Takano Mikihisa, Nakanishi Naoki, Kitahara Yasumi, Sasaki Yuki, Murakami Teruo, Nagai Junya
Institute of Pharmaceutical Sciences, Faculty of Medicine, Hiroshima University, Hiroshima, Japan.
Kidney Int. 2002 Nov;62(5):1707-17. doi: 10.1046/j.1523-1755.2002.00623.x.
Administration of cisplatin, cis-diamminedichloroplatinum (II) (CDDP), causes a severe impairment of renal function, including increases in urinary excretion of proteins. We recently found that CDDP inhibits vacuolar H+-ATPase, which plays an important role in receptor-mediated endocytosis in the renal proximal tubules. Therefore, CDDP-induced proteinuria may be due to an inhibition of the receptor-mediated endocytosis in the renal proximal tubules following a decrease in vacuolar H+-ATPase activity by the drug.
Effects of CDDP on receptor-mediated endocytosis of albumin in opossum kidney (OK) epithelial cells, and on urinary excretion of albumin and vitamin D binding protein, which are reabsorbed in the renal proximal tubules by endocytosis, in rats were examined.
CDDP inhibited uptake of fluorescein-isothiocyanate (FITC)-albumin, a receptor-mediated endocytosis marker, by OK cells in a time- and concentration-dependent fashion. In contrast, CDDP treatment did not affect the uptake of FITC-inulin, a fluid-phase endocytosis marker. CDDP caused a decrease in the affinity and in the maximal velocity of FITC-albumin uptake. The adenosine 5'-triphosphate (ATP) content in OK cells was not changed by CDDP at concentrations that inhibited FITC-albumin uptake. The endosomal pH in OK cells was increased by CDDP treatment. Administration of CDDP to rats increased the urinary excretion of albumin and vitamin D binding protein.
These results suggest that CDDP decreases the receptor-mediated endocytosis of protein following the inhibition of vacuolar H+-ATPase in the renal proximal tubules, and the inhibition of receptor-mediated endocytosis would be the mechanisms underlying the proteinuria induced by CDDP.
顺铂,即顺二氯二氨铂(II)(CDDP)的给药会导致肾功能严重受损,包括尿蛋白排泄增加。我们最近发现,CDDP会抑制液泡H⁺-ATP酶,该酶在肾近端小管的受体介导的内吞作用中起重要作用。因此,CDDP诱导的蛋白尿可能是由于药物使液泡H⁺-ATP酶活性降低后,肾近端小管中受体介导的内吞作用受到抑制所致。
研究了CDDP对负鼠肾(OK)上皮细胞中白蛋白受体介导的内吞作用的影响,以及对大鼠肾近端小管中通过内吞作用重吸收的白蛋白和维生素D结合蛋白的尿排泄的影响。
CDDP以时间和浓度依赖性方式抑制OK细胞对异硫氰酸荧光素(FITC)-白蛋白(一种受体介导的内吞作用标志物)的摄取。相比之下,CDDP处理不影响FITC-菊粉(一种液相内吞作用标志物)的摄取。CDDP导致FITC-白蛋白摄取的亲和力和最大速度降低。在抑制FITC-白蛋白摄取的浓度下,CDDP不会改变OK细胞中的三磷酸腺苷(ATP)含量。CDDP处理会使OK细胞内体pH值升高。给大鼠注射CDDP会增加白蛋白和维生素D结合蛋白的尿排泄。
这些结果表明,CDDP在抑制肾近端小管中的液泡H⁺-ATP酶后,会降低蛋白质的受体介导的内吞作用,而受体介导的内吞作用的抑制将是CDDP诱导蛋白尿的潜在机制。