苦参素对单侧输尿管梗阻大鼠肾间质纤维化的保护作用

目的探讨苦参素对单侧输尿管梗阻(UUO)大鼠肾间质纤维化的影响及可能机制。方法45只雄性SD大鼠随机分为3组:A假手术组,B单侧输尿管结扎(UUO)组,C治疗组。治疗组在UUO的基础上每天以苦参素100mg/Kg/d腹腔注射。B组和C组于术后第7,14,21,28分别处死5只大鼠,A组于第28天处死大鼠。用PAS及Masson染色法观察肾脏病理改变。用免疫组化法检测转化生长因子β1(transforming growth factor-beta1 TGF-β1),α-平滑肌肌动蛋白(alpha-smooth muscle actin-αSMA),Ⅰ型胶原(collagenⅠColⅠ)的表达。结果与UUO组相比,治疗组梗阻侧肾脏TGF-β1,-αSMA,ColⅠ的表达明显减少,肾小管损害和肾间质纤维化的程度也明显减轻。结论苦参素可通过下调TGF-β1,减少肾小管上皮细胞转分化而减轻肾间质纤维化。     

化瘀解毒中药抑制梗阻性肾病巨噬细胞浸润减轻炎性损伤的作用

为观察化瘀解毒中药对梗阻性肾病巨噬细胞浸润的影响及作用机制。将48只健康雄性Wistar大鼠随机分为假手术组、模型组、依普利酮组、中药组,每组12只。除假手术组外,其余大鼠结扎单侧输尿管(UUO)复制肾间质纤维化动物模型。治疗组分别给以依普利酮(100 mg/kg/d加入饲料喂养)和化瘀解毒中药煎剂(14 g/kg/d灌胃)。10 d后摘取肾脏,观察大鼠肾脏组织病理改变。免疫组化法标记巨噬细胞浸润,免疫组化、Western Blot方法检测血清和糖皮质激素诱导蛋白激酶1(SGK-1)、单核细胞趋化蛋白-1(MCP-1)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)的表达。肾脏病理显示,UUO组大鼠肾脏有明显的肾小管扩张及上皮细胞脱落,间质巨噬细胞浸润增多和细胞外基质(ECM)大量积聚,SGK-1、MCP-1、IL-1、TNF-α表达明显增强。化瘀解毒中药可明显减轻UUO大鼠肾脏巨噬细胞等炎性细胞浸润和ECM沉积,下调SGK-1、MCP-1、IL-1、TNF-α表达。以上结果说明化瘀解毒中药可抑制梗阻性肾病诱导的巨噬细胞浸润,减轻肾脏炎性损伤。     

羟苯磺酸钙通过抑制Ⅰ型胶原表达减轻肾间质纤维化

目的:研究羟苯磺酸钙对小鼠肾间质纤维化、Ⅰ型胶原表达的影响。方法:将C57小鼠随机分为假手术组(Sham组,n=4)、肾间质纤维化模型组(UUO组,n=5)及羟苯磺酸钙治疗组(CDT组,n=4);采用单侧输尿管梗阻制备肾间质纤维化模型,CDT组给予羟苯磺酸钙灌胃、Sham组和UUO组给予双蒸水灌胃;采用HE染色、Masson染色、免疫组化、实时定量PCR以及蛋白免疫印迹观察单侧输尿管梗阻术后14 d小鼠术侧肾脏的肾间质纤维化程度和Ⅰ型胶原表达情况。结果:与Sham组比较,UUO组小鼠术后14 d术侧肾脏肾发生显著肾间质纤维化,Ⅰ型胶原表达显著增强(Ⅰ型胶原基因相对表达量:Sham组:1.00000,UUO组:114.92289,P0.0001)。与UUO组比较,CDT组小鼠术后14 d术侧肾间质纤维化程度显著减轻,Ⅰ型胶原表达显著减弱(Ⅰ型胶原基因相对表达量:UUO组:114.92289,CDT组:45.33516,P0.005)。结论:羟苯磺酸钙通过抑制小鼠肾间质Ⅰ型胶原表达从而减轻单侧输尿管结扎小鼠肾间质纤维化。     

