Craven P A, DeRubertis F R, Kagan V E, Melhem M, Studer R K
Department of Medicine, University of Pittsburgh, Pennsylvania, USA.
J Am Soc Nephrol. 1997 Sep;8(9):1405-14. doi: 10.1681/ASN.V891405.
Oxidant stress and a reduction in antioxidant status, including reduced plasma and tissue ascorbic acid content, occur in diabetic patients and experimental models of diabetes. In this study, the effects of treatment of streptozotocin diabetic rats for 2 mo with vitamin C (10 g/kg body wt/d) or dietary vitamin E (200 mg/kg body wt/d) in the drinking water on urinary albumin excretion, glomerular transforming growth factor (TGF)-beta content, and glomerular size were examined. Treatment of diabetic rats with vitamin C or E had no effect on blood glucose levels compared with that in untreated diabetics (453 +/- 28 g/dl +/- SEM). Body weight, BP, and creatinine clearance rates were not significantly different among the study groups. Kidney weight was significantly higher in all of the diabetic groups compared with age-matched control rats. Treatment with vitamin C, but not vitamin E, significantly reduced kidney weight compared with that in untreated diabetic rats. Immunohistochemical staining for TGF-beta was 2.5-fold higher in glomeruli of cortical sections from untreated diabetic rats versus control rats. Treatment with vitamin C or E prevented the increase in glomerular TGF-beta immunoreactivity. Glomerular volume was also significantly increased (twofold) in kidneys of untreated diabetic rats compared with control rats, as assessed by light microscopy. Treatment with vitamin C prevented and treatment with vitamin E reduced the increase in glomerular volume. Treatment with vitamin C also prevented the sevenfold increase in albumin clearance otherwise seen in untreated diabetic rats. By contrast, treatment with vitamin E had no effect on albumin clearance despite reductions in glomerular size and TGF-beta. Renal cortical vitamin E and plasma, but not renal cortical vitamin C, were reduced in diabetic rats versus control rats. Supplementation of diabetic rats with vitamin C markedly increased plasma and renal cortical vitamin C content to values greater than those in control rats. Supplementation with vitamin E increased renal cortical vitamin E content by 50% compared with values in control rats and also increased plasma and renal cortical vitamin C. These results support the potential utility of antioxidant treatment for the prevention of renal injury in diabetes.
糖尿病患者以及糖尿病实验模型中会出现氧化应激和抗氧化状态降低的情况,包括血浆和组织中抗坏血酸含量减少。在本研究中,检测了用维生素C(10 g/kg体重/天)或饮用水中的膳食维生素E(200 mg/kg体重/天)对链脲佐菌素诱导的糖尿病大鼠进行2个月治疗后,对尿白蛋白排泄、肾小球转化生长因子(TGF)-β含量和肾小球大小的影响。与未治疗的糖尿病大鼠(453±28 mg/dl±SEM)相比,用维生素C或E治疗糖尿病大鼠对血糖水平没有影响。各研究组之间的体重、血压和肌酐清除率没有显著差异。与年龄匹配的对照大鼠相比,所有糖尿病组的肾脏重量均显著更高。与未治疗的糖尿病大鼠相比,用维生素C而非维生素E治疗可显著降低肾脏重量。未治疗的糖尿病大鼠皮质切片肾小球中TGF-β的免疫组化染色比对照大鼠高2.5倍。用维生素C或E治疗可防止肾小球TGF-β免疫反应性增加。通过光学显微镜评估,与对照大鼠相比,未治疗的糖尿病大鼠肾脏中的肾小球体积也显著增加(两倍)。用维生素C治疗可防止肾小球体积增加,用维生素E治疗可减少肾小球体积增加。用维生素C治疗还可防止未治疗的糖尿病大鼠中白蛋白清除率增加7倍。相比之下,尽管肾小球大小和TGF-β减少,但用维生素E治疗对白蛋白清除率没有影响。与对照大鼠相比,糖尿病大鼠肾皮质维生素E和血浆中的维生素C含量降低,但肾皮质维生素C含量未降低。给糖尿病大鼠补充维生素C可使血浆和肾皮质维生素C含量显著增加,高于对照大鼠。与对照大鼠相比,补充维生素E可使肾皮质维生素E含量增加50%,还可增加血浆和肾皮质维生素C含量。这些结果支持抗氧化治疗在预防糖尿病肾损伤方面的潜在效用。