Nephrology, Hannover Medical School , Hannover , Germany.
The Transplantation Center of the Affiliated Hospital, Zunyi Medical College, Zunyi, China.
Am J Physiol Renal Physiol. 2018 May 1;314(5):F881-F892. doi: 10.1152/ajprenal.00519.2016. Epub 2017 Dec 20.
Renal ischemia-reperfusion injury (IRI) is a severe complication of major surgery and a risk factor for increased morbidity and mortality. Here, we investigated mechanisms that might contribute to IRI-induced progression to chronic kidney disease (CKD). Acute kidney injury (AKI) was induced by unilateral IRI for 35 min in CD1 and C57BL/6 (B6) mice. Unilateral IRI was used to overcome early mortality. Renal morphology, NGAL upregulation, and neutrophil infiltration as well as peritubular capillary density were studied by immunohistochemistry. The composition of leukocyte infiltrates in the kidney after IRI was investigated by flow cytometry. Systemic blood pressure was measured with a tail cuff, and renal perfusion was quantified by functional magnetic resonance imaging (fMRI). Mesangial matrix expansion was assessed by silver staining. Following IRI, CD1 and B6 mice developed similar morphological signs of AKI and increases in NGAL expression, but neutrophil infiltration was greater in CD1 than B6 mice. IRI induced an increase in systemic blood pressure of 20 mmHg in CD1, but not in B6 mice; and CD1 mice also had a greater loss of renal perfusion and kidney volume than B6 mice ( P < 0.05). CD1 mice developed substantial interstitial fibrosis and decreased peritubular capillary (PTC) density by day 14 while B6 mice showed only mild renal scarring and almost normal PTC. Our results show that after IRI, CD1 mice develop more inflammation, hypertension, and later mesangial matrix expansion than B6 mice do. Subsequently, CD1 animals suffer from CKD due to impaired renal perfusion and pronounced permanent loss of peritubular capillaries.
肾缺血再灌注损伤(IRI)是大手术的严重并发症,也是发病率和死亡率增加的危险因素。在这里,我们研究了可能导致 IRI 进展为慢性肾脏病(CKD)的机制。在 CD1 和 C57BL/6(B6)小鼠中,通过单侧 IRI 诱导 35 分钟的急性肾损伤(AKI)。单侧 IRI 用于克服早期死亡率。通过免疫组织化学研究肾脏形态、NGAL 上调、中性粒细胞浸润和肾小管周围毛细血管密度。通过流式细胞术研究 IRI 后肾脏中白细胞浸润的组成。用尾套测量系统血压,用功能磁共振成像(fMRI)定量测量肾灌注。用银染评估系膜基质扩张。IRI 后,CD1 和 B6 小鼠均表现出类似的 AKI 形态学特征和 NGAL 表达增加,但 CD1 小鼠的中性粒细胞浸润高于 B6 小鼠。IRI 诱导 CD1 小鼠的系统血压升高 20mmHg,但 B6 小鼠没有;而且 CD1 小鼠的肾灌注和肾体积丢失也比 B6 小鼠更严重(P<0.05)。CD1 小鼠在第 14 天发生大量间质纤维化和肾小管周围毛细血管(PTC)密度降低,而 B6 小鼠仅表现出轻度肾瘢痕和几乎正常的 PTC。我们的结果表明,IRI 后,CD1 小鼠比 B6 小鼠表现出更多的炎症、高血压和随后的系膜基质扩张。随后,由于肾灌注受损和肾小管周围毛细血管明显永久性丢失,CD1 动物患有 CKD。