title: Mycophenolate mofetil improves renal haemodynamics, microvascular oxygenation, and inflammation in a rat model of supra-renal aortic clamping-mediated renal ischaemia reperfusion injury.
abstract: Ischaemia/reperfusion (I/R) is one of the main causes of acute kidney injury (AKI), which is characterized by sterile inflammation and oxidative stress. Immune cell activation can provoke overproduction of inflammatory mediators and reactive oxygen species (ROS), leading to perturbation of the microcirculation and tissue oxygenation associated with local and remote tissue injury. This study investigated whether the clinically employed immunosuppressant mycophenolate mofetil (MMF) was able to reduce I/R-induced renal oxygenation defects and oxidative stress by preventing sterile inflammation. Rats were divided into three groups (n=6/group): (1) a sham-operated control group; (2) a group subjected to renal I/R alone (I/R); and (3) a group subjected to I/R and MMF treatment (20 mg/kg prior to I/R) (I/R+MMF). Ischaemia was induced by a vascular occluder placed on the abdominal aorta for 30 minutes, followed by 120 minutes of reperfusion. Renal I/R deteriorated renal oxygenation (P<.001) and oxygen delivery (P<.01), reduced creatinine clearance (P<.01) and tubular sodium reabsorption (P<.001), and increased iNOS, renal tissue injury markers (P<.001), and IL-6 (P<.001). Oral MMF administration prior to insult restored renal cortical oxygenation (P<.05) and iNOS, renal injury markers, and inflammation parameters (P<.001) to near-baseline levels without affecting renal function. MMF exerted a prophylactic effect on renal microvascular oxygenation and abrogated tissue inflammation and renal injury following lower body I/R-induced AKI. These findings may have clinical implications during major vascular or renal transplant surgery.
authors: Department of Translational Physiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Department of Intensive Care, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors: Bulent
authors: B
authors: Ergin
authors: Department of Experimental Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Michal
authors: M
authors: Heger
authors: Department of Biology, Faculty of Science, University of Istanbul, Istanbul, Turkey.
authors: Asli
authors: A
authors: Kandil
authors: Department of Biology, Faculty of Science, University of Istanbul, Istanbul, Turkey.
authors: Cihan
authors: C
authors: Demirci-Tansel
authors: Department of Translational Physiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Department of Intensive Care, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors: Can
authors: C
authors: Ince
mesh_terms: D058186:Acute Kidney Injury / Q000276:immunology / Q000503:physiopathology / Q000517:prevention & control*; D000818:Animals; D001012:Aorta, Abdominal; D004195:Disease Models, Animal; D006439:Hemodynamics / Q000187:drug effects*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007511:Ischemia / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply / Q000187:drug effects* / Q000276:immunology / Q000503:physiopathology; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D055806:Microvessels / Q000187:drug effects / Q000503:physiopathology; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D010101:Oxygen Consumption / Q000187:drug effects*; D017208:Rats, Wistar; D012079:Renal Circulation / Q000187:drug effects; D015427:Reperfusion Injury / Q000276:immunology / Q000503:physiopathology / Q000517:prevention & control*
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid
keywords: immunosuppression; inflammation; ischaemia/reperfusion; microvascular oxygenation; mycophenolate mofetil