Defining the molecular response to ischemia-reperfusion injury and remote ischemic preconditioning in human kidney transplantation.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 01 09 2023
accepted: 22 09 2024
medline: 29 10 2024
pubmed: 29 10 2024
entrez: 29 10 2024
Statut: epublish

Résumé

Ischemia-reperfusion injury (IRI) inevitably occurs during kidney transplantation and extended ischemia is associated with delayed graft function and poor outcomes. Remote ischemic preconditioning (RIPC) is a simple, noninvasive procedure aimed at reducing IRI and improving graft function. Experimental studies have implicated the kynurenine pathway as a protective mechanism behind RIPC. First, paired biopsies from 11 living kidney donors were analyzed to characterize the acute transcriptomic response to IRI. Second, 16 living kidney donors were subjected to either RIPC (n = 9) or no pretreatment (n = 7) to evaluate the impact of RIPC on the transcriptomic response to IRI. Finally, the effect of RIPC on plasma metabolites was analyzed in 49 healthy subjects. There was a robust immediate response to IRI in the renal transcriptomes of living-donor kidney transplantation, including activation of the mitogen-activated protein kinase (MAPK) and epidermal growth factor receptor (EGFR) pathways. Preconditioning with RIPC did not significantly alter the transcriptomic response to IRI or the concentration of plasma metabolites. The present data validate living-donor kidney transplantation as a suitable model for mechanistic studies of IRI in human kidneys. The failure of RIPC to alter transcriptomic responses or metabolites in the kynurenine pathway raises the question of the robustness of the standard procedure used to induce RIPC, and might explain the mixed results in clinical trials evaluating RIPC as a method to attenuate IRI.

Sections du résumé

BACKGROUND BACKGROUND
Ischemia-reperfusion injury (IRI) inevitably occurs during kidney transplantation and extended ischemia is associated with delayed graft function and poor outcomes. Remote ischemic preconditioning (RIPC) is a simple, noninvasive procedure aimed at reducing IRI and improving graft function. Experimental studies have implicated the kynurenine pathway as a protective mechanism behind RIPC.
METHODS METHODS
First, paired biopsies from 11 living kidney donors were analyzed to characterize the acute transcriptomic response to IRI. Second, 16 living kidney donors were subjected to either RIPC (n = 9) or no pretreatment (n = 7) to evaluate the impact of RIPC on the transcriptomic response to IRI. Finally, the effect of RIPC on plasma metabolites was analyzed in 49 healthy subjects.
RESULTS RESULTS
There was a robust immediate response to IRI in the renal transcriptomes of living-donor kidney transplantation, including activation of the mitogen-activated protein kinase (MAPK) and epidermal growth factor receptor (EGFR) pathways. Preconditioning with RIPC did not significantly alter the transcriptomic response to IRI or the concentration of plasma metabolites.
CONCLUSIONS CONCLUSIONS
The present data validate living-donor kidney transplantation as a suitable model for mechanistic studies of IRI in human kidneys. The failure of RIPC to alter transcriptomic responses or metabolites in the kynurenine pathway raises the question of the robustness of the standard procedure used to induce RIPC, and might explain the mixed results in clinical trials evaluating RIPC as a method to attenuate IRI.

Identifiants

pubmed: 39471208
doi: 10.1371/journal.pone.0311613
pii: PONE-D-23-20971
pmc: PMC11521294
doi:

Substances chimiques

Kynurenine 343-65-7

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0311613

Informations de copyright

Copyright: © 2024 Nordström et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

J.S.R. reports funding from GSK and Sanofi and fees from Travere Therapeutics and Astex. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development, or marketed products associated with this research to declare.

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Auteurs

Johan Nordström (J)

Department of Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden.
Division of Transplantation Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Pau Badia-I-Mompel (P)

Institute for Computational Biomedicine, Bioquant, Faculty of Medicine, and Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.

Anna Witasp (A)

Division of Renal Medicine, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.

Angelina Schwarz (A)

Division of Renal Medicine, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.

Pieter Evenepoel (P)

Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, KU Leuven, Belgium.
Department of Nephrology and Renal Transplantation, University Hospitals Leuven, KU Leuven, Belgium.

Matthias B Moor (MB)

Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.

Lars Wennberg (L)

Department of Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden.
Division of Transplantation Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Julio Saez-Rodriguez (J)

Institute for Computational Biomedicine, Bioquant, Faculty of Medicine, and Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.

Annika Wernerson (A)

Division of Renal Medicine, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.

Hannes Olauson (H)

Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.

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Classifications MeSH