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阿霉素诱导雄性和雌性LOU/M/Wsl大鼠肾病和心肌病的时间进程研究:缺乏因果关系的证据

Time-course study on doxorubicin-induced nephropathy and cardiomyopathy in male and female LOU/M/Wsl rats: lack of evidence for a causal relationship.

作者信息

van Hoesel Q G, Steerenberg P A, Dormans J A, de Jong W H, de Wildt D J, Vos J G

出版信息

J Natl Cancer Inst. 1986 Feb;76(2):299-307.

PMID:3456068
Abstract

In a previous study on doxorubicin-induced cardiotoxicity in LOU/M/Wsl rats, severe nephropathy has been observed; therefore, the question was raised whether nephropathy adds to or even might be responsible for doxorubicin-induced cardiomyopathy in rats. For elucidation of this question, the temporal relationship between the onset of doxorubicin-induced cardiomyopathy and nephropathy was studied. In addition, examination was made of whether modifications of the treatment schedule could circumvent nephrotoxicity. Because preliminary studies had shown that female LOU/M/Wsl rats developed less doxorubicin-induced albuminuria, both male and female LOU/M/Wsl rats were treated with an iv dose of 1 mg doxorubicin/kg (body wt)/rat on five consecutive days and then weekly. Saline-treated animals served as controls. Albuminuria, serum albumin, and serum creatine levels were assessed weekly. For histologic examination, 5 male and 5 female rats were killed weekly. At day 14 and thereafter, doxorubicin-treated male rats showed albuminuria greater than or equal to 10 g/liter. Albuminuria of greater than or equal to 10 g/liter was not avoided by modifications of the treatment schedule. Female rats had on day 14 a urinary albumin level of 1.0-3.0 g/liter, yet reaching the level of greater than or equal to 10 g/liter at day 49. In male rats serum albumin levels decreased to levels below 10 g/liter (p less than .001 vs. finding for day 0); in contrast female rats maintained constant serum albumin levels till day 49. Serum creatine levels showed a tendency to rise, the values of male rats not being measured after day 28 due to hyperlipidemia; the levels of female rats increased from 37.8 +/- 3.0 mumol/liter to 53.7 +/- 2.5 mumol/liter on day 49 (P less than .001). At day 10 in male and female rats a grade 1-1.5 cardiomyopathy score, assessed according to the modified Billingham scoring system, was found, gradually increasing to grade 2.5-3 cardiomyopathy, both in males and females, on day 49. In male LOU/M rats the nephropathy developed steadily from day 14 and thereafter, whereas in females the rate of development of kidney damage was slower and at the end point of the study the severity of kidney lesions was less in comparison to that of the males. The onset of cardiomyopathy and nephropathy was simultaneous. It was concluded that cardiomyopathy observed in LOU/M rats is a phenomenon independent of nephropathy.

摘要

在之前一项关于阿霉素诱导LOU/M/Wsl大鼠发生心脏毒性的研究中,观察到了严重的肾病;因此,有人提出疑问,肾病是否会加重甚至可能是阿霉素诱导大鼠发生心肌病的原因。为了阐明这个问题,研究了阿霉素诱导的心肌病和肾病发作之间的时间关系。此外,还研究了改变治疗方案是否可以避免肾毒性。因为初步研究表明,雌性LOU/M/Wsl大鼠发生阿霉素诱导的蛋白尿较少,所以对雄性和雌性LOU/M/Wsl大鼠均连续5天静脉注射剂量为1 mg阿霉素/kg(体重)/只,然后每周注射一次。用生理盐水处理的动物作为对照。每周评估蛋白尿、血清白蛋白和血清肌酐水平。为了进行组织学检查,每周处死5只雄性和5只雌性大鼠。在第14天及之后,阿霉素处理的雄性大鼠出现蛋白尿大于或等于10 g/升。改变治疗方案也无法避免蛋白尿大于或等于10 g/升的情况。雌性大鼠在第14天的尿白蛋白水平为1.0 - 3.0 g/升,但在第49天达到大于或等于10 g/升的水平。雄性大鼠的血清白蛋白水平降至低于10 g/升(与第0天的结果相比,P <.001);相比之下,雌性大鼠的血清白蛋白水平在第49天之前保持恒定。血清肌酐水平有上升趋势,雄性大鼠在第28天后由于高脂血症未再测量;雌性大鼠的血清肌酐水平从37.8±3.0 μmol/升在第49天升至53.7±2.5 μmol/升(P <.001)。在雄性和雌性大鼠的第10天发现根据改良的比林厄姆评分系统评估的1 - 1.5级心肌病评分,在第49天逐渐升至2.5 - 3级心肌病,雄性和雌性大鼠均如此。在雄性LOU/M大鼠中,肾病从第14天及之后稳步发展,而在雌性大鼠中,肾损伤的发展速度较慢,在研究终点时,肾脏病变的严重程度低于雄性大鼠。心肌病和肾病同时发作。得出的结论是,在LOU/M大鼠中观察到的心肌病是一种独立于肾病的现象。

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