Caires Agnaldo, Convento Marcia Bastos, Castino Bianca, Leme Ala Moana, Pessoa Edson de Andrade, Aragão Alef, Schor Nestor, Borges Fernanda Teixeira
Universidade Federal de São Paulo, Departamento de Medicina, Disciplina de Nefrologia, São Paulo, SP, Brasil.
Universidade Cruzeiro do Sul, Programa Interdisciplinar em Ciências da Saúde, São Paulo, SP, Brasil.
J Bras Nefrol. 2019 Oct-Dec;41(4):451-461. doi: 10.1590/2175-8239-JBN-2018-0162.
Hypertension and Diabetes mellitus are the two main causes of chronic kidney disease that culminate in the final stage of kidney disease. Since these two risk factors are common and can overlap, new approaches to prevent or treat them are needed. Macitentan (MAC) is a new non-selective antagonist of the endothelin-1 (ET-1) receptor. This study aimed to evaluate the effect of chronic blockade of ET-1 receptor with MAC on the alteration of renal function observed in hypertensive and hyperglycemic animals. Genetically hypertensive rats were divided into control hypertensive (HT-CTL) group, hypertensive and hyperglycemic (HT+DIAB) group, and hypertensive and hyperglycemic group that received 25 mg/kg macitentan (HT-DIAB+MAC25) via gavage for 60 days. Kidney function and parameters associated with oxidative and nitrosative stress were evaluated. Immunohistochemistry for neutrophil gelatinase-associated lipocalin (NGAL), ET-1, and catalase in the renal cortex was performed. The HT+DIAB group showed a decrease in kidney function and an increase in NGAL expression in the renal cortex, as well as an increase in oxidative stress. MAC treatment was associated with attenuated ET-1 and NGAL production and increases in antioxidant defense (catalase expression) and nitric oxide production. In addition, MAC prevented an increase in oxidant injury (as measured by urinary hydroperoxide and lipid peroxidation), thus improving renal function. Our results suggest that the antioxidant effect of the ET-1 receptor antagonist MAC is involved in the improvement of kidney function observed in hypertensive and hyperglycemic rats.
高血压和糖尿病是导致慢性肾脏病最终发展至肾病终末期的两大主要病因。由于这两种风险因素较为常见且可能重叠,因此需要新的预防或治疗方法。马西替坦(MAC)是一种新型的内皮素 -1(ET-1)受体非选择性拮抗剂。本研究旨在评估用MAC长期阻断ET-1受体对高血压和高血糖动物肾功能改变的影响。将遗传性高血压大鼠分为对照高血压(HT-CTL)组、高血压合并高血糖(HT+DIAB)组以及通过灌胃给予25 mg/kg马西替坦持续60天的高血压合并高血糖组(HT-DIAB+MAC25)。评估了肾功能以及与氧化应激和亚硝化应激相关的参数。对肾皮质中的中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、ET-1和过氧化氢酶进行了免疫组织化学检测。HT+DIAB组显示肾功能下降,肾皮质中NGAL表达增加,氧化应激也增加。MAC治疗与ET-1和NGAL生成减少以及抗氧化防御(过氧化氢酶表达)和一氧化氮生成增加相关。此外,MAC可防止氧化损伤增加(通过尿过氧化氢和脂质过氧化测量),从而改善肾功能。我们的结果表明,ET-1受体拮抗剂MAC的抗氧化作用参与了高血压和高血糖大鼠肾功能的改善。