Kirschenbaum M A, Liebross B A, Serros E R
Prostaglandins. 1985 Aug;30(2):295-303. doi: 10.1016/0090-6980(85)90192-3.
Although non-steroidal anti-inflammatory agents have been used to reduce levels of urinary protein excretion in patients with the nephrotic syndrome, the general usefulness of these drugs in proteinuric states remains unclear. The present study was designed to confirm the efficacy and to investigate some of the mechanism/s of action of non-steroidal anti-inflammatory agents in animals with proteinuria as the result of a single form experimental renal disease. Autologous immune complex nephropathy was produced in groups of Lewis rats by the administration of autologous tubular Fx1A antigen. After marked proteinuria developed, indomethacin (8 mg/kg/day) was administered orally to one group of animals for five days while a control group received only vehicle. The level of urinary protein excretion in the indomethacin treated animals was 420 +/- 198 mg/day compared to a level of 1180 +/- 306 seen in the untreated animals (p less than 0.05). When the indomethacin-treated and control animals were compared, the reduction in proteinuria could not be found to be associated with a change in the glomerular filtration rate, urine electrolyte or osmolar excretion rates, electron microscopic appearance of the glomerular basement membrane, or a change in the glomerular permeability to neutral dextran. Treatment of animals with either sodium salicylate or lower does of indomethacin (both of which resulted also in significant falls in urinary prostaglandin E excretion rates) failed to reduce the levels of proteinuria. Thus, indomethacin was capable of reducing the levels of protein excretion in rats with autologous immune complex nephropathy although the mechanism of action of this agent remains unclear.
尽管非甾体抗炎药已被用于降低肾病综合征患者的尿蛋白排泄水平,但这些药物在蛋白尿状态下的总体效用仍不明确。本研究旨在证实非甾体抗炎药在因单一形式实验性肾病导致蛋白尿的动物中的疗效,并探究其一些作用机制。通过给予自体肾小管Fx1A抗原,在Lewis大鼠组中诱发自体免疫复合物肾病。在出现明显蛋白尿后,一组动物口服吲哚美辛(8毫克/千克/天),持续五天,而对照组仅给予赋形剂。吲哚美辛治疗组动物的尿蛋白排泄水平为420±198毫克/天,而未治疗组动物的尿蛋白排泄水平为1180±306毫克/天(p<0.05)。比较吲哚美辛治疗组和对照组动物时,未发现蛋白尿的减少与肾小球滤过率、尿电解质或渗透压排泄率的变化、肾小球基底膜的电子显微镜外观或肾小球对中性葡聚糖通透性的变化有关。用水杨酸钠或较低剂量的吲哚美辛治疗动物(两者均导致尿前列腺素E排泄率显著下降)均未能降低蛋白尿水平。因此,吲哚美辛能够降低自体免疫复合物肾病大鼠的蛋白排泄水平,尽管该药物的作用机制仍不明确。