La investigación fue apoyada por la Subvención de Desarrollo de Científicos Investigadores del NHLBI (1K01HL135461-01) a JAG. Gracias a David Carmona-Berrio e Isabel Adarve-Rengifo por su asistencia técnica.

Los ratones fueron alojados y cuidados en la División de Cuidado de Animales del Centro Médico de la Universidad de Vanderbilt (VUMC) siguiendo las pautas de los Institutos Nacionales de Salud (NIH) y la Guía para el Cuidado y Uso de Animales de Laboratorio, Departamento de Salud y Servicios Humanos de los Estados Unidos. Todos los procedimientos con animales fueron aprobados por el Comité Institucional de Cuidado y Uso de Animales de VUMC antes de comenzar los experimentos.
1. Preparación y disección de animales
<ol><li>Encienda el germinador y la bomba de agua de la almohadilla térmica unos 30 minutos antes de comenzar la cirugía.</li>
	<li>Corte tubos de poliuretano de 0,5 mm de longitud con un bisturí afilado. Retire 0,2 mm de la circunferencia haciendo un corte longitudinal para hacer un manguito. NOTA: Esta es una parte crítica del procedimiento de estenosis de la arteria renal que requiere extrema precisión, atención a los detalles y paciencia. Trate de cortar varias piezas de tubos de poliuretano a la vez. Realice todo este procedimiento bajo el microscopio.</li>
	<li>Antes de continuar, póngase guantes estériles quirúrgicos y una máscara quirúrgica.</li>
	<li>Utilice ratones C57BL/6 de tipo salvaje (WT) de 6-8 semanas. Use un número igual de ratones machos y hembras para evitar cualquier sesgo sexual.</li>
	<li>Registre el peso de los ratones antes de realizar la cirugía. El peso ideal para realizar estenosis de la arteria renal con tubo de poliuretano es de 18-22 g. Manipule los ratones suavemente y no agite mientras inyecta la anestesia. Administrar analgesia preoperatoria (Ketofgen, 5 mg/kg de peso corporal). NOTA: Al transferir los ratones de su habitación de alojamiento a la sala de cirugía, llévelos con gran delicadeza y cuidado para evitar la agitación. Llevar jaulas de ratones en las manos en lugar de un carrito es muy recomendable.</li>
	<li>Anestesiar a los ratones con una mezcla de ketamina (100 mg/kg de peso corporal) y xilazina (10 mg/kg de peso corporal) mediante inyecciones intraperitoneales (I.P.).</li>
	<li>Coloque el ratón de nuevo dentro de la jaula hasta que esté completamente anestesiado. Toma alrededor de 4-5 minutos antes de que el ratón esté completamente inconsciente. Pellizque la cola o el dedo del pie con fórceps para verificar si el ratón está completamente inconsciente y listo para la cirugía.</li>
	<li>Coloque el mouse boca arriba sobre una toalla de papel. Retire el vello del abdomen lateral con un cortapelos eléctrico siguiendo la dirección opuesta al crecimiento del vello. Después de afeitarse el sitio quirúrgico, limpie el área con un exfoliante quirúrgico que contenga yodo (o clorhexidina) seguido de un enjuague con etanol al 70% (o solución salina estéril).  Repita 3 veces. NOTA: El procedimiento de depilación debe realizarse a cierta distancia o preferiblemente en un banco diferente al del banco de procedimiento de cirugía para evitar cualquier interferencia de vello y contaminación del vello durante el procedimiento quirúrgico.</li>
	<li>Cubra la almohadilla térmica con una lámina estéril. Lleve el ratón al banco quirúrgico y colóquelo sobre la lámina estéril, mirando hacia el lado lateral derecho del ratón hacia el microscopio. Mantener una temperatura constante de la almohadilla de 37 °C con agua circulante.</li>
	<li>Abra la bolsa esterilizada que contiene todo el equipo quirúrgico. Usando un microscopio de disección y tijeras estériles para objetos punzantes, haga una pequeña incisión en el flanco (cerca de la13ª costilla torácica, la última costilla en el ratón) y a unos 0,5 cm de distancia de las vértebras. Proceda a lo largo de las vértebras lumbares y haga una incisión de 1 pulgada.</li>
	<li>Retire la piel y el músculo para exponer el riñón.</li>
	<li>Limpie y elimine la grasa circundante con hisopos de algodón estériles para aislar la arteria renal. Aislar el nervio renal de la arteria renal usando fórceps curvos.</li>
	<li>Al realizar la cirugía simulada, aplique suturas para cerrar la piel y aplique antibióticos a la herida cerrada, luego proceda a los cuidados postoperatorios. Si no es así, proceda con la siguiente sección para estenosis de la arteria. NOTA: Cada experimento debe tener animales simulados como controles del procedimiento quirúrgico. Los animales simulados consisten en ratones que han pasado por el procedimiento quirúrgico de exponer la arteria renal sin colocar un manguito sobre ella.</li>
</ol>2. Estenosis de la arteria renal derecha
<ol><li>Coloque dos suturas de nylon debajo de la arteria renal derecha, haga nudos sueltos y luego coloque el manguito alrededor de la arteria renal principal aproximadamente equidistante entre el riñón y la bifurcación de la aorta</li>
	<li>Cierre el manguito con las suturas de nylon. Haga cuatro nudos para cada sutura para evitar la probabilidad de perder las suturas después de la cirugía.</li>
	<li>Cierre la incisión en el músculo aplicando una sutura continua simple.</li>
	<li>Haga suturas simples interrumpidas para cerrar la piel.</li>
	<li>Administrar analgésicos aprobados por IACUC. NOTA: Herramientas quirúrgicas de autoclave antes de cada uso. Si se realiza más de una cirugía a la vez, limpie todas las herramientas usadas con un medidor de alcohol estéril y colóquelas en un germinador caliente durante 15-30 s después de cada cirugía. Cambie los guantes estériles también para cada ratón.</li>
</ol>3. Cuidados postoperatorios
<ol><li>Devuelva a los ratones a su jaula y deje la jaula medio encendida, mitad apagada, una almohadilla de calentamiento de agua circulante durante 2 a 3 horas. Agregue alimentos de recuperación de la dieta en gel dentro de la jaula.</li>
	<li>Administrar analgésico (ketoprofeno) por vía intraperitoneal (dosis: 5 mg/kg pc) al día siguiente.</li>
	<li>Pesar los ratones durante los próximos dos días; si algunos ratones pierden más del 20% de su peso consulte con el veterinario y decida si el animal necesita ser sacrificado siguiendo el procedimiento apropiado autorizado por IACUC.</li>
	<li>Controle a los ratones diariamente para evaluar si hay enrojecimiento, hinchazón, dolor o infección.</li>
	<li>Buscar consulta veterinaria por complicaciones postoperatorias de acuerdo con las políticas institucionales de IACUC.</li>
</ol>4. Recolección de tejidos
<ol><li>Cosechar tejido 3 semanas después del procedimiento quirúrgico. Registra el peso de cada ratón.</li>
	<li>Eutanasia del ratón con un procedimiento aprobado por IACUC.</li>
	<li>Coloque el ratón en una plataforma estéril en posición supina para diseccionar.</li>
	<li>Asegure y extienda las extremidades para limitar el movimiento.</li>
	<li>Rocíe bien los ratones con etanol al 70%.</li>
	<li>Haga una incisión en la línea media para abrir el abdomen y el área del pecho con tijeras afiladas.</li>
	<li>Retire la piel y la pared peritoneal.</li>
	<li>Exponga cuidadosamente el corazón y perfore el ventrículo derecho y exangre al ratón.</li>
	<li>Extirpar ambos riñones con fórceps. Los riñones se encuentran en la parte posterior de los ratones. NOTA: No mezcle ambos riñones. Tenga cuidado con los riñones estenosados, simulados y contralaterales.</li>
	<li>Retire la cápsula de riñón, límpielas de cualquier grasa y registre el peso de cada riñón por separado.</li>
	<li>Cortar una sección longitudinal de ambos riñones y fijar en PFA al 4% durante la noche a 4 °C para ser procesado posteriormente para la incrustación de parafina, para realizar hibridación in situ (ISH) e inmunohistoquímica (IHC). Siga los protocolos ISH e IHC como se informó23,24.</li>
	<li>Aísle la corteza del riñón restante y congele rápidamente en nitrógeno líquido para realizar Western blot. Almacenar las muestras a -80 °C hasta su análisis.</li>
	<li>Cuantificar las expresiones de renina y N-GAL con Western blot como se describe en la literatura23,24.</li>
</ol>5. Estadísticas
<ol><li>Utilice ANOVA unidireccional o bidireccional para experimentos con tres o más condiciones seguidas de pruebas post-hoc de Bonferroni para comparaciones entre grupos individuales. Considere un valor p igual o menor que 0.05 significativo. Utilice software (por ejemplo, GraphPad Prism 8.2) para realizar todos los análisis estadísticos.</li>
</ol>

