Nimbolide ameliorates the streptozotocin-induced diabetic retinopathy in rats through the inhibition of TLR4/NF-κB signaling pathway

BackgroundDiabetic retinopathy (DR) is a common problem in the diabetic patients due to the high blood glucose level. DR affects more number of diabetic patients worldwide with irreversible vision loss.ObjectiveThe current investigation was focused to reveal the therapeutic actions of nimbolide against the streptozotocin (STZ)-provoked DR in rats through inhibition of TLR4/NF-κB pathway.MethodologyDR was provoked to the rats through administering a single dose of STZ (60 mg/kg) intraperitoneally. The DR rats were then supplemented with the 50 mg/kg of nimbolide for 60 days. The bodyweight and blood glucose level was measured using standard methods. The lipid profiles (cholesterol, TG, LDL, and HDL), inflammatory markers, and antioxidants level was detected using respective kits. The level of MCP-1, VEGF, and MMP-9 was quantified using kits. The morphometric analysis of retinal tissues were done. The mRNA expressions of target genes were studied using RT-PCR assay.ResultsNimbolide treatment effective decreased the food intake and blood glucose, and improved the bodyweight of STZ-provoked animals. The levels of pro-inflammatory mediators, cholesterol, TG, LDL, and HDL, MCP-1, VEGF, and MMP-9 was remarkably suppressed by the nimbolide treatment. Nimbolide also improved the antioxidants, retinal thickness and cell numbers. The TLR4/NF-κB pathway was appreciably inhibited by the nimbolide.ConclusionOverall, our findings demonstrated that the nimbolide attenuated the STZ-provoked DR in rats through inhibiting the TLR4/NF-κB pathway.     

The role of dendritic cells regulated by HMGB1/TLR4 signalling pathway in myocardial ischaemia reperfusion injury

Inflammatory response plays an important role in ischaemia reperfusion injury (IRI) through a variety of inflammatory cells. Apart from neutrophils, macrophages and lymphocytes, the role of dendritic cells (DCs) in IRI has been noticed. The study was aimed at investigating whether the high‐mobility group protein box‐1/toll like receptor 4 (HMGB1/TLR4) signalling pathway regulate the migration, adhesion and aggregation of DCs to the myocardium, induce DCs activation and maturation, stimulate the expression of surface costimulatory molecules and participate in myocardial IRI. In vivo, migration, adhesion, and aggregation of DCs was enhanced; the expression of peripheral blood DCs CD80 and CD86, myocardial adhesion molecules were increased; and the infarct size was increased during myocardial ischaemia reperfusion injury myocardial ischemic/reperfusion injury (MI/RI). These responses induced by MI/RI were significantly inhibited by HMGB1 specific neutralizing antibody treatment. Cellular experiments confirmed that HMGB1 promoted the release of inflammatory cytokines through TLR4/MyD88/NF‐κB, upregulated CD80 and CD86 expression, mediated the damage of cardiomyocytes and accelerated the apoptosis. Our results indicate that DCs activation and maturation, stimulate the expression of surface costimulatory molecules by promoting the release of inflammatory factors through NF‐κB pathway and participate in myocardial IRI.     

NRG-1/ErbB4通路与脑缺血再灌注损伤细胞凋亡关系及电针干预作用

神经通路在电针治疗脑缺血再灌注损伤（CIRI）领域研究日渐深入。NRG-1/ErbB4通路是神经调节素（NRG）与其ErbB受体组成的一条在细胞的增殖分化以及神经系统发育等生命过程中起着关键作用的神经信号传导通路,前期研究发现该通路与神经发育异常疾病、心力衰竭、心肌梗死以及癌症等疾病密切相关。近年,国内外研究发现CIRI后细胞凋亡与该通路以及Caspase-3、NF-κB、Bcl-2/Bax等因子的调控有关。本文综述NRG-1/ErbB4通路以及相关凋亡因子在CIRI治疗中的研究进展。     

右美托咪定对大鼠I/R损伤肺组织TLR4表达及保护作用的影响

目的：探讨右美托嘧啶对大鼠再灌注损伤肺组织Toll样受体素4（TLR4）表达的调控,并分析其对肺保护作用机制。方法：采用大鼠在体左侧肺缺血/再灌注（I/R）模型,50只健康雄性成年SD大鼠随机分为5组（n=10）：对照组（Sham组）、缺血/再灌注组（I/R组）、右美托咪定组（Dex组）、阿替美唑组（Atip组）、右美托咪定+阿替美唑组（Dex+Atip组）,实验结束后处死大鼠,留取左肺,检测肺湿干重比（W/D）和总肺水含量（TLW）;光镜下观察肺组织形态结构变化;PCR检测肺组织TLR4 mRNA表达;Western blot检测肺组织TLR4的蛋白表达。结果：与Sham组相比,其余各组W/D和TLW明显升高（P<0.05,P<0.01）,TLR4 mRNA和蛋白表达量上升（P<0.01）,光镜显示肺组织结构出现明显损伤性变化;与I/R组相比,Dex组W/D和TLW下降（P<0.05,P<0.01）,TLR4 mRNA和蛋白表达量降低（P<0.01）,光镜下肺组织损伤减轻;与Dex组比较,Dex+Atip组W/D和TLW明显升高（P<0.05,P<0.01）,TLR4 mRNA和蛋白表达量上升（P<0.01）,光镜肺组织结构损伤严重;I/R组、Atip组、Dex+Atip组两两比较,以上各指标均无统计学差异（P > 0.05）。结论：I/R可引起大鼠肺组织TLR4表达上调和肺组织损伤;右美托咪啶可减轻肺I/R损伤,抑制TLR4表达,这种作用与α2-肾上腺素能受体有关。     

神经元-小胶质细胞EphA4/ephrin通路调控小胶质细胞介导的缺血后炎性损伤

目的观察神经元-小胶质细胞间EphA4/ephrin信号通路在脑缺血后的炎性损伤中的作用及机制。方法建立神经元-小胶质细胞混合培养体系和糖氧剥夺再复氧(oxygen-glucose deprivation and reperfusion, OGD/R)模型,使用预聚集化的EphA4-Fc激动小胶质细胞ephrin配体,检测OGD/R后的细胞凋亡、小胶质细胞增殖和亚型极化以及小胶质细胞功能改变。结果 EphA4受体高表达于原代神经元,与对照组相比,预聚集化EphA4-Fc干预加重OGD/R导致的细胞凋亡,促进小胶质细胞增殖以及向M1型(促炎型)极化(炎症表型)。结论神经元-小胶质细胞间EphA4/ephrin信号通路通过调控小胶质细胞亚型极化参与脑缺血后的炎性损伤的过程。     

ATPase inhibitory factor 1 protects the heart from acute myocardial ischemia/reperfusion injury through activating AMPK signaling pathway

Rationale: Myocardial ischemia/reperfusion (I/R) injury is a common clinic scenario that occurs in the context of reperfusion therapy for acute myocardial infarction (AMI). The mitochondrial F1Fo-ATPase inhibitory factor 1 (IF1) blocks the reversal of the F1Fo-ATP synthase to prevent detrimental consumption of cellular ATP and associated demise. In the present study, we study the role and mechanism of IF1 in myocardial I/R injury.Methods: Mice were ligated the left anterior descending coronary artery to build the I/R model in vivo. Rat hearts were isolated and perfused with constant pressure according to Langendorff. Also, neonatal cardiomyocytes hypoxia-reoxygenation (H/R) model was also used. Myocardial infarction area, cardiac function, cellular function, and cell viability was conducted and compared.Results: Our data revealed that IF1 is upregulated in hearts after I/R and cardiomyocytes with hypoxia/re-oxygenation (H/R). IF1 delivered with adenovirus and adeno-associated virus serotype 9 (AAV9) ameliorated cardiac dysfunction and pathological development induced by I/R ex vivo and in vivo. Mechanistically, IF1 stimulates glucose uptake and glycolysis activity and stimulates AMPK activation during in vivo basal and I/R and in vitro OGD/R conditions, and activation of AMPK by IF1 is responsible for its cardioprotective effects against H/R-induced injury.Conclusions: These results suggest that increased IF1 in the I/R heart confer cardioprotective effects via activating AMPK signaling. Therefore, IF1 can be used as a potential therapeutic target for the treatment of pathological ischemic injury and heart failure.     

