Central role for Rho in TGF-beta1-induced alpha-smooth muscle actin expression during epithelial-mesenchymal transition

New research suggests that, during tubulointerstitial fibrosis, alpha-smooth muscle actin (SMA)-expressing mesenchymal cells might derive from the tubular epithelium via epithelial-mesenchymal transition (EMT). Although transforming growth factor-beta(1) (TGF-beta(1)) plays a key role in EMT, the underlying cellular mechanisms are not well understood. Here we characterized TGF-beta(1)-induced EMT in LLC-PK(1) cells and examined the role of the small GTPase Rho and its effector, Rho kinase, (ROK) in the ensuing cytoskeletal remodeling and SMA expression. TGF-beta(1) treatment caused delocalization and downregulation of cell contact proteins (ZO-1, E-cadherin, beta-catenin), cytoskeleton reorganization (stress fiber assembly, myosin light chain phosphorylation), and robust SMA synthesis. TGF-beta(1) induced a biphasic Rho activation. Stress fiber assembly was prevented by the Rho-inhibiting C3 transferase and by dominant negative (DN) ROK. The SMA promoter was activated strongly by constitutively active Rho but not ROK. Accordingly, TGF-beta(1)-induced SMA promoter activation was potently abrogated by two Rho-inhibiting constructs, C3 transferase and p190RhoGAP, but not by DN-ROK. Truncation analysis showed that the first CC(A/T)richGG (CArG B) serum response factor-binding cis element is essential for the Rho responsiveness of the SMA promoter. Thus Rho plays a dual role in TGF-beta(1)-induced EMT of renal epithelial cells. It is indispensable both for cytoskeleton remodeling and for the activation of the SMA promoter. The cytoskeletal effects are mediated via the Rho/ROK pathway, whereas the transcriptional effects are partially ROK independent.

Dentin sealers' effect on the diameter of pulpal microvessels: a comparative vitalmicroscopic study

After crown preparation, exposed and untreated dentinal tubules can result in bacterial penetration into pulp. Treating the exposed dentin involves closing the tubules. Dentin sealers are often applied on a very thin dentin layer that covers the pulp chamber. In these cases, the sealers may have some effect on local micro-circulation through dentin. This study examined the acute effects of different dentin sealers on the vascular-diameter of pulpal vessels measured by vitalmicroscopic technique in rats. Gluma Desensitizer in Group 1 (n = 10), Seal & Protect with acid etching in Group 2 (n = 10) and Seal & Protect without acid etching in Group 3 (n = 10) were applied on a very thin layer of dentin in the left lower incisor of male Sprague-Dawley rats weighing 336 +/- 93SE/g. Saline served as the untreated control. After one-hour equilibration time, changes in vessel diameter were recorded with a digital camera connected to a microscope at baseline and at 5, 15, 30 and 60 minutes after the investigated materials were administered on dentin. The results were evaluated by ANOVA. In each group, diameter changes were averaged (compared to the baseline diameters) and standard errors of the mean were calculated for each examined time. The results suggest that Gluma Desensitizer caused the most severe pulpal vessel-diameter changes, followed by Seal & Protect with acid etching, while the least change was recorded in Seal & Protect without acid etching.

Comparative analysis of pulpal circulatory reaction to an acetone-containing and an acetone-free bonding agent as measured by vitalmicroscopy

Despite great progress in the production of new dental polymers, application of these products is still controversial. The unlined utilization of cytotoxic adhesive materials on pulpal dentin can adversely influence the pulp, leading to alterations in local microcirculation that can be an early sign of pathological changes. In a previous study by the authors, the effect of an acetone-free bondmaterial was examined on the vascular diameter of pulpal vessels by means of vitalmicroscopy. In this study, experiments comparing experimental data provided by an acetone-containing bondmaterial to these earlier findings with acetone-free ones have been performed. Thirty male Sprague-Dawley rats (weighing 333+/-9 g) were used for this investigation. The first lower incisor was prepared for vitalmicroscopy. Changes in vessel diameter were recorded prior to and 5, 15, 30 and 60 minutes after the investigated materials (Scotchbond Multi-Purpose Dental Adhesive System or Prime & Bond 2.1) were administered on dentin as recommended by the manufacturer. In control rats (saline administration), the vessel diameter was stable during the experiment. In the presence of acetone-free bondmaterial (Scotchbond), the vessel diameter was increased during the experimental period in relation to the baseline (12.15+/-2.85%; 16.36+/-2.39%; 14.16+/-3.48%; 12.12+/-3.72%). In the presence of acetone-containing bondmaterial (Prime & Bond 2.1), a similar result was observed (10.56+/-2.27%; 16.13+/-2.94%; 17.88+/-2.54%; 14.54+/-3.16%). The differences between the control values and those registered with test groups were significant (p<0.05; ANOVA). There was no significant difference among the test groups. The results of this study suggest that dental bond materials applied on a very thin layer of dentin may affect the blood supply to the dental pulp. However, no stasis or prestasis has been detected, indicating a possible reversible effect. The authors could not show any statistical difference between the vasodilatation caused by the acetone-containing and the acetone-free bond material.

