Administration of a single dose of lithium ameliorates rhabdomyolysis-associated acute kidney injury in rats

PLoS One. 2023 Feb 16;18(2):e0281679. doi: 10.1371/journal.pone.0281679. eCollection 2023.

Abstract

Rhabdomyolysis is characterized by muscle damage and leads to acute kidney injury (AKI). Clinical and experimental studies suggest that glycogen synthase kinase 3β (GSK3β) inhibition protects against AKI basically through its critical role in tubular epithelial cell apoptosis, inflammation and fibrosis. Treatment with a single dose of lithium, an inhibitor of GSK3β, accelerated recovery of renal function in cisplatin and ischemic/reperfusion-induced AKI models. We aimed to evaluate the efficacy of a single dose of lithium in the treatment of rhabdomyolysis-induced AKI. Male Wistar rats were allocated to four groups: Sham, received saline 0.9% intraperitoneally (IP); lithium (Li), received a single IP injection of lithium chloride (LiCl) 80 mg/kg body weight (BW); glycerol (Gly), received a single dose of glycerol 50% 5 mL/kg BW intramuscular (IM); glycerol plus lithium (Gly+Li), received a single dose of glycerol 50% IM plus LiCl IP injected 2 hours after glycerol administration. After 24 hours, we performed inulin clearance experiments and collected blood / kidney / muscle samples. Gly rats exhibited renal function impairment accompanied by kidney injury, inflammation and alterations in signaling pathways for apoptosis and redox state balance. Gly+Li rats showed a remarkable improvement in renal function as well as kidney injury score, diminished CPK levels and an overstated decrease of renal and muscle GSK3β protein expression. Furthermore, administration of lithium lowered the amount of macrophage infiltrate, reduced NFκB and caspase renal protein expression and increased the antioxidant component MnSOD. Lithium treatment attenuated renal dysfunction in rhabdomyolysis-associated AKI by improving inulin clearance and reducing CPK levels, inflammation, apoptosis and oxidative stress. These therapeutic effects were due to the inhibition of GSK3β and possibly associated with a decrease in muscle injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury* / complications
  • Acute Kidney Injury* / drug therapy
  • Animals
  • Apoptosis
  • Glycerol / pharmacology
  • Glycogen Synthase Kinase 3 beta
  • Inflammation / complications
  • Inflammation / drug therapy
  • Inflammation / metabolism
  • Inulin / pharmacology
  • Kidney / metabolism
  • Lithium / pharmacology
  • Lithium / therapeutic use
  • Male
  • Rats
  • Rats, Wistar
  • Rhabdomyolysis* / chemically induced
  • Rhabdomyolysis* / complications
  • Rhabdomyolysis* / drug therapy

Substances

  • Lithium
  • Glycogen Synthase Kinase 3 beta
  • Glycerol
  • Inulin

Grants and funding

This work was supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP; grant number 2015/11933-3 and the Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq; grant number 302599/2018-5.