TLR4 signaling induced TLR2 expression in the process of mimic cerebral ischemia/reperfusion <Emphasis Type="Italic">in vitro</Emphasis>

Both TLR4 and TLR2 participated in the mediation of the inflammatory injury in the process of partial cerebral ischemia/reperfusion. However, it still remains unclear whether a crosstalk exists between TLR2 and TLR4 in ischemic cerebral damage. In the present study, we investigated the effect of TLR4 signaling on TLR2 expression during mimic cerebral I/R in vitro. BV-2 cells were cultured and treated with ischemia/reperfusion, then transfected with the plasmid pEGFP-H1/TLR4-siRNA, the plasmid pEGFP-H1/control sequence-siRNA and the blank plasmid, respectively. Interestingly, the expression of TLR2 and TLR4 mRNA and protein, NF-κB p65 mRNA and supernatant TNF-α level were significantly higher in ischemia/reperfusion treated cells than those lack of ischemia/reperfusion treatment, and as compared with those in ischemia/reperfusion treated cells without transfection, no significant differences about the above mentioned gene and protein expression were found in the blank plasmid tranfected cells and the plasmid pEGFP-H1/control sequence-siRNA transfected cells respectively, while the expression levels in the plasmid pEGFP-H1/TLR4-siRNA transfected cells were significantly lower. Additionally, in order to determine the effects of pyrrolidinediethyldithiocarbamate (PDTC), an NF-κB inhibitor, on the TLR4-induced TLR2 expression in BV-2 cells treated with ischemia/reperfusion, it was found that TLR4 and TLR2 mRNA expressions in PDTC pretreated cells were significantly lower in comparison with normal saline pretreated cells and non-pretreated cells. The data suggested that TLR2 activation, signaled by TLR4 and regulated by NF-κB, might be directly involved play an important role in ischemia/reperfusion induced brain damage.     

Deficiency in TLR4 signal transduction ameliorates cardiac injury and cardiomyocyte contractile dysfunction during ischemia

Toll-like receptor 4 (TLR4), a proximal signalling receptor in innate immune responses to lipopolysaccharide of gram-negative pathogens, is expressed in the heart. Accumulating evidence have consolidated the notion that TLR4 plays an essential role in the pathogenesis of cardiac dysfunction. However, the molecular mechanisms of TLR4 responsible for ischemia-induced cardiac dysfunction remain unclear. To address the signalling mechanisms of TLR4-deficiency cardioprotection against ischemic injury, in vivo regional ischemia was induced by occlusion of the left anterior descending coronary artery in wild-type (WT) C3H/HeN and TLR4-mutated C3H/HeJ mice. The results demonstrated that blunted ischemic activation of p38 mitogen-activated protein kinase and JNK signalling occurred in C3H/HeJ hearts versus C3H/HeN hearts, while ERK and AMP-activated protein kinase (AMPK) signalling pathways were augmented during ischemia in C3H/HeJ hearts versus C3H/HeN hearts. Intriguingly, ischemia-stimulated endoplasmic reticulum stress was higher in C3H/HeN hearts than that in C3H/HeJ as demonstrated by up-regulation of Grp78/BiP, Gadd153/CHOP and IRE-1α. Myocardial infarct, caspase-3 activity and terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) staining demonstrated that C3H/HeN hearts suffered more damage than those of C3H/HeJ hearts during ischemia. Moreover, isolated cardiomyocytes from C3H/HeJ hearts showed resistance to hypoxia-induced contractile dysfunction compared to those from C3H/HeN hearts, which are associated with greater hypoxic activation of AMPK and ERK signalling, better intracellular Ca²⁺ handling in C3H/HeJ versus C3H/HeN cardiomyocytes. These findings suggest that the cardioprotective effects against ischemic injury of hearts with deficiency in TLR4 signalling may be mediated through modulating AMPK and ERK signalling pathway during ischemia.     

