贝那普利联合氯沙坦对环孢素A致大鼠慢性肾毒性的防治作用

目的:探讨贝那普利和氯沙坦防治环孢素A(CsA)慢性肾毒性的疗效及作用机制.方法:50只SD大鼠随机分为对照组、模型组、贝那普利组、氯沙坦组、联合用药组,每组10只.低盐饲料饲养,以CsA 15 mg/(kg·d)皮下注射造模,贝那普利组、氯沙坦组、联合用药组分别以单用贝那普利、氯沙坦及两者联用灌胃治疗,对照组和模型组以同体积生理盐水灌胃.于第4周末处死动物,取肾脏作肾组织血管紧张素Ⅱ(AngⅡ)含量测定,Masson染色检测肾脏纤维化,免疫组织化学方法检测生长转化因子-β1(TGF-β1)和胶原Ⅲ(ColⅢ)的表达情况.结果:与对照组相比,模型组的肾组织AngⅡ含量、间质纤维化程度、TGF-β1、ColⅢ明显升高;单药治疗组间质纤维化程度、TGF-β1、ColⅢ较模型组均有所下降,联合用药组低于单药治疗组,差异均有统计学意义(P＜0.05).结论:贝那普利和氯沙坦可能是通过下调TGF-β1,抑制ColⅢ表达,从而延缓CsA大鼠肾间质纤维化进展.两者联合应用,疗效更显著.     

朱砂对大鼠的肝肾毒性研究

目的:研究朱砂的肝、肾毒性特点,提出朱砂安全用药剂量和用药时间建议,为朱砂的临床安全用药提供科学依据.方法:小鼠单次灌胃给药,测定最大耐受量.采用SD大鼠随机分为对照组和朱砂0.025,0.05,0.1,0.4,0.8 g·kg-1·d~(-1)(相当于《中国药典》剂量高限的1/2,1,2,8,16倍)剂量组.各剂量组均每日灌胃给药1次,连续3个月,于给药后1,2,3个月和停药1个月,测定尿液定性、血常规以及血清生化指标,并观察肝、肾、心、脑等主要脏器的组织形态学变化,确定无明显不良作用水平(NOAEL).结果:朱砂在HgS为98%、可溶性汞为21.5μg·g~(-1)情况下,给小鼠单次灌胃给药最大耐受量达到24g·kg~(-1)(等于摄入可溶性汞516μg·kg~(-1)),相当于人日用量约3 000倍,未见明显毒性反应.朱砂超过一定剂量用药达到1个月以上,肾脏和肝脏均可见与朱砂毒性有关的病理改变,其中,肾脏对朱砂更为敏感.大鼠灌胃朱砂1个月和3个月的无明显毒性剂量分别为0.1,0.05 g·kg~(-1)·d~(-1)(累积摄入可溶性汞64.5,96μg·kg~(-1)).按照安全系数为60计算出人服用朱砂的日允许摄入量(acceptable daily intake,ADI)约为0.000 9～0.001 7 g·kg~(-1)·d~(-1),相当于60 kg人日用剂量为0.05～0.1 g.结论:反复使用朱砂时,建议在可溶性汞含量≤21 μg·g~(-1)的条件下,朱砂的用药剂量不宜超过0.05～0.1 g,用药时间不宜超过2周.     

万古霉素药物暴露量阈值与肾毒性的相关性分析

目的探讨万古霉素药物暴露量与肾毒性发生的相关性,并确定其上限阈值。方法前瞻性收集2018年5月-2019年1月接受静脉注射万古霉素治疗的成人住院患者信息。使用贝叶斯最大后验概率法计算药时曲线下面积(AUC)并采用分类和回归树(CART)的方法分析和确定万古霉素初始剂量及与肾毒性相关的稳态AUC阈值。通过受试者工作特征(ROC)曲线评估上述方法所得AUC阈值的预测性能及对万古霉素相关肾毒性的诊断价值,并采用多因素logistic回归分析量化肾毒性发生风险因素。结果共纳入患者155例,其中发生肾毒性患者13例(8.39%)。经CART分析得到AUC0-24、AUC24-48、AUCss0-24对肾毒性预测的最佳阈值点分别为622 mg·h/L、617 mg·h/L、578 mg·h/L。经多因素logistic回归分析,AUC超过最佳阈值点时肾毒性发生率显著提高(P≤0.01),联合使用肾毒性药物与肾毒性发生独立相关,会提高约6倍的肾毒性发生率(P<0.01)。结论万古霉素暴露量超过阈值时会大幅提高肾毒性发生风险,提示AUC监测对预测肾毒性发生有很高的临床价值。     

Proanthocyanidin and fish oil potent activity against cisplatin-induced renal cell cycle arrest and apoptosis in rats

Abstract

Cisplatin is an effective chemotherapeutic agent that displays dose-limiting nephrotoxicity. In the present study, the efficacy of grape seed proanthocyanidin extract (GSPE: 100?mg/kg/day) and fish oil (FO: 5?mL/kg/day) against cisplatin-induced nephrotoxicity was evaluated in terms of DNA damage, histopathological changes and expression levels of molecular markers of apoptosis. The administration of cisplatin (CP) (7?mg/kg) results in an increasing percentage of S-phase, G2/M and apoptosis. Furthermore, CP induces apoptosis as indicated by an elevation of renal caspase-3 and reduction in the expression of BCL-2. In addition to occurred renal histopathological changes as manifested by tubular degeneration, degenerative glomerulus, necrotic tubular cells, and cell debris. On the other hand, the administration of GSPE or FO pre-cisplatin treatment can be ameliorated the current DNA cell cycle alterations by the restoration of expression of proteins related to apoptosis and reduced the undesirable renal histopathological changes. So, it can be concluded that the consumption of GSPE or FO might be useful for minimizing nephrotoxicity caused by cisplatin chemotherapy through their anti-apoptotic and antioxidant properties.     

