Protective effect of L-arginine on hypercholesterolemia-enhanced renal ischemic injury

Hypoxia: The Force that Drives Chronic Kidney Disease

In the United States the prevalence of end-stage renal disease (ESRD) reached epidemic proportions in 2012 with over 600,000 patients being treated. The rates of ESRD among the elderly are disproportionally high. Consequently, as life expectancy increases and the baby-boom generation reaches retirement age, the already heavy burden imposed by ESRD on the US health care system is set to increase dramatically. ESRD represents the terminal stage of chronic kidney disease (CKD). A large body of evidence indicating that CKD is driven by renal tissue hypoxia has led to the development of therapeutic strategies that increase kidney oxygenation and the contention that chronic hypoxia is the final common pathway to end-stage renal failure. Numerous studies have demonstrated that one of the most potent means by which hypoxic conditions within the kidney produce CKD is by inducing a sustained inflammatory attack by infiltrating leukocytes. Indispensable to this attack is the acquisition by leukocytes of an adhesive phenotype. It was thought that this process resulted exclusively from leukocytes responding to cytokines released from ischemic renal endothelium. However, recently it has been demonstrated that leukocytes also become activated independent of the hypoxic response of endothelial cells. It was found that this endothelium-independent mechanism involves leukocytes directly sensing hypoxia and responding by transcriptional induction of the genes that encode the β2-integrin family of adhesion molecules. This induction likely maintains the long-term inflammation by which hypoxia drives the pathogenesis of CKD. Consequently, targeting these transcriptional mechanisms would appear to represent a promising new therapeutic strategy.

Antihypercholesterolemic effect of Cleome arabica L. on high cholesterol diet induced damage in rats

Dietary cholesterol is known to be one of the main risk factors that accelerate oxidation process leading to hypercholesterolemia and attendant cardiovascular diseases. The purpose of this study, carried out on adult male Wistar rats, was to evaluate the inhibitory effects of supplementation with aqueous of Cleome arabica leaf extract on hypercholesterolemia. After 3 months of treatment, animals were sacrificed by decapitation. Blood serum was obtained by centrifugation. Under our experimental conditions, administration of Cleome arabica leaf extract decreased the total cholesterol (TC), LDL-cholesterol (LDL-chol) and triglycerides (TG) levels by 27 %, 52 %, 37 %, respectively, and reduced SGOT SGPT, LDH and PAL levels in blood serum compared to untreated hypercholesterolemic rats. TBARS concentrations decreased by 21 % in liver, 22 % in heart and 30 % in kidney in a group of rats treated with cholesterol and Cleome arabica (Chol C.ar) compared to a Chol-treated group. The same treatment with Cleome arabica leaf extract increased superoxide dismutase and enhanced glutathione peroxidase activity. Catalase activity was found to increase in liver, heart and kidney by 17 %, 16 % and 23 %, respectively, in the C.ar Chol-treated group. The protective effect of Cleome arabica on hypercholesterolemia inducing oxidative stress in several organs was mainly attributed to antioxidant properties. The latter were due to the presence of phenolic acids and flavonoids shown by the obtained HPLC profiles.

Effects of short- and long-term hypercholesterolemia on contrast-induced acute kidney injury

BACKGROUND

Whether hypercholesterolemia is a risk factor for contrast-induced acute kidney injury (CI-AKI) remains unclear. In the present study, the effects of short- and long-term dietary hypercholesterolemia on contrast media-induced nephrotoxicity were evaluated.

METHODS

Rats were fed either a normal rodent diet (N) or high-cholesterol diet (H). At the end of 2 and 8 weeks, 8 rats from each diet group were given a tail vein injection of either iohexol (group NC and group HC) or vehicle (group N and group H). Blood lipids, renal function and renal hemodynamics were evaluated 1 day after contrast media administration. Renal and urinary prostaglandin E(2) (PGE(2)) and thromboxane B(2) (TXB(2)) were detected by radioimmunoassay. Renal nitric oxide and malondialdehyde (MDA) were measured by the Griess reaction and thiobarbituric acid method, respectively.

