Renoprotective immunosuppression by pioglitazone with low-dose cyclosporine in rat heart transplantation  Yosuke Tanaka, MD, Tomomi Hasegawa, MD, PhD,

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Renoprotective immunosuppression by pioglitazone with low-dose cyclosporine in rat heart transplantation  Yosuke Tanaka, MD, Tomomi Hasegawa, MD, PhD, Zhi Chen, MD, Yutaka Okita, MD, PhD, Kenji Okada, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 138, Issue 3, Pages 744-751 (September 2009) DOI: 10.1016/j.jtcvs.2009.04.019 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Effects of pioglitazone and cyclosporine on allograft survival in our rat heart transplantation model. ∗P < .005. Pio, Pioglitazone; CsA, cyclosporine A; NS, not significant. Data were analyzed by using a log-rank test of Kaplan–Meier analysis. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 744-751DOI: (10.1016/j.jtcvs.2009.04.019) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Histologic findings of cardiac allografts in acute rejection. A, Hematoxylin and eosin (HE) staining and immunohistochemical staining of CD4 and CD8. Bar = 100 μm. B, Rejection score. C, Quantitative analysis of CD4+ and CD8+ cells. NS, Not significant. All data are expressed as means ± standard errors of the mean. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 744-751DOI: (10.1016/j.jtcvs.2009.04.019) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Serum concentrations of interleukin 2 (IL-2; A) and interferon γ (IFN-γ; B) by means of enzyme-linked immunosorbent assay. NS, Not significant. All data are expressed as means ± standard errors of the mean. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 744-751DOI: (10.1016/j.jtcvs.2009.04.019) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Effects of pioglitazone and cyclosporine on recipient renal function: A, serum BUN levels; B, serum creatinine levels; and C, creatinine clearance. NS, Not significant. All data are expressed as means ± standard errors of the mean. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 744-751DOI: (10.1016/j.jtcvs.2009.04.019) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Histologic findings of renal apoptosis after heart transplantation. A, transferase-mediated dUTP-biotin nick end labeling (TUNEL) staining and immunofluorescent staining of Bax. TUNEL-positive cells (brown) are shown by arrows. Intracellular expression of Bax is identified by the green emission. Cell nuclei are identified by the blue emission. Bar = 100 μm. B, Quantitative analysis of TUNEL-positive cells. All data are expressed as means ± standard errors of the mean. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 744-751DOI: (10.1016/j.jtcvs.2009.04.019) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Renal expression of peroxisome proliferator–activated receptor γ (PPAR-γ) and transforming growth factor β1 (TGF-β1) after heart transplantation. A, Immunofluorescent staining of PPAR-γ and TGF-β1. Intracellular expression of PPAR-γ and TGF-β1 is identified by the green emission. Cell nuclei are identified by the blue emission. Bar = 100 μm. B, TGF-β1 protein levels in recipient kidney, as determined by means of enzyme-linked immunosorbent assay. NS, Not significant. All data are expressed as means ± standard errors of the mean. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 744-751DOI: (10.1016/j.jtcvs.2009.04.019) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions