Rat Renal Transplantation Model Research Articles

ACOX1 deficiency-induced lipid metabolic disorder facilitates chronic interstitial fibrosis development in renal allografts

Chronic interstitial fibrosis presents a significant challenge to the long-term survival of transplanted kidneys. Our research has shown that reduced expression of acyl-coenzyme A oxidase 1 (ACOX1), which is the rate-limiting enzyme in the peroxisomal fatty acid β-oxidation pathway, contributes to the development of fibrosis in renal allografts. ACOX1 deficiency leads to lipid accumulation and excessive oxidation of polyunsaturated fatty acids (PUFAs), which mediate epithelial–mesenchymal transition (EMT) and extracellular matrix (ECM) reorganization respectively, thus causing fibrosis in renal allografts. Furthermore, activation of Toll-like receptor 4 (TLR4)-nuclear factor kappa-B (NF-κB) signaling induced ACOX1 downregulation in a DNA methyltransferase 1 (DNMT1)-dependent manner. Overconsumption of PUFA resulted in endoplasmic reticulum (ER) stress, which played a vital role in facilitating ECM reorganization. Supplementation with PUFAs contributed to delayed fibrosis in a rat model of renal transplantation. The study provides a novel therapeutic approach that can delay chronic interstitial fibrosis in renal allografts by targeting the disorder of lipid metabolism.

Anterior-interrupted and posterior-continuous suture technique improved the success rate of kidney transplantation model in rats.

This study aimed to introduce and evaluate two new microvascular anastomosis techniques compared to the conventional method in a rat renal transplant model. Using a Fisher-to-Lewis rat kidney transplantation model, the renal artery anastomosis was performed using the interrupted (I) suture technique, Y-shaped continuous (Y) suture technique, and anterior-interrupted and posterior-continuous (I-C) suture technique. The rats were then divided into three groups: I group, Y group, and I-C group. Parameters such as arterial anastomosis time, warm ischemia time, seven-day survival rate of the rats, and vessel histopathology were assessed. The mean arterial anastomosis time, blood leakage scores, and warm ischemia time were significantly reduced in groups Y and I-C compared to group I. Moreover, the seven-day survival rate was significantly higher in the I-C group compared to the other two groups. Arterial histopathology demonstrated vessel wall recovery without damage in all three groups, suggesting the safety of both Y and I-C techniques. The anterior-interrupted and posterior-continuous suture method is particularly beneficial for small artery reconstruction in organ transplantation.

Targeted changes in blood lipids improves fibrosis in renal allografts

BackgroundChronic interstitial fibrosis is the primary barrier against the long-term survival of transplanted kidneys. Extending the lifespan of allografts is vital for ensuring the long-term health of patients undergoing kidney transplants. However, few targets and their clinical applications have been identified. Moreover, whether dyslipidemia facilitates fibrosis in renal allograft remains unclear.MethodsBlood samples were collected from patients who underwent kidney transplantation. Correlation analyses were conducted between the Banff score and body mass index, and serum levels of triacylglycerol, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. A rat model of renal transplantation was treated with the lipid-lowering drug, fenofibrate, and kidney fibrosis levels were determined by histochemical staining. Targeted metabolomic detection was conducted in blood samples from patients who underwent kidney transplantation and were divided into fibrotic and non-fibrotic groups. Rats undergoing renal transplantation were fed either an n-3 or n-6 polyunsaturated fatty acid (PUFA)-enriched diet. Immunohistochemical and Masson’s trichrome staining were used to determine the degree of fibrosis.ResultsHyperlipidemia was associated with fibrosis development. Treatment with fenofibrate contributed to improve fibrosis in a rat model of renal transplantation. Moreover, n-3 PUFAs from fibrotic group showed significant downregulation compared to patients without fibrotic renal allografts, and n-3 PUFAs-enriched diet contributed to delayed fibrosis in a rat model of renal transplantation.ConclusionsThis study suggests that hyperlipidemia facilitates fibrosis of renal allografts. Importantly, a new therapeutic approach was provided that may delay chronic interstitial fibrosis in transplanted kidneys by augmenting the n-3 PUFA content in the diet.

