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On the contrary, the incidence of apoptotic globules in kidneys of animals characterized by a very late resuscitation time (> 90 min) suggests an important role of apoptosis in asphyxia-related acute kidney injury. We may also speculate that sloughing should Lenvatinib be considered the morphological sign of tubular cell apoptosis: the detachment of tubular cells from each other and from the basal lamina and their removal by the urinary flow may be a limit for the development of the complete sequence of the apoptotic process, thus limiting their finding to few kidney samples. Our data clearly show that the Landrace/Large White piglet model provides useful data for the study of hypoxia-induced kidney injury. Tubular dilatation, tubular cell vacuolization, sloughing and brush border changes are the main, earliest and most severe lesions in the post-asphyxia kidney. A strong interindividual variability in the Ion Channel Ligand Library concentration severity of renal changes to asphyxia was observed. The extent of kidney lesions was not associated with the concentration of oxygen used during resuscitation, thus suggesting a previously unreported individual susceptibility to hypoxia. Further studies on pathological kidney changes from human and non-human models are needed to verify their role in the short- and long-term kidney damage following hypoxia-reoxygenation. COMMENTS Background The study focuses on the histological renal change following asphyxia in a experimental model of neonatal asphyxia. On the basis of recent data suggesting a role of reoxygenation in the development of renal lesions, the authors evaluated the presence and degree of renal lesions in piglets submitted to different oxygen percentages following asphyxia. Research frontiers The study is mainly related PIK-3 to the research field of tissue damage following asphyxia and reoxygenation in the perinatal period. Innovations and breakthroughs The most important data of the study regard the usefulness of the Landrace/Large White piglet model for the study of hypoxia-induced kidney injury. The strong interindividual variability in the severity of renal changes to asphyxia described in the study represents a new finding that may lead the neonatologist towards an individualized sartorial approach in each newborn affected by perinatal asphyxia. Applications In the study, tubular dilatation, tubular cell vacuolization, sloughing and brush border changes are the main, earliest and most severe lesions observed in the post-asphyxia kidney. These data may help pathologists involved in the study of asphyxia-induced renal pathology. Peer-review The study is interesting and well-conducted. Footnotes P- Reviewer: Menezes RG, Revuelta KL, Wagner KD S- Editor: Ji FF L- Editor: A E- Editor: Lu YJ Ethics approval: The authors declare that the study protocol has been approved by the institute��s committee on human research. Informed consent: The research complies with the guidelines for human studies and animal welfare regulations.