Overexpression of the type II transforming growth factor-beta receptor inhibits fibroblasts proliferation and activates extracellular signal regulated kinase and c-Jun N-terminal kinase

Transforming growth factor-beta (TGF-beta) is a bimodal regulator of cellular growth. The cellular effects of TGF-beta depend on the intensity of signals emanating from TGF-beta receptors. Low levels of receptor activity are sufficient to stimulate cell proliferation, while higher degrees of receptor activation are associated with growth inhibition. To study the mechanisms of these effects, a tetracycline-inducible expression system was used to overexpress type II TGF-beta receptors in NIH 3T3 fibroblasts. Overexpressed type II TGF-beta receptors suppressed fibroblast proliferation elicited by TGF-beta1, fibroblast growth factor (FGF) or platelet-derived growth factor (PDGF). Accompanying these anti-proliferative effects, increases in extracellular-signal regulated kinase (ERK) and c-Jun N-terminal kinase (JNK) activity were detected. Furthermore, PDGF alpha-, but not PDGF beta-receptor protein levels were reduced by type II TGF-beta receptor overexpression. In conclusion, our system is an excellent tool to study the molecular mechanisms of growth inhibition by TGF-beta in fibroblasts. Activation of JNK and ERK, or modulation of PDGF receptor expression may be involved in this process.

Angiotensin II directly stimulates macula densa Na-2Cl-K cotransport via apical AT(1) receptors

ANG II is a modulator of tubuloglomerular feedback (TGF); however, the site of its action remains unknown. Macula densa (MD) cells sense changes in luminal NaCl concentration ([NaCl](L)) via a Na-2Cl-K cotransporter, and these cells do possess ANG II receptors. We tested whether ANG II regulates Na-2Cl-K cotransport in MD cells. MD cell Na(+) concentration ([Na(+)](i)) was measured using sodium-binding benzofuran isophthalate with fluorescence microscopy. Resting [Na(+)](i) in MD cells was 27.7 +/- 1.05 mM (n = 138) and increased (Delta[Na(+)](i)) by 18.5 +/- 1.14 mM (n = 17) at an initial rate (Delta[Na(+)](i)/Deltat) of 5.54 +/- 0.53 x 10(-4) U/s with an increase in [NaCl](L) from 25 to 150 mM. Both Delta[Na(+)](i) and Delta[Na(+)](i)/Deltat were inhibited by 80% with 100 microM luminal furosemide. ANG II (10(-9) or 10(-12) M) added to the lumen increased MD resting [Na(+)](i) and [NaCl](L)-dependent Delta[Na(+)](i) and caused a twofold increase in Delta[Na(+)](i)/Deltat. Bath (10(-9) M) ANG II also stimulated cotransport activity, and there was no additive effect of simultaneous addition of ANG II to bath and lumen. The effects of luminal ANG II were furosemide sensitive and abolished by the AT(1) receptor blocker candesartan. ANG II at 10(-6) M failed to stimulate the cotransporter, whereas increased cotransport activity could be restored by blocking AT(2) receptors with PD-123, 319. Thus ANG II may modulate TGF responses via alterations in MD Na-2Cl-K cotransport activity.

The use of a second reporter plasmid as an internal standard to normalize luciferase activity in transient transfection experiments may lead to a systematic error

beta-galactosidase reporter plasmids containing different viral or minimal promoters are commonly used to correct variable transfection efficiencies in transient transfection experiments. The transcriptional activity of these promoters is thought to be stable under most circumstances. To determine if expression of beta-galactosidase from the commonly used beta-galactosidase plasmids remains stable upon stimulation of the cells with agonists we performed transient transfection experiments. CHO cells stably expressing the rat AT(1A) receptor were transfected with RSVbeta- or CMVbeta- or pTKbeta plasmids alone or together with a reporter construct in which luciferase transcription is driven by the c-fos promoter. Luciferase and/or beta-galactosidase activity was measured from the lysate of cells treated with angiotensin II or serum. We found that agonists increased the transcriptional activity of the different beta-galactosidase plasmids. The effect of angiotensin II and serum was different on the different promoters. Finally, cotransfection of other plasmids also modulated beta-galactosidase activity. These agonist induced variations of beta-galactosidase activity may influence the analysis and interpretation of the results in a systematic manner. Consequently we conclude that the use of a second reporter system to control for transfection efficiency in certain types of experiments may lead to a systematic error and is questionable as a general procedure.

