Hohenstein Bernd, Daniel Christoph, Wagner Andrea, Stasch Johannes-Peter, Hugo Christian
Div. of Nephrology, Univ. Erlangen-Nuremberg, Loschgestrasse 8, 91054 Erlangen, Germany.
Am J Physiol Renal Physiol. 2005 Apr;288(4):F685-93. doi: 10.1152/ajprenal.00280.2004. Epub 2004 Nov 23.
To date, no specific treatment is established in mesangial proliferative glomerulonephritis in humans. Specific stimulation of soluble guanylyl cyclase (sGC), an enzyme catalyzing the synthesis of cGMP from GTP, can be achieved by the novel pyrazolopyridine derivative BAY 41-2272. The effect of sGC stimulation via BAY 41-2272 on mesangial proliferation was assessed in vivo using a mesangial proliferative glomerulonephritis model in rats (anti-Thy1 model). Renal biopsies, as well as glomerular isolates, urine samples, and blood samples were compared in BAY 41-2272- and placebo-treated groups during anti-Thy1 nephritis. The sGC beta(1)-subunit is upregulated during anti-Thy1 nephritis and mainly confined to mesangial areas by immunohistochemistry. Specific therapeutic sGC stimulation during anti-Thy1 nephritis in vivo was achieved via BAY 41-2272 treatment as demonstrated by increased glomerular cGMP levels causing inhibition of mesangial proliferation, glomerular matrix accumulation, and proteinuria compared with placebo-treated animals. sGC is tightly regulated in glomeruli during experimental glomerulonephritis. Considering its beneficial antiproliferative, antifibrotic, and antiproteinuric effect in experimental glomerulonephritis, the therapeutic stimulation of sGC could become a promising future goal in mesangial proliferative glomerulonephritis in humans.
迄今为止,人类系膜增生性肾小球肾炎尚无特效治疗方法。新型吡唑并吡啶衍生物BAY 41-2272可特异性刺激可溶性鸟苷酸环化酶(sGC),该酶催化GTP合成cGMP。在大鼠系膜增生性肾小球肾炎模型(抗Thy1模型)中,评估了通过BAY 41-2272刺激sGC对系膜增生的体内作用。在抗Thy1肾炎期间,比较了BAY 41-2272治疗组和安慰剂治疗组的肾活检组织、肾小球分离物、尿液样本和血液样本。抗Thy1肾炎期间,sGCβ1亚基上调,免疫组化显示主要局限于系膜区。与安慰剂治疗的动物相比,BAY 41-2272治疗可使肾小球cGMP水平升高,从而抑制系膜增生、肾小球基质积聚和蛋白尿,这表明在体内抗Thy1肾炎期间可实现特异性治疗性sGC刺激。在实验性肾小球肾炎中,肾小球中的sGC受到严格调控。鉴于其在实验性肾小球肾炎中具有有益的抗增殖、抗纤维化和抗蛋白尿作用,sGC的治疗性刺激可能成为人类系膜增生性肾小球肾炎未来一个有前景的目标。