Influence of irbesarten on renal hypertrophy in streptozotocin-induced diabetic rats LIU Bi-cheng,LUO Dong-dong,ZHANG Xiao-liang.

AIM: To investigate the influence of irbesartan (Irb), a new angiotensin II receptor 1 antagonist, on renal hypertrophy in streptozotocin (STZ)-induced diabetic rats. METHODS: Sprague-Dawley (SD) rats were randomly divided into three groups: normal group (Group N, n=7), diabetic group (Group DN, n=6) and irbesartan treated group (Group DNI, n=7). In the experimental group, after the rats subjected to uninephrectomy, STZ was given by peritoneally injection at bolus dose of 50 mg/kg to induce diabetes. Blood glucose (BG), body weight (BW), urinary albumin excretion (Ualb), 24 hour proteinuria (24 h Upro) were measured at week 4, 8, 12, respectively. By the end of experiment at week 12, creatinine clearance (Ccr), kidney weight (KW), indicator of renal hypertrophy (KW/BW), renal total protein content (RTP), glomerular area (AG) and glomerular volume (VG) as well as glomerular basement membrane (GBM) were determined by semi-quantitative pathology technique. RESULTS: It was showed that there was no significant difference in BG between group DN and DNI, while Irb significantly reduced the increasing of Ualb, 24 h Upro in diabetic rats compared to control group (P＜0.01, respectively). Furthermore, Irb markedly inhibited the increasing of KW, KW/BW, RTP, A_G, V_G in diabetic rats (P＜0.05, P＜0.01, respectively). Of interest, Irb significantly prevented the increasing of GBM in diabetic rats. CONCLUSION: Irb exerts its early renal protective action by reducing proteinuria and inhibiting renal hypertrophy as well as the thickening of GBM.     

Effect of irbesartan on nephrin expression in the podocyte of early diabetic nephropathy rats

AIM: To investigate the expression of the nephrin in podocyte of the diabetic nephropathy(DN) rats and the mechanism of irbesartan-induced renal protection.METHODS: The DN model was established by a single injection of streptozotocin(STZ),and DN rats were randomly divided into 2 groups: model group and irbesartan treatment group.In addition,the normal rats served as a normal control group. All the rats were received daily gavage respectively for 8 weeks. The urinary protein quality in 24 hours,body weight(BW),kidney weight (KW),KW/BW,glucemia,urea nitrogen,creatinine,total cholesterol, triacylglycerol were detected with correlative methods and the pathological changes of kidney were also detected with optic microscope and transmission electron microscope.The expression of nephrin in podocyte were detected by immunohistochemistry. RESULTS: In DN rats, irbesartan reduced the urinary protein quality in 24 hours (P<0.01) and alleviated the damage of kidney. Meanwhile，the expression of nephrin was declined remarkably in podocytes in irbesartan treatment group compared with model group（P<0.05）.CONCLUSION: Irbesartan might protect kidney against STZ-induced injury via decreasing the expression of nephrin in podocytes.     

Study on relationship between expression of PKCα in glomeruli and development of nephropathy in diabetic rats

AIM:To observe the dynamic changes of expression of PKCα, TGF-β₁ and α-SMA in glomeruli of diabetic rats induced by the alloxon and to invesitigate their roles in the diabetic nephropathy(DN).METHODS:Rats were randomly divided into four groups: normal control group (group A), diabetic group of one week (group B), diabetic group of one month (group C), diabetic group of two months (group D). Immunohistochemistry and Western blotting were used to detect the expression of PKCα, TGF-β₁ and α-SMA in renal tissue of all groups. Blood glucose, triglycerides, cholesterol, creatinine and urine protein were analysed by chemical methods. The morphological changes of renal tissue were checked through microscopy.RESULTS:The expression of PKCα and TGF-β₁ in renal tissue of diabetic groups were increased comparing with those of nomal control group(P<0.05). The mesangial cells expressed α-SMA in two months group. Chronologically the expression of PKCα, TGF-β₁ and α-SMA were positively correlative with each other and the impairment of kidney was also observed.CONCLUSIONS: During the DN process the expression of PKCα increased. PKCα raised GFR and the permeability of glomerular filtration membrane which enhanced urinary albumin excretion. PKCα also increased expression of TGF-β and therefore to induce the expression of α-SMA. The appearance of α-SMA was a marker of the phenotypic transform of renal cells.     

