Renal necrosis and the involvement of a single enzyme of the de novo pathway for the biosynthesis of platelet-activating factor in the rat kidney inner medulla

Application of a TCA-precipitation method for the determination of 1-alkyl-sn-glycero-3-phosphate: Acetyl-CoA acetyltransferase in human renal tissue

The activity of 1-alkyl-sn-glycero-3-phosphate:Acetyl-CoA acetyltransferase, which catalyses the first step of the de novo biosynthesis of PAF, was determined and characterised in cortical and medullary human renal tissues. A novel thin-layer chromatographic system as well as a trichloroacetic acid precipitation method, were utilised in order to determine the enzyme's activity. The acetyltransferase activity was associated with the membranous fractions of the renal tissue, it showed an optimum pH of 8.4 and it had a bell-shaped dependence on BSA concentration. One or more disulphide bonds were necessary for the action of acetyltransferase while the enzyme seemed to be independent from divalent cations. Two assay products were extracted from the incubation mixture namely alkylacetylphosphatidic acid, produced by the acetylating action of the acetyltransferase on alkyllyso-phosphatidic acid and alkylacetyl-glycerol, which is produced by the action of a phosphohydrolase on alkylacetylphosphatidic acid. The presence of NaF in the assay mixture resulted to a decreased degradation of alkylacetylphosphatidic acid, as well as to an increased overall product formation. Cortical and medullary acetyltransferases share similar biochemical properties and there is no statistical difference between the two activities.

Plasma and Lp(a)-associated PAF-acetylhydrolase activity in uremic patients undergoing different dialysis procedures

Plasma and Lp(a)-associated PAF-acetylhydrolase activity in uremic patients undergoing different dialysis procedures.

BACKGROUND

Platelet-activating factor (PAF) is a potent inflammatory mediator associated with several physiopathological conditions, including renal diseases. PAF is degraded to the inactive metabolite lyso-PAF by PAF-acetylhydrolase (PAF-AH), which is considered as a potent anti-inflammatory and anti-atherogenic enzyme associated with lipoproteins. In this study, we evaluated the plasma- and lipoprotein(a) [Lp(a)]-associated PAF-AH activity in relationship to plasma lipid parameters and Lp(a) isoform size in patients with mild/moderate chronic renal failure (CRF), as well as in hemodialysis (HD) and chronic ambulatory peritoneal dialysis (CAPD) patients.

METHODS

We studied 74 patients undergoing maintenance HD, 44 patients undergoing CAPD, 56 patients with mild/moderate CRF, and 98 healthy subjects whose lipid profile, as well as plasma and high-density lipoprotein (HDL)-associated PAF-AH activity, was determined. Moreover, the effect of Lp(a) plasma levels on the distribution of PAF-AH among plasma lipoproteins, as well as the specific activity and kinetic properties of PAF-AH on two different Lp(a) isoforms, was measured in each studied group.

RESULTS

The plasma PAF-AH activity in all studied groups was significantly higher than in controls, and the increase was more profound in CAPD patients. The HDL-associated PAF-AH activity, expressed per milliliter of plasma, was similar among all studied groups; however, when it was expressed as either per milligrams of HDL cholesterol or per milligrams of plasma apolipoprotein (apo) AI, the PAF-AH activity was significantly higher in all patient groups compared with controls. All patient groups had significantly elevated plasma Lp(a) levels, which altered the distribution of PAF-AH among the plasma lipoproteins compared with that observed in subjects with very low plasma Lp(a) levels (<8 mg/dl). Additionally, in each studied group, the specific activity as well as the apparent Km and Vmax values of the 19K4 apo(a) isoform were significantly higher (P < 0.01) compared with the values of the 23K4 isoform. However, the specific activity, as well as the Km and Vmax values on either the 19K4 apo(a) isoform or the 23K4 isoform, was significantly higher in CAPD patients compared with the other three groups.

CONCLUSIONS

Plasma PAF-AH activity is increased in uremic patients. This elevation is more profound in CAPD patients, who also exhibit a more atherogenic lipid profile and more pronounced alterations in the specific activity and the kinetic constants of Lp(a)-associated PAF-AH.