上调miR-200c通过抑制TGF-β1/Smad3通路减轻单侧输尿管梗阻小鼠肾纤维化

目的观察mi R-200c在单侧输尿管梗阻(unilateral ureteral obstruction,UUO)小鼠肾组织中的表达变化及其对UUO小鼠肾间质纤维化和TGF-β1/Smad3通路的影响。方法 45只C57BL/6J小鼠,随机数字表法分为假UUO组、UUO组、UUO+agomi R-200c组,每组15只。假UUO组仅游离左侧输尿管但不结扎;UUO组和UUO+agomi R-200c组通过结扎左侧输尿管建立的肾纤维化模型,手术后第1、7、14d两组小鼠分别给予生理盐水和agomir-200c尾静脉注射。第21d后处死全部小鼠,取血测定血肌酐(Scr)、血尿素氮(BUN)。取小鼠梗阻侧肾脏组织,HE染色和Masson染色评价肾小管间质损伤和肾间质纤维化损伤程度,实时荧光定量PCR(q RT-PCR)检测肾组织mi R-200c的表达,Western blotting检测肾组织TGF-β1、Smad3及α平滑肌肌动蛋白(α-SMA)蛋白的表达。结果与假UUO组比较,UUO组小鼠肾组织mi R-200c的表达水平明显降低,血清Scr、BUN水平明显升高,肾小管间质损伤病理评分升高,肾胶原容积分数(c VF)增加,肾组织中TGF-β1、Smad3及α-SMA水平明显升高。与UUO组比较,UUO+agomi R-200c组小鼠肾组织mi R-200c的表达明显增高,血清Scr、BUN水平明显降低,肾小管间质损伤病理评分下降,肾胶原容积分数减少,肾组织中TGF-β1、Smad3及α-SMA水平明显降低。结论上调mi R-200c能够通过抑制TGF-β1/Smad3通路减轻UUO小鼠肾间质纤维化。     

依帕司他对单侧输尿管梗阻大鼠肾间质纤维化的干预作用及其机制

目的:观察依帕司他(EPS)对单侧输尿管梗阻(UUO)大鼠间质纤维化的保护作用及其机制。方法:实验设假手术组(Sham)组、UUO、UUO+EPS(50 mg/kg)及UUO+EPS(100 mg/kg)剂量组,每组n=8。左侧输尿管结扎制备UUO大鼠模型。造模后连续灌胃给药3周,sham和UUO组给予等体积的羟甲基纤维素钠。HE和Masson染色观察肾组织病理变化及胶原沉积情况。免疫组化法观察肾组织醛糖还原酶(AR)表达情况,分别采用real-time PCR和(或) Western blot检测肾脏I型胶原(collagen I)、III型胶原(collagen III)、α-平滑肌肌动蛋白(α-SMA)、成纤维细胞特异蛋白-1(FSP-1)、纤连蛋白(FN)、E-钙粘蛋白(E-cadherin)、转化生成因子-β1(TGF-β1)和AR mRNA及蛋白表达。结果:与Sham组相比,UUO组大鼠小管上皮细胞萎缩、空泡样变性,肾间质成纤维细胞及肌成纤维细胞大量增殖并伴大量炎症细胞浸润,胶原沉积明显增加,collagen I、collagen III、TGF-β1和AR mRNA及蛋白表达水平明显升高(P<0.01),同时EMT标志性蛋白α-SMA、FSP-1、FN mRNA及蛋白表达水平明显升高(P<0.01),而E-cadherin mRNA及蛋白表达水平明显降低。与UUO组相比,经EPS治疗3周后,肾间质纤维化程度明显减轻,胶原沉积明显减少,collagen I、collagen III、TGF-β1和AR mRNA及蛋白表达水平明显降低(P<0.01或P<0.05),另外α-SMA、FSP-1、FN mRNA及蛋白表达水平明显降低(P<0.01或P<0.05),而E-cadherin mRNA及蛋白表达水平明显升高(P<0.01或P<0.05),而且100 mg/kg剂量组上述指标的改变均好于低剂量组(P<0.05,P<0.01)。结论:依帕司他对肾间质纤维化具有一定的改善作用,其机制可能与其抑制TGF-β1介导的AR表达、进而抑制大鼠肾小管上皮细胞EMT有关。     

