La ricerca è stata sostenuta dal NHLBI Research Scientist Development Grant (1K01HL135461-01) a JAG. Grazie a David Carmona-Berrio e Isabel Adarve-Rengifo per la loro assistenza tecnica.

I topi sono stati ospitati e curati presso la Vanderbilt University Medical Center (VUMC) Division of Animal Care seguendo le linee guida del National Institutes of Health (NIH) e la Guida per la cura e l'uso degli animali da laboratorio, Dipartimento della salute e dei servizi umani degli Stati Uniti. Tutte le procedure sugli animali sono state approvate dal VUMC Institutional Animal Care and Use Committee prima di iniziare gli esperimenti.
1. Preparazione e dissezione degli animali
<ol><li>Accendere il germinatore e la pompa dell'acqua della piastra riscaldante circa 30 minuti prima di iniziare l'intervento chirurgico.</li>
	<li>Tagliare tubi in poliuretano lunghi 0,5 mm con un bisturi affilato. Rimuovere 0,2 mm della circonferenza facendo un taglio longitudinale per fare un polsino. NOTA: Questa è una parte critica della procedura di stenosi dell'arteria renale che richiede estrema precisione, attenzione ai dettagli e pazienza. Prova a tagliare diversi pezzi di tubi di poliuretano alla volta. Eseguire tutta questa procedura al microscopio.</li>
	<li>Prima di procedere oltre, indossare guanti chirurgici sterili e una maschera chirurgica.</li>
	<li>Utilizzare topi C57BL / 6 wild-type (WT) di 6-8 settimane. Utilizzare un numero uguale di topi maschi e femmine per evitare qualsiasi pregiudizio sessuale.</li>
	<li>Registra il peso dei topi prima di eseguire un intervento chirurgico. Il peso ideale per eseguire la stenosi dell'arteria renale con tubo in poliuretano è 18-22 g. Maneggiare i topi delicatamente e non agitare durante l'iniezione dell'anestesia. Somministrare l'analgesia preoperatoria (Ketofgen, 5 mg/kg di larghezza corporea). NOTA: Durante il trasferimento dei topi dalla loro stanza di alloggio alla sala operatoria, portarli con grande delicatezza e cura per evitare agitazione. Si consiglia vivamente di portare gabbie per topi in mano invece di un carrello.</li>
	<li>Anestetizzare i topi con una miscela di ketamina (100 mg/kg di peso corporeo) e xilazina (10 mg/kg di peso corporeo) tramite iniezioni intraperitoneali (I.P.).</li>
	<li>Riposizionare il mouse all'interno della gabbia fino a completa anestetizzazione. Ci vogliono circa 4-5 minuti prima che il mouse sia completamente incosciente. Pizzicare la coda o la punta del piede con una pinza per verificare se il topo è completamente incosciente e pronto per l'intervento chirurgico.</li>
	<li>Appoggia il mouse sulla schiena su un tovagliolo di carta. Rimuovere i peli dell'addome laterale utilizzando un tagliacapelli elettrico seguendo la direzione opposta della crescita dei capelli. Dopo aver rasato il sito chirurgico, pulire l'area con uno scrub chirurgico contenente iodio (o clorexidina) seguito da un risciacquo con etanolo al 70% (o soluzione salina sterile).  Ripeti 3 volte. NOTA: La procedura di depilazione deve essere eseguita a una certa distanza o preferibilmente su un banco diverso rispetto al banco della procedura chirurgica per evitare interferenze e contaminazione dei capelli durante la procedura chirurgica.</li>
	<li>Coprire la piastra riscaldante con un foglio sterile. Portare il topo al banco chirurgico e posizionarlo sul foglio sterile, rivolto verso il lato laterale destro del topo verso il microscopio. Mantenere una temperatura costante del tampone di 37 °C con acqua circolante.</li>
	<li>Aprire la sacca sterilizzata contenente tutte le attrezzature chirurgiche. Utilizzando un microscopio da dissezione e forbici sterili taglienti, fare una piccola incisione sul fianco (vicino alla 13acostola toracica, l'ultima costola nel topo) e a circa 0,5 cm di distanza dalle vertebre. Procedere lungo le vertebre lombari e fare un'incisione di 1 pollice.</li>
	<li>Tirare indietro la pelle e il muscolo per esporre il rene.</li>
	<li>Pulire e rimuovere il grasso circostante utilizzando tamponi di cotone sterili per isolare l'arteria renale. Isolare il nervo renale dall'arteria renale usando una pinza curva.</li>
	<li>Quando si esegue l'intervento chirurgico fittizio, applicare punti di sutura per chiudere la pelle e applicare antibiotici alla ferita chiusa, quindi procedere alla cura post-operatoria. In caso contrario, procedere con la sezione seguente per stenosare l'arteria. NOTA: Ogni esperimento dovrebbe avere animali fittizi come controlli della procedura chirurgica. Gli animali fittizi sono costituiti da topi che hanno attraversato la procedura chirurgica di esporre l'arteria renale senza posizionare un bracciale su di essa.</li>
</ol>2. Stenosi dell'arteria renale destra
<ol><li>Posizionare due suture di nylon sotto l'arteria renale destra, sciogliere i nodi e quindi posizionare il bracciale attorno all'arteria renale principale approssimativamente equidistante tra il rene e la biforcazione dell'aorta</li>
	<li>Chiudere il bracciale usando le suture di nylon. Fai quattro nodi per ogni sutura per evitare la probabilità di perdere le suture dopo l'intervento.</li>
	<li>Chiudere l'incisione nel muscolo applicando una semplice sutura continua.</li>
	<li>Fai semplici punti di sutura interrotti per chiudere la pelle.</li>
	<li>Somministrare analgesici approvati dalla IACUC. NOTA: Strumenti chirurgici in autoclave prima di ogni utilizzo. Se viene eseguito più di un intervento chirurgico contemporaneamente, pulire tutti gli strumenti usati con un indicatore alcolico sterile e metterli in un germinatore caldo per 15-30 secondi dopo ogni intervento chirurgico. Cambiare guanti sterili anche per ogni topo.</li>
</ol>3. Assistenza post-operatoria
<ol><li>Riportare i topi nella loro gabbia e lasciare la gabbia metà accesa, metà spenta, una piastra riscaldante ad acqua circolante per 2 - 3 ore. Aggiungi cibo per il recupero della dieta gel all'interno della gabbia.</li>
	<li>Somministrare antidolorifico (ketoprofene) per via intraperitoneale (dose: 5 mg/kg p.c.) il giorno successivo.</li>
	<li>Pesare i topi per i prossimi due giorni; se alcuni topi perdono più del 20% del loro peso, consultarsi con il veterinario e decidere se l'animale deve essere eutanasia seguendo l'appropriata procedura autorizzata IACUC.</li>
	<li>Monitorare i topi ogni giorno per valutare arrossamento, gonfiore, dolore o infezione.</li>
	<li>Cercare un consulto veterinario per le complicanze postoperatorie in conformità con le politiche istituzionali IACUC.</li>
</ol>4. Raccolta dei tessuti
<ol><li>Raccogliere il tessuto 3 settimane dopo la procedura chirurgica. Registra il peso di ciascun mouse.</li>
	<li>Eutanasia del mouse con una procedura approvata IACUC.</li>
	<li>Posizionare il mouse su una piattaforma sterile in posizione supina per sezionare.</li>
	<li>Fissare ed estendere gli arti per limitare i movimenti.</li>
	<li>Spruzzare accuratamente i topi con etanolo al 70%.</li>
	<li>Fai un'incisione della linea mediana per aprire l'addome e la zona del torace usando forbici affilate.</li>
	<li>Tirare indietro la pelle e la parete peritoneale.</li>
	<li>Esporre attentamente il cuore e perforare il ventricolo destro ed essanguare il topo.</li>
	<li>Rimuovere entrambi i reni usando una pinza. I reni si trovano sul retro dei topi. NOTA: Non mescolare entrambi i reni. Essere consapevoli dei reni stenosi, finti e controlaterali.</li>
	<li>Rimuovere la capsula renale, pulirli da qualsiasi grasso e registrare il peso di ciascun rene separatamente.</li>
	<li>Tagliare una sezione longitudinale di entrambi i reni e fissarla in PFA al 4% durante la notte a 4 °C per essere successivamente elaborata per l'incorporazione di paraffina, per eseguire l'ibridazione in situ (ISH) e l'immunoistochimica (IHC). Seguire i protocolli ISH e IHC come riportato23,24.</li>
	<li>Isolare la corteccia del rene rimanente e congelare l'azoto liquido per eseguire il western blot. Conservare i campioni a -80 °C fino all'analisi.</li>
	<li>Quantificare le espressioni di renina e N-GAL con Western blot come descritto in letteratura23,24.</li>
</ol>5. Statistiche
<ol><li>Utilizzare ANOVA unidirezionale o bidirezionale per esperimenti con tre o più condizioni seguiti da test post-hoc Bonferroni per confronti tra singoli gruppi. Si consideri un valore p uguale o minore di 0,05 significativo. Utilizzare un software (ad esempio, GraphPad Prism 8.2) per eseguire tutte le analisi statistiche.</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>

