Grape seed proanthocyanidin extract can prevent CsA nephropathy

Cyclosporine A (cyclosporine, CsA) inhibits IL-2 mediated T cell proliferation and helper immune T cell activity, and is used to prevent rejection and graft versus host disease after transplantation. , GVHD) response has also been used to treat a variety of autoimmune diseases. CsA is a cyclic polypeptide composed of 11 amino acids and is an active metabolite of a fungus in the soil. In terms of anti-rejection after transplantation, CsA can be said to have brought a revolution. In 1978, the United Kingdom first applied CsA to clinical kidney transplantation. Since then, CsA has been used for liver, heart, lung, pancreas, bone marrow and other organ transplants, which significantly improved the survival rate of patients.

Although CsA can effectively improve the prognosis of transplant patients, there have been some adverse events in the application, especially CsA nephropathy, which is manifested as glomerular thrombosis, renal tubule obstruction, proteinuria and tubular urine. Some researchers believe that although the pathogenesis of CsA nephropathy is still unclear, oxidative damage and tubular cell apoptosis must be among the factors. Grape seed proanthocyanidin extract (GSPE) has anti-oxidant and anti-apoptotic properties and may be expected to be used to prevent CsA nephropathy.

In order to evaluate whether GSPE has a preventive effect on CsA nephropathy, Sukru Ulusoy of the Department of Nephrology, Faculty of Medicine, Karadanza University of Technology, Turkey, conducted an animal study: 24 Sprague–Dawley (SD) rats were randomly divided into a blank control group and GSPE Group, CsA and CsA+GSPE group were given olive oil 1ml (blank control), GSPE 100 mg/kg, CsA25mg/kg and GSPE 100 mg/kg+CsA25mg/kg, respectively. On the 21st day, the serum urea nitrogen (BUN), creatinine (CCr) and CsA concentrations were measured; at the same time, the total oxidant system (TOS) and total anti-oxidant system (total anti-oxidant system) were performed on the kidney tissue. -oxidant system, TAS), oxidative stress index (OSI) and malondialdehyde (malondialdehyde, MDA) tests; in addition, renal histopathological examinations and apoptosis staining index (apoptotic index, AI) )an examination.

Results: The BUN, CCr, TOS, OSI, MDA, renal histopathological score and apoptosis index in the CsA group increased, suggesting impaired renal function; however, in the CsA+GSPE group, BUN, CCr, OSI, MDA , Kidney histopathology score and apoptosis index decreased, TAS increased, suggesting that GSPE effectively protects the kidney function of rats. In addition, there was no difference in CsA concentration between the CsA group and the CsA+GSPE group, suggesting that the addition of GSPE did not affect the CsA concentration.

Studies have confirmed that GSPE can effectively prevent CsA nephropathy through anti-apoptosis and anti-oxidation mechanisms, and can effectively protect renal function without affecting the plasma concentration of CsA. Therefore, when transplant patients use CsA to prevent graft-versus-host reaction, the addition of GSPE will help prevent CsA nephropathy.