Jo S K, Yun S Y, Chang K H, Cha D R, Cho W Y, Kim H K, Won N H
Department of Internal Medicine, Korea University Hospital, Seoul, Korea.
Nephrol Dial Transplant. 2001 Aug;16(8):1583-91. doi: 10.1093/ndt/16.8.1583.
Apoptosis frequently occurs in acute renal injury but the molecular mechanisms responsible for this distinct form of cell death are largely unknown. Fas belongs to the tumour necrosis factor (TNF)/nerve growth factor superfamily and engagement by Fas ligand induces apoptosis in various epithelial cells. To investigate the role of apoptosis and associated mechanisms, we examined the occurrence of apoptosis and Fas and Fas ligand expression, and the therapeutic effect of alpha-melanocyte-stimulating hormone (alpha-MSH), a potent anti-inflammatory cytokine in an ischaemic acute renal failure (ARF) rat model. We also examined neutrophil infiltration together with intercellular adhesion molecule-1 (ICAM-1) expression because of their possible involvement in apoptosis due to their ability to release various inflammatory cytokines and reactive oxygen species.
After unilateral nephrectomy in female Sprague-Dawley rats, the renal artery of the contralateral kidney was clamped for 40 min and reperfused. alpha-MSH or vehicle was injected intraperitoneally immediately after reperfusion and at 1, 6, or 24 h after reperfusion. The expression of Fas and Fas ligand was studied by western blot analysis and semiquantitative reverse transcription polymerase chain reaction (RT-PCR). Apoptosis was assessed by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling (TUNEL) method, and neutrophil infiltration by naphthol AS-D chloracetate staining. The degree of apoptosis, neutrophil infiltration, and Fas and Fas ligand, and ICAM-1 expression, as well as biochemical and histological data were compared between the alpha-MSH and the vehicle-treated groups.
Intraperitoneally administered alpha-MSH significantly reduced renal injury, measured by blood urea nitrogen (BUN) and creatinine and by the degree of tubular necrosis (109.6+/-7.1/54.7+/-3.1 mg/dl for BUN, and 1.6+/-0.2/1.03+/-0.06 mg/dl for creatinine 24 h after ischaemia) (5.4+/-0.8/2.6+/-0.3 for injury score 24 h after ischaemia). Ischaemia caused an increase in Fas and Fas ligand expression and was accompanied by morphological evidence of apoptosis. alpha-MSH significantly reduced the degree of apoptosis, as well as Fas and Fas ligand expression (mean apoptotic cell number, 41.7+/-3.5/14.2+/-2.2 per x200 field at 24 h after ischaemia. Fas protein expression: sham, 1409+/-159 DI (densitometric index); vehicle/alpha-MSH, 2818+/-635/1306+/-321 DI at 24 h and 5542+/-799/2867+/-455 DI at 72 h after ischaemia. Fas ligand protein expression: sham, 1221+/-181 DI; vehicle/alpha-MSH, 2590+/-85/1279+/-169 DI at 4 h, 4376+/-268/2432+/-369 DI at 24 h and 5200+/-648/2253.7+/-1104 DI at 72 h after ischaemia). Neutrophil infiltration and ICAM-1 expression were also significantly reduced in alpha-MSH group (neutrophil infiltration: vehicle/ alpha-MSH, 5.05+/-1.8/1.59+/-0.4) (ICAM-1 expression, vehicle/alpha-MSH 0.46+/-0.21/0.29+/-0.19).
These results suggest that apoptosis clearly contributes to tubular cell loss in ischaemia/reperfusion (I/R) injury possibly by neutrophil-mediated pathways or an increase in Fas-Fas ligand expression. The observed beneficial effect of alpha-MSH could be related to these mechanisms.
凋亡在急性肾损伤中频繁发生,但导致这种独特细胞死亡形式的分子机制大多尚不清楚。Fas属于肿瘤坏死因子(TNF)/神经生长因子超家族,Fas配体与之结合可诱导多种上皮细胞发生凋亡。为研究凋亡及其相关机制的作用,我们在缺血性急性肾衰竭(ARF)大鼠模型中检测了凋亡的发生情况、Fas和Fas配体的表达,以及强效抗炎细胞因子α-黑素细胞刺激素(α-MSH)的治疗效果。由于中性粒细胞能够释放多种炎性细胞因子和活性氧,可能参与凋亡过程,因此我们还检测了中性粒细胞浸润情况以及细胞间黏附分子-1(ICAM-1)的表达。
对雌性Sprague-Dawley大鼠进行单侧肾切除术后,夹闭对侧肾脏的肾动脉40分钟,然后再灌注。再灌注后立即以及再灌注后1、6或24小时腹腔注射α-MSH或赋形剂。通过蛋白质印迹分析和半定量逆转录聚合酶链反应(RT-PCR)研究Fas和Fas配体的表达。采用末端脱氧核苷酸转移酶介导的dUTP-生物素缺口末端标记(TUNEL)法评估凋亡情况,用萘酚AS-D氯乙酸酯染色评估中性粒细胞浸润情况。比较α-MSH组和赋形剂处理组之间的凋亡程度、中性粒细胞浸润情况、Fas和Fas配体以及ICAM-1的表达,以及生化和组织学数据。
腹腔注射α-MSH可显著减轻肾损伤,通过血尿素氮(BUN)、肌酐以及肾小管坏死程度来衡量(缺血24小时后,BUN为109.6±7.1/54.7±3.1mg/dl,肌酐为1.6±0.2/1.03±0.06mg/dl)(缺血24小时后损伤评分为5.4±0.8/2.6±0.3)。缺血导致Fas和Fas配体表达增加,并伴有凋亡的形态学证据。α-MSH可显著降低凋亡程度以及Fas和Fas配体的表达(缺血24小时后,每200视野平均凋亡细胞数为41.7±3.5/14.2±2.2。Fas蛋白表达:假手术组为1409±159密度指数(DI);赋形剂/α-MSH组,缺血24小时时为2818±635/1306±321DI,缺血72小时时为5542±799/2867±455DI。Fas配体蛋白表达:假手术组为1221±181DI;赋形剂/α-MSH组,缺血4小时时为2590±85/1279±169DI,缺血24小时时为4376±268/2432±369DI,缺血72小时时为5200±648/2253.7± ll04DI)。α-MSH组的中性粒细胞浸润和ICAM-1表达也显著降低(中性粒细胞浸润:赋形剂/α-MSH组为5.05±1.8/1.59±0.4)(ICAM-1表达,赋形剂/α-MSH组为0.46±0.21/0.29±0.19)。
这些结果表明,凋亡可能通过中性粒细胞介导的途径或Fas-Fas配体表达增加,在缺血/再灌注(I/R)损伤中导致肾小管细胞丢失。观察到的α-MSH的有益作用可能与这些机制有关。