Dietary phosphate restriction prevents the appearance of sarcopenia signs in old mice

BACKGROUND

Sarcopenia is defined by the progressive and generalized loss of muscle mass and function associated with aging. We have previously proposed that aging-related hyperphosphataemia is linked with the appearance of sarcopenia signs. Because there are not effective treatments to prevent sarcopenia, except for resistance exercise, we propose here to analyse whether the dietary restriction of phosphate could be a useful strategy to improve muscle function and structure in an animal model of aging.

METHODS

Five-month-old (young), 24-month-old (old) and 28-month-old (geriatric) male C57BL6 mice were used. Old and geriatric mice were divided into two groups, one fed with a standard diet (0.6% phosphate) and the other fed with a low-phosphate (low-P) diet (0.2% phosphate) for 3 or 7 months, respectively. A phosphate binder, Velphoro®, was also supplemented in a group of old mice, mixed with a standard milled diet for 3 months. Muscle mass was measured by the weight of gastrocnemius and tibial muscles, and quality by nuclear magnetic resonance imaging (NMRI) and histological staining assays. Muscle strength was measured by grip test and contractile properties of the tibialis muscle by electrical stimulation of the common peroneal nerve. Gait parameters were analysed during the spontaneous locomotion of the mice with footprinting. Orientation and motor coordination were evaluated using a static rod test.

RESULTS

Old mice fed with low-P diet showed reduced serum phosphate concentration (16.46 ± 0.77 mg/dL young; 21.24 ± 0.95 mg/dL old; 17.46 ± 0.82 mg/dL low-P diet). Old mice fed with low-P diet displayed 44% more mass in gastrocnemius muscles with respect to old mice (P = 0.004). NMRI revealed a significant reduction in T2 relaxation time (P = 0.014) and increased magnetization transfer (P = 0.045) and mean diffusivity (P = 0.045) in low-P diet-treated mice compared with their coetaneous. The hypophosphataemic diet increased the fibre size and reduced the fibrotic area by 52% in gastrocnemius muscle with respect to old mice (P = 0.002). Twitch force and tetanic force were significantly increased in old mice fed with the hypophosphataemic diet (P = 0.004 and P = 0.014, respectively). Physical performance was also improved, increasing gait speed by 30% (P = 0.032) and reducing transition time in the static rod by 55% (P = 0.012). Similar results were found when diet was supplemented with Velphoro®.

CONCLUSIONS

The dietary restriction of phosphate in old mice improves muscle quantity and quality, muscle strength and physical performance. Similar results were found using the phosphate binder Velphoro®, supporting the role of phosphate in the impairment of muscle structure and function that occurs during aging.

MO414: Sucroferric Oxyhydroxide (Velphoro®) Treatment Mitigates the Signs of Ageing-Related Sarcopaenia in Old Mice

BACKGROUND AND AIMS

Sarcopaenia, defined as the loss of muscle mass and function, is an ageing-related pathology associated with some important diseases such as chronic kidney disease (CKD). Hyperphosphatemia has been associated with both, ageing and CKD. Old mice show an increase in serum phosphate concentration and a reduction in muscle mass, forelimb strength, gait speed and transition time in the static bar, with respect to young mice. Previous results of our group showed the beneficial effects of a low phosphate diet on ageing-related sarcopaenia. Given that the implementation of dietary phosphate restriction entails difficulties in the elderly, the aim of this work was to analyse the beneficial effects of a diet supplemented with a phosphate binder on the signs of sarcopaenia.

METHOD

C57BL6 male mice were used for in vivo studies: 5-month-old (young) and 24-month-old (old), which were fed with a powder standard diet (containing 0.6% of phosphate). Some old mice were fed with a hypophosphatemic diet (containing 0.2% of phosphate) or with a diet supplemented with 5% sucroferric oxyhydroxide (Velphoro®) for the last 3 months before sacrifice. Serum phosphate levels were analysed with a commercial kit. Muscle mass was estimated by measuring the gastrocnemius muscle mass divided by total body mass, muscle force was measured by a grip test and physical performance was evaluated by a gait test and the static bar test.

