A Role for Human Renal Tubular Epithelial Cells in Direct Allo-Recognition by CD4+ T-Cells and the Effect of Ischemia-Reperfusion

Direct allorecognition is the earliest and most potent immune response against a kidney allograft. Currently, it is thought that passenger donor professional antigen-presenting cells (APCs) are responsible. Further, many studies support that graft ischemia-reperfusion injury increases the probability of acute rejection. We evaluated the possible role of primary human proximal renal tubular epithelial cells (RPTECs) in direct allorecognition by CD4+ T-cells and the effect of anoxia-reoxygenation. In cell culture, we detected that RPTECs express all the required molecules for CD4+ T-cell activation (HLA-DR, CD80, and ICAM-1). Anoxia-reoxygenation decreased HLA-DR and CD80 but increased ICAM-1. Following this, RPTECs were co-cultured with alloreactive CD4+ T-cells. In T-cells, zeta chain phosphorylation and c-Myc increased, indicating activation of T-cell receptor and co-stimulation signal transduction pathways, respectively. T-cell proliferation assessed with bromodeoxyuridine assay and with the marker Ki-67 increased. Previous culture of RPTECs under anoxia raised all the above parameters in T-cells. FOXP3 remained unaffected in all cases, signifying that proliferating T-cells were not differentiated towards a regulatory phenotype. Our results support that direct allorecognition may be mediated by RPTECs even in the absence of donor-derived professional APCs. Also, ischemia-reperfusion injury of the graft may enhance the above capacity of RPTECs, increasing the possibility of acute rejection.     

Proteomic study on protective mechanism of ischemic preconditioning to ischemia-reperfusion lung injury

Objective To investigate the change of protein expression of lung tissue of rabbit after ischemic preconditioning (IP) and try to elucidate the potential protective mechanism of IP. Methods 12 domestic rabbits were randomly divided into group IP and group control (6 rabbits in each group). All the left lungs were afflicted by ische mia-reperfusion injury except that those in group IP were subject to IP prior to ischemic phase. 2-DE was employed to separate the total protein of the lung tissue. PDQuest analysis software was used to distinguish the differently expressed protein spot. MALDI-TOF-MS and Mascot database searching were exploited to identify these proteins. Results 1) IP attenuated the ischemia-reperfusion lung injury. 2) The proteomic analysis showed 35 target proteins, of which 17 were characterized such as phosphatidylinositol 3-kinase(PI3k) delta catalytic subunit. Conclusions 1) Proteomic is a promising tool to investigate the IP and ischemia-reperfusion lung injury. 2) That IP inhibits inflammatory cascades through phosphatidylinositol 3-kinase signal transduction pathway may be one of its protective mechanism. Foundation item: Project(2004036433) supported by the Postdoctoral Science Foundation of China; project(B2004024) supported by the Science Foundation of Public Health Bureau of Hunan Province     

依达拉奉对大鼠缺血再灌注心肌的保护作用

目的 探讨依达拉奉对心肌缺血再灌注的保护作用及机制.方法 将50只成年SD大鼠按随机数字表法分为假手术组、再灌注组、低剂量组、中剂量组和高剂量组,每组10只.建立大鼠急性缺血再灌注模型,描记术中心电图变化.假手术组：开胸,分离左冠状动脉并穿线,不结扎,旷置225 min;再灌注组：缺血45 min,再灌注3 h,灌注前1 min将生理盐水按0.2 mL·kg-1经右股静脉注入;低剂量组：再灌注前1 min,将依达拉奉按3 mg·kg-1经右股静脉注入;中剂量组：灌注前1 min将依达拉奉按6 mg·kg-1经右股静脉注入;高剂量组：灌注前1 min将依达拉奉按9 mg·kg-1经右股静脉注入.于再灌注末测定血清肌钙蛋白、心肌组织Ca2＋、SOD、MDA及Na＋-K＋-ATPase 、Ca2＋-ATPase的含量或活性.结果 再灌注组与低剂量组、中剂量组、高剂量组相比,再灌注后ST段回落程度较低、室性心律失常发作例数稍高,但4组间比较差异均无统计学意义（均P＞0.05）.低剂量组、中剂量组和高剂量组的血清肌钙蛋白明显低于再灌注组（均P＜0.05）;中剂量组、高剂量组及再灌注组血清肌钙蛋白明显高于假手术组（P＜0.05或P＜0.01）.与假手术组比较,再灌注组心肌组织MDA活性、Ca2＋含量明显增高,SOD活力及Na＋-K＋-ATP酶、Ca2＋-ATP酶活性明显降低（均P＜0.05）;与再灌注组比较,低剂量组、中剂量组和高剂量组的MDA活力及Ca2＋含量降低,SOD活力及Na＋-K＋-ATP酶、Ca2＋-ATP酶活性明显增加（均P＜0.05）.结论 在再灌注前注射依达拉奉可减轻心肌缺血再灌注损伤.其作用机制是有效地清除氧自由基、提高机体抗氧化应激能力.     

