Dexmedetomidine pretreatment attenuates myocardial ischemia reperfusion induced acute kidney injury and endoplasmic reticulum stress in human and rat

被引:58
作者
Tang, Chaoliang [1 ]
Hu, Yida [2 ]
Gao, Jie [3 ]
Jiang, Jiazhen [4 ]
Shi, Si [2 ]
Wang, Jiawu [1 ]
Geng, Qingtian [1 ]
Liang, Xinghan [5 ]
Chai, Xiaoqing [1 ]
机构
[1] Univ Sci & Technol China, Dept Anesthesiol, Affiliated Hosp USTC 1, Div Life Sci & Med, Hefei 230001, Anhui, Peoples R China
[2] Wuhan Univ, Renmin Hosp, Dept Anesthesiol, Wuhan 430060, Hubei, Peoples R China
[3] Harvard Med Sch, Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02144 USA
[4] Fudan Univ, Huashan Hosp North, Dept Emergency, Shanghai 201907, Peoples R China
[5] Univ Sci & Technol China, Dept Clin Lab, Affiliated Hosp USTC 1, Div Life Sci & Med, Hefei 230000, Anhui, Peoples R China
基金
中国博士后科学基金; 中国国家自然科学基金;
关键词
Dexmedetomidine; Cardiopulmonary bypass; Acute kidney injury; Myocardial ischemia reperfusion; Endoplasmic reticulum (ER) stress; ACUTE-RENAL-FAILURE; CARDIAC-SURGERY; CARDIOPULMONARY BYPASS; PROPOFOL SEDATION; CELL-DEATH; BIOMARKERS; DIAGNOSIS; PROTECTS; RISK; METAANALYSIS;
D O I
10.1016/j.lfs.2020.118004
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: Patients undergoing cardiopulmonary bypass (CPB) often develop acute kidney injury (AKI) caused by myocardial ischemia reperfusion (MI/R), and this renal injury can be resolved notably by dexmedetomidine. Endoplasmic reticulum (ER) stress was reported to get involved in organ injury including AKI. Objectives: The current study aimed to address the correlation between MI/R induced AKI with ER stress and to assess the effects of dexmedetomidine pretreatment on AKI protection. Method: Patients selected for heart valve replacement surgery were randomly assigned to NS group (pre -anesthesia with 0.9% NaCl) and DEX group (pre-anesthesia with dexmedetomidine). Rat MI/R model was induced by occluding coronary artery for 30 min followed by 48-hour reperfusion. Rats were randomized into Sham (0.9% NaCl), I/R (MI/R + 0.9% NaCl) and I/R + DEX (MI/R + dexmedetomidine). Organ function and ER stress condition were evaluated by blood chemistry, pathology, and molecular test. Results: Clinical data indicated dexmedetomidine pretreatment attenuated AKI and oxidative stress as well as postischemic myocardial injury in patients. Accordingly animal results suggested dexmedetomidine reduced cellular injury and improved postischemic myocardial and renal function. Dexmedetomidine also reduced myocardial and renal cells apoptosis and down-regulated ER stress. Conclusions: These results suggested that dexmedetomidine pretreatment attenuates MI/R injury-induced AKI by relieving the ER stress.
引用
收藏
页数:11
相关论文
共 53 条
[1]   Protective effects of dexmedetomidine and remote ischemic preconditioning on renal ischemia reperfusion injury in rats [J].
Balci, Cansu ;
Akan, Mert ;
Boztas, Nilay ;
Ozkardesler, Sevda ;
Ergur, Bekir Ugur ;
Guneli, Mustafa Ensari ;
Unal, Belgin .
ULUSAL TRAVMA VE ACIL CERRAHI DERGISI-TURKISH JOURNAL OF TRAUMA & EMERGENCY SURGERY, 2017, 23 (04) :279-286
[2]   Acute Renal Failure Update 2013 [J].
Bienholz, A. ;
Feldkamp, T. ;
Kribben, A. .
DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT, 2013, 138 (23) :1229-1232
[3]   Perioperative acute kidney injury: risk factors, recognition, management, and outcomes [J].
Borthwick, Emma ;
Ferguson, Andrew .
BMJ-BRITISH MEDICAL JOURNAL, 2010, 341 :85-91
[4]   Antithrombin nanoparticles improve kidney reperfusion and protect kidney function after ischemia-reperfusion injury [J].
Chen, Junjie ;
Vemuri, Chandu ;
Palekar, Rohun U. ;
Gaut, Joseph P. ;
Goette, Matthew ;
Hu, Lingzhi ;
Cui, Grace ;
Zhang, Huiying ;
Wickline, Samuel A. .
AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY, 2015, 308 (07) :F765-F773
[5]   Endoplasmic reticulum stress and eIF2α phosphorylation: The Achilles heel of pancreatic β cells [J].
Cnop, Miriam ;
Toivonen, Sanna ;
Lgoillo-Esteve, Mariana ;
Saipea, Paraskevi .
MOLECULAR METABOLISM, 2017, 6 (09) :1024-1039
[6]   Deep hypothermic circulatory arrest is not a risk factor for acute kidney injury in thoracic aortic surgery [J].
Englberger, Lars ;
Suri, Rakesh M. ;
Greason, Kevin L. ;
Burkhart, Harold M. ;
Sundt, Thoralf M., III ;
Daly, Richard C. ;
Schaff, Hartzell V. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2011, 141 (02) :552-558
[7]   Myocardial reperfusion injury: looking beyond primary PCI [J].
Froehlich, Georg M. ;
Meier, Pascal ;
White, Steven K. ;
Yellon, Derek M. ;
Hausenloy, Derek J. .
EUROPEAN HEART JOURNAL, 2013, 34 (23) :1714-+
[8]   Acute Kidney Injury Biomarkers Predict an Increase in Serum Milrinone Concentration Earlier Than Serum Creatinine-Defined Acute Kidney Injury in Infants After Cardiac Surgery [J].
Gist, Katja M. ;
Cooper, David S. ;
Wrona, Julia ;
Faubel, Sarah ;
Altmann, Christopher ;
Gao, Zhiqian ;
Marino, Bradley S. ;
Alten, Jeffrey ;
Hock, Kristal M. ;
Mizuno, Tomoyuki ;
Vinks, Alexander A. ;
Joy, Melanie S. ;
Wempe, Michael F. ;
Bennett, Michael R. ;
Goldstein, Stuart L. .
THERAPEUTIC DRUG MONITORING, 2018, 40 (02) :186-194
[9]  
Goyal A., 2018, RENAL FAILURE
[10]   Valvular heart operation is an independent risk factor for acute renal failure [J].
Grayson, AD ;
Khater, M ;
Jackson, M ;
Fox, MA .
ANNALS OF THORACIC SURGERY, 2003, 75 (06) :1829-1835