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oai:repisalud.isciii.es:20.500.12105/91742024-11-29T09:55:09Zcom_20.500.12105_2052com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19609col_20.500.12105_16977col_20.500.12105_16980col_20.500.12105_16982

00925njm 22002777a 4500 dc Rubio-Navarro, Alfonso author Vázquez-Carballo, Cristina author Guerrero-Hue, Melania author García-Caballero, Cristina author Herencia, Carmen author Gutiérrez, Eduardo author Yuste, Claudia author Sevillano, Ángel author Praga, Manuel author Egea, Javier author Cannata, Pablo author Cortegano, Isabel author Andres, Belen de author Gaspar, Maria Luisa author Cadenas, Susana author Michalska, Patrycja author León, Rafael author Ortiz, Alberto author Egido, Jesús author Moreno, Juan Antonio author 2019 Massive intravascular hemolysis is associated with acute kidney injury (AKI). Nuclear factor erythroid-2-related factor 2 (Nrf2) plays a central role in the defense against oxidative stress by activating the expression of antioxidant proteins. We investigated the role of Nrf2 in intravascular hemolysis and whether Nrf2 activation protected against hemoglobin (Hb)/heme-mediated renal damage in vivo and in vitro. We observed renal Nrf2 activation in human hemolysis and in an experimental model of intravascular hemolysis promoted by phenylhydrazine intraperitoneal injection. In wild-type mice, Hb/heme released from intravascular hemolysis promoted AKI, resulting in decreased renal function, enhanced expression of tubular injury markers (KIM-1 and NGAL), oxidative and endoplasmic reticulum stress (ER), and cell death. These features were more severe in Nrf2-deficient mice, which showed decreased expression of Nrf2-related antioxidant enzymes, including heme oxygenase 1 (HO-1) and ferritin. Nrf2 activation with sulforaphane protected against Hb toxicity in mice and cultured tubular epithelial cells, ameliorating renal function and kidney injury and reducing cell stress and death. Nrf2 genotype or sulforaphane treatment did not influence the severity of hemolysis. In conclusion, our study identifies Nrf2 as a key molecule involved in protection against renal damage associated with hemolysis and opens novel therapeutic approaches to prevent renal damage in patients with severe hemolytic crisis. These findings provide new insights into novel aspects of Hb-mediated renal toxicity and may have important therapeutic implications for intravascular hemolysis-related diseases. Front Pharmacol. 2019 Jul 3;10:740. 10.3389/fphar.2019.00740 1663-9812 Frontiers in pharmacology 31333462 http://hdl.handle.net/20.500.12105/9174 Nrf2 Heme Hemoglobin Intravascular hemolysis Oxidative stress Sulforaphane Tubular injury Nrf2 Plays a Protective Role Against Intravascular Hemolysis-Mediated Acute Kidney Injury