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长期和短期使用伊马替尼可减轻实验性抗肾小球基底膜肾炎中慢性肾脏病的发展。

Long- and short-term treatment with imatinib attenuates the development of chronic kidney disease in experimental anti-glomerular basement membrane nephritis.

机构信息

Department of Medicine, Showa UniversitySchool of Medicine, Tokyo, Japan.

出版信息

Nephrol Dial Transplant. 2013 Mar;28(3):576-84. doi: 10.1093/ndt/gfs414. Epub 2012 Oct 8.

Abstract

BACKGROUND

Imatinib is a selective tyrosine kinase inhibitor that can block platelet-derived growth factor (PDGF) receptor activity. Imatinib is also known as an anti-inflammatory agent. We examined the therapeutic effects of long- or short-term imatinib treatment in Wistar-Kyoto (WKY) rats with established anti-glomerular basement membrane (GBM) nephritis.

METHODS

Nephrotoxic serum (NTS) nephritis was induced in WKY rats on day 0. Groups of animals were given either imatinib or vehicle daily by intraperitoneal injection, from day 7 to day 49 in the long-term treatment study, and from day 7 to 13 in the short-term treatment study; all rats were sacrificed at day 50.

RESULTS

In long-term treatment, imatinib showed marked renoprotective effects; imatinib suppressed proteinuria, improved renal function, attenuated the development of glomerulosclerosis and tubulointerstitial injury and reduced the expression levels of collagen type I and transforming growth factor-beta (TGF-β) in renal cortex. The key finding of the present study was that short-term treatment with imatinib also significantly attenuated the development of renal injury until day 50, although the degree of renoprotection was slightly inferior to that of long-term treatment.

CONCLUSIONS

These results suggest that administration of imatinib is a promising strategy for limiting the progression of glomerulonephritis (GN) to end-stage renal failure. In particular, a short period of treatment at an early stage of GN is more beneficial in terms of cost-effectiveness and reduction of adverse effects in comparison to a continuous and long period of treatment.

摘要

背景

伊马替尼是一种选择性酪氨酸激酶抑制剂,可阻断血小板衍生生长因子(PDGF)受体活性。伊马替尼也被称为抗炎剂。我们研究了长期或短期伊马替尼治疗在已建立的抗肾小球基底膜(GBM)肾炎的 Wistar-Kyoto(WKY)大鼠中的治疗效果。

方法

在第 0 天,在 WKY 大鼠中诱导肾毒性血清(NTS)肾炎。从第 7 天到第 49 天的长期治疗研究中,以及从第 7 天到第 13 天的短期治疗研究中,每天通过腹腔注射给予动物伊马替尼或载体;所有大鼠均在第 50 天处死。

结果

在长期治疗中,伊马替尼表现出明显的肾保护作用;伊马替尼抑制蛋白尿,改善肾功能,减轻肾小球硬化和肾小管间质损伤的发展,并降低肾皮质中胶原 I 型和转化生长因子-β(TGF-β)的表达水平。本研究的主要发现是,短期给予伊马替尼治疗也可显著减轻直至第 50 天的肾损伤,尽管其肾保护程度略低于长期治疗。

结论

这些结果表明,给予伊马替尼是限制肾小球肾炎(GN)进展为终末期肾衰竭的一种有前途的策略。特别是在 GN 的早期阶段,短期治疗在成本效益和减少不良反应方面比连续长期治疗更有利。

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