scholarly journals Tongfu Huoxue Decoction Reduces Autophagy and Apoptosis to Protect Against Acute Renal Injury in a Rat Model of Sepsis

Author(s):  
Yan Wang ◽  
Zixuan Wang ◽  
Qianlan Yang ◽  
Yuxin Fan ◽  
Lu Wang ◽  
...  

Abstract Background: To investigate the mechanism by which Tongfu Huoxue decoction protects against acute kidney injury in sepsis in rats, and provide a new therapeutic strategy for clinical intervention.Methods: Thirty-two Sprague–Dawley rats were randomly divided into a control group (saline), model group (lipopolysaccharide LPS group), LPS group+Tongfu Huoxue Decoction high-dose group (H group), and LPS group +Tongfu Huoxue Decoction low-dose group (L group). A rat model of acute kidney injury in sepsis was established by administration of LPS, and Tongfu Huoxue decoction was administered by gavage. The pathological and morphological changes of the kidneys were evaluated according to the levels of urea nitrogen (BUN) and blood creatinine (SCr). The expression of the inflammation-related factors IL-1b, IL-6 and TNF-a was determined by quantitative real-time PCR. Changes in the phosphorylation levels of the autophagy and apoptosis-related proteins LC3, beclin-1, caspase-3 and Akt were detected by Western blot analysis. Results: Compared with the model LPS group, kidney tissue damage was reduced in rats treated with Tongfu Huoxue decoction. The expression levels of inflammation-related and autophagy-related proteins in the kidney tissue of rats treated with Tongfu Huoxue decoction were significantly lower than those in the LPS group, which was showed a dose-dependent decrease in expression. After stimulation of HK-2 cells with LPS, the expression levels of the autophagy and apoptosis in the groups treated with Tongfu Huoxue decoction decreased in a dose-dependent manner. Furthermore, the rate of HK-2 cell apoptosis was higher in the LPS group than that in the control group, with lower rates in the H and L groups than that in the LPS group and were dose-dependent.Conclusion: Tongfu Huoxue decoction protects against acute renal injury in sepsis by reducing autophagy and apoptosis.


2020 ◽  
Vol 128 (4) ◽  
pp. 715-728 ◽  
Author(s):  
Christopher L. Chapman ◽  
Blair D. Johnson ◽  
Nicole T. Vargas ◽  
David Hostler ◽  
Mark D. Parker ◽  
...  

Occupational heat stress increases the risk of acute kidney injury (AKI) and kidney disease. This study tested the hypothesis that attenuating the magnitude of hyperthermia (i.e., increase in core temperature) and/or dehydration during prolonged physical work in the heat attenuates increases in AKI biomarkers. Thirteen healthy adults (3 women, 23 ± 2 yr) exercised for 2 h in a 39.7 ± 0.6°C, 32 ± 3% relative-humidity environmental chamber. In four trials, subjects received water to remain euhydrated ( Water), continuous upper-body cooling ( Cooling), a combination of both ( Water + Cooling), or no intervention ( Control). The magnitude of hyperthermia (increased core temperature of 1.9 ± 0.3°C; P < 0.01) and dehydration (percent loss of body mass of −2.4 ± 0.5%; P < 0.01) were greatest in the Control group. There were greater increases in the urinary biomarkers of AKI in the Control trial: albumin (increase of 13 ± 11 μg/mL; P ≤ 0.05 compared with other trials), neutrophil gelatinase-associated lipocalin (NGAL) (increase of 16 ± 14 ng/dL, P ≤ 0.05 compared with Cooling and Water + Cooling groups), and insulin-like growth factor-binding protein 7 (IGFBP7) (increase of 227 ± 190 ng/mL; P ≤ 0.05 compared with other trials). Increases in IGFBP7 in the Control trial persisted after correcting for urine production/concentration. There were no differences in the AKI biomarker tissue inhibitor of metalloproteinase 2 (TIMP-2) between trials ( P ≥ 0.11). Our findings indicate that the risk of AKI is highest with greater magnitudes of hyperthermia and dehydration during physical work in the heat. Additionally, the differential findings between IGFBP7 (preferentially secreted in proximal tubules) and TIMP-2 (distal tubules) suggest the proximal tubules as the location of potential renal injury. NEW & NOTEWORTHY We demonstrate that the risk for acute kidney injury (AKI) is higher in humans with greater magnitudes of hyperthermia and dehydration during physical work in the heat and that alleviating the hyperthermia and/or limiting dehydration equally reduce the risk of AKI. The biomarker panel employed in this study suggests the proximal tubules as the location of potential renal injury.



2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096400
Author(s):  
Qiuyu Li ◽  
Qin Cheng ◽  
Zhiling Zhao ◽  
Nini Dai ◽  
Lin Zeng ◽  
...  

Background The causative virus of coronavirus disease 2019 (COVID-19) may cause severe fatal pneumonia. The clinical presentation includes asymptomatic infection, severe pneumonia, and acute respiratory failure. Data pertaining to acute renal injury due to COVID-19 in patients who have undergone renal transplantation are scarce. We herein report two cases of COVID-19 along with acute kidney injury following kidney transplantation. Case presentation: Two patients with COVID-19 underwent renal transplantation and were subsequently diagnosed with acute kidney injury. The first patient presented with progressive respiratory symptoms and acute renal injury. He was treated with diuretics and suspension of immunosuppressive therapy; however, the patient died. The second patient presented with respiratory tract symptoms, hypoxemia, and progressive deterioration of renal function followed by improvement. Her mycophenolate mofetil was stopped after admission, and tacrolimus was discontinued 10 days later. Moxifloxacin and methylprednisolone were continued in combination with albumin and gamma globulin infusion. A diuretic was administered, and prednisone was gradually reduced along with tacrolimus. The patient exhibited a satisfactory clinical recovery. Conclusion Patients who develop COVID-19 after kidney transplantation are at risk of acute kidney injury, and their prednisone, immunosuppressant, and gamma globulin treatment must be adjusted according to their condition.



2021 ◽  
Vol 21 (2) ◽  
pp. 1345-1350
Author(s):  
Ye Chen ◽  
Xiaoxia Liu ◽  
Meiling Chen ◽  
Run Yan ◽  
Wenyu Song

This article explores the pathogenesis of sepsis AKI, and seeks to protect the acute damage of sepsis tissues and organs. This study is to prepare a rat sepsis-induced AKI model by CLP, and to observe the pathological changes of kidney tissue and the function of kidney changes, and observe the effect of siRNA nanoparticles on its intervention, preliminary explore the protective effect and possible mechanism of siRNA nanoparticles on AKI in sepsis rats, and provide more information for the clinical treatment of siRNA nanoparticles in sepsis theoretical and experimental basis. We analysis the benefit and deficiency of nuclear factor-κB (NF-κB) activation in the pathogenesis of glomerulonephritis and its regulatory effect on NF-κB activation. In the rat model group, no treatment was given after injection of nephrotoxic serum, and the rats were sacrificed on the 14th day; the compound siRNA nanoparticle intervention group (treatment group) was given dexamethasone 0.125 daily on the 1st to 14th day after nephrotoxic serum injection. Immunohistochemistry and medical image analysis system were used to observe NF-κB activation of monocyte chemotactic protein-1 (MCP-1) in glomeruli and tubules, and analyze their relationship with proteinuria and glomerular cells. The results showed that the expression of NF-κB in the glomeruli and tubules of the model group was significantly up-regulated regarding to the control group, and MCP-1’s expression in the glomeruli and tubules of the model group was higher than that of the control group. The activation of NF-κB and the expression of MCP-1 in glomeruli are closely related to monocyte infiltration and proteinuria; NF-κB activation and MCP-1 expression in glomeruli and tubules of the compound siRNA nanoparticles intervention group were significantly down-regulated. It was concluded that the activation of NF-κB has great impact on the pathogenesis of glomerulonephritis, and inhibition of NF-κB activation may be one of the mechanisms of anti-nephritis effect.



