Department of Radiation Oncology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL, USA.
Katz Family Division of Nephrology and Hypertension, Department of Medicine, Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miami, FL, USA.
Int J Radiat Biol. 2021;97(5):664-674. doi: 10.1080/09553002.2021.1876950. Epub 2021 Mar 15.
The kidney is a radiosensitive late-responding normal tissue. Injury is characterized by radiation nephropathy and decline of glomerular filtration rate (GFR). The current study aimed to compare two rapid and cost-effective methodologies of assessing GFR against more conventional biomarker measurements.
C57BL/6 mice were treated with bilateral focal X-irradiation (1x14Gy or 5x6Gy). Functional measurements of kidney injury were assessed 20 weeks post-treatment. GFR was estimated using a transcutaneous measurement of fluorescein-isothiocyanate conjugated (FITC)-sinistrin renal excretion and also dynamic contrast-enhanced CT imaging with a contrast agent (ISOVUE-300 Iopamidol).
Hematoxylin and eosin (H&E) and Periodic acid-Schiff staining identified comparable radiation-induced glomerular atrophy and mesangial matrix accumulation after both radiation schedules, respectively, although the fractionated regimen resulted in less diffuse tubulointerstitial fibrosis. Albumin-to-creatinine ratios (ACR) increased after irradiation (1x14Gy: 100.4 ± 12.2 µg/mg; 6x5Gy: 80.4 ± 3.02 µg/mg) and were double that of nontreated controls (44.9 ± 3.64 µg/mg). GFR defined by both techniques was negatively correlated with BUN, mesangial expansion score, and serum creatinine. The FITC-sinistrin transcutaneous method was more rapid and can be used to assess GFR in conscious animals, dynamic contrast-enhanced CT imaging technique was equally safe and effective.
This study demonstrated that GFR measured by dynamic contrast-enhanced CT imaging is safe and effective compared to transcutaneous methodology to estimate kidney function.
肾脏是一种对辐射敏感的迟发反应正常组织。损伤的特征是放射性肾病和肾小球滤过率(GFR)下降。本研究旨在比较两种快速且经济有效的 GFR 评估方法与更传统的生物标志物测量方法。
C57BL/6 小鼠接受双侧局灶性 X 射线照射(1x14Gy 或 5x6Gy)。治疗后 20 周评估肾脏损伤的功能测量。GFR 通过经皮测量荧光素异硫氰酸酯结合(FITC)-辛葡糖苷肾排泄和使用造影剂(ISOVUE-300 碘帕醇)的动态对比增强 CT 成像来估计。
苏木精和伊红(H&E)和过碘酸希夫染色分别在两种辐射方案后识别出可比的放射性肾小球萎缩和系膜基质积聚,但分割方案导致的弥漫性肾小管间质纤维化较少。照射后白蛋白与肌酐比值(ACR)增加(1x14Gy:100.4±12.2µg/mg;6x5Gy:80.4±3.02µg/mg),是未处理对照组的两倍(44.9±3.64µg/mg)。两种技术定义的 GFR 与 BUN、系膜扩张评分和血清肌酐呈负相关。FITC-辛葡糖苷经皮方法更快,可用于评估清醒动物的 GFR,动态对比增强 CT 成像技术同样安全有效。
本研究表明,与经皮方法相比,动态对比增强 CT 成像测量的 GFR 更安全有效,可用于估计肾功能。