PD31-06 THE EFFECT OF KIDNEY PRESERVATION AT 10°C WITH HEMOPURE AND HYDROGEN SULFIDE DONOR, SODIUM THIOSULFATE, IN A SYNGENEIC RAT RENAL TRANSPLANTATION MODEL

You have accessJournal of UrologyCME1 Apr 2023PD31-06 THE EFFECT OF KIDNEY PRESERVATION AT 10°C WITH HEMOPURE AND HYDROGEN SULFIDE DONOR, SODIUM THIOSULFATE, IN A SYNGENEIC RAT RENAL TRANSPLANTATION MODEL Maria Abou Taka and Alp Sener Maria Abou TakaMaria Abou Taka More articles by this author and Alp SenerAlp Sener More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003324.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal transplantation is the preferred treatment for patients with end-stage renal disease. Yet, donor kidney demand outweighs supply. Static cold storage (SCS) at 4°C is the current gold standard for renal preservation. SCS contributes to kidney damage through renal ischemia-reperfusion injury (IRI) that involves cellular death and inflammation. In porcine models of renal transplantation, we added non-FDA-approved hydrogen sulfide (H2S) donor, AP39, to a bovine-based blood substitute, Hemopure, at 21°C and 37°C, which improved renal graft quality; though, the experimental setup was costly to meet renal metabolic demand. In rats, we investigated sodium thiosulfate (STS), an FDA-approved H2S donor, at 4°C and observed similar benefits. However, there is still a risk of 4°C cold IRI. Recent studies showed that 10°C human organ graft preservation enhanced patient survival without requiring extensive oxygen during preservation. Therefore, we hypothesize that preservation solutions with STS and Hemopure at 10°C will reduce renal IRI compared to SCS. METHODS: Using an in vitro model of rat renal IRI, we evaluated STS use at 4°C, 10°C, 21°C, and 37°C. We treated rat proximal tubular epithelial cells with 150 µM STS for 24 hours in hypoxic conditions to mimic ischemia, and 24 hours in normoxic conditions to mimic reperfusion. To assess cellular viability, we used flow cytometry and stained cells with FITC-Annexin-V and PerCP-Propidium Iodide to determine apoptosis and necrosis levels, respectively. RESULTS: STS treatment significantly enhanced cellular viability at 10°C compared to 4°C, 21°C, and 37°C, as determined by the percentage of cells negatively stained with FITC-Annexin-V and PerCP-Propidium Iodide. STS treatment also significantly decreased apoptotic and necrotic cells at 10°C compared to 4°C, 21°C, and 37°C, as shown by the percentage of cells positively stained with FITC-Annexin-V and PerCP-Propidium Iodide. CONCLUSIONS: Overall, 10°C STS treatment significantly protects rat proximal tubular epithelial cells from IRI, suggesting that 10°C kidney preservation may enhance renal graft survival, especially in a cost-effective manner, compared to other preservation temperatures currently used in transplantation. Source of Funding: Ontario Graduate Scholarship, Department of Surgery Internal Research Funds, Lawson Internal Research Fund © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e902 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maria Abou Taka More articles by this author Alp Sener More articles by this author Expand All Advertisement PDF downloadLoading ...

Cyclophilin A/CD147 signaling induces the epithelial-to-mesenchymal transition and renal fibrosis in chronic allograft dysfunction by regulating p38 MAPK signaling

Objective Our study was designed to explore the role of Cyclophilin A (CyPA)/CD147 signaling in renal allograft fibrosis and chronic allograft dysfunction (CAD). Materials and methods A rat renal transplant model with significant CAD was successfully achieved. Renal allograft tissues and blood samples were collected. Hematoxylin and eosin, Masson’s, and immunohistochemistry staining were performed. Since CD147 is mainly expressed in the renal tubular epithelial cells, human HK-2 cells were used and intervened by specific concentrations of CyPA, and the total protein and mRNA were extracted. Western blot assay and polymerase chain reaction were performed to explore the protein and mRNA expression of CyPA, CD147, and epithelial-to-mesenchymal transition (EMT)-related biomarkers. SiRNA-CD147 and specific inhibitors of p38 MAPK were used to explore the cellular mechanisms involved in the process. Results We have successfully established and validated a 20-week renal transplant CAD model. We observed significant distributed and expressed CyPA and CD147 in the renal allograft fibrotic tissues. We also found a significant expression of CD147 and EMT-related markers in the HK-2 cells stimulated by CyPA. The CD147 siRNA confirmed the previous in vitro results. The selective inhibition of MAPK suggested the notable role of p38 MAPK signaling pathway in the CyP/CD147 signaling involved in renal allograft fibrosis. Conclusions Our study reported the positive relationship of CyPA-CD147 signaling with renal allograft dysfunction. The in vitro study suggested that CyPA-CD147 signaling induce the development of the EMT process by p38 MAPK signaling, thus contributing to renal allograft fibrosis and CAD.

