Laboratório do Dr. de CAESTECKER é suportado pelo NIH 1RO1 HL093057-01 e 1RC4DK090770-01. Laboratório Dr. Harris é suportado por DK38226, DK51265, DK62794 e financiamento da Administração de Veteranos. Suporte para rato renais cirurgias de lesões, creatinina sérica e ensaios de fibrose também fornecidos pela Vanderbilt O&#39;Brien Kidney Injury Centro concessão 1P30 DK079341.

<ol><li> Autoclave todos os instrumentos cirúrgicos antes da cirurgia. Note-se que se está realizando várias cirurgias em diferentes camundongos, lavar instrumentos após o uso e, em seguida, esterilizar utilizando um esterilizador talão quente. Não é suficiente para absorver, em etanol a 70%. </li><li> Dar origem a 0,5 ml de S / C de soro fisiológico estéril pré-operatório e pós-operatório imediato para compensar a perda de fluido do corpo durante a cirurgia. </li><li> Pesar os ratinhos. </li><li> Anestesiar mouse usando Xilazina IP / mistura de ketamina. Ele normalmente leva 3-5 minutos para os ratos para chegar a anestesia plano cirúrgico. </li><li> Raspar o local da cirurgia com a área de margem suficiente para manter o cabelo de contaminar o local da incisão. Isto precisa de ser realizado numa área de preparação, onde a cirurgia não é realizada. </li><li> Aplicar pomada lubrificante oftálmica nos olhos para evitar o ressecamento durante o procedimento. </li><li> Posicione o mouse propensos à superfície aquecida coberta com absorvente banco pad. Fita pernas para a superfície cirúrgico. </li><li> Se estiver usandoo sistema de banho de água, calor fixada em 38 ° C, 1 h antes da cirurgia. </li><li> Preparação asséptica utilizando Betadine solução escovilhão: esfregar a partir do centro do local para a periferia 3x, de cada vez, seguido por lavagem com Nolvasan para remover o Betadine. Todos Betadine deve ser removido do campo operatório antes da incisão por lavagem com Nolvasan. Antes de iniciar luvas de procedimento de assepsia deve ser alterado para ser estéril. </li><li> Cubra campo cirúrgico com uma cortina cirúrgica estéril. Isto irá evitar que o cabelo disperso de entrar no campo cirúrgico e proporcionar uma área em que para colocar os instrumentos estéreis durante a cirurgia. </li><li> Palpar localização rim através da pele. </li><li> Cortar a pele dorsal ao longo da linha média do rato (aproximadamente 1,5 cm) com uma tesoura e uma pinça. </li><li> Pele separada e subcutâneo sobre os lados dorsal direita e esquerda Através desta incisão por dissecção romba com uma tesoura e uma pinça. </li><li> Faça uma pequena incisão através da fl direitaank muscular e da fáscia acima do rim e exteriorizar o rim direito. </li><li> Dissecar cuidadosamente os pólos superior e inferior do rim livres de tecido circundante. Note-se que o tecido gordo em torno do pólo superior contém a glândula adrenal suportando o seu próprio fornecimento de sangue que pode ser empurrado para fora do rim, mas, obviamente, não devem ser removidos a partir do rato (Figura 1). Depois de rim libertadora do tecido circundante, amarre o fio de seda 4-0 ao redor do hilo do rim direito com um nó cirúrgico duplo. Deixe uma extremidade da sutura ~ 2 em tempo para manter-se o rim como você está cortando distal para o nó para que possa visualizar o local a ser cortado. Lavar o coto com solução salina estéril. </li><li> Feche a camada muscular, utilizando fio absorvível. </li><li> Adicione uma pequena incisão através do músculo flanco esquerdo e fáscia acima do rim e exteriorizar o rim esquerdo (Figura 2A). </li><li> Segure cuidadosamente renal usando uma pinça sem corte ao liberar renalpedículo de tecido adiposo ao redor usando uma pinça (Figuras 2B-2F). Demasiada pressão sobre os rins usando a pinça sem corte pode causar lesão renal assim é preciso lembrar disso quando projetar os controles de &quot;farsa&quot; para os estudos. Se você achar que seus controles sham estão desenvolvendo lesão renal (como evidenciado por um aumento na creatinina sérica), um método alternativo que você pode considerar para liberar o tecido adiposo em torno do pedículo renal é rolar suavemente os tecidos com solução salina estéril embebida de algodão cotonetes derrubado. Em nossa experiência, a gordura é muito bem ligado ao pedículo renal e não pode ser facilmente removida com cotonetes, e isso não pode ser a primeira aproximação que você gostaria de usar. No entanto, assim como outros aspectos deste modelo, isso é algo que você terá que estabelecer para si mesmo com a prática e experiência. </li><li> Grampo deixou pedículo renal com grampo vascular não traumático usando segurando uma pinça (para facilitar a colocação do grampo), use timer para diferentes clamp vezes, dependendo da estirpe do mouse e gravidade da lesão necessária (ver Tabela 1). </li><li> Cobrir o rim esquerdo com a pele (Figura 2H). </li><li> Cubra incisão na pele com gaze embebida salina. </li><li> Exteriorizar rim, confirmar aparência escura uniforme e soltar a braçadeira após os tempos indicados, e confirmar que a aparência escura inverte uniformemente em todo o rim (Figura 2I / G). Se o rim não é rápida e uniformemente re-perfundir (up-de-rosa), o mouse deve ser excluído da análise posterior. Com cuidado, empurre rim de volta para o espaço retroperitoneal. </li><li> Feche a camada muscular com fio absorvível. </li><li> Feche a camada de pele usando monofilamento de nylon sutura não absorvível. </li><li> Administrar buprenorfina analgesia. </li><li> Transferir ratos longe do campo cirúrgico para uma almofada de aquecimento até que eles acordam. </li><li> Devolver os ratos para quarto animal. </li><li> Acompanhar de perto os ratos e dar doses adicionaisde buprenorfina, como indicado acima de cada 8-12 horas, para a dor ou desconforto. Os sinais clínicos, resultando em administração de analgésicos incluem depressão ou outras alterações de comportamento, aparência anormal, ou postura como pilo-ereção, postura arqueada, a falta de higiene e alimentação, ou imobilidade. </li></ol>

