Liu Kun, Hu Can, Yin Wenjun, Zhou Lingyun, Gu Xurui, Zuo Xiaocong
Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha City, Hunan Province, China.
Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha City, Hunan Province, China.
J Biochem Mol Toxicol. 2023 Jan;37(1):e23238. doi: 10.1002/jbt.23238. Epub 2022 Oct 7.
Contrast-induced nephropathy (CIN) is an acute kidney injury (AKI) observed after the administration of contrast media. Calcium channel blockers (CCBs) have been reported to exert a renal protective effect. This study aims to investigate the role of cilnidipine, a novel CCBs, on CIN by regulating the calcium/calmodulin-dependent protein kinase Ⅱ(CaMKⅡ)/mitochondrial permeability transition pore (mPTP) pathway. Here, iohexol, a representative contrast media, was used to establish CIN model. KN-93 (CaMKⅡ inhibitor) and atractyloside (mPTP opener) were administered in rats, and CaMKⅡ overexpression was used in Human proximal tubular epithelial cells. Markers of renal injury (serum creatinine, blood urea nitrogen, and urinary NAGL), hematoxylin-eosin stain, oxidative stress (ROS, superoxide dismutase [SOD], and malondialdehyde [MDA] levels), cell death (MTT and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling [TUNEL]), mitochondrial function (mPTP, mitochondrial membrane potential [MMP], and ATP) were assessed. Western blots were used to measure the expression levels of Bax/Bcl-2, caspase-3, CaMKⅡ/mPTP signaling pathways. Results showed that cilnidipine markedly improved kidney function, and alleviated tubular cell apoptosis, oxidative stress and mitochondrial damage induced by iohexol in vitro and in vivo. The underlying mechanism may be that cilnidipine relieved CaMKⅡ activation and mPTP opening induced by iohexol. All of these protective effects of cilnidipine were attenuated by CaMKⅡ overexpression and atractyloside (mPTP opener) pretreatment. Moreover, KN-93 (CaMKⅡ inhibitor) treatment showed a similar renal protective effect with cilnidipine, while the protective effect of cilnidipine on kidney in CIN rats was not further suppressed by KN-93 cotreatment. These in vitro and in vivo results point toward the fact that cilnidipine might be a novel therapeutic drug against contrast-induced nephrotoxicity in a CaMKⅡ-dependent manner.
对比剂肾病(CIN)是在使用对比剂后观察到的急性肾损伤(AKI)。据报道,钙通道阻滞剂(CCB)具有肾脏保护作用。本研究旨在探讨新型CCB西尼地平通过调节钙/钙调蛋白依赖性蛋白激酶Ⅱ(CaMKⅡ)/线粒体通透性转换孔(mPTP)途径在CIN中的作用。在此,使用代表性对比剂碘海醇建立CIN模型。对大鼠给予KN-93(CaMKⅡ抑制剂)和苍术苷(mPTP开放剂),并在人近端肾小管上皮细胞中进行CaMKⅡ过表达。评估肾损伤标志物(血清肌酐、血尿素氮和尿NAGL)、苏木精-伊红染色、氧化应激(ROS、超氧化物歧化酶[SOD]和丙二醛[MDA]水平)、细胞死亡(MTT和末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸缺口末端标记[TUNEL])、线粒体功能(mPTP、线粒体膜电位[MMP]和ATP)。使用蛋白质免疫印迹法测量Bax/Bcl-2、半胱天冬酶-3、CaMKⅡ/mPTP信号通路的表达水平。结果表明,西尼地平在体外和体内均可显著改善肾功能,减轻碘海醇诱导的肾小管细胞凋亡、氧化应激和线粒体损伤。其潜在机制可能是西尼地平减轻了碘海醇诱导的CaMKⅡ激活和mPTP开放。西尼地平的所有这些保护作用均被CaMKⅡ过表达和苍术苷(mPTP开放剂)预处理减弱。此外KN-93(CaMKⅡ抑制剂)治疗显示出与西尼地平相似的肾脏保护作用,而KN-93联合治疗并未进一步抑制西尼地平对CIN大鼠肾脏的保护作用。这些体外和体内研究结果表明,西尼地平可能是以CaMKⅡ依赖性方式对抗对比剂诱导的肾毒性的新型治疗药物。