The toxicity of AgNPs has been considered as an important part of nanotoxicology(16). Exposure to AgNPs can occur in different ways, including dermal contact, inhalation, and ingestion (17, 18). Oral route as a kind of exposure route of AgNPs, may be important in many industries, food, and medicine products.
AgNPs exposure leads to particles translocated to the blood and distributed throughout various organs, particularly the kidneys, liver, spleen, brain, and lungs (19). Kidneys are known as one of the most vulnerable organs after prolonged exposure to nanoparticles (6). Kim et al. showed that AgNPs accumulated in the kidney after oral administration for 28 to 90 days(6). Plus, the deposition of nanoparticles and silver can occur along the mesangium and glomerular basement membrane(20, 21). That is why the present study was conducted to study the adverse effects of silver nanoparticles on rat kidney treated with repeated oral administration for 28 days by examining the body weight, renosomatic index, histology, apoptosis, fibrosis, and expression of some growth factor genes in kidneys.
There were no significant dose-related changes in the body weight gains of rats. No significant renosomatic index was observed in treated rats. These results agreed with Kim(6) and Ji(4) that did not show any significant changes in body weight and renal index relative to various concentrations of AgNPs during the 28-day experiment by oral and inhalation exposures.
BUN and creatinine were not increased significantly compared to control, but inflammatory responses were observed in the kidney. It seemed that the inflammatory responses are too week to impair the filtration capacity of the kidney. Other studies using different doses and duration also showed the same results (6, 19, 22).
Histopathological examination of kidney show dose-dependent AgNPs induced lesions in renal corpuscles, tubules, interstitial tissues, and inflammation. Partial to complete damage to the number of renal corpuscles with loss of glomerular capillary tufts were observed. The morphometry studies confirmed this by revealing a significant decrease in the diameter of affected renal corpuscles compared to the control. However, these changes are more prominent in 30, and 125 mg/kg treated groups. Marked glomerular capillary-tuft distortion or complete loss was described in case of severe renal injury and toxic conditions (23-25).
The results of histology of lining tubular epithelial cells showed damage, including vacuolization, cloudy swelling, severe necrosis, pyknotic nuclei, and degenerative changes together with desquamation of degenerated cells and shedding in the lumen of the tubules. Complete or partial loss of brush border, interrupted basal laminae, and tubular dilatation with intraluminal dense acidophilic hyaline casts were also evident. The results of this study showed that these changes were more frequent in the 30 and 125 mg/kg groups, indicating toxicity induction by these doses. In confirmation of the effect of toxic substances on vacuolar degeneration and cloudy swelling, the results of the effect of cisplatin and different kinds of nanoparticles showed the same results (26-28). Almost all observed cytoplasmic and nuclear degenerative changes in proximal tubules were more evident than distal tubules. This could be because the main and primary site of reabsorption and active transmission is proximal tubules(29).
The hyaline casts represent injured tubular epithelium. The hyaline casts form cellular debris that have undergone molecular changes. Cells and their debris, which are detached from the tubular basement membrane, interact with proteins in the tubular lumen, leading to cast formation. In addition, impaired sodium reabsorption, due to the damaged tubular epithelium results in increased sodium concentration in the lumen of tubules causing protein polymerization and contributing to cast formation (30).
Regarding vascular alterations, consistent with our results, other studies reported that different nanoparticles with different sizes and duration resulted in expanded and congested renal tubular capillaries with inflammatory infiltration(22, 25). It has been reported that cell infiltration is a sign of atrophy of tubular cells in chronic kidney disease(31). This inflammatory response seems to be a result of the oxidative stress caused by AgNPs and contributing to vascular congestion.