Amelioration of Renal Injury by Resveratrol in a Rat Renal Transplantation Model via Activation of the SIRT1/NF-κB Signaling Pathway.

Purpose The improvement of the long-term survival of patients receiving kidney transplantation remains challenging. Ischemia reperfusion injury (IRI) reduces long-term renal graft survival in the early posttransplantation phase. However, few studies have investigated the effects of IRI on the pathogenesis of chronic renal graft failure. Silent information regulator 1 (SIRT1) regulates antioxidative stress and inflammatory response and protects against IRI. This study is aimed at investigating the role of resveratrol (RSV), an SIRT1 activator, in preventing renal injury in a rat renal transplantation model. Methods A classical F334-to-LEW orthotopic renal transplantation rat model was established. The experiment group was treated with RSV from three days prior to kidney transplantation and the treatment lasted until the day of harvest. Uninephrectomized F344 and Lewis rats were used as controls. After 12 weeks, the effects of RSV were evaluated according to renal function, histopathology, immunohistochemistry, and western blotting. The activities of oxidative stress-related markers and proinflammatory cytokines were also assessed. Results RSV treatment significantly ameliorated renal function and histopathological lesions in kidney-transplanted rats and increased the levels of GSH, SOD, and CAT and decreased the levels of MDA and iNOS. Furthermore, RSV also inhibited the expression of proinflammatory cytokines/chemokines such as TNF-α, CD68, and IL-6 in kidney-transplanted rats. In addition, the transplant group displayed significantly lower level of SIRT1 and higher level of Ac-NF-κBp65. RSV increased the expression of SIRT1 and decreased the expression of Ac-NF-κBp65. Conclusion SIRT1 plays an important role in the pathogenesis of chronic renal allograft dysfunction. It is a potential therapeutic agent for ameliorating inflammation and oxidative stress-induced renal injury following kidney transplantation by activating the SIRT1/NF-κB signaling pathway.

Administration of adipose stromal vascular fraction attenuates acute rejection in donation after circulatory death rat renal transplantation.

Stem cell therapy represents a new approach to induce immune tolerance in solid organ transplantation. However, the time-consuming process of stem cell expending limits the range of stem cell treatment. Uncultured adipose stromal vascular fraction is considered an attractive cell source for cell-based therapy. This study aimed to evaluate the effect of stromal vascular fraction on the immune system in donation after circulatory death rat renal transplantation. Stromal vascular fraction cells and splenocytes were co-cultured to evaluate the effect of stromal vascular fraction on splenocyte proliferation and viability. Sprague-Dawley rats were used as donors. and Wistar rats as recipients to establish a donation after a circulatory death rat renal transplantation model. Warm ischemia time was 5min. Stromal vascular fraction was administered in the rat model following the intra-arterial route. The spleens and grafts of recipients were harvested on days1, 3 and 7 post-transplantation for assessing acute rejection, infiltration of inflammatory cells, indoleamine 2, 3-dioxygenase expression and T-cell frequency in the spleen. Stromal vascular fraction could inhibit proliferation and induce apoptosis of splenocytes invitro (P<0.05). The administration of stromal vascular fraction could significantly reduce acute rejection and infiltration of CD8+ Tcells and mononuclear macrophages in grafts, and increase indoleamine 2, 3-dioxygenase expression (P<0.05). The frequency of CD8+ Tcells decreased, and the frequency of CD25+ Foxp3+ regulatory Tcells increased in the spleen of the acute rejection+stromal vascular fraction group on day 7 post-transplantation (P<0.05). Administration of the adipose stromal vascular fraction could attenuate acute rejection in donation after circulatory death renal transplantation by increasing the ratio of regulatory Tcells and enhancing indoleamine 2, 3-dioxygenase expression.

