Chen Huihui, Zhu Jiefu, Liu Yu, Dong Zheng, Liu Hong, Liu Yinghong, Zhou Xiang, Liu Fuyou, Chen Guochun
Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, PR China.
Am J Nephrol. 2015;42(4):305-17. doi: 10.1159/000441506. Epub 2015 Oct 31.
Septic kidney injury is one of the most common complications in critically ill patients with a high risk of developing chronic kidney disease (CKD). Emerging data indicate that mammalian target of rapamyci (mTOR) signaling plays a major role in septic inflammation by regulating the immune response of macrophage. This study was designed to evaluate the role of mTOR signaling in kidney macrophages during endotoxemia-induced chronic kidney injury and subsequent fibrogenesis.
Male C57BL/6 mice were used for all animal studies (n=9 for each group). Lipopolysaccharide (LPS) was injected intraperitoneally (1 mg/kg) every 2 days to induce persistent endotoxemia. Rapamycin (1 mg/kg·day) was administered to a subgroup of mice 1 day prior to LPS treatment and continued to termination of the experiment. In ex-vivo experiment, RAW264.7 cells were cultured and treated with LPS (2 µg/ml) for 48 h while a subgroup of cells were incubated in the presence of rapamycin (50 nmol) for 2 h.
Continuous administration of LPS resulted in progressive macrophage infiltration, tubular injury and collagen deposition in mice kidneys. Rapamycin markedly ameliorated LPS-induced kidney pathological changes. Expression of pS6K was rarely observed in normal kidney macrophages, but significantly increased with time by LPS treatment. In ex-vivo study, LPS induced prominent production of IL-1β and MCP-1 in cultured RAW264.7 cells, which was significantly suppressed by rapamycin.
Taken together, our findings show that endotoxemia results in activation of mTOR signaling in macrophages, leading to progressive kidney inflammatory injuries and subsequent fibrosis. Our study may reveal a mechanism involved in the development of sepsis-associated CKD and kidney fibrosis.
脓毒症性肾损伤是危重症患者最常见的并发症之一,这些患者发生慢性肾脏病(CKD)的风险很高。新出现的数据表明,雷帕霉素靶蛋白(mTOR)信号通路通过调节巨噬细胞的免疫反应在脓毒症炎症中起主要作用。本研究旨在评估mTOR信号通路在内毒素血症诱导的慢性肾损伤及随后的纤维化过程中在肾脏巨噬细胞中的作用。
所有动物研究均使用雄性C57BL/6小鼠(每组n = 9)。每2天腹腔注射脂多糖(LPS,1 mg/kg)以诱导持续性内毒素血症。在LPS治疗前1天,对一组小鼠给予雷帕霉素(1 mg/kg·天),并持续至实验结束。在体外实验中,培养RAW264.7细胞,并用LPS(2 μg/ml)处理48小时,而一组细胞在雷帕霉素(50 nmol)存在的情况下孵育2小时。
持续给予LPS导致小鼠肾脏中巨噬细胞逐渐浸润、肾小管损伤和胶原沉积。雷帕霉素显著改善了LPS诱导的肾脏病理变化。正常肾脏巨噬细胞中很少观察到pS6K的表达,但LPS处理后其表达随时间显著增加。在体外研究中,LPS诱导培养的RAW264.7细胞中IL-1β和MCP-1的大量产生,而雷帕霉素显著抑制了这种产生。
综上所述,我们的研究结果表明,内毒素血症导致巨噬细胞中mTOR信号通路激活,导致进行性肾脏炎性损伤及随后的纤维化。我们的研究可能揭示了脓毒症相关CKD和肾脏纤维化发生发展的一种机制。