Matsushima H, Yonemura K, Ohishi K, Hishida A
First Department of Medicine, Hamamatsu University School of Medicine, Japan.
J Lab Clin Med. 1998 Jun;131(6):518-26. doi: 10.1016/s0022-2143(98)90060-9.
We examined the role of oxygen free radicals in cisplatin-induced acute renal failure (ARF). The intravenous injection of cisplatin (5 mg/kg body weight) induced an increase in serum creatinine and tubular damage in the outer stripe of the outer medulla in rats. The renal content of malondialdehyde (MDA) transiently increased. Treatment with the free radical scavengers dimethylthiourea (DMTU) or lecithinized superoxide dismutase (L-SOD) attenuated the increase in serum creatinine. The beneficial effect of DMTU, a hydroxyl radical scavenger, was associated with less accumulation of MDA, less tubular damage, and enhanced expression of proliferating cell nuclear antigen (PCNA) in the damaged tubular cells, but not with improvement of reduced renal blood flow (RBF). On the other hand, the beneficial effect of L-SOD, a superoxide anion scavenger, was associated with preservation of RBF and increased urinary guanosine 3',5'-cyclic monophosphate excretion but not with modification of tubular damage or PCNA expression. These results suggest that (1) cisplatin-induced nephrotoxicity was associated with lipid peroxidation, (2) the hydroxyl radical scavenger prevented ARF through both attenuation of tubular damage and enhanced regenerative response of the damaged tubular cells, and (3) the superoxide anion scavenger did the same through preservation of RBF. It follows that oxygen free radicals may play an important role in cisplatin-induced ARF by reducing RBF and inducing tubular damage.
我们研究了氧自由基在顺铂诱导的急性肾衰竭(ARF)中的作用。静脉注射顺铂(5毫克/千克体重)可导致大鼠血清肌酐升高以及外髓质外层条纹处的肾小管损伤。肾组织中丙二醛(MDA)含量短暂升高。用自由基清除剂二甲基硫脲(DMTU)或卵磷脂化超氧化物歧化酶(L-SOD)进行治疗可减轻血清肌酐的升高。作为羟基自由基清除剂的DMTU的有益作用与MDA积累减少、肾小管损伤减轻以及受损肾小管细胞中增殖细胞核抗原(PCNA)表达增强有关,但与肾血流量(RBF)降低的改善无关。另一方面,作为超氧阴离子清除剂的L-SOD的有益作用与RBF的维持以及尿中鸟苷3',5'-环磷酸排泄增加有关,但与肾小管损伤或PCNA表达的改变无关。这些结果表明:(1)顺铂诱导的肾毒性与脂质过氧化有关;(2)羟基自由基清除剂通过减轻肾小管损伤和增强受损肾小管细胞的再生反应来预防ARF;(3)超氧阴离子清除剂通过维持RBF来达到同样的效果。由此可见,氧自由基可能通过降低RBF和诱导肾小管损伤在顺铂诱导的ARF中发挥重要作用。