[Effect of pentoxifylline on the healing of experimental anastomosis of the left colon in rats]

The healing of colonic anastomoses is determined by several factors such as microcirculation, the strength of the inflammatory response, and the time required for regeneration. We investigated the effects of pentoxifylline--a drug which improves microcirculation and modulates leukocyte functions--on the healing of experimental anastomosis on the left colon of rats. As a result of drug treatment (0.25 mg/100 g, i.p.) in Group I anastomosis bursting pressure (ABP) was by 56 +/- 17% higher at day 2 than in controls with no pentoxifylline treatment. On the 5th postoperative day in Group I, ABP reached 80 +/- 8% the value for the intact colon (218 +/- 21 mmHg), whereas respective value in the control (untreated) group was only 47 +/- 7%. In Group II (pentoxifylline: 2 mg/100 g, i.p.) ABP was by 55 +/- 10% and by 73 +/- 8% higher than control values at postoperative days 1 and 2, respectively. At day 2, in Group I colonic blood flow measured at the anastomosis line by 86Rb uptake technique was significantly higher than in the untreated controls (0.18 +/- 0.01 ml/min vs. 0.14 +/- 0.01 ml/min, (p < 0.02). Blood flow measured in colon tissue above and below the anastomosis changed differently. Pentoxifylline treatment also suppressed the peritoneal inflammatory response assessed with peritoneal reaction index (2.0 +/- 0.3 vs. 1.1 +/- 0.2, p < 0.01). The results of the present study show that pentoxifylline treatment shortens the time needed for the healing of colonic anastomosis. These observations suggest that pentoxifylline medication can prevent failure of colonic anastomoses.

[Acute effect of calcium hydroxide-containing material in the rat's dental pulp microcirculation]

Experimental stimulation and clinical procedures applied on the crown of the tooth cause vascular reaction in the dental pulp. Laser-Doppler flowmetry is a good method for determining the blood flow of the dental pulp. The aim of these experiments was to study the acute effect of a calcium hydroxide-containing pulp-capping material (Dycal, DeTrey) on blood flow of the dental pulp after the application into a deep test-cavity. Two groups of male Sprague-Dawley rats (308 g +/- 50 S.E.) were used: control- and test-group, n = 10. A standardised deep class five cavity was prepared in the left lower incisor of each rat. Laser-Doppler flowmeter was used to measure the vascular reaction of the pulp. The levels of blood flow were recorded prior to (0 min.) and after the application (1, 5, 15, 30, 60 min.) of Dycal. Results were evaluated with one-way ANOVA. Significantly higher pulpal blood flow was found only in the first minute after the application of Dycal. In any other time no significant difference was found between the results before and after (5, 15, 30, 60 min.) the application in test- and control-group.

The effect of acid etching on vascular diameter of pulp-vessels in rat incisor (vitalmicroscopic study)

Conditioning agents used on dentin with composite materials are biologically active and may have deleterious effects on the pulpal microcirculation. No data are available on the immediate vascular effect of etching materials applied on a constant thin pulpal dentin. In this study the authors examined whether the application of 36% phosphoric acid (Conditioner 36, 15 seconds) or itakonic acid with 10% maleic acid (NRC Non-Rinse Conditioner, 20 seconds), as recommended by the manufacturers, alters the blood circulation in the pulp of the rat's lower incisors. The effect of prolonged etching time (60 seconds) was also assessed (Conditioner 36). The application of saline served as the untreated control. The technique of vitalmicroscopy was used on the first lower incisor of 40 (10-10 in each group) male Sprague-Dawley rats (weighing 350 +/- 8 g SE) to record the changes in vessel diameter prior to and at 5, 15, 30 and 60 minutes after the test materials were administered on the dentin. In the control rats, the vessel diameter was stable during the entire experiment. Acid conditioning as recommended by the manufacturers tended to cause vasodilatation, though these alterations were statistically not significant when compared to the control group (ANOVA, p > 0.05). After prolonged etching time (Conditioner 36, 60 seconds) significant vasoconstriction (-14.4 +/- 6.13; -10.59 +/- 4.2; -11.96 +/- 6.75; -5.49 +/- 5.78%) was observed (ANOVA, p < 0.05). In this group, stasis developed in pulpal blood circulation in 40% of rats (Cochran's-Q test, p < 0.05), gas-bubble formation was observed in 30% and the disappearance of the pulpal wall occurred in 20%. These results suggest that exposition time with acid is crucial to the pulpal microcirculation. That is, acid conditioning applied as indicated (for 15-20 seconds) onto a very thin layer of dentin only slightly affects the blood supply to the dental pulp; however, prolonged etching time (for 60 seconds) results in immediate failure of microcirculation in the dental pulp of rats.

