Vieira José Mauro, Mantovani Eduardo, Rodrigues Leonardo Tavares, Dellê Humberto, Noronha Irene Lourdes, Fujihara Clarice Kazue, Zatz Roberto
Internal Medicine, Renal Division, University of São Paulo, São Paulo, Brazil.
Nephrol Dial Transplant. 2005 Aug;20(8):1582-91. doi: 10.1093/ndt/gfh859. Epub 2005 Apr 26.
The pleiotropic actions of statins have been largely explored. These drugs have been tested in several models of progressive renal disease, most of them accompanied by hypertension. We sought to investigate more closely the effects of simvastatin on renal interstitial fibrosis due to unilateral ureteral obstruction (UUO).
Munich-Wistar rats were submitted to UUO and studied after 14 days. Animals were divided into two groups: vehicle (VH) or simvastatin (SIMV) 2 mg/kg b.i.d. by gavage. At sacrifice kidneys were harvested for morphology, mRNA and protein analysis. RT-PCR was done to assess expression of collagen I and III, fibronectin, MCP-1, TGF-beta1 and bFGF. Protein expression was assessed by western blot (TGF-beta) and immunostaining (macrophage, lymphocyte, PCNA, vimentin and alpha-smooth muscle actin). Contralateral kidneys (CL) were used as controls.
SIMV-treated animals had less severe renal inflammation. MCP-1 was markedly expressed in obstructed kidneys and diminished with SIMV (48.9+/- 2.5 vs 64.3+/-3.1 OD in VH, P<0.01). Interstitial fibrosis (IF) was significantly attenuated with SIMV (8.2+/-1.3 vs 13.2+/-0.6%, P<0.01 SIMV vs VH), which was confirmed by a decrease in collagen I and fibronectin renal expression. Vimentin, a marker of dedifferentiation, was expressed in tubular cells of VH and decreased with SIMV treatment. alpha-SMA, a marker of myofibroblast-type cells, was increased in renal interstitium of VH rats and SIMV significantly reduced its expression. PCNA was increased in the UUO kidneys, but SIMV did not decrease tubular or interstitial proliferating cells. TGF-beta1, which was highly induced in the obstructed kidneys, decreased at the post-transcriptional level with SIMV treatment (5.35+/-0.75 vs 13.10+/-2.9 OD in VH, P<0.05). bFGF mRNA was also overexpressed in the obstructed kidneys, although SIMV treatment did not significantly decrease its expression.
SIMV had an evident protective effect on renal interstitial inflammation and fibrosis. It is conceivable that by attenuating inflammation, SIMV prevented tubular activation and transdifferentiation, two processes largely involved in the renal fibrosis of the UUO model.
他汀类药物的多效性作用已得到广泛研究。这些药物已在多种进行性肾病模型中进行了测试,其中大多数伴有高血压。我们试图更深入地研究辛伐他汀对单侧输尿管梗阻(UUO)所致肾间质纤维化的影响。
将慕尼黑-维斯塔大鼠进行单侧输尿管梗阻手术,并在14天后进行研究。动物分为两组:对照组(VH)和经口灌胃给予2mg/kg bid辛伐他汀(SIMV)的组。处死动物后,取肾脏进行形态学、mRNA和蛋白质分析。采用逆转录-聚合酶链反应(RT-PCR)评估I型和III型胶原、纤连蛋白、单核细胞趋化蛋白-1(MCP-1)、转化生长因子-β1(TGF-β1)和碱性成纤维细胞生长因子(bFGF)的表达。通过蛋白质印迹法(检测TGF-β)和免疫染色法(检测巨噬细胞、淋巴细胞、增殖细胞核抗原(PCNA)、波形蛋白和α-平滑肌肌动蛋白)评估蛋白质表达。对侧肾脏(CL)用作对照。
接受SIMV治疗的动物肾脏炎症较轻。MCP-1在梗阻肾脏中明显表达,而辛伐他汀可使其表达降低(VH组为64.3±3.1光密度值,SIMV组为48.9±2.5光密度值,P<0.01)。辛伐他汀可显著减轻间质纤维化(IF)(SIMV组为8.2±1.3%,VH组为13.2±0.6%,SIMV组与VH组相比,P<0.01),这通过肾脏中I型胶原和纤连蛋白表达的降低得到证实。波形蛋白是去分化的标志物,在VH组肾小管细胞中表达,经SIMV治疗后降低。α-平滑肌肌动蛋白是肌成纤维细胞型细胞的标志物,在VH组大鼠肾间质中增加,而SIMV可显著降低其表达。PCNA在UUO肾脏中增加,但SIMV并未减少肾小管或间质中的增殖细胞。TGF-β1在梗阻肾脏中高度诱导表达,经SIMV治疗后在转录后水平降低(VH组为13.10±2.9光密度值,SIMV组为5.35±0.75光密度值,P<0.05)。bFGF mRNA在梗阻肾脏中也过度表达,尽管SIMV治疗并未显著降低其表达。
辛伐他汀对肾间质炎症和纤维化具有明显的保护作用。可以想象,通过减轻炎症,辛伐他汀可预防肾小管激活和转分化,这两个过程在UUO模型的肾纤维化中起主要作用。