<ol>
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K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acute+renal+failure.+II.+Experimental+models+of+acute+renal+failure:+Imperfect+but+indispensable.">Acute renal failure. II. Experimental models of acute renal failure: Imperfect but indispensable.</a> Am. J. Physiol. Renal Physiol. 278, F1-F12 (2000).</li><li>Dunn, S. R., Qi, Z., Bottinger, E. P., Breyer, M. D., Sharma, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Utility+of+endogenous+creatinine+clearance+as+a+measure+of+renal+function+in+mice.">Utility of endogenous creatinine clearance as a measure of renal function in mice.</a> Kidney Int. 65, 1959-1967 (2004).</li><li>Yuen, P. S., Dunn, S. R., Miyaji, T., Yasuda, H., Sharma, K., Star, R. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+simplified+method+for+HPLC+determination+of+creatinine+in+mouse+serum.">A simplified method for HPLC determination of creatinine in mouse serum.</a> Am. J. Physiol. Renal Physiol. 286, F1116-F1119 (2004).</li><li>Hetu, P. O., Gingras, M. E., Vinet, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+and+validation+of+a+rapid+liquid+chromatography+isotope+dilution+tandem+mass+spectrometry+(LC-IDMS/MS)+method+for+serum+creatinine.">Development and validation of a rapid liquid chromatography isotope dilution tandem mass spectrometry (LC-IDMS/MS) method for serum creatinine.</a> Clin. Biochem. 43, 1158-1162 (2010).</li><li>Keppler, A., Gretz, N., Schmidt, R., Kloetzer, H. M., Groene, H. J., Lelongt, B., Meyer, M., Sadick, M., Pill, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Plasma+creatinine+determination+in+mice+and+rats:+An+enzymatic+method+compares+favorably+with+a+high-performance+liquid+chromatography+assay.">Plasma creatinine determination in mice and rats: An enzymatic method compares favorably with a high-performance liquid chromatography assay.</a> Kidney Int. 71, 74-78 (2007).</li><li>Yang, L., Besschetnova, T. Y., Brooks, C. R., Shah, J. V., Bonventre, J. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Epithelial+cell+cycle+arrest+in+G2/M+mediates+kidney+fibrosis+after+injury.">Epithelial cell cycle arrest in G2/M mediates kidney fibrosis after injury.</a> Nat. Med. 16, 535-543 (2010).</li><li>Shanley, P. F., Rosen, M. D., Brezis, M., Silva, P., Epstein, F. H., Rosen, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Topography+of+focal+proximal+tubular+necrosis+after+ischemia+with+reflow+in+the+rat+kidney.">Topography of focal proximal tubular necrosis after ischemia with reflow in the rat kidney.</a> Am. J. Pathol. 122, 462-468 (1986).</li><li>Chawla, L. S., Amdur, R. L., Amodeo, S., Kimmel, P. L., Palant, C. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+severity+of+acute+kidney+injury+predicts+progression+to+chronic+kidney+disease.">The severity of acute kidney injury predicts progression to chronic kidney disease.</a> Kidney Int. 79, 1361-1369 (2012).</li><li>Lo, L. J., Go, A. S., Chertow, G. M., McCulloch, C. E., Fan, D., Ordonez, J. D., Hsu, C. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dialysis-requiring+acute+renal+failure+increases+the+risk+of+progressive+chronic+kidney+disease.">Dialysis-requiring acute renal failure increases the risk of progressive chronic kidney disease.</a> Kidney Int. 76, 893-899 (2009).</li><li>Burne, M. J., Haq, M., Matsuse, H., Mohapatra, S., Rabb, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genetic+susceptibility+to+renal+ischemia+reperfusion+injury+revealed+in+a+murine+model.">Genetic susceptibility to renal ischemia reperfusion injury revealed in a murine model.</a> Transplantation. 69, 1023-1025 (2000).</li><li>Muller, V., Losonczy, G., Heemann, U., Vannay, A., Fekete, A., Reusz, G., Tulassay, T., Szabo, A. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sexual+dimorphism+in+renal+ischemia-reperfusion+injury+in+rats:+Possible+role+of+endothelin.">Sexual dimorphism in renal ischemia-reperfusion injury in rats: Possible role of endothelin.</a> Kidney Int. 62, 1364-1371 (2002).</li><li>Schmitt, R., Marlier, A., Cantley, L. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Zag+expression+during+aging+suppresses+proliferation+after+kidney+injury.">Zag expression during aging suppresses proliferation after kidney injury.</a> J. Am. Soc. Nephrol. 19, 2375-2383 (2008).</li><li>Oxburgh, L., de Caestecker, M. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ischemia-reperfusion+injury+of+the+mouse+kidney.">Ischemia-reperfusion injury of the mouse kidney.</a> Methods Mol. Biol. 886, 363-379 (2012).</li></ol>

Autores não têm conflitos de interesse de divulgar.

