National Center for Trauma Medicine, Ministry of Education Key Laboratory of Trauma and Neural Regeneration, Trauma Medicine Center, Peking University People's Hospital, No. 11 XiZhiMen South Street, Xicheng District, Beijing, 100044, China.
J Orthop Surg Res. 2021 Jul 1;16(1):416. doi: 10.1186/s13018-021-02565-5.
The present study investigated the influence of ischemic postconditioning (I-postC) on the adjustment of renal injury after limb ischemia-reperfusion (I/R) injury, to elucidate the mechanisms of the Toll-like receptor 4 (TLR 4)/NF-κB signaling pathway using histopathological and immunohistochemical methods.
Male Sprague-Dawley rats were randomly assigned to five groups (numbered from 1 to 5): the sham group (Group 1, only the anesthesia procedure was conducted without limb I/R), the I/R group (Group 2, 4 h of reperfusion was conducted following 4 h limb ischemia under anesthesia), the I/R + I-postC group (Group 3, 4 h of ischemia and 4 h of reperfusion was conducted; before perfusion, 5 min of limb ischemia and 5 min of reperfusion were performed in the rats and repeated 3 times), the I/R + TAK group (Group 4, rats were injected with TLR4 antagonist TAK through the caudal vein before limb ischemia and reperfusion under anesthesia), the TAK group (Group 5, rats were injected with TAK, and the anesthesia procedure was conducted without limb I/R). Histological changes in the kidney in different groups were observed, and the extent of tubular injury was assessed. Changes in biochemical indexes and the expression of inflammatory factors, TLR4, and NF-κB were also evaluated.
Compared with rats in the I/R group, the secretion of inflammatory factors and the expression levels of TLR4 and NF-κB were decreased in rats in the I/R + I-postC group. Histological analysis revealed renal injury, including inflammatory cell infiltration, dilatation of the tubuli lumen, congestion in glomerular capillaries, degeneration of tubuli epithelial cells, and necrosis was ameliorated by I-postC. Immunohistochemical studies showed that I/R-induced elevation in TLR4 and NF-κB expression was reduced by I-postC treatment. Moreover, the expression levels of TLR4, NF-κB, and inflammatory factors in rats in the I/R + TAK group were also decreased, and the renal pathological lesion was alleviated, which was similar to that in rats in the I/R + I-postC group.
The present findings suggest that I-postC can reduce tissue injury and kidney inflammation induced by limb I/R injury, possibly via inhibition of the TLR4 and NF-κB pathways.
本研究通过组织病理学和免疫组织化学方法,探讨缺血后处理(I-postC)对肢体缺血再灌注(I/R)损伤后肾损伤调节的影响,阐明 Toll 样受体 4(TLR 4)/核因子-κB 信号通路的机制。
雄性 Sprague-Dawley 大鼠随机分为五组(编号 1 至 5):假手术组(第 1 组,仅行麻醉手术,不进行肢体 I/R)、I/R 组(第 2 组,麻醉下进行 4 h 肢体缺血后再灌注 4 h)、I/R+I-postC 组(第 3 组,进行 4 h 缺血和 4 h 再灌注;在再灌注前,对大鼠进行 5 min 的肢体缺血和 5 min 的再灌注,重复 3 次)、I/R+TAK 组(第 4 组,麻醉下进行肢体缺血和再灌注前经尾静脉注射 TLR4 拮抗剂 TAK)、TAK 组(第 5 组,经尾静脉注射 TAK,不进行肢体 I/R,仅行麻醉手术)。观察各组肾脏组织学变化,评估肾小管损伤程度。评估生化指标和炎症因子、TLR4 和 NF-κB 的表达变化。
与 I/R 组大鼠相比,I/R+I-postC 组大鼠炎症因子分泌和 TLR4、NF-κB 表达水平降低。组织学分析显示,I-postC 改善了肾损伤,包括炎性细胞浸润、肾小管腔扩张、肾小球毛细血管充血、肾小管上皮细胞变性和坏死。免疫组织化学研究显示,I-postC 可降低 I/R 诱导的 TLR4 和 NF-κB 表达升高。此外,I/R+TAK 组大鼠 TLR4、NF-κB 和炎症因子的表达水平也降低,肾脏病理损伤减轻,与 I/R+I-postC 组大鼠相似。
本研究结果表明,I-postC 可减轻肢体 I/R 损伤引起的组织损伤和肾脏炎症,可能通过抑制 TLR4 和 NF-κB 通路。