A wandering path toward prevention for acute kidney injury
Simon J. Atkinson
Simon J. Atkinson
Published April 18, 2016
Citation Information: J Clin Invest. 2016;126(5):1640-1642. https://doi.org/10.1172/JCI86826.
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Commentary

A wandering path toward prevention for acute kidney injury

Abstract

Acute kidney injury (AKI) is a common cause of hospital-related mortality; therefore, strategies to either prevent or treat this complication are of great interest. In this issue of the JCI, Inoue, Abe, and colleagues have uncovered a targetable neuroimmunomodulatory mechanism that protects mice from ischemia-reperfusion injury (IRI) and subsequent AKI. Specifically, the authors demonstrate that vagus nerve stimulation (VNS) activates the cholinergic antiinflammatory pathway (CAP), resulting in activation of antiinflammatory effects via α7 nicotinic acetylcholine receptor–expressing splenic macrophages. Together, the results of this study have potential clinical implications in the prevention of AKI in at-risk individuals.

Authors

Simon J. Atkinson

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Figure 1

Activation of the CAP by ultrasound or VNS attenuates IRI.

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Activation of the CAP by ultrasound or VNS attenuates IRI. Both VNS and ...
Both VNS and ultrasound prior to IRI in murine models protect against the development of AKI. This protective effect is mediated by the integration of neural signals and α7nAChR on splenic macrophages. In addition to reducing AKI, VNS also reduced plasma levels of the proinflammatory cytokine TNF-α. Adapted with permission from the Journal of the American Society of Nephrology (6).