Acute cholestasis-induced renal failure: effects of antioxidants and ligands for the thromboxane A2 receptor.
BACKGROUND
Acute biliary obstruction is associated with the development of renal impairment and oxidative stress. The F2-isoprostanes, formed during oxidant injury, are renal vasoconstrictors acting via thromboxane (TX)-like receptors. We determined whether the formation of F2-isoprostanes is increased in experimental cholestasis and whether thiol containing antioxidants or ligands for the TXA2 receptor could improve renal function.


METHODS
The effects on renal function of acute bile duct ligation (BDL) in the rat were studied for two days. The consequences of administration of N-acetylcysteine (NAC), alpha-lipoic acid (LA), the TX receptor antagonist (TXRA) BAYu3405, or placebo were then examined.


RESULTS
BDL caused a reduction in creatinine clearance from 1.10 +/- 0.05 to 0.55 +/- 0.05 ml/min and sodium excretion from 52 +/- 3 to 17 +/- 3 micromol/hr. Urinary F2-isoprostanes increased from 14 +/- 2 to 197 +/- 22 pg/ml following BDL. Renal functional changes were ameliorated by NAC (creatinine clearance 0.73 +/- 0.05 ml/min), LA (0.64 +/- 0.03 ml/min), and a TXRA (0.90 +/- 0.15 ml/min); P < 0.05. Similarly, sodium excretion was increased from 17 +/- 3 micromol/hr (placebo) to 34 +/- 3 micromol/hr (NAC), 29 +/- 3 micromol/hr (LA), and 38 +/- 5 micromol/hr (TXRA); P < 0.005. Hepatic glutathione concentrations increased from 6.5 +/- 0.3 micromol/g (normal liver) to 8.8 +/- 0.5 micromol/g (NAC) and 7.7 +/- 0.3 micromol/g (LA), P < 0.01. However, only LA markedly inhibited F2-isoprostane formation (197 +/- 22 to 36 +/- 11 pg/ml creatinine clearance; P < 0.05). Urinary TXB2 excretion was elevated after BDL (2.2 +/- 0.5 to 111.1 +/- 20.3 pg/min) but was unaffected by NAC and LA.


CONCLUSIONS
NAC, LA, and TXRA can partially prevent renal dysfunction in experimental cholestasis. The effects of the antioxidants are independent of their ability to inhibit lipid peroxidation or TX synthesis.
Holt
S
S
Department of Surgery and Department of Chemical Pathology, The Royal Free Hospital, London, England, United Kingdom.
Marley
R
R
Fernando
B
B
Harry
D
D
Anand
R
R
Goodier
D
D
Moore
K
K
D000111:Acetylcysteine / Q000494:pharmacology; D058186:Acute Kidney Injury / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism*; D000818:Animals; D000975:Antioxidants / Q000494:pharmacology*; D002227:Carbazoles / Q000494:pharmacology; D002779:Cholestasis / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism*; D015237:Dinoprost / Q000652:urine; D005978:Glutathione / Q000378:metabolism; D008024:Ligands; D015227:Lipid Peroxidation; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D017482:Receptors, Thromboxane / Q000037:antagonists & inhibitors / Q000378:metabolism*; D012964:Sodium / Q000652:urine; D013449:Sulfonamides / Q000494:pharmacology; D008063:Thioctic Acid / Q000494:pharmacology; D013929:Thromboxane B2 / Q000652:urine
D000975:Antioxidants; D002227:Carbazoles; D008024:Ligands; D017482:Receptors, Thromboxane; D013449:Sulfonamides; D013929:Thromboxane B2; D008063:Thioctic Acid; D012964:Sodium; D015237:Dinoprost; D005978:Glutathione; C063119:ramatroban; D000111:Acetylcysteine