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Abstract
The prevalence of obesity has increased dramatically during the past decades, which has been a major health problem. Since 1975, the number of people with obesity worldwide has nearly tripled. An increasing number of studies find obesity as a driver of chronic kidney disease (CKD) progression, and the mechanisms are complex and include hemodynamic changes, inflammation, oxidative stress, and activation of the renin-angiotensin-aldosterone system (RAAS). Obesity-related kidney disease is characterized by glomerulomegaly, which is often accompanied by localized and segmental glomerulosclerosis lesions. In these patients, the early symptoms are atypical, with microproteinuria being the main clinical manifestation and nephrotic syndrome being rare. Weight loss and RAAS blockers have a protective effect on obesity-related CKD, but even so, a significant proportion of patients eventually progress to end-stage renal disease despite treatment. Thus, it is critical to comprehend the mechanisms underlying obesity-related CKD to create new tactics for slowing or stopping disease progression. In this review, we summarize current knowledge on the mechanisms of obesity-related kidney disease, its pathological changes, and future perspectives on its treatment.
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Affiliation(s)
- Zongmiao Jiang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Yao Wang
- Department of Orthopedics, The Second Hospital Jilin University, Changchun, China
| | - Xue Zhao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Haiying Cui
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Mingyue Han
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Xinhua Ren
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
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Habibi J, Aroor AR, Das NA, Manrique-Acevedo CM, Johnson MS, Hayden MR, Nistala R, Wiedmeyer C, Chandrasekar B, DeMarco VG. The combination of a neprilysin inhibitor (sacubitril) and angiotensin-II receptor blocker (valsartan) attenuates glomerular and tubular injury in the Zucker Obese rat. Cardiovasc Diabetol 2019; 18:40. [PMID: 30909895 PMCID: PMC6432760 DOI: 10.1186/s12933-019-0847-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/18/2019] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE Diabetic nephropathy (DN) is characterized by glomerular and tubulointerstitial injury, proteinuria and remodeling. Here we examined whether the combination of an inhibitor of neprilysin (sacubitril), a natriuretic peptide-degrading enzyme, and an angiotensin II type 1 receptor blocker (valsartan), suppresses renal injury in a pre-clinical model of early DN more effectively than valsartan monotherapy. METHODS Sixty-four male Zucker Obese rats (ZO) at 16 weeks of age were distributed into 4 different groups: Group 1: saline control (ZOC); Group 2: sacubitril/valsartan (sac/val) (68 mg kg-1 day-1; ZOSV); and Group 3: valsartan (val) (31 mg kg-1 day-1; ZOV). Group 4 received hydralazine, an anti-hypertensive drug (30 mg kg-1 day-1, ZOH). Six Zucker Lean (ZL) rats received saline (Group 5) and served as lean controls (ZLC). Drugs were administered daily for 10 weeks by oral gavage. RESULTS Mean arterial pressure (MAP) increased in ZOC (+ 28%), but not in ZOSV (- 4.2%), ZOV (- 3.9%) or ZOH (- 3.7%), during the 10 week-study period. ZOC were mildly hyperglycemic, hyperinsulinemic and hypercholesterolemic. ZOC exhibited proteinuria, hyperfiltration, elevated renal resistivity index (RRI), glomerular mesangial expansion and podocyte foot process flattening and effacement, reduced nephrin and podocin expression, tubulointerstitial and periarterial fibrosis, increased NOX2, NOX4 and AT1R expression, glomerular and tubular nitroso-oxidative stress, with associated increases in urinary markers of tubular injury. None of the drugs reduced fasting glucose or HbA1c. Hypercholesterolemia was reduced in ZOSV (- 43%) and ZOV (- 34%) (p < 0.05), but not in ZOH (- 13%) (ZOSV > ZOV > ZOH). Proteinuria was ameliorated in ZOSV (- 47%; p < 0.05) and ZOV (- 30%; p > 0.05), but was exacerbated in ZOH (+ 28%; p > 0.05) (ZOSV > ZOV > ZOH). Compared to ZOC, hyperfiltration was improved in ZOSV (p < 0.05 vs ZOC), but not in ZOV or ZOH. None of the drugs improved RRI. Mesangial expansion was reduced by all 3 treatments (ZOV > ZOSV > ZOH). Importantly, sac/val was more effective in improving podocyte and tubular mitochondrial ultrastructure than val or hydralazine (ZOSV > ZOV > ZOH) and this was associated with increases in nephrin and podocin gene expression in ZOSV (p < 0.05), but not ZOV or ZOH. Periarterial and tubulointerstitial fibrosis and nitroso-oxidative stress were reduced in all 3 treatment groups to a similar extent. Of the eight urinary proximal tubule cell injury markers examined, five were elevated in ZOC (p < 0.05). Clusterin and KIM-1 were reduced in ZOSV (p < 0.05), clusterin alone was reduced in ZOV and no markers were reduced in ZOH (ZOSV > ZOV > ZOH). CONCLUSIONS Compared to val monotherapy, sac/val was more effective in reducing proteinuria, renal ultrastructure and tubular injury in a clinically relevant animal model of early DN. More importantly, these renoprotective effects were independent of improvements in blood pressure, glycemia and nitroso-oxidative stress. These novel findings warrant future clinical investigations designed to test whether sac/val may offer renoprotection in the setting of DN.
