RESUMEN
Snakebites have been recognized as a neglected public health problem in several tropical and subtropical countries. Bothrops snakebites frequently complicate with acute kidney injury (AKI) with relevant morbidity and mortality. To date, the only treatment available for Bothrops envenomation is the intravenous administration of antivenom despite its several limitations. Therefore, the study of novel therapies in Bothrops envenomation is compelling. The aim of this study was to evaluate the protective effect of Allopurinol (Allo) in an experimental model of Bothrops jararaca venom (BJ)-associated AKI. Five groups of Wistar rats were studied: Sham, Allo, BJ, BJ+Allo, BJ+ipAllo. BJ (0.25 mg/kg) was intravenously injected during 40'. Saline at same dose and infusion rate was administered to Sham and Allo groups. Allo and BJ+Allo groups received Allo (300 mg/L) in the drinking water 7 days prior to Saline or BJ infusion respectively. BJ+ipAllo rats received intraperitoneal Allo (25 mg/Kg) 40' after BJ infusion. BJ rats showed markedly reduced glomerular filtration rate (GFR, inulin clearance) associated with intense renal vasoconstriction, hemolysis, hemoglobinuria, reduced glutathione and increased systemic and renal markers of nitro-oxidative stress (Nitrotyrosine). Allo ameliorated GFR, renal blood flow (RBF), renal vascular resistance and arterial lactate levels. In addition, Allo was associated with increased serum glutathione as well as reduced levels of plasma and renal Nitrotyrosine. Our data show that Allo attenuated BJ-associated AKI, reduced oxidative stress, improved renal hemodynamics and organ perfusion. It might represent a novel adjuvant approach for Bothrops envenomation, a new use for an old and widely available drug.
Asunto(s)
Lesión Renal Aguda/tratamiento farmacológico , Alopurinol/farmacología , Antioxidantes/farmacología , Bothrops , Venenos de Crotálidos/toxicidad , Lesión Renal Aguda/inducido químicamente , Lesión Renal Aguda/fisiopatología , Alopurinol/uso terapéutico , Animales , Antioxidantes/uso terapéutico , Tasa de Filtración Glomerular/efectos de los fármacos , Glutatión/sangre , Hemólisis , Riñón/irrigación sanguínea , Riñón/fisiopatología , Ácido Láctico/sangre , Masculino , Estrés Oxidativo/efectos de los fármacos , Ratas Wistar , Tirosina/análogos & derivados , Tirosina/sangreRESUMEN
AIMS: We systematically reviewed the role of low-level laser therapy (LLLT) in cardiac remodeling after myocardial infarction. MAIN METHODS: Literatures were systematically searched in several electronic databases. We included only studies with a well-standardized coronary occlusion model in vivo LLLT application. KEY FINDINGS: After screening, 14 studies were eligible for review. The study heterogeneity was described in terms of rationality, gender, irradiation parameters, treatment numbers and moment of LLLT application. Three studies showed a null role of LLLT on infarct size, and only one study found positive LLLT effects on the cardiac performance. The cardioprotective role of LLLT was mediated by anti-inflammatory, pro-angiogenic and anti-oxidant actions. SIGNIFICANCE: The reduction in infarct size is a major finding. The LLLT cardioprotection may be mediated by several molecular and cellular mechanisms. Although these results are exciting, there are many limitations that must be resolved before LLLT clinical trials.
Asunto(s)
Terapia por Láser/métodos , Infarto del Miocardio/terapia , Remodelación Ventricular , Animales , Humanos , Terapia por Luz de Baja Intensidad , Infarto del Miocardio/patologíaRESUMEN
Low-level laser therapy (LLLT) has been used as an anti-inflammatory treatment in several disease conditions, even when inflammation is a secondary consequence, such as in myocardial infarction (MI). However, the mechanism by which LLLT is able to protect the remaining myocardium remains unclear. The present study tested the hypothesis that LLLT reduces inflammation after acute MI in female rats and ameliorates cardiac function. The potential participation of the Renin-Angiotensin System (RAS) and Kallikrein-Kinin System (KKS) vasoactive peptides was also evaluated. LLLT treatment effectively reduced MI size, attenuated the systolic dysfunction after MI, and decreased the myocardial mRNA expression of interleukin-1 beta and interleukin-6 in comparison to the non-irradiated rat tissue. In addition, LLLT treatment increased protein and mRNA levels of the Mas receptor, the mRNA expression of kinin B2 receptors and the circulating levels of plasma kallikrein compared to non-treated post-MI rats. On the other hand, the kinin B1 receptor mRNA expression decreased after LLLT. No significant changes were found in the expression of vascular endothelial growth factor (VEGF) in the myocardial remote area between laser-irradiated and non-irradiated post-MI rats. Capillaries density also remained similar between these two experimental groups. The mRNA expression of the inducible nitric oxide synthase (iNOS) was increased three days after MI, however, this effect was blunted by LLLT. Moreover, endothelial NOS mRNA content increased after LLLT. Plasma nitric oxide metabolites (NOx) concentration was increased three days after MI in non-treated rats and increased even further by LLLT treatment. Our data suggest that LLLT diminishes the acute inflammation in the myocardium, reduces infarct size and attenuates left ventricle dysfunction post-MI and increases vasoactive peptides expression and nitric oxide (NO) generation.