TNFRSF13C 在单侧输尿管梗阻大鼠肾组织中的表达及其意义

目的：检测单侧输尿管梗阻（UUO）大鼠肾组织中B 细胞激活因子受体（TNFRSF13C）的表达变化,探讨其在肾间质纤维化 病变中的作用。方法：采用UUO法建立肾间质纤维化大鼠模型,20只成年雄性大鼠,随机分为4组,分别于术后0、3、7、14 天处死 大鼠。取左侧梗阻肾脏进行Masson染色,拍照后,采用双盲法评定各组肾小管间质纤维化程度。提取肾组织中总RNA,用实时荧 光定量聚合酶链反应（RT-PCR）法检测各组肾组织中TNFRSF13C基因表达情况。Pearson 检测TNFRSF13C表达量与肾小管间质 纤维化程度的相关性。结果：随着梗阻时间的延长,肾组织中TNFRSF13C 的mRNA 表达量进行性升高,与肾间质纤维化病变程 度一致,两者呈显著正相关（r=0.915,P<0.01）。结论：TNFRSF13C可能在肾间质纤维化病程中起到了重要作用,并有望成为慢性 肾脏病的临床监测指标。     

单侧输尿管结扎再通大鼠模型的建立方法及其评价

目的比较单侧输尿管结扎（UUO）与单侧输尿管结扎再通（RUUO）建立的SD大鼠肾纤维化模型的优劣,从而得到更符合临床慢性肾衰进展特点的动物模型,以供临床药物筛选、疗效评介、科研、教学使用。方法健康SPF级雄性SD大鼠54只,随机分成假手术组、UUO组及UUO再通组各18只,造模成功后检测血肌酐（Scr）、尿素氮（BUN）及尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）,病理检查肾小管间质纤维化指数和免疫组化检查α-肌动蛋白（α-SMA）。结果无论从肾功能方面,还是病理检查方面,UUO再通的大鼠肾纤维化动物模型均优于UUO大鼠模型。结论再通UUO肾纤维化大鼠模型在功能及病理方面及其相关的免疫组化方面优于UUO组,其病理特点更符合慢性肾小管间质纤维化进程的动物模型。     

Sirt1活化剂对肾间质纤维化的保护作用及机制研究

研究Sirt1活化剂对单侧输尿管结扎导致的小鼠肾间质纤维化及TGF-β1/CTGF信号通路的影响。CD-1小鼠随机分为假手术组(Sham)、单侧输尿管结扎组(unilateral ureteral obstruction,UUO)和UUO+SRT1720(Sirt1活化剂)组(SRT1720)。Masson染色后光镜下观察肾小管间质病变面积;分别用Western blot和Real-time PCR检测Sirt1及纤维化相关因子Col1、α-SMA、TIMP-1、PAI-1蛋白质和m RNA表达水平;TUNEL检测细胞凋亡程度,同时检测凋亡相关因子Bcl-2/Bax的变化;检测SOD、MDA、GPx、GSH水平以示氧化应激变化。与Sham组相比,UUO组显示肾间质纤维化病变面积显著升高(P0.01);Sirt1水平及活性显著下降;TGF-β1/CTGF水平、纤维化相关因子表达及凋亡水平显著上升;氧化应激水平显著升高(P0.01)。SRT1720干预能够显著降低UUO引起的肾间质纤维化病变面积(P0.05),同时改善TGF-β1/CTGF水平、纤维化相关因子及凋亡水平(P0.01),显著降低肾脏氧化应激水平(P0.01)。以上说明,Sirt1活化剂SRT1720能显著改善肾间质纤维化水平,该作用可能是通过TGF-β1/CTGF信号通路的抑制和氧化应激实现的。     