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Affiliation(s)
- Javad Habibi
- Diabetes and Cardiovascular Center, University of Missouri School of Medicine, Columbia, MO, USA.,Division of Endocrinology and Metabolism, Department of Medicine, University of Missouri-Columbia School of Medicine, D110, DC043.0, One Hospital Dr, Columbia, MO, 65212, USA.,Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA
| | - Annayya R Aroor
- Diabetes and Cardiovascular Center, University of Missouri School of Medicine, Columbia, MO, USA.,Division of Endocrinology and Metabolism, Department of Medicine, University of Missouri-Columbia School of Medicine, D110, DC043.0, One Hospital Dr, Columbia, MO, 65212, USA.,Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA
| | - Nitin A Das
- Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio, TX, USA
| | - Camila M Manrique-Acevedo
- Diabetes and Cardiovascular Center, University of Missouri School of Medicine, Columbia, MO, USA.,Division of Endocrinology and Metabolism, Department of Medicine, University of Missouri-Columbia School of Medicine, D110, DC043.0, One Hospital Dr, Columbia, MO, 65212, USA.,Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA
| | - Megan S Johnson
- Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, MO, USA
| | - Melvin R Hayden
- Diabetes and Cardiovascular Center, University of Missouri School of Medicine, Columbia, MO, USA.,Division of Endocrinology and Metabolism, Department of Medicine, University of Missouri-Columbia School of Medicine, D110, DC043.0, One Hospital Dr, Columbia, MO, 65212, USA
| | - Ravi Nistala
- Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA.,Division of Nephrology, Department of Medicine, University of Missouri, Columbia, MO, USA
| | - Charles Wiedmeyer
- College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Bysani Chandrasekar
- Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA.,Division of Cardiology, Department of Medicine, University of Missour, Columbia, MO, USA.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA
| | - Vincent G DeMarco
- Diabetes and Cardiovascular Center, University of Missouri School of Medicine, Columbia, MO, USA. .,Division of Endocrinology and Metabolism, Department of Medicine, University of Missouri-Columbia School of Medicine, D110, DC043.0, One Hospital Dr, Columbia, MO, 65212, USA. .,Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA. .,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA.