The protective effects of angiotensin Ⅱ receptor blocker irbesartan on kidney function in diabetic rats

AIM: To investigate the effects and mechanisms of irbesartan, one of the angiotensin Ⅱreceptor blockers, on kidney function in diabetic rats. METHODS: Forty adult male Wistar rats were randomly divided into four groups: control group, diabetes group, irbesartan group and captopril group. At the end of 12 weeks, the rats were sacrificed. Urine volume, body weight, kidney weight/body weight, plasma, glucose, glycosylated hemoglobin (HbA₁c), urinary β₂-microglobulin (β₂-MG) excretion, urinary albumin excretion rate (UAR), creatinine clearance (Ccr) were measured. Nitric oxide (NO) and endothelin-1 (ET-1) levels in plasma, urinary and renal tissues were determined. RESULTS: Urine volume, kidney weight/body weight, plasma glucose, HbA1C, UAR, Ccr, urinary β₂-MG excretion, NO and ET-1 levels of urinary, blood and renal tissue in diabetic rats were significantly higher than those of normal controls ( P<0.01). UAR, Ccr, urinary β₂-MG excretion, ET-1 and NO levels of urinary and renal tissue in rats of irbesartan and captopril groups were significantly lower than those of DM rats ( P<0.01). There were positive relationships among the levels of plasma, urinary, renal tissue ET-1, NO and UAR, Ccr and urinary β₂-MG excretion. CONCLUSION: Irbesartan could prevent from the injury of renal function in STZ-induced diabetic rats. And it maybe one of the most importan mechanisms that irbesartan could reduce the NO and ET-1 levels in STZ-induced diabetic rats.     

Effect of rosuvastatin combined with irbesartan on remodeling of myocardial hypertrophy in rats

AIM: To evaluate the effect of rosuvastatin combined with irbesartan on the remodeling of myocardial hypertrophy in the rats. METHODS: Male SD rats(n=50) were randomly divided into control group, model group, rosuvastatin group, irbesartan group and combination group. The model of myocardial hypertrophy was established by subcutaneous injection of isoproterenol at dose of 2.5 mg/kg for 14 d. From the first day of modeling, the rats in control group and model group received intragastrical saline, and the rats in rosuvastatin group, irbesartan group and combination group were treated with rosuvastatin(4 mg·kg^-1·d^-1), irbesartan(15 mg·kg^-1·d^-1) and rosuvastatin(4 mg·kg^-1·d^-1)+ irbesartan(15 mg·kg^-1·d^-1), respectively. The interventions continued for 4 weeks. After the interventions, the cardiac mass index and left ventricular mass index of the SD rats were measured. Besides, the degree of myocardial hypertrophy was observed with HE staining. The mRNA expression of hypertrophy-related factors, such as ANF, β-MHC and AT1R was determined by RT-PCR, and the protein expression of AT1R was determined by Western blot. RESULTS: Compared with control group, the cardiac mass index, left ventricular mass index, as well as the mRNA expression of ANF and β-MHC in model group were significantly increased(P<0.05). Compared with model group, the above factors in rosuvastatin group and irbesartan group were decreased(P<0.05), and the factors in combination group were lower than those in rosuvastatin group and irbesartan group(P<0.05). In addition, the expression of AT1R at mRNA and protein levels in rosuvastatin group and irbesartan group was lower than that in model group(P<0.05), while the expression AT1R at mRNA and protein levels in combination group was lower than that in rosuvastatin group and irbesartan group(P<0.05). CONCLUSION: Rosuvastatin and irbesartan are equally effective drugs to resist the formation of myocardial hypertrophy by decreasing the expression of AT1R. Moreover, combination of the 2 drugs is more effective to improve the degree of myocardial hypertrophy than the 2 drugs alone.     

