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MARKED PROTECTION AGAINST ACUTE RENAL AND HEPATIC INJURY FOLLOWING NITRITED- MYOGLOBIN + TIN PROTOPORPHYRIN ADMINISTRATION #MMPMID26117289
Zager RA
Transl Res 2015[Nov]; 166 (5): 485-501 PMID26117289show ga
The phenomenon of so called renal ?ischemic preconditioning?, whereby an initial ischemic insult induces resistance against subsequent kidney damage, has been well established in the experimental literature. However, a clinically applicable way to safely recapitulate this state has not been defined. We hypothesized that a unique combination of agents (nitrited myoglobin + Sn protoporphyrin) can achieve these ends by safely, and synergistically, increasing cytoprotective proteins (e.g., HO-1, IL-10, haptoglobin) in kidney cells. To test this hypothesis, CD-1 mice received 1 mg N-Mgb and 1 µmole SnPP, either alone or in combination. Renal cortical HO-1, haptoglobin, and IL-10 gene expression (mRNA, protein levels) were determined 4 and 18 hrs later. Cytoresistance to three forms of AKI were assessed (glycerol- induced rhabdomyolysis; maleate nephrotoxicity; post-ischemic AKI progression to CKD). To ascertain whether cytoresistance might emerge in extra-renal organs, hepatic HO-1, IL-10, and haptoglobin levels were also measured, and resistance to 25 min of hepatic ischemia-reperfusion injury and hepatotoxicity (intraperitoneal glycerol injection) was sought. N-Mgb + SnPP induced additive or synergistic increases in renal HO-1, haptoglobin, and IL-10 mRNA/protein levels (up to 20 fold) without inducing any apparent renal or extra-renal damage. By 18 hrs post treatment, marked, or complete, protection against glycerol-induced AKI, maleate- induced AKI, and post ischemic AKI progression to CKD had emerged. Combined N-Mgb+SnPP was more protective than was either agent alone (assessed in glycerol model). N-Mgb+SnPP also up-regulated cytoprotective pathways in liver, and induced marked protection against both hepatic ischemia-reperfusion and toxic liver damage. In sum, we posit that ?preconditioning? with combined N-Mgb+SnPP administration represents a promising approach for protecting against diverse forms of renal and non renal (hepatic) forms of tissue damage.