Araştırma, JAG'ye NHLBI Research Scientist Development Grant (1K01HL135461-01) tarafından desteklenmiştir. David Carmona-Berrio ve Isabel Adarve-Rengifo'ya teknik yardımları için teşekkür ederiz.

Fareler, Ulusal Sağlık Enstitüleri (NIH) kılavuzlarını ve ABD Sağlık ve İnsan Hizmetleri Bakanlığı, Laboratuvar Hayvanlarının Bakımı ve Kullanımı Kılavuzu'nu izleyerek Vanderbilt Üniversitesi Tıp Merkezi (VUMC) Hayvan Bakımı Bölümü'nde barındırıldı ve bakıldı. Tüm hayvan prosedürleri, deneylere başlamadan önce VUMC Kurumsal Hayvan Bakımı ve Kullanımı Komitesi tarafından onaylanmıştır.
1. Hayvan hazırlama ve diseksiyon
<ol><li>Ameliyata başlamadan yaklaşık 30 dakika önce ısıtma yastığının çimlendiricisini ve su pompasını açın.</li>
	<li>0,5 mm uzunluğunda poliüretan boruları keskin bir neşterle kesin. Bir manşet yapmak için uzunlamasına bir kesim yaparak çevrenin 0,2 mm'sini çıkarın. NOT: Bu, renal arter darlığı prosedürünün aşırı hassasiyet, detaylara dikkat ve sabır gerektiren kritik bir parçasıdır. Bir seferde birkaç parça poliüretan boru kesmeye çalışın. Tüm bu prosedürü mikroskop altında gerçekleştirin.</li>
	<li>Daha fazla ilerlemeden önce, cerrahi steril eldivenler ve cerrahi maske takın.</li>
	<li>6-8 haftalık C57BL/6 vahşi tip (WT) fareler kullanın. Herhangi bir cinsiyet önyargısından kaçınmak için eşit sayıda erkek ve dişi fare kullanın.</li>
	<li>Ameliyat yapmadan önce farelerin ağırlığını kaydedin. Poliüretan tüp ile renal arter darlığı yapmak için ideal ağırlık 18-22 g'dır. Fareleri nazikçe tutun ve anesteziyi enjekte ederken ajitasyon yapmayın. Ameliyat öncesi analjezi uygulayın (Ketofgen, 5 mg/kg vücut genişliği). NOT: Fareleri barınma odalarından ameliyat odasına aktarırken, ajitasyonu önlemek için onları büyük bir nezaket ve özenle taşıyın. Fare kafeslerinin bir araba yerine ellerde taşınması şiddetle tavsiye edilir.</li>
	<li>Fareleri intraperitoneal (I.P.) enjeksiyonlar yoluyla ketamin (100 mg / kg BW) ve ksilazin (10 mg / kg BW) karışımı ile anestezi altına alın.</li>
	<li>Tamamen anestezi uygulanana kadar fareyi kafesin içine geri yerleştirin. Farenin tamamen bilinçsiz hale gelmesi yaklaşık 4-5 dakika sürer. Farenin tamamen bilinçsiz ve ameliyat için hazır olup olmadığını kontrol etmek için kuyruğu veya ayak parmağını forseps ile sıkıştırın.</li>