Apoptosis induction and inhibition of cellular proliferation by angiotensin II: possible implication and perspectives

The renin-angiotensin system plays a pivotal role in the regulation of fluid, electrolyte metabolism and blood pressure. Molecular cloning and pharmacological studies have defined two major classes of Angiotensin II (Ang II) receptors, designated AT1 and AT2. Recently, it has been well recognized that Ang II, beside its classical physiological actions, is a profibrogenic peptide and displays characteristics of a growth factor. The emerging picture suggests that angiotensin receptor subtypes exert opposing features in many aspects of their biological function, most importantly in cellular growth and proliferation. Accordingly, the proliferative and/or growth-promoting effects of Ang II are thought to be mediated by AT1 receptor, whereas the AT2 receptor subtype may have growth-inhibitory properties. The novel finding that Ang II is able to induce apoptosis by AT2 receptors in diverse cell types is of great scientific interest, as recent studies revealed a role for apoptosis as a deliberate form of cell death in the pathogenesis of various cardiovascular diseases such as heart failure and vascular remodeling. Furthermore apoptotic cell death might occur during the development of progressive glomerulosclerosis. It is tempting to speculate that autocrine-paracrine vasoactive substances such as Ang II might regulate these apoptotic processes during pathogenic conditions.

Extracellular signal-regulated kinase and the small GTP-binding protein p21Rac1 are involved in the regulation of gene transcription by angiotensin II

To study the role of extracellular-signal-regulated kinase (ERK) cascade and the small GTP-ase proteins in the activation of the c-fos promoter by angiotensin II (AII), transient transfection experiments were performed in CHO cells stably expressing the rat AT(1A) receptor. In this system AII activated ERK in 1 min and also increased the transcriptional activity of the c-fos promoter-luciferase reporter gene construct. The activation of the promoter proved to be dependent on the Ras-Raf-ERK cascade as cotransfection of expression vectors known to specifically inhibit this cascade blocked the effect of AII. Dominant-negative p21Rac1 mutant partially blocked the activation of the c-fos promoter by AII. However, activation of the c-fos promoter was independent of protein kinase C (PKC) as bisindolylmaleimide I, a specific PKC inhibitor did not block the effect of AII. These results suggest that AII activates the transcription of the c-fos through the Ras-Raf-ERK cascade. Furthermore, p21Rac1 is involved in the modulation of the c-fos promoter by AII.

Interleukin-2-dependent mechanisms are involved in the development of glomerulosclerosis after partial renal ablation in rats

BACKGROUND

Glomerulosclerosis is a common feature of many end-stage renal diseases. The contribution of cellular immune mechanisms has been implicated in the development of glomerulosclerosis. We investigated whether the inhibition of lymphocyte activation influences this process in an established rat model of renal hyperfiltration.

METHODS

After removal of two-thirds of their respective kidney mass, rats were treated with either tacrolimus (0.08 mg/kg/day) or vehicle until the end of the study (n = 10/group). The rats were pair-fed and proteinuria was assessed regularly. Twenty weeks after nephrectomy, creatinine clearance and systemic blood pressure were determined, and kidneys were harvested for morphological, immunohistological and PCR analysis.

RESULTS

In control animals, renal function started to decline from week 12, as indicated by an elevated proteinuria. Interleukin (IL)-2 and IL-2 receptor synthesis was upregulated in control animals and inhibited by tacrolimus treatment. Transforming growth factor-beta (TGF-beta(1)), platelet-derived growth factor-AA (PDGF-AA) and macrophage chemoattractant protein-1 (MCP-1) mRNA levels were upregulated in control animals, but were significantly lower in immunosuppressed hosts. Additionally, tacrolimus treatment resulted in a significant reduction of proteinuria. Morphological analysis supported these functional results; glomerular sclerosis, tubular atrophy and intimal proliferation were more pronounced in controls than in the tacrolimus group. These morphological parameters were accompanied by reduced infiltration of CD5+ (rat T-cell marker) T cells, ED1+ (rat macrophage marker) macrophages, and less intense staining for laminin and fibronectin.

CONCLUSION

A continuous treatment with tacrolimus - an inhibitor of lymphocyte proliferation - reduced the pace of glomerulosclerosis in the remnant kidney.

Angiotensin II: a regulator of inflammation during renal disease?

It has been recently recognized that besides its vasoactive actions Angiotensin II (Ang II) exerts various immunomodulatory effects that may contribute to renal injury and to the progression of renal disease. Consistent with this concept, Ang II facilitates macrophage recruitment into the kidney either directly or through the-upregulation of different chemotactic molecules such as RANTES (Regulated on Activation Normal T Expressed and Secreted), monocyte chemoattractant protein-1 (MCP-1) and osteopontin. Infiltrating macrophages not only produce a number of cytokines, growth factors and proinflammatory Mediators, but also synthesize Ang II intacellularly which increases tissue levels of the hormone within the kidney. Finally, specific binding sites for Ang II have been demonstrated on macrophages and increasing evidence indicates that Ang II directly modulates many of the cellular functions of these cells during the course of renal disease. Together these data suggest that Ang II plays an important role in modulating inflammatory responses in the kidney.