Nós descrevemos dois modelos de IR-AKI para estudar os efeitos da lesão renal moderada e grave. Estes modelos permitem induzir lesão consistente e previsível, com baixa mortalidade. Nosso protocolo descreve muitas das dificuldades e armadilhas tradicionalmente associados com este modelo. Além disso, mostrámos que, dependendo do comprimento do pedículo clampeamento renal, o modelo induz uma ligeira e moderada LRA reversível em grande parte, ou LRA mais grave, com uma recuperação incompleta e fibrose renal persi...

A variedade de modelos experimentais de lesão renal aguda (LRA) foram desenvolvidos para atender a diversidade e complexidade da condição humana (ver referência para a recente revisão abrangente 1). Cada um desses modelos tem as suas próprias forças e fraquezas, e enquanto cada imita as condições humanas correspondentes com eficiências variadas, nenhum modelar com precisão a fisiopatologia de seus colegas humanos. Isquemia-reperfusão (IR) induzida LRA tem sido desenvolvido como um modelo de lesão renal induzida por isquemia aguda em roedores. Embora a gravidade da lesão tubular renal visto neste modelo é raramente observada em pacientes com lesões hipoperfusão renal 2, apesar de suas limitações e, em grande parte devido à natureza relativamente reprodutível deste modelo, sua ampla utilização tem proporcionado e, espera-se, continuará fornecer importantes insights sobre muitos dos mecanismos básicos comuns da AKI, reparo e terapia 3. Cirurgia IR requer familiarity com a anatomia do rim do rato, que tenham ilustrado de forma simplificada na figura 1. Lesão de isquemia-reperfusão (IR) cirurgia lesão renal pode ser realizada por meio de ventrais (laparotomia) ou dorsal abordagens (retroperitoneal). Nós usamos uma abordagem dorsal, pois é menos traumática, permitindo que o tempo de recuperação mais rápido e melhor sobrevivência (particularmente quando se aprende primeiro o procedimento). Lesão renal IR pode ser feita unilateralmente ou bilateralmente. No entanto, as diferenças entre as pressões eficazes braçadeira (que podem resultar da interposição de gordura perihilário entre as mandíbulas de aperto) e / ou diferenças nas respostas renais, a isquemia, entre os lados conduz a resultados mais variáveis. Enquanto isso não é um problema insuperável, ele pode aumentar a variabilidade entre os experimentos, que é um grande problema para este modelo. IR unilateral pode ser realizada com a nefrectomia contralateral. Este é o nosso método de escolha, uma vez que reduz a variabilidade no aperto entre pedículos e, ao mesmo tempo, umallows uma para avaliar a função renal, o que não é afectado com IR unilateral sozinho. Houve discussão sobre o que é o método mais prático vs ideal para avaliar a função renal em camundongos. Uréia (BUN) fornece uma medida da função renal e é um &quot;primeiro olhar&quot; marcador útil em alguns modelos de AKI, incluindo lesão IR. No entanto, os níveis de uréia pode ser afetada pelo estado do volume dos ratos que podem ser afetados, especialmente após abordagem ventral lesão IR, quando a recuperação tardia reduz a ingestão oral de fluidos para um número de dias pós-cirurgia. A creatinina sérica é menos influenciada pelo estado de hidratação, mas está claramente afetada pela massa muscular. Uma das dificuldades com medidas de creatinina sérica tem havido problemas com a detecção de cromógenos não de creatinina no soro de rato usando técnicas à base de ácido pícrico. Como uma alternativa, um número de centros de ter desenvolvido um método baseado em HPLC para quantificar a creatinina do rato, que não é afectado por este artefato 4. No entanto, unlike BUN e pícrico ensaios de creatinina de ácido, que requerem apenas 5-10 ul de soro, HPLC ensaios requerem ~ 25 soro uL por ensaio, a qual se for realizada em duplicado exigirá ~ 100 uL de sangue total por ensaio. Isto pode ser limitante para estudos do rato. Alguns centros têm desenvolvido métodos HPLC e Massa baseada em espectrometria mais sensíveis que permitem a análise de volumes de amostra menores, 5, 6. No entanto, estas tecnologias não são facilmente acessíveis. Um, o ensaio de cascata enzimática alternativa (que requer apenas 5-10 ul de soro) foi avaliada em ratos e amostras de soro de rato e mostrado para paralelo de perto as medições de HPLC de creatinina sérica, enquanto os testes de ácido pícrico sempre valores de creatinina sobrestimar 7. Embora este ensaio não é amplamente utilizada na literatura LRA, o ensaio é comercialmente disponível, simples de utilizar, e descobrimos dá resultados fiáveis ​​com este modelo de IR induzida LRA em ratinhos.

