Choi Eun Kyung, Jung Hoon, Kwak Kyung Hwa, Yi Soo Jin, Lim Jung A, Park Sol Hee, Park Jun-Mo, Kim Sioh, Jee Dae-Lim, Lim Dong Gun
From the *Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Korea; and †Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Anesth Analg. 2017 Jan;124(1):204-213. doi: 10.1213/ANE.0000000000001565.
Superoxide, nitric oxide (NO), and peroxynitrite are important mediators in the pathogenesis of ischemia-reperfusion (I/R) injury. We tested the renoprotective effects of allopurinol (ALP), a xanthine oxidase inhibitor, N-nitro-L-arginine methyl ester (L-NAME), and 5,10,15,20-tetrakis (N-methyl-4-pyridyl) porphyrinato iron (III) (FeTMPyP) by selective inhibition of superoxide, NO, and peroxynitrite, respectively.
Male Sprague-Dawley rats were randomly assigned to 5 groups (n = 6 per group). Group 1 was a sham-operated group. Group 2 was the renal I/R group (30-minute ischemia followed by 24-hour reperfusion). Rats in groups 3, 4, and 5 received ALP, L-NAME, or FeTMPyP, respectively, at 5 minutes before the reperfusion. Serum creatinine (Cr), blood urea nitrogen (BUN), renal tissue malondialdehyde, superoxide dismutase, histological changes, apoptosis, and monocyte infiltration were evaluated. In addition, the combined treatment with ALP and L-NAME was compared with FeTMPyP in a second independent experiment.
The administration of ALP, L-NAME, and FeTMPyP diminished the increase in Cr (P = .0066 for all) and BUN (P = .0066 for ALP; and P = .013 for L-NAME) induced by I/R injury and decreased the histological damage (P = .0066 for all). In addition, ALP, L-NAME, and FeTMPyP attenuated the oxidative stress response as determined by a decrease in malondialdehyde level (P = .0066 for all), apoptotic renal tubular cells (P = .0066 for all), and monocyte infiltration (P = .0066 for all). The combined treatment of ALP and L-NAME decreased Cr and BUN levels to a greater degree than FeTMPyP (P = .016 for Cr; P = .0079 for BUN).
Superoxide, NO, and peroxynitrite are involved in renal I/R injury. The reduction of peroxynitrite formation, via inhibition of superoxide or NO, or the induction of peroxynitrite decomposition may be beneficial in renal I/R injury.
超氧化物、一氧化氮(NO)和过氧亚硝酸盐是缺血再灌注(I/R)损伤发病机制中的重要介质。我们分别通过选择性抑制超氧化物、NO和过氧亚硝酸盐,测试了黄嘌呤氧化酶抑制剂别嘌呤醇(ALP)、N-硝基-L-精氨酸甲酯(L-NAME)和5,10,15,20-四(N-甲基-4-吡啶基)卟啉铁(III)(FeTMPyP)的肾脏保护作用。
将雄性Sprague-Dawley大鼠随机分为5组(每组n = 6)。第1组为假手术组。第2组为肾脏I/R组(缺血30分钟,随后再灌注24小时)。第3、4和5组的大鼠在再灌注前5分钟分别接受ALP、L-NAME或FeTMPyP。评估血清肌酐(Cr)、血尿素氮(BUN)、肾组织丙二醛、超氧化物歧化酶、组织学变化、细胞凋亡和单核细胞浸润。此外,在第二个独立实验中,将ALP和L-NAME的联合治疗与FeTMPyP进行了比较。
给予ALP、L-NAME和FeTMPyP可减轻I/R损伤诱导的Cr(所有P = 0.0066)和BUN(ALP的P = 0.0066;L-NAME的P = 0.013)升高,并减少组织学损伤(所有P = 0.0066)。此外,ALP、L-NAME和FeTMPyP减轻了氧化应激反应,表现为丙二醛水平降低(所有P = 0.0066)、肾小管细胞凋亡(所有P = 0.0066)和单核细胞浸润减少(所有P = 0.0066)。ALP和L-NAME的联合治疗比FeTMPyP更显著地降低了Cr和BUN水平(Cr的P = 0.016;BUN的P = 0.0079)。
超氧化物、NO和过氧亚硝酸盐参与肾脏I/R损伤。通过抑制超氧化物或NO减少过氧亚硝酸盐的形成,或诱导过氧亚硝酸盐分解,可能对肾脏I/R损伤有益。