Manucha Walter, Oliveros Liliana, Carrizo Liliana, Seltzer Alicia, Vallés Patricia
Cátedra de Fisiopatología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Centro Universitario, Mendoza, Argentina.
Kidney Int. 2004 Jun;65(6):2091-107. doi: 10.1111/j.1523-1755.2004.00643.x.
Angiotensin II plays a central role in the initiation of renal fibrogenesis at a very early stage leading to a rapid progression in unilateral ureteral obstruction (UUO). We examined the effect of an angiotensin II receptor inhibitor (AT(1)) losartan, independent from its effects on blood pressure, on nitric oxide synthase (NOS) isoforms and cyclooxygenase-2 (COX-2) expression and the significance of this interaction on interstitial fibrosis in UUO.
Rats underwent UUO for 24 hours or control sham operation after been treated with losartan in the drinking water at 10 mg/kg/day for 15 days. AT(1) receptor binding and distribution was determined by in situ autoradiographic study. Renal fibrosis was evaluated through the relative volume of the tubulointerstitium (Vv) measured by an image analyzer, and transforming growth factor-beta (TGF-beta) at mRNA levels. NOS activity, expression of NOS isoforms by reverse transcription-polymerase chain reaction (RT-PCR) assay and COX-2 protein expression, were determined.
After administration of a nonhypotensive dose of losartan prevention of renal fibrogenesis was demonstrated in obstructed kidneys by means of Vv values and TGF-beta mRNA expression near controls. Decreased AT(1) receptor binding density was observed in cortex and inner stripe of the outer medulla of nontreated obstructed kidney compared to control, whereas no differences were observed in ipsilateral UUO related to obstructed kidney-treated group. The increased inducible NOS (iNOS) activity and expression of obstructed kidney medulla, increased neuronal NOS (nNOS), and endothelial NOS (eNOS) isoforms expression and COX-2 protein expression in obstructed kidney cortex showed down-regulation of iNOS, nNOS, and COX-2 with persistent levels of eNOS after losartan administration.
These results allowed us to infer an interstitial fibrogenesis prevention independent action of losartan, involving NOS isoforms and COX-2, in unilateral obstructive nephropathy.
血管紧张素II在肾纤维化形成的早期阶段起核心作用,可导致单侧输尿管梗阻(UUO)迅速进展。我们研究了血管紧张素II受体抑制剂(AT(1))氯沙坦在不依赖其对血压影响的情况下,对一氧化氮合酶(NOS)亚型和环氧合酶-2(COX-2)表达的影响,以及这种相互作用对UUO间质纤维化的意义。
大鼠在饮用含10mg/kg/天氯沙坦的水15天后,接受UUO手术24小时或进行对照假手术。通过原位放射自显影研究确定AT(1)受体结合和分布。通过图像分析仪测量肾小管间质的相对体积(Vv)以及转化生长因子-β(TGF-β)的mRNA水平来评估肾纤维化。测定NOS活性、通过逆转录-聚合酶链反应(RT-PCR)检测NOS亚型的表达以及COX-2蛋白表达。
给予非降压剂量的氯沙坦后,通过Vv值和接近对照的TGF-β mRNA表达证明,梗阻肾脏的肾纤维化形成得到预防。与对照相比,未治疗的梗阻肾脏皮质和外髓质内带的AT(1)受体结合密度降低,而与梗阻肾脏治疗组的同侧UUO相比未观察到差异。梗阻肾脏髓质中诱导型NOS(iNOS)活性和表达增加,梗阻肾脏皮质中神经元NOS(nNOS)和内皮型NOS(eNOS)亚型表达以及COX-2蛋白表达增加,氯沙坦给药后iNOS、nNOS和COX-2表达下调,而eNOS水平持续存在。
这些结果使我们推断氯沙坦在单侧梗阻性肾病中具有独立于间质纤维化形成预防的作用,涉及NOS亚型和COX-2。