氨磷汀预防顺铂所致肾毒性

目的观察氨磷汀对顺铂所致肾毒性的预防性保护作用。方法随机将大鼠分成5组,即空白对照组,顺铂5mg·kg-1组,顺铂7.5mg·kg-1组,顺铂5mg·kg-1 氨磷汀200mg·kg-1组和顺铂7.5mg·kg-1 氨磷汀200mg·kg-1组,分别测定肾脏脏器系数、血尿素氮、肌酐水平,并做肾组织病理学检查。结果顺铂5mg·kg-1及7.5mg·kg-1组大鼠BUN、Cr值均明显高于对照组和加用氨磷汀组,差异有显著性(P<0.05或P<0.01);氨磷汀组肾脏脏器系数明显下降,病理分级显示氨磷汀肾损害保护率分别为61.5%和56.8%。结论氨磷汀能有效地预防顺铂所致肾毒性。     

肺癌NP方案化疗后Hb下降相关因素的探讨

目的：探讨以顺铂联合盖诺的方案化疗后引起Hb下降的临床相关因素。方法：收集157例肺癌患者资料，均采用以顺铂联合盖诺的化疗方案，分别从年龄、病种、病理分型、分期、化疗周期累积量、有无化疗引起消化道反应等方面对Hb下降的影响进行统计学分析。结果：157例病例中有64．33％发生Hb下降，有消化道反应者Hb下降率为74．00％，平均Hb下降6．29g／L，无消化道反应者分别为59．81％和2．69g/L，有消化道反应者平均Hb下降值明显大于无消化道反应者（P〈0．05），而Hb的下降与病理分型、分期、化疗周期累积量、年龄等均无明显相关性（P〉0．05）。结论：NP方案一个周期化疗后对Hb下降的影响在肺癌中发生率很高，尤其是有消化道反应的患者，提示对肺癌患者化疗的同时积极防治Hb下降，可能对提高患者的疗效、改善生活质量、延长生存期具有重要的临床价值。     

利用代谢组学技术研究中药关木通的肾毒性作用

本文利用代谢组学技术方法研究了染中药关木通毒性大鼠尿液的代谢改变及其与靶器官毒性的相关性.分3个剂量组(36、32、28 g生药·kg-1·d-1)对雄性Wistar大鼠连续6 d灌胃给药,收集12 h的尿样,进行1H-NMR谱测定.实验结果表明,染毒后的大鼠尿样中氧化三甲胺、牛磺酸迅速下降,而柠檬酸、肌酐、2-酮戊二酸等代谢物也均有不同程度的下降;乙酸、丙氨酸则显著上升.主成分分析结果表明,给药组与对照组的代谢谱有明显差异,而造成组间差异的主要影响因素是乙酸、氧化三甲胺、丙氨酸和牛黄酸的变化.乙酸、丙氨酸的显著上升表明动物出现了肾小管坏死,与以前报道的肾脏病理和血浆生化改变相一致.关木通对动物的毒性作用有着明显的剂量依赖性.上述实验结果表明关木通能够对肾脏造成损害,且大鼠尿液的代谢物谱与关木通毒性作用强度密切相关,说明代谢组学方法在中药的毒性研究中有着潜在的应用前景.     

Effects of mercury vapor inhalation on reactive oxygen species and antioxidant enzymes in rat brain and kidney are minimal

Metals are known to induce the formation of reactive oxygen species (ROS) that initiate oxidative stress, an important mechanism of cell injury. The brain is particularly sensitive to oxidative attack because of its high level of unsaturated lipids and high rate of oxidative metabolism. The objective of this study was to determine if elemental mercury (Hg(0)) vapor inhalation increases ROS production and affects activities or levels of antioxidant-related biomolecules in the rat brain and kidney. Adult female Sprague-Dawley rats were exposed for 2 h per day for 11 consecutive days to Hg(0) vapor (1, 2, and 4 mg Hg(0) m(-3)). Brain regions (frontal cortex, cerebellum, brain stem) and kidney were assayed for total Hg, ROS and glutathione (GSH) levels, and for enzyme activities of glutathione peroxidase (GPx) and superoxide dismutase (SOD). Marked exposure-related increases (2500-5600-fold) in total Hg were detected in the brain regions and in kidney. A statistically significant increase in ROS production (ca. 30% above controls) was observed only in the cortex of rats exposed to 1 mg m(-3) Hg vapor, but no significant changes were apparent at other exposures. Although a trend towards increasing ROS production was observed in the kidney, these effects were not statistically significant. Mercury vapor exposure had no significant effects on GSH levels or GPx activity in the three brain regions, however, statistically significant decreases in GSH and GPx activity were detected in the kidneys of rats exposed to 2 mg m(-3). Mercury exposure did not cause significant effects on SOD activity in the brain or kidney. The data indicate that oxidative stress and changes in GSH and activities of antioxidant enzymes do not play a major role in Hg(0) vapor toxicity in brain and kidney.