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Publication : C-reactive protein exacerbates renal ischemia-reperfusion injury.

First Author  Pegues MA Year  2013
Journal  Am J Physiol Renal Physiol Volume  304
Issue  11 Pages  F1358-65
PubMed ID  23535585 Mgi Jnum  J:197251
Mgi Id  MGI:5491972 Doi  10.1152/ajprenal.00476.2012
Citation  Pegues MA, et al. (2013) C-reactive protein exacerbates renal ischemia-reperfusion injury. Am J Physiol Renal Physiol 304(11):F1358-65
abstractText  Renal ischemia-reperfusion injury (IRI) is a common cause of acute kidney injury (AKI), occurring with hypotension and cardiovascular surgery and inevitably during kidney transplantation. Mortality from AKI is high due to incomplete knowledge of the pathogenesis of IRI and the lack of an effective therapy. Inflammation accompanies IRI and increases the blood level of C-reactive protein (CRP), a biomarker of worsened outcomes in AKI. To test if CRP is causal in AKI we subjected wild-type mice (WT) and human CRP transgenic mice (CRPtg) to bilateral renal IRI (both pedicles clamped for 30 min at 37 degrees C then reperfused for 24 h). Serum human CRP level was increased approximately sixfold after IRI in CRPtg (10.62 +/- 1.31 mug/ml at baseline vs. 72.01 +/- 9.41 mug/ml at 24 h) but was not elevated by sham surgery wherein kidneys were manipulated but not clamped. Compared with WT, serum creatinine, urine albumin, and histological evidence of kidney damage were increased after IRI in CRPtg mice. RT-PCR analysis of mRNA isolated from whole kidneys of CRPtg and WT subjected to IRI revealed that in CRPtg kidneys 1) upregulation of markers of macrophage classical activation (M1 markers) was blunted, 2) downregulation of markers of macrophage alternative activation (M2 markers) was more robust, and 3) expression of the activating receptor FcgammaRI was increased. Our finding that CRP exacerbates IRI-induced AKI, perhaps by shifting the balance of macrophage activation and FcgammaR expression towards a detrimental portfolio, might make CRP a promising therapeutic target for the treatment of AKI.
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