Department of Nephrology, Eulji University Hospital, Korea.
Nephrology (Carlton). 2011 Feb;16(2):163-73. doi: 10.1111/j.1440-1797.2010.01386.x.
Hepatic ischaemia/reperfusion injury (IRI) frequently complicates acute kidney injury (AKI) during the perioperative period. This study was to determine whether hepatic IRI causes AKI and the effect of the sphingosine-1-phosphate (S1P) on AKI.
S1P and vehicle were given to mice before ischaemia and mice were subjected to hepatic IRI. Plasma creatinine (PCr), alanine transaminase (ALT), urinary neutrophil gelatinase-associated lipocalin (NGAL) and renal histological changes were determined. As a marker of endothelial injury, vascular permeability was measured. The effect of VPC 23019, a S1P(1) receptor antagonist, was also assessed.
Hepatic IRI resulted in liver injury (increased ALT) and systemic inflammation. Kidneys showed elevated inflammatory cytokines, leucocyte infiltration, increased vascular permeability, tubular cell apoptosis and increased urinary NGAL, although PCr did not increase. Pretreatment with S1P resulted in an attenuation of systemic inflammation and kidney injury without any effect on plasma ALT or peripheral lymphocytes. The protective effect of S1P was partially reversed by VPC 23019, suggesting the important contribution of the S1P/S1P(1) pathway to protect against hepatic IRI-induced AKI.
The study data demonstrate the important contribution of systemic inflammation and endothelial injury to AKI following hepatic IRI. Modulation of the S1P/S1P(1) receptor pathway might have some therapeutic potential in hepatic IRI-induced kidney injury.
肝缺血/再灌注损伤(IRI)在围手术期常并发急性肾损伤(AKI)。本研究旨在确定肝IRI 是否导致 AKI 以及鞘氨醇-1-磷酸(S1P)对 AKI 的影响。
在缺血前给予 S1P 和载体,并使小鼠发生肝 IRI。测定血浆肌酐(PCr)、丙氨酸转氨酶(ALT)、尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和肾脏组织学变化。血管通透性作为内皮损伤的标志物进行测量。还评估了 S1P(1)受体拮抗剂 VPC 23019 的作用。
肝 IRI 导致肝脏损伤(ALT 升高)和全身炎症。肾脏表现出炎症细胞因子升高、白细胞浸润、血管通透性增加、肾小管细胞凋亡和尿 NGAL 增加,尽管 PCr 没有增加。S1P 预处理可减轻全身炎症和肾脏损伤,对血浆 ALT 或外周淋巴细胞无影响。VPC 23019 部分逆转了 S1P 的保护作用,表明 S1P/S1P(1)途径对防止肝 IRI 引起的 AKI 有重要贡献。
研究数据表明,全身炎症和内皮损伤对肝 IRI 后 AKI 有重要贡献。S1P/S1P(1)受体途径的调节可能对肝 IRI 引起的肾损伤具有一定的治疗潜力。