甲磺酸伊马替尼对单侧输尿管梗阻小鼠肾间质纤维化的保护作用

目的研究甲磺酸伊马替尼（STI571）改善单侧输尿管梗阻（UUO）小鼠肾间质纤维化的作用及机制。方法48只小鼠随机分为4组：假手术组,模型组,小剂量治疗组（80mg/kg/d）,大剂量治疗组（160mg/kg/d）。采用左侧输尿管双结扎的方法建立UUO模型,治疗组每天以STI57180、160mg/Kg灌胃。分别于术后第8,11d分别处死各组小鼠6只。光镜下观察肾脏病理改变。用免疫组化技术检测肾组织TGF-β1、PAI-1、α-SMA和PCNA的表达。结果治疗组的肾间质纤维化定量显著低于模型组（P〈0.05）,且不同剂量组之间存在显著差异（P〈0.05）。模型组和治疗组左肾TGF-β1、PAI-1、α-SMA和PCNA的表达均随梗阻时间延长而逐渐增加,治疗组α-SMA和PCNA的表达较模型组明显减低（P〈0.05）。结论甲磺酸伊马替尼可显著减轻UUO小鼠梗阻侧肾脏间质纤维化,下调α-SMA和PCNA的表达,减少肾间质细胞外基质的沉积,对UUO小鼠肾间质纤维化有一定防治作用。     

辛伐他汀对糖尿病大鼠肾脏的保护作用及其可能机制

目的：观察辛伐他汀对糖尿病大鼠肾脏损伤的保护作用并探讨其可能的分子机制。方法：24只SD大鼠随机分为正常对照（NC,n=8）组和糖尿病造模组（n=16）。糖尿病造模组大鼠采用55 mg/kg链脲佐菌素（STZ）单次腹腔注射的方法建立糖尿病大鼠模型。造模成功后,糖尿病模型大鼠随机分为糖尿病（DM）组和糖尿病+辛伐他汀（DM+Sim）组。DM+Sim组大鼠每天给予辛伐他汀40 mg/kg灌胃,1次/日,连续4周。采用组织病理学方法观察肾脏的形态学改变和间质纤维化;采用分子生物学方法检测肾脏组织中内质网应激、炎性因子的表达以及细胞凋亡。结果：①与NC组相比,DM组可见肾小球和肾小管间质有明显的病理学改变,胶原纤维明显红染,呈不均匀分布;DM+Sim组形态学以及纤维化有明显改善。②DM组大鼠肾组织GRP78、p-IRE1α、NF-κB p65、MCP-1表达均高于NC组（P<0.05）,DM+Sim组GRP78、p-IRE1α、NF-κB p65、MCP-1表达较DM组均下降（P<0.05）。③TUNEL法检测,NC组肾小球及肾小管存在少量凋亡的细胞,DM组肾小球及肾小管存在大量凋亡的细胞（P<0.01）;与DM组比较,DM+Sim组凋亡的细胞明显减少（P<0.01）。结论：给予糖尿病大鼠辛伐他汀后,肾脏形态学以及纤维化明显改善,细胞凋亡明显减少。其对糖尿病肾脏的保护作用与抑制内质网应激和NF-κB炎症信号通路及减少肾脏细胞的凋亡有关。     

Fluorofenidone attenuates renal interstitial fibrosis in the rat model of obstructive nephropathy