Protective effects of Zhenwu decoction on kidney injury of diabetic rats induced by streptozotocin

AIM：To investigate the effects of Zhenwu decoction (ZWD) on the expression of α-smooth muscle actin (α-SMA) and NF-κB in diabetic nephropathy (DN) rats. METHODS：Diabetic rat model was induced by intrape-ritoneal injection of streptozotocin (STZ), and the animals were randomly divided into STZ group (n=22) and STZ+ZWD group (n=23). The normal rats served as control (n=16). All rats were sacrificed on 8 weeks after modeling. Biochemical assay and pathological observation (HE staining and transmission electron microscopy) were used to evaluate the effects of Zhenwu decoction on the renal function and pathological morphology. The body weight, renal index, blood glucose, total urinary protein in 24 h, and superoxide dismutase (SOD), malondialdehyde (MDA),inducible nitric oxide synthase (iNOS) were determined as well. Western blotting was used to observe the effects of Zhenwu decoction on the expression of α-SMA and NF-κB in diabetic nephropathy (DN) rats. RESULTS：Compared with normal group, the renal index, blood glucose concentration, total urinary protein in 24 h, blood urea nitrogen (BUN), serum creatinine (SCr) and MDA were significantly higher and body weight was lower in DN rats (P<0. 05). Pathological examination of the kidneys in DN group showed glomerular hypertrophy, glomerular basement membrane thickening, tubular epithelial cell degeneration, mesangial matrix proliferation, protein cast formation in some renal tubules. The protein expression levels of α-SMA and NF-κB were markedly increased (P<0.05). After ZWD treatment, the level of renal index, total urinary protein in 24 h, BUN, SCr and the expression of α-SMA and NF-κB at the protein level were significantly decreased (P<0.05). The renal histological injury in ZWD group was significantly ameliorated. CONCLUSION：Zhenwu decoction might protect kidney against STZ-induced injury via decreasing the expression of α-SMA and NF-κB.     

Effect of interlukin-22 antibody on diabetic nephropathy via inhibition on Snail1 expression

AIM:To investigate the effect of interlukin-22 (IL-22) on diabetic nephropathy (DN) and its possible mechanism. METHODS:C57BL/6 mice were randomized to normal control (NC) group,DN group, DN+recombinant IL-22 (rIL-22) group and DN+IL-22 antibody (anti-IL-22) group. After successful establishment of diabetes model for 8 weeks, the mice in DN+rIL-22 group and DN+anti-IL-22 group were intraperitoneally injected with rIL-22 (200 μg/kg) and anti-IL-22 (200 μg/kg), respectively, and the mice in NC group and DN group were intraperitoneally injected with 0.1% bovine serum albumin, twice a week for 4 weeks. After the intervention, blood glucose, kidney function, 24 h urine microalbumin (m-Alb) and 24 h urine creatinine (UCr) were measured. The pathological changes of renal tissues were observed under light microscope. The mRNA expression of Snail1 was detected by qPCR. The protein levels of fibronetin (FN) and E-cadherin were determined by Western blot. RESULTS:After the intervention, the ratio of 24 h m-Alb/UCr increased significantly in other model groups compared with NC group (P<0.05). The levels of 24 h m-Alb and 24 h UCr increased significantly in DN+rIL-22 group compared with DN group (P<0.05). However, in DN+anti-IL-22 group, the levels of 24 h m-Alb, 24 h UCr and 24 h m-Alb/UCr ratio were significantly lower than those in DN group and DN+rIL-22 group (P<0.05). The tubular epithelial cell vacuolar degeneration, protein cast formation and glomerular mesangial expansion in the renal tissues from diabetic mice were observed under light microscope. The lesions were more severe in DN+rIL-22 group, but attenuated in DN+anti-IL-22 group. The mRNA expression of Snail1 increased significantly in diabetic mice (P<0.05), but decreased significantly after a 4-week intervention by anti-IL-22 (P<0.05). The expression of FN, an extracellular matrix protein, increased significantly in DN+rIL-22 group (P<0.05). The expression of E-cadherin, an epithelial-mesenchymal transition marker, decreased significantly in DN+rIL-22 group as well (P<0.05). CONCLUSION:IL-22 neutralizing antibody may attenuate microalbuminuria and delay the progression of DN via inhibition of Snail1 expression in the renal tubular epithelial cells.     

