气腹可上调前内皮素-1信使核糖核酸。

Pneumoperitoneum upregulates preproendothelin-1 messenger RNA.

作者信息

Ambrose J A, Onders R P, Stowe N T, Simonson M S, Robinson A V, Wilhelm S, Schulak J A

机构信息

Department of Surgery, Case Western Reserve University, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106, USA.

出版信息

Surg Endosc. 2001 Feb;15(2):183-8. doi: 10.1007/s004640000313.

DOI:10.1007/s004640000313

PMID:11285964

Abstract

BACKGROUND

Laparoscopic pneumoperitoneum has been shown to decrease glomerular filtration rate (GFR) and urine volume (UV). Endothelin-1 (ET-1), a potent renal vasoconstrictor, has been implicated. The purpose of this study was to determine renal function, ET-1 gene expression, and peptide localization in kidneys subjected to CO2 pneumoperitoneum.

METHODS

Experiments were performed in three groups of anesthetized Sprague-Dawley rats in which GFR and UV were measured before, during, and after insufflation. In the first group (n = 8), pneumoperitoneum (10 mmHg) was established for 30 min. The second group (n = 4) underwent a sham operation without pneumoperitoneum. In the final group (n = 4), kidneys were obtained from normal control animals without any prior surgical instrumentation. PreproET-1 (ppET-1) mRNA levels were measured by reverse transcription-polymerase chain reaction (RT-PCR). The ET-1 peptide was localized within kidneys by immunohistochemistry (IHC).

RESULTS

Pneumoperitoneum caused a significant (p < 0.05) 87% decrease in GFR and a 79% decrease in UV from baseline, with a return to baseline values after desufflation. RT-PCR showed a significant (p < 0.05) increase in expression of ppET-1 mRNA in the laparoscopic group; it was 3.52 +/- 0.33 densitometric units (DU), as compared to 0.35 +/- 0.06 DU and 0.57 +/- 0.12 DU in the control and sham groups, respectively. IHC showed enhanced expression of the ET-1 peptide in the vascular endothelium and proximal tubular cells of the laparoscopic group compared to the control and sham groups.

CONCLUSION

Pneumoperitoneum induces ET-1 gene and peptide upregulation in the kidney. Expression of ET-1 is increased in the renal vasculature and proximal tubular cells. The elevation of ET-1 and its localization may account for some of the renal dysfunction observed during pneumoperitoneum. This suggests that antagonism of ET-1 may be beneficial in patients with renal impairment undergoing prolonged laparoscopic procedures or in protecting allograft function during and after living donor nephrectomy.

摘要

背景

腹腔镜气腹已被证明会降低肾小球滤过率（GFR）和尿量（UV）。内皮素-1（ET-1），一种强效的肾血管收缩剂，被认为与此有关。本研究的目的是确定接受二氧化碳气腹的肾脏的肾功能、ET-1基因表达和肽定位。

方法

对三组麻醉的Sprague-Dawley大鼠进行实验，在气腹前、气腹期间和气腹后测量GFR和UV。第一组（n = 8）建立气腹（10 mmHg）30分钟。第二组（n = 4）进行无气腹的假手术。最后一组（n = 4）从没有任何先前手术操作的正常对照动物获取肾脏。通过逆转录聚合酶链反应（RT-PCR）测量前内皮素原-1（ppET-1）mRNA水平。通过免疫组织化学（IHC）在肾脏内定位ET-1肽。

结果

气腹导致GFR从基线显著（p < 0.05）下降87%，UV下降79%，放气后恢复到基线值。RT-PCR显示腹腔镜组中ppET-1 mRNA表达显著（p < 0.05）增加；为3.52 ± 0.33光密度单位（DU），而对照组和假手术组分别为0.35 ± 0.06 DU和0.57 ± 0.12 DU。IHC显示与对照组和假手术组相比，腹腔镜组血管内皮和近端肾小管细胞中ET-1肽的表达增强。