Ay Hakan, Uzun Gunalp, Onem Yalcin, Aydinoz Secil, Yildiz Senol, Bilgi Oguz, Topal Turgut, Atasoyu Enes Murat
Department of Undersea and Hyperbaric Medicine, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Uskudar, Istanbul, Turkey.
Ren Fail. 2007;29(4):495-501. doi: 10.1080/08860220701274983.
Reactive oxygen species have been suggested to be involved in cyclosporine nephrotoxicity. Hyperbaric oxygen is known to induce the generation of reactive oxygen species in tissues. The aim of this study was to investigate whether the use of hyperbaric oxygen concurrently with cyclosporine potentiates cyclosporine nephrotoxicity by inducing oxidative stress in kidneys. The study consisted of four groups of rats: a control group, a cyclosporine group (15 mg/kg/day intraperitoneally for 14 days), a hyperbaric oxygen group (60 min. every day for five days at 2.5 atmosphere absolute), and a cyclosporine + hyperbaric oxygen group (cyclosporine 15 mg/kg/day intraperitoneally for 14 days + hyperbaric oxygen for 60 min at 2.5 atmosphere absolute every day for five days on the last five days of cyclosporine treatment). Oxidative stress was determined by measuring renal thiobarbituric acid-reactive substances content, renal superoxide dismutase, and glutathione peroxidase activities. Cyclosporine increased serum urea and creatinine levels, indicating the development of nephrotoxicity, and induced significant oxidative stress in rat kidneys. Hyperbaric oxygen alone did not alter any of the biochemical and oxidative stress parameters compared to the control group. When used concurrently with cyclosporine, hyperbaric oxygen significantly reduced cyclosporine-induced oxidative stress, but it neither attenuated nor aggravated cyclosporine-induced nephrotoxicity. These results suggest that reactive oxygen species are involved in cyclosporine nephrotoxicity, but are not the direct cause of the toxicity. Although concurrent use of cyclosporine and hyperbaric oxygen did not exacerbate cyclosporine nephrotoxicity in this model, we recommend that the renal functions of patients be monitored periodically when these treatments are used concurrently.
活性氧已被认为与环孢素肾毒性有关。已知高压氧可诱导组织中活性氧的产生。本研究的目的是调查高压氧与环孢素同时使用是否会通过诱导肾脏氧化应激而增强环孢素肾毒性。该研究包括四组大鼠:对照组、环孢素组(腹腔注射15mg/kg/天,共14天)、高压氧组(在2.5绝对大气压下每天60分钟,共五天)和环孢素+高压氧组(在环孢素治疗的最后五天,腹腔注射环孢素15mg/kg/天,共14天,同时每天在2.5绝对大气压下进行60分钟高压氧治疗,共五天)。通过测量肾脏硫代巴比妥酸反应性物质含量、肾脏超氧化物歧化酶和谷胱甘肽过氧化物酶活性来确定氧化应激。环孢素增加了血清尿素和肌酐水平,表明发生了肾毒性,并在大鼠肾脏中诱导了显著的氧化应激。与对照组相比,单独使用高压氧并未改变任何生化和氧化应激参数。当与环孢素同时使用时,高压氧显著降低了环孢素诱导的氧化应激,但既未减轻也未加重环孢素诱导的肾毒性。这些结果表明活性氧与环孢素肾毒性有关,但不是毒性的直接原因。虽然在该模型中环孢素和高压氧同时使用并未加重环孢素肾毒性,但我们建议在同时使用这些治疗方法时定期监测患者的肾功能。