中风胶囊对脑缺血/再灌注损伤模型鼠脑组织自噬相关蛋白表达的影响*

目的: 观察中风胶囊对脑缺血/再灌注损伤(CIRI)模型鼠脑组织自噬相关蛋白表达的影响,初步揭示其对神经元损伤保护的分子机制。方法: 采用改良线栓法构建大鼠脑缺血/再灌注损伤模型,随机将60只雄性SD大鼠分为假手术组、模型组、丁苯酞组(0.054 g/kg)、中风胶囊高剂量组(1.08 g/kg)、中风胶囊中剂量组(0.54 g/kg)、中风胶囊低剂量组(0.27 g/kg),每组10只。造模结束后灌胃给药10 d,每天1次,实验结束后处死各组大鼠,摘取脑组织。各组大鼠末次给药24 h后进行神经功能评分;HE染色法观察各组大鼠脑组织病理形态;ELISA法检测各组大鼠血清雌二醇(E2)和卵泡刺激素(FSH);RT-PCR法与Western blot法分别测定各组大鼠脑组织PI3K/Akt/Beclin1信号通路关键基因及蛋白的表达。结果: 与假手术组比较,模型组大鼠体重及脑组织中p-PI3K、p-Akt等蛋白表达均显著降低,脑指数、神经功能缺损评分及脑组织Beclin1、LC3基因和蛋白表达均显著升高(P＜0.05或P＜0.01),脑组织结构排列疏松,间质水肿,神经细胞呈三角形,核固缩深染。与模型组相比,中风胶囊高剂量组大鼠体重显著升高,神经功能缺损评分显著下降(P＜0.05),脑组织病理损伤较模型组明显改善;中风胶囊各剂量组的脑指数及脑组织Beclin1、LC3的基因和蛋白表达均显著降低,脑组织中p-PI3K、p-Akt等蛋白表达均显著升高(P＜0.05或P＜0.01)。结论: 中风胶囊通过调控PI3K/Akt/Beclin1信号通路中Beclin1和LC3的表达来抑制CIRI模型鼠的自噬反应,从而发挥保护其脑神经元损伤的作用。     

Germacrone attenuates cerebral ischemia/reperfusion injury in rats via antioxidative and antiapoptotic mechanisms

Germacrone (GM) is an anti-inflammatory compound extracted from Rhizoma curcuma. Here, we strived to investigate the neuroprotective effects of GM in rat models of transient middle cerebral artery occlusion/reperfusion injury. Rats immediately after cerebral ischemia were intraperitoneally injected with GM at doses of 5, 10, and 20 mg/kg. After 1 day of reperfusion, the water content in the brain, infarct volume, and neurological deficits were assessed. Hippocampus neurons were histopathologically examined by hematoxylin and eosin and terminal deoxynucleotidyl transferase dUTP nick end labeling staining. Activities of glutathione (GSH), superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione peroxidase (GSH-PX) in brain tissue were detected. Real-time PCR and Western blotting were utilized to quantify the expression of apoptosis markers, such as caspase-3, Bax, and Bcl-2. The content of phospho-Akt (p-Akt) was also measured using Western blotting. GM treatment markedly decreased the brain water content, infarct volume and the neurological deficits, which was corroborated by attenuated histopathologic change. MDA levels were reduced and activities of GSH, SOD, and GSH-PX were elevated after GM treatment. Caspase-3 and Bax were decreased, and Bcl-2 was increased at both messenger RNA and protein levels by GM treatment. The p-Akt expression was increased by GM. Our data indicated that the neuroprotective effects of GM may attenuate the injuries from cerebral ischemia/reperfusion in rats through antioxidative and antiapoptotic mechanisms.     

microRNA-129 overexpression in endothelial cell-derived extracellular vesicle influences inflammatory response caused by myocardial ischemia/reperfusion injury

Extracellular vesicles (EVs) have the potency to function as modulators in the process of myocardial ischemia/reperfusion (I/R) injury. This investigation was performed to decipher the mechanism of human umbilical vascular endothelial cells (HUVECs)-derived EVs in myocardial I/R injury with the involvement of microRNA-129 (miR-129). HUVECs-secreted EVs were collected and identified. An I/R mouse model was developed, and cardiomyocytes were used for vitro oxygen-glucose deprivation/reperfusion model establishment. Differentially expressed miRNAs in myocardial tissues after EV treatment were assessed using microarray analysis. The target relationship between miR-129 and toll-like receptor 4 (TLR4) was identified using a dual-luciferase assay. Gain- and loss-function studies regarding miR-129 were implemented to figure out its roles in myocardial I/R injury. Meanwhile, the activation of the nuclear factor-kappa-binding (NF-κB) p65 signaling and NOD-like receptor 3 (NLRP3) inflammasome was evaluated. EVs diminished the apoptosis of cardiomyocytes and the secretion of inflammatory factors, and all these trends were reversed by miR-129 reduction. miR-129 bound to the 3′-untranslated region of TLR4 directly. The NF-κB p65 signaling and NLRP3 inflammasome were abnormally activated after I/R injury, whose impairment after EVs was partially restored by miR-129 downregulation. This study illustrated that EVs could carry miR-129 to mitigate myocardial I/R injury via downregulating TLR4 and disrupting the NF-κB signaling and NLRP3 inflammasome.     

