Title Utjecaj nadomjesne prehrane višestruko nezasićenim masnim kiselinama na masnokiselinski sastav fosfolipida, stupanj oštećenja i izražaj VEGF, NF-κB i SATB1 u bubregu dijabetičnih štakora
Title (english) The influence of replacement nutrition with polyunsaturated fatty acids on the fatty acid composition of phospholipids, the degree of damage and the expression of VEGF, NF-κB and SATB1 in the kidney of diabetic rats
Author Marija Vitlov Uljević https://orcid.org/0000-0001-7812-3869
Mentor Natalija Filipović (mentor)
Committee member Anita Markotić (predsjednik povjerenstva)
Committee member Merica Glavina Durdov (član povjerenstva)
Committee member Joško Božić (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2023-06-09, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Basic Medical Sciences Cytology, Histology and Embryology
Universal decimal classification (UDC ) 61 - Medical sciences
Abstract Šećerna bolest (DM, diabetes mellitus) je poremećaj metabolizma karakteriziran
brojnim ozbiljnim komplikacijama, od kojih je jedna od najčešćih dijabetička nefropatija (DN,
engl. diabetic nephropathy) - kronično propadanje funkcije bubrega kod bolesnika s DM, kao
posljedica koje dolazi do gubitka serumskog albumina u urinu, pada glomerularne filtracije i
bubrežnog zatajenja. Višestruko nezasićene masne kiseline (PUFA; engl. polyunsaturated fatty
acids) posljednjih su desetljeća istraživane zbog svoje nutritivne vrijednosti i potencijalnih
zdravstvenih dobrobiti unošenja u organizam. Brojna patološka stanja i promjene u tkivima
povezani su s promjenom udjela PUFA u tkivima.
Cilj ovog istraživanja bio je istražiti utjecaj eksperimentalne šećerne bolesti tipa 1
(DM1, diabetes mellitus type 1) te odrediti potencijalno zaštitan / štetan učinak različitih omjera
omega-6/omega-3 (n-6/n-3) PUFA u hrani na masnokiselinski sastav fosfolipida u tkivu
bubrega i patološke promjene uzrokovane DM1. 25 mužjaka Wistar štakora podijeljeno je u 4
skupine koje su hranjene različitim omjerima n-6/n-3 PUFA u obroku. Kontrolna skupina (engl.
control C) i dijabetična skupina (STZ) dobivale su hranu s omjerom n-6/n-3 ≈ 7, skupina
STZ+N6 hranu s omjerom n-6/n-3 od ≈ 60 i skupina STZ+DHA hranu s omjerom n-6/n-3 od ≈
1 koji se sastojao od 16 % eikozapentanoične (EPA engl. eicosapentaenoic acid) i 19%
dokozaheksanoične kiseline (DHA engl. docosahexaenoic acid). Životinjama je
intraperitonealno apliciran streptozotocin ili fosfatni pufer te su 30 dana nakon indukcije DM1
štakori žrtvovani. Tkivo bubrega i uzorci krvi prikupljeni su kako bi se analizirao
masnokiselinski sastav fosfolipida te kako bi se proučile patohistološke promjene, ektopično
lipidno nakupljanje, kao i izražaj čimbenika rasta vaskularnog endotela (VEGF eng. Vascular
endothelial growth factor), jezgrinog čimbenika kappa B (NF-kB engl. nuclear factor kappalight-
chain-enhancer of activated B cells) i proteina koji organizira kromatin / globalnog
transkripcijskog regulatora (SATB1 engl. special AT-rich sequence-binding protein-1).
Patološke promjene proučavane su korištenjem transmisijskog elektronskog mikroskopa
(TEM) nakon bojenja na VEGF. Rezultati su pokazali da DM1 te različiti omjeri n-6/n-3 PUFA
u hrani dovode do značajnih promjena u masnokiselinskom sastavu fosfolipida u bubregu.
Isto tako, DM1 je posljedično doveo do opsežne vakuolizacije stanica distalnih kanalića,
ali je ona bila značajno umanjena u skupini STZ+DHA u kojoj je zabilježen i najviši bubrežni
izražaj Nf-KB.
Izraženo nakupljanje neutralnih lipida primijećeno je u stanicama proksimalnih kanalića svih
dijabetičnih životinja, ali je nakupljanje bilo značajno veće u skupini STZ+N6.
Kod svih dijabetičnih životinja uočen je poremećaj vezikularnog transporta VEGF-a u
proksimalnim kanalićima koji je bio značajno pogoršan u skupinama STZ+N6 i STZ+DHA.
Također smo određivali i analizirali imunoreaktivnost novog biljega oštećenja u
distalnim kanalićima i glomerulima- SATB1, a obzirom na njegovu ključnu ulogu u
patofiziologiji DN. Tako je vrlo jaka imunofluorescencija SATB1 pronađena u distalnim
kanalićima dijabetičnih štakora, a povećani postotak SATB1-imunoreaktivnih stanica distalnih
kanalića pronađen je u skupinama STZ+DHA i STZ+N6.
Ultrastrukturna analiza potvrdila je da VEGFza svoj promet koristi sustav endocitoze,
ali i da primjena PUFA nije pomogla u obnovi vezikularnog transporta VEGF koji je bio
oštećen u DM1.