C4d Deposition after Allogeneic Renal Transplantation in Rats Is Involved in Initial Apoptotic Cell Clearance.

In the context of transplantation, complement activation is associated with poor prognosis and outcome. While complement activation in antibody-mediated rejection is well-known, less is known about complement activation in acute T cell-mediated rejection (TCMR). There is increasing evidence that complement contributes to the clearance of apoptotic debris and tissue repair. In this regard, we have analysed published human kidney biopsy transcriptome data clearly showing upregulated expression of complement factors in TCMR. To clarify whether and how the complement system is activated early during acute TCMR, experimental syngeneic and allogeneic renal transplantations were performed. Using an allogeneic rat renal transplant model, we also observed upregulation of complement factors in TCMR in contrast to healthy kidneys and isograft controls. While staining for C4d was positive, staining with a C3d antibody showed no C3d deposition. FACS analysis of blood showed the absence of alloantibodies that could have explained the C4d deposition. Gene expression pathway analysis showed upregulation of pro-apoptotic factors in TCMR, and apoptotic endothelial cells were detected by ultrastructural analysis. Monocytes/macrophages were found to bind to and phagocytise these apoptotic cells. Therefore, we conclude that early C4d deposition in TCMR may be relevant to the clearance of apoptotic cells.

Klotho Regulates Epithelial-to-Mesenchymal Transition In Vitro via Wnt/β-Catenin Pathway and Attenuates Chronic Allograft Dysfunction in a Rat Renal Transplant Model.

BackgroundKlotho deficiency has been implicated in various kidney diseases and has been associated with renal fibrosis. However, the role of Klotho in renal allograft fibrosis still remains undetermined.Material/MethodsA 24-week-old rat renal transplant model with chronic allograft dysfunction (CAD) was carried out by orthotopic kidney transplantation using F344 donor rats to Lewis recipient rats. Successful establishment of the model was verified by HE and Masson staining and renal allograft function assessment. HK-2 cells were cultured and treated with TGF-β1 and/or siRNA-Klotho at various time points. Total proteins and RNA were extracted from the cultured cells and kidney tissues. Western blot assay and quantitative RT-PCR were used to analyze the expression of Klotho, fibronectin, and β-catenin pathways.ResultsWe successfully established and identified a 24-week-old rat renal transplant model with CAD. Loss of Klotho was identified to be associated with epithelial-to-mesenchymal transition (EMT), renal allograft fibrosis, and CAD. In HK-2 cells, a significant decrease of Klotho protein was observed in the renal fibrosis induced by TGF-β1 in a time-dependent manner. Moreover, intervention of siRNA-Klotho remarkably promoted the progression of renal fibrosis and activation of the Wnt/β-catenin signaling pathway.ConclusionsOur results show that Klotho has a significant protective role against EMT, renal allograft fibrosis, and CAD following kidney transplantation, which is mediated by inhibition of the Wnt/β-catenin signaling pathway.

Bortezomib limits renal allograft interstitial fibrosis by inhibiting NF-κB/TNF-α/Akt/mTOR/P70S6K/Smurf2 pathway via IκBα protein stabilization.

Chronic allograft dysfunction is a major cause of late graft failure after kidney transplantation. One of the histological changes is interstitial fibrosis, which is associated with epithelial-mesenchymal transition. Bortezomib has been reported to prevent the progression of fibrosis in organs. We used rat renal transplantation model and human kidney 2 cell line treated with tumor necrosis factor-α (TNF-α) to examine their response to bortezomib. To explore the mechanism behind it, we assessed the previously studied TNF-α/protein kinase B (Akt)/Smad ubiquitin regulatory factor 2 (Smurf2) signaling and performed RNA sequencing. Our results suggested that bortezomib could attenuate the TNF-α-induced epithelial-mesenchymal transition and renal allograft interstitial fibrosis in vitro and in vivo. In addition to blocking Akt/mammalian target of rapamycin (mTOR)/p70S6 kinase/Smurf2 signaling, bortezomib's effect on the epithelial-mesenchymal transition was associated with inhibition of nuclear factor kappa B (NF-κB) pathway by stabilizing inhibitor of NF-κB. The study highlighted the therapeutic potential of bortezomib on renal allograft interstitial fibrosis. Such an effect may result from inhibition of NF-κB/TNF-α/Akt/mTOR/p70S6 kinase/Smurf2 signaling via stabilizing protein of inhibitor of NF-κB.

