Exacerbated inflammatory response induced by insulin-like growth factor I treatment in rats with ischemic acute renal failure.
In agreement with recent studies showing a deleterious effect of growth hormone treatment in critically ill patients, preliminary data showed that insulin-like growth factor I (IGF-I) administration increased the mortality rate of rats with ischemic acute renal failure (ARF). The present study was designed to investigate the mechanism responsible for this unexpected effect. Male rats with ischemic ARF were given subcutaneous IGF-I, 50 microg/100 g at 0, 8, and 16 h after reperfusion (ARF+IGF-I, n = 5) or were untreated (ARF, n = 5). A group of 5 sham-operated rats were used as controls. Rats were killed 48 h after declamping, and the following studies were performed: in serum, creatinine and urea nitrogen; and in kidneys, histologic damage score, cellular proliferation by bromodeoxyuridine labeling, apoptosis by morphologic criteria, macrophage infiltration by immunohistochemistry using a specific antibody against ED-1, neutrophil infiltration by naphthol AS-D chloroacetate esterase staining, and levels of IGF-I and IGF-I receptor mRNA by RNase protection assay. ARF and ARF+IGF-I groups had a severe and similar degree of renal failure. Kidney damage was histologically more evident in ARF+IGF-I (1.9 +/- 0.1) than in ARF (1.3 +/- 0.2) rats, and the number of neutrophils/mm(2) of tissue was significantly greater in ARF+IGF-I than in ARF rats at the corticomedullary junction (52.3 +/- 5.2 versus 37.2 +/- 4.1) as well as at the renal medulla (172.5 +/- 30.0 versus 42.1 +/- 9.6). No other differences between the groups were found. It is concluded that IGF-I treatment enhanced the inflammatory response in rats with ischemic ARF. Cell toxicity derived from increased neutrophil accumulation might play a key role in the greater mortality risk of critically ill patients that are treated with growth hormone.
Fernández
Marta
M
Department of Pediatrics, Hospital Central de Asturias and School of Medicine, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Medina
Alberto
A
Department of Pediatrics, Hospital Central de Asturias and School of Medicine, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Santos
Fernando
F
Department of Pediatrics, Hospital Central de Asturias and School of Medicine, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Carbajo
Eduardo
E
Department of Anatomy, Hospital Central de Asturias and School of Medicine, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Rodríguez
Julián
J
Department of Pediatrics, Hospital Central de Asturias and School of Medicine, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Álvarez
Jesús
J
Department of Pediatrics, Hospital Central de Asturias and School of Medicine, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
Cobo
Angeles
A
Department of Pediatrics, Hospital Central de Asturias and School of Medicine, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Asturias, Spain.
D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D000818:Animals; D017209:Apoptosis; D004247:DNA / Q000096:biosynthesis; D007334:Insulin-Like Growth Factor I / Q000009:adverse effects* / Q000235:genetics / Q000627:therapeutic use*; D007511:Ischemia / Q000150:complications*; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D009393:Nephritis / Q000139:chemically induced* / Q000473:pathology; D020556:Neutrophil Infiltration; D012333:RNA, Messenger / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D017526:Receptor, IGF Type 1 / Q000235:genetics; D012079:Renal Circulation
D012333:RNA, Messenger; D007334:Insulin-Like Growth Factor I; D004247:DNA; D017526:Receptor, IGF Type 1