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G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pressor+responses+to+vasopressin+in+rabbits+with+3-day+renal+artery+stenosis.">Pressor responses to vasopressin in rabbits with 3-day renal artery stenosis.</a> American Journal of Physiology. 240 (6), 862-867 (1981).</li><li>Eirin, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Changes+in+glomerular+filtration+rate+after+renal+revascularization+correlate+with+microvascular+hemodynamics+and+inflammation+in+Swine+renal+artery+stenosis.">Changes in glomerular filtration rate after renal revascularization correlate with microvascular hemodynamics and inflammation in Swine renal artery stenosis.</a> Circulation: Cardiovascular Interventions. 5 (5), 720-728 (2012).</li><li>Ma, Z., Jin, X., He, L., Wang, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CXCL16+regulates+renal+injury+and+fibrosis+in+experimental+renal+artery+stenosis.">CXCL16 regulates renal injury and fibrosis in experimental renal artery stenosis.</a> American Journal of Physiology-Heart and Circulatory. 311 (3), 815-821 (2016).</li><li>Cheng, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Temporal+analysis+of+signaling+pathways+activated+in+a+murine+model+of+two-kidney,+one-clip+hypertension.">Temporal analysis of signaling pathways activated in a murine model of two-kidney, one-clip hypertension.</a> American Journal of Physiology-Renal Physiology. 297 (4), 1055-1068 (2009).</li><li>Wiesel, P., Mazzolai, L., Nussberger, J., Pedrazzini, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Two-kidney,+one+clip+and+one-kidney,+one+clip+hypertension+in+mice.">Two-kidney, one clip and one-kidney, one clip hypertension in mice.</a> Hypertension. 29 (4), 1025-1030 (1997).</li><li>Johns, C., Gavras, I., Handy, D. E., Salomao, A., Gavras, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Models+of+experimental+hypertension+in+mice.">Models of experimental hypertension in mice.</a> Hypertension. 28 (6), 1064-1069 (1996).</li></ol>