In vivo examination of the Scotchbond Multi-Purpose Dental Adhesive System in rat (vitalmicroscopic study)

No data are available on the direct acute vascular effect of dental bonding materials on the dental pulp. This study investigated the effects of the components of a composite resin-bonding system on pulpal vascular diameter. Three groups of 10 male Sprague-Dawley rats (weighing 330 +/- 51 g) were used for this investigation. The first lower incisor of the rats was prepared for vitalmicroscopy. Changes in vessel diameter were recorded prior to, and at 5, 15, 30 and 60 minutes after the bonding agents (with/without etching) or saline (control) were administered on dentin as recommended by the manufacturer. In control rats, the vessel diameter was elevated slightly (2.96 +/- 4.08%) during the whole experiment. However, in the presence of bonding materials, an enhancement of 12.58 +/- 7.1% without etching and 13.11 +/- 8.6% with acid etching was registered as the increase in vascular diameter. There were significant (p < 0.05) differences between the control group and those treated with bonding agent components. Results suggested that resin composite bonding agents applied to a thin layer of dentin have an acute vasodilating effect on the dental pulp. The clinical significance of this vascular alteration in the dental pulp requires further study.

[Effect of conditioning on the circulation of rat teeth]

Materials employed in "adhesive filling technique" often lack informative instructions concerning the depth of cavities which require lining. Etching-materials directly placed on the dentin can adversely influence the pulp leading to changes in local microcirculation which can be an early sign of the pathological changes in the pulp. Therefore, it is worth examining the effect of these materials on the diameters of pulpal vessels. In the present study we examined wether acid etching (test1: 15 s and test2: 60 s) alters the blood circulation of the pulp lower incisors, by applying it directly onto a thin layer of pulpal wall (40-50 microns) without any liner, and following the instructions provided by the manufacturer. Twenty male Sprague-Dawley rats (weighing 330 +/- 51 g) and the technique of vitalmicroscopy was used for this investigation. The left lower incisors of the rats were prepared for vitalmicroscopy. Changes in vessel diameter were recorded prior to and 5, 15, 30 and 60 minutes after investigated materials or saline (control) were administered on dentin. In control and test1 group the vessel diameter was unchanged during the experiment. However, in group test2 an intense vasoconstriction was registered. There were significant (p > 0.05, ANOVA) differences in diameter changes between the control group and those treated with acid etching for 60s. Our results suggest that extended etching time may affect the circulatory system in the dental pulp, when applied onto very thin layer of dentin.

Hypoglycemic effects of insulin-like growth factor-1 in experimental uremia: can concomitant growth hormone administration prevent this effect?

The risk of hypoglycemia limits the clinical application of insulin-like growth factor-1 (IGF-1). Our studies aimed to evaluate the mode of occurrence as well as the prevention of this side effect. Acute administration (i.v. infusion) of IGF-1 in subtotal nephrectomized uremic (U), sham-operated ad libitum fed control (C) and sham-operated pair-fed control (P) rats led to hypoglycemia, though more expressed in P. Serum glucose levels decreased within 60 min after the IGF-1 administration by 40% in U, by 45% in C and by 52% in P (p < 0.05, U vs. P). Chronic administration (7 days) of 1, 4 and 8 mg/kg/day IGF-1 in U rats led to hypoglycemia in an increasing manner as the dose of IGF-1 increased. On the first day, 2 h after injection, serum glucose levels were 116.5 +/- 8.6, 110.4 +/- 12.4, 60,3 +/- 19.2 and 50.6 +/- 18.3 mg/dl, respectively (p < 0. 01). One week later, IGF-1 therapy proved to be less hypoglycemic in all the groups. On day 7, 2 h after injection the serum glucose levels were 118.9 +/- 23.8, 89.0 +/- 23.9 and 66.0 +/- 32.0, respectively (in comparison to day 1 for 4 and 8 mg/kg/day IGF-1 p < 0.05). The combined effect of 4 mg/kg/day IGF-1 and 10 IU/kg/day growth hormone (GH) was also studied in U and P animals. Two hours after the first injections of IGF-1 serum glucose levels decreased in U from 120.0 +/- 11.3 to 49.2 +/- 21.6 mg/dl, while IGF-1 plus GH decreased the glucose level from 122.0 +/- 15.5 to 81.3 +/- 24.7 mg/dl (p < 0.05 IGF-1 vs. IGF-1 + GH). The hypoglycemic effect of IGF-1 was less expressed by long-term treatment and simultaneous administration of GH overcame the glucose-lowering effect of IGF-1 (serum glucose levels on day 11 one hour after the injections: 73.7 +/- 15.3 mg/dl with IGF-1, and 111.0 +/- 7.8 mg/dl with IGF-1 + GH). Methylprednisolone (MP) did not significantly alter the former effects of IGF-1 and GH. In summary, IGF-1 leads to hypoglycemia in control and uremic rats in a dose-dependent manner. This effect becomes less expressed after prolonged administration. GH attenuates the hypoglycemic effect of IGF-1. This suggests that the combined GH and IGF-1 treatment is more effective and less dangerous in correcting uremic growth failure.

