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Ticagrelor Protects against Sepsis-Induced Acute Kidney Injury through an Adenosine Receptor-Dependent Pathway

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Abstract

Objective

Ticagrelor is a widely used anti-platelet drug. However, the mechanisms by which ticagrelor protects against sepsis-induced acute kidney injury (AKI) have not been clearly demonstrated. We designed this study to explore the protective effect of ticagrelor on sepsis-induced AKI and to explore the underlying mechanisms.

Methods

C57BL6J mice received oral ticagrelor (20 mg/kg and 50 mg/kg) for 7 days, and then caecal ligation and puncture (CLP) were performed. An adenosine receptor antagonist, CGS15943, was administered (10 mg/kg, intraperitoneal injection) to block the adenosine pathway 2 h before CLP. After 24 h, serum creatinine levels were measured. Periodic acid-Schiff (PAS) staining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining were employed to analyze pathological changes and cell apoptosis. Serum concentrations of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and mRNA expression of tissue TNF-α and IL-1β were detected. Western blotting analysis was used to determine AKT and mammalian target of rapamycin (mTOR) protein expression in the kidney.

Results

PAS staining showed less swelling of renal tubules, and TUNEL staining revealed less cell apoptosis in the ticagrelor group than in the CLP group. Serum creatinine levels were significantly lower in the ticagrelor group than in the CLP group. Moreover, significantly lower serum and kidney levels of TNF-α and IL-1β were observed in the ticagrelor group. CGS15943 blocked the effects of ticagrelor. Western blotting analysis showed increased phosphorylation of AKT and mTOR in the kidneys of the 50 mg/kg ticagrelor group. The adenosine receptor antagonist inhibited the activation of AKT and mTOR.

Conclusion

This study demonstrates that the protective effect of ticagrelor on sepsis-induced AKI depends on adenosine receptor activation and the subsequent increase of AKT and mTOR phosphorylation.

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Author notes

  1. The authors contributed equally to this study.

Authors and Affiliations

  1. Department of Nephrology, Yi Ji Shan Hospital affiliated to Wan Nan Medical College, Wuhu, 241000, China

    Yu-han Cao & Yu-wei Wang

  2. Key Laboratory of Non-coding RNA Transformation Research of Anhui Higher Education Institution, Wan Nan Medical College, Wuhu, 241000, China

    Yu-han Cao & Cong Fu

  3. Department of Critical Care Medicine, Yi Ji Shan Hospital affiliated to Wan Nan Medical College, Wuhu, 241000, China

    Qian-cheng Xu

  4. Department of Cardiology, Yi Ji Shan Hospital Affiliated to Wan Nan Medical College, Wuhu, 241000, China

    Yang Ling & Cong Fu

Authors
  1. Yu-han Cao
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  2. Qian-cheng Xu
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  3. Yu-wei Wang
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  4. Yang Ling
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  5. Cong Fu
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Corresponding author

Correspondence to Yu-han Cao.

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Conflict of Interest Statement

The authors declare that there is no conflict of interest with any financial organization or corporation or individual that can inappropriately influence this work.

This study was supported by grants from the National Natural Science Foundation of China (No. 81700265 to Cong FU and No. 81702092 to Yu-han CAO).

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Cao, Yh., Xu, Qc., Wang, Yw. et al. Ticagrelor Protects against Sepsis-Induced Acute Kidney Injury through an Adenosine Receptor-Dependent Pathway. CURR MED SCI 42, 505–512 (2022). https://doi.org/10.1007/s11596-022-2516-5

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  • DOI: https://doi.org/10.1007/s11596-022-2516-5

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