Kidney Ischemia-Reperfusion Elicits Acute Liver Injury and Inflammatory Response

Citation

Shang, Y., Madduma Hewage, S., Wijerathne, C.U.B., Siow, Y.L., Isaak, C.K., Karmin, O. (2020). Kidney Ischemia-Reperfusion Elicits Acute Liver Injury and Inflammatory Response. Frontiers in Medicine, [online] 7 http://dx.doi.org/10.3389/fmed.2020.00201

Plain language summary

Acute kidney injury is a type of kidney failure that occurs within a short period of time and frequently results in death when it occurs in critically ill patients. Blockade of blood vessels leading to the kidneys can cause acute kidney injury. In this study, when acute kidney injury is induced in rats, the resulting inflammatory response in the kidneys and other organs such as liver. This compromised the function of multiple organs. Our results suggest the following route of organ malfunction: increase in levels of inflammatory factors in the kidney increases the inflammation in the blood system, inducing an inflammatory response in the liver and in turn further exacerbates the injury in the kidney. This may explain the frequently observed distant organ injury in clinical scenarios.

Abstract

Ischemia-reperfusion (IR) is a common risk factor that causes acute kidney injury (AKI). AKI is associated with dysfunction of other organs also known as distant organ injury. The liver function is often compromised in patients with AKI and in animal models. However, the underlying mechanisms are not fully understood. Inflammatory response plays an important role in IR-induced tissue injury. Although increased proinflammatory cytokines have been detected in the kidney and the distant organs after renal IR, their original sources remain uncertain. In the present study, we investigated the acute effect of renal IR on hepatic inflammatory cytokine expression and the mechanism involved. Sprague-Dawley rats that were subjected to renal IR (ischemia for 45 min followed by reperfusion for 1 h or 6 h) had increased plasma levels of creatinine, urea, and transaminases, indicating kidney and liver injuries. There was a significant increase in the expression of proinflammatory cytokine mRNA (MCP-1, TNF-α, IL-6) in the kidney and liver in rats with renal IR. This was accompanied by a significant increase in proinflammatory cytokine protein levels in the plasma, kidney, and liver. Activation of a nuclear transcription factor kappa B (NF-κB) was detected in the liver after renal IR. The inflammatory foci and an increased myeloperoxidase (MPO) activity were detected in the liver after renal IR, indicating hepatic inflammatory response and leukocyte infiltration. These results suggest that renal IR can directly activate NF-κB and induce acute production of proinflammatory cytokines in the liver. Renal IR-induced hepatic inflammatory response may contribute to impaired liver function and systemic inflammation.

Publication date

2020-06-02

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