Physiological doses of calcium regulatory hormones do not normalize bone cells in uraemic rats

BACKGROUND

Low bone turnover despite normal parathyroid hormone (PTH) concentrations has been found in many patients with end-stage renal failure. Hyporesponsiveness to the calcaemic action is also a known feature of uraemia. Hyporesponsiveness of bone surface cells involved in bone modelling has not been demonstrated to date. It was the purpose of this study using a rat model of moderate renal failure to investigate whether doses of PTH and calcitriol that reverse the effect of parathyroidectomy on calcaemia also normalize bone surface cell activity.

MATERIALS AND METHODS

Sham-operated pair-fed male Spraque-Dawley rats were compared with subtotally nephrectomized (SNX), parathyroidectomized (PTX) rats that received either solvent or calcitriol (5 pmol kg -1 h-1) + 1,34 rat PTH (100 ng kg -1 h-1) by osmotic mini-pump. Histomorphometric measurements were carried out in the vertebral body (L5).

RESULTS

In SNX/PTX animals, calcitriol + 1,34 rat PTH caused a modest increase in serum calcium (S-Ca) within the normal range. Osteoclast surface per cent was significantly lower in solvent-treated SNX/PTX rats than in sham-operated controls [3.7 +/- 2.8 osteoclast surface/bone surface (OcS/BS%) vs. 6.3 +/- 3.9], and this was not normalized by PTH + calcitriol (3.3 +/- 3). In contrast, osteoblast surface per cent and osteoid surface per cent were increased over values in sham-operated rats; as a result, co-administration of calcitriol and 1,34 rat PTH caused a highly significant increase in fractional bone volume (BV/TV).

CONCLUSIONS

The results show that administration of PTH and calcitriol in doses that raise serum calcium fails to normalize the percentage of osteoclast surface, but was effective in raising osteoblast number and osteoblast volume in experimental renal failure. The results argue for abnormal response of bone cells to calcium-regulating hormones and/or the action of factors other than calcium regulatory hormones in the genesis of skeletal abnormalities of renal failure.

[Comparison of the effect of acetone-containing and acetone-less bonding materials on dental pulp blood vessels in rats]

No data are available on the direct acute vascular effect of dental bond materials in the dental pulp. The purpose of the present study was to investigate the effect of composite resin bonding systems on the pulpal vascular diameter. Three groups of male Sprague-Dawley rats (weighing 300-490 g), each of 10 animals were used for this investigation. The left lower incisor of the rats was prepared for vitalmicroscopy. Changes in vessel diameter were recorded prior to; and 5, 15, 30, 60 minutes after the application of saline (control) or the bonding agents (test1: acetone containing--/Prime/Bond2.1, DeTrey/; test2: acetone free /Scotchbond Multi-Purpose Adhesive System, 3M/ bond material) on pulpal dentin as recommended by the manufacturer. In control rats, the vessel diameter was stable during the experiment. However, in the presence of bonding materials an enhancement was registered in vascular diameter (p < 0.05). The bond materials applied directly onto a very thin layer of dentin show acute vasodilating effect on the rat pulpal microvessels, but no stasis or prestasis has been detected, indicating a possible reversible effect. We could not show any statistical difference between the vasodilatation caused by the acetone containing and the acetone free bonding material.

The efficacy of long-term captopril treatment on micro- and macroalbuminuria in hypertensive diabetics

Microalbuminuric [16] and macroalbuminuric [17] hypertensive insulin dependent diabetics were followed up for 4 years after the initiation of captopril therapy to assess the efficacy of ACE inhibitor therapy on albuminuria and blood pressure normalisation. Within the first six months of captopril therapy mean systolic blood pressure decreased in microalbuminuric and macroalbuminuric patients from 168.1 +/- 17.6 mmHg to 134.4 +/- 12.1 mmHg (19.2 +/- 7.1%) and from 177.6 +/- 16.8 mmHg to 143.5 +/- 12.7 (18.9 +/- 6.7%) mmHg, respectively. Mean diastolic blood pressure, similarly, showed a decrease from 91.9 +/- 9.1 mmHg to 74.4 +/- 10.3 mmHg (19.0 +/- 9.4%) in the microalbuminuric and from 95.3 +/- 13.7 mmHg to 78.2 +/- 7.3 (16.9 +/- 9.5%) mmHg in the macroalbuminuric group. After six months of captopril administration albumin excretion rates decreased as well, from 97.4 +/- 35.9 micrograms/min to 51.9 +/- 19.9 micrograms/min (46.9 +/- 7.6%) and from 766.7 +/- 577.9 micrograms/min to 365.1 +/- 298.4 micrograms/min (50.4 +/- 8.4%) in the micro- and macroalbuminuric groups, respectively. Thereafter, mean albumin excretion rates and blood pressure rose significantly, but at the end of the fourth year they were still significantly lower compared to that of the pretreatment period. After four years, albumin excretion rates were 71.3 +/- 29.6 micrograms/min in the microalbuminuric and 391.2 +/- 204.7 micrograms/min in the macroalbuminuric group. We conclude that ACE inhibitor therapy results in a rapid decrease of albuminuria and blood pressure, and despite a slow gradual increase, the albumin excretion rates and blood pressure values remain significantly lower than the initial values after four years.

