Department of Internal Medicine III, Osaka Medical College, Takatsuki, Osaka, Japan.
Urology. 2011 Jan;77(1):249.e9-15. doi: 10.1016/j.urology.2010.07.496. Epub 2010 Nov 11.
To examine the effect of L- and T/L-type calcium channel blockers on interstitial fibrosis in chronic unilateral ureteral obstruction (UUO). Tubulointerstitial fibrosis is a common outcome of several progressive renal diseases. Calcium channel blockers are widely used for the treatment of hypertension with renal diseases; however, the direct effect of calcium channel blockers on renal diseases independent of lowering blood pressure has not been fully elucidated.
Sprague-Dawley rats were divided into 3 treatment groups: (1) vehicle control; (2) nifedipine, an L-type calcium channel blockers; and (3) efonidipine, a T/L-type calcium channel blockers. Treatment was initiated 1 day before and continued until 6 days after creation of the UUO.
Tubulointerstitial fibrosis in the obstructed kidney was significantly increased compared with that in the contralateral unobstructed kidney. Furthermore, the increased fibrosis was accompanied by increased fibrogenic signaling expressed by transforming growth factor β1 and connective tissue growth factor mRNA levels, increased oxidative stress expressed by p22phox, p47phox and gp91phox mRNA level. Moreover, treatment with a nonhypotensive dose of efonidipine but not nifedipine in the obstructed kidney significantly suppressed the fibrogenic signaling and the oxidative stress, resulting in reduced tubulointerstitial fibrosis. The plasma aldosterone level in efonidipine-treated animals was increased compared with vehicle-treated animals, although not significantly. The increased plasma aldosterone level did not increase sgk-1 mRNA level in efonidipine but not in nifedipine treated animals.
Treatment with efonidipine improved tubulointerstitial fibrosis more effectively than treatment with nifedipine in UUO. The antifibrogenic effect by efonidipine was obtained through suppression of fibrogenic signaling.
研究 L 型和 T/L 型钙通道阻滞剂对慢性单侧输尿管梗阻(UUO)间质纤维化的影响。肾小管间质纤维化是几种进行性肾脏疾病的常见结局。钙通道阻滞剂广泛用于治疗伴有肾脏疾病的高血压;然而,钙通道阻滞剂对独立于降压之外的肾脏疾病的直接作用尚未完全阐明。
将 Sprague-Dawley 大鼠分为 3 个治疗组:(1) vehicle 对照组;(2)硝苯地平,L 型钙通道阻滞剂;和(3)依福地平,T/L 型钙通道阻滞剂。治疗于 UUO 前 1 天开始,并持续至 UUO 后 6 天。
与对侧未梗阻肾脏相比,梗阻肾脏的肾小管间质纤维化明显增加。此外,增加的纤维化伴随着转化生长因子 β1 和结缔组织生长因子 mRNA 水平表达的纤维化信号增加,p22phox、p47phox 和 gp91phox mRNA 水平表达的氧化应激增加。此外,非降压剂量的依福地平而非硝苯地平治疗梗阻肾脏可显著抑制纤维化信号和氧化应激,从而减少肾小管间质纤维化。依福地平治疗动物的血浆醛固酮水平较 vehicle 对照组升高,尽管无统计学意义。依福地平治疗动物的 sgk-1 mRNA 水平未增加,但硝苯地平治疗动物的 sgk-1 mRNA 水平增加。
依福地平治疗 UUO 比硝苯地平治疗更有效地改善肾小管间质纤维化。依福地平的抗纤维化作用是通过抑制纤维化信号获得的。