首页|解毒活血汤调控YAP/ACSL4通路抑制铁死亡治疗急性肾损伤的作用与机制研究

解毒活血汤调控YAP/ACSL4通路抑制铁死亡治疗急性肾损伤的作用与机制研究

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解毒活血汤出自王清任《医林改错》,是国医大师张琪教授根据急性肾损伤(acute kidney injury,AKI)热毒瘀滞病机从古方中筛选出应用临床数十年的有效方剂,该文拟从调控铁死亡(ferroptosis)角度阐释解毒活血汤对AKI的治疗作用及其潜在机制。将 32 只雄性C57BL/6 小鼠随机分为 4 组:正常组、模型组及解毒活血汤低、高剂量组,每组 8 只。由于临床AKI的治疗普遍以支持或替代疗法为主,尚无特效药,故该实验未设置阳性药物组。解毒活血汤低剂量组对应 0。5 倍的临床等效剂量,高剂量组则对应临床等效剂量,予以每日晨间灌胃,连续干预 7 d;正常组及模型组小鼠分别灌以相应体积的纯水。给药第 5 天时,除正常组外其余各组小鼠均按 20 mg·kg-1 的剂量腹腔注射顺铂溶液进行造模,正常组给予生理盐水注射。造模72 h后取材,留取小鼠血清及肾脏组织,检测血清肌酐(serum creatinine,Scr)、尿素氮(blood urea nitrogen,BUN)水平以评价小鼠肾脏功能变化;酶联免疫吸附测定(enzyme-linked immunosorbent assay,ELISA)法检测血清肾损伤分子 1(kidney injury molecule 1,KIM-1)的表达水平;苏木素-伊红(hematoxylin-eosin,HE)染色法观察小鼠肾组织病理学改变;过碘酸雪夫(periodic acid-Schiff,PAS)染色法观察肾脏糖原沉积变化;普鲁士蓝染色观察肾组织铁沉积水平;生化比色法检测肾组织中还原型谷胱甘肽(glutathione,GSH)含量、超氧化物歧化酶(superoxide dismutase,SOD)以及过氧化氢酶(catalase,CAT)活力。采用Wes-tern blot法检测小鼠肾组织中酰基辅酶A合成酶长链家族成员 4(acyl-CoA synthetase long chain family member 4,ACSL4)、溶血磷脂酰胆碱酰基转移酶 3(lysophosphatidylcholine acyltransferase 3,LPCAT3)及Hippo通路关键分子Yes相关蛋白(Yes-asso-ciated protein,YAP)蛋白表达;免疫组化法检测YAP在肾组织中的定位与相对表达;再采用实时荧光定量PCR法检测ACSL4及谷胱甘肽过氧化物酶4(glutathione peroxidase 4,GPX4)mRNA表达。结果显示,与正常组相比,顺铂诱导的AKI小鼠血清中Scr、BUN、KIM-1水平显著升高;肾组织病理显示,模型组小鼠肾小管上皮细胞发生显著萎缩坏死脱落,肾小管刷状缘消失,管内大量蛋白管型填充,小管空泡样变性,肾间质增宽且可见水肿,肾脏结构严重损伤,肾小管损伤评分显著升高;肾组织部分区域有明显的铁沉积;肾组织GSH含量、SOD及CAT活力显著降低;同时,肾组织中铁死亡标志分子ASCL4、LPCAT3 显著升高,GPX4 显著降低,YAP显著上调。与模型组相比,高剂量解毒活血汤可有效保护肾脏功能,降低Scr、BUN、KIM-1水平,减轻肾脏病理损伤及糖原沉积和铁沉积;提升肾组织中GSH含量、SOD及CAT活力。进一步的机制研究表明,解毒活血汤组AC-SL4、LPCAT3 及YAP蛋白表达较模型组显著降低,而GPX4 水平显著升高。综上,解毒活血汤可以通过调控YAP/ACSL4 信号通路抑制铁死亡,对顺铂诱导的AKI发挥保护作用。
Effect and mechanism of Jiedu Huoxue Decoction in regulating YAP/ACSL4 pathway to inhibit ferroptosis in treatment of acute kidney injury
Jiedu Huoxue Decoction(JDHX),first recorded in the Correction on Errors in Medical Works by WANG Qing-ren,is an effective formula screened out from ancient formulas by the traditional Chinese medicine(TCM)master ZHANG Qi to treat acute kidney injury(AKI)caused by heat,toxicity,stasis,and stagnation.This paper elucidated the therapeutic effect of JDHX on AKI and probed into the potential mechanism from ferroptosis.Thirty-two male C57BL/6 mice were randomized into four groups(n = 8):normal,model,and low-and high-dose JDHX.Since the clinical treatment of AKI depends on supportive or alternative therapies and there is no specific drug,this study did not include a positive drug group.The low dose of JDHX corresponded to half of clinically equivalent dose,while the high dose corresponded to the clinically equivalent dose.Mice were administrated with JDHX by gavage daily for 7 consecutive days,while those in the normal group and the model group were administered with the corresponding volume of distilled water.On day 5 of drug administration,mice in other groups except the normal group were injected intraperitoneally with cisplatin solution at a dose of 20 mg·kg-1 to induce AKI,and the normal group was injected with saline.All of the mice were sacrificed 72 h after modeling,blood and kidney samples were collected for subsequent analysis.The levels of serum creatine(Scr)and blood urea nitrogen(BUN)were measured by the commercial kits.The expression level of kidney injury molecule 1(KIM-1)in the serum was measured by enzyme-linked immunosorbent assay.Hematoxylin-eosin(HE)staining,periodic acid-Schiff(PAS)staining,and Prussian blue staining were employed to observe the pathological changes,glycogen deposition,and iron deposition,respectively,in the renal tissue.In addition,the levels of glutathione(GSH),superoxide dismutase(SOD),and catalase(CAT)in the renal tissue were examined by biochemical colorimetry.Western blot was performed to determine the protein levels of acyl-CoA synthetase long chain family member 4(ACSL4),lysophosphatidylcholine acyltransferase 3(LPCAT3),and Yes-associated protein(YAP,a key molecule in the Hippo pathway)in the renal tissue.Immunohistochemistry was then employed to detect the location and expression of YAP in the renal tissue.Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was performed to measure the mRNA levels of ACSL4 and glutathione peroxidase 4(GPX4).Compared with the normal group,the model group showed elevated serum levels of Scr,BUN,and KIM-1.In the AKI model group,the tubular epithelial cells underwent atrophy and necrotic detachment,disappearance of brush border,and some tubules became protein tubules or experienced vacuole-like degeneration.In addition,this group presented widening of the interstitium or even edema,increased renal tubule injury score,and obvious glycogen and iron deposition in parts of the renal tissue.Moreover,the model group had lower GSH,SOD,and CAT levels,higher ASCL4 and LPCAT3 levels,and lower GPX4 expression and higher YAP expression than the normal group.Compared with the model group,high dose of JDHX effectively protected renal function,lowered the levels of Scr,BUN and KIM-1,alleviated renal pathological injury,reduced glycogen and iron deposition,and elevated the GSH,SOD,and CAT levels in the renal tissue.Furthermore,JDHX down-regulated the protein levels of ACSL4,LPCAT3,and YAP and up-regulated the level of GPX4,compared with the model group.In conclusion,JDHX can protect mice from cisplatin-induced AKI by inhibiting ferroptosis via regulating the YAP/ACSL4 signaling pathway.

