Department of Nephrology, Heraklion University Hospital, Crete, Greece.
Nephrol Dial Transplant. 2012 Aug;27(8):3141-8. doi: 10.1093/ndt/gfr791. Epub 2012 Jan 30.
In the normal kidney, rapamycin is considered to be non-nephrotoxic. In the present study, we investigated whether rapamycin is indeed non-nephrotoxic by examining the ultrastructural and molecular alterations of podocytes in healthy mice.
Balb/c mice were given three different intraperitoneal doses of rapamycin for 1 week (dose model)-low-dose group: 1 mg/kg/day, intermediate-dose (ID) group: 1.5 mg/kg/day and high-dose (HD) group: 3 mg/kg/day; four mice in each group. An ID of rapamycin was also given for three different periods (time model): 1, 4 and 8 weeks; four mice were in each group. Mice treated with dimethyl sulphoxide served as controls. Body weight was measured weekly. Renal function was assessed by serum creatinine at the time of sacrifice. For estimation of albuminuria, 24-h urine collections were performed before treatment and weekly thereafter. Glomerular content of nephrin, podocin, Akt and Ser473-phospho-Akt was estimated by western blot and immunofluorescence. Nephrin and podocin messenger RNA (mRNA) were measured by real-time polymerase chain reaction. Mean podocyte foot process width (FPW) was measured by electron microscopy.
Urine albumin levels increased in the HD and 4-week groups. Renal function was modestly deteriorated in the HD group. The mean FPW increased in a dose-dependant manner at Week 1, further deteriorated at Week 4 and finally improved at Week 8. Nephrin and podocin mRNA levels showed a significant decrease at Week 1 and were restored at Week 4 and 8. Nephrin and podocin protein levels were reduced at Week 4 and recovered at Week 8. Ser473-phospho-Akt significantly increased in all rapamycin-treated groups.
Rapamycin induced significant ultrastructural and molecular alterations in podocytes in association with albuminuria. These alterations happened early during treatment and they tended to improve over an 8-week treatment period.
在正常肾脏中,雷帕霉素被认为是非肾毒性的。在本研究中,我们通过检查健康小鼠足细胞的超微结构和分子改变来研究雷帕霉素是否确实无肾毒性。
Balb/c 小鼠接受了三种不同的腹腔内雷帕霉素剂量(剂量模型),持续 1 周:低剂量组:1mg/kg/天,中剂量(ID)组:1.5mg/kg/天,高剂量(HD)组:3mg/kg/天;每组 4 只小鼠。雷帕霉素的 ID 剂量也分别给予 3 个不同的时间段(时间模型):1、4 和 8 周;每组 4 只小鼠。用二甲基亚砜处理的小鼠作为对照。每周测量体重。在处死时通过血清肌酐评估肾功能。为了估计白蛋白尿,在治疗前和此后每周进行 24 小时尿液收集。通过 Western blot 和免疫荧光法估计肾小球中nephrin、podocin、Akt 和 Ser473-磷酸化-Akt 的含量。通过实时聚合酶链反应测量 nephrin 和 podocin 的信使 RNA(mRNA)。通过电子显微镜测量平均足细胞足突宽度(FPW)。
HD 组和 4 周组的尿白蛋白水平升高。HD 组肾功能略有恶化。FPW 均值呈剂量依赖性增加,第 1 周增加,第 4 周进一步恶化,第 8 周改善。Nephrin 和 podocin 的 mRNA 水平在第 1 周显著下降,在第 4 周和第 8 周恢复。Nephrin 和 podocin 蛋白水平在第 4 周降低,在第 8 周恢复。所有雷帕霉素治疗组的 Ser473-磷酸化-Akt 均显著增加。
雷帕霉素在与白蛋白尿相关的情况下,在足细胞中引起显著的超微结构和分子改变。这些改变在治疗早期发生,并在 8 周的治疗过程中趋于改善。