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      Fokal segmentale Glomerulosklerose und juxtaglomerulärer Apparat der hypertensiven "fawn-hooded" Ratte

      1 ,
      , Prof. Dr. (Referee), , Prof. Dr. (Referee), , Prof. Dr. (Referee)
      Medizinische Fakultät - Universitätsklinikum Charité, Humboldt-Universität
      Medizin, Glomerulosklerose, NO, Prostaglandine, Renin, nitric oxide, glomerulosclerosis, prostaglandins, renin, Medizin, YK 9200

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          Abstract

          In dieser Arbeit wurden 8 und 16 Wochen alte, hypertensive "fawn-hooded" Ratten (FHH8, FHH16) mit genetisch ähnlichen 16 Wochen alten "fawn-hooded" Ratten mit nur geringgradiger Blutdruckerhöhung (FHL16, Kontrollgruppe) hinsichtlich der pathologisch-anatomischen Veränderungen der Nierenmorphologie und hinsichtlich der Expression von NO-Synthase-1 (NOS1), Cyclooxygenase-2 (COX-2) und Renin am juxtaglomerulären Apparat (JGA) verglichen. Die histopathologischen Veränderungen bei FHH16 umfassten die klassischen Schädigungszeichen der fokal segmentalen Glomerulosklerose (FSGS) mit fokaler Überexpression von Kollagen IV und eine moderate Arteriolopathie. Bei FHH8 ließen sich, wie bei FHL16 keine morphologischen Schädigungen nachweisen. Die NOS1-Aktivität an der Macula densa, untersucht mittels der NADPH-Diaphorasereaktion und die NOS1 mRNA Expression waren bei FHH8 (+153 and +88%; P < 0.05) und FHH16 (+93 and +98%; P < 0.05) im Vergleich zu FHL16 signifikant erhöht. Eine gleichgerichtete signifikante Erhöhung zeigte sich für die COX-2-Expression an der Macula densa von FHH8 (+166%; P < 0.05) und FHH16 (+157%; P < 0.05) im Vergleich zu FHL16. Des weiteren ließ sich eine signifikante, ebenfalls gleichgerichtete Überexpression von Renin in der afferenten Arteriole auf Protein- und mRNA-Ebene bei FHH8 (+51 and +166%; P < 0.05) und FHH16 (+105 and +136%; P < 0.05) im Vergleich zu FHL16 nachweisen. Somit konnte gezeigt werden, dass die gleichgerichtete Überexpression von NOS1, COX-2 und Renin am JGA bei der FHH-Ratte der Entwicklung einer fokal segmentalen Glomerulosklerose vorausgeht und damit möglicherweise pathogenetische Bedeutung für die Entstehung der Nierenschädigung bei diesem Rattenstamm hat.

          Abstract

          This study describes elevated histochemical signals for nitric oxide synthase-1 (NOS1) and cyclooxygenase-2 (COX-2) in juxtaglomerular apparatus (JGA) and adjacent thick ascending limb of the kidney of fawn-hooded hypertensive rats (FHH). Two different age groups of FHH (8 and 16 wk; FHH8 and FHH16, respectively) were compared with genetically related fawn-hooded rats with close to normal blood pressure (FHL) that served as controls. Histopathological changes in FHH16 comprised focal segmental glomerulosclerosis (FSGS), focal matrix overexpression (mainly of collagen IV), and a moderate arteriolopathy with hypertrophy of the media, enhanced immunoreactivity for alpha-smooth muscle actin, and altered distribution of myofibrils. Macula densa NOS activity, as expressed by NADPH-diaphorase staining, and NOS1 mRNA abundance were significantly elevated in FHH8 (+153 and +88%; P < 0.05) and FHH16 (+93 and +98%; P < 0.05), respectively. Even higher elevations were registered for COX-2 immunoreactivity in FHH8 (+166%; P < 0.05) and FHH16 (+157%; P < 0.05). The intensity of renin immunoreactivity and renin mRNA expression in afferent arterioles was also elevated in FHH8 (+51 and +166%; P < 0.05) and FHH16 (+105 and +136%; P < 0.05), respectively. Thus we show that coordinate upregulation of tubular NOS1, COX-2, and renin expression precedes, and continues after, the manifestation of glomerulosclerotic damage in FHH. These observations may have implications in understanding the role of local paracrine mediators in glomerular disease.

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          Most cited references55

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          Cyclooxygenase-2 is associated with the macula densa of rat kidney and increases with salt restriction.