RESULTS

Contrast media administration increased serum creatinine levels and induced severe renal tubular necrosis in rats fed the high-cholesterol diet for 8 weeks but not in rats fed the normal diet or high-cholesterol diet for 2 weeks. The renal and urinary PGE(2) and TXB(2) levels increased significantly in rats in group H and group HC at the end of 8 weeks. Renal nitric oxide production decreased, and MDA levels increased markedly in group HC and group H at the end of 8 weeks.

CONCLUSIONS

We conclude that long-term hypercholesterolemia appeared to be a risk factor for CI-AKI, which might be associated with disorders in intrarenal prostaglandins and abnormalities in renal nitric oxide system induced by lipid peroxidation.

High cholesterol feeding may induce tubular dysfunction resulting in hypomagnesemia

BACKGROUND/AIMS

Hypomagnesemia may induce hypercholesterolemia, but the contrary has not been described yet. Thus, magnesium homeostasis was evaluated in rats fed a cholesterol-enriched diet for 8 days. This study has a relevant clinical application if hypomagnesemia, due to hypercholesterolemia, is confirmed in patients with long-term hypercholesterolemia.

METHODS

Both hypercholesterolemic (HC) and normocholesterolemic rats (NC) were divided into sets of experiments to measure hemodynamic parameters, physiological data, maximum capacity to dilute urine (C(H)((2))(O)), variations (Δ) in [Ca(2+)](i) and the expression of transporter proteins.

RESULTS

HC developed hypomagnesemia and showed high magnesuria in the absence of hemodynamic abnormalities. However, the urinary sodium excretion and C(H)((2))(O) in HC was similar to NC. On the other hand, the responses to angiotensin II by measuring Δ [Ca(2+)](i) were higher in the thick ascending limb of Henle's loop (TAL) of HC than NC. Moreover, high expression of the cotransporter NKCC2 was found in renal outer medulla fractions of HC. Taken together, the hypothesis of impairment in TAL was excluded. Actually, the expression of the epithelial Mg(2+) channel in renal cortical membrane fractions was reduced in HC.

CONCLUSION

Impairment in distal convoluted tubule induced by hypercholesterolemia explains high magnesuria and hypomagnesemia observed in HC.

Amelioration of renal ischemia-reperfusion injury by inhibition of IL-6 production in the poloxamer 407-induced mouse model of hyperlipidemia

It is largely unknown whether hyperlipidemia is involved in the pathobiology of renal ischemia-reperfusion (I/R) injury that is an important cause of acute kidney injury. Here we studied the effect of experimental dyslipidemia on renal I/R injury. Renal I/R injury was less severe in hyperlipidemic mice treated with poloxamer 407 than in the control mice. Cytokine analyses revealed decreased levels of renal and serum IL-6 in the hyperlipidemic mice after renal I/R. Protection from renal I/R injury in the hyperlipidemic mice was diminished by administration of recombinant IL-6. Concanavalin A-induced IL-6 release from cultured splenocytes derived from the hyperlipidemic mice was lower than that from splenocytes of normal mice. In hypercholesterolemic apolipoprotein E-knockout mice, in which renal I/R injury is less severe than in control mice, renal I/R-induced IL-6 production was also less than that in controls. In angiopoietin-like 3-deficient mice, which were hypolipidemic, renal dysfunction and renal IL-6 level after I/R were similar to those of control mice. Our data indicate that the presence of experimental hyperlipidemia may be associated with a decreased risk of renal I/R injury, possibly mediated by reduced renal IL-6 production after the insult and extend the notion that an anti-IL6 agent would be useful for the treatment of acute kidney injury.

Pravastatin improves renal ischemia-reperfusion injury by inhibiting the mevalonate pathway

Statins are known to lessen the severity of renal ischemia-reperfusion injury. The present study was undertaken to define the mechanism of renoprotective actions of statins using a mouse kidney injury model. Treatment of mice with pravastatin, a widely used statin, improved renal function after renal ischemia-reperfusion without lowering the plasma cholesterol level. Administration of pravastatin with mevalonate, a product of HMG-CoA reductase, eliminated renal protection suggesting an effect of pravastatin on mevalonate or its metabolism. In hypercholestrolemic apolipoprotein E knockout mice with reduced HMG-CoA reductase activity; the degree of injury was less severe than in control mice, however, there was no protective action of pravastatin on renal injury in the knockout mice. Treatment with a farnesyltransferase inhibitor (L-744832) mimicked pravastatin's protective effect but co-administration with the statin provided no additional protection. Both pravastatin and L-744832 inhibited the injury-induced increase in plasma IL-6 concentration to a similar extent. Our results suggest the protective effect of pravastatin on renal ischemia-reperfusion injury is mediated by inhibition of the mevalonate-isoprenoid pathway independent of its lipid lowering action.