<table border="1">
	<tbody>
		<tr>
			<td>Drug or solution</td>
			<td>Company</td>
			<td>Catalogue number</td>
			<td>Comments</td>
		</tr>
		<tr>
			<td>Ketamine (anesthetic)</td>
			<td>Webster Veterinary</td>
			<td>07-881-9413 (100 mg/ml)</td>
			<td>Final concentration 30 mg/ml Ketamine with 3 mg/ml Xylazine administered at 3-4 ml/kg (100 mg/kg Ketamine and 10 mg/kg Xylazine)</td>
		</tr>
		<tr>
			<td>Xylazine (analgesic)</td>
			<td>Webster Veterinary</td>
			<td>07-808-1939 (100 mg/ml)</td>
			<td>As above</td>
		</tr>
		<tr>
			<td>Antisedan (anti-Xylazine)</td>
			<td>Webster Veterinary</td>
			<td>07-867-7097 (5 mg/ml)</td>
			<td>Optional: to reverse effects of Xylazine in order to increase the rate of recovery after surgery Use 0.5-0.7 mg/kg</td>
		</tr>
		<tr>
			<td>Buprenorphine (analgesic)</td>
			<td>Bedford Laboratories</td>
			<td>NDC 55390-100-10 (0.3 mg/ml)</td>
			<td>Dose 0.05-0.1 &mu;g/g every 8-12 hr. Make up a 1:5 dilution in sterile normal saline preoperatively and give 2.5-5 &mu;l/g of the diluted solution.</td>
		</tr>
		<tr>
			<td>Ophthalmic ointment</td>
			<td>Dechra</td>
			<td>NDC 17033-211-38</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Betadine swab sticks</td>
			<td>Purdue Products L.P.</td>
			<td>NDC 67618-153-01</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Nolvasan Surgical Scrub</td>
			<td>Pfizer Animal Care</td>
			<td>300253</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td>Table 2. Drugs and solutions for I/R surgery.</td>
		</tr>
		<tr>
			<td>Iris Scissors</td>
			<td>Integra Miltex</td>
			<td>VWR 21909-404</td>
			<td>For skin and muscle dissection</td>
		</tr>
		<tr>
			<td>Curved iris forceps</td>
			<td>FST</td>
			<td>11065-07</td>
			<td>To hold skin and muscle, to remove peri-nephric fat</td>
		</tr>
		<tr>
			<td>Blunt forceps</td>
			<td>ROBOZ</td>
			<td>RS-5228</td>
			<td>To manipulate kidneys</td>
		</tr>
		<tr>
			<td>Vascular clamp (795 g pressure)</td>
			<td>ROBOZ</td>
			<td>RS-5459</td>
			<td>Good for C57BL/6 and BALB/c mice strains</td>
		</tr>
		<tr>
			<td>Schwartz clip applying forceps</td>
			<td>ROBOZ</td>
			<td>RS-5450</td>
			<td>For RS-5459 clamps</td>
		</tr>
		<tr>
			<td>Vascular clamp (75-85 g pressure)</td>
			<td>FST</td>
			<td>18055-02</td>
			<td>Optimal for CD1 mice strain, but also can be used for C57BL/6 and BALB/c</td>
		</tr>
		<tr>
			<td>Micro-Serrefine Clamp Applicator-14 cm with Lock</td>
			<td>FST</td>
			<td>18056-14</td>
			<td>For FST 18055-02 clamps</td>
		</tr>
		<tr>
			<td>Gayman T/Pump (water-bath heated platform)</td>
			<td>Braintree Scientific</td>
			<td>TP-650</td>
			<td>The water heater is set at 38 &deg;C 1 hr prior surgery</td>
		</tr>
		<tr>
			<td>15" W x 24" Heated platform</td>
			<td>Braintree Scientific</td>
			<td>HHP-2</td>
			<td>Connect to Gayman heated water pump</td>
		</tr>
		<tr>
			<td>Heating pad</td>
			<td>Braintree Scientific</td>
			<td>Model 39DP</td>
			<td>Uses microwave for heating. This is useful for warming during recovery</td>
		</tr>
		<tr>
			<td>Absorbable suture (Vicryl 5-0)</td>
			<td>ETHICON</td>
			<td>VCP834G</td>
			<td>For fascia and muscle</td>
		</tr>
		<tr>
			<td>Non-absorbable suture: monofilament nylon MONOMID 6/0 660B)</td>
			<td>CP Medical</td>
			<td>CP-B660B-03</td>
			<td>For skin</td>
		</tr>
		<tr>
			<td>Halsey needle holder: Tungsten Carbide/13 cm</td>
			<td>FST</td>
			<td>12501-13</td>
			<td>To hold suture needles</td>
		</tr>
		<tr>
			<td>Timer</td>
			<td>FST</td>
			<td>06-662-3</td>
			<td>To quantify ischemia time</td>
		</tr>
		<tr>
			<td>Hot bead sterilizer</td>
			<td>FST</td>
			<td>18000-45</td>
			<td>To sterilize instruments between mice if you are performing multiple surgeries (it is not sufficient to soak instruments in ethanol)</td>
		</tr>
		<tr>
			<td>Electric razor</td>
			<td>Braintree Scientific</td>
			<td>CLP-22965</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Tape</td>
			<td>Durapore</td>
			<td>1538-0</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>1 ml Syringe</td>
			<td>EXELint</td>
			<td>26044</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Sterile cotton tipped applicators</td>
			<td>Kendall</td>
			<td>8884541300</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Absorbent BenchPad</td>
			<td>VWR</td>
			<td>56617-014</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Surgical drapes</td>
			<td>VWR</td>
			<td>21902-985</td>
			<td>Need to be autoclaved</td>
		</tr>
		<tr>
			<td>2'' x 2'' Gauze Pads</td>
			<td>Medi-First</td>
			<td>60673</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Sterile gloves</td>
			<td>Cardinal Health</td>
			<td>2D7251</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td>Table 3. Equipment and instruments for I/R surgery.</td>
		</tr>
	</tbody>
</table>