Mechanism of Mitochondrial Connexin43′s Protection of the Neurovascular Unit under Acute Cerebral Ischemia-Reperfusion Injury

We observed mitochondrial connexin43 (mtCx43) expression under cerebral ischemia-reperfusion (I/R) injury, analyzed its regulation, and explored its protective mechanisms. Wistar rats were divided into groups based on injections received before middle cerebral artery occlusion (MCAO). Cerebral infarction volume was detected by 2,3,5-triphenyltetrazolim chloride staining, and cell apoptosis was observed by transferase dUTP nick end labeling. We used transmission electron microscopy to observe mitochondrial morphology and determined superoxide dismutase (SOD) activity and malondialdehyde (MDA) content. MtCx43, p-mtCx43, protein kinase C (PKC), and p-PKC expression were detected by Western blot. Compared with those in the IR group, cerebral infarction volumes in the carbenoxolone (CBX) and diazoxide (DZX) groups were obviously smaller, and the apoptosis indices were down-regulated. Mitochondrial morphology was damaged after I/R, especially in the IR and 5-hydroxydecanoic acid (5-HD) groups. Similarly, decreased SOD activity and increased MDA were observed after MCAO; CBX, DZX, and phorbol-12-myristate-13-acetate (PMA) reduced mitochondrial functional injury. Expression of mtCx43 and p-mtCx43 and the p-Cx43/Cx43 ratio were significantly lower in the IR group than in the sham group. These abnormalities were ameliorated by CBX, DZX, and PMA. MtCx43 may protect the neurovascular unit from acute cerebral IR injury via PKC activation induced by mitoKATP channel agonists.     

Human Endothelial Progenitor Cells Protect the Kidney against Ischemia-Reperfusion Injury via the NLRP3 Inflammasome in Mice

Ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury (AKI) and progression to chronic kidney disease (CKD). However, no effective therapeutic intervention has been established for ischemic AKI. Endothelial progenitor cells (EPCs) have major roles in the maintenance of vascular integrity and the repair of endothelial damage; they also serve as therapeutic agents in various kidney diseases. Thus, we examined whether EPCs have a renoprotective effect in an IRI mouse model. Mice were assigned to sham, EPC, IRI-only, and EPC-treated IRI groups. EPCs originating from human peripheral blood were cultured. The EPCs were administered 5 min before reperfusion, and all mice were killed 72 h after IRI. Blood urea nitrogen, serum creatinine, and tissue injury were significantly increased in IRI mice; EPCs significantly improved the manifestations of IRI. Apoptotic cell death and oxidative stress were significantly reduced in EPC-treated IRI mice. Administration of EPCs decreased the expression levels of NLRP3, cleaved caspase-1, p-NF-κB, and p-p38. Furthermore, the expression levels of F4/80, ICAM-1, RORγt, and IL-17RA were significantly reduced in EPC-treated IRI mice. Finally, the levels of EMT-associated factors (TGF-β, α-SMA, Snail, and Twist) were significantly reduced in EPC-treated IRI mice. This study shows that inflammasome-mediated inflammation accompanied by immune modulation and fibrosis is a potential target of EPCs as a treatment for IRI-induced AKI and the prevention of progression to CKD.     

