Experimental chronic kidney disease attenuates ischemia-reperfusion injury in an ex vivo rat lung model

PLoS One. 2017 Mar 14;12(3):e0171736. doi: 10.1371/journal.pone.0171736. eCollection 2017.

Abstract

Lung ischemia reperfusion injury (LIRI) is one of important complications following lung transplant and cardiopulmonary bypass. Although patients on hemodialysis are still excluded as lung transplant donors because of the possible effects of renal failure on the lungs, increased organ demand has led us to evaluate the influence of chronic kidney disease (CKD) on LIRI. A CKD model was induced by feeding Sprague-Dawley rats an adenine-rich (0.75%) diet for 2, 4 and 6 weeks, and an isolated rat lung in situ model was used to evaluate ischemia reperfusion (IR)-induced acute lung injury. The clinicopathological parameters of LIRI, including pulmonary edema, lipid peroxidation, histopathological changes, immunohistochemistry changes, chemokine CXCL1, inducible nitric oxide synthase (iNOS), proinflammatory and anti-inflammatory cytokines, heat shock protein expression, and nuclear factor-κB (NF-κB) activation were determined. Our results indicated that adenine-fed rats developed CKD as characterized by increased blood urea nitrogen and creatinine levels and the deposition of crystals in the renal tubules and interstitium. IR induced a significant increase in the pulmonary arterial pressure, lung edema, lung injury scores, the expression of CXCL1 mRNA, iNOS level, and protein concentration of the bronchial alveolar lavage fluid (BALF). The tumor necrosis factor-α levels in the BALF and perfusate; the interleukin-10 level in the perfusate; and the malondialdehyde levels in the lung tissue and perfusate were also significantly increased by LIRI. Counterintuitively, adenine-induced CKD significantly attenuated the severity of lung injury induced by IR. CKD rats exhibited increased heat shock protein 70 expression and decreased activation of NF-κB signaling. In conclusion, adenine-induced CKD attenuated LIRI by inhibiting the NF-κB pathway.

MeSH terms

  • Animals
  • Chemokine CXCL1 / metabolism
  • Cytokines / biosynthesis
  • In Vitro Techniques
  • Inflammation Mediators / metabolism
  • Kidney Failure, Chronic / metabolism
  • Kidney Failure, Chronic / physiopathology*
  • Lipid Peroxidation
  • Lung Diseases / pathology*
  • Male
  • NF-kappa B / metabolism
  • Nitric Oxide Synthase Type II / metabolism
  • Rats
  • Rats, Sprague-Dawley
  • Reperfusion Injury / prevention & control*
  • Signal Transduction

Substances

  • Chemokine CXCL1
  • Cxcl1 protein, rat
  • Cytokines
  • Inflammation Mediators
  • NF-kappa B
  • Nitric Oxide Synthase Type II

Grants and funding

This work was supported by grants from the cooperative research projects of Chi-Mei Medical Center and National Defense Medical Center (CMNDMC10011 and CMNDMC10109), the Li-Shin Hospital (LS2010-07), the Tri-Service General Hospital (TSGH-C100-79), and the Ministry of National Defense (MAB101-65).