Coinhibition of immune and renin-angiotensin systems reduces the pace of glomerulosclerosis in the rat remnant kidney

The development of progressive glomerulosclerosis (GS) has been attributed to a number of humoral and hemodynamic factors, however, neither the exact pathomechanism nor the prevention and treatment have been clearly established. Renin-angiotensin system (RAS), interleukin-2 (IL-2)-activated T cells, systemic BP, and serum lipid levels all have been recognized as pathogenetic factors. According to our working hypothesis, a combination therapy with the inhibition of RAS and IL-2 system may be more potent in the prevention of the progression of GS than a monotherapy. After 5/6 subtotal nephrectomy, rats were treated with either the angiotensin-converting enzyme-blocker enalapril (E), the angiotensin II AT1 receptor blocker candesartan cilexetil (CA), the IL-2 synthesis inhibitor tacrolimus (T), or a combination of these agents. Proteinuria, as a functional hallmark of GS, was determined regularly, and at week 16, systolic BP, plasma total cholesterol, and triglyceride (TG) levels were measured and kidneys were harvested for morphologic and immunohistochemical analysis. Combination therapy was more effective (proteinuria: CA + T: 29.3+/-12.8 mg/24 h, E + T: 31.3+/-13.0 mg/24 h; GS: CA + T: 10.7+/-4.1%, E + T: 8.3+/-4.6%, P < 0.01) than monotherapy (proteinuria: T: 49.3+/-17.3 mg/24 h, CA: 53.2+/-18.1 mg/24 h, E: 51.1+/-26.6 mg/24 h; GS: T: 10.9+/-4.4%, CA: 23.8+/-4%, E: 14.2+/-5.3%, P < 0.05, with control values of proteinuria: 77.6+/-27.1 mg/24 h and GS: 28+/-2.9%). The number of infiltrating ED-1 (rat macrophage marker) macrophages (T: 161.5+/-51.2 cells/field of view, CA: 203.6+/-102.3, E: 178.6+/-35.3, CA + T: 140.2+/-63.2, E + T:128.2+/-75.6), and CD-5+ (rat T cell marker) T lymphocytes (CA + T: 261.5+/-103.6, E + T: 236+/-94.8) was significantly reduced by the treatment protocols (controls: ED-1: 356+/-100, CD-5: 482.9+/-154.5). These results indicate that an inhibition of RAS either with angiotensin-converting enzyme or AT1 receptor blockade, together with the inhibition of IL-2 synthesis, is more effective in the prevention of GS than a single treatment alone.

Endothelial permeability of the afferent arteriole and its changes as the result of alteration in the activity of the renin-angiotensin system

Recent studies have demonstrated fenestrations in the juxtaglomerular part of the afferent arteriole facing the extraglomerular mesangium and the epithelioid cells in different mammals including humans. The permeability of the endothelium in afferent arteriole may play an important role in various physiologic and pathophysiologic processes. This study therefore was conducted to examine the permeability along the length of afferent arteriole using ferritin particles as an indicator of permeability/fenestration. Assuming the presence of a relationship between the development of permeable endothelial fenestration and renin formation, the permeability of the endothelium and renin granulation and their correlation along the wall of the afferent arteriole under control conditions and during inhibition of renin-angiotensin system by converting enzyme inhibition or AT1 receptor blockade were examined. The intra-aortically administered ferritin particles appeared in the interstitium of the distal part of the afferent arterioles. About one-third to half of the length of the afferent arteriole wall was ferritin-positive. There was a correlation between ferritin-positive and renin-positive portions. The density of ferritin particles was high close to the glomerulus and decreased continuously, similar to the profile of renin distribution. There was also a correlation between ferritin density in basal membrane and the renin granulation index. On the basis of these results, the afferent arteriole, according to its endothelial permeability, can be divided into two distinct portions, i.e., the permeable and the nonpermeable, the length and ratio of which may be related to the actual renin formation. These portions not only are different in the presence or absence of fenestration of the endothelium, but they also show difference in myosin and renin contents, suggesting that each portion may serve different function(s).

Albuminuria after fetal pancreatic islet transplantation: a 10-year follow-up

AIM OF THE STUDY

The prevention of diabetic nephropathy is as yet an unresolved issue. The aim of our study was to assess the effects of transplantation of long-term cultured and cryopreserved fetal pancreas islets on metabolic control and the development of diabetic nephropathy.

METHODS

Serum C-peptide, glucose, HbA1c, insulin requirements, urinary albumin excretion rate, and blood pressure of 10 insulin-dependent diabetic patients after transplantation were compared with a group of 27 insulin-dependent diabetic controls on insulin therapy only during a 10-year follow-up.

