Effects of intravenous lipid emulsions on irisin, MMP9, NF-κB, TNF-α in rat kidneys with bupivacaine toxicity: An immunohistochemical study
Abstract
This study aims to investigate the effects of bupivacaine- induced toxicity on renal tissue and the potential protective role of intravenous lipid emulsion. 28 adult male Wistar Albino rats were randomly assigned to four groups as follows: Control, local anesthesia, intravenous lipid emulsion, and local anesthesia + intravenous lipid emulsion. group local anesthesia received a 3 μg·kg-1·min-1 bupivacaine infusion, group intravenous lipid emulsion received a 1.5 mL bolus followed by 0.25 μg·kg-1·min-1 intravenous lipid emulsion infusion, and group local anesthesia + intravenous lipid emulsion received bupivacaine with intravenous lipid emulsion intervention upon toxicity signs. All animals were closely monitored throughout the study. In group local anesthesia, bupivacaine induced significant renal alterations histopathologically, and increased irisin, matrix metalloproteinase-9 (MMP-9), nuclear factor-kappa B (NF-κB), and tumor necrosis factor-α (TNF-α) immunoreactivity compared to control (P<0.05). Histopathology revealed marked edema, congestion, tubular degeneration, inflammatory cell infiltration, glomerular degeneration, and tubular cell shedding (P<0.001). Conversely, rats in the local anesthesia + intravenous lipid emulsion group showed decreased renal tissue edema and congestion, attenuated tubular degeneration, and reduced infiltration, glomerular degeneration, and tubular cell shedding, and reduced immunoreactivity of irisin, MMP-9, NF-κB, and TNF-α (P<0.001), indicating a nephroprotective effect of intravenous lipid emulsion. These findings suggest that irisin, MMP-9, NF-κB, and TNF-α serve as reliable biomarkers of bupivacaine-induced nephrotoxicity. Intravenous lipid emulsion administration mitigates these biochemical and histopathological changes, highlighting its potential as a protective agent against local anesthetic-induced renal damage. The study underscores the importance of monitoring these biomarkers and provides evidence for the therapeutic benefits of intravenous lipid emulsion in the management of bupivacaine toxicity.
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