Renoprotective effects of artesunate against renal ischemia-reperfusion injury in rat model

Background: Renal ischemia-reperfusion (Renal I/R) leads to acute kidney injury (AKI), a major kidney disease associated with an increasing prevalence and high mortality rates. A variety of experimental models, both in vitro and in vivo, have been used to study the pathogenic mechanisms of ischemic AKI and to test reno-protective strategies. Aim: To study potential protective effects of artesunate on renal I/R injury. Materials and Methods: Renal I/R injury was unilaterally induced in adult (3 to 5 months) male Sprague-Dawely rats, whose weights ranged from 180 to 390 g. Thereafter, the animals were pre-treated with artesunate intra-peritoneally, and at the end of reperfusion sacrificed humanely. Plasma, serum and tissue samples were obtained for analysis. Plasma concentrations of NGAL (neutrophil gelatinase-associated lipocalin), an iron-trafficking protein involved in multiple processes such as apoptosis, innate immunity and renal development, and tissue concentrations of IL-18 (Interleukin-18) were measured via ELISA analysis. Serum urea and creatinine were also measured in the samples. Results: Artesunate improved renal ischemia reperfusion, including renal function and brought about reductions in inflammatory mediators and kidney tissue injury. Plasma concentrations of NGAL and tissue concentrations of IL-18 were significantly (p < 0.05) lower in the artesunate-pretreated group than in the vehicle and control groups. Furthermore, serum concentrations of urea and creatinine were significantly (p < 0.05) decreased in the pretreated group as compared to the control group. Conclusion: Artesunate can significantly improve renal function following I/R through down-regulation of inflammatory parameters and NGAL expression. Furthermore, it could serve as a potential therapy in ischemia reperfusion-induced acute kidney injury.