RESULTS

Velphoro® treated old mice showed a significant and more effective reduction in phosphate serum levels than old mice fed with the hypophosphatemic diet. No differences were observed in the relative gastrocnemius muscle mass between the three old mice experimental groups. By contrast, old mice fed with the standard diet supplemented with Velphoro® displayed an increased muscular strength and physical performance, improving the gait speed and reducing the transition time in the static bar, compared with old mice fed with the standard diet. Results obtained with Velphoro® treatment were similar to those observed in old mice fed with the hyphophosphatemic diet, but Velphoro® treatment achieve better results in motor coordination in the static bar test.

CONCLUSION

Dietary restriction of phosphate is a useful approach to mitigate the signs of ageing-related sarcopaenia (muscle strength and physical performance) in old mice. The use of Velphoro®, as a phosphate binder, exhibits similar or even better results than the hypophosphatemic diet. Therefore, the administration of Velphoro® could attenuate the signs of sarcopaenia in the elderly or in ageing-related diseases in which sarcopaenia is common, like CKD.

MO581: Hyperphosphatemia Induces Lung Fibrosis in OLD Mice

BACKGROUND AND AIM

Hyperphosphatemia is a common condition associated with chronic kidney disease (CKD) and also with aging. Furthermore, lung dysfunction is described in both cases; however, the relationship between high phosphate levels and lung function is still unknown. The aim of this work is to analyze the effect of hyperphosphatemia in the development of lung fibrosis related to aging.

METHODS

For in vivo studies, C57BL6 male mice of 5 months old (Young) and 24 months old (Old) fed with a standard diet containing 0.6% phosphate were used. Additionally, some old mice were fed with a hypophosphatemic diet containing 0.2% phosphate (Old-Low P) for the last 3 months. Serum phosphate levels were measured with DIPI-500 assay. Lung fibrosis was evaluated by Sirius Red staining and by expression of extracellular matrix proteins such as fibronectin or collagen V assessed by western blot. In vitro studies were performed on a human cell line from lung fibroblasts (Wi-38), which were treated with a phosphate donor called β-glycerophosphate (BGP, 10 mM) at different times. Fibrosis was detected by expression of fibronectin by western blot as in lung tissues. Oxidative stress was measured by confocal microscopy using the fluorogenic probe CellROX. EMSA assays was used to check the activation of fibronectin promoter by NFκB transcription factor.

RESULTS

Old mice that showed higher serum phosphate levels had more lung fibrosis than young mice. Old mice fed with the low phosphate diet, which had less serum phosphate levels, reduced significantly the lung fibrosis respect to old mice fed with the standard diet. In order to elucidate a possible mechanism, in vitro studies were performed in lung fibroblasts treated with BGP. BGP induced a significant increased on fibronectin expression. BGP also rose oxidative stress at short times. As NF-kB transcription factor can be activated by oxidative stress, we checked whether BGP induced the binding of this factor to fibronectin promoter to upregulate this gene. The EMSA analysis showed that BGP promoted the binding of NF-κB to fibronectin promoter. Besides, in the presence of an antioxidant such as catalase, BGP did not induce the binding of NF-kB to fibronectin promoter, suggesting a role for oxidative stress.

CONCLUSION

Old mice showed hyperphosphatemia and lung fibrosis, which both were improved using a low phosphate diet. In vitro studies in lung fibroblasts confirmed that fibrosis induced by BGP seems to be mediated by activation on NF-kB via oxidative stress. These results show a relationship between hyperphosphatemia and lung fibrosis in aging; however, more studies are necessary in order to elucidate the relationship with other chronic diseases related to aging.

Aging-related hyperphosphatemia impairs myogenic differentiation and enhances fibrosis in skeletal muscle

BACKGROUND

Hyperphosphatemia has been related to the development of sarcopenia in aging mice. We describe the intracellular mechanisms involved in the impairment of the myogenic differentiation promoted by hyperphosphatemia and analyse these mechanisms in the muscle from older mice.