	<li>Fareyi sırt üstü bir kağıt havlunun üzerine koyun. Saç büyümesinin ters yönünü takip eden elektrikli bir saç kesme makinesi kullanarak lateral karın kıllarını çıkarın. Cerrahi bölgeyi tıraş ettikten sonra, bölgeyi iyot (veya klorheksidin) içeren cerrahi bir ovma ile temizleyin ve ardından% 70 etanol (veya steril salin) ile durulayın.  3 kez tekrarlayın. NOT: Epilasyon prosedürü, ameliyat prosedürü sırasında herhangi bir saç parazitini ve saç kontaminasyonunu önlemek için belirli bir mesafede veya tercihen cerrahi prosedür tezgahından farklı bir tezgahta yapılmalıdır.</li>
	<li>Isıtma yastığını steril bir tabaka ile örtün. Fareyi cerrahi tezgaha getirin ve farenin sağ yan tarafına mikroskopa doğru bakacak şekilde steril tabakaya yerleştirin. Dolaşımdaki su ile 37 °C'lik sabit bir ped sıcaklığını koruyun.</li>
	<li>Tüm cerrahi ekipmanı içeren sterilize edilmiş torbayı açın. Diseksiyon yapan bir mikroskop ve steril keskin makas kullanarak, küçük bir yan kesi (13. torasik kaburgaya yakın, faredeki son kaburga) ve omurlardan yaklaşık 0,5 cm uzakta yapın. Bel omurları boyunca ilerleyin ve 1 inçlik bir kesi yapın.</li>
	<li>Böbreği açığa çıkarmak için cildi ve kası geri çekin.</li>
	<li>Renal arteri izole etmek için steril pamuklu çubuklar kullanarak çevredeki yağları temizleyin ve çıkarın. Kavisli forseps kullanarak renal siniri renal arterden izole edin.</li>
	<li>Sahte ameliyatı gerçekleştirirken, cildi kapatmak için dikişler uygulayın ve kapalı yaraya antibiyotik uygulayın, ardından ameliyat sonrası bakıma devam edin. Değilse, arteri stenose etmek için aşağıdaki bölüme devam edin. NOT: Her deney, cerrahi prosedürün kontrolleri olarak sahte hayvanlara sahip olmalıdır. Şam hayvanları, üzerine bir manşet yerleştirmeden renal arteri açığa çıkarmanın cerrahi prosedüründen geçen farelerden oluşur.</li>
</ol>2. Sağ renal arter darlığı
<ol><li>Sağ renal arterin altına iki naylon sütür yerleştirin, gevşek düğümler yapın ve ardından manşeti ana renal arterin etrafına böbrek ve aort bifurkasyonu arasında yaklaşık olarak eşit mesafeye yerleştirin.</li>
	<li>Naylon dikişleri kullanarak manşeti kapatın. Ameliyattan sonra dikişleri kaybetme olasılığını önlemek için her dikiş için dört düğüm yapın.</li>
	<li>Basit bir sürekli dikiş uygulayarak kastaki kesiyi kapatın.</li>
	<li>Cildi kapatmak için basit kesilmiş dikişler yapın.</li>
	<li>IACUC onaylı analjezikleri uygulayın. NOT: Her kullanımdan önce otoklav cerrahi aletleri. Aynı anda birden fazla ameliyat yapılıyorsa, kullanılan tüm aletleri steril bir alkol göstergesi ile silin ve her ameliyattan sonra 15-30 sn boyunca sıcak çimlendiriciye yerleştirin. Her fare için steril eldivenleri de değiştirin.</li>
</ol>3. Ameliyat sonrası bakım
<ol><li>Fareleri kafeslerine geri döndürün ve kafesi yarı açık, yarı kapalı, 2-3 saat boyunca dolaşımdaki bir su ısıtma yastığı olarak bırakın. Kafesin içine jel diyet kurtarma yiyecekleri ekleyin.</li>
