Zhang Jun, Fallahzadeh Mohammad Kazem, McCullough Peter A
Baylor Heart and Vascular Institute, Dallas, Tex., USA.
Department of Internal Medicine, Baylor University Medical Center, Dallas, Tex., USA.
Cardiorenal Med. 2016 Nov;7(1):1-10. doi: 10.1159/000447542. Epub 2016 Jul 21.
Although there are some animal models for biomarkers of contrast-induced acute kidney injury (CI-AKI), for cardiorenal syndrome (CRS) and for acute renal failure, the interplay between CI-AKI and CRS has yet to be evaluated. Insight into the pathogenesis of CRS is urgently needed from animal models in order to foster the discovery and implementation of novel biomarkers for this disease. Specially designed animal models for type 1 and 3 CRS, particularly CI-AKI, have not yet emerged.
We hypothesize that the aging male spontaneously hypertensive rat (SHR) is likely to be a suitable model. The SHR model is able to mimic risk factors for preclinical CRS that appears in the clinical setting, specifically hypertension, age, preexisting damage and dysfunction of the heart and kidney, endothelial dysfunction, increased level of reactive oxygen species, decreased level and bioavailability of nitric oxide (NO), impairment of the L-arginine-NO pathway, and insulin resistance. In the SHR, CI-AKI results in a different profile of AKI biomarkers than is seen with preexisting chronic kidney injury.
The SHR model can be used to evaluate the interaction between CI-AKI and CRS type 1 and 3 and to verify neutrophil gelatinase-associated lipocalin (NGAL) as a reliable CI-AKI biomarker for clinical application. Further research is warranted with a large number of aging male SHRs to prove NGAL as a sensitive, specific, highly predictive, early biomarker for CI-AKI.
尽管存在一些用于对比剂诱导的急性肾损伤(CI-AKI)、心肾综合征(CRS)和急性肾衰竭生物标志物研究的动物模型,但CI-AKI与CRS之间的相互作用尚未得到评估。迫切需要从动物模型中深入了解CRS的发病机制,以促进该疾病新型生物标志物的发现和应用。专门设计用于1型和3型CRS,特别是CI-AKI的动物模型尚未出现。
我们假设老龄雄性自发性高血压大鼠(SHR)可能是一种合适的模型。SHR模型能够模拟临床环境中出现的临床前期CRS的危险因素,特别是高血压、年龄、心脏和肾脏预先存在的损伤和功能障碍、内皮功能障碍、活性氧水平升高、一氧化氮(NO)水平和生物利用度降低、L-精氨酸-NO途径受损以及胰岛素抵抗。在SHR中,CI-AKI导致的急性肾损伤生物标志物谱与预先存在的慢性肾损伤不同。
SHR模型可用于评估CI-AKI与1型和3型CRS之间的相互作用,并验证中性粒细胞明胶酶相关脂质运载蛋白(NGAL)作为临床应用中可靠的CI-AKI生物标志物。有必要对大量老龄雄性SHR进行进一步研究,以证实NGAL作为CI-AKI敏感、特异、高度预测性的早期生物标志物。