Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo São Paulo, São Paulo, Brazil.
Laboratory of Transplantation Immunobiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
Hypertens Res. 2019 Jun;42(6):779-789. doi: 10.1038/s41440-019-0226-6. Epub 2019 Feb 26.
We previously reported that rats treated with an NF-κB inhibitor, pyrrolidine dithiocarbamate (PDTC), during lactation developed hypertension in adult life, without apparent functional or structural damage to kidneys, providing a new model of essential hypertension. Here, we investigated whether uninephrectomy associated with salt overload would unveil a latent renal dysfunction in this model, aggravating arterial hypertension and promoting renal injury. Male Munich-Wistar rat pups received PDTC from maternal milk (PDTC) from 0 to 20 days after birth. Another group received no treatment during lactation. All offspring underwent uninephrectomy (UNx) at 10 weeks of age and then were subdivided into NS, receiving a normal salt (0.5% Na) diet, PDTC + NS, HS, receiving a high-salt diet (2% Na chow + 0.5% saline to drink), and PDTC+HS. Twelve weeks later, HS rats were moderately hypertensive with mild albuminuria and renal injury. In contrast, severe hypertension, glomerulosclerosis, and cortical collagen deposition were prominent in PDTC + HS animals, along with "onion-skin" arteriolar lesions, evidence of oxidative stress and intense renal infiltration by macrophages, and lymphocytes and angiotensin II-positive cells, contrasting with low circulating renin. The NF-κB pathway was also activated. In a separate set of PDTC+HS rats, Losartan treatment prevented NF-κB activation and strongly attenuated glomerular injury, cortical fibrosis, and renal inflammation. NF-κB activity during late nephrogenesis is essential for the kidneys to properly maintain sodium homeostasis in adult life. Paradoxically, this same system contributed to renal injury resembling that caused by malignant hypertension when renal dysfunction caused by its inhibition during lactation was unmasked by uninephrectomy associated with HS.
我们之前曾报道过,哺乳期接受 NF-κB 抑制剂吡咯烷二硫代氨基甲酸盐(PDTC)治疗的大鼠在成年后会发展为高血压,而肾脏没有明显的功能或结构损伤,为原发性高血压提供了一个新的模型。在这里,我们研究了在这种模型中,单侧肾切除术(UNx)联合高盐负荷是否会揭示潜在的肾功能障碍,从而加重动脉高血压并促进肾脏损伤。雄性慕尼黑-维斯塔大鼠幼崽从出生后 0 到 20 天通过母乳接受 PDTC(PDTC)治疗。另一组在哺乳期不接受任何治疗。所有幼崽在 10 周龄时接受单侧肾切除术(UNx),然后分为 NS 组(接受正常盐饮食,即 0.5%Na)、PDTC+NS 组、HS 组(接受高盐饮食,即 2%Na 饲料+0.5%盐水饮用)和 PDTC+HS 组。12 周后,HS 组大鼠出现中度高血压,伴有轻度蛋白尿和肾脏损伤。相比之下,PDTC+HS 动物表现出严重的高血压、肾小球硬化和皮质胶原沉积,伴有“洋葱皮”样小动脉病变、氧化应激的证据,以及巨噬细胞、淋巴细胞和血管紧张素 II 阳性细胞的强烈浸润,与低循环肾素形成对比。NF-κB 途径也被激活。在一组单独的 PDTC+HS 大鼠中,洛沙坦治疗可防止 NF-κB 激活,并强烈减轻肾小球损伤、皮质纤维化和肾脏炎症。晚期肾发生过程中 NF-κB 活性对于肾脏在成年期适当维持钠稳态至关重要。矛盾的是,当单侧肾切除术(UNx)联合高盐负荷暴露了哺乳期抑制 NF-κB 活性导致的肾功能障碍时,同一系统会导致类似于恶性高血压引起的肾脏损伤。