Lee Sik, Kim Won, Kim Duk Hoon, Moon Sang-Ok, Jung Yu Jin, Lee Ae Sin, Kang Kyung Pyo, Jang Kyu Yun, Lee Sang Yong, Sung Mi Jeong, Koh Gou Young, Park Sung Kwang
Department of Internal Medicine, Chonbuk National University Medical School, 634-18, Keum-Am Dong, Jeonju, 561-712, Korea.
Nephrol Dial Transplant. 2008 Sep;23(9):2784-94. doi: 10.1093/ndt/gfn168. Epub 2008 May 7.
Peritubular capillary injury induces chronic hypoxia in the renal tubulointerstitium, and renal peritubular capillary dysfunction is an early event that contributes to tubulointerstitial fibrosis. Cyclosporine A (CsA) is a potent immunosuppressant and improves survival of renal allografts. However, the limitation of CsA use is chronic nephrotoxicity. A soluble, stable and potent angiopoietin-1 (Ang1) variant, cartilage oligomeric matrix protein (COMP)-Ang1 has been developed. We investigated whether COMP-Ang1 ameliorates CsA-induced renal injury.
CsA-treated mice were injected with recombinant adenovirus expressing either COMP-Ang1 or LacZ. Histology, inflammatory, haemodynamic and fibrotic parameters, and signalling pathway were evaluated.
Histologic examination showed that COMP-Ang1 significantly decreased CsA-induced tubular damage and tubulointerstitial fibrosis. CsA-induced increases in macrophage infiltration and expression of MCP-1 and ICAM-1 after CsA treatment were significantly reduced by COMP-Ang1. Treatment with COMP-Ang1 also decreased the CsA-induced increases in TGF-beta1 and Smad 2/3 levels while increasing Smad 7 levels. Laser-Doppler sonographic findings and endothelial factor VIII staining revealed that COMP-Ang1 preserved the integrity of peritubular vasculature and intrarenal haemodynamics from the CsA-induced renal injury. COMP-Ang1 inhibited tubular cell apoptosis while increasing tubular cell proliferation in CsA-induced renal injury.
These results indicate that COMP-Ang1 exhibited a protective effect on damaged peritubular capillaries, haemodynamic alteration and inflammation in CsA-induced renal injury. Thus, COMP-Ang1 may be useful as a therapeutic and prophylactic agent for specific protection against endothelial dysfunction and inflammation.
肾小管周围毛细血管损伤可导致肾小管间质慢性缺氧,而肾肾小管周围毛细血管功能障碍是导致肾小管间质纤维化的早期事件。环孢素A(CsA)是一种强效免疫抑制剂,可提高肾移植存活率。然而,CsA使用的局限性在于其慢性肾毒性。一种可溶性、稳定且强效的血管生成素-1(Ang1)变体,即软骨寡聚基质蛋白(COMP)-Ang1已被研发出来。我们研究了COMP-Ang1是否能改善CsA诱导的肾损伤。
给经CsA处理的小鼠注射表达COMP-Ang1或LacZ的重组腺病毒。评估组织学、炎症、血流动力学和纤维化参数以及信号通路。
组织学检查显示,COMP-Ang1显著降低了CsA诱导的肾小管损伤和肾小管间质纤维化。COMP-Ang1显著降低了CsA处理后巨噬细胞浸润以及MCP-1和ICAM-1表达的增加。COMP-Ang1治疗还降低了CsA诱导的TGF-β1和Smad 2/3水平的升高,同时增加了Smad 7水平。激光多普勒超声检查结果和内皮因子VIII染色显示,COMP-Ang1保护肾小管周围血管系统的完整性以及肾内血流动力学免受CsA诱导的肾损伤。COMP-Ang1抑制了CsA诱导的肾损伤中肾小管细胞凋亡,同时增加了肾小管细胞增殖。
这些结果表明,COMP-Ang1对CsA诱导的肾损伤中受损的肾小管周围毛细血管、血流动力学改变和炎症具有保护作用。因此,COMP-Ang1可能作为一种治疗和预防药物,用于特异性保护内皮功能障碍和炎症。