ischemia-reperfusion model of acute kidney injury and post injury fibrosis in mice

Isquemia-reperfusão induzida lesão renal aguda (IR-AKI) é amplamente utilizado como um modelo de LRA em camundongos, mas os resultados são muitas vezes bastante variável, com altas taxas de mortalidade muitas vezes não declarada que pode confundir análises. Bilateral pedículo clampeamento renal é comumente usado para induzir o IR-AKI, mas as diferenças entre as pressões de fixação eficazes e / ou respostas renais à isquemia entre os rins muitas vezes levam a resultados mais variáveis. Além disso, os tempos mais curtos da braçadeira são conhecidas por induzir a lesão tubular mais variável, e quando os ratos submetidos a lesão bilateral com tempos mais longos da braçadeira desenvolver lesão tubular mais consistente, eles morrem frequentemente durante os primeiros 3 dias após a lesão devido a insuficiência renal grave. Para melhorar a sobrevivência pós-lesão e obter resultados mais consistentes e previsíveis, desenvolvemos dois modelos de lesão unilateral de isquemia-reperfusão, seguido por nefrectomia contralateral. Ambas as cirurgias são realizadas através de uma abordagem dorsal, reduzindo o stress cirúrgico resultando from laparotomia ventral, comumente usado para rato IR-AKI cirurgias. Para a indução da lesão ratinhos BALB / c moderadas submeter unilateral de aperto do pedículo renal durante 26 min, e também submetidos a nefrectomia contralateral simultâneo. Utilizando esta abordagem, 50-60% dos ratinhos desenvolvem moderada LRA 24 h depois da lesão, mas 90-100% dos ratinhos sobreviver. Para induzir o LRA mais grave, ratinhos BALB / c sofrem pedículo renal aperto durante 30 min seguido por nefrectomia contralateral 8 dias após o ferimento. Isto permite a avaliação funcional da recuperação renal após lesão com 90-100% de sobrevivência. Cedo dano tubular pós-lesão, bem como a fibrose pós lesão são altamente consistente com esse modelo.

Moderado IR induzida AKI. IR Unilateral com nefrectomia contralateral simultânea reduz substancialmente a variabilidade nos resultados, mas com tempos mais curtos de fixação necessários para os ratos para sobreviver a este procedimento, ainda constatou que apenas 50-60% dos camundongos desenvolveu o esperado insuficiência renal 24 hr após a lesão (Figura 3A). Em termos práticos, isso cria dificuldades avaliação dos dados, a menos que os estudos envolvem esquemas de tratamento ...

Watch this Scientific Journal Video about Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice at JoVE.com

Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice

Descrevemos modelos de lesão renal por isquemia e reperfusão induzida moderada e grave em que os ratos submetidos a clampeamento do pedículo renal unilateral seguido de nefrectomia contralateral simultânea ou tardia, respectivamente. Estes modelos consistentemente dar origem a uma disfunção renal e fibrose pós-lesão, mas a gravidade da lesão e sobrevivência dependem de fundo, idade e equipamento cirúrgico mouse.

Isquemia-reperfusão modelo de lesão renal aguda e Pós Lesão fibrose em camundongos

Ischemia-reperfusion induced acute kidney injury (IR-AKI) is widely used as a model of AKI in mice, but results are often quite variable with high, often ...

ischemia-reperfusion-model-acute-kidney-injury-post-injury-fibrosis

Research

JoVE Journal

Medicine

39.4K visualizações.  Vanderbilt University Medical Center. Descrevemos modelos de lesão renal por isquemia e reperfusão induzida moderada e grave em que os ratos submetidos a clampeamento do pedículo renal unilateral seguido de nefrectomia contralateral simultânea ou tardia, respectivamente. Estes modelos consistentemente dar origem a uma disfunção renal e fibrose pós-lesão, mas a gravidade da lesão e sobrevivência dependem de fundo, idade e equipamento cirúrgico mouse.