2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jufitriani Ismy ◽  
Maimun Syukri ◽  
Dessy R. Emril ◽  
Nanan Sekarwana ◽  
Jufriady Ismy ◽  
...  

Sepsis is one of the leading causes contributing to the incidence of acute kidney injury (AKI). Oxidative stress can be used as the main approach against sepsis-induced AKI. One of the primary antioxidants that plays a role in warding off oxidative stress is superoxide dismutase (SOD). This research aimed to observe the effect of antioxidant SOD in inhibiting sepsis in AKI based on kidney tissue histopathology. The research method was an experimental laboratory with a post-test-only control group design. Twenty-five adult male rats aged 12–16 weeks, weighing between 200 and 250 g, were randomly divided into five groups: Group I, as a positive control, where rats were injected with lipopolysaccharides (LPS); Group II, as a negative control; Group III, as treatment 1, where rats were injected with LPS and administered orally with SOD (Glisodin®) 250 IU daily; Group IV, as treatment 2, where rats were injected with LPS and administered orally with SOD (Glisodin®) 500 IU daily; and Group V, as treatment 2, where rats were injected with LPS and administered orally with SOD (Glisodin®) 1000 IU daily. Rats were administered with SOD (Glisodin®) by oral gavage with a flexible feeding tube for 16 weeks, given once daily in the morning, and then injected with LPS of 10 mg/kg body weight. Glisodin SOD had a significant effect on murine sepsis score (MSS). MSS influenced the tubular injury score linearly. We conclude that the optimal dose of SOD at 1000 IU for inhibiting sepsis-induced AKI incidence is compared to SOD at a dose of 250 and 500 IU. The antioxidant effect of SOD can prevent sepsis-induced AKI with oxidative stress events.



2021 ◽  
Vol 8 (3) ◽  
pp. 97-107
Author(s):  
I. O. Dementev ◽  
K. M. Nyushko ◽  
O. B. Karyakin ◽  
V. S. Chaikov ◽  
A. V. Troyanov ◽  
...  

Currently, due to the dynamic development of surgical technologies, indications for organ-sparing treatment of kidney cancer are expanding. Acute kidney injury is a serious complication that leads to chronic kidney disease, increased postoperative mortality, deterioration of long-term functional outcomes, and increased hospitalization. At present, it is known that even a slight damage to kidneys or their impairment, presented by a decreased urine output and change in blood biochemical parameters, entails serious clinical consequences and is associated with a poor prognosis. Damaging factors, when the kidney is exposed, initially induce molecular changes, which entail the production of certain biomarkers, and only after that clinical aspects of kidney damage develop. The causes of acute kidney injury can be different, from specific renal disorders (acute interstitial nephritis, vascular and glomerular lesions, prerenal azotemia, obstructive disorders) to toxic damages, direct trauma and surgical treatment. The development of acute renal injury in the postoperative period is a serious complication of the surgical treatment of kidney disease, and, according to various authors, the frequency of its occurrence varies from 5.5 % to 34 %. An active study of this problem made it possible to find specific biomarkers that give the possibility to predict and diagnose acute renal injury in the early stages, to optimize the treatment strategy, to reduce the incidence of postoperative complications, and to shorten the period of postoperative rehabilitation. Currently, the most studied of acute kidney injury (AKI) biomarkers are cystatin C, neutrophil gelatinase-associated lipocalin‑2 (NGAL), hepatic protein L-FABP, KIM‑1 (Kidney injury molecule‑1), Interleukin – 18. Further study of AKI biomarkers will make it possible to determine the most significant ones for subsequent use in everyday practice



2018 ◽  
Vol 11 ◽  
pp. 117954761878513
Author(s):  
Yuko Mutsuyoshi ◽  
Shohei Kaneko ◽  
Saori Minato ◽  
Katsunori Yanai ◽  
Hiroki Ishii ◽  
...  

We herein report a case of ureter rupture with severe oliguric acute renal injury due to benign prostatic hypertrophy. After insertion of an indwelling urinary catheter, the patient’s urine output immediately increased. His symptoms and renal function also rapidly improved to the normal range without a surgical operation. Clinicians should note this complication in patients with oliguria.