Dynamic regulation of anti-oxidation following donation repairing after circulatory determined death renal transplantation with prolonged non-heart-beating time.

Donation after circulatory-determined death (DCD) is an important part of renal transplantation. Therefore, DCD renal transplantation animal model should be established to study the mechanism of organ injury. Here, we established a stable DCD rat renal transplantation model and investigated the dynamic regulation of graft self-repairing and antioxidant capacities with different non-heart-beating times (NHBTs). Male Sprague-Dawley rats were randomly divided into four groups with the NHBT of the donors from 0 to 15, 30, and 45 minutes. Recipients in long NHBT groups had a significantly lower survival rate and poorer graft function than those in short NHBT groups. Grafts from the 15-minute and 30-minute NHBT groups showed light and severe injury respectively at an early stage after transplantation and recovered within 7 days after transplantation, whereas the self-repairing of the grafts in the 45-minute NHBT group was delayed. The expressions of proliferating cell nuclear antigen (PCNA) and von Willebrand factor (vWF) were dependent on NHBT. The expression of antioxidant proteins paralleled graft recovery. In conclusion, the recipients can up-regulate antioxidant capacity to enhance graft self-repairing in DCD renal transplantation. Prolonged NHBT can delay the self-repairing and antioxidation of grafts.

SRC INDUCES ENDOTHELIAL-TO-MESENCHYMAL TRANSITION AND RENAL ALLOGRAFT FIBROSIS VIA PROMOTING WNT/β-CATENIN PATHWAY

Endothelial-to-mesenchymal (EndMT) is recognized as an important source of myofibroblasts contributing to the pathogenesis of allograft interstitial fibrosis in our previous studies. Increased proto-oncogene tyrosine-protein kinase Src (Src) activity has been associated with several organs fibrosis including some renal diseases, but its role in allograft fibrosis of kidney transplant remains elusive. In the present study, we used immunohistochemistry (IHC) and immunofluorescence (IF) staining to detect the active form of Src (phopsho-Src Tyr416) of chronic renal allograft dysfunction (CAD) and healthy patients. Moreover, we cultured human umbilical vein endothelial cells (HUVEC) and human arterial endothelial cell (HAEC) which were treated with transforming growth factor-β1 (TGF-β1). Biomarkers of EndMT, as well as total Src and Src Tyr416, were examined in various doses or at various time points with or without PP1, a selective inhibitor of Src, using Western Blotting or qRT- PCR. Furthermore, knockdown or overexpressed Src plasmids in HUVEC and HAEC were constructed to confirm the exclusive effect of Src on the EndMT. Finally, rat renal transplant model was established and injected by PP1. Allograft tissues from human and rats were also collected and prepared for HE, Masson’s trichrome, IHC staining and western blotting assays. As a result, we demonstrate Src activity has been upregulated in glomerulus and vascular endothelium of rat renal transplant model and CAD patients. We found also TGF-β1 significant promoted development of EndMT and Src Tyr416 in a time-dependent and dose-dependent manner through raising β-catenin nuclear translocation. More importantly, PP1 alleviated the progression of EndMT and allograft interstitial fibrosis in vivo and in vitro by inhibiting WNT/β-catenin pathway. Thus, Src is an important mediator of allograft interstitial fibrosis, and suggest that Src will be a potential therapeutic target for prevention and treatment of renal allograft interstitial fibrosis.

BORTEZOMIB EXHIBITS THERAPEUTIC IMPLICATION IN RENAL INTERSTITIAL FIBROSIS AFTER KIDNEY TRANSPLANTATION BY INHIBITING AKT-MTOR-P70S6K-SMURF2 PATHWAY AND STABILIZING IΚBΑ PROTEIN