Renal papillary necrosis--40 years on

Analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) are well recognized as a major class of therapeutic agent that causes renal papillary necrosis (RPN). Over the last decade a broad spectrum of other therapeutic agents and many chemicals have also been reported that have the potential to cause this lesion in animals and man. There is consensus that RPN is the primary lesion that can progress to cortical degeneration; and it is only at this stage that the lesion is easily diagnosed. In the absence of sensitive and selective noninvasive biomarkers of RPN there is still no clear indication of which compound, under what circumstances, has the greatest potential to cause this lesion in man. Attempts to mimic RPN in rodents using analgesics and NSAIDs have not provided robust models of the lesion. Thus, much of the research has concentrated on those compounds that cause an acute or subacute RPN as the basis by which to study the pathogenesis of the lesion. Based on the mechanistic understanding gleaned from these model compounds it has been possible to transpose an understanding of the underlying processes to the analgesics and NSAIDs. The mechanism of RPN is still controversial. There are data that support microvascular changes and local ischemic injury as the underlying cause. Alternatively, several model papillotoxins, some analgesics, and NSAIDs target selectively for the medullary interstitial cells, which is the earliest reported aberration, after which there are a series of degenerative processes affecting other renal cell types. Many papillotoxins have the potential to undergo prostaglandin hydroperoxidase-mediated metabolic activation, specifically in the renal medullary interstitial cells. These reactive intermediates, in the presence of large quantities of polyunsaturated lipid droplets, result in localized and selective injury of the medullary interstitial cells. These highly differentiated cells do not repair, and it is generally accepted that continuing insult to these cells will result in their progressive erosion. The loss of these cells is thought to be central to the degenerative cascade that affects the cortex. There is still a need to understand better the primary mechanism and the secondary consequences of RPN so that the risk of chemical agents in use and novel molecules can be fully assessed.

Normal ultrastructure of the kidney and lower urinary tract

The mammalian urinary tract includes the kidneys, ureters, urinary bladder, and urethra. The renal parenchyma is composed of the glomeruli and a heterogeneous array of tubule segments that are specialized in both function and structure and are arranged in a specific spatial distribution. The ultrastructure of the glomeruli and renal tubule epithelia have been well characterized and the relationship between the cellular structure and the function of the various components of the kidney have been the subject of intense study by many investigators. The lower urinary tract, the ureters, urinary bladder, and urethra, which are histologically similar throughout, are composed of a mucosal layer lined by transitional epithelium, a tunica muscularis, and a tunica serosa or adventitia. The present manuscript reviews the normal ultrastructural morphology of the kidney and the lower urinary tract. The normal ultrastructure is illustrated using transmission electron microscopy of normal rat kidney and urinary bladder preserved by in vivo perfusion with glutaraldehyde fixative and processed in epoxy resin.

CDP-choline:alkylacetylglycerol cholinephosphotransferase catalyzes the final step in the de novo synthesis of platelet-activating factor

Platelet-activating factor (PAF) can be synthesized de novo or by a remodeling mechanism involving the sn-2 acyl moiety of alkylacylglycerophosphocholines, a membrane-bound precursor. The final step in the de novo pathway is catalyzed by a dithiothreitol-insensitive cholinephosphotransferase that utilizes 1-alkyl-2-acetyl-sn-glycerol and CDP-choline as substrates. This article reviews various studies concerning the occurrence, assay, subcellular location, biochemical properties, substrate specificity, and regulatory controls of the PAF-related cholinephosphotransferase. Alkylacetylglycerol cholinephosphotransferase, which is located on the cytoplasmic surface of the endoplasmic reticulum, is widely distributed among mammalian tissues. Both the alkyl and acyl analogs of radylacetylglycerol are utilized at equivalent rates. Optimal enzyme activity occurs at pH 8.0 and Mg2+ is required, whereas calcium, deoxycholate, ethanol, and centrophenoxine are inhibitory. Formation of CDP-choline by cytidylyltransferase appears to play a crucial role in the regulation of PAF produced via the cholinephosphotransferase route. Significant differences exist in the behavior of the cholinephosphotransferase activities responsible for the synthesis of PAF and phosphatidylcholine. However, neither enzyme activity has been purified or cloned and, therefore, it is unknown whether a single or two separate proteins are responsible for the observed catalytic activities that form these two distinctly different classes of phospholipids.

Platelet-activating factor and cardiac diseases: therapeutic potential for PAF inhibitors

Platelet-activating factor (PAF) is a potent phospholipid mediator released from inflammatory cells in response to diverse immunologic and non-immunologic stimuli. Animal studies have implicated PAF as a major mediator involved in coronary artery constriction, modulation of myocardial contractility and the generation of arrhythmias which may bear on cardiac disorders such as ischemia, infarction and sudden cardiac death. PAF effects are induced by direct actions of PAF on cardiac tissue to modify chronotropic and inotropic activity, or indirectly via the release of eicosanoids such as thromboxane A2 (TXA2), leukotrienes (LT) or cytokines (TNF alpha). The development of selective, high affinity PAF receptor antagonists has permitted investigations on the role of PAF in experimental animal models of cardiac injury. In vivo and in vitro studies strongly suggest that PAF receptor antagonists might convey therapeutic benefits in ischemic conditions and certain arrhythmias. In addition, PAF antagonists might have a cardiac allograft-preservation effect. Although clinical studies with PAF receptor antagonists in patients with cardiac diseases have not yet been reported, the experimental results to date suggest that PAF receptor antagonists might be useful in some specific cardiac disorders in humans.

