Denver Veterans Affairs Medical Center and Division of Renal Diseases and Hypertension, Anschutz Medical Campus, University of Colorado, Aurora, CO 80262, USA.
Transplantation. 2011 Dec 15;92(11):1215-21. doi: 10.1097/TP.0b013e3182366401.
We have previously shown that cold ischemia (CI) results in massive increases in caspase-3 activity, tubular apoptosis, and brush border injury (BBI) in mouse kidneys. During hibernation, the 13-lined ground squirrel (GS) cycles through repeated CI during torpor, followed by warm ischemia/reperfusion (WI) during interbout arousal (IBA). We sought to determine whether CI and WI during hibernation caused caspase-3 activation, tubular apoptosis, acute tubular necrosis, or BBI, and reduced renal function. We also determined whether protection was dependent on the stage of hibernation.
Radiotelemeters were implanted in 1-year-old GS, and core body temperature was remotely monitored. GS kidneys at various stages of hibernation were subjected to ex vivo CI.
Tubular apoptosis was not detected and caspase-3-like activity was not different between hibernating and summer kidneys. Despite prolonged CI followed by WI and reperfusion, acute tubular necrosis and apoptosis did not occur in hibernating kidneys. BBI was absent in torpid kidneys but significantly increased in IBA kidneys and associated with an increase in caspase-3-like activity, suggesting that IBA kidneys are more susceptible to injury than summer or torpid kidneys. Renal function and urine concentrating ability diminished during torpor but returned during IBA.
Despite BBI, IBA kidneys clear serum creatinine and concentrate urine. Kidneys from both summer and hibernating animals tolerated ex vivo CI, confirming that protection from apoptotic and necrotic cell death is independent of the stage of hibernation. An understanding of how renal protection occurs during hibernation may help in understanding the pathophysiology of delayed graft function.
我们之前已经证明,冷缺血(CI)会导致小鼠肾脏中的 caspase-3 活性、管状细胞凋亡和刷状缘损伤(BBI)大量增加。在冬眠期间,十三线地松鼠(GS)在蛰伏期间经历反复的 CI,然后在唤醒期(IBA)经历温缺血/再灌注(WI)。我们试图确定冬眠期间的 CI 和 WI 是否会引起 caspase-3 激活、管状细胞凋亡、急性肾小管坏死或 BBI,并降低肾功能。我们还确定了保护作用是否取决于冬眠的阶段。
在 1 岁的 GS 中植入无线电遥测仪,并远程监测核心体温。在冬眠的各个阶段,GS 肾脏均进行离体 CI。
未检测到管状细胞凋亡,冬眠和夏季肾脏之间的 caspase-3 样活性无差异。尽管 CI 时间延长,随后进行 WI 和再灌注,但冬眠肾脏并未发生急性肾小管坏死和凋亡。在蛰伏期,BBI 不存在,但在 IBA 期明显增加,且与 caspase-3 样活性增加相关,表明 IBA 期肾脏比夏季或蛰伏期肾脏更容易受到损伤。在蛰伏期,肾功能和尿液浓缩能力下降,但在 IBA 期恢复。
尽管存在 BBI,IBA 肾脏仍能清除血清肌酐并浓缩尿液。来自夏季和冬眠动物的肾脏均可耐受离体 CI,证实了对凋亡和坏死性细胞死亡的保护作用与冬眠阶段无关。了解在冬眠期间如何发生肾脏保护作用,可能有助于理解延迟移植物功能障碍的病理生理学。