Effect of erlotinib on renal injury in rats with STZ-induced diabetic nephropathy

AIM: To investigate the effect of epidermal growth factor receptor (EGFR) inhibitor erlotinib on kidney injury in diabetic nephropathy (DN) rat and the underlying mechanism. METHODS: The rat model of DN was induced by intraperitoneal injection of streptozotocin (STZ) at dose of 55 mg/kg. One week after STZ injection, the rats with blood glucose level exceeding 16.7 mmol/L were identified as diabetic. Diabetic rats were randomly divided into 2 groups:STZ group and STZ+erlotinib group. In addition, the normal rats were used as control group. The rats in STZ+erlotinib group were treated with erlotinib at 100 mg·kg^-1·d^-1 for 4 weeks(5th~8th week). The fasting blood glucose (FBG), serum creatinine (SCr) and 24 h urine protein were measured. The pathological changes of the kidney were observed by HE staining and Masson staining. The protein levels of EGFR, p-EGFR, transforming growth factor β1 (TGFβ1), Smad2/3, p-Smad2/3, collagen Ⅳ (ColⅣ) and fibronectin in the kidney tissues were determined by Western blot. The reactive oxygen species (ROS) level and malondialdehyde (MDA) content in the renal tissues were futher analyzed. RESULTS: Compared with control group, the levels of FBG, 24 h urine protein and Scr were significantly increased in STZ group (P<0.01). Compared with STZ group, the levels of FBG, 24 h urine protein and SCr in STZ+erlotinib group were markedly decreased (P<0.05). In additon, the glomerular structure was restored to normal, the proliferative degree of mesangial cells markedly attenuated, and the epithelial cells were in alignment in STZ+erlotinib group. Moreover, erlotinib significantly inhibited the protein levels of p-EGFR, TGFβ1, p-Smad2/3, ColⅣ and fibronectin in the kidney tissues of STZ rats. In addition, erlotinib also significantly inhibited the levels of ROS and MDA in the kidney tissues of STZ rats. CONCLUSION: Erlotinib ameliorates STZ-induced diabetic nephropathy possibly through inhibiting the activation of EGFR/TGFβ1-Smad2/3 signaling pathway in association with suppression of fibrosis and oxidative stress.     

Renoprotective effect of L-carnitine on streptozotocin-induced diabetic nephropathy in rats

AIM: To investigate whether L-carnitine (LC) treatment confers renoprotection in a rat model of streptozotocin (STZ)-induced diabetic nephropathy (DN). METHODS: Diabetic animal model was established by intraperitoneal injection of STZ (65 mg/kg) in Sprague-Dawley rats. Diabetic rats were treated with LC (50 mg·kg^-1·d^-1 or 200 mg·kg^-1·d^-1 intravenously) daily for 12 weeks. The effects of LC on STZ-induced DN were evaluated by assessing renal function, urinary protein excretion, histopathological changes, macrophage infiltration, the expression of proinflammatory and prosclerotic cytokines, and the expression of nuclear factor-κB (NF-κB) and apoptosis-related gene. RESULTS: LC administration significantly decreased glomerulosclerosis, preserved the number of podocytes, and reduced macrophage infiltration. These changes were accompanied by improvements in urinary protein excretion and renal dysfunction. LC treatment suppressed the expression of proinflammatory and prosclerotic cytokines, and these changes were paralleled by significant attenuation of NF-κB and apoptosis-related gene expression. CONCLUSION: LC has a renoprotective effect against STZ-induced DN in rats.     

Role of pp60c-src in human umbilical vein endothelial cell proliferation induced by high hydrostatic pressure

AIM: To investigate whether or not short-term high pressure proliferates human umbilical vein endothelial cells (HUVECs), and the role of pp60c-src in cell proliferation. METHODS: Cultured HUVECs of 3-6th passage were exposed to atmosphere 0 mmHg (AP), 120 mmHg (MP), 180 mmHg (HP) and interfered with captopril(Cap, 10 μmol/L)or irbesartan(Irb, 10 μmol/L). Cell proliferation was quantified by measuring hexosaminidase activity. The content of pp60c-src in cells was investigated by Western blotting. RESULTS:① Hexosaminidase activities which reflected cell number increased significantly at 4 h in MP and HP(0.145±0.018 and 0.144±0.019 vs 0.118±0.003,P＜0.01). Correspondingly, the expression of pp60c-src of 2 h in MP or HP groups was higher than that in AP which increased slowly to reach the level in MP and HP groups at 4 h. ② Cap and Irb had no effect on cell proliferation at each time points in AP group , but increased the hexosaminidase activities in MP and HP groups at 12 h. The contents of pp60c-src in groups with or without intervention of Cap or Irb were similar at each time points. CONCLUSION: High hydrostatic pressure induces early cell proliferation. The expression of pp60c-src occurs before cell proliferation in different pressure groups, which suggests that pp60c-src is involved in signal transmission pathway of pressure-induced cell proliferation. This process is not regulated mainly by renin-angiotensin system (RAS).     