Los autores no declaran ningún conflicto de intereses, financieros o de otro tipo.

La estenosis de la arteria renal es una causa importante de hipertensión secundaria o resistente, y lesión renal 1,29. El modelo Goldblatt de dos riñones y un clip (2K1C) se ha empleado para estudiar la hipertensión renovascular inducida por RAStenosis 1,17,18,19. Varios estudios previos con varios modelos animales han demostrado qu...

La estenosis de la arteria renal (RAStenosis) es un problema intratable que afecta a alrededor del 6% de las personas mayores de 65 años y en hasta el 40% de las personas con enfermedad coronaria o vascular periférica 1,2. Los tratamientos actuales para la enfermedad son limitados; por lo tanto, existe una necesidad crítica de desarrollar nuevas terapias para tratar la hipertensión renovascular o la hipertensión resistente inducida por RAStenosis. El sistema renina angiotensina aldosterona (SRAA) es la vía clave implicada en la patogénesis de la hipertensión inducida por RAStenosis o hipertensión renovascular 3,4. Las terapias conocidas dirigidas al SRAA, como los inhibidores de la ECA o los bloqueadores de los receptores de angiotensina, alivian la hipertensión, pero necesitan un examen minucioso para detectar insuficiencia renal e hiperpotasemia 5,6,7. La renina cataliza el paso de limitación de velocidad en RAAS; convierte el angiotensinógeno en angiotensina I. En la aterosclerosis, la formación de placa causa el estrechamiento de la arteria renal que impulsa la secreción de renina, lo que resulta en hipertensión renovascular y daño renal8. Varios estudios han reportado un aumento de los niveles de estrés oxidativo durante la hipertensión renovascular en humanos, que fueron corroborados con el modelo de dos ratones de riñón un clip (2K1C), así como otros modelos animales hipertensos 2,9,10,11,12,13,14,15,16 . El mecanismo molecular del control de la expresión de renina durante la hipertensión renovascular inducida por RAStenosis no se comprende bien y justifica una mayor investigación.
Los modelos animales experimentales que recapitulan RAStenosis de manera confiable y reproducible son importantes para dilucidar los mecanismos celulares y moleculares del control de la expresión de renina para el desarrollo de nuevas terapias. El modelo de ratón 2K1C es un modelo experimental bien establecido para estudiar la patogénesis de la hipertensión renovascular17,18,19,20. Este modelo es generado por la constricción de la arteria renal utilizando un clip 17,20,21, produciendo así la oclusión de la arteria renal que resulta en un aumento de la expresión de renina e hipertensión17,19,20,21. Sin embargo, no hay informes técnicos disponibles, que describen un procedimiento paso a paso para generar estenosis de la arteria renal en modelos animales.
Se han utilizado clips de plata convencionales en forma de U, tubos de poliuretano y otros clips para constreñir la arteria renal para inducir la estenosis de la arteria renal. Algunos estudios han demostrado que el diseño y el material del clip son críticos para obtener datos confiables y reproducibles con el modelo animal 2K1C. Según Lorenz et al., el uso de clips de plata convencionales diseñados en U induce una baja tasa de éxito de la hipertensión arterial (40-60%)21. Debido al diseño del clip, la arteria renal se presiona lateralmente, lo que desencadena algunas constricciones y una mayor probabilidad de desprenderse de la arteria renal. La maleabilidad y ductilidad de la plata pueden permitir cambios en los anchos de los clips; por lo tanto, causando diferentes niveles de hipertensión entre los ratones. Los dióxidos de plata en el clip pueden causar inflamación perivascular, proliferación de la íntima y granulación del tejido, alterando el diámetro de la arteria renal22. Debido a la variabilidad en los niveles de hipertensión obtenidos con el clip de plata convencional U-design, Warner et al. y Lorenz et al. han utilizado con éxito un tubo de poliuretano de diseño más redondo para iniciar la estenosis de la arteria renal en ratones, generando una inducción más confiable y consistente de los dos riñones un clip animal modelo20,21.
En este informe, describimos un protocolo quirúrgico para generar RAStenosis experimental en ratones, utilizando el tubo de poliuretano para constreñir la arteria renal. El manguito de diseño redondo de poliuretano es un clip más reproducible, confiable y de bajo costo para generar estenosis en el ratón. El objetivo de este modelo experimental es estudiar y definir el mecanismo molecular y celular del control de la expresión de renina durante la estenosis de la arteria renal. Confirmamos el éxito del modelo de ratones RAStenosis midiendo la expresión de renina y el marcador de lesión renal de lipocalina asociada a gelatinasa de neutrófilos (N-GAL).

