BACKGROUND: Ischemia/reperfusion injury (IRI) resulting from the procedure of transplantation has a negative impact on both short- and long- time graft survival. Early activation of innate immunity contributes to IRI. Intralipid has been reported to have immumodulatory effects. Hence, we tested whether Intralipid has protective effect on renal IRI in a rat model.

METHODS: Renal IRI was induced in male Brown-Norway rats with 45 min bilateral clamping of renal pedicles followed by 24 h of reperfusion. Renal function, tubular damages, inflammatory cellular infiltration and cytokine production were compared between groups of sham operation (Sham), receiving intralipid (2g/kg, iv) 30 min prior to ischemia (pre-ITL), 30 min post reperfusion (post-ITL) or 0.9% saline (vehicle), with MRI, Plasma creatinine, cytokine and pathology assessments.

RESULTS: Renal function was significantly protected in rats from both pre-ITL and post-ITL groups compared with rats treated with vehicle as attested by plasma creatinine levels. Histological inspection of kidneys from rats receiving vehicle revealed significant cell necrosis, tubular dilatation, loss of brush border and cast deposition. Whereas IRI rats with administration of Intralipd have markedly reduced tubular damage,diminished inflammatory cellular infiltration and decreased production of the proinflammatory event. Reduced tubular damage in rats receiving intralipid was associated with a decrease in tubular cell apoptosis as indicated by hematoxylin and eosin (H&E) and TUNEL staining (Figure 1).

CONCLUSION: Our preliminary results indicate that Intralipid exerts a protective effect during renal IRI, at least in part, through an anti-apoptosis pathway. Intralipid could be potential therapeutic approach to prevent renal IRI relevant to various clinical conditions.

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