INDUCTION OF HEAT-SHOCK PROTEINS DOES NOT PREVENT RENAL TUBULAR INJURY FOLLOWING ISCHEMIA

The possible protective effect of heat-shock proteins (HSPs) on ischemic injury to renal cells was assessed in two different experimental models: ischemia-reflow in intact rats and medullary hypoxic injury as seen in the isolated perfused rat kidney. Heat shock was induced by raising the core temperature of rats to 42 degrees C for 15 minutes. Following this, Northern blots showed enhanced gene expression of HSP70, HSP60 and ubiquitin at one hour and reaching a maximum by six hours after heat shock in all regions of the kidney, but most prominently in medulla and papilla. The HSP70 protein in the kidney, estimated by immunohistochemical means, was detectable 74 hours following heat shock and further increased at 48 hours following heat shock. In the first set of experiments, the animals underwent uninephrectomy followed by cross clamping of the remaining renal artery for 40 minutes prior to reflow. Serum creatinine and urea nitrogen rose to 3.15 +/- 0.98 and 126.4 +/- 62.5 mg/dl at 24 hours. No significant differences were observed at 24, 48 and 72 hours after reflow between these values in central rats and rats pretreated with heat shock 48 hours earlier. Severe morphological damage to proximal tubules of the renal cortex was observed to the same extent in both groups. In a second set of experiments, the right kidney was removed either 24 or 48 hours after heat shock and perfused in isolation for 90 minutes. Functional and morphological parameters were compared with those of isolated perfused kidneys obtained from animals that had not been subjected to heat shock. No difference was observed in the degree or extent of hypoxic injury to the medullary thick ascending limb, characteristically observed in the isolated perfused rat kidney, nor did prior induction of HSPs modify the progressive decline in glomerular filtration rate or fractional reabsorption of glucose seen in perfused kidneys. Fractional reabsorption of sodium was slightly higher in kidneys from rats earlier exposed to heat shock. These results do not support the hypothesis that heat shock proteins prevent ischemic renal injury.