<table>
	<tbody>
		<tr>
			<td>Diet Gel</td>
			<td>Clear H2O</td>
			<td>Diet-Gel 76A</td>
			<td>Surgery recovery diet</td>
		</tr>
		<tr>
			<td>EMC Heated Hard pad</td>
			<td>Hallowell</td>
			<td>000A2788B</td>
			<td>Heating pads were used to keep mice warm</td>
		</tr>
		<tr>
			<td>Ethilon Nylon Suture</td>
			<td>Ethicon</td>
			<td>662G</td>
			<td>4-0 (1.5 metric), This suture was used to close the peritoneum, and skin</td>
		</tr>
		<tr>
			<td>Ethilon Nylon Suture</td>
			<td>Ethicon</td>
			<td>2815 G</td>
			<td>8-0 (0.4 metric), This suture was used to close cuff to tie and constrict the artery</td>
		</tr>
		<tr>
			<td>Germinator 500</td>
			<td>Braintree Scientific Inc.</td>
			<td>GER 5287</td>
			<td>Sterilize surgical tools between surgeries</td>
		</tr>
		<tr>
			<td>Ketoprofen</td>
			<td>Zoetis</td>
			<td>Ketofen</td>
			<td>Painkiller</td>
		</tr>
		<tr>
			<td>Polyurethane</td>
			<td>Braintree Scientific Inc.</td>
			<td>MRE-025</td>
			<td>This tube was used to initiate stenosis</td>
		</tr>
		<tr>
			<td>Povidone-iodine antiseptic swabsticks</td>
			<td>Medline</td>
			<td>MDS093901</td>
			<td>It was applied after hair removal and surgery on the skin</td>
		</tr>
		<tr>
			<td>Reflex 7 Clip Applier</td>
			<td>Roboz Surgical Instrument Co</td>
			<td>204-1000</td>
			<td>This clip applier was used to apply clip in case one or more sutures went off</td>
		</tr>
		<tr>
			<td>Sterile towel drapes</td>
			<td>Dynarex</td>
			<td>4410</td>
			<td>It was used as a bedsheet for mice during surgery</td>
		</tr>
		<tr>
			<td>Triple antibiotic ointment</td>
			<td>Medi-First</td>
			<td>22312</td>
			<td></td>
		</tr>
		<tr>
			<td>Water pump</td>
			<td>Stryker</td>
			<td>T/pump Professionals</td>
			<td>Used to warm and circulate water in the heating hard pad to keep mice warm during and post-surgery</td>
		</tr>
	</tbody>
</table>

a modified two kidney one clip mouse model of renin regulation in renal artery stenosis

La estenosis de la arteria renal es una afección común en pacientes con enfermedad coronaria o vascular periférica donde el sistema renina angiotensina aldosterona (SRAA) está sobreactivado. En este contexto, hay un estrechamiento de las arterias renales que estimulan un aumento en la expresión y liberación de renina, la proteasa limitante de la velocidad en RAAS. El aumento resultante en la expresión de renina es un impulsor conocido de la hipertensión renovascular, frecuentemente asociada con lesión renal y daño a los órganos terminales. Por lo tanto, existe un gran interés en desarrollar nuevos tratamientos para esta condición. El mecanismo molecular y celular del control de la renina en la estenosis de la arteria renal no se comprende completamente y justifica una mayor investigación. Para inducir estenosis de la arteria renal en ratones, se desarrolló un modelo modificado de ratón Goldblatt de 2 riñones 1 clip (2K1C). El riñón derecho se estenosó en ratones de tipo salvaje y se utilizaron ratones operados con simulacro como control. Después de la estenosis de la arteria renal, determinamos la expresión de renina y la lesión renal. Se recolectaron riñones y se utilizaron cortezas frescas para determinar la expresión de proteínas y ARNm de renina. Este modelo animal es reproducible y se puede utilizar para estudiar respuestas fisiopatológicas, vías moleculares y celulares involucradas en la hipertensión renovascular y la lesión renal.

