Ultrasound prevents renal ischemia-reperfusion injury by stimulating the splenic cholinergic anti-inflammatory pathway

J Am Soc Nephrol. 2013 Sep;24(9):1451-60. doi: 10.1681/ASN.2013010084. Epub 2013 Aug 1.

Abstract

AKI affects both quality of life and health care costs and is an independent risk factor for mortality. At present, there are few effective treatment options for AKI. Here, we describe a nonpharmacologic, noninvasive, ultrasound-based method to prevent renal ischemia-reperfusion injury in mice, which is a model for human AKI. We exposed anesthetized mice to an ultrasound protocol 24 hours before renal ischemia. After 24 hours of reperfusion, ultrasound-treated mice exhibited preserved kidney morphology and function compared with sham-treated mice. Ultrasound exposure before renal ischemia reduced the accumulation of CD11b(+)Ly6G(high) neutrophils and CD11b(+)F4/80(high) myeloid cells in kidney tissue. Furthermore, splenectomy and adoptive transfer studies revealed that the spleen and CD4(+) T cells mediated the protective effects of ultrasound. Last, blockade or genetic deficiency of the α7 nicotinic acetylcholine receptor abrogated the protective effect of ultrasound, suggesting the involvement of the cholinergic anti-inflammatory pathway. Taken together, these results suggest that an ultrasound-based treatment could have therapeutic potential for the prevention of AKI, possibly by stimulating a splenic anti-inflammatory pathway.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Kidney Injury / metabolism
  • Acute Kidney Injury / pathology
  • Acute Kidney Injury / prevention & control
  • Animals
  • CD11b Antigen / metabolism
  • CD4-Positive T-Lymphocytes / pathology
  • CD4-Positive T-Lymphocytes / physiology
  • Disease Models, Animal
  • Kidney / blood supply*
  • Kidney / metabolism
  • Kidney / pathology*
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Myeloid Cells / immunology
  • Myeloid Cells / pathology
  • Neutrophils / immunology
  • Neutrophils / pathology
  • Receptors, Cholinergic / deficiency
  • Receptors, Cholinergic / genetics
  • Receptors, Cholinergic / physiology*
  • Receptors, Nicotinic / deficiency
  • Receptors, Nicotinic / genetics
  • Receptors, Nicotinic / physiology
  • Reperfusion Injury / metabolism
  • Reperfusion Injury / pathology
  • Reperfusion Injury / prevention & control*
  • Signal Transduction / physiology*
  • Spleen / physiology*
  • Spleen / surgery
  • Splenectomy
  • Ultrasonic Therapy*
  • alpha7 Nicotinic Acetylcholine Receptor

Substances

  • CD11b Antigen
  • Chrna7 protein, human
  • Chrna7 protein, mouse
  • Receptors, Cholinergic
  • Receptors, Nicotinic
  • alpha7 Nicotinic Acetylcholine Receptor