UMR Inserm U1082, Inserm Nouvelle Aquitaine, F-86021 Poitiers, France.
Faculté de Médecine et de Pharmacie, Université de Poitiers, F-86021 Poitiers, France.
Int J Mol Sci. 2019 May 8;20(9):2268. doi: 10.3390/ijms20092268.
Current organ shortages have led centers to extend the acceptance criteria for organs, increasing the risk for adverse outcomes. Current preservation protocols have not been adapted so as to efficiently protect these organs. Herein, we target oxidative stress, the key mechanism of ischemia reperfusion injury. Vectisol is a novel antioxidant strategy based on the encapsulation of resveratrol into a cyclodextrin, increasing its bioavailability. We tested this compound as an additive to the most popular static preservation solutions and machine perfusion (LifePort) in a preclinical pig model of kidney autotransplantation. In regard to static preservation, supplementation improved glomerular filtration and proximal tubular function early recovery. Extended follow-up confirmed the higher level of protection, slowing chronic loss of function (creatininemia and proteinuria) and the onset of histological lesions. Regarding machine perfusion, the use of Vectisol decreased oxidative stress and apoptosis at the onset of reperfusion (30 min post declamping). Improved quality was confirmed with decreased early levels of circulating SOD (Superoxide Dismutase) and ASAT (asparagine amino transferase). Supplementation slowed the onset of chronic loss of function, as well as interstitial fibrosis and tubular atrophy. The simple addition of Vectisol to the preservation solution significantly improved the performance of organ preservation, with long-term effects on the outcome. This strategy is thus a key player for future multi-drug therapy aimed at ischemia reperfusion in transplantation.
目前器官短缺导致中心扩大器官接受标准,增加不良结果的风险。目前的保存方案尚未进行调整,无法有效地保护这些器官。在此,我们针对氧化应激,即缺血再灌注损伤的关键机制。Vectisol 是一种基于将白藜芦醇封装到环糊精中的新型抗氧化策略,可提高其生物利用度。我们在猪肾自体移植的临床前模型中,将这种化合物作为附加物添加到最受欢迎的静态保存溶液和机器灌注(LifePort)中进行了测试。在静态保存方面,补充剂可改善肾小球滤过和近端肾小管功能的早期恢复。延长的随访证实了更高水平的保护,减缓慢性肾功能丧失(肌酐血症和蛋白尿)和组织学损伤的发生。关于机器灌注,使用 Vectisol 可在再灌注开始时(夹闭后 30 分钟)降低氧化应激和细胞凋亡。循环 SOD(超氧化物歧化酶)和 ASAT(天冬氨酸氨基转移酶)的早期水平降低,证实了质量的提高。补充剂可减缓慢性功能丧失以及间质纤维化和肾小管萎缩的发生。将 Vectisol 简单地添加到保存溶液中可显著提高器官保存的性能,并对结果产生长期影响。因此,这种策略是未来针对移植中缺血再灌注的多药物治疗的关键因素。