Renal protection of combination of irbesartan and sulodexide on diabetic rat

AIM: To assess renal protective effects of the combination of irbesartan and sulodexide on STZ-induced diabetic rats. METHODS: Diabetes was induced by injection of streptozotocin in rats. The animals were randomly divided into five groups: control (C), diabetes (D), diabetes treated with irbesartan (I), diabetes treated with sulodexide (S), and diabetes treated with combination of irbesartan and sulodexide (I+S). Urine albumin excretion rate (UAER), the level of malondialdehyde (MDA) and activities of antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-PX) in renal tissues were determined, and renal tissue morphology was observed under light microscope after 12 weeks. Expression of ICAM-1 mRNA was examined by RT-PCR. NF-κB was evaluated using electrophoretic mobility shift assay (EMSA). RESULTS: Increased UAER and kidney pathologic injury were attenuated by treatment with either irbesartan or sulodexide alone and further reduced by using the combination of the two drugs. Elevated MDA level and decreased activities of SOD, CAT and GSH-PX in diabetic renal tissues were improved by irbesartan or sulodexide, and more effectively by combination of irbesartan and sulodexide. NF-κB activities were higher in renal tissue of diabetic rats than those in control group, and further abrogated by combination therapy in both cases (P<0.05). Over-expression of ICAM-1 mRNA observed in diabetic rats was attenuated by irbesartan or sulodexide to a similar level and further reduced by the combination of two drugs(P<0.05). CONCLUSION: The combination of irbesartan and sulodexide confers superiority over mono-therapies on the effect of renal protection. The mechanism may be at least partly correlated with synergestic suppression of increasing oxidative stress and NF-κB activities as well as over-expression of ICAM-1 mRNA in renal tissues.     

Effects of benazepril on cardiac function,free oxygen radicals,sarcoplasmic reticulum Ca2+-ATPase following cardiac ischemia-reperfusion in spontaneously hypertensive rats

AIM: To investigate the effects of angiotensin converting enzyme inhibitor (ACEI), benazepril (B), on cardiac function , free oxygen radicals, sarcoplasmic reticulum(SR) Ca²⁺-ATPase following ischemia-reperfusion in sportaneously hypertensive rats (SHRs). METHODS: Thirty 10-week-old female SHRs were randomly assigned into two groups: group SHR was control; The animal in group SHR+B was given with 10 mg/kg of benazepril per day. Another 15 Wistar rats with the same age and sex were normal control (group Wistar). After 12 weeks of pretreatment, all rats in each group were subjected to 30 min of left anterior descending coronary artery occlusion and 30 min of reperfusion. Hemodynamic parameters, left heart-to-body weight ratio (LVW/BW), myocardial malondialdehyde (MDA) concentration, superoxide dismutase (SOD) activity, and SR Ca²⁺-ATPase activity were measured. RESULTS: Compared to group Wistar, the rats in group SHR had higher blood pressure, LVW/BW and myocardial MDA concentration, more serious left cardiac function injury and lower myocardial SOD activity and SR Ca²⁺-ATPase activity; group SHR+B had lower myocardial MDA concentration, higher myocardial SOD activity, but no difference in blood pressure, LVW/BW, the degree of left cardiac function injury and myocardial SR Ca²⁺-ATPase activity. CONCLUSION: Benazepril can attenuate ischemia-reperfusion-induced cardiac function injury by regression of left ventricular hypertrophy (LVH), improving SR Ca²⁺-ATPase activity and decreasing oxygen free radicals injury in SHRs.     

Effect of p53 agonist nutlin-3 on proliferation of mesangial cells cultured in high glucose

