Abstract

The heme component of myoglobin plays a crucial role in the pathogenesis of rhabdomyolysis-associated acute kidney injury (RM-AKI). Heme oxiganenase-1 (HO-1) is the rate-limiting enzyme of heme catabolism, and its metabolites, iron, biliverdin, and carbon monoxide, have antioxidant properties. Tin chloride (SnCl2) is a kidney specific HO-1 inducer. In this study, we examined whether the induction of HO-1 in the kidney by SnCl₂ pretreatment ameliorates RM-AKI in rats and if the effect is due to the degradation of excess renal free heme. We developed an RM-AKI rat (male Sprague-Dawley rats) model by injecting glycerol (Gly) in the hind limbs. RM-AKI rats were pretreated with saline or SnCl₂ or additional SnMP (tin mesoporphyrin, a specific HO inhibitor) followed by Gly treatment. Serum blood urea nitrogen (BUN) and creatinine (Crea) were measured as indicators of renal function. Renal free heme level was assessed based on the levels of δ-aminolevulinate synthase (ALAS1), a heme biosynthetic enzyme, and nuclear BTB and CNC homology 1 (Bach1), an inhibitory transcription factor of HO-1. Elevated free heme levels lead to decreases in ALAS1 and nuclear Bach1. After 24 h of Gly injection, serum BUN and Crea levels in saline-pretreated rats were significantly higher than those in untreated control rats. In contrast, SnCl₂-pretreated rats showed no significant increase in the indices. However, additional treatment of SnMP abolished the beneficial effect of SnCl₂. Renal ALAS1 mRNA levels and renal nuclear Bach1 protein levels in the saline pretreated rats were significantly lower than those in control rats 3 h after Gly injection. In contrast, the levels in SnCl₂-pretreated rats were not altered. The findings indicate that SnCl2 pretreatment confers protection against RM-AKI by virtue of HO-1 induction in the renal system, at least in part through excess free heme degradation.

Highlights

  • Rhabdomyolysis is a life-threatening condition characterized by extensive muscle damage leading to the expression of myoglobin

  • We proposed that there was a marked rise in intracellular heme concentration in the renal system of rhabdomyolysis-associated acute kidney injury (RM-AKI) rats based on dynamic changes in three substances, including Heme oxiganenase-1 (HO-1), δ-aminolevulinate synthase (ALAS1)—a key enzyme involved in heme metabolism that is usually downregulated by heme—and the nuclear Broad-complex, Tramtrack and Bric-a-brac (BTB), and cap’n’collar (CNC) homology proteins 1 (Bach1), a heme responsive transcription factor, which is exported from the nucleus and binds to intracellular heme

  • We have demonstrated for the first time that SnCl2 pretreatment ameliorates RM-AKI induced upon injecting glycerol into the hind limbs of rats

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Summary

Objectives

We aimed to investigate whether pharmacological induction of HO-1 expression by SnCl2 prevents RM-AKI in rats. We aimed to determine whether the effect of SnCl2 pretreatment on ameliorating RM-AKI is mediated through heme metabolism

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