呈上升趋势并于48~96 h维持较高水平;AKI后RIR组SP-C转录水平在24 h显著上调(与Sham组比较,P<0.001),48~120 h大幅下降至低水平(与RIR组24 h比较,P<0.05),而Dex可改善此种AKI所致的SP-C转录抑制现象。结论Dex可改善急性肾损伤继发肺损伤后肺换气功能,并将肺损伤修复时间窗从96~120 h提前至48~72 h。

黄芪甲苷尾静脉注射对大鼠肾缺血再灌注损伤的干预作用及其机制

目的 观察黄芪甲苷尾静脉注射对大鼠肾缺血再灌注损伤的干预作用,并基于PI3K/AKT信号通路及自噬调控探讨相关机制。方法 60只健康雄性SD大鼠随机分为黄芪甲苷组、渥曼青霉素组、模型组和对照组。黄芪甲苷组、渥曼青霉素组、模型组制作肾缺血再灌注损伤模型,对照组只游离双肾肾蒂并行右肾切除术,不进行其他处理;黄芪甲苷组于再灌注前5 min采用尾静脉注射黄芪甲苷10 mg/kg,渥曼青霉素组分别于再灌注前5、10 min依次注射10 mg/kg黄芪甲苷和0.6 mg/kg渥曼青霉素(PI3K特异性抑制剂),对照组和模型组于同时间点注射等容量生理盐水。再灌注24 h时检测血清肌酐(Cr)和尿素氮(BUN),取肾组织HE染色观察病理变化,观察肾组织细胞凋亡情况并计算凋亡指数,检测肾组织中的微管相关蛋白1轻链3-Ⅱ(LC3-Ⅱ)、自噬效应蛋白Beclin-1和磷酸化AKT(p-AKT)蛋白。结果 黄芪甲苷组、渥曼青霉素组、模型组血清Cr、BUN水平高于对照组,模型组、渥曼青霉素组、黄芪甲苷组血清Cr、BUN水平依次降低(P均<0.05)。黄芪甲苷组和渥曼青霉素组肾脏组织病理损伤较模型组有所减轻,其中黄芪甲苷组更为明显。黄芪甲苷组、渥曼青霉素组、模型组肾组织细胞凋亡指数和LC3-Ⅱ、Beclin-1、p-AKT蛋白表达高于对照组,模型组、渥曼青霉素组、黄芪甲苷组凋亡指数和LC3-Ⅱ、Beclin-1蛋白表达依次降低,渥曼青霉素组p-AKT蛋白表达低于黄芪甲苷组(P均<0.05)。结论 黄芪甲苷干预可减轻大鼠肾缺血再灌注损伤,其机制可能与调控PI3K/AKT通路、抑制自噬有关。

低温诱导的RBM3对各器官缺血再灌注损伤研究进展

缺血再灌注损伤(IRI)是一种复杂的血流动力学紊乱状态,致死率极高,且目前的治疗方法相对有限。亚低温治疗是临床上公认的一种缓解缺血、缺氧损伤的治疗方式,尤其在脑保护中的研究较多。多项研究表明,RNA结合基序蛋白3(RBM3)作为一种冷应激蛋白,主要在低温诱导下产生,可促进翻译,减轻氧化应激、降低细胞凋亡率。因此,诱导RBM3可能代表一种治疗IRI的新策略,代替亚低温治疗,减轻低温对机体的不良影响。基于这一观点,文章对RBM3蛋白功能的最新发现进行综述,重点关注RBM3对各器官IRI相关疾病的保护作用以及未来前景,为相关研究提供新思路。

超选择性经动脉栓塞术在零缺血机器人辅助腹腔镜肾部分切除术中的应用

目的探讨T1期肾癌术前超选择性经动脉栓塞后机器人辅助腹腔镜肾部分切除术的可行性和安全性。方法回顾性分析2015年5月至2022年3月207例机器人辅助腹腔镜肾部分切除术(RALPN)患者的临床资料,根据术前不同干预方式分为STE+RALPN组32例、Off-clamp RALPN组35例、S-RALPN组140例。比较各组术后肾功能、尿常规、CT、术前及术后肾小球滤过率(GFR)等指标。结果三组患者手术时间、失血量、术后24 h血红蛋白下降、引流管清除时间、手术前后GFR的下降比较,差异有统计学意义(P<0.05)。STE+RALPN组患者无尿漏、低体温、发热等治疗相关不良反应。无复发或转移发生。结论肾动脉栓塞后的机器人辅助腹腔镜下零缺血肾部切除可保留更多的残肾功能,并发症少,提供一种安全可行的手术方法。

