Nishikawa Tetsuo, Matsuzawa Yoko, Suematsu Sachiko, Saito Jun, Omura Masao, Kino Tomoshige
Department of Medicine, Yokohama Rosai Hospital, Yokohama City, Kanagawa, Japan.
Arzneimittelforschung. 2010;60(7):445-51. doi: 10.1055/s-0031-1296310.
Nephropathy is a major complication of diabetes mellitus, thus development of rational therapeutic means is critical for improving public health. It was previously reported that human mesangial cells locally produced aldosterone, a steroid hormone that plays an important role in the development of diabetic nephropathy. The present experiments clarified the effect of glucose, LDL and angiotensin II, the molecules frequently elevated in patients with diabetic nephropathy, on aldosterone production in human primary mesangial cells. These cells expressed the CYP11B2 mRNA, a rate-limiting enzyme in the aldosterone biosynthesis. LDL and angiotensin II stimulated CYP11B2 mRNA expression in these cells, while a high concentration of glucose, angiotensin II and/or LDL increased aldosterone production. Importantly, atorvastatin (CAS 134523-03-8), an HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase inhibitor, strongly suppressed their effects on aldosterone production. Atorvastatin also suppressed positive effects of these compounds on the mRNA expression of the angiotensin II receptor type 1, thus atorvastatin exerted its negative effect in part through changing expression of this receptor. Since elevated levels of glucose and LDL, and increased action of the renin-angiotensin-aldosterone system is known to participate in the progression of diabetic nephropathy, it is speculated that the mesangial endocrine system that produces aldosterone locally is a promising therapeutic target for diabetic nephropathy where HMG-CoA reductase inhibitors provide a beneficial effect.
肾病是糖尿病的主要并发症,因此开发合理的治疗方法对于改善公众健康至关重要。此前有报道称,人系膜细胞可局部产生醛固酮,这是一种在糖尿病肾病发展中起重要作用的类固醇激素。本实验阐明了糖尿病肾病患者体内常见升高的分子葡萄糖、低密度脂蛋白(LDL)和血管紧张素II对人原代系膜细胞醛固酮生成的影响。这些细胞表达了CYP11B2 mRNA,这是醛固酮生物合成中的一种限速酶。LDL和血管紧张素II刺激了这些细胞中CYP11B2 mRNA的表达,而高浓度的葡萄糖、血管紧张素II和/或LDL则增加了醛固酮的生成。重要的是,HMG-CoA(3-羟基-3-甲基戊二酰辅酶A)还原酶抑制剂阿托伐他汀(CAS 134523-03-8)强烈抑制了它们对醛固酮生成的影响。阿托伐他汀还抑制了这些化合物对1型血管紧张素II受体mRNA表达的积极作用,因此阿托伐他汀部分通过改变该受体的表达发挥其负面作用。由于已知葡萄糖和LDL水平升高以及肾素-血管紧张素-醛固酮系统的作用增强参与了糖尿病肾病的进展,推测局部产生醛固酮的系膜内分泌系统是糖尿病肾病的一个有前景的治疗靶点,而HMG-CoA还原酶抑制剂可在其中发挥有益作用。