Changes in glycerophospholipid profile in experimental nephrotic syndrome

We investigated changes in the glycerophospholipids in kidney tissue and its various intracellular fractions in rats with nephrotic syndrome induced by puromycin aminonucleoside. The ethanolamine plasmalogen, 1-O-alk-1'-enyl-2-acyl-GPE (EP), was increased in kidney tissue obtained from the puromycin-treated animals. A similar increase was found in the mitochondria and endoplasmic reticulum (microsomes) of this tissue. These increases were not found in the liver. Since platelet-activating factor (PAF) is known to be produced in increased amounts in inflammatory disorders, it is suggested that the higher plasmalogen found in rat kidneys during experimental nephrotic syndrome might be derived from increased levels of this autacoid. The increase in PAF may also result in the elevation of plasma PAF-acetylhydrolase (AH) activity observed in these animals.

Platelet-activating factor: the biosynthetic and catabolic enzymes

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Synthesis and preclinical evaluation of technetium-99m-labeled hippurate analogues

We have synthesized seven 99mTc-labeled hippurate analogues: 99mTc-hippurate. 99mTc-alpha-hydroxyhippurate, 99mTc-m-hydroxyhippurate. 99mTc-o-hydroxyhippurate [99m-salicylglycine (99mTc-SG)], 99mTc-p-hydroxyhippurate, 99mTc-salicylglycylglycine and 99mTc-salicylglycylglycylglycine. All of the 99mTc-hippurates were cleared rapidly from the rat blood and accumulated in the kidney. Of them 99mTc-SG has the desirable biological properties of two diagnostic agents. 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) and 99mTc-dimercaptosuccinate (99mTc-DMSA). A fraction of 99mTc-SG showed a transit time in the kidney and was excreted rapidly into the urine, being similar to 99mTc-MAG3. The binding ratio to the plasma proteins was 96.0% (91.1% in the albumin), being higher than that of 99mTc-DMSA, at 30 min. The lipophilicity revealed far less pH-dependent changes in a range of pH 4.0 to 7.4. 99mTc-SG distributed about 91% in the renal cortex, being similar to that of 99mTc-DMSA. From the present studies, the biological properties of 99mTc-SG suggest that it is a promising agent for measuring renal plasma flow and renal morphology.

Modulation by drugs acting on the autonomic nervous system of platelet-activating factor in the stomach of rats

Platelet-activating factor (PAF), an ether linked choline glycerophospholipid, is a potent initiator of diverse physiological and pathological processes. We have reported that gastric endogenous PAF levels were reduced and the contents of each of its molecular species changed during water-immersion stress in rats (Sugatani J et al., FASEB J 3: 65-70, 1989 and Sugatani J et al., Lipids 26: 1347-1353, 1991). In this study, we determined the effects of autonomic drugs on the level of gastric PAF, its molecular heterogeneity and formation of gastric erosions in unstressed rats and those subjected to water-immersion stress. Atropine, an anticholinergic drug, suppressed both the stress-induced changes and development of gastric lesions. 6-Hydroxydopamine-induced sympathectomy induced a small decrease in the gastric PAF levels and the addition of stress further decreased the PAF levels and development of gastric lesions. Carbamylcholine induced a transient decrease in the gastric PAF level of normal rats, which was not associated with gastric erosion formation. In contrast, the endogenous gastroprotective factor dopamine evoked transient dose- and time-dependent increases in the gastric PAF levels. These observations indicate that cholinergic muscarinic-receptor activation in rats led to decreases in gastric PAF levels and a prolonged and marked decrease in its level was associated with the development of gastric lesions, and that dopamine increases gastric PAF levels. Gastric endogenous PAF levels are closely associated with the autonomic nervous system and should be considered further in investigations of gastric function.

