Recombinant antithrombin attenuates acute kidney injury associated with rhabdomyolysis: an in vivo animal study

重组抗凝血酶减轻横纹肌溶解症相关的急性肾损伤:一项体内动物研究

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作者:Tomotaka Miura #, Tomoki Okuda #, Kodai Suzuki #, Hideshi Okada, Hiroyuki Tomita, Chihiro Takada, Kosuke Mori, Hirotaka Asano, Soichiro Kano, Yugo Wakayama, Yohei Fukuda, Hirotsugu Fukuda, Ayane Nishio, Yuki Kawasaki, Ayumi Kuroda, Keiko Suzuki, Ryo Kamidani, Haruka Okamoto, Tetsuya Fukuta, Yuichiro

Background

Rhabdomyolysis is characterized by the destruction and necrosis of skeletal muscle tissue, resulting in acute kidney injury (AKI). Recombinant antithrombin (rAT) has DNA repair and vascular endothelial-protection properties. Herein, we investigated whether rAT therapy has beneficial effects against rhabdomyolysis-induced AKI. Ten-week-old male B6 mice were injected with 5 mL/kg of 50% glycerol intramuscularly in the left thigh after 24 h of fasting to create a rhabdomyolysis mouse model. Further, 750 IU/kg rAT was injected intraperitoneally at 24 and 72 h after the rhabdomyolysis model was established. The mice were euthanized after 96 h for histological analysis. Saline was administered to mice in the control group.

Conclusions

Treatment with rAT suppressed rhabdomyolysis-induced AKI, suggesting that rAT therapy may be a novel therapeutic approach.

Results

Blood tests show elevated serum creatinine, urea nitrogen, and neutrophil gelatinase-associated lipocalin levels in rhabdomyolysis. Loss of tubular epithelial cell nuclei and destruction of the tubular luminal surface structure was observed in the untreated group, which improved with rAT treatment. Immunostaining for Ki-67 showed increased Ki-67-positive nuclei in the tubular epithelial cells in the rAT group, suggesting that rAT may promote tubular epithelial cell regeneration. The microvilli of the brush border of the renal tubules were shed during rhabdomyolysis, and rAT treatment reduced this injury. The vascular endothelial glycocalyx, which is usually impaired by rhabdomyolysis, became functional following rAT treatment. Conclusions: Treatment with rAT suppressed rhabdomyolysis-induced AKI, suggesting that rAT therapy may be a novel therapeutic approach.

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