The high-mobility group protein B1-Toll-like receptor 4 pathway contributes to the acute lung injury induced by bilateral nephrectomy

Kidney Int. 2014 Aug;86(2):316-26. doi: 10.1038/ki.2014.62. Epub 2014 Mar 19.

Abstract

Acute lung injury and acute kidney injury are severe complications in critically ill patients and synergistically increase mortality in intensive care units. Organ cross-talk between the kidney and the lung has been implicated recently as amplifying injury in each organ. Here we sought to identify a possible mechanism of acute kidney injury-induced acute lung injury using a mouse bilateral nephrectomy model. Toll-like receptor 4 (TLR4)-mutant C3H/HeJ mice were more resistant to lung injury including neutrophil infiltration, increased neutrophil elastase activity, and vascular permeability caused by bilateral nephrectomy compared with TLR4-wild-type C3H/HeN mice 6 h after surgery. High-mobility group protein B1 (HMGB1) is one agonist for TLR4. Its blood concentrations were increased significantly by bilateral nephrectomy. Blockade of HMGB1 by neutralizing antibody reduced neutrophil infiltration in TLR4-wild-type C3H/HeN but not in TLR4-mutant C3H/HeJ mice. However, HMGB1 blockade in a renal ischemia reperfusion model reduced pulmonary neutrophil infiltration independent from TLR4. Thus, an enhanced HMGB1-TLR4 pathway contributes to lung injury induced by bilateral nephrectomy and the other HMGB1-dependent pathway exists in pulmonary neutrophil infiltration caused by renal ischemia reperfusion. Targeting the HMGB1-TLR4 pathway might enable development of a new therapeutic strategy to improve the outcomes of severely ill patients with both acute lung and acute kidney injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Lung Injury / etiology*
  • Acute Lung Injury / pathology
  • Acute Lung Injury / physiopathology
  • Animals
  • Antibodies, Neutralizing / administration & dosage
  • Capillary Permeability
  • Cytokines / genetics
  • Disease Models, Animal
  • Gene Expression
  • HMGB1 Protein / antagonists & inhibitors
  • HMGB1 Protein / metabolism*
  • Humans
  • Kidney / injuries
  • Kidney / physiopathology
  • Lipid Peroxidation
  • Male
  • Mice
  • Mice, Inbred C3H
  • Mice, Mutant Strains
  • Mutation
  • Nephrectomy / adverse effects*
  • Neutrophil Infiltration
  • Signal Transduction
  • Toll-Like Receptor 4 / genetics
  • Toll-Like Receptor 4 / metabolism*

Substances

  • Antibodies, Neutralizing
  • Cytokines
  • HMGB1 Protein
  • HMGB1 protein, mouse
  • Tlr4 protein, mouse
  • Toll-Like Receptor 4