Ma Seong Kwon, Bae Eun Hui, Lee Jongun, Kim Sun Young, Kim Sung Zoo, Choi Ki Chul, Kim Soo Wan
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Department of Physiology, Chonnam National University Medical School, Gwangju, Korea.
Electrolyte Blood Press. 2007 Dec;5(2):55-61. doi: 10.5049/EBP.2007.5.2.55. Epub 2007 Dec 31.
Metabolic acidosis was shown to correlate with deterioration of renal function in patients with rhabdomyolysis. The present study was aimed to investigate whether the changes of type 3 Na(+)/H(+) exchanger (NHE3), type 1 Na(+)/HCO3 (-) cotransporter (NBC1), and Na(+),K(+)-ATPase α1 subunit may play a role in the pathogenesis of metabolic acidosis in glycerol-induced experimental rhabdomyolysis. Male Sprague-Dawley rats were deprived of fluid intake for 24 hours, and then were injected with 50% glycerol in normal saline (10 mL/kg, intramuscularly). At 24 hours after the glycerol injection, rats were sacrificed by decapitation. Control rats were injected with normal saline. The protein expression of NHE3, NBC1 and Na(+),K(+)-ATPase α1 subunit was determined in the cortex of the kidney by immunoblotting and immunohistochemistry. Following the treatment of glycerol, creatinine clearance was significantly decreased, and high anion gap metabolic acidosis developed. In the experimental group, the expression of Na(+),K(+)-ATPase α1 subunit was significantly decreased in the cortex of the kidney. On the contrary, the expression of NHE3 and NBC1 was significantly increased. Immunohistochemical analyses confirmed the immunoblotting data. In conclusion, the coordinate up-regulation of NHE3 and NBC1 may play an adaptive role against the metabolic acidosis in glycerol-induced rhabdomyolysis.
代谢性酸中毒被证明与横纹肌溶解症患者的肾功能恶化相关。本研究旨在调查3型钠氢交换体(NHE3)、1型钠-碳酸氢根协同转运蛋白(NBC1)以及钠钾ATP酶α1亚基的变化是否在甘油诱导的实验性横纹肌溶解症所致代谢性酸中毒的发病机制中起作用。雄性Sprague-Dawley大鼠禁水24小时,然后肌肉注射50%甘油生理盐水(10 mL/kg)。甘油注射后24小时,断头处死大鼠。对照组大鼠注射生理盐水。通过免疫印迹法和免疫组织化学法测定肾皮质中NHE3、NBC1和钠钾ATP酶α1亚基的蛋白表达。甘油处理后,肌酐清除率显著降低,出现高阴离子间隙代谢性酸中毒。在实验组中,肾皮质中钠钾ATP酶α1亚基的表达显著降低。相反,NHE3和NBC1的表达显著增加。免疫组织化学分析证实了免疫印迹数据。总之,NHE3和NBC1的协同上调可能在甘油诱导的横纹肌溶解症所致代谢性酸中毒中发挥适应性作用。