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血管紧张素 II 型 1 型受体阻滞剂与 CCR2 拮抗剂联合应用可显著减轻新月体性肾小球肾炎。

Addition of angiotensin II type 1 receptor blocker to CCR2 antagonist markedly attenuates crescentic glomerulonephritis.

机构信息

Department of Physiology and Hypertension and Renal Center of Excellence, Tulane University Health Sciences Center, New Orleans, LA 70112-2699, USA.

出版信息

Hypertension. 2011 Mar;57(3):586-93. doi: 10.1161/HYPERTENSIONAHA.110.165704. Epub 2011 Jan 31.

Abstract

The monocyte chemoattractant protein-1 (MCP-1)/CC-chemokine receptor 2 (CCR2) pathway plays a critical role in the development of antiglomerular basement membrane (anti-GBM) nephritis. We recently showed angiotensin II (Ang II) infusion in rats activated MCP-1 and transforming growth factor-β1 (TGF-β1), which in turn induced macrophage infiltration of renal tissues. This study was performed to demonstrate that combination therapy with a CCR2 antagonist (CA) and an Ang II type 1 receptor blocker (ARB) ameliorated renal injury in the anti-GBM nephritis model. An anti-GBM nephritis rat model developed progressive proteinuria and glomerular crescent formation, accompanied by increased macrophage infiltration and glomerular expression of MCP-1, angiotensinogen, Ang II, and TGF-β1. Treatment with CA alone or ARB alone moderately ameliorated kidney injury; however, the combination treatment with CA and ARB dramatically prevented proteinuria and markedly reduced glomerular crescent formation. The combination treatment also suppressed the induction of macrophage infiltration, MCP-1, angiotensinogen, Ang II, and TGF-β1 and reversed the fibrotic change in the glomeruli. Next, primary cultured glomerular mesangial cells (MCs) stimulated by Ang II showed significant increases in MCP-1 and TGF-β1 expression. Furthermore, cocultured model consisting of MCs, parietal epithelial cells, and macrophages showed an increase in Ang II-induced cell proliferation and collagen secretion. ARB treatment attenuated these augmentations. These data suggest that Ang II enhances glomerular crescent formation of anti-GBM nephritis. Moreover, our results demonstrate that inhibition of the MCP-1/CCR2 pathway with a combination of ARB effectively reduces renal injury in anti-GBM nephritis.

摘要

单核细胞趋化蛋白-1(MCP-1)/CC-趋化因子受体 2(CCR2)途径在抗肾小球基底膜(anti-GBM)肾炎的发展中起着关键作用。我们最近发现,血管紧张素 II(Ang II)在大鼠中的输注激活了 MCP-1 和转化生长因子-β1(TGF-β1),进而诱导巨噬细胞浸润肾组织。本研究旨在证明 CCR2 拮抗剂(CA)和血管紧张素 II 型 1 受体阻滞剂(ARB)联合治疗可改善抗 GBM 肾炎模型中的肾脏损伤。抗 GBM 肾炎大鼠模型发展为进行性蛋白尿和肾小球新月体形成,伴有巨噬细胞浸润和肾小球 MCP-1、血管紧张素原、Ang II 和 TGF-β1 的表达增加。单独使用 CA 或 ARB 治疗可适度改善肾脏损伤;然而,CA 和 ARB 的联合治疗可显著预防蛋白尿并显著减少肾小球新月体形成。联合治疗还抑制了巨噬细胞浸润、MCP-1、血管紧张素原、Ang II 和 TGF-β1 的诱导,并逆转了肾小球的纤维化变化。接下来,Ang II 刺激的原代培养肾小球系膜细胞(MCs)显示 MCP-1 和 TGF-β1 表达显著增加。此外,由 MCs、壁细胞和巨噬细胞组成的共培养模型显示 Ang II 诱导的细胞增殖和胶原分泌增加。ARB 治疗减轻了这些增加。这些数据表明,Ang II 增强了抗 GBM 肾炎的肾小球新月体形成。此外,我们的结果表明,用 ARB 联合抑制 MCP-1/CCR2 途径可有效减少抗 GBM 肾炎的肾脏损伤。

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