	<li>Ağrı kesici (ketoprofen) ertesi gün intraperitoneal olarak (doz: 5 mg / kg BW) uygulayın.</li>
	<li>Fareleri önümüzdeki iki gün boyunca tartın; Bazı fareler ağırlıklarının% 20'sinden fazlasını kaybederse veterinere danışın ve uygun IACUC yetkili prosedürünü takiben hayvanın ötenazi yapılması gerekip gerekmediğine karar verin.</li>
	<li>Kızarıklık, şişlik, ağrı veya enfeksiyon açısından değerlendirmek için fareleri günlük olarak izleyin.</li>
	<li>Kurumsal IACUC politikalarına uygun olarak postoperatif komplikasyonlar için veteriner konsültasyonu isteyin.</li>
</ol>4. Doku hasadı
<ol><li>Cerrahi işlemden 3 hafta sonra doku hasadı. Her farenin ağırlığını kaydedin.</li>
	<li>IACUC onaylı bir prosedürle fareyi ötenazileştirin.</li>
	<li>Fareyi steril bir platforma diseksiyon yapmak için sırtüstü pozisyonda yerleştirin.</li>
	<li>Hareketi sınırlamak için uzuvları sabitleyin ve uzatın.</li>
	<li>Farelere% 70 etanol ile iyice püskürtün.</li>
	<li>Keskin makas kullanarak karın ve göğüs bölgesini açmak için orta hat kesisi yapın.</li>
	<li>Cildi ve periton duvarını geri çekin.</li>
	<li>Kalbi dikkatlice ortaya çıkarın ve sağ ventrikülü delin ve fareyi exsanguinate edin.</li>
	<li>Forseps kullanarak her iki böbreği de çıkarın. Böbrekler farelerin arkasında bulunur. NOT: Her iki böbreği de karıştırmayın. Stelsezli, sahte ve kontralateral böbreklerin farkında olun.</li>
	<li>Böbrek kapsülünü çıkarın, herhangi bir yağdan temizleyin ve her böbreğin ağırlığını ayrı ayrı kaydedin.</li>
	<li>Her iki böbreğin uzunlamasına bir bölümünü kesin ve daha sonra parafin gömme için işlenmek, in situ hibridizasyon (ISH) ve immünohistokimya (IHC) gerçekleştirmek için 4 ° C'de bir gecede% 4 PFA'ya sabitlenir. ISH ve IHC protokollerini rapor edildiği gibi takip edin23,24.</li>
	<li>Kalan böbreğin korteksini izole edin ve batı lekesini gerçekleştirmek için sıvı azotta dondurun. Numuneleri analize kadar -80 °C'de saklayın.</li>
	<li>Renin ve N-GAL ifadelerini literatür23,24'te tanımlandığı gibi Batı lekesi ile sayısallaştırın.</li>
</ol>5. İstatistik
<ol><li>Üç veya daha fazla koşullu deneyler için tek yönlü veya iki yönlü ANOVA'yı kullanın, ardından bireysel gruplar arasındaki karşılaştırmalar için Bonferroni post-hoc testleri yapın. 0,05'e eşit veya daha küçük bir p değerinin önemli olduğunu düşünün. Tüm istatistiksel analizleri yapmak için yazılım kullanın (örneğin, GraphPad Prism 8.2).</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>

