Taipei, Taiwan From the Division of Plastic Surgery, Department of Surgery, Division of Nephrology, Department of Medicine, and Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital; and School of Medicine, Department and Institute of Physiology, Institute of Clinical Medicine, and Institute of Pharmacology, National Yang-Ming University.
Plast Reconstr Surg. 2013 Dec;132(6):940e-951e. doi: 10.1097/PRS.0b013e3182a806ce.
Acute kidney injury is a major challenge in critical care medicine, with high rates of in-hospital morbidity and mortality. Stem cell therapy has emerged as an evolving technology that could have a substantial impact on acute kidney injury outcomes in the critical care environment. Therefore, the authors investigated the therapeutic effects of adipose-derived stem cells in ischemic acute kidney injury in rats.
The authors used an ischemia-reperfusion-induced acute kidney injury rat model. The effects of rescuing acute kidney injury were assessed with regard to different adipose-derived stem cell numbers and various routes of administration compared with sham-operated and phosphate-buffered saline-treated groups.
Both intrarenal arterial and intravenous administration of adipose-derived stem cells reduced blood urea nitrogen and creatinine levels, and also decreased the tubular injury score 48 hours after ischemia-reperfusion-induced acute kidney injury in a dose-dependent manner, compared with the phosphate-buffered saline-treated group. In the authors' study, it was determined that the optimal cell number was 5 × 10. Furthermore, adipose-derived stem cell transplantation exhibited antioxidative and antiinflammatory properties to reduce apoptosis and promote proliferation of renal tubular cells.
An optimal number of adipose-derived stem cells administered by means of the intrarenal arterial or the intravenous route effectively rescued ischemia-reperfusion-induced acute kidney injury in rats. Antioxidative and antiapoptotic properties of adipose-derived stem cells to reduce tubular cell injury also merit recognition and further study.
急性肾损伤是重症医学中的一个主要挑战,其院内发病率和死亡率都很高。干细胞治疗是一种新兴技术,可能会对重症监护环境中急性肾损伤的结果产生重大影响。因此,作者研究了脂肪源性干细胞在大鼠缺血性急性肾损伤中的治疗作用。
作者使用了缺血再灌注诱导的急性肾损伤大鼠模型。通过与假手术组和磷酸盐缓冲盐水治疗组相比,评估了不同数量的脂肪源性干细胞和不同给药途径对急性肾损伤的抢救效果。
与磷酸盐缓冲盐水治疗组相比,肾内动脉和静脉内注射脂肪源性干细胞均可降低血尿素氮和肌酐水平,并在缺血再灌注诱导的急性肾损伤后 48 小时呈剂量依赖性降低肾小管损伤评分。在作者的研究中,确定最佳细胞数为 5×10。此外,脂肪源性干细胞移植具有抗氧化和抗炎特性,可减少细胞凋亡并促进肾小管细胞增殖。
通过肾内动脉或静脉途径给予最佳数量的脂肪源性干细胞可有效抢救大鼠缺血再灌注诱导的急性肾损伤。脂肪源性干细胞的抗氧化和抗细胞凋亡特性可减少肾小管细胞损伤,这一点值得关注和进一步研究。