Ratlarda ESWL sonrası böbrekte oluşan oksidatif stres hasarında N-asetil sisteinin koruyucu etkisinin araştırılması
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Dosyalar
Tarih
2015
Yazarlar
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Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada ratlarda böbreğe Ekstrakorporeal Şok Dalga Litotripsi (ESWL) uygulanmasının, oksidatif stresin bir göstergesi olan plazma oksidatif stres indeksine (OSİ) olası etkisinin ve böbrekte oluşturduğu histopatolojik değişikliklerin değerlendirilmesi amaçlanmıştır. Ayrıca koruyucu olarak N-Asetil Sistein (NAC)' in etkinliğinin araştırılması planlanmıştır. Gereç ve Yöntem: Çalışmada kontrol grubu (grup I, n: 6 ), ESWL grubu (Grup II, n: 9) ve ESWL+NAC grubu (Grup III, n: 9) olarak toplam 24 adet adet rat kullanıldı. Tüm grublar; erken dönem ve geç dönem olarak 2 alt gruba ayrıldı. Grup II ve III' deki ratlara anestezi altında ratların kuyruk venine yerleştirilen intravenöz kateterden kontrast madde verilerek floroskopi altında toplayıcı sistemin görüntülenmesi sağlandı. Sol böbreklerine 18 kV şiddetinde, 60 SW/dakika toplam 2000 şok dalgası uygulandı. Grup I deki ratlara herhangibir sistemik tedavi verilmedi, Grup II deki ratlara ESWL sonrası 1. günden başlanarak 1cc/kg/gün dozunda interaperitoneal salin, grup III deki ratlara ESWL sonrası 1. günden başlanarak 300 mg/kg/gün dozunda interaperitoneal N-asetil sistein verildi. Erken dönem alt gruplara ESWL sonrası 14. günde, geç dönem alt gruplara ise 28. günde kan alma ve sol nefrektomi yapılarak biyokimyasal analiz ve spesimenler histopatolojik olarak incelendi. Çalışmada akut ve kronik hasar ayrı ayrı değerlendirildi. Histopatolojik hasar değerlendirilmesi için tübüler hasar, interstisyel inflamasyon ve kanama, glomerüler ve vasküler yapılarda dilatasyon – konjesyon, inflamatuar hücre artışı, tubüler atrofi ve interstisyel fibrozis incelenirken, plazmadan total antioksidan kapasite (TAS) ve total oksidan kapasite (TOS) ölçümü yapılarak oksidatif stres indexi (OSİ) hesaplandı. Bulgular: ESWL uygulaması sonrası NAC verilen grupta (grup III), TOS düzeyi anlamlı derecede daha düşük bulunurken (p = 0,027), TAS seviyesinin anlamlı derecede daha yüksek olduğu saptanmıştır (p =0,006). Bunun sonucu olarak OSİ anlamlı derecede daha düşük bulunmuştur (p =0,013). Bu etki özellikle erken dönemde daha belirgindir. Tübüler hasarın ESWL grubunda daha yüksek olduğu sonucuna varılmıştır (p=0,022). Gruplar arasında intertisyel inflamasyon, konjesyon, inflamatuar hücre artışı, fibrozis ve atrofi değişkenleri ortancaları bakımından anlamlı bir farklılığa rastlanmamıştır. Sonuç: Bu çalışmada, böbreğe ESWL uygulamasının serbest oksijen radikal oluşumunu artırıp, oksidatif strese yol açabileceği ve tübüler hasara sebep olabileceği göstermiştir. ESWL'ye bağlı oksidatif stresin ve tübüler hasarın azaltılmasında NAC etkili bulunmuştur.