Rezultati istraživanja pokazali su da je u ranoj fazi dijabetičke nefropatije primjetno
opsežno oštećenje i vakuolizacija stanica distalnog kanalića, što može biti ublaženo
suplementacijom EPA/DHA. Ovaj podatak stavlja u fokus distalni kanalić kao važan segment
u ranom liječenju i prevenciji oštećenja bubrega. S obzirom na mali broj postojećih istraživanja,
potrebno je dodatno istražiti patofiziološke promjene i mehanizme distalnog tubularnog
oštećenja. Možemo zaključiti da masnokiselinski sastav, nastao kao posljedica manipulacije
prehranom, može snažno utjecati na ishode DN. Odgovarajući omjer n-3/n-6 PUFA u prehrani
ima povoljan učinak na smanjenje oštećenja distalnih kanalića. Potrebna su dodatna istraživanja
koja će rasvijetliti mehanizam učinka različitih omjera n-3/n-6 PUFA na oštećenje distalnih
tubula.
Abstract (english) Diabetes mellitus (DM) is a metabolic disease characterized by numerous serious
complications. One of the most common is diabetic nephropathy (DN), a chronic deterioration
of renal function in patients with DM, leading to a loss of serum albumin in the urine, a decrease
in glomerular filtration, and consequent renal failure. Long-chain polyunsaturated fatty acids
(PUFA; polyunsaturated fatty acids) have been studied in recent decades for their nutritional
value and potential health benefits when absorbed into the body. Numerous pathological
conditions in tissues have been associated with a change in the proportion of PUFA in tissues.
The aim of this study was to investigate the effects of experimental type 1 diabetes
(DM1, diabetes mellitus type 1) and to determine the potentially protective/harmful effect of
the different ratio of dietary n-6/n-3 PUFA on the fatty acid composition of phospholipids in
renal tissue and the pathological changes caused by DM1.
Twenty-five male Wistar rats were divided into 4 groups and fed different ratios of n-
6/n-3 PUFA in the meal. The control group (eng. control C) and the diabetic group (STZ) were
fed diets with an n-6/n-3 ratio of ≈ 7, the STZ+N6 group was fed diets with an n-6/n-3 ratio of
≈ 60, and the STZ+DHA group was fed diets with an n-6/n-3 ratio of ≈ 1, which consisted of
16% eicosapentaenoic acid (EPA) and 19% docosahexaenoic acid (DHA). Streptozotocin or
phosphate buffer was administered intraperitoneally to the animals. Thirty days after DM1
induction, the rats were sacrificed. Kidney tissue and blood samples were collected to analyze
the fatty acid composition of phospholipids and to examine pathohistological changes, ectopic
lipid accumulation, and expression of vascular endothelial growth factor (VEGF), nuclear
factor kappa B (NF-kB), and chromatin organizing/global transcriptional regulator protein
(SATB1 English special AT-rich sequence-binding protein-1). Pathological changes were
examined by transmission electron microscopy (TEM) after VEGF staining.
As a result of this experiment, DM1 and the different levels of n-6/n-3 PUFA in the diet
led to significant changes in the fatty acid composition of phospholipids.
DM1 consequently led to extensive vacuolization of distal tubule cells, but this was
significantly lower in the STZ+DHA group, in which the highest renal Nf- KB expression was
also recorded. The pronounced accumulation of neutral lipids was observed in the cells of
proximal tubules of all diabetic animals, but the accumulation was significantly higher in the
STZ+N6 group.
To our knowledge, there is no study that has investigated the effects of the n6/n3 PUFA
ratio in experimentally induced DM1 on the expression of VEGF, NF-kB, and SATB1.
In all diabetic animals we found disturbance of VEGF- transporting vesicular proximal
tubules cell system, which was substantially worsened in the groups STZ+N6 and STZ+DHA.
We also determined and analyzed the immunoreactivity of a new marker of damage in
the distal tubuli and glomeruli- SATB-1, due to its key role in the pathophysiology of diabetic
nephropathy. Thus, very strong immunofluorescence SATB1 was found in distal tubuli of
diabetic rats, and an increased percentage of SATB1-immunoreactive distal tubular cells were
found in the STZ+DHA and STZ+N6 group.
Ultrastructural analysis confirmed that VEGF uses an endocytosis system for its
transport, addition of PUFA did not help in the restoration of vesicular VEGF transport that
was damaged in DM1.
The results have shown that in the early stages of DN there is extensive damage and
vacuolization of the cells of the distal tubules, which can be attenuated by EPA/DHA
supplementation. These data focus on the distal tubules as an important segment in the early
treatment and prevention of renal injury. Considering the paucity of studies, it is necessary to
further investigate the pathophysiological changes and mechanisms of distal tubule damage.
We can conclude that the fatty acid composition resulting from dietary manipulation may
strongly influence the outcomes of DN. An appropriate ratio of n-3/n-6-PUFA in the diet has a
beneficial effect on reducing distal tubule damage. Further studies are needed to confirm or
refute the above results and to further clarify the effects of different n-3/n-6-PUFA ratios on
distal tubule damage.
Keywords
Eksperimentalni dijabetes melitus
Komplikacije dijabetesa
Dijabetička retinopatija
Nezasićene masne kiseline
Štakori Wistar
Keywords (english)
Experimental Diabetes Mellitus
Diabetes Complications
Diabetic Retinopathy
Unsaturated Fatty Acids
Wistar Rats
Language croatian
URN:NBN urn:nbn:hr:171:797800
Study programme Title: Obtaining a doctorate of science outside of doctoral studies Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti (doktor/doktorica znanosti)
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Created on 2023-06-06 06:51:10