Ischemic post-conditioning protects brain and reduces inflammation in a rat model of focal cerebral ischemia/reperfusion

Ischemic post-conditioning (Post-cond) is a phenomenon in which intermittent interruptions of blood flow in the early phase of reperfusion can protect organ from ischemia/reperfusion (I/R) injury. Recent studies demonstrated ischemic Post-cond reduced infarct size in cerebral I/R injury. However, the molecular mechanisms underlying this phenomenon are not completely understood. As inflammation is known to be detrimental to the neurological outcome during the acute phase after stroke, we investigated whether ischemic Post-cond played its protective role in preventing post-ischemic inflammation in the rat middle cerebral artery occlusion model. Rats were treated with ischemic Post-cond after 60 min of occlusion (beginning of reperfusion). The infarct volume and myeloperoxidase activity were assessed at 24 h. The lipid peroxidation levels was evaluated by malondialdehyde assay and the expressions of interleukin-1β, tumor necrosis factor-α, and intercellular adhesion molecule 1 were studied by RT-PCR or western blotting. Ischemic Post-cond decreased myeloperoxidase activity and expressions of interleukin-1β, tumor necrosis factor-α, and intercellular adhesion molecule 1. Ischemic Post-cond also reduced infarct volume and lipid peroxidation levels. These findings indicated that ischemic Post-cond may be a promising neuroprotective approach for focal cerebral I/R injury and it is achieved, at least in part, by the inhibition of inflammation.     

NOTCH1信号通路介导白藜芦醇抗肝缺血/再灌注所致大鼠心脏损伤保护作用的机制研究

目的：观察Notch1信号通路在肝缺血/再灌注损伤时对心脏损伤的保护作用并探讨其相关的机制。方法：36只健康雄性SD大鼠随机分为3组,假手术组（SC组）、肝缺血/再灌注组（HIR组）、白藜芦醇预处理组（Res处理组）,每组12只。各组均与肝脏缺血40 min再灌注2 h（SC组旷置相等时间）后,记录左室血流动力学变化,测定血清肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、肿瘤坏死因子（TNF-α）和白细胞介素-6（IL-6）浓度,取心肌组织测定SOD活力及MDA含量,Western blot检测心肌组织反应Notch通路活化标志的NICD表达,以RT-PCR法从转录水平检测Notch1和TNF-α的表达水平。结果：与SC比较,HIR组左室收缩及舒张功能均显著降低（P<0.01）,血清CK、LDH活力,TNF-α和IL-6浓度明显升高（P<0.01）,心肌MDA含量明显升高而SOD活力明显降低（P<0.01）,且Notch1表达下降,TNF-α表达增加;与I/R组相比,Res处理组左室舒缩功能明显升高,血清CK、LDH活力及TNF-α、IL-6浓度明显降低,同时心肌SOD活力明显升高而MDA含量明显降低,Notch1表达上升TNF-α表达降低。结论：白藜芦醇对肝缺血/再灌注大鼠心脏具有保护作用,其机制可能与Notch1信号通路的激活进而调节炎症反应及氧化应激有关。     

Alda-1, an ALDH2 activator,protects against hepatic ischemia/reperfusion injury in rats via inhibition of oxidative stress