Primary culture and characterization of human renal inner medullary collecting duct epithelial cells

PURPOSE

Our understanding of physiological and pathophysiological events associated with inner medullary collecting duct epithelium is based on studies in cells isolated from mice and rats. We established primary cultures of hIMCD (human papillary collecting duct epithelial) cells.

MATERIALS AND METHODS

Normal papillary tissues were dissected from the surgical waste of consenting patients undergoing renal surgery. Tissues were digested enzymatically. Cells were maintained in Dulbecco's modified Eagle's medium supplemented with glucose and antibiotics. Cultures were treated with ethylenediaminetetraacetic acid and epithelial select medium was also used to obtain a pure epithelial culture.

RESULTS

The hIMCD cells grew in a monolayer. Cells showed the expression of epithelial specific markers, including cytokeratin, the tight junction marker zonula occludens 1 and the cytoskeletal protein vimentin. They lacked expression of factor VIII, which is a glycoprotein synthesized by endothelial cells. To our knowledge we also noted for the first time uroplakin expression in collecting duct epithelial cells. This expression was maintained in primary culture. The hIMCD cells in culture were highly resistant to hypertonic solutions and they responded to hypertonicity by cyclooxygenase-2 over expression. Moreover, these cells also survived prolonged periods of hypoxia.

CONCLUSIONS

To our knowledge this is the first report of successful culture and characterization of primary cultures of collecting duct epithelial cells from human renal papillae. These cells will serve as essential tools in helping us fill the gaps in our understanding of the events associated with the physiology and pathophysiology of human renal inner medullary collecting duct epithelium.

Effect of radiocontrasts on selected membrane transport systems

BACKGROUND

This study was aimed at examining the effects of radiocontrast agents on selected membrane transport functions.

METHODS

The effect of diatrizoate sodium (DS), diatrizoate meglumine (DM), and diatrizoate compound (DC) on Na+/K+ pump activity and number, L-arginine, and choline transports were evaluated in erythrocytes of normal individuals and patients undergoing cardiac catheterization.

RESULTS

Norrmal individuals' erythrocytes potassium influxes were 1.50+/-0.35, 1.32+/-0.37, 1.28+/-0.30, and 1.01+/-0.25 mmol/L cell/h in control, DS, DM, and DC groups, respectively (P=0.004; DC vs. control). Patients exposure to Hypaque M-76 significantly diminished Na+/K+ pump activity (1.40+/-0.36 before, vs. 1.27+/-0.40 mmol/L cell/h after; P=0.039). The number of Na+/K+ pumps was reduced (156+/-36 vs. 143+/-34 pumps/erythrocyte; P=0.015) in presence of DS. L-arginine and choline transports changed only at high radiocontrast concentrations.

CONCLUSION

Selective changes in erythrocytes membrane transport function take place on exposure to radiocontrasts.

Influence of age and vitamin E on post-ischemic acute renal failure

The aging process causes progressive deterioration in kidney structure and function. Aberrant generation of reactive oxygen species has been implicated in both age-related and ischemia-related tissue injury. Vitamin E (VE), one of the most powerful and effective exogenous antioxidants, prevents lipid peroxidation and protects against the effects of oxidative stress. The objective of this study was to determine the influence of age and VE on post-ischemic acute renal failure (ARF). Young adult, middle-aged and aged male Wistar rats were maintained on three different 30-day diets: Normal, VE absent and VE supplemented. On day 30, urinary protein and serum cholesterol and VE were measured. On day 31, rats were subjected to 60' clamping of the left renal artery plus right nephrectomy. Inulin clearance (InCl) was performed 48 h after renal ischemia. Malondialdehyde (MDA) was measured in the cortex of normal and 48-h post-ischemic kidneys. Urinary protein and serum cholesterol were higher in aged rats than in other rats. With aging, InCl decreased progressively. Vitamin E deficiency aggravated ARF. In middle-aged and aged rats, VE supplementation protected against ARF. In the absence of VE, MDA increased with age. In conclusion, our data suggest that ARF becomes more severe with age and that ischemia/reperfusion injury is exacerbated when antioxidant-scavenging ability of the kidney is impaired by VE deficiency. Supplementation with VE is essential for protecting aging kidneys against ischemic ARF.

