国际麻醉学与复苏杂志   2022, Issue (12): 1-1
    
异氟醚调控Toll样受体4/核因子‑κB信号通路保护大鼠肾缺血再灌注损伤
刘超, 李继峰, 武强, 王芳, 陈娜1()
1.鹤壁市人民医院
Isoflurane protects renal ischemia reperfusion injury by regulating Toll‑like receptor 4/nuclear factor‑κB signaling pathway in rats
 全文:
摘要:

机数字表法分为假手术组(S组)、肾缺血再灌注损伤组(IRI组)、异氟醚预处理组(Iso+IRI组)和异氟醚+脂多糖组(Iso+IRI+LPS组),每组8只。Iso+IRI组进行异氟醚(isoflurane, Iso)预处理,Iso+IRI+LPS组进行Iso预处理后腹腔注射脂多糖(lipopolysaccharide, LPS)0.1 mg/kg,其他组同时注射同体积生理盐水。而后IRI组、Iso+IRI组及Iso+IRI+LPS组采用夹闭肾蒂法建立肾IRI模型,S组进行假手术。术后24 h检测大鼠静脉血Cr和BUN水平,ELISA法检测肾组织IL‑1β、TNF‑α、IL‑6水平,超氧化物歧化酶(superoxide dismutase, SOD)活性检测试剂盒检测肾组织SOD活性,可见分光光度法检测肾组织丙二醛(malondialdehyde, MDA)、谷胱甘肽过氧化物酶(glutathion peroxidase, GSH‑Px)水平,H‑E染色观察肾组织病理学变化并进行组织病理学评分,TUNEL染色法检测肾小管细胞凋亡率,Western blot法检测肾组织Toll样受体4(Toll‑like receptor 4, TLR4)、NF‑κB p65、髓样分化因子(myeloid differentiation factor88, MyD88)水平。 结果 与S组比较:IRI组、Iso+IRI组、Iso+IRI+LPS组Cr、BUN、IL‑1β、TNF‑α、IL‑6、MDA、TLR4、MyD88、NF‑κB p65水平及细胞凋亡率均升高(P<0.05),IRI组、Iso+IRI组、Iso+IRI+LPS组SOD活性及IRI组、Iso+IRI+LPS组GSH‑Px水平均降低(P<0.05)。与IRI组比较:Iso+IRI组、Iso+IRI+LPS组Cr、IL‑1β、TNF‑α、IL‑6、MDA、TLR4、MyD88、NF‑κB p65水平及细胞凋亡率,Iso+IRI组组织病理学评分及BUN水平均降低(P<0.05);Iso+IRI组SOD活性及GSH‑Px水平均升高(P<0.05)。与Iso+IRI组比较:Iso+IRI+LPS组组织病理学评分,Cr、BUN、IL‑1β、TNF‑α、IL‑6、MDA、TLR4、MyD88、NF‑κB p65水平及细胞凋亡率均升高(P<0.05),SOD活性及GSH‑Px水平均降低(P<0.05)。 结论 Iso可以通过抑制TLR4/NF‑κB信号通路改善肾IRI。

关键词: 肾缺血再灌注损伤; 异氟醚; Toll样受体4/核因子‑κB
Abstract:

Objective To investigate the protective effect of isoflurane on renal ischemia reperfusion injury (IRI) and the related molecular mechanism. Methods According to random number table method, thirty‑two rats were divided into the sham group (S group), renal ischemia reperfusion injury group (IRI group), isoflurane preintervention group (Iso+IRI group) and isoflurane+lipopolysaccharide group (Iso+IRI+LPS group), with 8 rats in each group. The Iso+IRI group was pretreated with isoflurane (Iso), and the Iso+IRI+LPS group was intraperitoneal injected with lipopolysaccharide (LPS) 0.1 mg/kg after Iso pretreatment, the other groups were given the same volume of normal saline. Then renal IRI model was established by clamping renal pedicle method in IRI group, Iso+IRI group and Iso+IRI+LPS group, and the S group were treated with sham operation. The levels of creatinine (Cr), urea nitrogen (BUN) in venous blood were detected 24 h after operation, the levels of interleukin (IL)‑1β, tumor necrosis factor (TNF)‑α, IL‑6, in renal tissues were detected by enzyme linked immunosorbent assay (ELISA), the superoxide dismutase (SOD) activity in renal tissues were detected by SOD kit, the malondialdehyde (MDA) and glutathion peroxidase (GSH‑Px) were detected by visible spectrophotometry. The histopathological changes of kidney and pathological score were observed by hematoxylin‑eosin (H‑E) staining, while the apoptotic rate of renal tubular cells was detected by terminal deoxynucleotidyl transferase‑mediated dUTP‑biotin nick end labeling (TUNEL) method. The levels of Toll‑like receptor 4 (TLR4), nuclear factor (NF)‑κB p65 and myeloid differentiation factor88 (MyD88) were detected by Western blot. Results Compared with the S group: the levels of Cr, BUN, IL‑1β, TNF‑α, IL‑6, MDA, TLR4, MyD88, NF‑κB p65 and apoptosis rate in IRI, Iso+IRI and Iso+IRI+LPS groups were increased (P<0.05); the SOD activity in IRI group, Iso+IRI group, Iso+IRI+LPS group, and the levels of GSH‑Px in IRI group, Iso+IRI+LPS group were decreased (P<0.05). Compared with IRI group: the levels of Cr, IL‑1β, TNF‑α, IL‑6, MDA, TLR4, MyD88, NF‑κB p65 and apoptosis rate in Iso+IRI and Iso+IRI+LPS groups, and the pathological score and the levels of BUN in Iso+IRI group were all decreased (P<0.05); while the SOD activity and the levels of GSH‑Px in Iso+IRI group were increased (P<0.05). Compared with Iso+IRI group: the pathological score, the levels of Cr, BUN, IL‑1β, TNF‑α, IL‑6, MDA, TLR4, MyD88, NF‑κB p65, apoptosis rate were increased (P<0.05); the SOD activity and the levels of GSH‑Px were decreased in Iso+IRI+LPS group (P<0.05). Conclusion Iso ameliorates renal IRI by inhibiting TLR4/NF‑κB signaling.

Key words: Renal ischemia reperfusion injury; Isoflurane; Toll‑like receptor 4/nuclear factor‑κB