Skip to content

Advertisement

  • Poster presentation
  • Open Access

Insulin inhibits IL-6 production in the kidneys in brain-dead pigs

  • 1,
  • 2,
  • 1,
  • 1,
  • 1,
  • 2 and
  • 1
Critical Care200610 (Suppl 1) :P250

https://doi.org/10.1186/cc4597

  • Published:

Keywords

  • Graft Survival
  • Brain Death
  • Balloon Catheter
  • Cytokine Response
  • Renal Medulla

Introduction

Kidneys transplanted from brain dead donors have a poorer function and a higher risk of rejection than kidneys from living donors [1]. This might partly be due to the inflammatory changes in the kidneys after brain death [2]. In a previous porcine study we found that a high-insulinaemic-euglucaemic clamp modulated the renal cytokine response to lipopolysaccharide infusion towards anti-inflammation [3]. We hypothesized that insulin in brain death would give a similar cytokine response, and tested this hypothesis in brain-dead pigs by studying the effect of insulin on renal IL-6 content.

Methods

In 16 anaesthetized and mechanically ventilated pigs (38–42 kg bw) brain death was induced by inflation of an epidurally placed balloon catheter. Eight pigs received insulin at a constant rate (0.6 mU/kg/min). Blood glucose was clamped at 4.5 mmol/l by infusion of 20% glucose. The kidneys were removed 6 hours after brain death and biopsies from the renal cortex and medulla were taken for measurements of IL-6, by ELISA (pg/mg total protein) and of IL-6 mRNA by PCR (optimal density ratio IL-6/ HRPT).

Results

See Table 1. In the renal medulla IL-6 and IL-6 mRNA were lower in the treated group, whereas in the cortex only IL-6 was lower.
Table 1

(abstract P250)

 

Minus insulin

Plus insulin

P value (t test)

IL-6 cortex

3981 ± 1373

2472 ± 1249

0.04

IL-6 mRNA

0.39 ± 0.23

0.63 ± 0.24

0.06

IL-6 medulla

2043 ± 1128

999 ± 293

0.05

IL-6 mRNA medulla

1.20 ± 0.24

0.92 ± 0.12

0.0002

Data presented as mean ± SD.

Conclusion

Insulin inhibits renal IL-6 production in brain-dead pigs. This indicates that insulin treatment of organ donors might be beneficial for kidney graft survival after transplantation.

Authors’ Affiliations

(1)
Aarhus University Hospital, Århus C, Denmark
(2)
Aalborg University Hospital, Aalborg, Denmark

References

  1. Terasaki PI, Cecka JM, Gjertson DW, Takemoto S: High survival rates of kidney transplants from spousal and living unrelated donors. N Engl J Med 1995, 333: 333-336. 10.1056/NEJM199508103330601View ArticlePubMedGoogle Scholar
  2. Skrabal CA, Thompson LO, Potapov EV, et al.: Organ-specific regulation of pro-inflammatory molecules in heart, lung, and kidney following brain death. J Surg Res 2005, 123: 118-125. 10.1016/j.jss.2004.07.245View ArticlePubMedGoogle Scholar
  3. Brix-Christensen V, Andersen SK, Andersen R, et al.: Acute hyperinsulinemia restrains endotoxin-induced systemic inflammatory response: an experimental study in a porcine model. Anesthesiology 2004, 100: 861-870. 10.1097/00000542-200404000-00016View ArticlePubMedGoogle Scholar

Copyright

© BioMed Central Ltd 2006

Advertisement