2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Siqi Xu ◽  
Youguang Gao ◽  
Qin Zhang ◽  
Siwei Wei ◽  
Zhongqing Chen ◽  
...  

Sepsis often results in damage to multiple organ systems, possibly due to severe mitochondrial dysfunction. Two members of the sirtuin family, SIRT1 and SIRT3, have been implicated in the reversal of mitochondrial damage. The aim of this study was to determine the role of SIRT1/3 in acute kidney injury (AKI) following sepsis in a septic rat model. After drug pretreatment and cecal ligation and puncture (CLP) model reproduction in the rats, we performed survival time evaluation and kidney tissue extraction and renal tubular epithelial cell (RTEC) isolation. We observed reduced SIRT1/3 activity, elevated acetylated SOD2 (ac-SOD2) levels and oxidative stress, and damaged mitochondria in RTECs following sepsis. Treatment with resveratrol (RSV), a chemical SIRT1 activator, effectively restored SIRT1/3 activity, reduced acetylated SOD2 levels, ameliorated oxidative stress and mitochondrial function of RTECs, and prolonged survival time. However, the beneficial effects of RSV were greatly abrogated by Ex527, a selective inhibitor of SIRT1. These results suggest a therapeutic role for SIRT1 in the reversal of AKI in septic rat, which may rely on SIRT3-mediated deacetylation of SOD2. SIRT1/3 activation could therefore be a promising therapeutic strategy to treat sepsis-associated AKI.



2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Ender Hur ◽  
Alev Garip ◽  
Asuman Camyar ◽  
Sibel Ilgun ◽  
Melih Ozisik ◽  
...  

Introduction. Acute kidney injury (AKI) pathogenesis is complex. Findings of gentamicin nephrotoxicity are seen in 30% of the AKI patients. Vitamin D has proven to be effective on renin expression, inflammatory response, oxidative stress, apoptosis, and atherosclerosis. We aimed to investigate the effect of vitamin D in an experimental rat model of gentamicin-induced AKI.Methods. Thirty nonuremic Wistar albino rats were divided into 3 groups: Control group, 1 mL saline intramuscular (im) daily; Genta group, gentamicin 100 mg/kg/day (im); Genta + vitamin D, gentamicin 100 mg/kg/day (im) in addition to 1α, 25 (OH)2D30.4 mcg/kg/day subcutaneously for 8 days. Blood pressures and 24-hour urine were measured. Blood urea and creatinine levels and urine tubular injury markers were measured. Renal histology was semiquantitatively assessed.Results. Urea, creatinine and urine neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1 were all increased in Genta group indicating AKI model. Systolic blood pressure decreased, but urine volume and glutathione increased in Genta + Vit D group compared to Control group. Histological scores indicating tubular injury increased in Genta and Genta + Vit D groups.Conclusions. Vitamin D does not seem to be effective on histological findings although it has some beneficial effects via RAS system and a promising effect on antioxidant system.



2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Milan Ivanov ◽  
Zoran Miloradovic ◽  
Nevena Mihailovic-Stanojevic ◽  
Djurdjica Jovovic ◽  
Danijela Karanovic ◽  
...  

