| Aim:Renal denervation(RDN)with radiofrequency energy can destroy part of the sympathetic nerve around the renal artery,and reduce the sympathetic nerve activity of the kidney and whole body,which can not only reduce blood pressure,but also has potential effects on other diseases associated with high sympathetic activity,such as chronic kidney disease,heart failure,arrhythmia and diabetes.The purpose of this study is to investigate the effect of RDN from the renal arterial intima and adventitial on high-cholesterol induced renal interstitial fibrosis.Methods18 Bama miniature pigs were randomly divided into three groups,the intimal RDN of renal artery group(Intima-RDN,n=6),adventitial renal denervation group(Adventitia-RDN,n=6),sham operation group(n=6).After all experimental animals were taken renal Angiography under general anesthesia;in the Intima-RDN group and the Adventitia-RDN group,radiofrequency ablation was respectively performed in the renal artery and the lateral side,and the sham operation group was as the control group.Blood lipid levels were measured before and 6 months after operation in all three groups.All animals were subjected to renal angiography after 6 months of high-cholesterol feeding,kidney tissue samples were taken for pathological staining,and the expression of serum transforming growth factor-?1(TGF-?1)and smad3 was detected.Results:1.After 6 months surgery,total cholesterol TC is [(3.54±0.55)mmol/L)?(3.46±0.95)?(3.53±0.47)] in sham operation group,adventitia-RDN group and intima-RDN group.The levels of low density lipoprotein LDL-C [(4.09±0.71)mmol/L)?(4.04±0.73)?(3.88±0.95)] were significantly higher than those [TC:(2.59±0.61)mmol/L?(2.62±0.82)?(2.57±0.43);LDL-C:(2.12±0.40)mmol/L?(2.12±0.67)?(2.11±0.40)]in the baseline(P<0.01),however there has no significant difference among the groups at the end of the same period(P>0.05).2.Compared with the sham operation group(324.19±92.03 pg/ml),the levels of transforming factor-?1(TGF-?1)in the adventitial(205.98±69.16pg/ml)and intimal-RDN group(227.25±51.10 pg/ml)were significantly lower.(P<0.05).The expression of smad3 protein in renal tissue,if the relative gray value of the sham group was 1,the relative gray value of the adventitia-RDN group was 0.38±0.03,and the intima-RDN group was 0.42±0.08,both of them were lower than sham group(P<0.001),however it has no significant difference between adventitia and intima-RDN group.(P>0.05).3.HE and Masson staining of the kidney showed obvious renal interstitial fibrosis and glomerular structural damage in the sham group,while the degree of renal interstitial fibrosis was significantly reduced in the adventitia and intima RDN group contrast to the sham group.Conclusions:1?6 months after surgery,the lipid levels of the adventitia,intima-RDN,and sham groups were significantly increased than the baseline,but there was no significant difference between the groups at the same period.RDN had no significant effect on blood lipids of experimental animals.2?After high-fat feeding,there were different degrees of necrosis of renal tubular epithelial cells and inflammatory infiltration around the glomerular stroma in the each group.Compared with the sham group,the level of serum TGF-?1 and the expression of smad3 protein were decreased by adventitia-RDN and the intima-RDN.Adventitia and the intima-RDN also inhibited the occurrence of glomerular structural damage and fibrosis.In terms of inhibiting renal fibrosis,RDN from the renal arterial intima and adventitial has a similar effect.3?Compared with the sham operation group,the adventitia-RDN group and the intima-RDN group showed no obvious vascular plaque and stenosis on imageology. |
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