Nessun conflitto di interessi, finanziario o di altro tipo, è dichiarato dagli autori.

La stenosi dell'arteria renale è una causa importante di ipertensione secondaria o resistente e danno renale 1,29. Il modello Goldblatt a due rene una clip (2K1C) è stato impiegato per studiare l'ipertensione renovascolare indotta da RAStenosi 1,17,18,19. Numerosi studi precedenti che utilizzano vari modelli animali hanno dimostrato c...

La stenosi dell'arteria renale (RAStenosis) è un problema intrattabile che colpisce circa il 6% delle persone sopra i 65 anni e fino al 40% delle persone con malattia coronarica o vascolare periferica 1,2. I trattamenti attuali per la malattia sono limitati; pertanto, vi è una necessità critica di sviluppare nuove terapie per trattare l'ipertensione renovascolare o l'ipertensione resistente indotta da RAStenosis. Il sistema dell'angiotensina aldosterone renina (RAAS) è la via chiave coinvolta nella patogenesi dell'ipertensione indotta da RAStenosi o dell'ipertensione renovascolare 3,4. Le terapie note che prendono di mira la RAAS, come gli ACE-inibitori o i bloccanti del recettore dell'angiotensina, alleviano l'ipertensione, ma richiedono un attento esame per insufficienza renale e iperkaliemia 5,6,7. La renina catalizza la fase limitante del tasso in RAAS; converte l'angiotensinogeno in angiotensina I. Nell'aterosclerosi, la formazione di placche provoca il restringimento dell'arteria renale che guida la secrezione di renina, con conseguente ipertensione renovascolare e danno renale8. Numerosi studi hanno riportato un aumento dei livelli di stress ossidativo durante l'ipertensione renovascolare nell'uomo, che sono stati corroborati con il modello di topi a due rene una clip (2K1C) e altri modelli animali ipertesi 2,9,10,11,12,13,14,15,16 . Il meccanismo molecolare del controllo dell'espressione della renina durante l'ipertensione renovascolare indotta da RAStenosi non è ben compreso e giustifica ulteriori indagini.
Modelli animali sperimentali che ricapitolano RAStenosi in modo affidabile e riproducibile sono importanti per chiarire i meccanismi cellulari e molecolari del controllo dell'espressione della renina per lo sviluppo di nuove terapie. Il modello murino 2K1C è un modello sperimentale consolidato per studiare la patogenesi dell'ipertensione renovascolare17,18,19,20. Questo modello è generato dalla costrizione dell'arteria renale utilizzando una clip 17,20,21, producendo quindi occlusione dell'arteria renale che si traduce in un aumento dell'espressione della renina e ipertensione17,19,20,21. Tuttavia, non ci sono relazioni tecniche disponibili, che descrivono una procedura passo passo per generare stenosi dell'arteria renale in modelli animali.
Clip d'argento convenzionali a forma di U, tubi in poliuretano e altre clip sono stati utilizzati per restringere l'arteria renale per indurre la stenosi dell'arteria renale. Alcuni studi hanno dimostrato che il design e il materiale della clip sono fondamentali per ottenere dati affidabili e riproducibili con il modello animale 2K1C. Secondo Lorenz et al., l'uso di clip d'argento convenzionali progettate a U induce un basso tasso di successo di ipertensione (40-60%)21. A causa del design della clip, l'arteria renale viene premuta lateralmente, innescando alcune costrizioni e una maggiore probabilità di essere spostata dall'arteria renale. La malleabilità e la duttilità dell'argento possono consentire variazioni nella larghezza delle clip; pertanto, causando diversi livelli di ipertensione tra i topi. I biossidi d'argento sulla clip possono causare infiammazione perivascolare, proliferazione intimale e granulazione dei tessuti, alterando il diametro dell'arteria renale22. A causa della variabilità dei livelli di ipertensione ottenuti con la clip d'argento convenzionale U-design, Warner et al. e Lorenz et al. hanno utilizzato con successo un tubo in poliuretano dal design più rotondo per iniziare la stenosi dell'arteria renale nei topi, generando un'induzione più affidabile e coerente del modello animale a due rene una clip20,21.
In questo rapporto, descriviamo un protocollo chirurgico per generare RAStenosi sperimentale nei topi, utilizzando il tubo di poliuretano per restringere l'arteria renale. Il polsino rotondo in poliuretano è una clip più riproducibile, affidabile e a basso costo per generare stenosi nel mouse. L'obiettivo di questo modello sperimentale è quello di studiare e definire il meccanismo molecolare e cellulare del controllo dell'espressione della renina durante la stenosi dell'arteria renale. Abbiamo confermato il successo del modello di topi RAStenosis misurando l'espressione della renina e il marcatore di danno renale lipocalina associata alla gelatinasi neutrofila (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 stenosi dell'arteria renale è una condizione comune nei pazienti con malattia coronarica o vascolare periferica in cui il sistema renina-angiotensina aldosterone (RAAS) è iperattivato. In questo contesto, c'è un restringimento delle arterie renali che stimola un aumento dell'espressione e del rilascio di renina, la proteasi limitante nella RAAS. Il conseguente aumento dell'espressione della renina è un noto driver dell'ipertensione renovascolare, frequentemente associata a danno renale e danno agli organi terminali. Pertanto, vi è un grande interesse nello sviluppo di nuovi trattamenti per questa condizione. Il meccanismo molecolare e cellulare del controllo della renina nella stenosi dell'arteria renale non è completamente compreso e merita ulteriori indagini. Per indurre la stenosi dell'arteria renale nei topi, è stato sviluppato un modello murino Goldblatt modificato 2 rene 1 clip (2K1C). Il rene destro è stato stenoso in topi wild type e topi operati fittizi sono stati utilizzati come controllo. Dopo la stenosi dell'arteria renale, abbiamo determinato l'espressione della renina e il danno renale. I reni sono stati raccolti e sono state utilizzate cortecce fresche per determinare l'espressione di proteine e mRNA della renina. Questo modello animale è riproducibile e può essere utilizzato per studiare le risposte fisiopatologiche, le vie molecolari e cellulari coinvolte nell'ipertensione renovascolare e nel danno renale.

La costrizione dell'arteria renale aumenta l'espressione della renina nel rene stenoso mentre reprime l'espressione nel rene controlaterale. Il modello di stenosi a due rene una clip (2K1C) o Goldblatt induce un aumento dell'espressione di renina e danno renale. Questo è riconosciuto come il miglior modello rappresentativo di stenosi unilaterale dell'arteria renale nell'uomo.
L'espressione di renina e prorenina (precursore della renina) è stata misurata utilizzando immunoblotting. I dati mo...

