Shi Xingyu, Xing Jiayu, Wang Yi, Li Jian, Chai Ruifeng, Yu Xiangyou
Department of Critical Medicine Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China. Corresponding author: Yu Xiangyou, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024 Nov;36(11):1147-1152. doi: 10.3760/cma.j.cn121430-20231025-00902.
To explore the protective effect and mechanism of acetate on sepsis-induced acute kidney injury (AKI) in rats.
Male Sprague-Dawley (SD) rats were divided into sham operation group (Sham group), sepsis group caused by cecal ligation and puncture (CLP group), and acetate pretreatment group [NaA group, gavage sodium acetate (NaA) 300 mg/kg twice a day for 7 consecutive days before CLP] using a random number table method, with 7 rats in each group. The blood was taken from the main abdominal artery 24 hours after modeling, and renal tissue was collected from the rats. Enzyme linked immunosorbent assay (ELISA) was used to detect the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), and kidney injury molecule-1 (KIM-1). The concentration of serum acetate was determined by high performance liquid chromatography. The level of malondialdehyde (MDA) in renal tissue was detected by thiobarbituric acid method. Myeloperoxidase (MPO) in renal tissue was detected by colorimetric method. Hematoxylin-eosin (HE) staining was used to observe histopathological changes and assess renal tubule injury score. Western blotting was used to detect the protein expressions of G-protein coupled receptor 43 (GPR43) and adenosine monophosphate-activated protein kinase/silence infor-mation regulator 1/peroxlsome proliferator-activated receptor-γ coactlvator-1α (AMPK/SIRT1/PGC-1α) pathway. The positive expressions of GPR43, phosphorylation-AMPK (p-AMPK), SIRT1, PGC-1α were detected by immunohistochemistry.
Compared with Sham group, the serum levels of IL-6, TNF-α and KIM-1 were significantly increased in CLP group, the contents of MDA and MPO in renal tissue were increased, and the content of acetate was significantly decreased. HE staining results showed that most of the tubular epithelial cells were denaturated with local necrosis, a large number of brush border injuries and shedding, tubular structure destruction and fragmentation, and more inflammatory cells infiltrated the renal interstitium, the renal tubular injury score significantly increased. The expressions of GPR43, p-AMPK/AMPK, SIRT1, and PGC-1α in renal tissue were significantly reduced, indicating renal injury and increased levels of oxidative stress and inflammation in septic rats. Compared with the CLP group, the serum levels of IL-6, TNF-α and KIM-1 in the NaA group were decreased [IL-6 (ng/L): 126.20±6.23 vs. 161.00±17.37, TNF-α (ng/L): 85.59±7.70 vs. 123.50±17.78, KIM-1 (μg/L): 2.92±0.38 vs. 4.73±0.36, all P < 0.05]. The contents of MDA and MPO in renal tissue were significantly decreased [MDA (μmol/g): 6.56±0.18 vs. 8.53±0.34, MPO (U/g): 2.99±0.20 vs. 3.72±0.29, both P < 0.05]. HE staining showed that kidney injury had been alleviated, with a decrease in renal tubular injury score [1 (1, 2) vs. 3 (2, 3), P < 0.05]. Western blotting showed that the expressions of GPR43 and AMPK/SIRT1/PGC-1α pathway related proteins were significantly increased in renal tissue (GPR43/β-actin: 0.62±0.09 vs. 0.41±0.09, p-AMPK/AMPK: 0.58±0.07 vs. 0.44±0.06, SIRT1/β-actin: 0.85±0.06 vs. 0.73±0.03, PGC-1α/β-actin: 0.79±0.07 vs. 0.62±0.05, all P < 0.05). Immunohistochemistry showed that the positive expressions of GPR43, p-AMPK, SIRT1 and PGC-1α were significantly increased in renal tissue [GPR43 positive area: (33.66±2.62)% vs. (16.21±1.66)%, p-AMPK positive area: (16.64±2.11)% vs. (5.04±1.28)%, SIRT1 positive area: (14.61±2.86)% vs. (7.34±1.00)%, PGC-1α positive area: (15.30±2.39)% vs. (4.84±1.67)%, all P < 0.05], the serum acetate concentration significantly increased (μg/L: 32 479±14 683 vs. 12 935±3 197, P < 0.05).
