Departament of Medicine, Renal Division, Federal University of Sao Paulo, Sao Paulo, Brazil.
PLoS One. 2013 Nov 4;8(11):e78464. doi: 10.1371/journal.pone.0078464. eCollection 2013.
Renovascular hypertension induced by 2 Kidney-1 Clip (2K-1C) is a renin-angiotensin-system (RAS)-dependent model, leading to renal vascular rarefaction and renal failure. RAS inhibitors are not able to reduce arterial pressure (AP) and/or preserve the renal function, and thus, alternative therapies are needed. Three weeks after left renal artery occlusion, fluorescently tagged mesenchymal stem cells (MSC) (2×10(5) cells/animal) were injected weekly into the tail vein in 2K-1C hypertensive rats. Flow cytometry showed labeled MSC in the cortex and medulla of the clipped kidney. MSC prevented a further increase in the AP, significantly reduced proteinuria and decreased sympathetic hyperactivity in 2K-1C rats. Renal function parameters were unchanged, except for an increase in urinary volume observed in 2K-1C rats, which was not corrected by MSC. The treatment improved the morphology and decreased the fibrotic areas in the clipped kidney and also significantly reduced renal vascular rarefaction typical of 2K-1C model. Expression levels of IL-1β, TNF-α angiotensinogen, ACE, and Ang II receptor AT1 were elevated, whereas AT2 levels were decreased in the medulla of the clipped kidney. MSC normalized these expression levels. In conclusion, MSC therapy in the 2K-1C model (i) prevented the progressive increase of AP, (ii) improved renal morphology and microvascular rarefaction, (iii) reduced fibrosis, proteinuria and inflammatory cytokines, (iv) suppressed the intrarenal RAS, iv) decreased sympathetic hyperactivity in anesthetized animals and v) MSC were detected at the CNS suggesting that the cells crossed the blood-brain barrier. This therapy may be a promising strategy to treat renovascular hypertension and its renal consequences in the near future.
2 肾-1 夹(2K-1C)诱导的肾血管性高血压是一种肾素-血管紧张素系统(RAS)依赖性模型,导致肾血管稀疏和肾功能衰竭。RAS 抑制剂不能降低动脉压(AP)和/或保护肾功能,因此需要替代疗法。左肾动脉闭塞 3 周后,将荧光标记的间充质干细胞(MSC)(2×10(5)个细胞/动物)每周一次注射到 2K-1C 高血压大鼠的尾静脉中。流式细胞术显示标记的 MSC 位于夹闭肾脏的皮质和髓质中。MSC 可防止 AP 进一步升高,显著减少 2K-1C 大鼠的蛋白尿和交感神经活性亢进。肾功能参数没有改变,除了观察到 2K-1C 大鼠的尿量增加,而 MSC 未纠正这一现象。该治疗改善了夹闭肾脏的形态,并减少了纤维化区域,还显著减少了 2K-1C 模型中典型的肾血管稀疏。夹闭肾脏髓质中 IL-1β、TNF-α血管紧张素原、ACE 和 Ang II 受体 AT1 的表达水平升高,而 AT2 水平降低。MSC 使这些表达水平正常化。总之,MSC 治疗 2K-1C 模型(i)防止 AP 持续升高,(ii)改善肾脏形态和微血管稀疏,(iii)减少纤维化、蛋白尿和炎症细胞因子,(iv)抑制肾内 RAS,(iv)减少麻醉动物的交感神经活性亢进,(v)MSC 在中枢神经系统中被检测到,表明细胞穿过了血脑屏障。这种治疗方法可能是治疗肾血管性高血压及其肾脏后果的一种很有前途的策略。