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Oliveira BM, de Almeida LF, Deluque AL, Souza CS, Maciel ALD, Francescato HDC, Costa RS, Giovanini C, de Paula FJA, Coimbra TM. Calcitriol Reduces the Inflammation, Endothelial Damage and Oxidative Stress in AKI Caused by Cisplatin. Int J Mol Sci 2022; 23:ijms232415877. [PMID: 36555517 PMCID: PMC9783003 DOI: 10.3390/ijms232415877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/21/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Cisplatin treatment is one of the most commonly used treatments for patients with cancer. However, thirty percent of patients treated with cisplatin develop acute kidney injury (AKI). Several studies have demonstrated the effect of bioactive vitamin D or calcitriol on the inflammatory process and endothelial injury, essential events that contribute to changes in renal function and structure caused by cisplatin (CP). This study explored the effects of calcitriol administration on proximal tubular injury, oxidative stress, inflammation and vascular injury observed in CP-induced AKI. Male Wistar Hannover rats were pretreated with calcitriol (6 ng/day) or vehicle (0.9% NaCl). The treatment started two weeks before i.p. administration of CP or saline and was maintained for another five days after the injections. On the fifth day after the injections, urine, plasma and renal tissue samples were collected to evaluate renal function and structure. The animals of the CP group had increased plasma levels of creatinine and of fractional sodium excretion and decreased glomerular filtration rates. These changes were associated with intense tubular injury, endothelial damage, reductions in antioxidant enzymes and an inflammatory process observed in the renal outer medulla of the animals from this group. These changes were attenuated by treatment with calcitriol, which reduced the inflammation and increased the expression of vascular regeneration markers and antioxidant enzymes.
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Affiliation(s)
- Beatriz M. Oliveira
- Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
| | - Lucas Ferreira de Almeida
- Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
| | - Amanda L. Deluque
- Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
| | - Claudia S. Souza
- Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
| | - Ana Lívia D. Maciel
- Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
| | - Heloísa D. C. Francescato
- Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
| | - Roberto S. Costa
- Department of Medical Clinic, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
| | - Cleonice Giovanini
- Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
| | - Francisco José A. de Paula
- Department of Medical Clinic, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
| | - Terezila M. Coimbra
- Department of Physiology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 140490-900, Sao Paulo, Brazil
- Correspondence: ; Tel.: +55-16-3315–3021
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de Paula FJA. Vitamin D: more does not mean better. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:493-494. [PMID: 33047904 PMCID: PMC10118955 DOI: 10.20945/2359-3997000000303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
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Role of the renin-angiotensin system in kidney development and programming of adult blood pressure. Clin Sci (Lond) 2020; 134:641-656. [PMID: 32219345 DOI: 10.1042/cs20190765] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 02/06/2023]
Abstract
Adverse events during fetal life such as insufficient protein intake or elevated transfer of glucocorticoid to the fetus may impact cardiovascular and metabolic health later in adult life and are associated with increased incidence of type 2 diabetes, ischemic heart disease and hypertension. Several adverse factors converge and suppress the fetal renin-angiotensin-aldosterone system (RAAS). The aim of this review is to summarize data on the significance of RAAS for kidney development and adult hypertension. Genetic inactivation of RAAS in rodents at any step from angiotensinogen to angiotensin II (ANGII) type 1 receptor (AT1) receptors or pharmacologic inhibition leads to complex developmental injury to the kidneys that has also been observed in human case reports. Deletion of the 'protective' arm of RAAS, angiotensin converting enzyme (ACE) 2 (ACE-2) and G-protein coupled receptor for Angiotensin 1-7 (Mas) receptor does not reproduce the AT1 phenotype. The changes comprise fewer glomeruli, thinner cortex, dilated tubules, thicker arterioles and arteries, lack of vascular bundles, papillary atrophy, shorter capillary length and volume in cortex and medulla. Altered activity of systemic and local regulators of fetal-perinatal RAAS such as vitamin D and cyclooxygenase (COX)/prostaglandins are associated with similar injuries. ANGII-AT1 interaction drives podocyte and epithelial cell formation of vascular growth factors, notably vascular endothelial growth factor (VEGF) and angiopoietins (Angpts), which support late stages of glomerular and cortical capillary growth and medullary vascular bundle formation and patterning. RAAS-induced injury is associated with lower glomerular filtration rate (GFR), lower renal plasma flow, kidney fibrosis, up-regulation of sodium transporters, impaired sodium excretion and salt-sensitive hypertension. The renal component and salt sensitivity of programmed hypertension may impact dietary counseling and choice of pharmacological intervention to treat hypertension.
