Fontana J, Vogt A, Hohenstein A, Vettermann U, Doroshenko E, Lammer E, Yard B A, Hoeger S
Department of Anesthesiology, Klinikum Memmingen, Memmingen, Germany.
Bioassay GmbH, Heidelberg, Germany.
Indian J Nephrol. 2017 Sep-Oct;27(5):365-371. doi: 10.4103/ijn.IJN_40_17.
Inflammation plays a crucial role in acute kidney injury (AKI). The current study was designed to analyze the influence of prednisolone treatment on the inflammatory reaction during the first 96 h after AKI induction in a rat model. AKI was induced by unilateral clipping of the renal vessels. The treatment group received prednisolone 5 mg/kg s.c. daily. Infiltration rates of macrophages, leukocytes, and T-cells (24, 96 h) as well as plasma concentrations of the inflammatory markers intercellular adhesion molecule, interleukin-1 beta (IL-1β), IL-18, IL-6, and tumor necrosis factor-alpha (0, 6, 24, 96 h) were determined by fluorescence-activated cell sorting (FACS) analysis only. Ninety-six hours after AKI induction, the prednisolone group demonstrated significantly lower creatinine concentrations compared to the control group ( < 0.05). Twenty-four hours after induction of AKI, a significantly higher rate of infiltrating leukocytes was detectable with FACS analysis in the control group ( < 0.01) with a corresponding significantly higher rate of macrophages after 96 h ( < 0.01). IL-6 and IL-1β demonstrated a peak after 6 h with a significantly higher release in the control group (IL-6: < 0.01; IL-1β: < 0.05). In contrast to the control group, the prednisolone group demonstrated no further incline of IL-18 after 24 h. The results demonstrate the importance of stretching the observation period in an ischemia-reperfusion-induced AKI setting beyond the first 24 h. Despite the demonstrated protective effects of a continuous prednisolone application, it seems that this single anti-inflammatory agent will not be able to completely suppress the inflammatory response after an ischemia-reperfusion-induced AKI.
炎症在急性肾损伤(AKI)中起关键作用。本研究旨在分析泼尼松龙治疗对大鼠AKI诱导后最初96小时内炎症反应的影响。通过单侧夹闭肾血管诱导AKI。治疗组每天皮下注射5mg/kg泼尼松龙。仅通过荧光激活细胞分选(FACS)分析测定巨噬细胞、白细胞和T细胞的浸润率(24、96小时)以及炎症标志物细胞间黏附分子、白细胞介素-1β(IL-1β)、IL-18、IL-6和肿瘤坏死因子-α的血浆浓度(0、6、24、96小时)。AKI诱导96小时后,泼尼松龙组的肌酐浓度显著低于对照组(<0.05)。AKI诱导24小时后,对照组通过FACS分析可检测到浸润白细胞的比例显著更高(<0.01),96小时后巨噬细胞比例相应显著更高(<0.01)。IL-6和IL-1β在6小时后达到峰值,对照组的释放量显著更高(IL-6:<0.01;IL-1β:<0.05)。与对照组相比,泼尼松龙组在24小时后IL-18没有进一步升高。结果表明,在缺血再灌注诱导的AKI环境中,将观察期延长至24小时以上具有重要意义。尽管持续应用泼尼松龙已显示出保护作用,但这种单一的抗炎药物似乎无法完全抑制缺血再灌注诱导的AKI后的炎症反应。