Interstitial tissue fibrosis involves excessive accumulation of collagen fibrils and is a common feature of many diseases that progress to chronic renal failure(32). Results of this study revealed marked deposition of collagen within the glomeruli and also between renal tubules in the 30 and 125 mg/kg treated groups than in other groups. In the formation of renal interstitial fibrosis, a variety of inflammatory cells and growth factors such as TGF-β1 participate. TGF-β1 is regarded as a key mediator of renal interstitial fibrosis(33). In our study, expression of TGF-β1 was increased in 30 and 125 mg/kg AgNPs treated groups almost 3.98 and 3 fold of the control group, respectively. Also, the mean area percent of collagen fibers in 30 mg/kg group was significantly higher than the control.
In the present study, it seems that obtained more severe histological changes in rats administrated 30 and 125 and slight damage in 300 and 700 mg/kg/day be due to translocation of AgNPs into the kidney. It may be due to the agglomeration of AgNPs used in this study (~250 nm hydrodynamic diameter agglomerates). The small intestine is the first site for nanoparticles to be absorbed following oral administration. Agglomeration of AgNPs in high concentrations may also have hindered their intestinal absorption and so resulted in an insufficient amount of AgNPs being available to the kidney. Kim et al. reported similar results(6).
The number of renal cells during the development and progression of renal disorders is regulated by apoptosis(34). Through studying the gene expression of apoptotic regulatory and effector molecules in different doses of AgNPs treated rats, we obtained a greater understanding of the control of apoptosis in the affected kidney.
Bcl-2 is an apoptosis inhibitory factor, while Bax promotes the process of apoptosis in various tissues. The state of cell apoptosis is determined by the ratio of their level of expression(35). We examined whether the increased ratio of these genes is related to the process of apoptosis in the renal tissue of the AgNPs treated rats. It was found that the number of caspase-3 positive cells were significantly increased in rats treated with 125 and 300 mg/kg within interstitial and tubular epithelial cells. Furthermore, the ratio of Bax /Bcl-2 mRNA was correlated with caspase-3 positive cells. The findings indicate a possible implication of Bax and Bcl-2 in the apoptotic process during AgNPs treatment.
TUNEL, caspase-3, and Bax /Bcl-2 mRNA evaluation showed a lower rate of apoptosis in 30 mg/kg group compare to other tested groups. Given the lack of association between apoptosis (caspase+cells) and fibrosis or glomerular and tubal injury, the alternative non-apoptotic pathways may be activated in this group as more prominent necrosis were found more in 30 mg/kg group.
Activated immune cells produce TNF-α and also other pro-inflammatory cytokines in chronic renal disorders, which stimulate the release of chemo-attractive molecules by tubular epithelial cells(36). It also recruits leukocytes to tubulointerstitium, increasing inflammation, tubulointerstitial damage, and renal dysfunction. Similarly, the results of our study showed that infiltrated immune cells increased parallel with expression in TNF-α mRNAs in 30 and 700 mg/kg groups. In 30 mg/kg group tubulointerstitial damage, unlike 700 mg/kg group, was found. It seems that the upregulation of TNF-α in 700 mg/kg group was because of increased infiltrated leukocytes that are the early stage of renal injury. This inflammatory response is because of the oxidative stress caused by AgNPs and results in vascular congestion.
The positive association between TGF-β1 expression and the severity of the tubulointerstitial injury and renal dysfunction has been reported in studies in which upregulation of TGF-β1 is correlated with increased risk of progression from chronic renal disease to end-stage renal failure(12, 37).
It has shown that TGF-β1 contributes to tubulointerstitial damage and renal dysfunction through the loss of tubular epithelial cells, by inducing apoptosis, increasing fibrosis. Similarly, our results showed more prominent histological changes in 30, 125, and then 300 mg/kg groups.
Our finding revealed an increase in TGF-β1, TNF-α and, EGF mRNA in some treated groups compared to controls but failed to show any statistically significant correlation between them and caspase-3 or TUNEL+ cells.
A study by Gobe et al. exhibited that the expression of EGF and Bcl-2 in distal tubules increases in the ischemic kidney, leading to distal tubule stress resistance(38). On the other hand, according to the significant increase of Bcl-2 in the 300 mg/kg group compared to the other groups, the decreased expression of EGF seems to have led to an increase in apoptosis.