Fluorofenidone (FD) is a novel pyridone agent with significant antifibrotic effects in vitro. The purpose of this study is to investigate the effects of FD on renal interstitial fibrosis in rats with obstructive nephropathy caused by unilateral ureteral obstruction (UUO). With pirfenidone (PD, 500 mg/kg/day) and enalapril (10 mg/kg/day) as the positive treatment controls, the rats in different experimental groups were administered with FD (500 mg/kg/day) from day 4 to day 14 after UUO. The tubulointerstitial injury, interstitial collagen deposition, and expression of type I and type III collagen, transforming growth factor-β(1) (TGF-β(1)), connective tissue growth factor (CTGF), platelet-derived growth factor (PDGF), α-smooth muscle actin (α-SMA), and tissue inhibitor of metalloproteinase-1 (TIMP-1) were assessed. FD treatment significantly attenuated the prominently increased scores of tubulointerstitial injury, interstitial collagen deposition, and protein expression of type I and type III collagen in ureter-obstructed kidneys, respectively. As compared with untreated rats, FD also significantly reduced the expression of α-SMA, TGF-β(1), CTGF, PDGF, and inhibitor of TIMP-1 in the obstructed kidneys. Fluorofenidone attenuates renal interstitial fibrosis in the rat model of obstructive nephropathy through its regulation on fibrogenic growth factors, tubular cell transdifferentiation, and extracellular matrix.     

Tubulointerstitial macrophage accumulation is regulated by sequentially expressed osteopontin and macrophage colony-stimulating factor: implication for the role of atorvastatin

Infiltration and local proliferation are known factors that contribute to tubulointerstitial macrophage accumulation. This study explored the time course of these two contributors' roles as tubulointerstitial inflammation and fibrosis progressing, and evaluated the mechanisms of the protective effect of atorvastatin. Unilateral ureteral obstructive (UUO) rats were treated with atorvastatin (10 mg/Kg) or vehicle. Expression of osteopontin (OPN) and macrophage colony-stimulating factor (M-CSF) was evaluated by RT-PCR and immunohistochemistry. Immunohistochemistry staining of ED1 was used to assess macrophage accumulation in interstitium. Histological evaluation was performed to semiquantify tubulointerstitial fibrosis. The results showed that on day 3 after UUO operation, OPN expression significantly increased and positively correlated with the number of the interstitial ED1(+) cells, while on day 10, M-CSF expression upregulated and correlated with interstitial ED1(+) cells. In atorvastatin treatment group, the increments of these two factors were attenuated significantly at the two time points, respectively. ED1(+) cell accumulation and fibrosis also ameliorated in the treatment group. For all the samples of UUO and treatment group on day 10, ED1(+) cells also correlated with interstitial fibrosis scores. The results suggest that OPN may induce the early macrophage/monocyte infiltration and M-CSF may play an important role in regulating macrophage accumulation in later stage of UUO nephropathy. Statin treatment decreases interstitial inflammation and fibrosis, and this renoprotective effect may be mediated by downregulating the expression of OPN and M-CSF.     

Overexpression of Heme Oxygenase-1 Prevents Renal Interstitial Inflammation and Fibrosis Induced by Unilateral Ureter Obstruction

Renal fibrosis plays an important role in the onset and progression of chronic kidney diseases. Many studies have demonstrated that heme oxygenase-1 (HO-1) is involved in diverse biological processes as a cytoprotective molecule, including anti-inflammatory, anti-oxidant, anti-apoptotic, antiproliferative, and immunomodulatory effects. However, the mechanisms of HO-1 prevention in renal interstitial fibrosis remain unknown. In this study, HO-1 transgenic (TG) mice were employed to investigate the effect of HO-1 on renal fibrosis using a unilateral ureter obstruction (UUO) model and to explore the potential mechanisms. We found that HO-1 was adaptively upregulated in kidneys of both TG and wild type (WT) mice after UUO. The levels of HO-1 mRNA and protein were increased in TG mice compared with WT mice under normal conditions. HO-1 expression was further enhanced after UUO and remained high during the entire experimental process. Renal interstitial fibrosis in the TG group was significantly attenuated compared with that in the WT group after UUO. Moreover, overexpression of HO-1 inhibited the loss of peritubular capillaries. In addition, UUO-induced activation and proliferation of myofibroblasts were suppressed by HO-1 overexpression. Furthermore, HO-1 restrained tubulointerstitial infiltration of macrophages and regulated the secretion of inflammatory cytokines in UUO mice. We also found that high expression of HO-1 inhibited reactivation of Wnt/β-catenin signaling, which could play a crucial role in attenuating renal fibrosis. In conclusion, these data suggest that HO-1 prevents renal tubulointerstitial fibrosis possibly by regulating the inflammatory response and Wnt/β-catenin signaling. This study provides evidence that augmentation of HO-1 levels may be a therapeutic strategy against renal interstitial fibrosis.     