Acetate can ameliorate sepsis-induced AKI, the mechanism may be related to the activation of AMPK/SIRT1/PGC-1α pathway by GPR43.
探讨乙酸盐对脓毒症诱导的大鼠急性肾损伤(AKI)的保护作用及机制。
采用随机数字表法将雄性Sprague-Dawley(SD)大鼠分为假手术组(Sham组)、盲肠结扎穿孔术致脓毒症组(CLP组)和乙酸盐预处理组[NaA组,在CLP术前连续7天每天两次灌胃乙酸钠(NaA)300 mg/kg],每组7只大鼠。建模后24小时从腹主动脉取血,并采集大鼠肾组织。采用酶联免疫吸附测定(ELISA)法检测血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和肾损伤分子-1(KIM-1)水平。采用高效液相色谱法测定血清乙酸盐浓度。采用硫代巴比妥酸法检测肾组织中丙二醛(MDA)含量。采用比色法检测肾组织中髓过氧化物酶(MPO)含量。采用苏木精-伊红(HE)染色观察组织病理学变化并评估肾小管损伤评分。采用蛋白质免疫印迹法检测G蛋白偶联受体43(GPR43)和腺苷酸活化蛋白激酶/沉默信息调节因子1/过氧化物酶体增殖物激活受体γ共激活因子-1α(AMPK/SIRT1/PGC-1α)通路的蛋白表达。采用免疫组织化学法检测GPR43、磷酸化-AMPK(p-AMPK)、SIRT1、PGC-1α的阳性表达。
与Sham组比较,CLP组血清IL-6、TNF-α、KIM-1水平显著升高,肾组织MDA、MPO含量增加,乙酸盐含量显著降低。HE染色结果显示大部分肾小管上皮细胞变性伴局部坏死,大量刷状缘损伤和脱落,肾小管结构破坏和断裂,肾间质有较多炎性细胞浸润,肾小管损伤评分显著增加。肾组织中GPR43、p-AMPK/AMPK、SIRT1、PGC-1α表达显著降低,提示脓毒症大鼠存在肾损伤且氧化应激和炎症水平升高。与CLP组比较,NaA组血清IL-6、TNF-α、KIM-1水平降低[IL-6(ng/L):126.20±6.23比161.00±17.37,TNF-α(ng/L):85.59±7.70比123.50±17.78,KIM-1(μg/L):2.92±0.38比4.73±0.36,均P<0.05]。肾组织MDA、MPO含量显著降低[MDA(μmol/g):6.56±0.18比8.53±0.34,MPO(U/g):2.99±0.20比3.72±0.29,均P<0.05]。HE染色显示肾损伤减轻,肾小管损伤评分降低[1(1,2)比3(2,3),P<0.05]。蛋白质免疫印迹法显示肾组织中GPR43及AMPK/SIRT1/PGC-1α通路相关蛋白表达显著增加(GPR4³/β-肌动蛋白:².62±0.09比0.41±0.09,p-AMPK/AMPK:0.58±0.07比0.44±0.06,SIRT1/β-肌动蛋白:0.85±0.06比0.73±0.03,PGC-1α/β-肌动蛋白:0.79±0.07比0.62±0.05,均P<0.05)。免疫组织化学法显示肾组织中GPR43、p-AMPK、SIRT1、PGC-1α阳性表达显著增加[GPR43阳性面积:(33.66±2.62)%比(16.21±1.66)%,p-AMPK阳性面积:(16.64±2.11)%比(5.04±1.28)%,SIRT1阳性面积:(14.61±2.86)%比(7.34±1.00)%,PGC-1α阳性面积:(15.30±2.39)%比(4.84±1.67)%,均P<0.05],血清乙酸盐浓度显著升高(μg/L:32 479±14 683比12 935±3 197,P<0.05)。
乙酸盐可改善脓毒症诱导的AKI,其机制可能与GPR43激活AMPK/SIRT1/PGC-1α通路有关。