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地塞米松:一种减轻输尿管热损伤后继发性狭窄的廉价且便捷的方法。

Dexamethasone: a cheap and convenient way to alleviate subsequent stenosis after thermal injury on ureter.

作者信息

Xia Weiping, Huang Fang, Song Qingtian, He Yunbo, Li Bingsheng

机构信息

Department of Intensive Care Medicine, Xiangya Hospital, Central South University, Changsha, China.

National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Transl Androl Urol. 2024 Nov 30;13(11):2498-2509. doi: 10.21037/tau-24-343. Epub 2024 Nov 28.

Abstract

BACKGROUND

Ureteral thermal injury (UTI) occurs when the ureter is exposed to high temperatures during surgical procedures, leading to tissue damage and ureteral stricture. Dexamethasone (DEX) has been widely used to treat a variety of diseases for its anti-inflammatory and immunosuppressant effects. However, its role in treating UTI remains unclear. The aim of this study was to determine the efficacy of treatment in mice with UTI.

METHODS

Thirty C57BL/6J mice were randomly divided into three groups (n=10 per group): (I) control group, (II) UTI group, (III) UTI + DEX group. UTI mouse models were constructed using a fast-pack pro-obturation pack handpiece instrument, and the therapeutic effect of DEX (2.5 mg/kg) on UTI was investigated via intraperitoneal injection for two weeks. Pathological changes in the ureter, renal function, extracellular matrix protein deposition, and inflammatory markers in the kidneys were evaluated in mouse models.

RESULTS

Ureteral histopathological changes were more severe in the UTI group than in the control group; however, DEX treatment alleviated these changes to a certain extent. Mice in the UTI group exhibited elevated renal function. Although DEX alleviated renal function deterioration, the difference was not statistically significant. Moreover, in comparison to the control group, kidney samples from the mice in the UTI group revealed increased messenger RNA (mRNA) levels of inflammation markers, indicating a progressive inflammation response, while DEX significantly reversed interleukin-1β (IL-1β) expression at the protein level. Additionally, fibrosis-related markers were markedly increased in the kidneys of UTI mice. These findings were significantly reversed by DEX treatment, revealing its anti-inflammatory and anti-fibrotic activities.

CONCLUSIONS

DEX reduces the severity of renal fibrosis and inflammation after UTI and exerts a significant renal protective effect.

摘要

背景

输尿管热损伤(UTI)是指在手术过程中输尿管暴露于高温下,导致组织损伤和输尿管狭窄。地塞米松(DEX)因其抗炎和免疫抑制作用已被广泛用于治疗多种疾病。然而,其在治疗UTI中的作用仍不清楚。本研究的目的是确定DEX对UTI小鼠的治疗效果。

方法

将30只C57BL/6J小鼠随机分为三组(每组n = 10):(I)对照组,(II)UTI组,(III)UTI + DEX组。使用快速填充前列腺闭塞包手持器械构建UTI小鼠模型,并通过腹腔注射DEX(2.5 mg/kg)两周来研究其对UTI的治疗效果。评估小鼠模型中输尿管的病理变化、肾功能、细胞外基质蛋白沉积和肾脏中的炎症标志物。

结果

UTI组输尿管组织病理学变化比对照组更严重;然而,DEX治疗在一定程度上减轻了这些变化。UTI组小鼠的肾功能升高。虽然DEX减轻了肾功能恶化,但差异无统计学意义。此外,与对照组相比,UTI组小鼠的肾脏样本显示炎症标志物的信使核糖核酸(mRNA)水平升高,表明炎症反应在进展,而DEX在蛋白质水平上显著逆转了白细胞介素-1β(IL-1β)的表达。此外,UTI小鼠肾脏中纤维化相关标志物明显增加。DEX治疗显著逆转了这些发现,揭示了其抗炎和抗纤维化活性。

结论

DEX降低了UTI后肾纤维化和炎症的严重程度,并发挥了显著的肾脏保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e93/11650345/cf81c6a6557b/tau-13-11-2498-f1.jpg

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