晚期缺血预适应促进低氧诱导因子的表达减轻肾脏缺血再灌注损伤

目的: 探讨晚期缺血预适应对肾脏缺血再灌注损伤的作用,以及低氧诱导因子1α(HIF-1α)在其中的作用。方法: 将雄性C57/BL6N小鼠随机分为3组:假手术组(sham)、缺血再灌注组(IR)和缺血预适应组(IPC)。采用夹闭双侧肾蒂30 min后恢复灌注的方法建立肾缺血再灌注小鼠模型;缺血预适应组4 d前给予肾脏15 min预缺血。观察缺血预处理对再灌注后不同时点血肌酐(Scr)、尿素氮(BUN)、肾组织形态学和细胞凋亡的影响。采用免疫组化及Western印迹法,分析HIF-1α在肾组织的表达;采用实时定量RT-PCR法,检测血管内皮生长因子(VEGF)和葡萄糖转运子-1(Glut-1)的mRNA表达。结果: 再灌注24 h后,IPC组小管间质损伤程度较IR组显著减轻,Scr、BUN水平以及小管上皮细胞凋亡明显下降。IPC组的HIF-1α核内表达显著高于IR组,且HIF-1下游靶基因VEGF和Glut-1的mRNA表达亦显著增加。结论: 晚期缺血预适应能够显著改善缺血再灌注后肾脏的形态和功能,这种保护作用可能与促进低氧诱导因子高表达有关。

Protective effect of delayed ischemic preconditioning on renal ischemia/reperfusion injury via induction of hypoxia inducible factor

AIM: To investigate the effects of delayed ischemic preconditioning on renal ischemia-reperfusion injury in mice and to study the role of hypoxia inducible factor 1α(HIF-1α). METHODS: Male C57/BL6N mice were randomly divided into 3 groups: sham operation group(sham), ischemia/reperfusion group(IR) and ischemic preconditioning group(IPC). Thirty-minute ischemia was induced by clamping renal bilateral pedicles followed by reperfusion in IR group. Fifteen-minute pre-ischemia was performed 4 days before IR in IPC group. Serum creatinine(Scr), blood urea nitrogen(BUN), kidney morphology and apoptosis were observed at different time points following reperfusion. The expression of HIF-1α in the renal tissues was evaluated by the methods of immunohistochemistry and Western blotting analysis. The mRNA expression of vascular endothelial growth factor(VEGF) and glucose transporter-1(Glut-1) was detected by real-time quantitative RT-PCR.RESULTS: Compared with IR group at 24 h following reperfusion, acute tubulointerstitial injury was significantly relieved in IPC group. The levels of Scr and BUN, and apoptosis of tubular epithelial cells were also decreased in IPC group. Nuclear expression of HIF-1α was higher in IPC group than that in IR group. The mRNA expression of VEGF and Glut-1, the target genes of HIF-1, was also increased significantly in IPC group. CONCLUSION: Delayed ischemic preconditioning attenuates both morphologic and functional injuries induced by renal ischemia/reperfusion. This protective effect may be related to the increased expression of hypoxia inducible factor.