Hoffmann Linda S, Kretschmer Axel, Lawrenz Bettina, Hocher Berthold, Stasch Johannes-Peter
Pharma Research Centre, Bayer HealthCare, Wuppertal, Germany.
Instute of Nutritional Science, University of Potsdam, Potsdam, Germany, and IFLb Laboratoriumsmedizin Berlin GmbH, Berlin, Germany.
PLoS One. 2015 Dec 30;10(12):e0145048. doi: 10.1371/journal.pone.0145048. eCollection 2015.
The nitric oxide (NO)/soluble guanylate cyclase (sGC)/cyclic guanosine monophasphate (cGMP)-signalling pathway is impaired under oxidative stress conditions due to oxidation and subsequent loss of the prosthetic sGC heme group as observed in particular in chronic renal failure. Thus, the pool of heme free sGC is increased under pathological conditions. sGC activators such as cinaciguat selectively activate the heme free form of sGC and target the disease associated enzyme. In this study, a therapeutic effect of long-term activation of heme free sGC by the sGC activator cinaciguat was investigated in an experimental model of salt-sensitive hypertension, a condition that is associated with increased oxidative stress, heme loss from sGC and development of chronic renal failure. For that purpose Dahl/ss rats, which develop severe hypertension upon high salt intake, were fed a high salt diet (8% NaCl) containing either placebo or cinaciguat for 21 weeks. Cinaciguat markedly improved survival and ameliorated the salt-induced increase in blood pressure upon treatment with cinaciguat compared to placebo. Renal function was significantly improved in the cinaciguat group compared to the placebo group as indicated by a significantly improved glomerular filtration rate and reduced urinary protein excretion. This was due to anti-fibrotic and anti-inflammatory effects of the cinaciguat treatment. Taken together, this is the first study showing that long-term activation of heme free sGC leads to renal protection in an experimental model of hypertension and chronic kidney disease. These results underline the promising potential of cinaciguat to treat renal diseases by targeting the disease associated heme free form of sGC.
在氧化应激条件下,一氧化氮(NO)/可溶性鸟苷酸环化酶(sGC)/环磷酸鸟苷(cGMP)信号通路会受到损害,这是由于sGC辅基血红素基团发生氧化并随后丢失,尤其在慢性肾衰竭中观察到这种情况。因此,在病理条件下,无血红素的sGC池会增加。sGC激活剂(如西那吉多)可选择性激活无血红素形式的sGC,并作用于与疾病相关的酶。在本研究中,在盐敏感性高血压的实验模型中研究了sGC激活剂西那吉多长期激活无血红素sGC的治疗效果,盐敏感性高血压与氧化应激增加、sGC血红素丢失以及慢性肾衰竭的发展有关。为此,对高盐摄入时会发生严重高血压的Dahl/ss大鼠喂食含安慰剂或西那吉多的高盐饮食(8%氯化钠)21周。与安慰剂相比,西那吉多显著提高了生存率,并改善了西那吉多治疗后盐诱导的血压升高。与安慰剂组相比,西那吉多组的肾功能显著改善,表现为肾小球滤过率显著提高和尿蛋白排泄减少。这是由于西那吉多治疗具有抗纤维化和抗炎作用。综上所述,这是第一项表明长期激活无血红素sGC可在高血压和慢性肾病实验模型中产生肾脏保护作用的研究。这些结果强调了西那吉多通过作用于与疾病相关的无血红素形式的sGC来治疗肾脏疾病的潜在前景。