La constricción de la arteria renal aumenta la expresión de renina en el riñón estenosado mientras reprime la expresión en el riñón contralateral. Los dos riñones de un clip (2K1C) o el modelo de Goldblatt de estenosis inducen un aumento de la expresión de renina y lesión renal. Esto es reconocido como el modelo mejor representativo de estenosis unilateral de la arteria renal en humanos.
La expresión de renina y prorenina (precursor de la renina) se midió mediante inmunotransferen...

Watch this Scientific Journal Video about A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis at JoVE.com

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis

Se desarrolló un modelo modificado de ratón Goldblatt de 2 riñones 1 clip (2K1C) utilizando tubos de poliuretano para iniciar la estenosis de la arteria renal, induciendo un aumento en la expresión de renina y lesión renal. Aquí, describimos un procedimiento detallado de preparación y colocación del manguito en la arteria renal para generar un modelo de ratón 2K1C reproducible y consistente.

Un modelo modificado de dos riñones y un ratón clip de regulación de renina en la estenosis de la arteria renal

Renal artery stenosis is a common condition in patients with coronary or peripheral vascular disease where the renin angiotensin aldosterone system (RAAS) ...

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Research

JoVE Journal

Medicine

4.6K vistas.  Vanderbilt University Medical Center. Se desarrolló un modelo modificado de ratón Goldblatt de 2 riñones 1 clip (2K1C) utilizando tubos de poliuretano para iniciar la estenosis de la arteria renal, induciendo un aumento en la expresión de renina y lesión renal. Aquí, describimos un procedimiento detallado de preparación y colocación del manguito en la arteria renal para generar un modelo de ratón 2K1C reproducible y consistente.

Video: A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis

Use of a Hanging-weight System for Isolated Renal Artery Occlusion

In hospitalized patients, over 50% of cases of acute kidney injury (AKI) are caused by renal ischemia 1-3. A recent study of hospitalized patients revealed that only a mild increase in serum creatinine levels (0.3 to 0.4 mg/dl) is associated with a 70% greater risk of death than in persons without any increase 1. Along these lines, surgical procedures requiring cross-clamping of the aorta and renal vessels are associated with a renal failure rates of up to 30% 4. Similarly, AKI after cardiac surgery occurs in over 10% of patients under normal circumstances and is associated with dramatic increases in mortality. AKI are also common complications after liver transplantation. At least 8-17% of patients end up requiring renal replacement therapy 5. Moreover, delayed graft function due to tubule cell injury during kidney transplantation is frequently related to ischemia-associated AKI 6. Moreover, AKI occurs in approximately 20% of patients suffering from sepsis 6.The occurrence of AKI is associated with dramatic increases of morbidity and mortality 1. Therapeutic approaches are very limited and the majority of interventional trials in AKI have failed in humans. Therefore, additional therapeutic modalities to prevent renal injury from ischemia are urgently needed 3, 7-9. 
To elucidate mechanisms of renal injury due to ischemia and possible therapeutic strategies murine models are intensively required 7-13. Mouse models provide the possibility of utilizing different genetic models including gene-targeted mice and tissue specific gene-targeted mice (cre-flox system). However, murine renal ischemia is technically challenging and experimental details significantly influence results. We performed a systematic evaluation of a novel model for isolated renal artery occlusion in mice, which specifically avoids the use of clamping or suturing the renal pedicle 14. This model requires a nephrectomy of the right kidney since ischemia can be only performed in one kidney due to the experimental setting. In fact, by using a hanging-weight system, the renal artery is only instrumented once throughout the surgical procedure. In addition, no venous or urethral obstruction occurs with this technique. We could demonstrate time-dose-dependent and highly reproducible renal injury with ischemia by measuring serum creatinine. Moreover, when comparing this new model with conventional clamping of the whole pedicle, renal protection by ischemic preconditioning is more profound and more reliable. Therefore his new technique might be useful for other researchers who are working in the field of acute kidney injury.

A precise murine model for acute kidney injury (AKI) due to ischemia is an important tool to investigate acute kidney injury and possibly find therapeutic tools to treat renal injury. The hanging weight system offers a tool for immediate and reliable renal artery occlusion and reperfusion without causing renal congestion.

