Zhou Min, Yang Lei, Zhuo Yuzhen, Li Dihua, Zhang Lanqiu, Cui Lingzhi, Li Jiarui
Department of Nephrology, Nankai Hospital, Tianjin 300100, China.
Institute of Acute Abdomen, Tianjin Nankai Hospital, Tianjin 300100, China.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023 Mar;35(3):250-255. doi: 10.3760/cma.j.cn121430-20221122-01018.
To investigate the effect of Liangxue Huoxue decoction on intestinal flora, intestinal barrier and NOD-like receptor protein 3 (NLRP3)/caspase-1/gasdermin D (GSDMD) pyroptosis signaling pathway in mice model of sepsis-induced acute kidney injury (AKI).
The model of AKI was established by cecal ligation and perforation (CLP). Thirty male C57BL/6 mice were randomly divided into sham operation group (Sham group), sepsis group (CLP group) and sepsis+Liangxue Huoxue decoction (CLP+LXHX group), with 10 mice in each group. Mice in Sham group only underwent laparotomy. Two hours before model establishment, mice in CLP+LXHX group were treated with Liangxue Huoxue decoction (6 g/kg) by gavage; mice in Sham group and CLP group were given equal volume of normal saline by gavages. After 24 hours of modeling, all mice were sacrificed under anesthesia, and the colon and kidney tissues and fresh feces in the colon were taken. The pathological changes of kidney and colon were observed by hematoxylin-eosin (HE) staining under light microscope. Real-time polymerase chain reaction (RT-PCR) was used to detect inflammatory factors (interleukins, IL-1β and IL-18) in renal tissue. The expressions of NLRP3, caspase-1 and GSDMD were detected by Western blotting. The changes of intestinal flora in mice were detected by 16S rDNA high-throughput sequencing.
Compared with the Sham group, the inflammatory cell infiltration of the kidney tissue was increased and the kidney became vacuolated in CLP group, the mRNA expressions of IL-1β, IL-18, and the protein expressions of NLRP3, caspase-1 and GSDMD were significantly increased in CLP group, the species richness of intestinal microflora decreased significantly, the relative abundance of Enterococcus and Escherichia-Shigella increased significantly, and the relative abundance of Ileibacterium, Alloprevotella, Lachnospiraceae, Klebsiella and Parasutterella increased significantly in CLP group. Compared with CLP group, Liangxue Huoxue decoction can significantly reduce the pathological changes of kidney and colon tissue, reduce the pathological score (1.75±0.43 vs. 3.50±0.50 for kidney tissue, 1.25±0.43 vs. 4.50±0.50 for colon tissue, both P < 0.05), improve the composition of intestinal flora, reduce the relative abundance of Enterococcus and Escherichia-Shigella, and significantly increase the relative abundance of Lactobacillus and Akkermansia. In addition, Liangxue Huoxue decoction can significantly reduce mRNA expressions of IL-1β and IL-18 in kidney tissue [IL-1β mRNA (2): 1.59±0.05 vs. 4.61±0.88, IL-18 mRNA (2): 1.69±0.17 vs. 2.86±0.63, both P < 0.05] and the protein expressions of NLRP3, caspase-1 and GSDMD (NLRP3/GAPDH: 0.71±0.04 vs. 0.89±0.01, caspase-1/GAPDH: 1.04±0.04 vs. 1.48±0.04, GSDMD/GAPDH: 0.90±0.01 vs. 1.41±0.02, all P < 0.05).
Liangxue Huoxue decoction has obvious protective effect on AKI induced by sepsis. It can improve intestinal barrier by regulating intestinal flora, thereby inhibiting the activation of NLRP3/caspase-1/GSDMD signaling pathway in kidney tissue and reducing the expression of proptosis-related inflammatory factors.
探讨凉血活血汤对脓毒症诱导的急性肾损伤(AKI)小鼠模型肠道菌群、肠道屏障及NOD样受体蛋白3(NLRP3)/半胱天冬酶-1(caspase-1)/gasdermin D(GSDMD)焦亡信号通路的影响。
采用盲肠结扎穿孔术(CLP)建立AKI模型。将30只雄性C57BL/6小鼠随机分为假手术组(Sham组)、脓毒症组(CLP组)和脓毒症+凉血活血汤组(CLP+LXHX组),每组10只。Sham组小鼠仅行剖腹术。在模型建立前2小时,CLP+LXHX组小鼠经灌胃给予凉血活血汤(6 g/kg);Sham组和CLP组小鼠经灌胃给予等体积的生理盐水。建模24小时后,所有小鼠在麻醉下处死,取结肠和肾脏组织以及结肠内新鲜粪便。通过苏木精-伊红(HE)染色在光镜下观察肾脏和结肠的病理变化。采用实时聚合酶链反应(RT-PCR)检测肾组织中的炎性因子(白细胞介素-1β和白细胞介素-18)。通过蛋白质印迹法检测NLRP3、caspase-1和GSDMD的表达。采用16S rDNA高通量测序检测小鼠肠道菌群的变化。
与Sham组相比,CLP组肾组织炎性细胞浸润增加且肾组织出现空泡化,CLP组中白细胞介素-1β、白细胞介素-18的mRNA表达以及NLRP3、caspase-1和GSDMD的蛋白表达均显著增加,肠道微生物群的物种丰富度显著降低,肠球菌和大肠埃希菌-志贺菌属的相对丰度显著增加,而CLP组中艾克曼菌属、别样杆菌属、毛螺菌科、克雷伯菌属和副萨特菌属的相对丰度显著增加。与CLP组相比,凉血活血汤可显著减轻肾脏和结肠组织的病理变化,降低病理评分(肾组织:1.75±0.43比3.50±0.50,结肠组织:1.25±0.43比4.50±0.50,均P<0.05),改善肠道菌群组成,降低肠球菌和大肠埃希菌-志贺菌属的相对丰度,并显著增加乳酸杆菌属和阿克曼菌属的相对丰度。此外,凉血活血汤可显著降低肾组织中白细胞介素-1β和白细胞介素-18的mRNA表达[白细胞介素-1β mRNA(2):1.59±0.05比4.61±0.88,白细胞介素-18 mRNA(2):1.69±0.17比2.86±0.63,均P<0.05]以及NLRP3、caspase-1和GSDMD的蛋白表达(NLRP3/GAPDH:0.71±0.04比0.89±0.01,caspase-1/GAPDH:1.04±0.04比1.48±0.04,GSDMD/GAPDH:0.90±0.01比1.41±0.02,均P<0.05)。
凉血活血汤对脓毒症诱导的AKI具有明显的保护作用。它可通过调节肠道菌群改善肠道屏障,从而抑制肾组织中NLRP3/caspase-1/GSDMD信号通路的激活并降低焦亡相关炎性因子的表达。