Abstract Background and Aims Renal ischemia–reperfusion (RIR) injury is one of the factors in the development of acute kidney injury (AKI). AKI is multifactorially caused, but the mechanism of pathogenesis and development of this disease is still incompletely defined. AKI is characterized by the sudden appearance, rapid progression of disease and very uncertain and often fatal outcome. Heme oxygenase-1 (HO-1) is a cytoprotective enzyme that catalyzes the breakdown of heme to biliverdin, carbon monoxide, and iron. HO-1 is now recognized as a protection factor in acute kidney injury. The aim of this study was to determine the effect of preconditioning with hyperbaric oxygen (HBO) on HO-1 expression in kidney tissue and kidney function in spontaneously hypertensive rats (SHR) during kidney ischemia–reperfusion injury. Method An experiment was performed in anesthetized, adult six-month-old male SHR. The right kidney was removed and the renal ischemia was performed by clamping the left renal artery for 40 minutes. SHR were randomly selected in three experimental groups: sham operated group (SHAM; n=7); AKI control group (AKI; n=9); and AKI group with HBO (AKI+HBO; n=9). Treated group were placed into experimental HBO chambers and exposed to pure oxygen, twice a day (in a 12 hour period, 8AM and 8 PM) for two consecutive days in the following manner: 10 minutes slow compression, 2.026 bar for 60 minutes, 10 minutes slow decompression. Mean arterial pressure (MAP) and HO-1 expression in kidney tissue were measured 24h after reperfusion. Clearance of creatinine (CCr), urea (CUr) and phosphate (CPh) were calculated 24h after reperfusion. Results After AKI induction reduction of blood pressure was recorded in both groups with AKI. Preconditioning with HBO significantly improved kidney function in rats with AKI compared to control group. HO-1 expression in kidney tissue was significantly higher in the treated group (p&lt;0,01) compared to SHAM and AKI control group. Conclusion Our results suggest that HBO treatment improves kidney function in the AKI+HBO vs. AKI control group. This implies that increased level of HO-1 due to preconditioning with hyperbaric oxygen may have beneficial effects on kidney function, and potentially protective effect in an ischemic model of AKI with hypertension.



2020 ◽  
Vol 24 (4) ◽  
pp. 11
Author(s):  
N. O. Kamenshchikov ◽  
Yu. K. Podoksenov ◽  
M. L. Diakova ◽  
A. M. Boyko ◽  
B. N. Kozlov

<p>Surgical intervention on an ‘open’ heart during cardio-pulmonary bypass is the method of choice for patients with valvular defects, complicated forms of coronary heart disease and combined pathology. The level of perioperative mortality in these interventions range from 2 % to 10 %. Acute kidney injury associated with cardiac surgery is a common and serious complication which dramatically worsens operative prognoses and results. According to several major studies, the incidence of acute renal injury in cardiac surgery is comparable with the incidence of myocardial infarction, with corresponding unsatisfactory outcomes.<br />The introduction of the term ‘acute kidney injury’ into clinical practise, replacing the concept of acute renal failure, occurred relatively recently. This facilitated a universal definition for this condition, and unified the criteria for diagnosis and stratification of acute renal dysfunction severity. The article defines acute kidney injury using RIFLE, AKIN and KDIGO criteria. Acute kidney injury in cardiac surgery dramatically worsens short-term results and long-term outcomes, and thus increases the economic cost of treating patients. According to some reports, in industrialised countries, the health costs associated with acute kidney injury are estimated at $ 1 billion. Acute kidney injury is associated with approximately 300,000 deaths per annum, as well as approximately 300,000 new cases of chronic kidney disease. Cumulative expenses associated with acute renal injury in cardiac surgery are not directly limited to the hospitalisation period, but are often prolonged and/or deferred. These patients require additional financial expenses after discharge from hospital, which once again exemplifies this problem in cardiac surgery.<br />Manifest acute kidney injury in the postoperative period of cardiac surgery leads to an increased number of extrarenal complications, reduced short-and long-term survival rates, increased economic costs in hospitals and prolonged treatment effects in the long-term. The introduction of a single definition of cardiac acute renal injury according to KDIGO criteria into clinical practise will identify patient groups with a high risk of developing this pathology. Similarly, it will also facilitate timely measures to prevent the development of complications in postoperative periods, which will reduce the risk of complications in cardiac patients.</p><p>Received 10 July 2020. Revised 2 September 2020. Accepted 9 September 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and design: N.O. Kamenshchikov, Y.K. Podoksenov, M.L. Diakova<br />Data collection and analysis: N.O. Kamenshchikov, A.M. Boyko, M.L. Diakova<br />Drafting the article: N.O. Kamenshchikov, M.L. Diakova, A.M. Boyko<br />Critical revision of the article: M.L. Diakova, Y.K. Podoksenov<br />Final approval of the version to be published: N.O. Kamenshchikov, Y.K. Podoksenov, M.L. Diakova, A.M. Boyko, B.N. Kozlov</p>



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