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Kidney:白藜芦醇可改善败血症诱导的急性肾损伤

Tags: 白藜芦醇   败血症   肾损伤      作者:MedSci 更新:2012-03-08

近日,Kidney杂志在线发表了美国阿肯色大学研究人员的成果,研究发现败血症患者发生AKI后其死亡率几乎增加了一倍,由于治疗只是在发生AKI后才开始,所以其疗效往往欠佳。

活性氮的产生可导致肾脏微循环的衰竭,白藜芦醇属于多酚类血管扩张药物,同时可以清除盲肠处穿刺结扎(CLP)诱发败血症诱导急性肾损伤鼠模型中活性氮,给药后在CLP 5.5h时在活体显微镜检查下可以发现逆转皮质毛细血管灌注的下降,到了6h时候就存在剂量依赖性。

白藜芦醇在不影响系统性血压变化情况下可以最大程度的改善肾脏毛细血管的灌注和提高肾脏血流以及肾小球率过滤。在CLP发生6h时给予单剂量治疗后,在18h时就失去了改善肾脏微循环的作用,而如果在12h给予第二次剂量时候则可显著改善微循环和降低肾小管中活性氮的水平,因而改善了肾功能。同样,分别在6h、12h和18h时都给予白藜芦醇则可以提高生存率。

由此可见,白藜芦醇可能是通过恢复肾脏微循环和清楚活性氮双相作用来对败血症诱发的AKI起到保护肾小管上皮细胞的作用。

Resveratrol improves renal microcirculation, protects the tubular epithelium, and prolongs survival in a mouse model of sepsis-induced acute kidney injury

Joseph H Holthoff, Zhen Wang, Kathryn A Seely, Neriman Gokden and Philip R Mayeux

The mortality rate of patients who develop acute kidney injury during sepsis nearly doubles. The effectiveness of therapy is hampered because it is usually initiated only after the onset of symptoms. As renal microvascular failure during sepsis is correlated with the generation of reactive nitrogen species, the therapeutic potential of resveratrol, a polyphenol vasodilator that is also capable of scavenging reactive nitrogen species, was investigated using the cecal ligation and puncture (CLP) murine model of sepsis-induced acute kidney injury. Resveratrol when given at 5.5?h following CLP reversed the decline in cortical capillary perfusion, assessed by intravital microscopy, at 6?h in a dose-dependent manner. Resveratrol produced the greatest improvement in capillary perfusion and increased renal blood flow and the glomerular filtration rate without raising systemic pressure. A single dose at 6?h after CLP was unable to improve renal microcirculation assessed at 18?h; however, a second dose at 12?h significantly improved microcirculation and decreased the levels of reactive nitrogen species in tubules, while improving renal function. Moreover, resveratrol given at 6, 12, and 18?h significantly improved survival. Hence, resveratrol may have a dual mechanism of action to restore the renal microcirculation and scavenge reactive nitrogen species, thus protecting the tubular epithelium even when administered after the onset of sepsis.

来源:MedSci原创
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