El uso de un sistema de suspensión de peso para la oclusión de la arteria renal aislada

In hospitalized patients, over 50% of cases of acute kidney injury (AKI) are caused by renal ischemia 1-3. A recent study of hospitalized patients ...

Investigación

Medicina

Mouse Model of Middle Cerebral Artery Occlusion

Stroke is the most common fatal neurological disease in the United States 1. The majority of strokes (88%) result from blockage of blood vessels in the brain (ischemic stroke) 2. Since most ischemic strokes (~80%) occur in the territory of middle cerebral artery (MCA) 3, many animal stroke models that have been developed have focused on this artery. The intraluminal monofilament model of middle cerebral artery occlusion (MCAO) involves the insertion of a surgical filament into the external carotid artery and threading it forward into the internal carotid artery (ICA) until the tip occludes the origin of the MCA, resulting in a cessation of blood flow and subsequent brain infarction in the MCA territory 4. The technique can be used to model permanent or transient occlusion 5. If the suture is removed after a certain interval (30 min, 1 h, or 2 h), reperfusion is achieved (transient MCAO); if the filament is left in place (24 h) the procedure is suitable as a model of permanent MCAO. This technique does not require craniectomy, a neurosurgical procedure to remove a portion of skull, which may affect intracranial pressure and temperature 6. It has become the most frequently used method to mimic permanent and transient focal cerebral ischemia in rats and mice 7,8. To evaluate the extent of cerebral infarction, we stain brain slices with 2,3,5-triphenyltetrazolium chloride (TTC) to identify ischemic brain tissue 9. In this video, we demonstrate the MCAO method and the determination of infarct size by TTC staining.

We demonstrate in the video a method for producing a middle cerebral artery occlusion in adult mice using an intraluminal monofilament. We also show how to evaluate the extent of cerebral infarction by 2,3,5-triphenyltetrazolium chloride (TTC) staining.

Modelo de ratón de la oclusión arteria cerebral media

Stroke is the most common fatal neurological disease in the United States 1. The majority of strokes (88%) result from blockage of blood vessels in the ...

Modified Technique for Coronary Artery Ligation in Mice

Myocardial infarction (MI) is one of the most important causes of mortality in humans1-3. In order to improve morbidity and mortality in patients with MI we need better knowledge about pathophysiology of myocardial ischemia. This knowledge may be valuable to define new therapeutic targets for innovative cardiovascular therapies4. Experimental MI model in mice is an increasingly popular small-animal model in preclinical research in which MI is induced by means of permanent or temporary ligation of left coronary artery (LCA)5. In this video, we describe the step-by-step method of how to induce experimental MI in mice.
The animal is first anesthetized with 2% isoflurane. The unconscious mouse is then intubated and connected to a ventilator for artificial ventilation. The left chest is shaved and 1.5 cm incision along mid-axillary line is made in the skin. The left pectoralis major muscle is bluntly dissociated until the ribs are exposed. The muscle layers are pulled aside and fixed with an eyelid-retractor. After these preparations, left thoracotomy is performed between the third and fourth ribs in order to visualize the anterior surface of the heart and left lung. The proximal segment of LCA artery is then ligated with a 7-0 ethilon suture which typically induces an infarct size ~40% of left ventricle. At the end, the chest is closed and the animals receive postoperative analgesia (Temgesic, 0.3 mg/50 ml, ip). The animals are kept in a warm cage until spontaneous recovery.

The surgical procedure used to induce experimental myocardial infarction in mice begins with left thoracotomy between the third and the fourth ribs in order to visualize the anterior surface of the heart and left lung. The left coronary artery is ligated, the chest is closed and the mouse is allowed to recover spontaneously.

Técnica modificada para la ligadura de la arteria coronaria en ratones

Myocardial infarction (MI) is one of the most important causes of mortality in humans1-3. In order to improve morbidity and mortality in patients with MI ...

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this is only partially explained by traditional CVD risk factors. Vascular dysfunction is an important non-traditional risk factor, characterized by vascular endothelial dysfunction (most commonly assessed as impaired endothelium-dependent dilation [EDD]) and stiffening of the large elastic arteries. While various techniques exist to assess EDD and large elastic artery stiffness, the most commonly used are brachial artery flow-mediated dilation (FMDBA) and aortic pulse-wave velocity (aPWV), respectively. Both of these noninvasive measures of vascular dysfunction are independent predictors of future cardiovascular events in patients with and without kidney disease. Patients with CKD demonstrate both impaired FMDBA, and increased aPWV. While the exact mechanisms by which vascular dysfunction develops in CKD are incompletely understood, increased oxidative stress and a subsequent reduction in nitric oxide (NO) bioavailability are important contributors. Cellular changes in oxidative stress can be assessed by collecting vascular endothelial cells from the antecubital vein and measuring protein expression of markers of oxidative stress using immunofluorescence. We provide here a discussion of these methods to measure FMDBA, aPWV, and vascular endothelial cell protein expression.