          The kidney is a rich source of prostaglandins. These eicosanoids, formed by cyclooxygenase-dependent metabolism of arachidonic acid, are important physiologic mediators of renal glomerular hemodynamics and tubular sodium and water reabsorption. Two separate isoforms of cyclooxygenase (COX) have now been identified: constitutive COX-1, encoded by a 2.8-kb mRNA, and mitogen-activated COX-2, encoded by a 4.0-4.5-kb mRNA. COX-2 expression increases during development and inflammation, but, except for brain, constitutive expression is low. It has been generally accepted that physiologic renal production of prostaglandins is mediated by COX-1. However, in the absence of inflammation, low levels of COX-2 mRNA are also detectable in the kidney. To examine the role of COX-2 in the kidney and determine its intrarenal localization, we used a 1.3-kb cDNA probe specific for the 3' untranslated region of rat COX-2 and COX-2-specific antiserum. The COX-2-specific cDNA probe hybridized with a 4.4-kb transcript in total RNA from adult rat kidney. Immunoblots of microsomes isolated from kidney cortex and papilla indicated immunoreactive COX-2 in both locations. In situ hybridization and immunohistochemistry indicated that renal cortical COX-2 expression was localized to the macula densa of the juxtaglomerular apparatus and to adjacent epithelial cells of the cortical thick ascending limb of Henle. In addition, COX-2 immunoreactivity was detected in interstitial cells in the papilla. No COX-2 message or immunoreactive protein was detected in arterioles, glomeruli, or cortical or medullary collecting ducts. When animals were chronically sodium restricted, the level of COX-2 in the region of the macula densa increased threefold (from 0.86 +/- 0.08 to 2.52 +/- 0.43/mm2) and the total area of the COX-2 immunoreactive cells in cortex increased from 34 microns2/mm2 of cortex to 226 microns2/mm2 of cortex. The intrarenal distribution of COX-2 and its increased expression in response to sodium restriction suggest that in addition to its proposed role in inflammatory and growth responses, this enzyme may play an important role in the regulation of salt, volume, and blood pressure homeostasis.
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            Effect of plasma protein adsorption on protein excretion in kidney-transplant recipients with recurrent nephrotic syndrome.

            Among patients with the idiopathic nephrotic syndrome who have focal and segmental glomerulosclerosis and undergo renal transplantation, 15 to 55 percent have recurrent nephrotic syndrome. The recurrence may be caused by a plasma factor or factors that increase glomerular permeability, because plasma exchange transiently decreases or abolishes proteinuria in some patients. We studied the effect on proteinuria of the removal of protein (mostly immunoglobulins) by adsorption onto protein A from the plasma of patients with recurrent nephrotic syndrome. Eight patients were treated with one to three cycles of two to seven 1-day sessions of protein adsorption, and the patients' urinary protein excretion was measured repeatedly. Their immunosuppressive regimens were not changed during the treatment. The adsorbed proteins were eluted from the protein A and injected into rats, and the urinary albumin excretion of the rats was measured. The protein-adsorption treatment consistently decreased urinary protein excretion by an average of 82 percent at the end of a cycle (P < 0.001). In one patient proteinuria disappeared, and in another urinary protein excretion remained below 2.5 g per day with repeated cycles of protein adsorption. In all but one patient the effect of adsorption was limited in time, with a return to the preadsorption level of protein excretion within a maximum of two months. The administration to rats of material eluted from the protein A increased urinary albumin excretion 2.9- to 4.6-fold (P < 0.001 and P = 0.005, respectively). Although protein A primarily binds immunoglobulins, the active fraction of the eluted proteins had a molecular weight below 100,000, indicating that immunoglobulin was not directly involved. Adsorption of plasma protein decreases urinary protein excretion in patients with recurrence of the nephrotic syndrome after renal transplantation. Studies of the adsorbed proteins should provide information about the mechanism of this disease.
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              Endogenous nitric oxide enhances prostaglandin production in a model of renal inflammation.

              The interaction between nitric oxide (NO) and cyclooxygenase (COX) was studied in a rabbit model of renal inflammation, the ureteral obstructed hydronephrotic kidney (HNK). Ex vivo perfusion of the HNK but not the control kidney (e.g., unobstructed contralateral kidney, CLK), led to a time-dependent release of nitrite (NO2-), a breakdown product of NO. Stimulation of the HNK with bradykinin (BK) evoked a time-dependent increase in prostaglandin E2 (PGE2) production. NG-monomethyl-L-arginine (L-NMMA), which blocks the activity of both constitutive and inducible nitric oxide synthase (cNOS and iNOS), aminoguanidine, a recently described selective iNOS inhibitor, dexamethasone, or cycloheximide abolished the release of NO2- and attenuated the exaggerated BK-induced PGE2 production. This supports the existence of iNOS and COX-2 in the HNK. In the CLK, BK elicited release of both NO2- and PGE2 but this did not augment with time. L-NMMA but not aminoguanidine, dexamethasone, or cycloheximide attenuated NO2- and PGE2 release indicative of the presence of constitutive but not inducible NOS or COX. The current study suggests that the endogenous release of NO from cNOS in the CLK activates a constitutive COX resulting in optimal PGE2 release by BK. In addition, in the HNK, NO release from iNOS activates the induced COX resulting in markedly increased release of proinflammatory prostaglandin. The broader implication of this study is that the cyclooxygenase isozymes are potential receptor targets for nitric oxide.
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                Author and article information

                Journal
                Medizinische Fakultät - Universitätsklinikum Charité, Humboldt-Universität (kvv )
                17 December 2001
                1 August 2002
                Affiliations
                [1 ] Medizinische Fakultät
                Article
                oai:HUBerlin.de:10388
                1edc8ca6-734a-4b0c-ac15-55ee7089ff9d
                History

                Medizin,Glomerulosklerose,NO,Prostaglandine,Renin,nitric oxide,glomerulosclerosis,prostaglandins,renin,YK 9200

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