AIM:To observe the effect of p53 agonist nutlin-3 on the proliferation, apoptosis and expression of extracellular matrix in the glomerular mesangial cells (MCs) cultured in high glucose, and to explore its possible mechanism. METHODS:After successful modeling of diabetic nephropathy (DN), PAS staining was performed on the kidney tissues to observe pathological changes. In addition, the p53 expression in the kidney tissue was detected by immunohistochemical staining. The mesangial cell SV40 was cultured in vitro and divided into mannitol (Motl) group, normal glucose (NG) group, high glucose (HG) group, high glucose plus nutlin-3 (HG+Nut) group and nutlin-3 control (Nut) group. The cell viability was detected by CCK-8 assay, and the living cell counting was performed by the method of Trypan blue exclusion. The apoptosis was analyzed by flow cytometry. The protein levels of collagen type IV (Col-IV), p53, p-p53, Bcl-2 and Bax were determined by Western blot. RESULTS:The significant increases in the proliferation of mesangial cells and the levels of p53 in renal tissue of diabetic nephropathy mice were observed. The results of CCK-8 assay showed that high glucose promoted the viability of mesangial cells, and nutlin-3 at 40 μmol/L inhibited the viability of mesangial cells in high glucose environment. Western blot analysis showed that the protein levels of p53, Bax and p-p53 were significantly increased (P<0.05), and the protein levels of Bcl-2 and Col-IV was decreased in HG+Nut group compared with HG group (P<0.05). Furthermore, the ratio of Bax/Bcl-2 was greater than 1. The results of flow cytometry showed that compared with HG group, nutlin-3 promoted the apoptosis of mesangial cells in high glucose environment, the apoptotic rate was significantly increased (P<0.05).CONCLUSION:High glucose promotes the proliferation of mesangial cells. p53 agonist inhibits the viability and promotes apoptosis of mesangial cells under high glucose.     

Screening of lentiviral vectors carrying effective siRNA targeting S1P2 gene

AIM:To screen the lentiviral vector carrying siRNA with higher efficiency of suppressing the sphingosine-1-phosphate receptor 2(S1P2) gene expression in the primarily cultured corpus cavernosum smooth muscle cells of spontaneously hypertensive rats (SHR).METHODS:SHR and SD rats (n=5 each) were used for primarily culturing corpus cavernosum smooth muscle cells.The cells were randomly divided into 6 groups:SHR siRNA-1,SHR siRNA-2,SHR siRNA-3,SHR GFP,SHR control (SHR non-transfection group),and SD control (SD rat control group).Each group had 5 samples with 1.0×10⁵ cells of each sample.At 72 h after transfection (MOI=60) with lentiviral vectors carrying S1P2 siRNA into the SHR corpus cavernosum smooth muscle cells,the expression of GFP was observed under fluorescence microscope.The protein expression of S1P2,ROCK1,ROCK2 and eNOS in the corpus cavernosum smooth muscle cells,and the mRNA expression of S1P2,ROCK1 and ROCK2 were determined by by Western blot and RT-PCR.RESULTS:The transfection efficiency of the corpus cavernosum smooth muscle cells in SHR siRNA-1,SHR siRNA-2,SHR siRNA-3 and SHR GFP groups were>80%.Compared with SHR control group,the mRNA levels and the protein expression of S1P2,ROCK1 and ROCK2 in SHR GFP group showed no remarkable changes,while those in SHR siRNA-1,SHR siRNA-2,SHR siRNA-3 and SD control groups were significantly lower than those in SHR control group (P<0.05).The protein expression of eNOS in SHR siRNA-1,SHR siRNA-2,SHR siRNA-3 and SHR GFP groups were not significantly changed as compared with SHR control group,but that in SD control group was significantly higher than that in SHR control group.CONCLUSION:Three groups of siRNA lentiviral vectors targeting S1P2 inhibit the expression of S1P2 in the corpus cavernosum smooth muscle cells of SHR,and by silencing the S1P2 expression,the expression of ROCK1 and ROCK2 is inhibited.Among them,siRNA-1 has the highest inhibitory efficiency.     

Changes of urinary exosomal leucine aminopeptidase and dipeptidyl peptidase 4 in diabetic nephropathy