RESULTS

In the first year after transplantation mean insulin requirement decreased from 53.6+/-2.2 to 35.8+/-1.2 units. C-peptide levels appeared (0.55+/-0.08 ng/ml) and remained detectable throughout the follow-up. Blood glucose and HbA1c were significantly (P<0.05) lower than in the controls. Mean albumin excretion rates of the transplant and the control groups during the follow up were 18.8+/-8.5 and 11.7+/-2.0, 16.6+/-6.6 and 14.0+/-2.3, 15.0+/-5.0 and 15.1+/-2.7, 15.3+/-7.5 and 20.4+/-4.2, 19.8+/-6.2 and 36.7+/-11.1, 11.7+/-3.6 and 51.3+/-14.6, 14.1+/-4.2 and 71.4+/-23.1, 22.7+/-8.6 and 92.0+/-28.1, 18.0+/-5.9 and 107.6+/-35.6, 21.7+/-11.0 and 101.5+/-29.3 microg/min respectively. From the 6th year the difference between the two groups was significant (P<0.001). In the transplant group initial mean systolic and diastolic blood pressure values were 132.0+/-3.3 and 81.5+/-1.5 mmHg, in the controls 130.4+/-3.4 and 79.6+/-1.6 mmHg respectively. Significant changes (P<0.05) of blood pressure during the follow-up or differences between the two groups were not observed.

CONCLUSIONS

We conclude that fetal islet transplantation is effective in achieving good long-term diabetes control and in the prevention of diabetic nephropathy.

Hemodynamics of gastric microcirculation in rats

Recently, we described a novel preparation of rat stomach for vascular micropuncture studies. The aim of the present study was to directly measure basic microvascular parameters along the length of the gastric vasculature. Blood vessels were identified, and intravascular pressure was measured with a servo-null transducer, vessel dimensions with videometry, blood flow with microspheres, and plasma colloid osmotic pressure with an osmometer. When systemic arterial pressure was 100-110 mmHg, intravascular pressures in small arteries, primary, secondary, and tertiary submucosal arterioles, mucosal terminal arterioles, and muscle arterioles were 77.8 +/- 2.6, 74.6 +/- 2.5, 54.1 +/- 1.8, 34.4 +/- 1.6, 32.4 +/- 1.2, and 30.5 +/- 1.4 (SE) mmHg, respectively. Intravascular pressures in collecting veins, secondary and primary submucosal venules, muscle venules, and small veins were 26.6 +/- 1.1, 21.8 +/- 1.6, 17.1 +/- 0. 8, 18.2 +/- 0.9, and 14.4 +/- 0.6 mmHg, respectively. Capillary pressure in the mucosa (28 mmHg), as estimated by interpolation between terminal arteriole and collecting venule pressures, was significantly higher than in the muscle layer (23.6 +/- 1.4 mmHg). A total of 155 vessels from 25 animals were sampled. Relative blood flows were 16 +/- 3% in the muscle and 84 +/- 3% in the mucosa-submucosa. Analysis of filtration forces in these two different capillary beds suggests that gastric mucosal capillaries are primarily a filtering network, whereas muscle capillaries are in fluid balance. Calculated resistance ratios indicate low precapillary but relatively high postcapillary vascular resistance in the gastric mucosa.

Diurnal blood pressure variation and albuminuria in normotensive patients with insulin-dependent diabetes mellitus

BACKGROUND

Abnormalities of the systemic blood pressure are closely associated with the development of diabetic nephropathy. Our aim was to examine the relationship between diurnal blood pressure pattern and albuminuria in insulin-dependent normotensive diabetic patients before the development of overt nephropathy.

METHODS

Urinary albumin excretion rates were determined by radioimmunoassay, and 24-h ambulatory blood pressure monitoring was performed. Means and diurnal index was calculated for systolic, diastolic and mean arterial blood pressure, for day-time, night-time, and the whole day. The results of the normoalbuminuric (n = 39) and microalbuminuric (n = 29) groups are compared, and correlation of the blood pressure parameters with albuminuria is analysed.

RESULTS

Twenty-four hours and night-time mean blood pressures were significantly higher, diurnal indices characterizing the night-time blood pressure drop were smaller in the microalbuminuric group. With multiple regression analysis a significant positive correlation was found between albumin excretion rates and 24-h mean systolic blood pressure and a significant negative correlation between albumin excretion rates and the diurnal index of mean arterial pressure (r2= 0.40, P<0.0001). In the normoalbuminuric group 1 (2.6%) patient, in the microalbuminuric group 7 (24.1%/) were 'non-dippers'.

CONCLUSION

We conclude that in normotensive insulin-dependent diabetic patients the night-time decrease of blood pressure is smaller if microalbuminuria is present. Higher nocturnal blood pressure load is associated with the increase of albuminuria, even before the onset of overt diabetic nephropathy or hypertension.