Vídeo: Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice

Normothermic Cardiac Arrest and Cardiopulmonary Resuscitation: A Mouse Model of Ischemia-Reperfusion Injury

Acute Kidney Injury (AKI) is a common, highly lethal, complication of critical illness which has a high mortality1-4 and which is most 
frequently caused by whole-body hypoperfusion.5,6 Successful reproduction of whole-body hypoperfusion in rodent models has been fraught with 
difficulty.7-9,9,10 Models which employ focal ischemia have repeatedly demonstrated results which do not translate to the clinical setting, and larger 
animal models which allow for whole body hypoperfusion lack access to the full toolset of genetic manipulation possible in the mouse.11,12 However, in recent 
years a mouse model of cardiac arrest and cardiopulmonary resuscitation has emerged which can be adapted to model AKI.13 This model reliably reproduces 
physiologic, functional, anatomic, and histologic outcomes seen in clinical AKI, is rapidly repeatable, and offers all of the significant advantages of a murine surgical 
model, including access to genetic manipulative techniques, low cost relative to large animals, and ease of use. Our group has developed extensive experience 
with use of this model to assess a number of organ-specific outcomes in AKI.14,15

A powerful model for perioperative and critical care related acute kidney injury is presented. Using whole body hypoperfusion induced by cardiac arrest it is possible to nearly replicate the histologic and functional changes of clinical AKI.

Cardiac Arrest normotérmica e Ressuscitação Cardiopulmonar: um modelo do rato de isquemia-reperfusão

Acute Kidney Injury (AKI) is a common, highly lethal, complication of critical illness which has a high mortality1-4 and which is most 
frequently caused ...

Medicina

Induction and Assessment of Ischemia-reperfusion Injury in Langendorff-perfused Rat Hearts

The biochemical events surrounding ischemia reperfusion injury in the acute setting are of great importance to furthering novel treatment options for myocardial infarction and cardiac complications of thoracic surgery. The ability of certain drugs to precondition the myocardium against ischemia reperfusion injury has led to multiple clinical trials, with little success. The isolated heart model allows acute observation of the functional effects of ischemia reperfusion injury in real time, including the effects of various pharmacological interventions administered at any time-point before or within the ischemia-reperfusion injury window. Since brief periods of ischemia can precondition the heart against ischemic injury, in situ aortic cannulation is performed to allow for functional assessment of non-preconditioned myocardium. A saline filled balloon is placed into the left ventricle to allow for real-time measurement of pressure generation. Ischemic injury is simulated by the cessation of perfusion buffer flow, followed by reperfusion. The duration of both ischemia and reperfusion can be modulated to examine biochemical events at any given time-point. Although the Langendorff isolated heart model does not allow for the consideration of systemic events affecting ischemia and reperfusion, it is an excellent model for the examination of acute functional and biochemical events within the window of ischemia reperfusion injury as well as the effect of pharmacological intervention on cardiac pre- and postconditioning. The goal of this protocol is to demonstrate how to perform in situ aortic cannulation and heart excision followed by ischemia/reperfusion injury in the Langendorff model.

The isolated rat heart is an enduring model for ischemia reperfusion injury. Here, we describe the process of harvesting the beating heart from a rat via in situ aortic cannulation, Langendorff perfusion of the heart, simulated ischemia-reperfusion injury, and infarct staining to confirm the extent of ischemic insult.

Indução e Avaliação de isquemia-reperfusão em Langendorff-perfundidos Rato Corações

The biochemical events surrounding ischemia reperfusion injury in the acute setting are of great importance to furthering novel treatment options for ...

Murine Model of Intestinal Ischemia-reperfusion Injury

Intestinal ischemia is a life-threatening condition associated with a broad range of clinical conditions including atherosclerosis, thrombosis, hypotension, necrotizing enterocolitis, bowel transplantation, trauma and chronic inflammation. Intestinal ischemia-reperfusion (IR) injury is a consequence of acute mesenteric ischemia, caused by inadequate blood flow through the mesenteric vessels, resulting in intestinal damage. Reperfusion following ischemia can further exacerbate damage of the intestine. The mechanisms of IR injury are complex and poorly understood. Therefore, experimental small animal models are critical for understanding the pathophysiology of IR injury and the development of novel therapies.
Here we describe a mouse model of acute intestinal IR injury that provides reproducible injury of the small intestine without mortality. This is achieved by inducing ischemia in the region of the distal ileum by temporally occluding the peripheral and terminal collateral branches of the superior mesenteric artery for 60 min using microvascular clips. Reperfusion for 1 hr, or 2 hr after injury results in reproducible injury of the intestine examined by histological analysis. Proper position of the microvascular clips is critical for the procedure. Therefore the video clip provides a detailed visual step-by-step description of this technique. This model of intestinal IR injury can be utilized to study the cellular and molecular mechanisms of injury and regeneration.

Here we describe the detailed procedure of intestinal ischemia-reperfusion in mice which results in reproducible injury without mortality to encourage the standardization of this technique across the field. This model of intestinal ischemia-reperfusion injury can be utilized to study the cellular and molecular mechanisms of injury and regeneration.

Modelo murino de isquemia-reperfusão

Intestinal ischemia is a life-threatening condition associated with a broad range of clinical conditions including atherosclerosis, thrombosis, ...

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Coronary artery disease is the leading cause of death worldwide. After an acute myocardial infarction, early and successful myocardial intervention via recanalization of the coronary artery is the most effective strategy for reducing the size of ischemic myocardium. The coronary microvasculature cannot be visualized and imaged&#160;in vivo, but there are several invasive and noninvasive techniques that can be used to assess parameters which depend directly on coronary microvascular function. The endothelial function after ischemia reperfusion can be assessed also at the level of the coronary circulation via the coronary flow reserve (CFR).&#160;In this study, peak velocity of left anterior descending (LAD) coronary arteries was measured in rats in vivo via Transthoracic Doppler Echocardiography during resting and stress challenge (induced by Dobutamine). A normal heart can increase its coronary blood flow up to four times above the resting values during stress induction. Following ischemia reperfusion, we found a significantly diminished CFR, which can be used as a marker of coronary microvascular dysfunction. CFR has opened a window on the importance of microvascular dysfunction and has been shown to predict cardiovascular risk independent of whether the severe obstructive disease is present.