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Kaimori JY, Isaka Y, Hatanaka M, Yamamoto S, Ichimaru N, Fujikawa A, Shibata H, Fujimori A, Miyoshi S, Yokawa T, Kuroda K, Moriyama T, Rakugi H, Takahara S. Visualization of kidney fibrosis in diabetic nephropathy by long diffusion tensor imaging MRI with spin-echo sequence. Sci Rep 2017; 7:5731. [PMID: 28720778 PMCID: PMC5515876 DOI: 10.1038/s41598-017-06111-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/07/2017] [Indexed: 12/27/2022] Open
Abstract
Renal fibrosis (RF) is an indicator for progression of chronic kidney disease (CKD). Although diabetic nephropathy (DN) is the leading cause of CKD and end-stage renal disease in Western populations, the ability of MRI to evaluate RF in DN patients has not been determined. As a first step to identify possible MRI methods for RF evaluation, we examined the use of diffusion tensor imaging (DTI) MRI to evaluate RF in a rat model of DN (SHR/NDmcr-cp(cp/cp): SHR/ND). The signal-to-noise ratio in DTI MRI was enhanced using a spin-echo sequence, and a special kidney attachment was developed for long-term stabilization. The changes in renal temperature and blood flow during measurement were minimal, suggesting the feasibility of this method. At 38 weeks of age, RF had aggressively accumulated in the outer stripe (OS) of the outer medulla. FA maps showed that this method was successful in visualizing and evaluating fibrosis in the OS of the SHR/ND rat kidney (r = 0.7697, P = 0.0126). Interestingly, in the FA color maps, the directions of water molecule diffusion in RF were random, but distinct from conventional water diffusion in brain neuron fibers. These findings indicate that DTI MRI may be able to evaluate RF in CKD by DN.
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Affiliation(s)
- Jun-Ya Kaimori
- Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0781, Japan. .,Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Yoshitaka Isaka
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masaki Hatanaka
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Satoko Yamamoto
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Naotsugu Ichimaru
- Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0781, Japan
| | - Akihiko Fujikawa
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki, 305-8585, Japan
| | - Hiroshi Shibata
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki, 305-8585, Japan
| | - Akira Fujimori
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki, 305-8585, Japan
| | - Sosuke Miyoshi
- Drug Discovery Research, Astellas Pharma Inc., 21 Miyukigaoka, Tsukuba, Ibaraki, 305-8585, Japan
| | - Takashi Yokawa
- BioView Inc., 2-16-16 Iwamoto-cho, Chiyoda-ku, Tokyo, 101-0032, Japan
| | - Kagayaki Kuroda
- Department of Human and Information Science, Tokai University School of Information Science and Technology, 4-1-1 Kitakaname, Hiratsuka, Kanagawa, 259-1292, Japan
| | - Toshiki Moriyama
- Osaka University Health Care Center, 2-1 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hiromi Rakugi
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shiro Takahara
- Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0781, Japan
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Li H, Li M, Liu P, Wang Y, Zhang H, Li H, Yang S, Song Y, Yin Y, Gao L, Cheng S, Cai J, Tian G. Telmisartan Ameliorates Nephropathy in Metabolic Syndrome by Reducing Leptin Release From Perirenal Adipose Tissue. Hypertension 2016; 68:478-90. [PMID: 27296996 DOI: 10.1161/hypertensionaha.116.07008] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 05/09/2016] [Indexed: 12/16/2022]
Abstract
Metabolic syndrome (MetS) is associated with nephropathy. Along with common risk factors such as hypertension and hyperglycemia, adipocytokines released from perirenal adipose tissue (PRAT) are implicated in the pathogenesis of MetS nephropathy. The study was designed to elucidate the adverse effects of PRAT-derived leptin on nephropathy and to determine whether the angiotensin II type 1 receptor antagonist telmisartan exerts a renoprotective effect by decreasing the PRAT-derived leptin level in the high-fat diet-induced MetS rat. In MetS rats, PRAT-derived leptin expression increased concomitant with dysfunction of adipogenesis, and the activities of the angiotensin II-angiotensin II type 1 receptor and the angiotensin-converting enzyme 2-angiotensin (1-7)-Mas receptor axes were imbalanced in PRAT. PRAT-derived leptin from MetS rats promoted proliferation of rat glomerular endothelial cells (GERs) by activating the p38 MAPK (mitogen-activated protein kinase) pathway, thereby contributing to the development of nephropathy. Long-term telmisartan treatment improved metabolic parameters and renal function, decreased the amount of PRAT, promoted adipogenesis, increased the expression of angiotensin-converting enzyme 2, restored balanced activities of the angiotensin II-AT1R and angiotensin-converting enzyme 2-angiotensin (1-7)-Mas axes, and exerted an indirect renoprotective effect on MetS rats by decreasing PRAT-derived leptin release. Our results demonstrate a novel link between nephropathy and PRAT in MetS and show that telmisartan confers an underlying protective effect on visceral adipose tissue and the kidney, suggesting that it has potential as a therapeutic agent for the treatment of MetS-associated nephropathy.
