[HTML][HTML] Combined iron sucrose and protoporphyrin treatment protects against ischemic and toxin-mediated acute renal failure

RA Zager, ACM Johnson, KB Frostad - Kidney international, 2016 - Elsevier
RA Zager, ACM Johnson, KB Frostad
Kidney international, 2016Elsevier
Tissue preconditioning, whereby various short-term stressors initiate organ resistance to
subsequent injury, is well recognized. However, clinical preconditioning of the kidney for
protection against acute kidney injury (AKI) has not been established. Here we tested
whether a pro-oxidant agent, iron sucrose, combined with a protoporphyrin (Sn
protoporphyrin), can induce preconditioning and protect against acute renal failure. Mice
were pretreated with iron sucrose, protoporphyrin, cyanocobalamin, iron sucrose and …
Tissue preconditioning, whereby various short-term stressors initiate organ resistance to subsequent injury, is well recognized. However, clinical preconditioning of the kidney for protection against acute kidney injury (AKI) has not been established. Here we tested whether a pro-oxidant agent, iron sucrose, combined with a protoporphyrin (Sn protoporphyrin), can induce preconditioning and protect against acute renal failure. Mice were pretreated with iron sucrose, protoporphyrin, cyanocobalamin, iron sucrose and protoporphyrin, or iron sucrose and cyanocobalamin. Eighteen hours later, ischemic, maleate, or glycerol models of AKI were induced, and its severity was assessed the following day (blood urea nitrogen, plasma creatinine concentrations; post-ischemic histology). Agent impact on cytoprotective gene expression (heme oxygenase 1, hepcidin, haptoglobin, hemopexin, α1-antitrypsin, α1-microglobulin, IL-10) was assessed as renal mRNA and protein levels. AKI-associated myocardial injury was gauged by plasma troponin I levels. Combination agent administration upregulated multiple cytoprotective genes and, unlike single agent administration, conferred marked protection against each tested model of acute renal failure. Heme oxygenase was shown to be a marked contributor to this cytoprotective effect. Preconditioning also blunted AKI-induced cardiac troponin release. Thus, iron sucrose and protoporphyrin administration can upregulate diverse cytoprotective genes and protect against acute renal failure. Associated cardiac protection implies potential relevance to both AKI and its associated adverse downstream effects.
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