AIM: To investigate the changes of urinary exosomal enzymes and the correlation with diabetic nephropathy.METHODS: Thirty-four healthy volunteers and 127 patients of type 2 diabetes mellitus (T2DM) were included in the study. The healthy volunteers served as control. The patients with T2DM were divided into 3 groups based on their 24 h urinary albumin/creatinine ratio (UACR): 50 patients with microalbuminuria in early DN group (DN1), 34 patients with macroalbuminuria in overt DN group (DN2) and 43 patients without albuminuria in DM group. The levels of urine exosomal leucine aminopeptidase(exosome-LAP) and exosomal dipeptidyl peptidase 4(exosome-DPP4) were determined by enzyme-linked immunosorbent assay (ELISA). The following methods were used to determine the biochemical parameters: liquid chromatography for glycated hemoglobin (HbA1c), chemical modification method for cholesterol (CH), Jaffe-kinetic assay for creatinine (CR) and urease-GLDH method for blood urea nitrogen (BUN). Multiple stepwise linear regressions were used to analyze the relationship of exosome-LAP or exosome-DPP4 with HbA1c, CH, UACR, CR and BUN. RESULTS: The levels of exosome-LAP and exosome-DPP4 in DM, DN1 and DN2 groups were significantly higher than those in control group (P<0.01). The exosome-LAP in DN2 group was significantly higher than that in DM group. Correlation analysis showed that the levels of urinary exosome-LAP and exosome-DPP4 were positively correlated with HbA1c, CH, UACR, CR and BUN. Multiple stepwise linear regression analysis showed that CH and UACR were independent determinants for exosome-LAP (P<0.01), and UACR and HbA1c were independent determinants for exosome-DPP4 (P<0.01). CONCLUSION: Urine exosome-LAP and exosome-DPP4 are correlated with the severity of diabetic nephropathy. These parameters may serve as clinical markers for the diagnosis and prognosis evaluation of diabetic nephropathy.     

Mechanism of Sos2 inhibiting NFATc1-mediated podocyte injury in diabetic nephropathy

AIM: To observe the effect of high glucose (HG) stimulation on the expression of guanine nucleotide exchange factor Sos2 (Son of Sevenless homolog 2) in mouse podocytes, and to explore the role of Sos2 in HG-induced podocyte damage and its possible molecular mechanisms. METHODS: The expression of Sos2 in the podocytes of diabetic nephropathy patients was observed by immunofluorescence staining and laser confocal microscopy. In vitro, the Sos2 expression at mRNA and protein levels in immortalized podocytes with HG (30 mmol/L glucose) stimulation for 48 h was determined by the methods of RT-PCR, Western blot and immunofluorescence. Using Western blot, immunofluorescence and wound-healing assay, the expression of podocin, the translocation of NFATc1 into the nucleus and the podocyte migration with or without Sos2 silencing or overexpression were analyzed. The expression of downstream target genes for NFATc1 was detected by RT-PCR. RESULTS: The expression of Sos2 was significantly decreased in the podocytes of diabetic nephropathy patients and in vitro cultured podocytes with HG stimulation (P<0.05). When Sos2 was silenced, the expression of podocin was significantly decreased, the migration ability of podocytes was increased, and the translocation of NFATc1 into the nucleus was increased (P<0.05). In contrast, after overexpression of Sos2 in the podocytes with HG stimulation, the podocin expression level was obviously higher, and the podocyte migration ability and the translocation of NFATc1 into the nucleus were decreased (P<0.05).CONCLUSION: Sos2 may attenuate the diabetic nephropathy-induced podocyte injury by inhibiting NFATc1.     

Expression of CTGF and its role in the streptozotocin-induced diabetic rat kidney

AIM:To investigate the change of connective tissue growth factor(CTGF) expression and its role in streptozotocin-induced diabetic rat kidney. METHODS:Male SD rats were randomly divided into two groups: control(sham operated rats, group C，n=32) and diabetic rats (group DN，n=35). Rats in each group were sacrificed at 1, 2, 4, and 8 weeks respectively after induction of diabetes. Body weight（BW）, blood glucose（BG）, 24-hour urine volumn（UV）, kidney weight, KW/BW,24-hour urinary albumin excretion (24Ualb), creatinine clearance (Ccr), kidney weight (KW), KW/BW, glomerular area (A_G), proximal tubular area (A_T) and the width of GBM、TBM at each time point were measured. Expression of CTGF and α-SMA were detected by immunostaining. RESULTS:There was a significant increase of 24 h Ualb, Ccr, KW/BW, A_G, V_G and the expression of CTGF in glomeruli and tubuli from week 1 onward in diabetic rats compared with those in group C (P<0.05, P<0.01, respectively), and an increasing expression of α-SMA mainly located in dilated tubuli from week 4 was found in group DN, which was more evident at week 8 accompanied by the decrease in A_T. Diabetic rats also had a significant increase in A_T from week 1 onward, which peaked at week 4. CONCLUSION:In the early stage of DN, the time-dependently upregulated CTGF might mediate the renal hypertrophy, which might be associated with the subsequent tubular epithelial-mesenchymal transdifferentiation (EMT) and renal fibrosis.     