Inhibition of Toll-Like Receptor 4 Signaling Mitigates Microvascular Loss but Not Fibrosis in a Model of Ischemic Acute Kidney Injury

The development of chronic kidney disease (CKD) following an episode of acute kidney injury (AKI) is an increasingly recognized clinical problem. Inhibition of toll-like receptor 4 (TLR4) protects renal function in animal models of AKI and has become a viable therapeutic strategy in AKI. However, the impact of TLR4 inhibition on the chronic sequelae of AKI is unknown. Consequently, we examined the chronic effects of TLR4 inhibition in a model of ischemic AKI. Mice with a TLR4-deletion on a C57BL/6 background and wild-type (WT) background control mice (C57BL/6) were subjected to bilateral renal artery clamping for 19 min and reperfusion for up to 6 weeks. Despite the acute protective effect of TLR4 inhibition on renal function (serum creatinine 1.6 ± 0.4 mg/dL TLR4-deletion vs. 2.8 ± 0.3 mg/dL·WT) and rates of tubular apoptosis following ischemic AKI, we found no difference in neutrophil or macrophage infiltration. Furthermore, we observed significant protection from microvascular rarefaction at six weeks following injury with TLR4-deletion, but this did not alter development of fibrosis. In conclusion, we validate the acute protective effect of TLR4 signal inhibition in AKI but demonstrate that this protective effect does not mitigate the sequential fibrogenic response in this model of ischemic AKI.     

Donor Heart Preservation with Hydrogen Sulfide: A Systematic Review and Meta-Analysis

Preclinical studies have shown that postconditioning with hydrogen sulfide (H₂S) exerts cardioprotective effects against myocardial ischemia-reperfusion injury (IRI). The aim of this study was to appraise the current evidence of the cardioprotective effects of H₂S against IRI in order to explore the future implementation of H₂S in clinical cardiac transplantation. The current literature on H₂S postconditioning in the setting of global myocardial ischemia was systematically reviewed and analyzed, performing meta-analyses. A literature search of the electronic databases Medline, Embase and Cinahl identified 1835 studies that were subjected to our pre-defined inclusion criteria. Sixteen studies were considered eligible for inclusion. Postconditioning with H₂S showed significant robust effects with regard to limiting infarct size (standardized mean difference (SMD) = −4.12, 95% CI [−5.53–−2.71], p < 0.00001). Furthermore, H₂S postconditioning consistently resulted in a significantly lower release of cardiac injury markers, lower levels of oxidative stress and improved cardiac function. Postconditioning with slow-releasing H₂S donors offers a valuable opportunity for novel therapies within cardiac preservation for transplantation. Before clinical implication, studies evaluating the long-term effects of H₂S treatment and effects of H₂S treatment in large animal studies are warranted.     