METHODS

C₂ C₁₂ cells were grown in 2% horse serum in order to promote myogenic differentiation, in the presence or absence of 10 mM beta-glycerophosphate (BGP) for 7 days. Troponin T, paired box 7 (Pax-7), myogenic factor 5 (Myf5), myogenic differentiation 1 (MyoD), myogenin (MyoG), myocyte enhancer factor 2 (MEF2C), P300/CBP-associated factor (PCAF), histone deacetylase 1 (HDAC1), fibronectin, vimentin, and collagen I were analysed at 48, 72, and 168 h, by western blotting or by immunofluorescence staining visualized by confocal microscopy. Studies in mice were performed in 5- and 24-month-old C57BL6 mice. Three months before sacrifice, 21-month-old mice were fed with a standard diet or a low phosphate diet, containing 0.6% or 0.2% phosphate, respectively. Serum phosphate concentration was assessed by a colorimetric method and forelimb strength by a grip test. Fibrosis was observed in the tibialis anterior muscle by Sirius Red staining. In gastrocnemius muscle, MyoG, MEF2C, and fibronectin expressions were analysed by western blotting.

RESULTS

Cells differentiated in the presence of BGP showed near five times less expression of troponin T and kept higher levels of Pax-7 than control cells indicating a reduced myogenic differentiation. BGP reduced Myf5 about 50% and diminished MyoD transcriptional activity by increasing the expression of HDAC1 and reducing the expression of PCAF. Consequently, BGP reduced to 50% the expression of MyoG and MEF2C. A significant increase in the expression of fibrosis markers as collagen I, vimentin, and fibronectin was found in cells treated with BGP. In mice, serum phosphate (17.24 ± 0.77 mg/dL young; 23.23 ± 0.81 mg/dL old; 19.09 ± 0.75 mg/dL old with low phosphate diet) correlates negatively (r = -0.515, P = 0.001) with the muscular strength (3.13 ± 0.07 gf/g young; 1.70 ± 0.12 gf/g old; 2.10 ± 0.09 gf/g old with low phosphate diet) and with the expression of MyoG (r = -0.535, P = 0.007) and positively with the expression of fibronectin (r = 0.503, P = 0.001) in gastrocnemius muscle. The tibialis anterior muscle from old mice showed muscular fibrosis. Older mice fed with a low phosphate diet showed improved muscular parameters relative to control mice of similar age.

CONCLUSIONS

Hyperphosphatemia impairs myogenic differentiation, by inhibiting the transcriptional activity of MyoD, and enhances the expression of fibrotic genes in cultured myoblasts. Experiments carried out in older mice demonstrate a close relationship between age-related hyperphosphatemia and the decrease in the expression of myogenic factors and the increase in factors related to muscle fibrosis.

Hyperphosphatemia-Induced Oxidant/Antioxidant Imbalance Impairs Vascular Relaxation and Induces Inflammation and Fibrosis in Old Mice

Aging impairs vascular function, but the mechanisms involved are unknown. The aim of this study was to analyze whether aging-related hyperphosphatemia is implied in this effect by elucidating the role of oxidative stress. C57BL6 mice that were aged 5 months (young) and 24 months (old), receiving a standard (0.6%) or low-phosphate (0.2%) diet, were used. Isolated mesenteric arteries from old mice showed diminished endothelium-dependent vascular relaxation by the down-regulation of NOS3 expression, increased inflammation and increased fibrosis in isolated aortas, compared to those isolated from young mice. In parallel, increased Nox4 expression and reduced Nrf2, Sod2-Mn and Gpx1 were found in the aortas from old mice, resulting in oxidant/antioxidant imbalance. The low-phosphate diet improved vascular function and oxidant/antioxidant balance in old mice. Mechanisms were analyzed in endothelial (EC) and vascular smooth muscle cells (SMCs) treated with the phosphate donor ß-glycerophosphate (BGP). In EC, BGP increased Nox4 expression and ROS production, which reduced NOS3 expression via NFκB. BGP also increased inflammation in EC. In SMC, BGP increased Collagen I and fibronectin expression by priming ROS production and NFκB activity. In conclusion, hyperphosphatemia reduced endothelium-dependent vascular relaxation and increased inflammation and vascular fibrosis through an impairment of oxidant/antioxidant balance in old mice. A low-phosphate diet achieved improvements in the vascular function in old mice.