Yazarlar tarafından finansal veya başka türlü hiçbir çıkar çatışması beyan edilmez.

Renal arter darlığı, sekonder veya dirençli hipertansiyonun ve böbrek hasarının 1,29'unun önemli bir nedenidir. İki böbrek bir klip (2K1C) Goldblatt modeli, RAStenozise bağlı renovasküler hipertansiyonu1,17,18,19 incelemek için kullanılmıştır. Çeşitli hayvan modellerini kullanan bir dizi önceki çalışma, renal art...

Renal arter darlığı (RAStenosis), 65 yaş üstü kişilerin yaklaşık% 6'sını ve koroner veya periferik vasküler hastalığı olan kişilerin% 40'ına kadarını etkileyen inatçı bir sorundur 1,2. Hastalık için mevcut tedaviler sınırlıdır; Bu nedenle, renovasküler hipertansiyonu veya RAStenosis'in neden olduğu dirençli hipertansiyonu tedavi etmek için yeni tedavilerin geliştirilmesine kritik bir ihtiyaç vardır. Renin anjiyotensin aldosteron sistemi (RAAS), RAStenozise bağlı hipertansiyon veya renovasküler hipertansiyonun patogenezinde rol oynayan anahtar yoldur 3,4. ACE inhibitörleri veya anjiyotensin reseptör blokerleri gibi RAAS'ı hedef alan bilinen tedaviler hipertansiyonu hafifletir, ancak böbrek yetmezliği ve hiperkalemiiçin yakından incelenmelidir 5,6,7. Renin, RAAS'taki hız sınırlama adımını katalize eder; anjiyotensinojeni anjiyotensin I'e dönüştürür. Aterosklerozda plak oluşumu, renin sekresyonunu yönlendiren renal arterin daralmasına neden olarak renovasküler hipertansiyon ve böbrek hasarı ile sonuçlanır8. Bir dizi çalışma, insanlarda renovasküler hipertansiyon sırasında oksidatif stres düzeylerinin arttığını bildirmiştir; bunlar, iki böbrek bir klip (2K1C) fare modelinin yanı sıra diğer hipertansif hayvan modelleri 2,9,10,11,12,13,14,15,16 ile doğrulanmıştır. . RAStenozise bağlı renovasküler hipertansiyon sırasında renin ekspresyon kontrolünün moleküler mekanizması iyi anlaşılmamıştır ve daha fazla araştırma gerektirmektedir.
RAStenosis'i güvenilir ve tekrarlanabilir bir şekilde özetleyen deneysel hayvan modelleri, yeni tedavilerin geliştirilmesi için renin ekspresyon kontrolünün hücresel ve moleküler mekanizmalarının aydınlatılmasında önemlidir. 2K1C fare modeli, renovasküler hipertansiyonun patogenezini incelemek için iyi kurulmuş bir deneysel modeldir17,18,19,20. Bu model, 17,20,21 numaralı bir klips kullanılarak renal arterin daralmasıyla üretilir, bu nedenle renin ekspresyonunda ve hipertansiyonda 17,19,20,21'de bir artışa neden olan renal arter tıkanıklığı üretir. Bununla birlikte, hayvan modellerinde renal arter darlığı oluşturmak için adım adım bir prosedürü tanımlayan teknik raporlar mevcut değildir.
Geleneksel U-şekilli gümüş klipsler, poliüretan tüpler ve diğer klipsler, renal arter darlığını indüklemek için renal arteri daraltmak için kullanılmıştır. Bazı çalışmalar, klibin tasarımının ve malzemesinin, 2K1C hayvan modeli ile güvenilir ve tekrarlanabilir veriler elde etmek için kritik öneme sahip olduğunu göstermiştir. Lorenz ve ark.'ya göre, geleneksel U-tasarımlı gümüş klipslerin kullanımı, düşük bir hipertansiyon başarı oranına neden olur (%40-60)21. Klips tasarımı nedeniyle, renal arter lateral olarak bastırılır, birkaç daralmayı tetikler ve renal arterden çıkma olasılığı daha yüksektir. Gümüş dövülebilirliği ve sünekliği, klips genişliklerinde değişikliklere izin verebilir; bu nedenle, fareler arasında farklı hipertansiyon seviyelerine neden olur. Klips üzerindeki gümüş dioksitler perivasküler inflamasyona, intimal proliferasyona ve doku granülasyonuna neden olarak renal arter çapı22'yi değiştirebilir. Geleneksel U-design gümüş klips ile elde edilen hipertansiyon seviyelerindeki değişkenlik nedeniyle, Warner ve ark. ve Lorenz ve ark., farelerde renal arter darlığını başlatmak için yuvarlak tasarımlı bir poliüretan tüpü başarıyla kullanmış ve iki böbrek bir klips hayvan modeli 20,21'in daha güvenilir ve tutarlı bir indüksiyonunu sağlamıştır.
Bu yazıda, renal arteri daraltmak için poliüretan tüpü kullanarak, farelerde deneysel RAStenoz oluşturmak için cerrahi bir protokol tanımlanmıştır. Poliüretan yuvarlak tasarımlı manşet, farede darlık oluşturmak için daha tekrarlanabilir, güvenilir ve düşük maliyetli bir klipstir. Bu deneysel modelin amacı, renal arter darlığı sırasında renin ekspresyon kontrolünün moleküler ve hücresel mekanizmasını incelemek ve tanımlamaktır. RAStenosis fareleri modelinin başarısını, renin ekspresyonu ve böbrek hasarı belirteci nötrofil jelatinaz ile ilişkili lipokalini (N-GAL) ölçerek doğruladık.