miR-145通过调节SOD活性介导人参皂苷Rb1对脑缺血再灌注损伤大鼠的脑保护作用

目的: 探讨人参皂苷Rb1是否通过减少miR-145含量来上调脑缺血再灌注损伤大鼠脑组织SOD活性发挥脑保护作用。方法: 将60只SD大鼠按随机数字表法分成模型组、生理盐水对照组、人参皂苷Rb1组、人参皂苷Rb1+miR-145模拟物组、人参皂苷Rb1+miR-145质控品组,每组12只。采用大脑中动脉闭塞（MCAO）法建立大鼠脑缺血再灌注损伤模型。人参皂苷Rb1组和生理盐水对照组大鼠在制模后即刻分别腹腔注射人参皂苷Rb1（40 mg/kg）和等量生理盐水;人参皂苷Rb1+miR-145模拟物组和人参皂苷Rb1+miR-145质控品组大鼠在制模前2 d分别侧脑室注射miRNA 145模拟物和miRNA 145质控品,其他操作同人参皂苷Rb1组。再灌注损伤后24 h测各组大鼠神经行为学评分,其中6只大鼠测量脑梗死体积;另6只大鼠取大脑皮质,测定miR-145、超氧化物歧化酶（SOD）含量。结果: 与模型组比较,人参皂苷Rb1组大鼠行为学评分明显降低（P＜0.05）,脑梗死体积明显减小（P＜0.05）,miR-145含量明显减少（P＜0.05）,SOD活性明显增加（P＜0.05）。与人参皂苷Rb1组,人参皂苷Rb1+miR-145模拟物组大鼠行为学评分明显升高（P＜0.05）,脑梗死体积明显增加（P＜0.05）,miR-145含量明显增加（P＜0.05）,SOD活性显著下降（P＜0.05）。结论: 人参皂苷Rb1可以通过减少miR-145含量来上调脑缺血再灌注损伤大鼠脑组织SOD活性发挥脑保护作用。     

水蛭多肽对大鼠脑缺血-再灌注损伤的保护作用及其机制

目的：探讨水蛭多肽提取物对大鼠脑缺血-再灌注损伤的保护作用及其作用机制。方法采用线栓法制备大鼠脑缺血-再灌注损伤模型,制模成功后按随机数字表法分为4组：模型组（A 组,n＝6）、水蛭多肽低剂量组（5 mg· kg－1,B 组,n＝7）、水蛭多肽高剂量组（10 mg·kg－1,C 组,n＝8）及灯盏花素注射液阳性对照组（5 mg·kg－1,D 组,n＝7）;另取大鼠7只制作假手术组（E 组）。5组均尾静脉注射给药,每日1次,连续7 d;B、C、D 组给予相对应药物,A、E组给予等体积生理盐水。采用称重法测定大鼠体质量、进食量,TTC 染色法测定脑梗死体积,伊文思蓝法测定血-脑屏障功能。结果与 A 组比较,B、C、D 组体质量降低程度、神经功能评分、脑梗死体积均显著减小,进食量显著增加,血-脑屏障功能显著改善（P ＜0．05或 P ＜0．01）。结论水蛭多肽对大鼠脑缺血-再灌注损伤具有显著的保护作用,其保护机制与其对血-脑屏障损伤的改善有关。     

Baicalin Ameliorates H2O2 Induced Cytotoxicity in HK-2 Cells through the Inhibition of ER Stress and the Activation of Nrf2 Signaling

Renal ischemia-reperfusion injury plays a key role in renal transplantation and greatly affects the outcome of allograft. Our previous study proved that Baicalin, a flavonoid glycoside isolated from Scutellaria baicalensis, protects kidney from ischemia-reperfusion injury. This study aimed to study the underlying mechanism in vitro. Human renal proximal tubular epithelial cell line HK-2 cells were stimulated by H₂O₂ with and without Baicalin pretreatment. The cell viability, apoptosis and oxidative stress level were measured. The expression of endoplasmic reticulum (ER) stress hallmarks, such as binding immunoglobulin protein (BiP) and C/EBP homologous protein (CHOP), were analyzed by western blot and real-time PCR. NF-E2-related factor 2 (Nrf2) expression was also measured. In the H₂O₂ group, cell viability decreased and cell apoptosis increased. Reactive Oxygen Species (ROS) and Glutathione/Oxidized Glutathione (GSH/GSSG) analysis revealed increased oxidative stress. ER stress and Nrf2 signaling also increased. Baicalin pretreatment ameliorated H₂O₂-induced cytotoxicity, reduced oxidative stress and ER stress and further activated the anti-oxidative Nrf2 signaling pathway. The inducer of ER stress and the inhibitor of Nrf2 abrogated the protective effects, while the inhibitor of ER stress and the inducer of Nrf2 did not improve the outcome. This study revealed that Baicalin pretreatment serves a protective role against H₂O₂-induced cytotoxicity in HK-2 cells, where the inhibition of ER stress and the activation of downstream Nrf2 signaling are involved.