Vascular and Interventional Radiology Translational Laboratory, Department of Radiology, Mayo Clinic, Rochester, Minnesota.
Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Am J Physiol Renal Physiol. 2020 May 1;318(5):F1210-F1219. doi: 10.1152/ajprenal.00004.2020. Epub 2020 Mar 23.
Contrast-induced acute kidney injury (CI-AKI) is a vexing problem, and more than 70 million patients undergo studies using iodinated contrast. The molecular mechanisms responsible for CI-AKI are poorly understood. The goal of the present article was to determine the role of transforming growth factor-β1 (TGF-β1)/mothers against decapentaplegic homolog (SMAD)3 and associated collagen expression in a murine model of intra-arterial CI-AKI. The murine model of CI-AKI after intra-arterial contrast agent administration was created by first performing a partial nephrectomy to induce chronic kidney disease. Twenty-eight days later, 100 μL of contrast agent [iodixanol (320 mg/mL)] or saline were administered via the carotid artery. Two days after contrast administration, compared with saline, average serum creatinine was significantly elevated ( < 0.05). In the cortex, there was a significant increase in phosphorylated SMAD3 and gene expression of TGF-β1, TGF-β receptor type I, and TGF-β receptor type II at in the contrast group compared with the saline group. Average gene expressions of connective tissue growth factor, matrix metalloproteinase-2 and -9, and collagen type I-α and type IV-α were significantly increased at 2 days after contrast administration (all < 0.05). Moreover, there was a decrease in Ki-67 staining in the cortex, with an increase in terminal deoxynucleotidyl transferase dUTP nick-end labeling in the cortex and medulla after contrast administration ( < 0.05). In the murine intra-arterial CI-AKI model, there was increased hypoxia and TGF-β1/SMAD3 pathway activation and collagen expression, resulting in renal fibrosis. Together, these results suggest that the TGF-β1/SMAD3 pathway could be a potential target in alleviating tissue fibrosis in CI-AKI.
对比剂诱导的急性肾损伤(CI-AKI)是一个令人困扰的问题,超过 7000 万患者接受了碘造影剂的研究。导致 CI-AKI 的分子机制尚不清楚。本文的目的是确定转化生长因子-β1(TGF-β1)/母亲抗 decapentaplegic 同源物(SMAD)3 及其相关胶原表达在动脉内 CI-AKI 小鼠模型中的作用。通过先进行部分肾切除术诱导慢性肾脏病来创建动脉内造影剂给药后 CI-AKI 的小鼠模型。28 天后,通过颈动脉给予 100 μL 造影剂[碘昔醇(320mg/mL)]或生理盐水。造影剂给药后 2 天,与生理盐水组相比,平均血清肌酐显著升高(<0.05)。在皮质中,与生理盐水组相比,造影剂组在时磷酸化 SMAD3 和 TGF-β1、TGF-β 受体 I 型和 TGF-β 受体 II 型的基因表达显著增加。在造影剂给药后 2 天,结缔组织生长因子、基质金属蛋白酶-2 和 -9 以及胶原 I-α 和 IV-α 的平均基因表达显著增加(均<0.05)。此外,皮质中 Ki-67 染色减少,皮质和髓质中末端脱氧核苷酸转移酶 dUTP 缺口末端标记增加(<0.05)。在动脉内 CI-AKI 小鼠模型中,缺氧增加,TGF-β1/SMAD3 途径激活和胶原表达增加,导致肾纤维化。总之,这些结果表明 TGF-β1/SMAD3 途径可能是减轻 CI-AKI 组织纤维化的潜在靶点。