Okada Mitsuru, Takemura Tsukasa, Yanagida Hidehiko, Yoshioka Kazuo
Department of Pediatrics, Kinki University School of Medicine, Osaka-Sayama, Japan.
Kidney Int. 2002 Jan;61(1):113-24. doi: 10.1046/j.1523-1755.2002.00107.x.
Progression of diabetic nephropathy is closely associated with morphological changes in glomeruli, such as thickening of the glomerular basement membrane, mesangial expansion, and glomerulosclerosis. To elucidate early glomerular events, we compared the mitogenic activity and extracellular matrix production in mesangial cells (MC) isolated from diabetic rats prior to the manifestation of nephropathy and those showing overt nephropathy. This study may help to clarify the mechanisms underlying diabetic nephropathy and provide clues about early therapeutic interventions for preventing or slowing this process.
Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a chronic model for human type 2 diabetes mellitus, and age-matched control (LETO) rats were used. Glomerular cell numbers, expression of immediate early genes (c-Fos and c-Myc) and proliferating cell nuclear antigen (PCNA), and low-density lipoprotein (LDL) deposition were determined in renal tissue sections from rats aged 15 to 75 weeks. Mesangial cells (MCs) from OLETF rats at two different stages of the disease, that is, young (12- to 14-week-old) OLETF rats (y-OLETF) prior to the manifestation of nephropathy and old (48- to 50-week-old) OLETF rats (o-OLETF) showing nephropathy, were isolated and cultured. After stimulation with native (n-) or oxidized (ox-) LDL or angiotensin II (Ang II), DNA synthesis and extracellular matrix (ECM) production were examined. Cellular expression of LDL/scavenger receptors was analyzed using fluorescence-labeled LDL and binding to 125I-labeled-LDL.
The number of cells per glomerular cross section was significantly higher in OLETF rats than in LETO rats between 25 and 65 weeks of age. In OLETF glomeruli, c-Fos, c-Myc, and PCNA were transiently expressed in the early phase. Glomerular LDL deposition increased with the age of OLETF rats. Addition of a low dose of n-LDL (10 microg/mL) to the culture medium significantly stimulated DNA synthesis of y-OLETF MCs, as compared with o-OLETF MCs and LETO MCs (P < 0.05). A high dose of n-LDL (100 microg/mL) caused cytotoxic effects in all cells. Exposure to ox-LDL minimally affected DNA synthesis of OLETF or LETO MCs. LDL receptors and scavenger receptors were predominant in y-OLETF and o-OLETF, respectively. After stimulation with n-LDL and ox-LDL, expression of type I and type III collagen, along with transforming growth factor-beta (TGF-beta), was higher in o-OLETF MCs that in y-OLETF MCs or LETO MCs. Exposure to Ang II markedly induced DNA synthesis and ECM mRNA expression in y-OLETF MCs and o-OLETF MCs, respectively.
These findings indicate that the cell proliferation process precedes the evolution of diabetic glomerulopathy. The responses of OLETF MCs to n-LDL/ox-LDL and Ang II differed depending on the stage of diabetes. In the early phase, MCs were prone to proliferate, whereas in the late stage, MCs, which expressed higher levels of TGF-beta, tended to synthesize ECM. A functional switch in MCs may contribute to the development of glomerulosclerosis in diabetic nephropathy.
糖尿病肾病的进展与肾小球的形态学改变密切相关,如肾小球基底膜增厚、系膜扩张和肾小球硬化。为了阐明早期肾小球事件,我们比较了在肾病表现之前从糖尿病大鼠分离的系膜细胞(MC)与出现明显肾病的系膜细胞的促有丝分裂活性和细胞外基质产生。本研究可能有助于阐明糖尿病肾病的潜在机制,并为预防或减缓这一过程的早期治疗干预提供线索。
使用大冢长-艾维森德岛肥胖(OLETF)大鼠,一种人类2型糖尿病的慢性模型,以及年龄匹配的对照(LETO)大鼠。测定了15至75周龄大鼠肾组织切片中的肾小球细胞数量、即刻早期基因(c-Fos和c-Myc)和增殖细胞核抗原(PCNA)的表达以及低密度脂蛋白(LDL)沉积。分离并培养了处于疾病两个不同阶段的OLETF大鼠的系膜细胞(MC),即肾病表现之前的年轻(12至14周龄)OLETF大鼠(y-OLETF)和出现肾病的老年(48至50周龄)OLETF大鼠(o-OLETF)。在用天然(n-)或氧化(ox-)LDL或血管紧张素II(Ang II)刺激后,检测DNA合成和细胞外基质(ECM)产生。使用荧光标记的LDL分析LDL/清道夫受体的细胞表达,并检测与125I标记的LDL的结合。
在25至65周龄之间,OLETF大鼠每个肾小球横截面的细胞数量显著高于LETO大鼠。在OLETF肾小球中,c-Fos、c-Myc和PCNA在早期短暂表达。肾小球LDL沉积随着OLETF大鼠年龄的增加而增加。与o-OLETF系膜细胞和LETO系膜细胞相比,向培养基中添加低剂量的n-LDL(10μg/mL)显著刺激了y-OLETF系膜细胞的DNA合成(P < 0.05)。高剂量的n-LDL(100μg/mL)对所有细胞均产生细胞毒性作用。暴露于ox-LDL对OLETF或LETO系膜细胞的DNA合成影响最小。LDL受体和清道夫受体分别在y-OLETF和o-OLETF中占主导地位。在用n-LDL和ox-LDL刺激后,o-OLETF系膜细胞中I型和III型胶原蛋白以及转化生长因子-β(TGF-β)的表达高于y-OLETF系膜细胞或LETO系膜细胞。暴露于Ang II分别显著诱导了y-OLETF系膜细胞和o-OLETF系膜细胞中的DNA合成和ECM mRNA表达。
这些发现表明细胞增殖过程先于糖尿病肾小球病变的发展。OLETF系膜细胞对n-LDL/ox-LDL和Ang II的反应因糖尿病阶段而异。在早期阶段,系膜细胞易于增殖,而在晚期阶段,表达较高水平TGF-β的系膜细胞倾向于合成ECM。系膜细胞的功能转换可能有助于糖尿病肾病中肾小球硬化的发展。