Coronary flow reserve (CFR), is defined as the ratio of maximal coronary blood flow to the resting coronary blood flow. We present a protocol for evaluating CFR in rats via ultrasound, which offers the opportunity to predict cardiovascular risk factors in the absence of obstructive coronary disease.

Avaliação da reserva de fluxo coronariano após reperfusão de isquemia miocárdica em ratos

Coronary artery disease is the leading cause of death worldwide. After an acute myocardial infarction, early and successful myocardial intervention via ...

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

Ischemia-reperfusion injury is the main cause of flap failure in reconstructive microsurgery. The rat is the preferred preclinical animal model in many areas of biomedical research due to its cost-effectiveness and its translation to humans. This protocol describes a method to create a preclinical free skin flap model in rats with ischemia-reperfusion injury. The described 3 cm x 6 cm rat free skin flap model is easily obtained after the placement of several vascular ligatures and the section of the vascular pedicle. Then, 8 h after the ischemic insult and completion of the microsurgical anastomosis, the free skin flap develops the tissue damage. These ischemia-reperfusion injury-related damages can be studied in this model, making it a suitable model for evaluating therapeutic agents to address this pathophysiological process. Furthermore, two main monitoring techniques are described in the protocol for the assessment of this animal model: transit-time ultrasound technology and laser speckle contrast analysis.

Here, we describe a pre-clinical animal model for studying the pathophysiology of ischemia-reperfusion injury in reconstructive microsurgery. This free skin flap model based on the superficial caudal epigastric vessels in the rat may also allow for the evaluation of different therapies and compounds to counteract ischemia-reperfusion injury-related damage.

Um modelo pré-clínico do rato para o estudo da lesão da Isquemia-reperfusion na microcirurgia reconstrutiva

Ischemia-reperfusion injury is the main cause of flap failure in reconstructive microsurgery. The rat is the preferred preclinical animal model in many ...

Delayed Intramyocardial Delivery of Stem Cells after Ischemia Reperfusion Injury in a Murine Model

There is significant interest in the use of stem cells (SCs) for the recovery of cardiac function in individuals with myocardial injuries. Most commonly, cardiac stem cell therapy is studied by delivering SCs concurrently with the induction of myocardial injury. However, this approach presents two significant limitations: the early hostile pro-inflammatory ischemic environment may affect the survival of transplanted SCs, and it does not represent the subacute infarction scenario where SCs will likely be used. Here we describe a two-part series of surgical procedures for the induction of ischemia-reperfusion injury and delivery of mesenchymal stem cells (MSCs). This method of stem cell administration may allow for the longer viability and retention around damaged tissue by circumventing the initial immune response. A model of ischemia reperfusion injury was induced in mice accompanied by the delivery of mesenchymal stem cells (3.0 x 105), stably expressing the reporter gene firefly luciferase under the constitutively expressed CMV promoter, intramyocardially 7 days later. The animals were imaged via ultrasound and bioluminescent imaging for confirmation of injury and injection of cells, respectively. Importantly, there was no added complication rate when performing this two-procedure approach for SC delivery. This method of stem cell administration, collectively with the utilization of state-of-the-art reporter genes, may allow for the in vivo study of viability and retention of transplanted SCs in a situation of chronic ischemia commonly seen clinically, while also circumventing the initial pro-inflammatory response. In summary, we established a protocol for the delayed delivery of stem cells into the myocardium, which can be used as a potential new approach in promoting regeneration of the damaged tissue.

Stems cells are continuously investigated as potential treatments for individuals with myocardial damage, however, their decreased viability and retention within injured tissue can impact their long-term efficacy. In this manuscript we describe an alternative method for stem cell delivery in a murine model of ischemia reperfusion injury.

Entrega intramiocárdica atrasada de células-tronco após lesão de reperfusão de Isquemia em um modelo murino

There is significant interest in the use of stem cells (SCs) for the recovery of cardiac function in individuals with myocardial injuries. Most commonly, ...

Acute Kidney Injury Model Induced by Cisplatin in Adult Zebrafish

Cisplatin is commonly used as chemotherapy. Although it has positive effects in cancer-treated individuals, cisplatin can easily accumulate in the kidney due to its low molecular weight. Such accumulation causes the death of tubular cells and can induce the development of Acute Kidney Injury (AKI), which is characterized by a quick decrease in kidney function, tissue damage, and immune cells infiltration. If administered in specific doses cisplatin can be a useful tool as an AKI inducer in animal models. The zebrafish has appeared as an interesting model to study renal function, kidney regeneration, and injury, as renal structures conserve functional similarities with mammals. Adult zebrafish injected with cisplatin shows decreased survival, kidney cell death, and increased inflammation markers after 24 h post-injection (hpi). In this model, immune cells infiltration and cell death can be assessed by flow cytometry and TUNEL assay. This protocol describes the procedures to induce AKI in adult zebrafish by intraperitoneal cisplatin injection and subsequently demonstrates how to collect the renal tissue for flow cytometry processing and cell death TUNEL assay. These techniques will be useful to understand the effects of cisplatin as a nephrotoxic agent and will contribute to the expansion of AKI models in adult zebrafish. This model can also be used to study kidney regeneration, in the search for compounds that treat or prevent kidney damage and to study inflammation in AKI. Moreover, the methods used in this protocol will improve the characterization of tissue damage and inflammation, which are therapeutic targets in kidney-associated comorbidities.

