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Leukocyte recruitment and acute renal failure

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Abstract

Despite advances in medical technology, acute renal failure (ARF) still represents a major challenge in clinical medicine, as morbidity and mortality have remained unchanged over the past two decades. The pathophysiology of ARF is highly complex and only poorly understood; new insights into the pathophysiology of ARF are therefore of utmost importance to develop better understanding and therapies. Acute tubular necrosis (ATN) is the predominant cause of ARF and often arises as a consequence of septic, toxic, or ischemic insults. The recruitment of leukocytes into the kidney has recently emerged as a key event in the development of experimental ischemic and septic ARF. A few descriptive clinical studies support this idea. However, the clinical relevance of various animal models remains unclear, as does the importance of different leukocyte subsets, and even methodological aspects as how to quantify renal leukocyte recruitment. This review summarizes and critically evaluates experimental findings that provide insight into the role of leukocytes and their recruitment during ARF. We aim to provide a valid description of ARF, illustrate animal models of ARF, review qualitative and quantitative methods to assess renal leukocyte recruitment, and discuss the components of the leukocyte recruitment cascade and their role in ARF.

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Abbreviations

ARF :

Acute renal failure

ATN :

Acute tubular necrosis

ICAM :

Intercellular adhesion molecule

I-R :

Ischemia-reperfusion

LPS :

Lipopolysaccharide

MPO :

Myeloperoxidase

MSH :

Melanocyte-stimulating hormone

PAF :

Platelet-activating factor

PMN :

Neutrophil

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Acknowledgements

Our original work on ARF was supported by the Deutsche Forschungsgemeinschaft (DFG SI-680/1-1 to K.S.) and National Institutes of Health (NIH HL S4136 to K.L.).

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  1. Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Münster, Albert-Schweitzer-Strasse 33, 48129, Münster, Germany

    Kai Singbartl

  2. Cardiovascular Research Center, University of Virginia, Charlottesville, Virginia, USA

    Klaus Ley

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Correspondence to Kai Singbartl.

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Singbartl, K., Ley, K. Leukocyte recruitment and acute renal failure. J Mol Med 82, 91–101 (2004). https://doi.org/10.1007/s00109-003-0498-8

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