Abstract
Acute ischemic kidney injury is the most frequent cause of acute renal failure in daily clinical practice. It has become increasingly recognized that microvascular endothelial cell dysfunction (ED) in peritubular capillaries inhibits the process of postischemic renal reperfusion. ED can serve as therapeutic target in the management of acute ischemic kidney injury. Postischemic reflow can be restored by systemic administration of either mature endothelial cells or of endothelial progenitor cells. Endothelial progenitor cells EPCs can be cultured from the peripheral circulation of humans and different animals. The cells act vasoprotectively by direct and indirect mechanisms. The protective effects of EPCs in acute ischemic kidney injury can be stimulated by preincubating the cells with different agonistic mediators. This paper summarizes the currently available data on strategies to improve the renoprotective activity of EPCs in acute ischemic kidney injury.
Highlights
Acute ischemic kidney injury is the most frequent cause of acute renal failure in daily clinical practice [1]
It has become increasingly recognized that microvascular endothelial cell dysfunction (ED) in peritubular capillaries inhibits the process of postischemic renal reperfusion
This paper summarizes the currently available data on strategies to improve the renoprotective activity of EPCs in acute ischemic kidney injury
Summary
Acute ischemic kidney injury is the most frequent cause of acute renal failure in daily clinical practice [1]. In vivo microscopic analyses confirmed the aforementioned significant postischemic endothelial cell swelling within the peritubular capillary network, and in addition showed that complete normalization of microvascular tissue perfusion occurs as late as 24 hours after ischemia In this setting, systemic administration of HUVECs markedly inhibited endothelial cell swelling and promoted a faster functional and structural recovery of the organ. Injected cells had partly been incorporated into the endothelial layer of small blood vessels surrounding the tubular integrity [4, 5] These studies showed for the first time that targeting postischemic ED by International Journal of Nephrology the administration of cells of the endothelial lineage is a true option in the treatment of acute ischemic kidney injury
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