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Deluque AL, de Almeida LF, Francescato HDC, da Silva CGA, Costa RS, Antunes-Rodrigues J, Coimbra TM. Effect of Calcitriol on the Renal Microvasculature Differentiation Disturbances Induced by AT 1 Blockade During Nephrogenesis in Rats. Front Med (Lausanne) 2020; 7:23. [PMID: 32118008 PMCID: PMC7016013 DOI: 10.3389/fmed.2020.00023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 01/15/2020] [Indexed: 12/11/2022] Open
Abstract
Alterations in the renal vasculature during fetal programming can cause disturbances in renal structure and function that persist into adulthood. Calcitriol can affect cellular differentiation and proliferation, and promote endothelial cell maintenance, each of which is a key event in nephrogenesis. Calcitriol is a negative endocrine regulator of the renin gene. Rats exposed to renin-angiotensin system (RAS) antagonists during lactation have been shown to develop renal disorders, which demonstrated that the RAS may play an important role in mammalian kidney development. We evaluated the effects of calcitriol administration on losartan [angiotensin II receptor antagonist (ANGII), AT1]-induced changes in renal differentiation in rats during lactation. Rats treated with losartan showed alterations in renal function and structure that persisted into adulthood. These disruptions included hydronephrosis, papillary atrophy, endothelial dysfunction, and aberrant endothelial structure. These changes were mitigated by treatment with calcitriol. The results of our study showed that animals exposed to AT1 blockade during lactation exhibited altered renal microvasculature differentiation in adulthood that was attenuated by treatment with calcitriol.
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Affiliation(s)
- Amanda L Deluque
- Laboratory of Renal Physiology, Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Lucas F de Almeida
- Laboratory of Renal Physiology, Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Heloísa D C Francescato
- Laboratory of Renal Physiology, Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Cleonice G A da Silva
- Laboratory of Renal Physiology, Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Roberto S Costa
- Laboratory of Renal Pathology, Division of Nephrology, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - José Antunes-Rodrigues
- Laboratory of Neuroendocrinology, Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Terezila M Coimbra
- Laboratory of Renal Physiology, Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
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Ferreira de Almeida L, Della Coletta Francescato H, Antunes-Rodrigues J, Jose Albuquerque de Paula F, Giovanni Alves da Silva C, Silva Costa R, Machado Coimbra T. Imbalance of Pro- and Anti-Angiogenic Factors Due to Maternal Vitamin D Deficiency Causes Renal Microvasculature Alterations Affecting the Adult Kidney Function. Nutrients 2019; 11:nu11081929. [PMID: 31426337 PMCID: PMC6723450 DOI: 10.3390/nu11081929] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 12/22/2022] Open
Abstract
Vitamin D (Vit.D) is involved in cellular proliferation and differentiation and regulation of the renin gene, which are important aspects of nephrogenesis and quiescence of renal health in adulthood. This study evaluated the angiogenic mechanisms involved in long term renal disturbances induced by Vit.D deficiency persistent in adulthood in rats. First-generation male Hannover offspring from mothers fed either a control diet (control group, CG) or Vit.D-deficient diet (Vit.D- group) were evaluated. Systolic blood pressure (SBP) was measured monthly during the first 6 months after birth, and blood and urine samples were collected to evaluate renal function. Nitric oxide (NO), angiotensin II (ANGII), parathyroid hormone (PTH), calcium, and Vit.D were measured. The kidneys were then removed for morphometric, NO, immunohistochemical, and Western blot studies. We evaluated the expression of vascular growth factor (VEGF) and angiopoietins 1 and 2 and their receptors since this intrinsic renal axis is responsible for endothelial quiescence. Compared to CG, the Vit.D- group presented higher SBP, ANG II plasma levels, renin expression, and AT1 receptor expression levels. Capillary rarefaction was observed, as well as an imbalance between pro- and anti-angiogenic factors. Collectively, the present findings support the role of Vit.D for maintaining the integrity of renal microcirculation.
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Affiliation(s)
- Lucas Ferreira de Almeida
- Department of Physiology of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14049-900, Brazil.
| | | | - Jose Antunes-Rodrigues
- Department of Physiology of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14049-900, Brazil
| | | | | | - Roberto Silva Costa
- Department of Pathology of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14049-900, Brazil
| | - Terezila Machado Coimbra
- Department of Physiology of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14049-900, Brazil
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de Almeida LF, Coimbra TM. When Less or More Isn't Enough: Renal Maldevelopment Arising From Disequilibrium in the Renin-Angiotensin System. Front Pediatr 2019; 7:296. [PMID: 31380328 PMCID: PMC6650528 DOI: 10.3389/fped.2019.00296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/04/2019] [Indexed: 12/11/2022] Open
Abstract
Environmental and nutritional factors during fetal and neonatal life can have long-lasting effects on renal functions and physiology and susceptibility to kidney disease in adulthood. All components of the renin-angiotensin system (RAS) are highly expressed in the kidneys during the period of renal development. The RAS plays a central role in the regulation of various cellular growth factors and stimulates adhesion molecules and cellular migration. The use of antagonists of this system during fetal development represents a major risk factor for hypertension, renal vascular dysfunction, and kidney medulla atrophy in adulthood. The inappropriate activation of the RAS by vitamin D (VitD) deficiency has been studied in recent years. Clinical and experimental studies have demonstrated an inverse relationship between circulating VitD levels and blood pressure, plasma and renin activity, and an increase in angiotensin II and the receptor AT1. These data raise new questions about the importance of the integrity of the RAS during development since RAS pathway inhibitors and VitD deficiency have opposing functions. This is a literature review on the possible mechanisms by which antagonists of the RAS and VitD deficiency during fetal development provoke disturbances in kidney structure and function. Potential mechanisms are presented and discussed, and the possible pathways by which an imbalanced maternal RAS may negatively impact fetal development and have consequences in adulthood are also explored.
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Affiliation(s)
- Lucas Ferreira de Almeida
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Terezila Machado Coimbra
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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