Fluid resuscitation with preventive peritoneal dialysis attenuates crush injury-related acute kidney injury and improves survival outcome

Zhou, Xianlong; Ni, Shao-Zhou; Xiong, Dan; Cheng, Xueqi; Xu, Peng; Zhao, Yan

doi:10.1186/s13049-019-0644-0

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…Crush syndrome is frequently related to acute kidney injury. Unfortunately, there are no specific treatments for CS-AKI and affected patients’ managements are mainly symptomatic [ 22 ]. Researches indicated that myoglobin is involved in the pathophysiology of AKI and acts as a molecule of damage-associated molecular patterns (DAMPs) [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Myoglobin promotes macrophage polarization to M1 type and pyroptosis via the RIG-I/Caspase1/GSDMD signaling pathway in CS-AKI

Chen

Geng

et al. 2022

Cell Death Discov.

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Crush syndrome (CS) is a life-threatening illness in traffic accidents and earthquakes. Crush syndrome-induced acute kidney injury (CS-AKI) is considered to be mainly due to myoglobin (Mb) circulation and deposition after skeletal muscle ruptures and releases. Macrophages are the primary immune cells that fight foreign substances and play critical roles in regulating the body’s natural immune response. However, what effect does myoglobin have on macrophages and the mechanisms involved in the CS-AKI remain unclear. This study aims to look into how myoglobin affects macrophages of the CS-AKI model. C57BL/6 mice were used to construct the CS-AKI model by digital crush platform. Biochemical analysis and renal histology confirmed the successful establishment of the CS-AKI mouse model. Ferrous myoglobin was used to treat Raw264.7 macrophages to mimic the CS-AKI cell model in vitro. The macrophage polarization toward M1 type and activation of RIG-I as myoglobin sensor were verified by real-time quantitative PCR (qPCR), Western blotting (WB), and immunofluorescence (IF). Macrophage pyroptosis was observed under light microscopy. The interaction between RIG-I and caspase1 was subsequently explored by co-immunoprecipitation (Co-IP) and IF. Small interfering RNA (siRIG-I) and pyroptosis inhibitor dimethyl fumarate (DMF) were used to verify the role of macrophage polarization and pyroptosis in CS-AKI. In the kidney tissue of CS-AKI mice, macrophage infiltration and M1 type were found. We also detected that in the cell model of CS-AKI in vitro, ferrous myoglobin treatment promoted macrophages polarization to M1. Meanwhile, we observed pyroptosis, and myoglobin activated the RIG-I/Caspase1/GSDMD signaling pathway. In addition, pyroptosis inhibitor DMF not only alleviated kidney injury of CS-AKI mice but also inhibited macrophage polarization to M1 phenotype and pyroptosis via the RIG-I/Caspase1/GSDMD signaling pathway. Our research found that myoglobin promotes macrophage polarization to M1 type and pyroptosis via the RIG-I/Caspase1/GSDMD signaling pathway in CS-AKI.

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Section: Discussionmentioning

confidence: 99%

Myoglobin promotes macrophage polarization to M1 type and pyroptosis via the RIG-I/Caspase1/GSDMD signaling pathway in CS-AKI

Chen

Geng

et al. 2022

Cell Death Discov.

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“…Recognize crush syndrome – all crush victims should be accepted in the hospital; appropriate fluid compensation may prevent crush-related acute kidney injury (AKI) and prevent the need of dialysis ( 24 ).…”

Section: Triage Principles (Adapted Based On Haller ...mentioning

confidence: 99%

Crush Syndrome in Earthquakes – Stay and Play or Load and Go?

Nola

2023

ACC

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Earthquakes are unpredictable natural disasters accompanied by material damage and many victims. In the case of a person remaining trapped under the collapsed material, the development of crush syndrome can occur. Crush syndrome is the result of traumatic rhabdomyolysis and is present in 2%-15% of all injured persons in an earthquake. It is not easy to recognize, and proper treatment is challenging. Persons who have a clear crush injury and/or have been immobilized for more than four hours should be considered potential victims of crush syndrome. Therefore, knowledge about crush syndrome must be comprehensive and accessible to all parties involved. In this paper, the management of crush syndrome victims, which includes the principles of triage, and medical and logistic principles as well, is presented. Triage principles are presented at the level of triage priorities, places, and diagnoses. Medical principles, crucial for crush syndrome, are presented regarding the duration of compression and time before or after extraction of the patient. Logistic principles provide an overview of the priorities and modes of transport in relation to distance of health institutions, and the importance of management and education associated with crush syndrome. Each country with recognized disasters (natural or manmade) in which crush-related victims are expected, will benefit if the knowledge about triage, medical and logistic principles for crush syndrome is incorporated in their educational programs and regularly updated.

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“…Decompression is accompanied by restoring blood flow in the damaged limbs and by release of toxic compounds, including peptides, formed during anaerobic proteolysis of myoglobin, which penetrate into the blood, causing toxemia and systemic pathological changes [42]. The combination of peritoneal dialysis and massive fluid resuscitation is used to reduce lactic acidosis, serum levels of myoglobin and K þ and myoglobin-derived toxic peptides, which protect against tissue damage increasing the survival of animals with long-term crush injuries [43]. We revealed four toxic peptides resulting from anaerobic cleavage of muscle myoglobin after long-term compression (more than 2-5 h), accompanied by ischemia and necrosis, resulting in MI and cardiac arrest [44].…”

Section: The Effect Of Hypothalamic Peptides On Heart Damage Following Crush Syndromementioning

confidence: 99%

The effect of hypothalamic peptides, neurohormone C and proline-rich peptide-1on the Ca2+-handling system in heartin pathophysiological conditions

Guevorkian

2020

Heliyon

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Institute of Biochemistry named after H. Buniatyan we discovered and studied hypothalamic peptides with coronary dilatory and antioxidant activities:neurohormone C (NC) and proline-rich peptide-1 (PRP-1). Both NC and PRP-1 exhibit cardioprotective effects, in part by restoring the calcium affinity for calcium-binding membrane proteins in cardiomyocytes. This affinity is diminished in the sarcoplasmic reticulum and mitochondriawith myocardial damage, heart failure, pancreatic necrosis and crush syndrome caused by isoproterenol. The peptides can also destroy the four detected toxic peptides and myocardial depressant factor, and protect against ischemiareperfusion injury. Further studies of these peptides may be promising for the treatment of patients at high risk of cardiovascular disease, regardless of pathology.

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Fluid resuscitation with preventive peritoneal dialysis attenuates crush injury-related acute kidney injury and improves survival outcome

Cited by 6 publications

References 27 publications

Myoglobin promotes macrophage polarization to M1 type and pyroptosis via the RIG-I/Caspase1/GSDMD signaling pathway in CS-AKI

Myoglobin promotes macrophage polarization to M1 type and pyroptosis via the RIG-I/Caspase1/GSDMD signaling pathway in CS-AKI

Crush Syndrome in Earthquakes – Stay and Play or Load and Go?

The effect of hypothalamic peptides, neurohormone C and proline-rich peptide-1on the Ca2+-handling system in heartin pathophysiological conditions

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