Aim: The aim of this study was to evaluate the possible effects of renal extracorporeal shock wave lithotripsy (ESWL) on the plasma oxidative stress index (OSI) as a marker for oxidative stress, and to obseve the histopathological changes that occur in the kidneys. Secondly, the protective role of N-acetyl-cysteine administration was evaluatied. Material-method: The current study included 24 rats. These rats divided into 3 groups as the control group (Group I, n: 6), ESWL group (Group II, n: 9), and ESWL+NAC group (Group III, n: 9). All groups were further divided into two subgroups as short-term and long-term. In Groups II and III, contrast material was administered through an intravenous catheter that was placed in the vein of the rat tail, and a collecting system was visualized under fluoroscopy with general anesthesia. A total of 2000 shock waves were applied to the left kidney with at an amplitude of 18 kV and a rate of 60 SW/minute. From the 1st day after ESWL, intraperitoneal saline at a dose of 1 ml/kg/day was administered to the rats in Group II, intraperitoneal N-acetyl cysteine at a dose of 300 mg/kg/day was given to Group III and no treatment was administered to Group I. Blood samples were taken and left nephrectomy specimens were obtained for blood biochemical analyses and histopathological examinations on the 14th day following ESWL in the short-term subgroups and on the 28th day following ESWL in the long-term subgroups, respectively. Acute and chronic damage were evaluated individually. Tubular damage, interstitial inflammation and hemorrhage, dilatation-congestion in the glomerular and vascular structures, increase in inflammatory cells, tubular atrophy, and interstitial fibrosis were examined for histopathological damage. The oxidative stress index (OSI) was calculated by measuring plasma total antioxidant status (TAS) and total oxidant status (TOS). Results: In the group in which NAC was administered following ESWL (Group III), TOS levels were significantly lower (p = 0.027) and TAS levels were significantly higher (p =0.006). As a result, OSI was lower (p =0.013). This effect was particularly significant in the short-term sugroup. It was also concluded that tubular damage was higher in the ESWL group (p=0.022). No significant difference was observed between the median values of the groups in terms of interstitial inflammation, congestion, increase in inflammatory cells, fibrosis, and atrophic changes. Conclusion: Current study demonstrated that ESWL can cause oxidative stress and tubular damage by increasing free oxygen radical production. NAC was effective in decreasing ESWL-induced oxidative stress and tubular damage.
Aim: The aim of this study was to evaluate the possible effects of renal extracorporeal shock wave lithotripsy (ESWL) on the plasma oxidative stress index (OSI) as a marker for oxidative stress, and to obseve the histopathological changes that occur in the kidneys. Secondly, the protective role of N-acetyl-cysteine administration was evaluatied. Material-method: The current study included 24 rats. These rats divided into 3 groups as the control group (Group I, n: 6), ESWL group (Group II, n: 9), and ESWL+NAC group (Group III, n: 9). All groups were further divided into two subgroups as short-term and long-term. In Groups II and III, contrast material was administered through an intravenous catheter that was placed in the vein of the rat tail, and a collecting system was visualized under fluoroscopy with general anesthesia. A total of 2000 shock waves were applied to the left kidney with at an amplitude of 18 kV and a rate of 60 SW/minute. From the 1st day after ESWL, intraperitoneal saline at a dose of 1 ml/kg/day was administered to the rats in Group II, intraperitoneal N-acetyl cysteine at a dose of 300 mg/kg/day was given to Group III and no treatment was administered to Group I. Blood samples were taken and left nephrectomy specimens were obtained for blood biochemical analyses and histopathological examinations on the 14th day following ESWL in the short-term subgroups and on the 28th day following ESWL in the long-term subgroups, respectively. Acute and chronic damage were evaluated individually. Tubular damage, interstitial inflammation and hemorrhage, dilatation-congestion in the glomerular and vascular structures, increase in inflammatory cells, tubular atrophy, and interstitial fibrosis were examined for histopathological damage. The oxidative stress index (OSI) was calculated by measuring plasma total antioxidant status (TAS) and total oxidant status (TOS). Results: In the group in which NAC was administered following ESWL (Group III), TOS levels were significantly lower (p = 0.027) and TAS levels were significantly higher (p =0.006). As a result, OSI was lower (p =0.013). This effect was particularly significant in the short-term sugroup. It was also concluded that tubular damage was higher in the ESWL group (p=0.022). No significant difference was observed between the median values of the groups in terms of interstitial inflammation, congestion, increase in inflammatory cells, fibrosis, and atrophic changes. Conclusion: Current study demonstrated that ESWL can cause oxidative stress and tubular damage by increasing free oxygen radical production. NAC was effective in decreasing ESWL-induced oxidative stress and tubular damage.
Açıklama
YÖK Tez No: 394010
Anahtar Kelimeler
Üroloji, Urology, Böbrek hastalıkları, Kidney diseases, Böbrek taşları, Kidney calculi, ESWL, ESWL, N-asetilsistein, N-acetylcysteine, Oksidatif hasar, Oxidative damage, Sıçanlar, Rats, vücut dışı şok dalga ile taş kırma, böbrek, oksidatif stres, sıçan, Extracorporeal shock wave lithotripsy, kidney, oxidative stress, rat
