Abstract

Acute kidney injury (AKI) is the most common condition in hospitalized patients. As ischemia/reperfusion-induced AKI (IR-AKI) is as a major contributor to end-stage disease, an effective therapeutic intervention for IR-AKI is imperative. Erythropoietin (EPO) is a potent stimulator of erythroid progenitor cells and is significantly upregulated during hypoxia. Here, we investigated the renoprotective effects of EPO in an IR-AKI mouse model. Mice were assigned to sham, EPO only, and IR only groups, and the IR group was treated with EPO prior to injury. EPO was administered twice at 30 min prior to bilateral renal artery occlusion, and 5 min before reperfusion, with all mice sacrificed 24 h after IR-AKI. The serum was harvested for renal functional measurements. The kidneys were subjected to histological evaluation, and the biochemical changes associated with renal injury were assessed. EPO significantly attenuated the renal dysfunction associated with IR-AKI, as well as tissue injury. Apoptotic cell death and oxidative stress were significantly reduced in EPO-treated mice. Macrophage infiltration and expression of ICAM-1 and MCP-1 were also significantly reduced in EPO-treated mice. Furthermore, the expression of inflammasome-related factors (NLRP1, NLRP3, and caspase-1 cleavage), via the activation of the COX-2 and NF-κB signaling pathways were significantly reduced following EPO treatment. To our knowledge, this is the first study to demonstrate that inflammasome-mediated inflammation might be a potential target of EPO as a treatment for ischemic AKI.

Highlights

  • Acute kidney injury (AKI) is the most common condition in hospitalized patients [1]

  • Serum blood urea nitrogen (BUN) and serum creatinine (Cr) levels were markedly elevated in the IR group, and pre-treatment with EPO significantly attenuated BUN and Cr elevation in IR mice (Figure 1A)

  • This study showed that EPO protected against ischemia/reperfusion-induced AKI (IR-AKI) via the inactivation of inflammasome-dependent signaling pathways, as well as the inhibition of oxidative stress

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Summary

Introduction

Renal inflammation is a universal response to both infectious and noninfectious insults. Experimental models suggest that pathogen-associated molecular patterns (PAMPs), and the uncontrolled release of danger-associated molecular patterns (DAMPs) from damaged or dying cells drive inflammatory responses, and subsequent tissue and organ injury. Inflammasomes are multiprotein complexes that regulate cytokine maturation, inflammation, and cell death via the activation of certain caspases [2]. NLRP3 is the most well-studied of the inflammasome-related proteins and is activated by DAMPs, which regulate the secretion of pro-inflammatory cytokines such as IL-1β and IL-18. These inflammasome components have been directly implicated in renal inflammation injury [4]

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