Terada Yoshio, Kuwana Hitoshi, Kobayashi Takahiko, Okado Tomokazu, Suzuki Noriko, Yoshimoto Takanobu, Hirata Yukio, Sasaki Sei
Department of Blood Purification and Nephrology, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo 113-8519, Japan.
J Am Soc Nephrol. 2008 Feb;19(2):298-309. doi: 10.1681/ASN.2007050531. Epub 2008 Jan 9.
Several recent reports support the hypothesis that aldosterone contributes to the progression of renal injury. Mineralocorticoids increase the expression of serum- and glucocorticoid-inducible protein kinase 1 (SGK1), which is upregulated in several fibrotic diseases. It was hypothesized that SGK1 may mediate the effects of aldosterone on glomerular fibrosis and inflammation. In primary cultures of rat mesangial cells, aldosterone stimulated the expression, phosphorylation, and kinase activity of SGK1, as well as SGK1-dependent NF-kappaB activity. Furthermore, aldosterone augmented the promoter activity and protein expression of intercellular adhesion molecule-1 (ICAM-1), which modulates the inflammatory response, and the profibrotic cytokine connective tissue growth factor (CTGF) in an SGK1- and NF-kappaB-dependent manner. Similar to the in vitro results, uninephrectomized rats that were treated with aldosterone demonstrated increased glomerular expression of SGK1, ICAM-1, and CTGF proteins than untreated rats; these changes were accompanied by hypertension, glomerulosclerosis, and inflammation. In conclusion, these findings suggest that aldosterone stimulates ICAM-1 and CTGF transcription via the activation of SGK1 and NF-kappaB, effects that may contribute to the progression of aldosterone-induced mesangial fibrosis and inflammation.
最近的几份报告支持醛固酮促进肾损伤进展这一假说。盐皮质激素可增加血清和糖皮质激素诱导蛋白激酶1(SGK1)的表达,该蛋白在几种纤维化疾病中表达上调。据推测,SGK1可能介导醛固酮对肾小球纤维化和炎症的作用。在大鼠系膜细胞原代培养中,醛固酮刺激SGK1的表达、磷酸化和激酶活性,以及依赖SGK1的核因子κB活性。此外,醛固酮以依赖SGK1和核因子κB的方式增强细胞间黏附分子1(ICAM-1)的启动子活性和蛋白表达,ICAM-1可调节炎症反应,以及促纤维化细胞因子结缔组织生长因子(CTGF)。与体外实验结果相似,接受醛固酮治疗的单侧肾切除大鼠与未治疗大鼠相比,肾小球SGK1、ICAM-1和CTGF蛋白表达增加;这些变化伴有高血压、肾小球硬化和炎症。总之,这些发现表明醛固酮通过激活SGK1和核因子κB刺激ICAM-1和CTGF转录,这些作用可能促进醛固酮诱导的系膜纤维化和炎症进展。