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富氢盐水对严重烧伤大鼠急性肾损伤的影响及机制

[Influences of hydrogen-rich saline on acute kidney injury in severely burned rats and mechanism].

作者信息

Wang L L, Guo S X, Wu P, Shao H W, Han C M

机构信息

Department of Burns, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2018 Sep 20;34(9):629-636. doi: 10.3760/cma.j.issn.1009-2587.2018.09.013.

Abstract

To explore the influences of hydrogen-rich saline on acute kidney injury in severely burned rats and to analyze the related mechanism. Fifty-six Sprague Dawley rats were divided into sham injury group (=8), burn group (=24), and hydrogen-rich saline group (=24) according to the random number table. Rats in sham injury group were treated by 20 ℃ water bath on the back for 15 s to simulate injury, and rats in burn group and hydrogen-rich saline group were inflicted with 30% total body surface area (TBSA) full-thickness scald (hereinafter referred to as burns) by 100 ℃ water bath on the back for 15 s. Immediately after injury, hydrogen-rich saline at the dose of 10 mL/kg were intraperitoneally injected to the rats in hydrogen-rich saline group at one time, while normal saline with the same dose were intraperitoneally injected to the rats in sham injury group and burn group. At post injury hour (PIH) 6, rats in the 3 groups were intraperitoneally injected with 4 mL·kg(-1)·%TBSA(-1) lactated Ringer's solution for resuscitation. Eight rats from sham injury group at PIH 72 and eight rats from burn group and hydrogen-rich saline group at PIH 6, 24, and 72 were sacrificed respectively after their blood samples from abdominal aorta were collected. Then their kidney tissue was harvested for histopathological observation and renal tubular injury scoring by hematoxylin and eosin staining, serum creatinine and blood urea nitrogen were detected by the clinical blood biochemical analyzer, expression distribution and mRNA expressions of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), and IL-6 in renal tissue were evaluated by immunohistochemical staining and real time fluorescent quantitive reverse transcription polymerase chain reaction respectively, and protein expression of high mobility group protein 1 (HMGB1) was detected by Western blotting. Data were processed with Kruskal-Wallis test, Dunn test, one-way analysis of variance, Bonferroni test. (1) The renal tubular structure of rats in sham injury group at PIH 72 was complete with no inflammatory cell infiltration and no cellular degeneration or necrosis. Since PIH 6, the changes such as vacuolation and shape change of cells and aggregation of broken protein in renal tubules were observed in rats of burn group, and all these changes deteriorated with time. The renal injury of rats in hydrogen-rich saline group at different post injury time points were relieved compared with those of rats in burn group at the corresponding time points. The renal tubular injury scores of rats in burn group and hydrogen-rich saline group at PIH 6, 24, and 72 were significantly higher than the score in sham injury group at PIH 72 (<0.05). The renal tubular injury scores of rats in hydrogen-rich saline group were significantly lower than those in burn group at PIH 6, 24, and 72 (<0.05). (2) Except for those in hydrogen-rich saline group at PIH 6 and 72 (>0.05), the levels of serum creatinine of rats in burn group at all the time points and hydrogen-rich saline group at the other time points were significantly higher than the level of serum creatinine of rats in sham injury group at PIH 72 (<0.01). The levels of blood urea nitrogen of rats in burn group and hydrogen-rich saline group at PIH 6, 24, and 72 were significantly higher than the level of blood urea nitrogen of rats in sham injury group at PIH 72 (<0.01). The levels of serum creatinine and blood urea nitrogen of rats in hydrogen-rich saline group at PIH 6, 24, and 72 were significantly lower than those in burn group at the corresponding time points (<0.05). (3) There were certain degree of positive expressions of TNF-α, IL-1β, and IL-6 in renal tissue of rats in sham injury group at PIH 72, which were mainly observed in the cytoplasm of renal tubular epithelium cell. The expressions of above-mentioned inflammatory cytokines in renal tissue of rats in burn group at PIH 6, 24, and 72 were higher than those in sham injury group. The expressions of above-mentioned inflammatory cytokines in renal tissue of rats in hydrogen-rich saline group at all the time points were less than those in burn group at the corresponding time points. (4) Compared with those in sham injury group at PIH 72, the mRNA expression levels of TNF-α, IL-1β, and IL-6 of rats in burn group at PIH 6, 24, and 72 were significantly increased (<0.01). The mRNA expression levels of TNF-α were significantly increased in hydrogen-rich saline group at PIH 6 and 24 (<0.05 or <0.01), and the mRNA expression level of IL-6 was significantly increased in hydrogen-rich saline group at PIH 6 (<0.01). Compared with those at the corresponding time points in burn group, except for the mRNA expression level of TNF-α in hydrogen-rich saline group at PIH 6 showed no significant differences (>0.05), and the mRNA expression levels of TNF-α, IL-1β, and IL-6 at the other time points in hydrogen-rich saline group were significantly decreased (<0.05). (5) Compared with 0.39±0.03 in sham injury group at PIH 72, the protein expression of HMGB1 of rats in burn group at PIH 6, 24, and 72 (1.19±0.07, 1.00±0.06, 0.80±0.05) were significantly increased (<0.05), while the protein expression of HMGB1 of rats in hydrogen-rich saline group at PIH 6, 24, and 72 (0.35±0.08, 0.47±0.06, 0.42±0.06) showed no significant differences (>0.05). Compared with those in burn group, the protein expressions of HMGB1 of rats in hydrogen-rich saline group at PIH 6, 24, and 72 were significantly decreased (<0.05). Hydrogen-rich saline can alleviate the acute kidney injury in severely burned rats through regulating the release of inflammatory cytokines in renal tissue.