Protective effects of certoparin sodium, a low molecular weight heparin derivative, in experimental atherosclerosis

BACKGROUND

The association of atherosclerosis and hypercholesterolemia is well known. Hypercholesterolemic diet-induced atherogenesis is a widely accepted experimental model that is amenable to exploration of both the disease as well as therapeutic interventions. We evaluated the role of low molecular weight heparin (LMWH) in modulating the early biochemical changes in atherogenesis.

METHODS

Male Wistar rats (140 +/- 10 g) were fed an atherogenic diet comprising of normal rat chow supplemented with 4% cholesterol, 1% cholic acid and 0.5% thiouracil (CCT diet) for 2 weeks. While one of the CCT diet-fed group served as the untreated pathologic model, the other group received LMWH (Certoparin sodium, Troparin; 300 microg/day/rat s.c.) treatment, commencing on day 8 and continued for 1 week.

RESULTS

Decreased concentrations of serum albumin and increased serum urea, uric acid and creatinine concentrations were normalized by LMWH treatment. The atherogenic diet induced abnormal rise in the activities of lactate dehydrogenase, aminotransferases and alkaline phosphatase, as well as the high serum cholesterol and triglyceride concentrations were restored to near control values in the treated group. LMWH administration prevented the hypertrophic cardiac histology and fatty changes in the liver in early atherogenesis.

CONCLUSION

The present study encapsulates the early cellular abnormalities in the heart, liver and kidney tissues of atherogenic diet fed rats. Treatment with LMWH affords considerable protection to the tissues challenged by hypercholesterolemia, evidenced by its correction of lipemia and restoration of serum and tissue indices of injury, to normalcy. LMWH intervention minimized the atherogenic diet-induced histopathological lesions in heart, liver and kidney tissues.

Effects of maternal hypercholesterolemia on pregnancy and development of offspring

The effect of maternal hypercholesterolemia on the course of pregnancy and the development of offspring was investigated. Rats were fed either an enriched-cholesterol diet (HC) or a standard diet (control) from 1 week before mating until weaning of offspring. Compared with the control group, HC dams showed a fourfold increase in abortions, a twofold increase in neonatal mortality, smaller litter size, and lower birth weight of pups. At weaning, Na(+),K(+)-ATPase activity in the outer renal medulla was reduced in HC pups compared with control pups, suggesting retarded or impaired development of medullary nephron segments. At this point, to better examine the adverse effects of maternal hypercholesterolemia, the HC pups were divided into two groups: one fed a cholesterol-enriched diet (HC/hc) and the other a standard diet (HC/nc), while control pups were maintained on the standard diet. In adulthood, the HC/hc group showed growth impairment and reduced renal function, demonstrated by low creatinine clearance (0.24+/-0.04 ml/min per 100 g body weight) and high fractional excretion of sodium, potassium, and water ( P<0.05 vs. control). These effects were partially reversed in the HC/nc group. In this study, neither dams nor offspring developed hypertension. Thus, maternal hypercholesterolemia adversely affected pregnancy outcomes and the development of offspring by inducing abnormalities and thereby reducing renal function.

Arginine nutrition in development, health and disease

As a precursor of nitric oxide, polyamines and other molecules with enormous biologic importance, L-arginine plays versatile key roles in nutrition and metabolism. Arginine is an essential amino acid in the fetus and neonate, and is conditionally an essential nutrient for adults, particularly in certain disease conditions. L-Arginine administration is beneficial in improving reproductive, cardiovascular, pulmonary, renal, gastrointestinal, liver and immune functions, and in facilitating wound healing. The effect of L-arginine in treating many common health problems is unique among amino acids, and offers great promise for improved health and well-being in the future.