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Affiliation(s)
- Hao Li
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - Min Li
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - Ping Liu
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - YaPing Wang
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - Heng Zhang
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - HongBin Li
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - ShiFeng Yang
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - Yan Song
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - YanRong Yin
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - Lan Gao
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - Si Cheng
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - Jun Cai
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
| | - Gang Tian
- From the Department of Critical Care Medicine (H.L., L.G.), Department of Cardiology (M.L., H.Z., H.L., Y.Y., S.C., G.T.), Department of Nephrology (S.Y.), and Department of Ultrasound Medicine (Y.S.), The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China; Department of Endocrinology, The Affiliated Xi'an Central Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China (P.L.); Department of Geriatric Cardiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, P. R. China (Y.W.); Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College (J.C.); and Key Laboratory of Shaanxi Province on Molecular Cardiology and Key Laboratory of Ministry of Education of People's Republic of China on Environment and Genes Related to Diseases, Xi'an, Shaanxi, P. R. China (H.L., G.T.)
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5
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Thornton SN. Increased Hydration Can Be Associated with Weight Loss. Front Nutr 2016; 3:18. [PMID: 27376070 PMCID: PMC4901052 DOI: 10.3389/fnut.2016.00018] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/30/2016] [Indexed: 12/25/2022] Open
Abstract
This mini-review develops the hypothesis that increased hydration leads to body weight loss, mainly through a decrease in feeding, and a loss of fat, through increased lipolysis. The publications cited come from animal, mainly rodent, studies where manipulations of the central and/or the peripheral renin–angiotensin system lead to an increased drinking response and a decrease in body weight. This hypothesis derives from a broader association between chronic hypohydration (extracellular dehydration) and raised levels of the hormone angiotensin II (AngII) associated with many chronic diseases, such as obesity, diabetes, cancer, and cardiovascular disease. Proposed mechanisms to explain these effects involve an increase in metabolism due to hydration expanding cell volume. The results of these animal studies often can be applied to the humans. Human studies are consistent with this hypothesis for weight loss and for reducing the risk factors in the development of obesity and type 2 diabetes.
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Affiliation(s)
- Simon N Thornton
- INSERM U_1116, Université de Lorraine , Vandoeuvre les Nancy , France
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Michel MC, Brunner HR, Foster C, Huo Y. Angiotensin II type 1 receptor antagonists in animal models of vascular, cardiac, metabolic and renal disease. Pharmacol Ther 2016; 164:1-81. [PMID: 27130806 DOI: 10.1016/j.pharmthera.2016.03.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 03/30/2016] [Indexed: 02/07/2023]
Abstract
We have reviewed the effects of angiotensin II type 1 receptor antagonists (ARBs) in various animal models of hypertension, atherosclerosis, cardiac function, hypertrophy and fibrosis, glucose and lipid metabolism, and renal function and morphology. Those of azilsartan and telmisartan have been included comprehensively whereas those of other ARBs have been included systematically but without intention of completeness. ARBs as a class lower blood pressure in established hypertension and prevent hypertension development in all applicable animal models except those with a markedly suppressed renin-angiotensin system; blood pressure lowering even persists for a considerable time after discontinuation of treatment. This translates into a reduced mortality, particularly in models exhibiting marked hypertension. The retrieved data on vascular, cardiac and renal function and morphology as well as on glucose and lipid metabolism are discussed to address three main questions: 1. Can ARB effects on blood vessels, heart, kidney and metabolic function be explained by blood pressure lowering alone or are they additionally directly related to blockade of the renin-angiotensin system? 2. Are they shared by other inhibitors of the renin-angiotensin system, e.g. angiotensin converting enzyme inhibitors? 3. Are some effects specific for one or more compounds within the ARB class? Taken together these data profile ARBs as a drug class with unique properties that have beneficial effects far beyond those on blood pressure reduction and, in some cases distinct from those of angiotensin converting enzyme inhibitors. The clinical relevance of angiotensin receptor-independent effects of some ARBs remains to be determined.
