Cai Jieru, Yu Xiaofang, Zhang Bingying, Zhang Hui, Fang Yi, Liu Shaopeng, Liu Tongqiang, Ding Xiaoqiang
Division of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Am J Nephrol. 2014;39(6):466-75. doi: 10.1159/000362623. Epub 2014 May 17.
To investigate the impacts of combinatorial atorvastatin (Ator) perioperative administration and mesenchymal stem cell (MSC) implantation on therapeutic effects in the rat experimental acute kidney injury.
The model of renal ischemia-reperfusion (I/R) injury was induced by the release of bilateral renal pedicle clamps following 45 min of occlusion. Immediately after reperfusion, CM-Dil-labeled MSCs (1 × 10(6) cells) or vehicles only were administered through the carotid artery of the animals pretreated with or without Ator.
The combined treatment with Ator and MSCs (Ator+MSCs) markedly reduced the elevated levels of serum creatinine and blood urea nitrogen, as well as the severity of renal damage 24 h after I/R injury. In addition, we also observed inhibition of renal tubular cell apoptosis and promotion of proliferation in the Ator+MSCs group compared with the other groups. Consistent with the improvement in renal function and morphology, Ator pretreatment significantly ameliorated oxidative stress, inhibited inflammation response, and increased the viability of implanted MSCs. With regard to the further mechanism, we found that the expression of Toll-like receptor 4 (TLR4) and high-mobility group box 1, potential mediators of innate immunity, was significantly decreased in the Ator-treated groups.
Ator treatment may protect the kidney undergoing I/R injury through suppression of TLR4 signaling, creating a better environment for the survival of grafted MSCs. The extra benefit of the Ator+MSCs combined therapy may result from the Ator-mediated inhibition of oxidative stress and inflammation in the ischemic kidney.
研究围手术期联合使用阿托伐他汀(Ator)及植入间充质干细胞(MSC)对大鼠实验性急性肾损伤治疗效果的影响。
通过夹闭双侧肾蒂45分钟后松开,诱导肾缺血再灌注(I/R)损伤模型。再灌注后立即通过颈动脉给预先用或未用Ator处理的动物注射CM-Dil标记的MSC(1×10⁶个细胞)或仅注射赋形剂。
Ator与MSC联合治疗(Ator+MSC)显著降低了I/R损伤24小时后血清肌酐和血尿素氮的升高水平以及肾损伤的严重程度。此外,与其他组相比,我们还观察到Ator+MSC组肾小管细胞凋亡受到抑制且细胞增殖增加。与肾功能和形态学的改善一致,Ator预处理显著减轻了氧化应激,抑制了炎症反应,并提高了植入MSC的活力。关于进一步的机制,我们发现Ator治疗组中先天免疫的潜在介质Toll样受体4(TLR4)和高迁移率族蛋白B1的表达显著降低。
Ator治疗可能通过抑制TLR4信号通路保护遭受I/R损伤的肾脏,为移植的MSC存活创造更好的环境。Ator+MSC联合治疗的额外益处可能源于Ator介导的对缺血肾脏氧化应激和炎症的抑制。