Previous studies have proved that activation of aldehyde dehydrogenase two (ALDH2) can attenuate oxidative stress through clearance of cytotoxic aldehydes, and can protect against cardiac, cerebral, and lung ischemia/reperfusion (I/R) injuries. In this study, we investigated the effects of the ALDH2 activator Alda-1 on hepatic I/R injury. Partial warm ischemia was performed in the left and middle hepatic lobes of Sprague-Dawley rats for 1?h, followed by 6?h of reperfusion. Rats received either Alda-1 or vehicle by intravenous injection 30?min before ischemia. Blood and tissue samples of the rats were collected after 6-h reperfusion. Histological injury, proinflammatory cytokines, reactive oxygen species (ROS), cellular apoptosis, ALDH2 expression and activity, 4-hydroxy-trans-2-nonenal (4-HNE) and malondialdehyde (MDA) were measured. BRL-3A hepatocytes were subjected to hypoxia/reoxygenation (H/R). Cell viability, ROS, and mitochondrial membrane potential were determined. Pretreatment with Alda-1 significantly alleviated I/R-induced elevations of alanine aminotransferase and aspartate amino transferase, and significantly blunted the pathological injury of the liver. Moreover, Alda-1 significantly inhibited ROS and proinflammatory cytokines production, 4-HNE and MDA accumulation, and apoptosis. Increased ALDH2 activity was found after Alda-1 administration. No significant changes in ALDH2 expression were observed after I/R. ROS was also higher in H/R cells than in control cells, which was aggravated upon treatment with 4-HNE, and reduced by Alda-1 treatment. Cell viability and mitochondrial membrane potential were inhibited in H/R cells, which was attenuated upon Alda-1 treatment. Activation of ALDH2 by Alda-1 attenuates hepatic I/R injury via clearance of cytotoxic aldehydes.     

Downregulation of tripartite motif protein 11 attenuates cardiomyocyte apoptosis after ischemia/reperfusion injury via DUSP1-JNK1/2

Currently, the prevention of ischemic diseases such as myocardial infarction associated with ischemia/reperfusion (I/R) injury remains to be a challenge. Thus, this study was designed to explore the effects of tripartite motif protein 11 (TRIM11) on cardiomyocytes I/R injury and its underlying mechanism. Cardiomyocytes AC16 were used to establish an I/R injury cell model. After TRIM11 downregulation in I/R cells, cell proliferation (0, 12, 24, and 48 h) and apoptosis at 48 h as well as the related molecular changes in oxidative stress-related pathways was detected. Further, after the treatment of TRIM11 overexpression, SP600125, or DUSP1 overexpression, cell proliferation, apoptosis, and related genes were detected again. As per our findings, it was determined that TRIM11 was highly expressed in the cardiomyocytes AC16 after I/R injury. Downregulation of TRIM11 was determined to have significantly reduced I/R-induced proliferation suppression and apoptosis. Besides, I/R-activated c-Jun N-terminal kinase (JNK) signaling and cleaved caspase 3 and Bax expression were significantly inhibited by TRIM11 downregulation. In addition, the overexpression of TRIM11 significantly promoted apoptosis in AC16 cells, and JNK1/2 inhibition and DUSP1 overexpression potently counteracted the induction of TRIM11 overexpression in AC16 cells. These suggested that the downregulation of TRIM11 attenuates apoptosis in AC16 cells after I/R injury probably through the DUSP1-JNK1/2 pathways.     

褪黑素与缺血再灌注损伤

褪黑素(melatonin,MT)具有强效抗氧化作用,在肠、肝脏、心脏、脑等器官的缺血再灌注损伤实验中具有清除自由基、保护线粒体、抗细胞凋亡等保护性作用。本文综合褪黑素应用于缺血再灌注损伤的动物实验的近几年相关文献,总结并分析褪黑素在缺血再灌注损伤动物实验中的保护作用及其相关机制。     

Protective effect of N-acetylcysteine (NAC) on renal ischemia/reperfusion injury through Nrf2 signaling pathway

Abstract

The aim of this study was to investigate whether N-acetylcysteine (NAC), a known antioxidant, can protect kidney against ischemic injury through regulating Nrf2 signaling pathway. The expression of Nrf2, HO-1 and cleaved caspase 3 were analyzed by Western blot analysis. Apoptosis of renal tubular epithelial cells was assessed by the TUNEL method. Malondialdehyde (MDA) levels were measured by the thiobarbituric acid reaction. Blood serum creatinine and blood urea nitrogen levels were measured with an Olympus automatic multi-analyzer. We found that NAC significantly increased Nrf2 and downstream HO-1 expression. Furthermore, NAC significantly decreased cleaved caspase 3, p53 and renal epithelial tubular cell apoptosis. In addition, NAC reduced the MDA level. These findings suggest that the protective action of NAC on ischemia renal injury is associated closely with Nrf2 signaling pathway.