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Affiliation(s)
- Martin C Michel
- Dept. Pharmacology, Johannes Gutenberg University, Mainz, Germany; Dept. Translational Medicine & Clinical Pharmacology, Boehringer Ingelheim, Ingelheim, Germany.
| | | | - Carolyn Foster
- Retiree from Dept. of Research Networking, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | - Yong Huo
- Dept. Cardiology & Heart Center, Peking University First Hospital, Beijing, PR China
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Kadakol A, Pandey A, Goru SK, Malek V, Gaikwad AB. Insulin sensitizing and cardioprotective effects of Esculetin and Telmisartan combination by attenuating Ang II mediated vascular reactivity and cardiac fibrosis. Eur J Pharmacol 2015; 765:591-7. [DOI: 10.1016/j.ejphar.2015.09.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/19/2015] [Accepted: 09/22/2015] [Indexed: 12/20/2022]
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Pandey A, Goru SK, Kadakol A, Malek V, Gaikwad AB. Differential regulation of angiotensin converting enzyme 2 and nuclear factor-κB by angiotensin II receptor subtypes in type 2 diabetic kidney. Biochimie 2015; 118:71-81. [PMID: 26271886 DOI: 10.1016/j.biochi.2015.08.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 08/05/2015] [Indexed: 12/22/2022]
Abstract
Angiotensin II (Ang II) acts through Angiotensin Converting Enzyme (ACE)/Ang II type 1 receptor (AT1R) axis to promote renal failure whereas the Ang II type 2 receptor (AT2R)/Angiotensin Converting Enzyme 2 (ACE2)/Ang1-7/Mas axis constitutes the protective arm of Renin Angiotensin System (RAS). Though Ang II has been known to activate the Nuclear Factor-κB (NF-κB) signalling pathway through different receptor subtype(s) in different tissues under various diseases, the subtype orchestrating this stimulation in type 2 diabetic kidney remains elusive. ACE2, a protective monocarboxypeptidase, responsible for conversion of Ang II to Ang1-7, opposes the deleterious effects of RAS pathway but how its expression is altered with blockade of AT1R and AT2R is not yet known. Hence, the present study was conceived to understand the regulation of NF-κB and ACE2 by using specific AT1 and AT2 receptor antagonists in non-genetic model of type 2 diabetic nephropathy. Our results show that the AT1R and AT2R antagonists lead to the repression and activation of NF-κB signalling pathway, respectively which suggests the role of AT1R in NF-κB activation. The blockade of AT2R led to an increase in ACE2 expression, which may be a compensatory response to the drastically increased inflammatory mediators and oxidative stress in the diabetic kidney. To the best of our knowledge, this is the first study showing the differential regulation of NF-κB and ACE2 by Ang II receptor subtypes and thus this study improves our understanding regarding regulation of inflammatory cascade and ACE2 by AT1R and AT2R in type 2 diabetic kidney, which may help in designing novel strategies to combat the disease in future.
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Affiliation(s)
- Anuradha Pandey
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, 333031, India
| | - Santosh Kumar Goru
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, 333031, India
| | - Almesh Kadakol
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, 333031, India
| | - Vajir Malek
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, 333031, India
| | - Anil Bhanudas Gaikwad
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, 333031, India.
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Telmisartan ameliorates cisplatin-induced nephrotoxicity by inhibiting MAPK mediated inflammation and apoptosis. Eur J Pharmacol 2015; 748:54-60. [DOI: 10.1016/j.ejphar.2014.12.008] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 12/02/2014] [Accepted: 12/08/2014] [Indexed: 12/31/2022]
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Lezcano EJ, Iñigo P, Larraga AM, Barranquero C, Gimenez I, Osada J. Caloric restriction or telmisartan control dyslipidemia and nephropathy in obese diabetic Zücker rats. Diabetol Metab Syndr 2014; 6:10. [PMID: 24468233 PMCID: PMC3906927 DOI: 10.1186/1758-5996-6-10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 01/23/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The obese Zücker diabetic fatty male rat (ZDF:Gmi™-fa) is an animal model of type II diabetes associated with obesity and related metabolic disturbances like dyslipidaemia and diabetic nephropathy. In addition, diabetic dyslipidaemia has been linked to vascular and glomerular damage too. Dietary fat restriction is a current strategy to tackle obesity and, telmisartan, as a renoprotective agent, may mediate cholesterol efflux by activating PPARγ. To test the hypothesis that both therapeutical alternatives may influence dyslipidaemia and nephropathy in the ZDF rat, we studied their effect on development of diabetes. METHODS Male Zücker Diabetic Fatty (ZDF) rats received a low-calorie diet, vehicle or telmisartan for 9 weeks. Blood samples were obtained for analyses of lipids and lipoproteins, LDL-oxidisability, HDL structural and functional properties. Urinalysis was carried out to estimate albumin loss. At the end of the experimental period, rats were sacrificed, liver extracted and APOA1 mRNA quantified. RESULTS Results indicated that low-calorie diet and telmisartan can slower the onset of overt hyperglycaemia and renal damage assessed as albuminuria. Both interventions decreased the oxidative susceptibility of LDL and hepatic APOA1 mRNA expression but only dietary restriction lowered hyperlipidaemia. CONCLUSION Either a dietary or pharmacologic interventions with telmisartan have important beneficial effects in terms of LDL oxidative susceptibility and progression of albuminuria in obesity related type II diabetes.