摘要

探讨富氢盐水对重度烧伤大鼠急性肾损伤的影响并分析其相关机制。将56只Sprague Dawley大鼠按随机数字表法分为假伤组(n = 8)、烧伤组(n = 24)和富氢盐水组(n = 24)。假伤组大鼠背部以20℃水浴处理15 s模拟损伤,烧伤组和富氢盐水组大鼠背部以100℃水浴处理15 s造成30%总体表面积(TBSA)的全层烫伤(以下简称烧伤)。伤后即刻,对富氢盐水组大鼠一次性腹腔注射10 mL/kg的富氢盐水,假伤组和烧伤组大鼠则腹腔注射相同剂量的生理盐水。伤后6小时(PIH 6),对3组大鼠腹腔注射4 mL·kg⁻¹·%TBSA⁻¹的乳酸林格液进行复苏。分别于PIH 72处死假伤组8只大鼠,于PIH 6、24及72处死烧伤组和富氢盐水组各8只大鼠,采集腹主动脉血样后,取肾组织进行苏木精-伊红染色行组织病理学观察及肾小管损伤评分,用临床血液生化分析仪检测血清肌酐和血尿素氮,分别用免疫组化染色和实时荧光定量逆转录聚合酶链反应评估肾组织中肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)及IL-6的表达分布和mRNA表达,用蛋白质免疫印迹法检测高迁移率族蛋白1(HMGB1)的蛋白表达。数据采用Kruskal-Wallis检验、Dunn检验、单因素方差分析、Bonferroni检验进行处理。(1)PIH 72时假伤组大鼠肾小管结构完整,无炎性细胞浸润,无细胞变性或坏死。自PIH 6起,烧伤组大鼠肾小管出现细胞空泡化、形态改变及破碎蛋白聚集等变化,且随时间推移这些变化逐渐加重。富氢盐水组大鼠在不同伤后时间点的肾损伤较相应时间点的烧伤组大鼠有所减轻。烧伤组和富氢盐水组大鼠在PIH 6、24及72时的肾小管损伤评分均显著高于PIH 72时的假伤组(P < 0.05)。富氢盐水组大鼠在PIH 6、24及72时的肾小管损伤评分显著低于烧伤组(P < 0.05)。(2)除富氢盐水组在PIH 6及72时(P > 0.05)外,烧伤组大鼠各时间点及富氢盐水组其他时间点的血清肌酐水平均显著高于PIH 72时假伤组大鼠的血清肌酐水平(P < 0.01)。烧伤组和富氢盐水组大鼠在PIH 6、24及72时的血尿素氮水平均显著高于PIH 72时假伤组大鼠的血尿素氮水平(P < 0.01)。富氢盐水组大鼠在PIH 6、24及72时的血清肌酐和血尿素氮水平均显著低于相应时间点的烧伤组(P < 0.05)。(3)PIH 72时假伤组大鼠肾组织中TNF-α、IL-1β及IL-6有一定程度的阳性表达,主要见于肾小管上皮细胞胞质。烧伤组大鼠在PIH 6、24及72时肾组织中上述炎性细胞因子的表达高于假伤组。富氢盐水组大鼠各时间点肾组织中上述炎性细胞因子的表达均少于相应时间点的烧伤组。(4)与PIH 72时假伤组相比,烧伤组大鼠在PIH 6、24及72时TNF-α、IL-1β及IL-6的mRNA表达水平显著升高(P < 0.01)。富氢盐水组大鼠在PIH 6及24时TNF-α的mRNA表达水平显著升高(P < 0.05或P < 0.01),富氢盐水组大鼠在PIH 6时IL-6的mRNA表达水平显著升高(P < 0.01)。与烧伤组相应时间点相比,除富氢盐水组大鼠在PIH 6时TNF-α的mRNA表达水平无显著差异(P > 0.05)外,富氢盐水组大鼠在其他时间点TNF-α、IL-1β及IL-6的mRNA表达水平均显著降低(P < 0.05)。(5)与PIH 72时假伤组的0.39±0.03相比,烧伤组大鼠在PIH 6、24及72时HMGB1的蛋白表达(1.19±0.07、1.00±0.06、0.80±0.05)显著升高(P < 0.05),而富氢盐水组大鼠在PIH 6、24及72时HMGB1的蛋白表达(0.35±0.08、0.47±0.06、0.42±0.06)无显著差异(P > 0.05)。与烧伤组相比,富氢盐水组大鼠在PIH 6、24及72时HMGB1的蛋白表达显著降低(P < 0.05)。富氢盐水可通过调节肾组织炎性细胞因子的释放减轻重度烧伤大鼠的急性肾损伤。

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