Background: Allograft interstitial fibrosis and fibrogenesis significantly exacerbate the progression of chronic allograft disease (CAD) and are essential therapeutic targets. Epithelial-mesenchymal transition (EMT) is recognized as an important source of myofibroblasts contributing to the pathogenesis of allograft interstitial fibrosis. We previously demonstrated that tumor necrosis factor-alpha (TNF-α) induced EMT via the TNF-α/Akt/Smurf2 signaling pathways in renal proximal tubule epithelial (HK-2) cells. Bortezomib (BZM) is a proteasome inhibitor used for the treatment of multiple myeloma (MM). Several studies have demonstrated that BZM prevents the progression of fibrosis in organs including kidney. Methods: To investigate the effect of BZM on allograft interstitial fibrosis and its mechanism both in vivo and in vitro. We used rat renal transplantation model and HK2 cell line treated with TNF-α to examine their response to BZM by assessing changes on morphology, renal function, expression of fibrosis/EMT related markers and evaluating cell movement. Besides, we explored the effect of BZM on TNF-α/Akt/Smurf2 signaling pathways. RNA sequencing was applied to assess the mechanism by which BZM inhibits the EMT. Based on RNA sequencing data, we further detected changes on NF-κB pathway. Results: BZM significantly attenuated renal allograft interstitial fibrosis and prevented allograft renal function impairment in vivo. In HK2 cell line, BZM inhibited the development of TNF-α-induced EMT as well as the abilities of motility and migration. In addition to blocking of Akt/mTOR/P70S6K/Smurf2 pathway, the antifibrotic effect of BZM on the EMT was associated with inhibition of NF-κB pathway by stabilizing IκBα protein. Conclusion: Our study suggests that BZM attenuates the development of TNF-α-induced EMT and renal allograft interstitial fibrosis, which provides novel insights into renal interstitial fibrosis and CAD following kidney transplantation. The results also highlight the therapeutic potential of BZM via its effect on NF-κB/TNF-α/Akt/mTOR/P70S6K/Smurf2 signaling pathways by stabilizing IκBα protein.

Therapeutic Effects and Functional Mechanism of Intravenous Immunoglobulin in Preclinical Rat Renal Transplant Model of Antibody-Mediated Rejection

BackgroundIntravenous immunoglobulin (Ig) therapy is used based on empirical findings for treatment of antibody-mediated rejection (AMR) in cases of renal transplantation, although its therapeutic efficacy has not been proven and the functional mechanism of an administered Ig remains elusive. In this study, the therapeutic effects of an Ig were examined in a preclinical rat renal transplant model of AMR to investigate this mechanism. MethodsTo establish an AMR renal graft model, skin graft specimens were obtained from Brown-Norway (BN) rats and transplanted to Lewis rats to produce donor-specific antibodies (DSAs), after which kidney transplantation from the Brown-Norway to Lewis rats was performed. AMR model rats were administered the Ig at a dose of 2 g/kg or saline as a control. Survival period, renal graft histopathology, complement factors, and DSA levels were assessed. ResultsThe survival period of the group administered the Ig was significantly prolonged. Histopathological examinations of renal grafts also showed significant suppression of glomerulitis and peritubular capillaritis in the Ig group, and real-time polymerase chain reaction analysis results demonstrated significantly lower levels of expression of the complement factors C1q and C3. When the Ig was given to rats that underwent skin grafting but not renal transplantation, DSA was decreased after 6 hours and remained lower than the baseline level for at least 7 days. ConclusionIg administration suppressed DSA production. The present results showed that suppression of the complement system contributed to effective Ig treatment for AMR.

Targeting of intragraft reactive oxygen species by APP-103, a novel polymer product, mitigates ischemia/reperfusion injury and promotes the survival of renal transplants.

Inflammatory responses associated with ischemia/reperfusion injury (IRI) play a central role in alloimmunity and transplant outcomes. A key event driving these inflammatory responses is the burst of reactive oxygen species (ROS), with hydrogen peroxide (H2 O2 ) as the most abundant form that occurs as a result of surgical implantation of the donor organ. Here, we used a syngeneic rat renal transplant and IRI model to evaluate the therapeutic properties of APP-103, a polyoxalate-based copolymer molecule containing vanillyl alcohol (VA) that exhibits high sensitivity and specificity toward the production of H2 O2 . We show that APP-103 is safe, and that it effectively promotes kidney function following IRI and survival of renal transplants. APP-103 reduces tissue injury and IRI-associated inflammatory responses in models of both warm ischemia (kidney clamping) and prolonged cold ischemia (syngeneic renal transplant). Mechanistically, we demonstrate that APP-103 exerts protective effects by specifically targeting the production of ROS. Our data introduce APP-103 as a novel, nontoxic, and site-activating therapeutic approach that effectively ameliorates the consequences of IRI in solid organ transplantation.