<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

Renal arter darlığı, renin anjiyotensin aldosteron sisteminin (RAAS) aşırı aktive olduğu koroner veya periferik vasküler hastalığı olan hastalarda sık görülen bir durumdur. Bu bağlamda, RAAS'ta hız sınırlayıcı proteaz olan renin ekspresyonunda ve salınımında bir artışı uyaran renal arterlerde daralma vardır. Renin ekspresyonunda ortaya çıkan artış, sıklıkla böbrek hasarı ve son organ hasarı ile ilişkili olan renovasküler hipertansiyonun bilinen bir sürücüsüdür. Bu nedenle, bu durum için yeni tedaviler geliştirmeye büyük ilgi vardır. Renal arter darlığında renin kontrolünün moleküler ve hücresel mekanizması tam olarak anlaşılamamıştır ve daha fazla araştırmayı gerektirmektedir. Farelerde renal arter darlığını indüklemek için, modifiye edilmiş 2 böbrek 1 klip (2K1C) Goldblatt fare modeli geliştirilmiştir. Sağ böbrek vahşi tip farelerde stenozlandı ve sahte ameliyat edilen fareler kontrol olarak kullanıldı. Renal arter darlığı sonrası renin ekspresyonu ve böbrek hasarı saptandı. Böbrekler toplandı ve reninin protein ve mRNA ekspresyonunu belirlemek için taze korteksler kullanıldı. Bu hayvan modeli tekrarlanabilir ve renovasküler hipertansiyon ve böbrek hasarında rol oynayan patofizyolojik yanıtları, moleküler ve hücresel yolları incelemek için kullanılabilir.

Renal arter daralması, stenozlu böbrekte renin ekspresyonunu arttırırken, kontralateral böbrekte ekspresyonu baskılar. İki böbrek bir klip (2K1C) veya Goldblatt stenoz modeli, artmış renin ekspresyonuna ve böbrek hasarına neden olur. Bu, insanlarda tek taraflı renal arter darlığının en iyi temsili modeli olarak kabul edilmektedir.
Renin ve prorenin ekspresyonu (renin öncüsü) immünoblotlama kullanılarak ölçüldü. Veriler, renin ve prorenin ekspresyonunun stenozlu böbr...

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

Renal arter darlığını başlatmak için poliüretan tüp kullanılarak modifiye edilmiş 2 böbrek 1 klips (2K1C) Goldblatt fare modeli geliştirildi ve renin ekspresyonunda ve böbrek hasarında artışa neden oldu. Burada, tekrarlanabilir ve tutarlı bir 2K1C fare modeli oluşturmak için manşetin renal arter üzerine hazırlanması ve yerleştirilmesi için ayrıntılı bir prosedür açıklıyoruz.

Renal Arter Darlığında Renin Regülasyonunun Modifiye İki Böbrek Bir Klipsli Fare Modeli

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 Görüntüleme.  Vanderbilt University Medical Center. Renal arter darlığını başlatmak için poliüretan tüp kullanılarak modifiye edilmiş 2 böbrek 1 klips (2K1C) Goldblatt fare modeli geliştirildi ve renin ekspresyonunda ve böbrek hasarında artışa neden oldu. Burada, tekrarlanabilir ve tutarlı bir 2K1C fare modeli oluşturmak için manşetin renal arter üzerine hazırlanması ve yerleştirilmesi için ayrıntılı bir prosedür açıklıyoruz.

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.

İzole Renal Arter Tıkanıklığı Asılı ağırlık Sistemi

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 ...

Tıp

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.

Orta Serebral Arter Tıkanıklığı Fare Modeli

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.

Kronik Böbrek Hastalarında Vasküler Fonksiyon Değerlendirilmesi

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.

Renal İskemi Reperfüzyon Hasarı: Yaralanma Fare Modeli ve Rejenerasyon

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.

Murin Böbrek nakli Tekniği

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.

Fare modeli değiştirilmiş manşet tekniği kullanarak pankreas nakli için

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.

Fare modelleri Glomerular hastalığı böbrek fonksiyonlarının değerlendirilmesi

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.

İzometrik Contractility ölçüm tel Myography kullanarak fare mezenterik arter

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.

Yetişkin sıçan böbrek üzerinden olduğu gibi Glomeruli yalıtmak için verimli bir eleme yöntemi

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.

Böbrek Atardamarı Ile Böbreğe Doğrudan İlaç Verilmesi

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