铁死亡在缺血-再灌注急性肾损伤中的研究进展

缺血-再灌注(I/R)是急性肾损伤(AKI)的常见原因,常见于肾移植、休克、创伤、泌尿外科和心血管外科手术,对此尚无有效的治疗方法。铁死亡是一种新发现的调节性细胞死亡模式,其特征是铁依赖性脂质过氧化物的致命积累。已有大量研究表明,铁死亡参与I/R AKI的发生发展,其病理生理机制及治疗靶点逐渐成为研究的热点。本文概述了近年来关于I/R AKI中铁死亡的相关研究进展,旨在为I/R AKI的预防及治疗提供新的思路和策略。

黄芪甲苷与三七总皂苷配伍冰片改善大鼠脑缺血再灌注后肾脏损伤的研究

目的观察黄芪甲苷(astragaloside Ⅳ,AST Ⅳ)与三七总皂苷(Panax notoginseng saponins,PNS)配伍冰片改善大鼠脑缺血再灌注后肾脏损伤的作用。方法采用大脑中动脉线栓法建立局灶性脑缺血模型,实验随机分为假手术组、模型组、单用冰片组、ASTⅣ配伍PNS(AP)组、ASTⅣ与PNS配伍冰片(APB)组,缺血2 h后再灌注48 h,神经功能评分、HE染色和尼氏染色检测脑组织功能和神经细胞损伤,HE染色检测肾脏损伤,通过肾脏质量指数和血肌酐以及血清中尿素氮含量评价肾脏功能,ELISA法检测血清IL-1β和IL-10含量,免疫组织化学检测肾组织NF-κB蛋白的表达,Western blot检测肾组织TLR4和MyD88蛋白的表达。结果与假手术组比较,模型组神经功能评分和神经细胞损伤率显著升高(P<0.01),尼氏体数量显著减少(P<0.01),同时肾小管水肿、核固缩,肾脏质量指数降低(P<0.01),血清肌酐和尿素氮含量升高(P<0.01),提示脑缺血再灌注可诱发肾脏继发性损伤。与模型组比较,各药物组均能不同程度地降低神经功能评分(P<0.01),减少神经细胞损伤率(P<0.01或P<0.05),增加尼氏体数量(P<0.01),改善肾脏结构损伤,增加肾脏质量指数(P<0.01或P<0.05),降低血清肌酐和尿素氮含量(P<0.01或P<0.05),以ASTⅣ与PNS配伍冰片效果最佳。与假手术组比较,模型组血清IL-1β含量升高(P<0.01),肾组织NF-κB、TLR4和MyD88蛋白表达增高(P<0.01)。与模型组比较,各药物组血清IL-1β含量降低(P<0.01或P<0.05),血清IL-10含量升高(P<0.01或P<0.05),肾脏组织中NF-κB、TLR4和My D88的蛋白表达降低(P<0.01或P<0.05)。结论脑缺血后可诱发肾脏继发性损伤,ASTⅣ和PNS配伍冰片除可减轻脑缺血再灌注后脑组织损伤外,还可减轻脑缺血后继发性肾脏损伤,其作用与调控TLR4/MyD88/NF-κB信号通路、抑制肾脏炎症有关。

硫氢化钠左肾动脉注入对大鼠肾缺血再灌注损伤的改善作用及其机制

目的 观察硫氢化钠(Na HS)对大鼠肾缺血再灌注损伤的改善作用,探讨其作用机制与Klotho蛋白的关系。方法 取18只雄性SD大鼠,随机分为假手术组、模型组、Na HS干预组,每组各6只。模型组摘除右肾后,用无创动脉夹夹闭左肾蒂模拟急性肾缺血状态,夹闭45 min后解除动脉夹,模拟肾再灌注状态;Na HS干预组建立急性肾缺血模型后,向左肾动脉注入Na HS,随后进行再灌注;假手术组不予夹闭。再灌注24 h后,留取各组血液标本,采用比色法检测血清肾功能指标尿素氮(BUN)和肌酐(Scr)。取各组肾组织标本,HE染色法观察肾组织病理学改变,比色法检测肾组织超氧化物歧化酶(SOD)、丙二醛(MDA)含量,Western blotting法检测肾组织Klotho、Nrf2蛋白。结果 与假手术组比较,模型组血清Scr、BUN升高,肾小管损伤加重,肾组织SOD活性下降、MDA含量升高,肾组织Klotho蛋白表达降低、Nrf2蛋白表达升高(P<0.05或<0.01);与模型组比较,Na HS干预组血清Scr、BUN下降,肾小管损伤减轻,肾组织SOD活性升高、MDA含量降低,Klotho、Nrf2蛋白表达均升高(P<0.05或<0.01)。结论 Na HS能够减轻急性肾缺血大鼠肾缺血再灌注损伤,其机制可能与上调Klotho蛋白表达、减轻氧化应激有关。