Endothelial dysfunction in ischemic acute renal failure: rescue by transplanted endothelial cells.
There is accumulating circumstantial evidence suggesting that endothelial cell dysfunction contributes to the "no-reflow" phenomenon in postischemic kidneys. Here, we demonstrated the vulnerability of in vitro, ex vivo, and in vivo endothelial cells exposed to pathophysiologically relevant insults, such as oxidative and nitrosative stress or ischemia. All of these stimuli compromised the integrity of the endothelial lining. Next, we performed minimally invasive intravital microscopy of blood flow in peritubular capillaries, which provided direct evidence of the existence of the no-reflow phenomenon, attributable, at least in part, to endothelial injury. In an attempt to ameliorate the hemodynamic consequences of lost endothelial integrity, we transplanted endothelial cells or surrogate cells expressing endothelial nitric oxide synthase into rats subjected to renal artery clamping. Implantation of endothelial cells or their surrogates expressing functional endothelial nitric oxide synthase in the renal microvasculature resulted in a dramatic functional protection of ischemic kidneys. These observations strongly suggest that endothelial cell dysfunction is the primary cause of the no-reflow phenomenon, which, when ameliorated, results in prevention of renal injury seen in acute renal failure.
Brodsky
Sergey V
SV
Department of Medicine, State University of New York at Stony Brook, Stony Brook, New York 11794-8152, USA.
Yamamoto
Tokunori
T
Tada
Tetsuhiro
T
Kim
Byungsoo
B
Chen
Jun
J
Kajiya
Fumihiko
F
Goligorsky
Michael S
MS
D058186:Acute Kidney Injury / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D000818:Animals; D001783:Blood Flow Velocity; D017690:Cell Transplantation / Q000379:methods; D003404:Creatinine / Q000097:blood; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000166:cytology / Q000503:physiopathology / Q000637:transplantation*; D004847:Epithelial Cells / Q000473:pathology; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D007668:Kidney / Q000098:blood supply / Q000503:physiopathology; D008297:Male; D018715:Microscopy, Video; D009569:Nitric Oxide / Q000378:metabolism; D019001:Nitric Oxide Synthase / Q000096:biosynthesis / Q000235:genetics; D052250:Nitric Oxide Synthase Type III; D018384:Oxidative Stress; D051381:Rats; D011923:Rats, Nude; D012039:Regional Blood Flow; D015427:Reperfusion Injury / Q000517:prevention & control*
D009569:Nitric Oxide; D003404:Creatinine; C496314:NOS3 protein, human; D019001:Nitric Oxide Synthase; D052250:Nitric Oxide Synthase Type III; C496316:Nos3 protein, rat