Sue Yuh-Mou, Cheng Ching-Feng, Chang Chih-Cheng, Chou Ying, Chen Cheng-Hsien, Juan Shu-Hui
1Department of Nephrology, Taipei Medical University, Wan Fang Hospital, Taipei, Taiwan.
Nephrol Dial Transplant. 2009 Mar;24(3):769-77. doi: 10.1093/ndt/gfn545. Epub 2008 Oct 8.
Gentamicin, a widely used antibiotic for the treatment of bacterial infection, can cause nephrotoxicity. Tetramethylpyrazine (TMP) is a compound purified from the rhizome of Ligusticum wallichi (called chuanxiong in Chinese). Besides its protection against ischaemia-reperfusion injury and nephritis in mice, we previously reported that TMP reverses gentamicin-induced apoptosis in rat kidneys. Haem oxygenase-1 (HO-1) induction by TMP has also been shown to attenuate myocardial ischaemia/reperfusion injury in rats.
We used rat renal tubular (NRK-52E) cells, transformed cells with HO-1 overexpression or knockdown, and an adenovirus carrying the HO-1 gene (Adv-HO-1) as gene therapy targeting murine kidneys to explore the role of HO-1 in protection by TMP against gentamicin-induced toxicity both in vitro and in vivo. We evaluated the protective effects of HO-1 on several apoptotic parameters induced by gentamicin: cleaved caspases-3 and -9, cycloxygenase-2 (Cox-2) and subcellular localization of nuclear factor kappa B-p65 (NF-kappaB-p65), Bcl-xl and HS-1-associated protein (Hax-1) in NRK-52E cells.
NRK-52E cells treated with TMP exhibited transcriptional upregulation of the HO-1 protein by approximately twofold. Overexpression of HO-1 in NRK-52E cells significantly increased mitochondrial protein levels of the antiapoptotic molecules, Bcl-xL and Hax-1, and markedly decreased the NADPH oxidase activity and proinflammatory molecules, NF-kappaB-p65 and Cox-2, which might decrease gentamicin-induced activation of caspases-9 and -3. Conversely, NRK-52E cells with HO-1 knockdown significantly exacerbated gentamicin-induced tubular cell apoptosis. Additionally, the concomitant HO-1 induction by TMP was also evident in vivo, and HO-1 therapy markedly attenuated gentamicin-induced renal apoptosis to a similar extent as TMP pretreatment.
Collectively, we suggest that HO-1 induced by TMP might, at least in part, protect against gentamicin-induced nephrotoxicity through antiapoptotic and anti-inflammatory mechanisms, and that it may have therapeutic potential for patients with renal disease. This is also the first demonstration that HO-1 increases Hax-1 mitochondrial localization.
庆大霉素是一种广泛用于治疗细菌感染的抗生素,可导致肾毒性。川芎嗪(TMP)是从川芎根茎中提纯的一种化合物。除了对小鼠缺血再灌注损伤和肾炎具有保护作用外,我们之前还报道过TMP可逆转庆大霉素诱导的大鼠肾脏细胞凋亡。TMP诱导的血红素加氧酶-1(HO-1)也已被证明可减轻大鼠心肌缺血/再灌注损伤。
我们使用大鼠肾小管(NRK-52E)细胞、HO-1过表达或敲低的转化细胞,以及携带HO-1基因的腺病毒(Adv-HO-1)作为针对小鼠肾脏的基因治疗手段,来探究HO-1在TMP对庆大霉素诱导的毒性的体外和体内保护作用中的角色。我们评估了HO-1对庆大霉素诱导的几种凋亡参数的保护作用:NRK-52E细胞中裂解的半胱天冬酶-3和-9、环氧化酶-2(Cox-2)以及核因子κB-p65(NF-κB-p65)、Bcl-xl和HS-1相关蛋白(Hax-1)的亚细胞定位。
用TMP处理的NRK-52E细胞表现出HO-1蛋白转录上调约两倍。NRK-52E细胞中HO-1的过表达显著增加了抗凋亡分子Bcl-xL和Hax-1的线粒体蛋白水平,并显著降低了NADPH氧化酶活性以及促炎分子NF-κB-p65和Cox-2,这可能会减少庆大霉素诱导的半胱天冬酶-9和-3的激活。相反,HO-1敲低的NRK-52E细胞显著加剧了庆大霉素诱导的肾小管细胞凋亡。此外,TMP在体内伴随的HO-1诱导也很明显,并且HO-1治疗显著减轻了庆大霉素诱导的肾脏细胞凋亡,其程度与TMP预处理相似。
总体而言,我们认为TMP诱导的HO-1可能至少部分地通过抗凋亡和抗炎机制来保护机体免受庆大霉素诱导的肾毒性,并且它可能对肾病患者具有治疗潜力。这也是首次证明HO-1可增加Hax-1的线粒体定位。