Vasodilator and constrictor actions of platelet-activating factor in the isolated microperfused afferent arteriole of the rabbit kidney. Role of endothelium-derived relaxing factor/nitric oxide and cyclooxygenase products

It has been suggested that platelet-activating factor (PAF) plays a prominent role in the control of glomerular hemodynamics in various physiological and pathological conditions. We examined the direct effect of PAF on rabbit glomerular afferent arterioles (Af-Arts) microperfused in vitro and tested whether endothelium-derived relaxing factor/nitric oxide (EDNO) and cyclooxygenase products are involved in its actions. In nanomolar concentrations PAF caused dose-dependent constriction of Af-Arts, with the maximum constriction being 34 +/- 10% at 4 x 10(-8) M (n = 9, P < 0.001). The constriction was blunted by cyclooxygenase inhibition (11 +/- 6%, n = 7, P < 0.05) but augmented by EDNO inhibition (76 +/- 14%, n = 8, P < 0.005). To study a possible vasodilator effect of PAF, Af-Arts were preconstricted with norepinephrine and increasing concentrations of PAF added to the lumen. At picomolar concentrations (lower than those that caused constriction), PAF produced dose-dependent vasodilation that was unaffected by cyclooxygenase inhibition but was abolished by EDNO synthesis inhibition. Both PAF-induced constriction and dilation of Af-Arts were blocked by a PAF receptor antagonist. This study demonstrates that PAF has a receptor-mediated biphasic effect on rabbit Af-Arts, dilating them at low concentrations while constricting them at higher concentrations. Our results suggest that PAF's vasodilator action may be due to production of EDNO, while its constrictor action is mediated at least in part through cyclooxygenase products.

Platelet activating factor acetylhydrolase activity in the urine of patients with renal disease

Platelet activating factor has been demonstrated in blood and urine and has a broad range of effects on kidney function. The kidney possesses the enzymes responsible for PAF synthesis as well as the specific acetylhydrolase which deactivates PAF. We used a radioactive assay to measure PAF-acetylhydrolase activity in urine samples obtained from normal individuals and patients with various nephropathies. Activity was detected in the majority of normal urines with a mean + 2 SD = 0.70 nmol/30 min/ml. Activity exceeding this value was measured in the urines of 11 of 14 patients with diabetes mellitus, 14 of 22 with glomerulonephritis, and 5 of 16 with hypertensive renal disease. Further study is necessary to relate urine hydrolase activity to specific functional and structural abnormalities of the kidney.

Platelet-activating factor and related acetylated lipids as potent biologically active cellular mediators

Platelet-activating factor (PAF or 1-alkyl-2-acetyl-sn-glycero-3-phosphocholine) is the most potent lipid mediator yet discovered. It is known to stimulate a wide span of biological responses ranging from aggregation and degranulation of platelets and neutrophils to a variety of cellular effects involving the stimulation of chemotaxis; chemokinesis; superoxide formation; protein phosphorylation; activation of protein kinase C, arachidonic acid, and phosphoinositide metabolites; glycogenolysis; and tumor necrosis factor production. Obviously, with such a diversity of biological activities, it is not surprising that PAF has been considered to be a key component in numerous diseases related to hypersensitivity and inflammatory responses. Evidence has also been presented for the role of PAF in physiological processes, particularly those involving reproduction and fetal development. Furthermore, because of its potent hypotensive action, PAF has been implicated as a contributing factor in blood pressure regulation. PAF is produced by two independent enzymatic pathways. The remodeling route involves the structural modification of a membrane lipid (1-alkyl-2-acyl-sn-glycero-3-phosphocholine) by replacement of the acyl moiety with an acetate group. An alternate route is the de novo synthesis of PAF from an O-alkyl analogue of a lysophosphatidic acid that requires a reaction sequence of acetylation, dephosphorylation, and phosphocholine addition steps. Hypersensitivity and other pathophysiological reactions are thought to be caused by activation of the remodeling pathway, whereas the de novo route is believed to be the source of endogenous levels of PAF required for physiological functions. Inactivation of PAF occurs when the acetate group is hydrolyzed by an acetylhydrolase that is present in both extra- and intracellular compartments, although the catalytic activity of the two forms of acetylhydrolase are identical, some of their properties differ. The control of PAF metabolism is very complex, but acetylhydrolase, Ca2+, phosphorylation/dephosphorylation of enzymes, and fatty acids (especially polyunsaturates) appear to be important regulatory factors. Specific PAF receptors have clearly been demonstrated on several different types of cells, and although the mechanism of PAF actions is poorly understood, it appears that the PAF/receptor-induced responses are closely associated with the signal transduction process; both G proteins and adenyl cyclase appear to be involved. Because significant quantities of PAF are often retained within certain cells, the possibility of PAF serving as an intracellular mediator has also been proposed.