Jiedu Huoxue Decoctionacute kidney injury(AKI)ferroptosisYes-associated protein(YAP)acyl-CoA syn-thetase long chain family member 4(ACSL4)

程冉、田瑞敏、黄丽华、王晓婉、郭珊、吴爱君、黎创、陈静、李淑菊、陈明、毛炜、徐鹏

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广州中医药大学 第二附属医院&广东省中医院 省部共建中医湿证国家重点实验室,广东 广州 510120

广州中医药大学 第二临床医学院, 广东 广州 510405

广东省中医药科学院, 广东 广州 510006

澳门科技大学 中医药学院, 澳门 999078

黑龙江省中医药科学院, 黑龙江 哈尔滨 150036

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解毒活血汤 急性肾损伤(AKI) 铁死亡 Yes相关蛋白(YAP) 酰基辅酶A合成酶长链家族成员4(ACSL4)

国家自然科学基金国家自然科学基金广东省中医院朝阳人才科研专项广东省中医药局科研项目省部共建中医湿证国家重点实验室专项

8237435682004157ZY2022KY1320225002SZ2021ZZ10

2024

中国中药杂志
中国药学会

中国中药杂志

CSTPCD北大核心
影响因子:1.718
ISSN:1001-5302
年,卷(期):2024.49(1)
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