Tokuyama Hirobumi, Kelly Darren J, Zhang Yuan, Gow Renae M, Gilbert Richard E
Department of Medicine, St. Vincent's Hospital, University of Melbourne, Melbourne, Vic., Australia.
Nephron Physiol. 2007;106(3):p54-62. doi: 10.1159/000103910. Epub 2007 Jun 15.
BACKGROUND/AIMS: Although ischemic renal failure remains a major cause of morbidity and mortality, whether ischemic changes within a kidney might also have adverse effects on other organs has not been examined. Furthermore, given the protective effects of angiotensin II receptor (AT1) antagonism in renal ischemia, we considered whether a similar strategy might also modulate the response to acute renal insult.
Unilateral renal artery ligation was performed in Sprague-Dawley rats, treated with or without the AT1 antagonist losartan (30 mg/kg/day). After 24 h of renal ischemia, changes in the contralateral kidney and heart were examined.
Contralateral non-ischemic kidneys displayed increased expression of platelet-derived growth factor-B (PDGF-B) in association with increased tubular cell proliferation. Gene expression for the macrophage chemokine osteopontin (OPN) was similarly increased along with substantial macrophage infiltration. In the heart, expression of OPN and macrophage numbers were increased. All of these changes, in both the heart and kidney were attenuated by losartan.
Rather than affecting a single organ, the present study demonstrates that after prolonged renal ischemia, the contralateral kidney and heart undergo changes in growth factor and chemokine expression, resulting in pathological proliferation and inflammation that can be modulated by blockade of the AT1 receptor.
背景/目的:尽管缺血性肾衰竭仍是发病和死亡的主要原因,但肾脏内的缺血变化是否也会对其他器官产生不利影响尚未得到研究。此外,鉴于血管紧张素II受体(AT1)拮抗作用在肾缺血中的保护作用,我们考虑类似的策略是否也能调节对急性肾损伤的反应。
对Sprague-Dawley大鼠进行单侧肾动脉结扎,分别给予或不给予AT1拮抗剂氯沙坦(30毫克/千克/天)。肾缺血24小时后,检查对侧肾脏和心脏的变化。
对侧非缺血性肾脏中血小板衍生生长因子-B(PDGF-B)表达增加,同时肾小管细胞增殖增加。巨噬细胞趋化因子骨桥蛋白(OPN)的基因表达同样增加,同时伴有大量巨噬细胞浸润。在心脏中,OPN表达和巨噬细胞数量增加。氯沙坦减轻了心脏和肾脏中的所有这些变化。
本研究表明,长时间肾缺血后,对侧肾脏和心脏的生长因子和趋化因子表达发生变化,导致病理性增殖和炎症,而非仅影响单个器官,且这种变化可通过阻断AT1受体来调节。