Toll-like receptor signaling and SIGIRR in renal fibrosis upon unilateral ureteral obstruction

Innate immune activation via IL-1R or Toll-like receptors (TLR) contibutes to acute kidney injury but its role in tissue remodeling during chronic kidney disease is unclear. SIGIRR is an inhibitor of TLR-induced cytokine and chemokine expression in intrarenal immune cells, therefore, we hypothesized that Sigirr-deficiency would aggravate postobstructive renal fibrosis. The expression of TLRs as well as endogenous TLR agonists increased within six days after UUO in obstructed compared to unobstructed kidneys while SIGIRR itself was downregulated by day 10. However, lack of SIGIRR did not affect the intrarenal mRNA expression of proinflammatory and profibrotic mediators as well as the numbers of intrarenal macrophages and T cells or morphometric markers of tubular atrophy and interstitial fibrosis. Because SIGIRR is known to block TLR/IL-1R signaling at the level of the intracellular adaptor molecule MyD88 UUO experiments were also performed in mice deficient for either MyD88, TLR2 or TLR9. After UUO there was no significant change of tubular interstitial damage and interstitial fibrosis in neither of these mice compared to wildtype counterparts. Additional in-vitro studies with CD90+ renal fibroblasts revealed that TLR agonists induce the expression of IL-6 and MCP-1/CCL2 but not of TGF-β, collagen-1α or smooth muscle actin. Together, postobstructive renal interstitial fibrosis and tubular atrophy develop independent of SIGIRR, TLR2, TLR9, and MyD88. These data argue against a significant role of these molecules in renal fibrosis.     

兔慢性肾功能衰竭模型的建立与评价

目的建立兔慢性肾功能衰竭模型,为干细胞移植治疗和相关研究奠定基础。方法普通级大耳白兔随机分为正常对照组和单侧输尿管结扎（unilateral ureteral obstruction,UUO）组。UUO组于输尿管结扎后2、4、6、8周进行血生化肾功能指标检测,并取肾组织观察肾脏病理学改变,通过SPECT动态观察肾小球滤过率的变化,采用免疫组织化学方法观察肾组织转化生长因子-β1（TGF-β1）的表达情况。结果①UUO组术后第2周,出现明显的血肌酐升高,尿素氮术后第8周开始升高（P〈0.01）。②UUO组术后第4周,肾脏组织出现了早期间质纤维化的病理改变,术后第8周肾小球开始出现硬化,间质纤维化明显,皮质明显变薄。术后第12周,肾小球硬化比例增加,肾小管玻璃样变性,间质纤维化进一步加重（P〈0.05）。③SPECT动态观察肾小球滤过率,UUO组第4周GFR值比正常对照组降低,到第8周时,GFR值进一步下降,结扎侧肾脏功能降低甚至丧失。④免疫组织化学染色显示,TGF-β1在术后第4、8、12周均明显增强,并且各时间点表达均有显著差异（P〈0.05）。结论单侧输尿管结扎法成功制作比较稳定的慢性肾功能不全模型,UUO后第8周符合肾脏间质纤维化模型标准。