Fischer Dania, Seifen Christopher, Baer Patrick, Jung Michaela, Mertens Christina, Scheller Bertram, Zacharowski Kai, Hofmann Rainer, Maier Thorsten J, Urbschat Anja
Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt, Germany.
Clinic of Internal Medicine III, Division of Nephrology, University Hospital Frankfurt, Frankfurt, Germany.
Front Pharmacol. 2018 Apr 27;9:369. doi: 10.3389/fphar.2018.00369. eCollection 2018.
Early and adequate restoration of endothelial and tubular renal function is a substantial step during regeneration after ischemia reperfusion (IR) injury, occurring, e.g., in kidney transplantation, renal surgery, and sepsis. While tubular epithelial cell injury has long been of central importance, recent perception includes the renal vascular endothelium. In this regard, the fibrin cleavage product fibrinopeptide Bβ mitigate IR injury by stabilizing interendothelial junctions through its affinity to VE-cadherin. Therefore, this study focused on the effect of Bβ on post-acute physiological renal regeneration. For this, adult male C57BL/6 mice were exposed to a 30 min bilateral renal ischemia and reperfusion for 24 h or 48 h. Animals were randomized in a non-operative control group, two operative groups each treated with i.v. administration of either saline or Bβ (2.4 mg/kg) immediately prior to reperfusion. Endothelial activation and inflammatory response was attenuated in renal tissue homogenates by single application of Bβ. Meanwhile, Bβ did not affect acute kidney injury markers. Regarding the angiogenetic players VEGF-A, Angiopoietin-1, Angiopoietin-2, however, we observed significant higher expressions at mRNA and trend to higher protein level in Bβ treated mice, compared to saline treated mice after 48 h of IR, thus pointing toward an increased angiogenetic activity. Similar dynamics were observed for the intermediate filament vimentin, the cytoprotective protein klotho, stathmin and the proliferation cellular nuclear antigen, which were significantly up-regulated at the same points in time. These results suggest a beneficial effect of anatomical contiguously located endothelial cells on tubular regeneration through stabilization of endothelial integrity. Therefore, it seems that Bβ represents a novel pharmacological approach in the targeted therapy of acute renal failure in everyday clinical practice.
内皮和肾小管功能的早期充分恢复是缺血再灌注(IR)损伤后再生过程中的重要一步,IR损伤发生在例如肾移植、肾脏手术和脓毒症中。虽然肾小管上皮细胞损伤长期以来一直至关重要,但最近的认识也包括肾血管内皮。在这方面,纤维蛋白裂解产物纤维蛋白肽Bβ通过其与血管内皮钙黏蛋白的亲和力稳定内皮细胞间连接,从而减轻IR损伤。因此,本研究聚焦于Bβ对急性后生理性肾再生的影响。为此,成年雄性C57BL/6小鼠接受30分钟的双侧肾脏缺血并再灌注24小时或48小时。动物被随机分为非手术对照组、两个手术组,每个手术组在再灌注前立即静脉注射生理盐水或Bβ(2.4毫克/千克)进行治疗。单次应用Bβ可减轻肾组织匀浆中的内皮激活和炎症反应。同时,Bβ不影响急性肾损伤标志物。然而,关于血管生成相关因子血管内皮生长因子A(VEGF-A)、血管生成素-1、血管生成素-2,我们观察到在IR 48小时后,与生理盐水处理的小鼠相比,Bβ处理的小鼠在mRNA水平上表达显著更高,蛋白水平有升高趋势,这表明血管生成活性增加。对于中间丝波形蛋白、细胞保护蛋白klotho、微管相关蛋白stathmin和增殖细胞核抗原也观察到类似动态变化,它们在相同时间点显著上调。这些结果表明,通过稳定内皮完整性,解剖学上相邻的内皮细胞对肾小管再生具有有益作用。因此,在日常临床实践中,Bβ似乎代表了一种针对急性肾衰竭靶向治疗的新的药理学方法。