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Affiliation(s)
- Eduardo J Lezcano
- Servicio de Cardiología, Hospital de San Pedro, Logroño, Calle Piqueras, 98 26006 Logroño, La Rioja, Spain
| | - Pablo Iñigo
- Departamento de Medicina. Facultad de Medicina. Servicio de Nefrología, Hospital Clínico Universitario “Lozano Blesa”, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana M Larraga
- Departamento de Medicina. Facultad de Medicina. Servicio de Nefrología, Hospital Clínico Universitario “Lozano Blesa”, Universidad de Zaragoza, Zaragoza, Spain
| | - Cristina Barranquero
- Departamento de Bioquímica y Biología Molecular y Celular, Facultad de Veterinaria, Instituto de Investigación Sanitaria de Aragón - Universidad de Zaragoza, Zaragoza, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Gimenez
- Departamento de Farmacología y Fisiología, Universidad de Zaragoza, Zaragoza, Spain
| | - Jesús Osada
- Departamento de Bioquímica y Biología Molecular y Celular, Facultad de Veterinaria, Instituto de Investigación Sanitaria de Aragón - Universidad de Zaragoza, Zaragoza, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
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Yoshihara D, Kugita M, Sasaki M, Horie S, Nakanishi K, Abe T, Aukema HM, Yamaguchi T, Nagao S. Telmisartan ameliorates fibrocystic liver disease in an orthologous rat model of human autosomal recessive polycystic kidney disease. PLoS One 2013; 8:e81480. [PMID: 24324698 PMCID: PMC3855683 DOI: 10.1371/journal.pone.0081480] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/19/2013] [Indexed: 01/13/2023] Open
Abstract
Human autosomal recessive polycystic kidney disease (ARPKD) produces kidneys which are massively enlarged due to multiple cysts, hypertension, and congenital hepatic fibrosis characterized by dilated bile ducts and portal hypertension. The PCK rat is an orthologous model of human ARPKD with numerous fluid-filled cysts caused by stimulated cellular proliferation in the renal tubules and hepatic bile duct epithelia, with interstitial fibrosis developed in the liver. We previously reported that a peroxisome proliferator activated receptor (PPAR)-γ full agonist ameliorated kidney and liver disease in PCK rats. Telmisartan is an angiotensin receptor blocker (ARB) used widely as an antihypertensive drug and shows partial PPAR-γ agonist activity. It also has nephroprotective activity in diabetes and renal injury and prevents the effects of drug-induced hepatotoxicity and hepatic fibrosis. In the present study, we determined whether telmisartan ameliorates progression of polycystic kidney and fibrocystic liver disease in PCK rats. Five male and 5 female PCK and normal control (+/+) rats were orally administered 3 mg/kg telmisartan or vehicle every day from 4 to 20 weeks of age. Treatment with telmisartan decreased blood pressure in both PCK and +/+ rats. Blood levels of aspartate amino transferase, alanine amino transferase and urea nitrogen were unaffected by telmisartan treatment. There was no effect on kidney disease progression, but liver weight relative to body weight, liver cystic area, hepatic fibrosis index, expression levels of Ki67 and TGF-β, and the number of Ki67- and TGF-β-positive interstitial cells in the liver were significantly decreased in telmisartan-treated PCK rats. Therefore, telmisartan ameliorates congenital hepatic fibrosis in ARPKD, possibly through the inhibition of signaling cascades responsible for cellular proliferation and interstitial fibrosis in PCK rats. The present results support the potential therapeutic use of ARBs for the treatment of fibrocystic liver disease in ARPKD patients.
