Journal article
Toll-like receptor 4 induction during renal ischemia correlates with serum creatinine in a pig model
Journal of endourology, Vol.37(7), pp.828-833
07/2023
DOI: 10.1089/end.2023.0081
PMID: 37221836
Abstract
To determine whether toll-like receptor 4 (TLR4), a mediator of organ ischemia-reperfusion injury (IRI), is overexpressed during warm ischemia in a porcine solitary kidney model, and whether its expression correlates with creatinine, a surrogate for kidney function.
Eight adult Yorkshire pigs underwent initial laparoscopic nephrectomy. After 1 week, animals were randomized into 2 groups: group 1 underwent laparoscopic renal hilar dissection, renal ischemia by cross-clamping, and reperfusion (ischemia group); group 2 underwent laparoscopic renal hilar dissection alone (sham group). Animals were survived to day 7 post-randomization. Peripheral blood was sampled for serum creatinine (sCr) and TLR4 expression at the following time points or corresponding intervals: pre-nephrectomy, 1-week post-nephrectomy (pre-ischemia), after 90 minutes of ischemia, 30 minutes post-reperfusion and at sacrifice. Intra-group TLR4 expression changes were analyzed using repeated measures ANOVA. Inter-group TLR4 expression was compared using Mann-Whitney's test. Correlation between sCr and TLR4 was assessed using Spearman's test.
Seven animals successfully completed the experiment (4 ischemia, 3 sham). Relative TLR4 expression significantly increased from baseline levels during ischemia, reperfusion and sacrifice time points only in the ischemia group, and was significantly higher for the ischemia group after 90 minutes of ischemia (p=0.034). sCr was significantly higher for the ischemia group during the reperfusion phase (p=0.048). Relative TLR4 expression level significantly correlated with sCr in the overall cohort (Spearman's rho = 0.69) and in the ischemia group (Spearman's rho = 0.82), (p<0.0001 for each).
Warm ischemia in a porcine solitary kidney induces acute overexpression of TLR4 in peripheral blood leukocytes which is detectable. Relative TLR4 expression level strongly correlated with sCr, but had an observable change sooner than change in sCr. Pending further investigation, TLR4 overexpression during renal ischemia may represent a sensitive, quantitative marker of unilateral renal injury sustained during nephron-sparing surgery.
Details
- Title: Subtitle
- Toll-like receptor 4 induction during renal ischemia correlates with serum creatinine in a pig model
- Creators
- Ryan L Steinberg - University of IowaBrett Allen Johnson - The University of Texas Southwestern Medical CenterIgor Sorokin - University of Massachusetts Chan Medical SchoolAlaina Garbens - The University of Texas Southwestern Medical CenterZhiyong Zhang - Rutgers, The State University of New JerseyBeatrice Haimovich - Rutgers, The State University of New JerseyJeffrey A Cadeddu - Southwestern Medical CenterEphrem Olweny - Rush University Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of endourology, Vol.37(7), pp.828-833
- DOI
- 10.1089/end.2023.0081
- PMID
- 37221836
- eISSN
- 1557-900X
- Language
- English
- Electronic publication date
- 05/24/2023
- Date published
- 07/2023
- Academic Unit
- Urology
- Record Identifier
- 9984419459302771
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