GSK-3β Inhibitor Induces Expression of the TLR4/MyD88/NF-κB Signaling Pathway to Protect Against Renal Ischemia-Reperfusion Injury During Rat Kidney Transplantation.

Ischemia-reperfusion injury (IRI) is an inevitable consequence of kidney transplantation (KT). The aim of our study was to investigate the protective effect of a glycogen synthase kinase 3β (GSK-3β) inhibitor against cold IRI in a rat renal transplantation (RT) model and a rat cold-IRI model through the toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor κ-light-chain-enhancer of the activated B cell (NF-κB) signaling pathway. We treated Sprague Dawley (SD) rats in the RT and cold-IRI models with 5mg/kg and 1mg/kg, respectively, of the GSK-3β inhibitor 4-benzyl-2-methyl-1,2,4-thiadiazolidine-3,5-dione (TDZD-8). We then measured inflammatory factors, i.e., tumor necrosis factor alpha (TNF-α) and interleukins-1β and IL-6 (IL-1β, IL-6), as well as oxidative stress markers, i.e., superoxide dismutase (SOD) and malondialdehyde (MDA), in serum and kidneys. Renal function tests and pathological examinations were performed at 0, 1, 2, 3, and 7days after RT or cold IRI. We measured expression of TLR4, MyD88, inhibitor of NF-κB kinase (IκB), phosphorylated IκB (p-IκB), NF-κB p65, p-p65, GSK-3β, and phosphorylated GSK-3β (p-GSK-3β) by Western blot and immunohistological staining. After intervention with the GSK-3β inhibitor, renal function was improved; oxidative stress injury was reduced; expression of p-GSK-3β was upregulated; expression of p-IκB, TLR4, MyD88, and p-p65 was downregulated; pathological damage was significantly reduced; and expression of TNF-α, IL-1β, and IL-6 messenger ribonucleic acid (mRNA) was downregulated. These results strongly suggested that GSK-3β might be a key target for the treatment of IRI in KT. The GSK-3β inhibitor inhibited phosphorylation of NF-κB p65 and IκB by inhibiting the TLR/MyD88 pathway, reducing oxidative stress injury and the production of downstream inflammatory factors.

Bortezomib attenuates renal interstitial fibrosis in kidney transplantation via regulating the EMT induced by TNF-α-Smurf1-Akt-mTOR-P70S6K pathway.

Allograft interstitial fibrosis was characterized by massive extracellular matrix deposition caused by activated fibroblasts and myofibroblasts. Epithelial‐mesenchymal transition (EMT) is recognized as an important source of myofibroblasts contributing to the pathogenesis of allograft interstitial fibrosis. Smad ubiquitination regulatory factor 1 (Smurf1) has been recently reported to be involved in the progression of EMT. Our study was to detect the effect of Bortezomib and Smurf1 in the EMT and allograft interstitial fibrosis. Biomarkers of EMT, as well as Smurf1, were examined in human proximal tubular epithelial cells (HK‐2) treated with tumour necrosis factor‐alpha (TNF‐α) in various doses or at various time points by Western Blotting or qRT‐PCR. We knockdown or overexpressed Smurf1 in HK‐2 cells. Furthermore, rat renal transplant model was established and intervened by Bortezomib. Allograft tissues from human and rats were also collected and prepared for HE, Masson's trichrome, immunohistochemical staining and western blotting assays. As a result, we found that TNF‐α significantly promoted the development of EMT in a time‐dependent and dose‐dependent manner through Smurf1/Akt/mTOR/P70S6K signalling pathway. More importantly, Bortezomib alleviated the progression of EMT and allograft interstitial fibrosis in vivo and in vitro by inhibiting the production of TNF‐α and expression of Smurf1. In conclusion, Smurf1 plays a critical role in the development of EMT induced by TNF‐α. Bortezomib can attenuate the Sumrf1‐mediated progression of EMT and renal allograft interstitial fibrosis, which could be suggested as a novel choice for the prevention and treatment of renal allograft interstitial fibrosis.

