恬尔心对大鼠FK506肾毒性的防治作用

目的探讨肾移植术后首剂治疗剂量他克莫司（FKS06）对大鼠肾脏的毒性作用以及地尔硫革（恬尔心,Dil）对FKS06肾毒性的防治作用。方法按公式将肾移植术后FKS06、环孢素A（CsA）和Dil的首剂治疗剂量换算成大鼠的治疗剂量。SD大鼠24只随机分成对照组、CsA组（25mg·kg^-1·d^-1）、FKS06组（0．8mg·kg^-1·d^-1）和FKS06＋Dil组（0．8mg·kg^-1·d^-1及8mg·kg^-1·d^-1）,用药4周后建立起各组大鼠肾毒性模型。检测各组大鼠的体重、尿标本、肾功能,以及观察肾组织的病理改变。结果CsA组与FKS06组均出现明显的血肌酐上升、肌酐清除率下降、肾小管细胞浊肿及空泡变性。FKS06＋Dil组上述各项指标的变化明显减轻或接近正常。结论肾移植术后首剂治疗剂量FKS06与CsA一样,对大鼠肾脏均具有毒性作用。恬尔心可以防治FKS06的肾毒性。

Prevention of diltiazem in tacrolimus-induced nephrotoxicity: experiment with rats

OBJECTIVE: To study the nephrotoxicity induced by first oral administration of tacrolimus (FK506) and the prevention of diltiazem (Dil). METHODS: 24 Sprague-Dawley male rats were randomly divided into 4 equal groups: control (n = 6), cyclosporine A (CsA) group (receiving CsA 25 mg.kg(-1).d(-1) so as to develop CsA-induced nephropathy model), FK506 group (receiving FK506 0.8 mg.kg(-1).d(-1), the common renal transplantation therapeutic dose, so as to develop FK506-induced nephropathy model), FK506 + Dil group (receiving CsA 0.8 mg.kg(-1).d(-1) and Dil 8 mg.kg(-1).d(-1)), and control group. Four weeks later body weight was measured, blood samples were collected to examine the creatinine, urea nitrogen, and uric acid, and urine samples were collected to examine the 24 h urine protein, uric acid, and creatinine. Then the rats were killed with their kidneys taken out to undergo histopathological examination. RESULTS: The urine creatinine levels of the CsA and FK506 groups were significantly lower than that of the control group (both P < 0.05), however, there was no significant difference in urine creatinine between the FK506 + Dil group and control group. The blood creatinine levels of both CsA and FK506 groups were significantly higher than those of the FK506 + Dil group and control group (all P < 0.05), however, there was no significant difference in blood creatinine between the FK506 + Dil group and control group. The urea nitrogen level of the CsA group was significantly higher than those of the other 3 groups (all P < 0.05). The creatinine clearance rates of the CsA and FK506 groups were both significantly lower than that of the control group (both P < 0.05), and the creatinine clearance rate of the FK506 + Dil group was between those of the FK506 group and control group, however, with significant differences with both of them. Histopathology examination showed cloudy swelling and vacuolization of the renal tubular epithelial cells in the CsA and FK506 groups. However, the pathological changes of the FK506 + Dil group were remarkably milder in comparison with these 2 groups. CONCLUSION: FK506 and CsA at the renal transplantation therapeutic dose induce nephrotoxicity. Diltiazem prevents FK506-induced nephrotoxicity.