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Affiliation(s)
- Daisuke Yoshihara
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University, Toyoake, Aichi, Japan
| | - Masanori Kugita
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University, Toyoake, Aichi, Japan
| | - Mai Sasaki
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University, Toyoake, Aichi, Japan
| | - Shigeo Horie
- Department of Urology, Juntendo University, Graduate School of Medicine, Bunkyou, Tokyo, Japan
| | - Koichi Nakanishi
- Department of Pediatrics, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Takaaki Abe
- Division of Medical Science, Tohoku University Graduate School of Biomedical Engineering, Sendai, Miyagi, Japan
| | - Harold M. Aukema
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tamio Yamaguchi
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shizuko Nagao
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University, Toyoake, Aichi, Japan
- * E-mail:
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Kagota S, Tada Y, Nejime N, Nakamura K, Kunitomo M, Shinozuka K. Telmisartan provides protection against development of impaired vasodilation independently of metabolic effects in SHRSP.Z-Lepr(fa)/IzmDmcr rats with metabolic syndrome. Can J Physiol Pharmacol 2011; 89:355-64. [PMID: 21619437 DOI: 10.1139/y11-029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Metabolic syndrome is known to facilitate the development of cardiovascular disease. We have demonstrated that mesenteric arteries of SHRSP.Z-Lepr(fa)/IzmDmcr (SHRSP-fatty) rats with metabolic syndrome display an impaired vasorelaxation response mediated by nitric oxide. We examined whether the condition could be alleviated by treatment with telmisartan, an angiotensin II type 1 (AT1) receptor antagonist with PPAR-γ-activating properties and compared the results with those from pioglitazone, a PPAR-γ agonist. Telmisartan (5 mg·kg(-1)·day(-1)) or pioglitazone (2.5 mg·kg(-1)·day(-1)) was orally administered to male SHRSP-fatty rats for 8 weeks. Serum triglyceride and cholesterol levels were determined, and the oral glucose tolerance test was performed to evaluate insulin resistance. Vasodilations in response to acetylcholine and nitroprusside were determined by wire myographs under isometric tension conditions, protein expressions of soluble guanylyl cyclase in mesenteric arteries by Western blotting, and the contents of 3-nitrotyrosine in aortas by high-performance liquid chromatography with electrochemical detection. Telmisartan exerted antihypertensive effects, while pioglitazone ameliorated metabolic abnormalities in SHRSP-fatty rats. Telmisartan increased acetylcholine- and nitroprusside-induced relaxation and soluble guanylyl cyclase protein expression in mesenteric arteries and reduced 3-nitrotyrosine content in aortas. Pioglitazone displayed no such alleviating effects on vascular functions. These findings indicate that telmisartan protects against vasodilation disturbance through anti-oxidative and -nitrative stress independently of metabolic effects in SHRSP-fatty rats with metabolic syndrome.
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Affiliation(s)
- Satomi Kagota
- Department of Pharmacology, School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University, Nishinomiya, Japan.
