Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, RS, Brazil.
Life Sci. 2013 Jul 10;92(24-26):1174-9. doi: 10.1016/j.lfs.2013.05.001. Epub 2013 May 13.
Angiotensin-converting enzyme (ACE) inhibitors are used in diabetic kidney disease to reduce systemic/intra-glomerular pressure. The objective of this study was to investigate whether reducing blood pressure (BP) could modulate renal glucose transporter expression, and urinary markers of diabetic nephropathy in diabetic hypertensive rats treated with ramipril or amlodipine.
Diabetes was induced in spontaneously-hypertensive rats (~210 g) by streptozotocin (50mg/kg). Thirty days later, animals received ramipril 15 μg/kg/day (R, n=10), or amlodipine 10mg/kg/day (A, n=8,) or water (C, n=10) by gavage. After 30-day treatment, body weight, glycaemia, urinary albumin and TGF-β1 (enzyme-linked immunosorbent assay) and BP (tail-cuff pressure method) were evaluated. Kidneys were removed for evaluation of renal cortex glucose transporters (Western blotting) and renal tissue ACE activity (fluorometric assay).
After treatments, body weight (p=0.77) and glycaemia (p=0.22) were similar among the groups. Systolic BP was similarly reduced (p<0.001) in A and R vs. C (172.4 ± 3.2; 1867 ± 3.7 and 202.2 ± 4.3 mmHg; respectively). ACE activity (C: 0.903 ± 0.086; A: 0.654 ± 0.025, and R: 0.389 ± 0.057 mU/mg), albuminuria (C: 264.8 ± 15.4; A: 140.8 ± 13.5 and R: 102.8 ± 6.7 mg/24h), and renal cortex GLUT1 content (C: 46.81 ± 4.54; A: 40.30 ± 5.39 and R: 26.89 ± 0.79 AU) decreased only in R (p<0.001, p<0.05 and p<0.001; respectively).
We concluded that the blockade of the renin-angiotensin system with ramipril reduced early markers of diabetic nephropathy, a phenomenon that cannot be specifically related to decreased BP levels.
血管紧张素转换酶(ACE)抑制剂用于糖尿病肾病以降低全身/肾小球内压。本研究的目的是探讨在接受雷米普利或氨氯地平治疗的糖尿病高血压大鼠中,降低血压是否可以调节肾脏葡萄糖转运蛋白的表达和糖尿病肾病的尿标志物。
通过链脲佐菌素(50mg/kg)诱导自发性高血压大鼠(~210g)糖尿病。30 天后,动物每天经灌胃给予雷米普利 15μg/kg(R 组,n=10)、氨氯地平 10mg/kg(A 组,n=8)或水(C 组,n=10)。治疗 30 天后,评估体重、血糖、尿白蛋白和 TGF-β1(酶联免疫吸附测定)以及血压(尾套血压法)。取出肾脏评估肾皮质葡萄糖转运体(Western 印迹)和肾组织 ACE 活性(荧光测定法)。
治疗后,各组体重(p=0.77)和血糖(p=0.22)相似。A 组和 R 组的收缩压均显著降低(p<0.001),分别为 172.4±3.2mmHg、1867±3.7mmHg 和 202.2±4.3mmHg。ACE 活性(C 组:0.903±0.086;A 组:0.654±0.025,和 R 组:0.389±0.057mU/mg)、白蛋白尿(C 组:264.8±15.4;A 组:140.8±13.5,和 R 组:102.8±6.7mg/24h)和肾皮质 GLUT1 含量(C 组:46.81±4.54;A 组:40.30±5.39,和 R 组:26.89±0.79AU)仅在 R 组降低(p<0.001,p<0.05 和 p<0.001;分别)。
我们得出结论,雷米普利阻断肾素-血管紧张素系统可降低糖尿病肾病的早期标志物,这种现象不能专门与降低血压水平相关。