Increased expression of miR-155 correlates with abnormal allograft status in solid organ transplant patients and rat kidney transplantation model

AimsIncreasing evidence has shown the diagnostic value of miR-155 in organ transplantation. The dysregulation of miR-155 is reported to be associated with development of acute or chronic complications in solid organ transplant recipients. Here, we summarized related evidence to explore the correlation between the dysregulation of miR-155 and various allograft dysfunction in transplant recipients, and verified the dynamic change of miR-155 level in acute rejection (AR) using a rat renal transplantation model. Main methodsEligible studies were retrieved from PubMed, Embase, and Cochrane Library databases. A meta-analysis method was performed to evaluate the diagnostic value of miR-155 in transplant recipients. Furthermore, the F344-Lewis rat renal transplantation model was established to validate the dynamic change of miR-155 expression during AR. Key findingsA total of 275 transplant patients, including renal, heart, and lung transplantation from 6 studies were analysed. The pooled SEN of miR-155 was 0.87 (95% CI, 0.78–0.93), the pooled SPE was 0.76 (95% CI, 0.63–0.85), the pooled PLR was 3.6 (95% CI, 2.2–5.8), the pooled NLR was 0.17 (95% CI, 0.09–0.31), the pooled DOR was 17.31 (95% CI, 7.20–41.65) and pooled AUC was 0.89 (95% CI, 0.86–0.92). The rat renal transplantation model (n = 24) and control model (n = 15) were successfully established. Expression of miR-155 in plasma was significantly increased in 7 d and 9 d post-transplantation compared to the control group (P < 0.05), and was consistent with the dynamic change of AR degree. SignificancemiR-155 is a potential biomarker for monitoring the abnormal allograft status in solid organ transplantation.

A Cycle of Altered Proteasome and Reactive Oxygen Species Production in Renal Proximal Tubular Cells

AimsAn intricate relationship exists between the mitochondrial function and proteasome activity. Our recent report showed in a rat model of renal transplantation that mitochondrial dysfunction precedes compromised proteasome function and this results in a vicious cycle of mitochondrial injury and proteasome dysfunction. In this study, we studied whether reactive oxygen species (ROS) has a role in proteasome alteration in renal cells and vice versa.MethodsWe used the genomic and pharmacologic approach on rat normal kidney proximal tubular (NRK) cell lines. First, we knocked down β5 or Rpt6 subunit of the proteasome using small interfering RNA (siRNA) in NRK cells. We also treated NRK cells with Bortezomib, a proteasome inhibitor, and peroxynitrite (a potent ROS).ResultsStudies with RNA interference showed increased mitochondrial ROS following knockdown of β5 or Rpt6 subunit in NRK cells. Similarly, pharmacological inhibition of the proteasome in NRK cells using Bortezomib also showed an increase of mitochondrial ROS in a dose-dependent manner. Next, exposing NRK cells to different concentrations of peroxynitrite provided evidence that the higher levels of peroxynitrite exposure decreased the key subunits (β5 and α3) of the proteasome in NRK cells.ConclusionOur results suggest that proteasome inhibition/downregulation increases ROS, which then impairs proteasome subunits in renal proximal tubular cells.

Effect of ozone oxidative preconditioning on inflammation and oxidative stress injury in rat model of renal transplantation.

To investigate the effect of ozone oxidative preconditioning (OzoneOP) on inflammation and oxidative stress injury in rat model of renal transplantation. Thirty six male Sprague Dawley (SD) rats were randomly divided into three groups. Sham group: rats were treated with opening and closing abdomen. Kidney transplantation group (KT group): SD rat received the donor's left kidney derived from another SD rat. Ozone oxidative preconditioning and kidney transplantation (OOP+KT group): donor SD rats received OzoneOP treatments by transrectal insufflations before kidney transplantation. After transplantation, parameters of renal function of recipients were determined. Morphology and pathological changes of renal allograft were examined. Expression of NF-κBp65, HMGB-1 were also determined by Western-blot. Compared to KT group, the morphology and pathological damages of renal allograft were less serious in OOP+KT group. Meanwhile, levels of SOD and GSH-Px of renal allograft in OOP+KT group were higher than those in KT group respectively. Western-blot showed that the expressions of NF-κBp65 and HMGB-1 in OOP+KT group were obviously less than those in KT group. Ozone oxidative preconditioning could attenuate the inflammatory reaction and oxidative stress injury in renal allograft, which might be related with the enhancement of anti-oxidative system and suppression of inflammatory reaction.