Canale Daniele, de Bragança Ana Carolina, Gonçalves Janaína Garcia, Shimizu Maria Heloisa Massola, Sanches Talita Rojas, Andrade Lúcia, Volpini Rildo Aparecido, Seguro Antonio Carlos
Nephrology Department, University of São Paulo School of Medicine, São Paulo, Brazil.
PLoS One. 2014 Jul 21;9(7):e103055. doi: 10.1371/journal.pone.0103055. eCollection 2014.
Vitamin D deficiency (VDD) is prevalent among HIV-infected individuals. Vitamin D has been associated with renal and cardiovascular diseases because of its effects on oxidative stress, lipid metabolism and renin-angiotensin-aldosterone system (RAAS). Tenofovir disoproxil fumarate (TDF), a widely used component of antiretroviral regimens for HIV treatment, can induce renal injury. The aim of this study was to investigate the effects of VDD on TDF-induced nephrotoxicity. Wistar rats were divided into four groups: control, receiving a standard diet for 60 days; VDD, receiving a vitamin D-free diet for 60 days; TDF, receiving a standard diet for 60 days with the addition of TDF (50 mg/kg food) for the last 30 days; and VDD+TDF receiving a vitamin D-free diet for 60 days with the addition of TDF for the last 30 days. TDF led to impaired renal function, hyperphosphaturia, hypophosphatemia, hypertension and increased renal vascular resistance due to downregulation of the sodium-phosphorus cotransporter and upregulation of angiotensin II and AT1 receptor. TDF also increased oxidative stress, as evidenced by higher TBARS and lower GSH levels, and induced dyslipidemia. Association of TDF and VDD aggravated renovascular effects and TDF-induced nephrotoxicity due to changes in the redox state and involvement of RAAS.
维生素D缺乏(VDD)在HIV感染者中普遍存在。维生素D因其对氧化应激、脂质代谢和肾素-血管紧张素-醛固酮系统(RAAS)的影响,与肾脏和心血管疾病有关。替诺福韦酯(TDF)是用于HIV治疗的抗逆转录病毒方案中广泛使用的一种成分,可导致肾损伤。本研究的目的是调查VDD对TDF诱导的肾毒性的影响。将Wistar大鼠分为四组:对照组,接受标准饮食60天;VDD组,接受无维生素D饮食60天;TDF组,接受标准饮食60天,在最后30天添加TDF(50mg/kg食物);VDD + TDF组,接受无维生素D饮食60天,在最后30天添加TDF。由于钠-磷共转运体下调以及血管紧张素II和AT1受体上调,TDF导致肾功能受损、高磷尿症、低磷血症、高血压和肾血管阻力增加。TDF还增加了氧化应激,表现为较高的丙二醛水平和较低的谷胱甘肽水平,并诱导血脂异常。由于氧化还原状态的变化和RAAS的参与,TDF与VDD的联合加重了肾血管效应和TDF诱导的肾毒性。