Cao Chang Chun, Ding Xiao Qiang, Ou Zhou Lou, Liu Chun Feng, Li Peng, Wang Lei, Zhu Chun Fang
Department of Nephrology, Zhongshan Hospital, Shanghai, China.
Kidney Int. 2004 Mar;65(3):834-45. doi: 10.1111/j.1523-1755.2004.00463.x.
Ischemic acute renal failure (ARF) is a common and often fatal condition characterized by tubular epithelial cell necrosis and marked monocyte infiltration. Inflammatory mechanisms, including cell adhesion, cell infiltration, and cytokine production, are involved. These processes are thought to be directly or indirectly regulated by nuclear factor kappaB (NF-kappaB). Targeted of NF-kappaB might ameliorate ischemia/reperfusion (I/R) injury by inhibiting the production of genes that involved in ischemic ARF. The objective of the present study was to evaluate the effect of NF-kappaB decoy oligodeoxynucleotides (ODN) in experimental rat ischemic ARF.
Ischemic ARF was induced by left renal artery clamping for 60 minutes, while the right kidney was being removed in female Sprague-Dawley rats. The effect of cationic liposome-protamine-NF-kappaB decoy ODN was evaluated after infusion into the kidney via the renal artery before clamping. After 24 hours of reperfusion, we then assessed morphologic and functional parameters, NF-kappaB/DNA binding activity, monocyte/macrophage (M/MPhi) infiltration, and gene expression in I/R kidney.
After 24 hours of reperfusion, compared with sham-operated animals, serum creatinine and blood urea nitrogen (BUN) levels in ischemic ARF animals were increased about 10-fold and fivefold respectively. (255.67 +/- 34.48 micromol/L vs. 25.33 +/- 2.23 micromol/L and 43.47 +/- 5.50 mmol/L vs. 8.45 +/- 0.43 mmol/L, P < 0.001), NF-kappaB/DNA binding activity was markedly elevated [median value was 1.75 vs. 0.15 relative density unit (RDU), P < 0.005]. NF-kappaB decoy ODN treatment reduced the elevation of serum creatinine level by 70% (79.17 +/- 8.64 micromol/L vs. 255.67 +/- 34.48 micromol/L, P < 0.01), BUN level by 40% (28.33 +/- 4.86 mmol/L vs. 43.47 +/- 5.50 mmol/L, P= NS), and almost abolished the NF-kappaB activation compared with levels observed in sham-operated rats (median value was 0.25 vs. 1.9 RDU, P < 0.005). Furthermore, NF-kappaB decoy ODN pretreatment prevented the occurrence of tubular necrosis and reduced the renal tubular damage scores markedly (1.85 +/- 0.06 vs. 3.63 +/- 0.06 scores, P < 0.01). In addition, M/MPhi infiltration was obviously suppressed (9.77 +/- 1.19 cells/hpf vs. 29.22 +/- 1.94 cells/hpf, P < 0.01), Moreover, results of reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry showed the up-regulation of monocyte chemoattractant protein-1 (MCP-1) and intercellular adhesion molecule-1 (ICAM-1) was greatly decreased, inducible nitric oxide synthase (iNOS) and endothelin-1 (ET-1) expression were also reduced, approaching levels observed in sham-operated animals. The data suggest that NF-kappaB decoy ODN treatment protects renal tissue from the effects of I/R injury and thus reduces the severity of ARF.
These experiments demonstrated that NF-kappaB plays a critical role in renal I/R injury by reducing a series of inflammatory genes. NF-kappaB decoy ODN treatment reduces the renal dysfunction and damage associated with ischemic ARF. Therefore, in vivo transfection of NF-kappaB decoy ODN provides a new therapeutic strategy for ischemic ARF.
缺血性急性肾衰竭(ARF)是一种常见且往往致命的疾病,其特征为肾小管上皮细胞坏死和显著的单核细胞浸润。炎症机制,包括细胞黏附、细胞浸润和细胞因子产生,均参与其中。这些过程被认为直接或间接受核因子κB(NF-κB)调控。靶向NF-κB可能通过抑制参与缺血性ARF的基因产生来改善缺血/再灌注(I/R)损伤。本研究的目的是评估NF-κB诱饵寡脱氧核苷酸(ODN)在实验性大鼠缺血性ARF中的作用。
在雌性Sprague-Dawley大鼠中,通过夹闭左肾动脉60分钟并切除右肾来诱导缺血性ARF。在夹闭前经肾动脉将阳离子脂质体-鱼精蛋白-NF-κB诱饵ODN注入肾脏后,评估其效果。再灌注24小时后,我们评估了I/R肾脏的形态学和功能参数、NF-κB/DNA结合活性、单核细胞/巨噬细胞(M/MPhi)浸润以及基因表达。
再灌注24小时后,与假手术动物相比,缺血性ARF动物的血清肌酐和血尿素氮(BUN)水平分别升高了约10倍和5倍(255.67±34.48微摩尔/升对25.33±2.23微摩尔/升,43.47±5.50毫摩尔/升对8.45±0.43毫摩尔/升,P<0.001),NF-κB/DNA结合活性显著升高[中位数为1.75对0.15相对密度单位(RDU),P<0.005]。NF-κB诱饵ODN治疗使血清肌酐水平升高降低了70%(79.17±8.64微摩尔/升对255.67±34.48微摩尔/升,P<0.01),BUN水平降低了40%(28.33±4.86毫摩尔/升对43.47±5.50毫摩尔/升,P=无统计学意义),与假手术大鼠相比,几乎消除了NF-κB的激活(中位数为0.25对1.9 RDU,P<0.005)。此外,NF-κB诱饵ODN预处理可预防肾小管坏死的发生,并显著降低肾小管损伤评分(1.85±0.06对3.63±0.06分,P<0.01)。此外,M/MPhi浸润明显受到抑制(9.77±1.19个细胞/高倍视野对29.22±1.94个细胞/高倍视野,P<0.01)。此外,逆转录-聚合酶链反应(RT-PCR)和免疫组织化学结果显示,单核细胞趋化蛋白-1(MCP-1)和细胞间黏附分子-1(ICAM-1)的上调显著降低,诱导型一氧化氮合酶(iNOS)和内皮素-1(ET-1)的表达也降低,接近假手术动物中观察到的水平。数据表明,NF-κB诱饵ODN治疗可保护肾组织免受I/R损伤的影响,从而降低ARF的严重程度。
这些实验表明,NF-κB通过减少一系列炎症基因在肾脏I/R损伤中起关键作用。NF-κB诱饵ODN治疗可减轻与缺血性ARF相关的肾功能障碍和损伤。因此,体内转染NF-κB诱饵ODN为缺血性ARF提供了一种新的治疗策略。