The degree of vascular dysfunction and contributing physiological mechanisms can be assessed in patients with chronic kidney disease by measuring brachial artery flow-mediated dilation, aortic pulse-wave velocity, and vascular endothelial cell protein expression.

Evaluación de la función vascular en pacientes con enfermedad renal crónica

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this ...

Renal Ischaemia Reperfusion Injury: A Mouse Model of Injury and Regeneration

Renal ischaemia reperfusion injury (IRI) is a common cause of acute kidney injury (AKI) in patients and occlusion of renal blood flow is unavoidable during renal transplantation. Experimental models that accurately and reproducibly recapitulate renal IRI are crucial in dissecting the pathophysiology of AKI and the development of novel therapeutic agents. Presented here is a mouse model of renal IRI that results in reproducible AKI. This is achieved by a midline laparotomy approach for the surgery with one incision allowing both a right nephrectomy that provides control tissue and clamping of the left renal pedicle to induce ischaemia of the left kidney. By careful monitoring of the clamp position and body temperature during the period of ischaemia this model achieves reproducible functional and structural injury. Mice sacrificed 24 hr&#160;following surgery demonstrate loss of renal function with elevation of the serum or plasma creatinine level as well as structural kidney damage with acute tubular necrosis evident. Renal function improves and the acute tissue injury resolves during the course of 7 days following renal IRI such that this model may be used to study renal regeneration. This model of renal IRI has been utilized to study the molecular and cellular pathophysiology of AKI as well as analysis of the subsequent renal regeneration.

The mouse model of renal ischaemia reperfusion injury described here comprises of a right nephrectomy that provides control tissue and clamping of the left renal pedicle to induce ischaemia that results in acute kidney injury. This model uses a midline laparotomy approach with all steps performed via one incision.

La isquemia reperfusión renal: un modelo de ratón de la lesión y regeneración

Renal ischaemia reperfusion injury (IRI) is a common cause of acute kidney injury (AKI) in patients and occlusion of renal blood flow is unavoidable ...

Murine Kidney Transplant Technique

The first mouse kidney transplant technique was published in 19731 by the Russell laboratory. Although it took some years for other labs to become proficient in and utilize this technique, it is now widely used by many laboratories around the world. A significant refinement to the original technique using the donor aorta to form the arterial anastomosis instead of the renal artery was developed and reported in 1993 by Kalina and Mottram 2 with a further advancement coming from the same laboratory in 1999 3. While one can become proficient in this model, a search of the literature reveals that many labs still experience a high proportion of graft loss due to arterial thrombosis. We describe here a technique that was devised in our laboratory that vastly reduces the arterial thrombus reported by others 4,5. This is achieved by forming a heel-and-toe cuff of the donor infra-renal aorta that facilitates a larger anastomosis and straighter blood flow into the kidney.

The goal of this manuscript is to describe the steps required to perform a kidney transplant in a mouse, paying particular attention to the details of the arterial anastomosis.

Riñón murino Trasplante Técnica

The first mouse kidney transplant technique was published in 19731 by the Russell laboratory. Although it took some years for other labs to become ...

Assessment of Kidney Function in Mouse Models of Glomerular Disease

The use of murine models to mimic human kidney disease is becoming increasingly common. Our research is focused on the assessment of glomerular function in diabetic nephropathy and podocyte-specific VEGF-A knock-out mice; therefore, this protocol describes the full kidney work-up used in our lab to assess these mouse models of glomerular disease, enabling a vast amount of information regarding kidney and glomerular function to be obtained from a single mouse. In comparison to alternative methods presented in the literature to assess glomerular function, the use of the method outlined in this paper enables the glomerular phenotype to be fully evaluated from multiple aspects. By using this method, the researcher can determine the kidney phenotype of the model and assess the mechanism as to why the phenotype develops. This vital information on the mechanism of disease is required when examining potential therapeutic avenues in these models. The methods allow for detailed functional assessment of the glomerular filtration barrier through measurement of the urinary albumin creatinine ratio and individual glomerular water permeability, as well as both structural and ultra-structural examination using the Periodic Acid Schiff stain and electron microscopy. Furthermore, analysis of the genes dysregulated at the mRNA and protein level enables mechanistic analysis of glomerular function. This protocol outlines the generic but adaptable methods that can be applied to all mouse models of glomerular disease.

This protocol describes a full kidney work-up that should be carried out in mouse models of glomerular disease. The methods allow for detailed functional, structural, and mechanistic analysis of glomerular function, which can be applied to all mouse models of glomerular disease.

