Does apoptosis have a role in septic acute kidney injury?
The traditional model of apoptosis in kidney and other cells is similar [78]. Processes involving the mitochondria and cell respiration are labeled ‘intrinsic,’ while binding of cell surface proteins leading to subsequent intracellular signaling events are termed ‘extrinsic’ processes (Figure 2)[78]. However, the mechanisms whereby cells in the septic kidney succumb (or do not succumb) to apoptosis are still under investigation. One important route may be via the tumor necrosis factor receptor-1 (TNFR-1; Figure 2). TNFR-1 knockout mice were resistant to LPS-induced kidney failure while they also manifested much less apoptosis and neutrophil accumulation, suggesting a direct role for both necrosis and apoptosis in septic AKI [79]. Downstream of TNFR-1, Jo and colleagues[80] have shown that apoptosis in LPS, TNF-α, and IL-1 exposed HK-2 cells is likely dependent in part on Fas and caspase expression. Caspase inhibition has also been shown to prevent apoptotic proximal, distal, and peri-tubular cell death in LPS models of septic AKI [81]. Cantaluppi and associates [38] have demonstrated a role for the Fas and caspase-mediated pathway in septic AKI as well. Using primary human proximal tubule epithelial cells exposed to septic human plasma, they showed that: 1) apoptosis as detected through DNA TUNEL assays was significantly increased in cells exposed to septic plasma; 2) levels of Fas and caspase-3, -8, and -9 were all significantly increased in response to septic plasma; and 3) levels of those effector signals and apoptosis can be decreased by removal of inflammatory mediators via a resin adsorption method to filter septic plasma [38]. Indeed, initiation of apoptosis was observed in cultured kidney tubular cells exposed to plasma taken from patients suffering from severe burns and septic AKI .
Apoptosis มีบทบาทในการบาดเจ็บเฉียบพลันไตกำจัดของเสียหรือไม่The traditional model of apoptosis in kidney and other cells is similar [78]. Processes involving the mitochondria and cell respiration are labeled ‘intrinsic,’ while binding of cell surface proteins leading to subsequent intracellular signaling events are termed ‘extrinsic’ processes (Figure 2)[78]. However, the mechanisms whereby cells in the septic kidney succumb (or do not succumb) to apoptosis are still under investigation. One important route may be via the tumor necrosis factor receptor-1 (TNFR-1; Figure 2). TNFR-1 knockout mice were resistant to LPS-induced kidney failure while they also manifested much less apoptosis and neutrophil accumulation, suggesting a direct role for both necrosis and apoptosis in septic AKI [79]. Downstream of TNFR-1, Jo and colleagues[80] have shown that apoptosis in LPS, TNF-α, and IL-1 exposed HK-2 cells is likely dependent in part on Fas and caspase expression. Caspase inhibition has also been shown to prevent apoptotic proximal, distal, and peri-tubular cell death in LPS models of septic AKI [81]. Cantaluppi and associates [38] have demonstrated a role for the Fas and caspase-mediated pathway in septic AKI as well. Using primary human proximal tubule epithelial cells exposed to septic human plasma, they showed that: 1) apoptosis as detected through DNA TUNEL assays was significantly increased in cells exposed to septic plasma; 2) levels of Fas and caspase-3, -8, and -9 were all significantly increased in response to septic plasma; and 3) levels of those effector signals and apoptosis can be decreased by removal of inflammatory mediators via a resin adsorption method to filter septic plasma [38]. Indeed, initiation of apoptosis was observed in cultured kidney tubular cells exposed to plasma taken from patients suffering from severe burns and septic AKI .
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