Shen-fu injection alleviates acute renal injury by reducing cytokine levels and modulating apoptosis in a porcine hemorrhagic shock model.

Wei Yuan,Chun-Sheng Li,Junyuan Wu,Qiang Zhang,Yong Liang,Mingqqing Zhang,Hongjie Qin

doi:10.1590/acb360405

Abstract

ABSTRACTPurposeShen-fu injection (SFI) was used to intervene in the resuscitation of porcine hemorrhagic shock (HS) model to study its protective effects on acute kidney injury.MethodsAfter 60 min of HS, 28 animals were randomly assigned into four groups. The groups were as follows: hemorrhagic shock group (HS); HS resuscitation with shed-blood group (HSR); HS resuscitation with shed-blood and SFI (1 mL·kg–1) group (HSR-SFI); and the sham operation group (Sham). The bloods were analyzed for serum creatinine (sCr), cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL). BAX, Bcl-2, and caspase-3 protein expressions by Western blot analysis and immunohistochemical staining. The renal tissues were removed and pathologic changes were observed.ResultsMean aortic pressure (MAP) in HSR-SFI groups were higher than that in HSR groups after shock. At the 6th hour after shock, the urine volume per hour in the HSR-SFI groups was more than that in the HSR groups. The sCr, NGAL, CysC and cytokine levels of HSR-SFI groups were lower. The Bcl-2 expression was increased in the HSR-SFI groups. The BAX and caspase-3 expressions were reduced. The histopathologic score in the HSR-SFI was lower.ConclusionsSFI may reduce the risk of acute kidney injury (AKI) following hemorrhagic shock by attenuating systemic inflammatory responses, and regulating the expression of apoptosis-related proteins.

Highlights

Trauma is the third leading cause of death worldwide, and the leading cause of mortality in people older than 44 years[1]
There was no significant difference in Heart rate (HR) between the HS resuscitation with shed-blood group (HSR) and HSR-Shen-fu injection (SFI) groups during resuscitation, either at 4 or 6 h
No significant differences in intrathoracic blood volume index (ITBVI) between the HSR and HRS-SFI groups during the experimental protocol were found (Table 1)

Summary

Introduction

Trauma is the third leading cause of death worldwide, and the leading cause of mortality in people older than 44 years[1]. Secondary organ dysfunction is one of the main causes of trauma deaths. Acute kidney injury (AKI) is the most common complication after trauma with a reported incidence of 50%2. Acute kidney injury may be caused by several reasons. Except for decreased renal perfusion that results from hemorrhage, rhabdomyolysis, and systematic inflammation, renal oxidative stress during resuscitation is the critical indicator associated with later AKI3–5. Reducing the incidence of AKI may reduce mortality of trauma patients

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Conclusion