Huri Emre, Haznedaroglu Ibrahim C, Akgul Turgay, Astarci Muzeyyen, Ustun Huseyin, Germiyanoulu Cankon
Department of Second Urology Clinic, Ankara Training and Research Hospital, Ankara, Turkey.
Saudi Med J. 2010 Aug;31(8):864-8.
To investigate the effect of Ankaferd Blood Stopper (ABS), on renal tubular apoptosis and on expressions of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), and apoptosis protease-activating factor-1 (Apaf-1) in the ipsilateral kidney after an experimentally formed partial nephrectomy in a rat model.
The study was performed in 2009 at the Ankara Training and Research Hospital, Animal Laboratory Center, Ankara, Turkey. We divided 24 Wistar rats into the following 4 groups. Group I (GI) - partial nephrectomy (PN) with hilar control as the conventional technique, Group II (GII)-the conventional technique with ABS, Group III (GIII) - received ABS application to the renal parenchyma and collecting duct with hilar control (non-sutured group). Group IV (GIV) - PN and ABS were performed without hilar control. The ABS solution (1 cc) was applied during the surgery to stop bleeding from resected renal tissue. At first month, all rats were sacrificed. Renal tubular apoptosis was investigated.
The mean percentage of apoptotic cell counts in GI were 20% iNOS, 20% eNOS, and 10% Apaf-1. In GII they were 10% iNOS, 20% eNOS, 5% Apaf-1, in GIII they were 40% iNOS, 50% eNOS, 30% Apaf-1, and in GIV they were 5% iNOS, 5% eNOS, and 3% Apaf-1. There was no significant decrease in apoptotic cells in GII, GIII, and GIV, to which we applied ABS. The highest percentage of apoptosis was shown in GIII accompanied by significant inflammation. The lowest percentage was determined in GIV, the non-warm ischemia group. The ABS has a dual biphasic de novo effects on apoptosis.
The challenge of severe hemorrhage in the renal tubular cellular micro-environment causes ABS-induced down-regulations in the expressions of apoptotic molecules, indicating that ABS may act as a topical biological response modifier.
在大鼠模型中，研究安卡芬德止血剂（ABS）对实验性部分肾切除术后同侧肾脏肾小管凋亡以及内皮型一氧化氮合酶（eNOS）、诱导型一氧化氮合酶（iNOS）和凋亡蛋白酶激活因子-1（Apaf-1）表达的影响。
该研究于2009年在土耳其安卡拉培训与研究医院动物实验中心进行。将24只Wistar大鼠分为以下4组。第一组（GI）——采用肾门控制的部分肾切除术（PN）作为传统技术；第二组（GII）——采用传统技术并使用ABS；第三组（GIII）——对肾实质和集合管应用ABS且进行肾门控制（非缝合组）；第四组（GIV）——进行PN和ABS但不进行肾门控制。手术期间应用1毫升ABS溶液以阻止切除肾组织出血。在第一个月时，处死所有大鼠，研究肾小管凋亡情况。
GI组凋亡细胞计数的平均百分比为iNOS 20%、eNOS 20%、Apaf-1 10%。GII组分别为iNOS 10%、eNOS 20%、Apaf-1 5%；GIII组分别为iNOS 40%、eNOS 50%、Apaf-1 30%；GIV组分别为iNOS 5%、eNOS 5%、Apaf-1 3%。在应用了ABS的GII、GIII和GIV组中，凋亡细胞数量无显著减少。GIII组凋亡百分比最高且伴有明显炎症。GIV组（非热缺血组）凋亡百分比最低。ABS对凋亡具有双重双相的新效应。
肾小管细胞微环境中严重出血的挑战导致ABS诱导凋亡分子表达下调，表明ABS可能作为一种局部生物反应调节剂发挥作用。