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

Un modello murino Goldblatt modificato a 2 rene 1 clip (2K1C) è stato sviluppato utilizzando tubi in poliuretano per avviare la stenosi dell'arteria renale, inducendo un aumento dell'espressione della renina e un danno renale. Qui, descriviamo una procedura dettagliata di preparazione e posizionamento del bracciale sull'arteria renale per generare un modello murino 2K1C riproducibile e coerente.

Un modello di topo modificato a due rene una clip della regolazione della renina nella stenosi dell'arteria renale

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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4.5K Views.  Vanderbilt University Medical Center. Un modello murino Goldblatt modificato a 2 rene 1 clip (2K1C) è stato sviluppato utilizzando tubi in poliuretano per avviare la stenosi dell'arteria renale, inducendo un aumento dell'espressione della renina e un danno renale. Qui, descriviamo una procedura dettagliata di preparazione e posizionamento del bracciale sull'arteria renale per generare un modello murino 2K1C riproducibile e coerente.

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.

L&#39;uso di un Hanging-peso di sistema per isolati di occlusione dell&#39;arteria renale

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 ...

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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.

Modello murino di Mezzo occlusione dell&#39;arteria cerebrale

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 ...

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.

Valutazione della funzione vascolare nei pazienti con malattia renale cronica

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.

Renale ischemia riperfusione: un modello murino di infortuni e rigenerazione

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.

Rene Murine Tecnica trapianto

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

Mouse Model for Pancreas Transplantation Using a Modified Cuff Technique

Mouse models have several advantages in transplantation research, including easy handling, a variety of genetically well-defined strains, and the availability of the widest range of molecular probes and reagents to perform in vivo as well as in vitro studies. Based on our experience with various murine transplantation models, we developed a heterotopic pancreas transplantation model in mice with the intent to analyze mechanisms underlying severe ischemia reperfusion injury-associated early graft damage. In contrast to previously described techniques using suture techniques, herein we describe a new procedure using a non-suture cuff technique. 
In recent years, we have performed more than 300 pancreas transplantations in mice with an overall success rate of &gt;90%, a success rate never described before in mouse pancreas transplantation. The backbone of this non-suture cuff technique for graft revascularization consists of two major steps: (I) pulling the recipient vessel over a polyethylene/polyamide cuff and fixing it with a circumferential ligature, and (II) placing the donor vessel over the everted recipient vessel and fixing it with a second circumferential ligature. The resultant continuity of the endothelial layer results in less thrombogenic lesions with high patency rates and, finally, high success rates.
In this model, arterial anastomosis is achieved by pulling the abdominal aorta of the donor graft over the everted common carotid artery of the recipient animal. Venous drainage of the graft is achieved by pulling the portal vein of the graft over the everted external jugular vein of the recipient. This manuscript provides details and crucial steps of the organ recovery and organ implantation procedures, which will allow researchers with microsurgical skills to perform the transplantation successfully in their laboratories.

Among abdominal solid organ transplantation, pancreatic grafts are prone to develop severe ischemia reperfusion injury-associated graft damage, leading eventually to early graft loss. This protocol describes a model of murine pancreas transplantation using a non-suture cuff technique, ideally suited for analyzing these early, deleterious damages.

Modello di topo per il trapianto di Pancreas usando una tecnica modificata polsino

Mouse models have several advantages in transplantation research, including easy handling, a variety of genetically well-defined strains, and the ...

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.

Valutazione della funzione del rene in modelli murini di malattia glomerulare

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.

Misurazione di contrattilità isometrica dell'arteria mesenterica Mouse con filo Myography

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 metodo efficiente di setacciatura per isolare i Glomeruli intatti dal rene di ratto adulto.

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.

Consegna diretta di farmaci ai reni attraverso l'arteria renale

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