This protocol describes the procedures to induce Acute Kidney Injury (AKI) in adult zebrafish using cisplatin as a nephrotoxic agent. We detailed the steps to evaluate the reproducibility of the technique and two techniques to analyze inflammation and cell death in the renal tissue, flow cytometry and TUNEL, respectively.

Modelo de lesão renal aguda induzida por cisplatina em zebrafish adulto

Cisplatin is commonly used as chemotherapy. Although it has positive effects in cancer-treated individuals, cisplatin can easily accumulate in the kidney ...

Organ Ischemia-Reperfusion Injury by Simulating Hemodynamic Changes in Rat Liver Transplant Model

Orthotopic liver transplantation (OLT) in rats is a tried and proven animal model used for preoperative, intraoperative, and postoperative studies, including ischemia-reperfusion injury (IRI) of extrahepatic organs. This model requires numerous experiments and devices. The duration of anhepatic phase is closely related to the time to develop IRI after transplantation. In this experiment, we used hemodynamic changes to induce extrahepatic organ damage in rats and determined the maximum tolerance time. The time until the most severe organ injury varied for different organs. This method can easily be replicated and can also be used to study IRI of the extrahepatic organs after liver transplantation.

This paper provides a detailed description of how to build an animal model of the anhepatic phase (liver ischemia) in rats to facilitate basic research into ischemia-reperfusion injury after liver transplantation.

Lesão por Isquemia-Reperfusão de Órgãos simulando alterações hemodinâmicas no modelo de transplante de fígado de rato

Orthotopic liver transplantation (OLT) in rats is a tried and proven animal model used for preoperative, intraoperative, and postoperative studies, ...

A Rat Lung Transplantation Model of Warm Ischemia/Reperfusion Injury: Optimizations to Improve Outcomes

From our experience with rat lung transplantation, we have found several areas for improvement. Information in the existing literature regarding methods for choosing appropriate cuff sizes for the pulmonary vein (PV), pulmonary artery (PA), or bronchus (Br) are varied, thus making the determination of proper cuff size during rat lung transplantation an exercise of trial and error. By standardizing the cuffing technique to use the smallest effective cuff appropriate for the size of the vessel or bronchus, one can make the transplantation procedure safer, faster, and more successful. Since diameters of the PV, PA, and Br are related to the body weight of the rat, we present a strategy to choosing an appropriate size using a weight-based guide. Since lung volume is also related to body weight, we recommend that this relationship should also be considered when choosing the proper volume of air for donor lung inflation during warm ischemia as well as for the proper volume of PBS to be instilled during bronchoalveolar lavage (BAL) fluid collection. We also describe methods for 4th intercostal space dissection, wound closure, and sample collection from both the native and transplanted lobes.

Here, we present optimizations to a rat lung transplantation model that serve to improve outcomes. We provide a size guide for cuffs based on body weight, a measurement strategy to ascertain the 4th intercostal space, and methods of wound closure and BAL (bronchoalveolar lavage) fluid and tissue collection.

Modelo de Lesão de Isquemia/Reperfusão de Pulmão de Rato em Transplante de Pulmão de Rato: Otimizações para Melhorar os Resultados

From our experience with rat lung transplantation, we have found several areas for improvement. Information in the existing literature regarding methods ...

An Effective Mouse Model of Unilateral Renal Ischemia-Reperfusion Injury

Ischemia-reperfusion injury (IRI) is the leading cause of acute renal failure and is a significant contributor to delayed graft function. Animal models are the only available resources that mimic the complexities of the IRI-associated damage encountered in vivo. This paper describes an effective mouse model of unilateral renal IRI that delivers highly reproducible data. Ischemia is induced by occluding the right renal pedicle for 30 min followed by reperfusion. In addition to the surgical procedure, a sequential overview of the expected physiological and histopathological changes following renal IRI will be provided by comparing data from seven different reperfusion times (4 h, 8 h, 16 h, 1 day, 2 days, 4 days, and 7 days). Critical data for planning experiments ahead, such as mean surgical time, average anesthetic consumption, and body weight changes over time, will be shared. This work will help researchers implement a reliable renal IRI model and select the appropriate reperfusion time that aligns with their intended investigative goals.

Renal ischemia-reperfusion injury is associated with high morbidity and mortality in hospitalized patients. Here, we present a simple and effective mouse model of unilateral renal ischemia-reperfusion injury and provide a sequential overview of representative pathological changes observed in the kidney.

Um modelo eficaz de rato de isquemia renal unilateral-reperfusão lesão

Ischemia-reperfusion injury (IRI) is the leading cause of acute renal failure and is a significant contributor to delayed graft function. Animal models ...