Takayanagi Kaori, Shimizu Taisuke, Tayama Yosuke, Ikari Akira, Anzai Naohiko, Iwashita Takatsugu, Asakura Juko, Hayashi Keitaro, Mitarai Tetsuya, Hasegawa Hajime
Ishikawa Kinenkai Kawagoe Ekimae Clinic, Kawagoe, Saitama, Japan; Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan;
Department of Nephrology and Hypertension, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan;
Am J Physiol Renal Physiol. 2015 Jun 15;308(12):F1386-97. doi: 10.1152/ajprenal.00593.2013. Epub 2014 Dec 17.
We assessed the expression profile of Mg(2+)-transporting molecules in obese diabetic rats as a cause of hypermagnesiuric hypomagnesemia, which is involved in the development of insulin resistance, hypertension, and coronary diseases. Kidneys were obtained from male Otsuka Long-Evans Tokushima fatty (OLETF) and Long-Evans Tokushima Otsuka (LETO) obese diabetic rats at the ages of 16, 24, and 34 wk. Expression profiles were studied by real-time PCR and immunohistochemistry together with measurements of urine Mg(2+) excretion. Urine Mg(2+) excretion was increased in 24-wk-old OLETF rats and hypomagnesemia was apparent in 34-wk-old OLETF rats but not in LETO rats (urine Mg(2+) excretion: 0.16 ± 0.01 μg·min(-1)·g body wt(-1) in 24-wk-old LETO rats and 0.28 ± 0.01 μg·min(-1)·g body wt(-1) in 24-wk-old OLETF rats). Gene expression of transient receptor potential (TRP)M6 was downregulated (85.5 ± 5.6% in 34-wk-old LETO rats and 63.0 ± 3.5% in 34-wk-old OLETF rats) concomitant with Na(+)-Cl(-) cotransporter downregulation, whereas the expression of claudin-16 in tight junctions of the thick ascending limb of Henle was not different. The results of the semiquantitative analysis of immunohistochemistry were consistent with these findings (TRPM6: 0.49 ± 0.04% in 16-wk-old LETO rats, 0.10 ± 0.01% in 16-wk-old OLETF rats, 0.52 ± 0.03% in 24-wk-old LETO rats, 0.10 ± 0.01% in 24-wk-old OLETF rats, 0.48 ± 0.02% in 34-wk-old LETO rats, and 0.12 ± 0.02% in 34-wk-old OLETF rats). Gene expression of fibrosis-related proinflammatory cytokines as well as histological changes showed that the hypermagnesiuria-related molecular changes and tubulointerstitial nephropathy developed independently. TRPM6, located principally in distal convoluted tubules, appears to be a susceptible molecule that causes hypermagnesiuric hypomagnesemia as a tubulointerstitial nephropathy-independent altered tubular function in diabetic nephropathy.
我们评估了肥胖糖尿病大鼠中镁离子转运分子的表达谱,将其作为高镁尿性低镁血症的一个病因,高镁尿性低镁血症与胰岛素抵抗、高血压及冠状动脉疾病的发生发展有关。从16周龄、24周龄和34周龄的雄性大冢长- Evans德岛肥胖(OLETF)大鼠和长- Evans德岛大冢(LETO)肥胖糖尿病大鼠获取肾脏。通过实时聚合酶链反应(PCR)、免疫组织化学以及测定尿镁离子排泄来研究表达谱。24周龄的OLETF大鼠尿镁离子排泄增加,34周龄的OLETF大鼠出现明显的低镁血症,而LETO大鼠未出现(24周龄LETO大鼠尿镁离子排泄:0.16±0.01μg·min⁻¹·g体重⁻¹,24周龄OLETF大鼠尿镁离子排泄:0.28±0.01μg·min⁻¹·g体重⁻¹)。瞬时受体电位(TRP)M6的基因表达下调(34周龄LETO大鼠为85.5±5.6%,34周龄OLETF大鼠为63.0±3.5%),同时钠-氯共转运体下调,而亨利袢厚壁升支紧密连接处的紧密连接蛋白16的表达无差异。免疫组织化学半定量分析结果与这些发现一致(TRPM6:16周龄LETO大鼠为0.49±0.04%,16周龄OLETF大鼠为0.10±0.01%,24周龄LETO大鼠为0.52±0.03%,24周龄OLETF大鼠为0.10±0.01%,34周龄LETO大鼠为0.48±0.02%,34周龄OLETF大鼠为0.12±0.02%)。纤维化相关促炎细胞因子的基因表达以及组织学变化表明,高镁尿相关分子变化和肾小管间质性肾病是独立发生的。主要位于远曲小管的TRPM6似乎是一个易感分子,它可导致高镁尿性低镁血症,这是糖尿病肾病中一种不依赖于肾小管间质性肾病的肾小管功能改变。