Acute tubular
necrosis is a clinical problem that lacks specific
therapy and is characterized by high mortality rate. The ischemic renal injury affects the proximal tubule cells causing dysfunction and cell death after severe hypoperfusion. We utilized a cell-based screening approach in a
hypoxia-reoxygenation model of tubular injury to search for cytoprotective action using a library of pharmacologically active compounds.
Oxygen-
glucose deprivation (OGD) induced
ATP depletion, suppressed aerobic and anaerobic metabolism, increased the permeability of the monolayer, caused
poly(ADP-ribose) polymerase cleavage and
caspase-dependent cell death. The only compound that proved cytoprotective either applied prior to the
hypoxia induction or during the reoxygenation was
adenosine. The protective effect of
adenosine required the coordinated actions of
adenosine deaminase and
adenosine kinase, but did not requisite the
purine receptors.
Adenosine and
inosine better preserved the cellular
ATP content during
ischemia than equimolar amount of
glucose, and accelerated the restoration of the cellular
ATP pool following the OGD. Our results suggest that radical changes occur in the cellular metabolism to respond to the energy demand during and following
hypoxia, which include the use of
nucleosides as an essential energy source. Thus
purine nucleoside supplementation holds promise in the treatment of
acute renal failure.