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Restoration of podocyte structure and improvement of chronic renal disease in transgenic mice overexpressing renin. PLoS One 2009; 4:e6721. [PMID: 19696925 PMCID: PMC2725297 DOI: 10.1371/journal.pone.0006721] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Accepted: 07/12/2009] [Indexed: 11/19/2022] Open
Abstract
Background Proteinuria is a major marker of the decline of renal function and an important risk factor of coronary heart disease. Elevated proteinuria is associated to the disruption of slit-diaphragm and loss of podocyte foot processes, structural alterations that are considered irreversible. The objective of the present study was to investigate whether proteinuria can be reversed and to identify the structural modifications and the gene/protein regulation associated to this reversal. Methodology/Principal Findings We used a novel transgenic strain of mouse (RenTg) that overexpresses renin at a constant high level. At the age of 12-month, RenTg mice showed established lesions typical of chronic renal disease such as peri-vascular and periglomerular inflammation, glomerular ischemia, glomerulosclerosis, mesangial expansion and tubular dilation. Ultrastructural analysis indicated abnormal heterogeneity of basement membrane thickness and disappearance of podocyte foot processes. These structural alterations were accompanied by decreased expressions of proteins specific of podocyte (nephrin, podocin), or tubular epithelial cell (E-cadherin and megalin) integrity. In addition, since TGFβ is considered the major pro-fibrotic agent in renal disease and since exogenous administration of BMP7 is reported to antagonize the TGFβ-induced phenotype changes in kidney, we have screened the expressions of several genes belonging in the TGFβ/BMP superfamily. We found that the endogenous inhibitors of BMPs such as noggin and Usag-1 were several-fold activated inhibiting the action of BMPs and thus reinforcing the deleterious action of TGFβ.Treatment with an AT1 receptor antagonist, at dose that did not decrease arterial pressure, gradually reduced albuminuria. This decrease was accompanied by re-expression of podocin, nephrin, E-cadherin and megalin, and reappearance of podocyte foot processes. In addition, expressions of noggin and Usag-1 were markedly decreased, permitting thus activation of the beneficial action of BMPs. Conclusions/Significance These findings show that proteinuria and alterations in the expression of proteins involved in the integrity and function of glomerular and renal epithelial phenotype are reversible events when the local action of angiotensin II is blocked, and provide hope that chronic renal disease can be efficiently treated.
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Clemenz M, Frost N, Schupp M, Caron S, Foryst-Ludwig A, Böhm C, Hartge M, Gust R, Staels B, Unger T, Kintscher U. Liver-specific peroxisome proliferator-activated receptor alpha target gene regulation by the angiotensin type 1 receptor blocker telmisartan. Diabetes 2008; 57:1405-13. [PMID: 18184928 DOI: 10.2337/db07-0839] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The angiotensin type 1 receptor blocker (ARB) and peroxisome proliferator-activated receptor (PPAR) gamma modulator telmisartan has been recently demonstrated to reduce plasma triglycerides in nondiabetic and diabetic hypertensive patients. The present study investigates the molecular mechanisms of telmisartans hypolipidemic actions, in particular its effect on the PPARalpha pathway. RESEARCH DESIGN AND METHODS; Regulation of PPARalpha target genes by telmisartan was studied by real-time PCR and Western immunoblotting in vitro and in vivo in liver/skeletal muscle of mice with diet-induced obesity. Activation of the PPARalpha ligand binding domain (LBD) was investigated using transactivation assays. RESULTS Telmisartan significantly induced the PPARalpha target genes carnitine palmitoyl transferase 1A (CPT1A) in human HepG2 cells and acyl-CoA synthetase long-chain family member 1 (ACSL1) in murine AML12 cells in the micromolar range. Telmisartan-induced CPT1A stimulation was markedly reduced after small interfering RNA-mediated knockdown of PPARalpha. Telmisartan consistently activated the PPARalpha-LBD as a partial PPARalpha agonist. Despite high in vitro concentrations required for PPARalpha activation, telmisartan (3 mg x kg(-1) x day(-1)) potently increased ACSL1 and CPT1A expression in liver from diet-induced obese mice associated with a marked decrease of hepatic and serum triglycerides. Muscular CPT1B expression was not affected. Tissue specificity of telmisartan-induced PPARalpha target gene induction may be the result of previously reported high hepatic concentrations of telmisartan. CONCLUSIONS The present study identifies the ARB/PPARgamma modulator telmisartan as a partial PPARalpha agonist. As a result of its particular pharmacokinetic profile, PPARalpha activation by telmisartan seems to be restricted to the liver. Hepatic PPARalpha activation may provide an explanation for telmisartan's antidyslipidemic actions observed in recent clinical trials.
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Affiliation(s)
- Markus Clemenz
- Center for Cardiovascular Research, Institute of Pharmacology, Charité-Universitätsmedizin Berlin, Hessische Str. 3-4, 10115 Berlin, Germany
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