Efectos de emulsiones lipídicas intravenosas sobre irisin, MMP-9, NF-κB, TNF-α en riñones de ratas con toxicidad por bupivacaína: estudio inmunohistoquímico
Resumen
Este estudio investigó los efectos de la toxicidad inducida por bupivacaína en el tejido renal y el posible papel protector de la emulsión lipídica intravenosa. Veintiocho ratas Wistar Albino macho adultas fueron asignadas aleatoriamente a cuatro grupos: Control, anestesia local, emulsión lipídica intravenosa y anestesia local + emulsión lipídica intravenosa. El grupo anestesia local recibió una infusión de bupivacaína de 3 μg·kg-1·min-1, el grupo emulsión lipídica intravenosa recibió un bolo de 1,5 mL seguido de una infusión de emulsión lipídica intravenosa de 0,25 μg·kg-1·min-1, y el grupo anestesia local + emulsión lipídica intravenosa recibió bupivacaína con intervención de emulsión lipídica intravenosa al observar signos de toxicidad. Todos los animales fueron monitoreados de cerca durante el estudio. En el grupo anestesia local, la bupivacaína indujo alteraciones renales significativas, incluyendo un aumento en la inmunorreactividad de irisina, metaloproteinasa de matriz-9, factor nuclear kappa B y factor de necrosis tumoral-α en comparación con los controles (P<0,05). La histopatología reveló edema, congestión, degeneración tubular, infiltración, degeneración glomerular y desprendimiento de células tubulares significativos (P<0,001). Por el contrario, las ratas del grupo anestesia local + emulsión lipídica intravenosa mostraron disminución del edema y congestión renal, atenuación de la degeneración tubular y reducción de la infiltración, degeneración glomerular y desprendimiento celular tubular (P<0,001), indicando un efecto nefroprotector de emulsión lipídica intravenosa. Estos hallazgos sugieren que irisina, factor nuclear kappa B, metaloproteinasa de matriz-9 y factor de necrosis tumoral-α son biomarcadores fiables de la nefrotoxicidad inducida por bupivacaína. La administración de emulsión lipídica intravenosa atenúa estos cambios bioquímicos e histopatológicos, destacando su potencial como agente protector frente al daño renal inducido por anestésicos locales. El estudio subraya la importancia de monitorear estos biomarcadores y proporciona evidencia de los beneficios terapéuticos de emulsión lipídica intravenosa en el manejo de la toxicidad por bupivacaína.
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