Department of Emergency Medicine, Renmin Hospital of Wuhan University, Wuhan, China.
Kidney Int. 2012 Aug;82(4):436-44. doi: 10.1038/ki.2012.186.
It is assumed that acute myocardial infarction affects renal function. To study the mechanism, we used mice following permanent ligation of their left coronary artery that results in extensive myocardial infarction. Soon after ligation, there was a marked rise in circulating pro-inflammatory cytokines and malondialdehyde (thiobarbituric acid-positive evidence of lipid peroxidation). Renal function had significantly declined by the third day in association with mild fibrosis, and swelling of glomeruli and tubules. There was a significant increase in the expression of the lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), interelukin-1β, vascular cell adhesion molecule-1, and thiobarbituric acid-reactive substances in the kidney. Renal function showed some recovery by Day 21; however, there was progressive fibrosis of the kidneys. LOX-1 knockout mice had significantly diminished increases in systemic and renal pro-inflammatory cytokines, malondialdehyde, structural alterations, and decline in renal function than the wild-type mice following ligation of the left coronary artery. Cardiac function and survival rates were also significantly better in the LOX-1 knockout mice than in the wild-type mice. Hence, severe myocardial ischemia results in renal dysfunction and histological abnormalities suggestive of acute renal injury. Thus, LOX-1 is a key modulator among multiple mechanisms underlying renal dysfunction following extensive myocardial infarction.
据认为,急性心肌梗死会影响肾功能。为了研究其机制,我们使用了永久性结扎左冠状动脉的小鼠,这会导致广泛的心肌梗死。结扎后不久,循环中促炎细胞因子和丙二醛(脂质过氧化的硫代巴比妥酸阳性证据)明显升高。肾功能在第三天显著下降,伴有轻度纤维化、肾小球和肾小管肿胀。肾脏中凝集素样氧化低密度脂蛋白受体-1(LOX-1)、白细胞介素-1β、血管细胞黏附分子-1 和硫代巴比妥酸反应物质的表达显著增加。第 21 天肾功能有所恢复;然而,肾脏的纤维化逐渐加重。与野生型小鼠相比,左冠状动脉结扎后,LOX-1 基因敲除小鼠的全身和肾脏促炎细胞因子、丙二醛、结构改变以及肾功能下降的增加明显减少。LOX-1 基因敲除小鼠的心脏功能和存活率也明显优于野生型小鼠。因此,严重的心肌缺血会导致肾功能障碍和组织学异常,提示急性肾损伤。因此,LOX-1 是广泛心肌梗死后肾功能障碍多种机制中的关键调节因子。