Effect of simvastatin on expression of integrin-linked kinase and renal tubulointerstitium injury in rats induced by high fat diet

AIM: To explore the effect of simvastatin on expression of integrin-linked kinase (ILK) and the injury of renal tubulointerstitium in the rats induced by high fat diet. METHODS: Fifty-four 6-8 week-old female Wistar rats were randomly assigned to the following three groups: high fat diet group, simvastatin group (rats were fed with high fat diet plus 10 mg·kg-1·d-1 simvastatin) and control group. Six rats in each group were sacrificed at 4th week, 10th week, and the others at 20th week. The injury of renal tubulointerstitium was observed under microscope with HE staining and the expression of renal ILK was determined by Western blotting analysis and immunohistochemistry. Levels of total cholesterol (TC) and triglyceride (TG) in serum were measured by enzymatic colormetric methods. RESULTS: The serum TC and TG levels and the expression of renal ILK significantly increased in both high-fat diet group and simvastatin group, compared to control group at 4th week, reaching a maximum at 20th week (P<0.01). Tubulointerstitium injuries including vacuolar degeneration, syncytial change, clody swelling, necrosis and atrophy of renal tubular epithelial cells, thinning of tubal wall, lumens compensational expansion or even abolition, and inflammatory cell infiltration, interstitial fibrosis were found in both high fat diet group and simvastatin group, compared to control group at 4th week, worsened to a maximum at 20th week. However, all of these ameliorated in simvastatin group, compared to high fat diet group at each time point. CONCLUSION: The results indicate that high-fat diet induces significant lesion of renal tubulointerstitium and increased expression of renal ILK. Simvastatin may play an important role in protecting against tubulointerstitium injury induced by hyperlipoidemia by down-regulating the expression of renal ILK.     

Roles of gap junction in TGF-β1-induced proliferation of vascular smooth muscle cells from spontaneous hypertensive rats

AIM: To investigate whether gap junction participates in transforming growth factor β₁(TGF-β₁)-induced proliferation of spontaneous hypertensive rat (SHR) vascular smooth muscle cells (VSMCs). METHODS: The thoracic aorta of the rats were sampled. The primary SHR VSMCs were isolated and cultured in vitro. The cells were divided into 4 groups: control group, TGF-β₁ group,18α-glycyrrhetinic acid(18α-GA) group and TGF-β₁+18α-GA group. The proliferation of SHR VSMCs was observed by the methods of MTT and flow cytometry. The protein expression and co-localization of connexin(Cx)43 and Cx40 in SHR VSMCs were detected by immunofluorescence staining. The protein levels of Cx43 and Cx40 in the cells were also measured by Western blotting. The method of molecular dye transfer (scrape dye transfer method) was applied to detect the function of gap junction in SHR VSMCs. RESULTS: The protein expression of Cx43 and Cx40 in SHR VSMCs was positive and co-localized in the cytoplasm. Compared with control group, the percentage of S-phase detected by cell cycle and A value detected by MTT in TGF-β₁ group were obviously increased (P<0.05), indicating that the proliferation of the cells was enhanced. However, the proliferation of the cells decreased in 18α-GA group (P<0.05). Compared with TGF-β₁ group, the percentage of S-phase and A value in TGF-β₁+18α-GA group were both significantly decreased (P<0.05), indicating that the proliferation of the cells decreased. Compared with control group, the protein expression of Cx43 in TGF-β₁ group was increased (P<0.05), whereas the protein expression of Cx40 was not changed (P>0.05), and the protein expression of Cx43 and Cx40 in 18α-GA group were decreased (P<0.05). Compared with TGF-β₁ group, the expression of Cx43 in TGF-β₁+18α-GA group was significantly decreased (P<0.05),but no difference of the Cx40 protein levels between the two groups was observed. Compared with control group, the function of gap junction detected by scrape dye transfer method in TGF-β₁ group was enhanced (P<0.05), and weakened in 18α-GA group (P<0.05). Compared with the TGF-β₁ group, the function of gap junction in TGF-β₁+18α-GA group was significantly attenuated (P<0.05). CONCLUSION: TGF-β₁ enhances the function of gap junction to stimulate the proliferation of SHR VSMCs through the expression of Cx43 protein. The expression of Cx40 protein may not play a major role in this process.