Evaluación de la función renal en modelos de ratón de la enfermedad Glomerular

The use of murine models to mimic human kidney disease is becoming increasingly common. Our research is focused on the assessment of glomerular function ...

Isometric Contractility Measurement of the Mouse Mesenteric Artery Using Wire Myography

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and drugs. It is widely used in many studies on the physiological functions of vascular smooth muscle, the pathogenesis of vascular diseases such as hypertension, and the development of smooth muscle relaxant drugs. The mouse is a widely used model animal with a large pool of disease models and genetically modified strains. We introduced this method to measure the isometric contraction of mouse mesenteric artery in detail. A 1.4-mm segment of mouse mesenteric resistance artery was isolated and mounted on a myograph chamber by passing two steel wires through its lumen. After equilibration and normalization steps, the vessel segment was potentiated by a high-K+ solution twice prior to the contraction assay. As an example of the application of this method in drug development, we measured the relaxant effect of a novel natural substance, neoliensinine, isolated from a Chinese herb, embryos of the lotus seed (Nelumbo nucifera Gaertn.) on mouse mesenteric arteries. The vessel segments mounted on the myograph chamber were stimulated with a high-K+ solution. When the force tension reached a stable sustained phase, cumulative doses of neoliensinine were added to the chamber. We found that neoliensinine had a dose-dependent relaxant effect on smooth muscle contraction, thus suggesting that it bears potential activity against hypertension. In addition, as the vessel segment can survive at least 4 hours after mounting and maintain contractility induced by the high-K+ solution for many times, we suggest that the wire myograph system may be used for the time-consuming process of drug screening.

The wire myograph technique is used to investigate vascular smooth muscle functions and screen new drugs. We report a detailed protocol for measuring the isometric contractility of the mouse mesenteric artery and for screening new relaxants of vascular smooth muscle.

Medición de la contractilidad isométrica de la arteria mesentérica de ratón con cable miografía

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and ...

An Efficient Sieving Method to Isolate Intact Glomeruli from Adult Rat Kidney

Preservation of glomerular structure and function is pivotal in the prevention of glomerulonephritis, a category of kidney disease characterized by proteinuria which can eventually lead to chronic and end-stage renal disease. The glomerulus is a complex apparatus responsible for the filtration of plasma from the body. In disease, structural integrity is lost and allows for the abnormal leakage of plasma contents into the urine. A method to isolate and examine glomeruli in culture is critical for the study of these diseases. In this protocol, an efficient method of retrieving intact glomeruli from adult rat kidneys while conserving structural and morphological characteristics is described. This process is capable of generating high yields of glomeruli per kidney with minimal contamination from other nephron segments. With these glomeruli, injury conditions can be mimicked by incubating them with a variety of chemical toxins, including protamine sulfate, which causes foot process effacement and proteinuria in animal models. Degree of injury can be assessed using transmission electron microscopy, immunofluorescence staining, and western blotting. Nephrin and Wilms Tumor 1 (WT1) levels can also be assessed from these cultures. Due to the ease and flexibility of this protocol, the isolated glomeruli can be utilized as described or in a way that best suits the needs of the researcher to help better study glomerular health and structure in diseased states.

The main focus of this protocol is to efficiently isolate viable primary glomeruli cultures with minimal contaminants for use in a variety of downstream applications. The isolated glomeruli retain structural relationships between component cell types and can be cultured ex vivo for a short time.

Un método eficiente de tamizado para aislar intactos glomérulos del riñón de rata adulta

Preservation of glomerular structure and function is pivotal in the prevention of glomerulonephritis, a category of kidney disease characterized by ...

Direct Drug Delivery to Kidney via the Renal Artery

There is a need for directed injections to enable increased and specific renal exposure for efficient evaluation of drug targets in the renal research field. Accumulation of drugs in certain organs may give rise to adverse and unwanted effects, depending on the nature of injectate. To minimize spillover and/or accumulation in other tissues, the herein described method directs the formulation into the renal artery bloodstream by inserting a catheter in the infra renal aorta, just below where it branches into the renal artery, resulting in the kidney as first reached organ and distributing of formulation throughout the kidney.
This manuscript provides a detailed description of the method, as well as its challenges and difficulties. It guides the experimenter to become skillful with this type of microsurgery that requires accuracy under sterile conditions. Speed is crucial for minimizing the ischemia and practicing the procedure will increase the chance of successful injections without adverse effects. By modulating the time between injection and reperfusion as well as the injected volume, the risk of spillover to other organs is mitigated. 
Note that this technique is suitable for single dosing strategies.

This manuscript describes a method for targeted delivery to a single kidney via a catheter placed in the infrarenal abdominal aorta in the mouse.

Entrega directa de medicamentos al riñón a través de la arteria renal

There is a need for directed injections to enable increased and specific renal exposure for efficient evaluation of drug targets in the renal research ...