Fujimura Toshiko, Yamagishi Sho-ichi, Ueda Seiji, Fukami Kei, Shibata Ryo, Matsumoto Yuriko, Kaida Yusuke, Hayashida Ayako, Koike Kiyomi, Matsui Takanori, Nakamura Kei-ichiro, Okuda Seiya
Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
Nephrol Dial Transplant. 2009 May;24(5):1397-406. doi: 10.1093/ndt/gfn659. Epub 2008 Nov 28.
Pigment epithelium-derived factor (PEDF) is a glycoprotein with potent neuronal differentiating activity. We, along with others, have recently found that PEDF inhibits retinal hyperpermeability by counteracting the biological effects of vascular endothelial growth factor (VEGF). However, the protective role of PEDF against nephrotic syndrome (NS), a condition of hyperpermeability in the glomerular capillaries, remains to be elucidated. In this study, we investigated whether and how PEDF reduced proteinuria in rats with adriamycin (ADR)-induced nephropathy (ADN), an experimental model of NS.
ADN was induced by a single intravenous injection of doxorubicin hydrochloride (n = 12). Half the ADN rats were intravenously administrated human recombinant PEDF; the other half were given vehicle everyday for up to 14 days. Control rats (n = 6) received vehicle only.
In ADN, expression levels of PEDF in isolated glomeruli were significantly decreased, which were associated with a marked proteinuria and increased urinary excretion of nephrin, an index of podocyte damage. Loss of nephrin and decreased podocyte cell number and fusion of foot processes of podocytes with nuclear factor-kappa B (NF-kappaB) activation and VEGF overexpression were also observed in the glomeruli of rats with ADN. Intravenous administration of PEDF ameliorated all of these changes in ADN rats.
The present findings suggest that PEDF could reduce proteinuria by suppressing podocyte damage and decreased nephrin as well as increased VEGF expression in the glomeruli of ADN rats. Pharmacological up-regulation or substitution of PEDF may offer a promising therapeutic strategy for the treatment of nephrotic syndrome.
色素上皮衍生因子(PEDF)是一种具有强大神经元分化活性的糖蛋白。我们和其他研究人员最近发现,PEDF通过对抗血管内皮生长因子(VEGF)的生物学效应来抑制视网膜高通透性。然而,PEDF对肾病综合征(NS)(一种肾小球毛细血管高通透性疾病)的保护作用仍有待阐明。在本研究中,我们调查了PEDF是否以及如何降低阿霉素(ADR)诱导的肾病(ADN)大鼠(NS的一种实验模型)的蛋白尿。
通过单次静脉注射盐酸阿霉素诱导ADN(n = 12)。一半的ADN大鼠静脉注射人重组PEDF;另一半每天给予赋形剂,持续14天。对照大鼠(n = 6)仅接受赋形剂。
在ADN中,分离肾小球中PEDF的表达水平显著降低,这与明显的蛋白尿以及足细胞损伤指标nephrin尿排泄增加有关。在ADN大鼠的肾小球中还观察到nephrin丢失、足细胞数量减少以及足细胞足突融合,伴有核因子-κB(NF-κB)激活和VEGF过表达。静脉注射PEDF改善了ADN大鼠的所有这些变化。
目前的研究结果表明,PEDF可通过抑制ADN大鼠肾小球中的足细胞损伤、降低nephrin以及增加VEGF表达来减少蛋白尿。药理学上调或替代PEDF可能为肾病综合征的治疗提供一种有前景的治疗策略。