广西医科大学学报2026,Vol.43Issue(4):537-548,12.DOI:10.16190/j.cnki.45-1211/r.2026.04.010
甘氨熊去氧胆酸减轻脓毒症相关急性肾损伤作用的研究
Study on the effect of glycoursodeoxycholic acid in alleviating sepsis-associated acute kidney injury
摘要
Abstract
Objective:To identify potential key metabolites alleviating sepsis-associated acute kidney injury(SA-AKI)based on metabolomics,and to investigate the renal protective effect of glycoursodeoxycholic acid(GUDCA).Methods:From July 2024 to February 2025,60 sepsis patients admitted to the intensive care unit(ICU)of Bobai County People's Hospital in Guangxi were selected and divided into AKI group(n=30)and con-trol group(n=30)based on the presence or absence of acute kidney injury(AKI).Spearman correlation analysis was used to explore the correlation of bile acid metabolites with kidney function and prognosis-related indicators.Male C57BL/6 mice were divided into control group,GUDCA group,lipopolysaccharide(LPS)group and GUDCA+LPS group.A mouse model of SA-AKI was established via intraperitoneal injection of LPS.Plasma urea nitrogen levels were detected using the diacetyl-monoxime colorimetric method.Plasma creatinine levels were measured using the creatine oxidase method.Plasma levels of inflammatory factors interleukin-1β(IL-1β),IL-6 and tumor necrosis factor-α(TNF-α)were measured using enzyme-linked immunosorbent assay(ELISA).Hematoxylin-eosin(HE)staining was used to observe pathological changes in kidney tissues.Immunofluores-cence staining was used to detect the expressions of kidney injury markers neutrophil gelatinase-associated lipo-calin(NGAL)and kidney injury molecule-1(KIM-1),and quantitative real-time polymerase chain reaction(RT-qPCR)was used to detect the expressions of oxidative stress-related genes in kidney tissues.An LPS-induced hu-man renal tubular epithelial cell injury model was established,and the levels of reactive oxygen species(ROS)and the expressions of inflammatory factors were detected after the intervention with GUDCA.Results:GUDCA was negatively correlated with plasma creatinine level and positively correlated with glomerular filtration rate(GFR),24-hour urine output,and 28-day survival rate(P<0.05).Compared with those in the control group,mice in the LPS group exhibited aggravated renal tubular pathological damage,increased fluorescence intensities of KIM-1 and NGAL,increased plasma creatinine,urea nitrogen,IL-1 β,IL-6 and TNF-α levels and relative expres-sions of NOX4 gene in kidney tissues,and decreased relative expressions of SOD2 and GPX1 genes(P<0.05).Compared with those in the LPS group,mice in the GUDCA+LPS group showed alleviated renal tubular patho-logical damage,decreased fluorescence intensities of KIM-1 and NGAL,decreased plasma creatinine,urea nitro-gen,IL-1 β,IL-6 and TNF-α levels and relative expressions of NOX4 gene in kidney tissues,increased relative ex-pressions of SOD2 and GPX1 genes and increased expressions of NQO1,HO-1 and Nrf2(P<0.05).Cell experi-ments demonstrated that compared with the control group,the LPS group exhibited increased levels of ROS and expressions of IL-1β、IL-6 and TNF-α in HK-2 cells(P<0.05),whereas compared with the LPS group,the GUDCA+LPS group showed decreased levels of ROS and expressions of IL-1β、IL-6 and TNF-α in HK-2 cells af-ter the intervention with GUDCA(P<0.01).Conclusion:GUDCA is correlated with the degree of renal function impairment and short-term prognosis in SA-AKI.It can alleviate renal tubular injury by inhibiting inflammatory response and oxidative stress,suggesting its potential as a biomarker for SA-AKI.关键词
甘氨熊去氧胆酸/脓毒症相关急性肾损伤/代谢组学/免疫保护作用/胆汁酸/氧化应激/炎症反应/炎症因子Key words
glycoursodeoxycholic acid/sepsis-associated acute kidney injury/metabolomics/immunoprotective effect/bile acid/oxidative stress/inflammatory response/inflammatory factors分类
医药卫生引用本文复制引用
刘净闻,李勇辰,麦迪曼,谭人志,王超,莫曾南..甘氨熊去氧胆酸减轻脓毒症相关急性肾损伤作用的研究[J].广西医科大学学报,2026,43(4):537-548,12.基金项目
国家自然科学基金资助项目(82270806 ()
82572537) ()
广西科技计划项目(桂科LT2600640048) (桂科LT2600640048)