Institute of Clinical Pharmacology, Johann Wolfgang Goethe-University, Frankfurt, Germany.
Br J Pharmacol. 2011 Jul;163(5):927-36. doi: 10.1111/j.1476-5381.2011.01313.x.
Deletion of the cyclooxygenase-2 (COX-2) gene causes impairment of kidney development, but the effect of selective inhibitors of COX-2 (coxibs) or the non-selective inhibitors of COX (the classical non-steroidal anti-inflammatory drugs; NSAIDs) on kidney development was less well described.
We assessed the effects of equipotent analgesic doses of celecoxib, rofecoxib, valdecoxib, etoricoxib and lumiracoxib and of the NSAIDs, diclofenac and naproxen, on postpartum kidney development in mice, from postnatal day 1 (P1) to P21.
All the COX inhibitors, at the doses used, blocked COX-2 activity by more than 80% as assayed by PGE(2) synthesis in lipopolysaccharide-stimulated mouse blood samples. Rofecoxib, etoricoxib and lumiracoxib exerted the most marked impairment of postpartum kidney development, demonstrated by attenuation of kidney growth, reduction in size of glomeruli, increase in immature superficial glomeruli, thinning of subcapsular cortical mass and reduction in size of juxtamedullary glomeruli. These defects were less severe than those in kidneys from COX-2(-/-) mice. Administration of diclofenac and naproxen revealed renal defects similar to those after coxib treatment, but both NSAIDs induced greater arrest of immature superficial glomeruli in the outer cortex and increased the number of undifferentiated proliferating cell nuclear antigen-positive cells. Treatment with celecoxib or valdecoxib caused only minimal changes in renal morphology.
Classical NSAIDs cause similar or even stronger nephrodysgenesis than the coxibs. Also, the ranking of coxibs regarding adverse effects on renal development, using equi-analgesic doses, is rofecoxib = etoricoxib = lumiracoxib > valdecoxib > celecoxib.
环氧化酶-2 (COX-2) 基因缺失会导致肾脏发育受损,但选择性 COX-2 抑制剂 (coxibs) 或非选择性 COX 抑制剂(经典非甾体抗炎药;NSAIDs)对肾脏发育的影响则描述较少。
我们评估了等效镇痛剂量的塞来昔布、罗非昔布、伐地昔布、依托考昔和鲁米昔布以及 NSAIDs 双氯芬酸和萘普生对产后第 1 天(P1)至第 21 天的小鼠肾脏发育的影响。
所有 COX 抑制剂,在使用剂量下,通过脂多糖刺激的小鼠血液样本中 PGE2 合成测定,均使 COX-2 活性抑制超过 80%。罗非昔布、依托考昔和鲁米昔布对产后肾脏发育的影响最为显著,表现为肾脏生长受阻、肾小球体积减小、不成熟的浅层肾小球增多、皮质下包膜质量变薄和近髓质肾小球体积减小。这些缺陷比 COX-2(-/-) 小鼠肾脏中的缺陷轻。给予双氯芬酸和萘普生后,肾脏也出现类似 COX 抑制剂治疗后的缺陷,但两种 NSAIDs 均导致更多的不成熟浅层肾小球在外皮层停滞,并增加了未分化增殖细胞核抗原阳性细胞的数量。塞来昔布或伐地昔布治疗仅引起肾脏形态的微小变化。
经典 NSAIDs 引起的肾发育不良与 coxibs 相似甚至更严重。此外,使用等效镇痛剂量,根据对肾脏发育的不良影响,coxibs 的排序为罗非昔布=依托考昔=鲁米昔布>伐地昔布>塞来昔布。