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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Soc+Nephrol
2017 ; 28
(5
): 1437-1449
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Mitochondria Protection after Acute Ischemia Prevents Prolonged Upregulation of
IL-1? and IL-18 and Arrests CKD
#MMPMID27881606
Szeto HH
; Liu S
; Soong Y
; Seshan SV
; Cohen-Gould L
; Manichev V
; Feldman LC
; Gustafsson T
J Am Soc Nephrol
2017[May]; 28
(5
): 1437-1449
PMID27881606
show ga
The innate immune system has been implicated in both AKI and CKD. Damaged
mitochondria release danger molecules, such as reactive oxygen species, DNA, and
cardiolipin, which can cause NLRP3 inflammasome activation and upregulation of
IL-18 and IL-1? It is not known if mitochondrial damage persists long after
ischemia to sustain chronic inflammasome activation. We conducted a 9-month study
in Sprague-Dawley rats after 45 minutes of bilateral renal ischemia. We detected
glomerular and peritubular capillary rarefaction, macrophage infiltration, and
fibrosis at 1 month. Transmission electron microscopy revealed mitochondrial
degeneration, mitophagy, and deformed foot processes in podocytes. These changes
progressed over the study period, with a persistent increase in renal cortical
expression of IL-18, IL-1?, and TGF-?, despite a gradual decline in TNF-?
expression and macrophage infiltration. Treatment with a mitoprotective agent
(SS-31; elamipretide) for 6 weeks, starting 1 month after ischemia, preserved
mitochondrial integrity, ameliorated expression levels of all inflammatory
markers, restored glomerular capillaries and podocyte structure, and arrested
glomerulosclerosis and interstitial fibrosis. Further, helium ion microscopy
vividly demonstrated the restoration of podocyte structure by SS-31. The
protection by SS-31 was sustained for ?6 months after treatment ended, with
normalization of IL-18 and IL-1? expression. These results support a role for
mitochondrial damage in inflammasome activation and CKD and suggest mitochondrial
protection as a novel therapeutic approach that can arrest the progression of
CKD. Notably, SS-31 is effective when given long after AKI and provides
persistent protection after termination of drug treatment.
|Acute Disease
[MESH]
|Animals
[MESH]
|Interleukin-18/*physiology
[MESH]
|Interleukin-1beta/*physiology
[MESH]
|Ischemia/*complications
[MESH]
|Kidney/*blood supply
[MESH]
|Male
[MESH]
|Mitochondria/*drug effects/*physiology
[MESH]
|Oligopeptides/*pharmacology/*therapeutic use
[MESH]
|Podocytes/drug effects
[MESH]
|Rats
[MESH]
|Rats, Sprague-Dawley
[MESH]
|Renal Insufficiency, Chronic/*etiology/*prevention & control
[MESH]