St. Joseph's Hospital, 50 Charlton Ave East, Rm. T3311, Hamilton, ON, L8N 4A6, Canada.
Am J Physiol Renal Physiol. 2013 Nov 15;305(10):F1466-76. doi: 10.1152/ajprenal.00057.2013. Epub 2013 Aug 14.
Hypertension is a risk factor for chronic kidney disease, particularly when associated with impaired renal autoregulation and thereby increased intraglomerular pressure (Pgc). Elevated Pgc can be modeled in vitro by exposing glomerular mesangial cells to mechanical strain. We previously showed that RhoA mediates strain-induced matrix production. Here, we show that RhoA activation is dependent on an intact microtubule network. Upregulation of the profibrotic cytokine connective tissue growth factor (CTGF) by mechanical strain is dependent on RhoA activation and inhibited by microtubule disruption. We tested the effects of the microtubule depolymerizing agent colchicine in 5/6 nephrectomized rats, a model of chronic kidney disease driven by elevated Pgc. Colchicine inhibited glomerular RhoA activation and attenuated both glomerular sclerosis and interstitial fibrosis without affecting systemic blood pressure. Upregulation of the matrix proteins collagen I and fibronectin, as well as CTGF, was attenuated by colchicine. Activity of the profibrotic cytokine TGF-β, as assessed by Smad3 phosphorylation, was also inhibited by colchicine. Microtubule disruption significantly decreased renal infiltration of lymphocytes and macrophages. Our studies thus indicate that colchicine modifies hypertensive renal fibrosis. Its protective effects are likely mediated by inhibition of RhoA signaling and renal infiltration of inflammatory cells. Already well-established in clinical practice for other indications, prevention of hypertension-associated renal fibrosis may represent a new potential use for colchicine.
高血压是慢性肾脏病的一个风险因素,特别是当它与肾脏自身调节受损相关联,从而导致肾小球内压(Pgc)升高时。体外通过使肾小球系膜细胞承受机械应变,可以模拟升高的 Pgc。我们之前曾表明 RhoA 介导应变诱导的基质产生。在这里,我们表明 RhoA 的激活依赖于完整的微管网络。机械应变引起的促纤维化细胞因子结缔组织生长因子(CTGF)的上调依赖于 RhoA 的激活,并且微管破坏会抑制其上调。我们在 5/6 肾切除大鼠模型中(一种由升高的 Pgc 驱动的慢性肾脏病模型),测试了微管解聚剂秋水仙碱的作用。秋水仙碱抑制肾小球 RhoA 的激活,并减轻肾小球硬化和间质纤维化,而不影响全身血压。胶原 I 和纤维连接蛋白等基质蛋白以及 CTGF 的上调被秋水仙碱减弱。通过 Smad3 磷酸化评估的促纤维化细胞因子 TGF-β的活性也被秋水仙碱抑制。微管破坏显著减少了淋巴细胞和巨噬细胞在肾脏中的浸润。因此,我们的研究表明秋水仙碱可修饰高血压性肾纤维化。其保护作用可能是通过抑制 RhoA 信号和肾脏中炎症细胞的浸润来介导的。秋水仙碱已经在其他适应症的临床实践中得到广泛应用,预防与高血压相关的肾纤维化可能代表其新的潜在用途。