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Am J Physiol Renal Physiol 291: F546-F556, 2006. First published April 25, 2006; doi:10.1152/ajprenal.00072.2006
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Acute renal failure: determinants and characteristics of the injury-induced hyperinflammatory response

Richard A. Zager,1,2 Ali C. M. Johnson,2 Steve Lund,2 and Sherry Hanson2

1Department of Medicine, University of Washington, and the 2Fred Hutchinson Cancer Research Center, Seattle, Washington

Submitted 28 February 2006 ; accepted in final form 19 April 2006

Acute renal failure (ARF) markedly sensitizes mice to endotoxin (LPS), as evidenced by exaggerated renal cytokine/chemokine production. This study sought to further characterize this state by testing the following: 1) does anti-inflammatory heme oxygenase-1 (HO-1) upregulation in selected ARF models prevent this response? 2) Is the ARF hyperresponsive state specifically triggered by LPS? 3) Does excess iNOS activity/protein nitrosylation participate in this phenomenon? and 4) are upregulated Toll receptors involved? Mice with either 1) rhabdomyolysis-induced ARF (massive HO-1 overexpression), 2) cisplatin nephrotoxicity, 3) or HO-1 inhibition (Sn protoporphyrin) were challenged with either LPS (a TLR4 ligand), lipoteichoic acid (LTA; a TLR2 ligand), or vehicle. Two hours later, renal and plasma TNF-{alpha}/mRNA, MCP-1/mRNA, renal nitrotyrosine/iNOS mRNA, and plasma cytokines were assessed. Renal TLR4 was gauged by mRNA and Western blot analysis. Both ARF models markedly hyperresponded to both LPS and LTA, culminating in exaggerated TNF-{alpha}, MCP-1, and iNOS/nitrotryosine increments. This was despite the fact that HO-1 exerted anti-inflammatory effects. TLR4 levels were either normal (cisplatin), or markedly depressed (~50%; rhabdomyolysis) in the ARF kidneys, despite the LPS hyperresponsive state. 1) The ARF kidney can hyperrespond to chemically dissimilar Toll ligands; 2) HO-1 does not prevent this response; 3) excess NO/protein nitrosylation can result; and 4) this hyperresponsiveness can be expressed with either normal or reduced renal TLR4 expression. This suggests that diverse signaling pathways may be involved.

endotoxin; lipoteichoic acid; iNOS; tumor necrosis factor-{alpha}; monocyte chemoattractant protein-1


Address for reprint requests and other correspondence: R. A. Zager, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N, Rm. D2-190, Seattle, WA 98109-1024 (e-mail: dzager{at}fhcrc.org)




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