MO588DECREASED IL-15 PRODUCTION INDUCED BY HYPERPHOSPHATEMIA AS A POSSIBLE MECHANISM OF AGED-RELATED SARCOPENIA*

Background and Aims

The loss of muscle mass and function, termed sarcopenia, is an aging-related condition associated to some important diseases such as chronic kidney disease (CKD). Hyperphosphatemia has been related to both pathologies. A chronic subclinical inflammation and a dysregulated immune system function are associated to aging affecting to multiple pathways in the skeletal muscle, and this fact has been linked to the development of sarcopenia. Interleukin-15 (IL-15) is a skeletal muscle-derived cytokine which promotes muscle regeneration. The aim of this work was to analyze the role of hyperphosphatemia on the IL-15 production of the skeletal muscle and its implication in aging-related sarcopenia.

Method

Cultured C2C12 myoblasts were used for in vitro experiments. Cells were treated with 10 mM beta-glycerophosphate (BGP) as a phosphate donor for 2, 4, 6, 8 and 24 hours. IL-15 mRNA levels were assessed by RT-qPCR. Three groups of C57BL6 male mice were used for the in vivo studies: 5-months-old mice (young), 24-month-old mice fed with a standard diet containing 0.6 % of phosphate (old) and 24-month-old mice fed with a hypophosphatemic diet, containing a 0.2% of phosphate (old+lowPi), for the last three months before sacrifice. Muscle force was measured by a grip test. Serum phosphate levels were analyzed with a commercial kit. Quadriceps muscle samples were collected to evaluate in them the IL-15 mRNA expression by RT-qPCR.

Results

C2C12 cells treated with BGP show a significant decrease in the IL-15 mRNA expression. On the other hand, in vivo studies showed that old mice had an increase in serum phosphate concentration and a reduction in forelimb strength and muscle mass, compared to young mice. Old animals fed with the hypophosphatemic diet displayed lower levels of phosphate serum linked to an improvement in the muscle mass and function. IL-15 expression of quadriceps muscle was reduced in old mice compared to young mice, whereas those values were increased in old mice fed with the low phosphate diet. Furthermore, there was a negative correlation between IL-15 expression levels and serum phosphate concentrations and a positive correlation between IL-15 and forelimb strength and muscle mass, suggesting that a decreased IL-15 expression affects muscle function.

Conclusion

High extracellular phosphate concentrations decrease IL-15 mRNA expression in myoblasts, and it is correlated with low IL-15 mRNA expression in the quadriceps muscle isolated from old mice. This reduction was associated to a decreased muscular strength and muscle mass, whereas the dietary restriction of phosphate improved these features. These results point to a role of hyperphosphatemia in the impaired immune system function, disrupting the skeletal muscle function, and this could be involved in aging and CKD-related sarcopenia.

MO596HYPERPHOSPHATEMIA INDUCES ENDOTHELIN-1 SYNTHESIS AND INFLAMMATION IN LUNG FIBROBLASTS

Background and Aims

Hyperphosphatemia is an aging-related condition associated to chronic diseases such as chronic kidney disease (CKD). In both cases, aging and CKD, it has been described a decline lung function, however, relationship between high serum levels of phosphate and lung damage has not been described yet. The aim of this work was to evaluate if phosphate could induce inflammation in lung, studying the mechanisms implied.

Method

In vitro studies were performed on a cell line from human lung fibroblasts (Wi-38) which were treated with a phosphate donor termed β-glycerophosphate (BGP, 10 mM) and also with endothelin 1 (ET-1, 10 nM) at different times. To assess inflammation, the expression of several cytokines such as TNF-α,IL-1β, IL-6 and MCP-1 were measured by real time PCR. mRNA expressions of prepro-ET-1 and endothelin-converting enzyme-1 (ECE-1) were also analyzed by real time PCR. Reactive oxygen species (ROS) production was evaluated by confocal microscopy in live cells using the fluorogenic probe CellROX as oxidative stress reagent.

Results

Treatment with BGP induced a significant rise of the pro-inflammatory cytokines expression, TNF-α, IL-1β, IL-6 and MCP-1, on lung fibroblasts. Moreover, BGP was able to regulate ET-1 system, as we found a significant increase of mRNA expressions not only of prepro-ET-1 but also of ECE-1, reaching a peak around 2 and 6 hours, respectively. Later, it was checked whether ET-1 could induce inflammation itself in lung fibroblasts. Cells incubated with ET-1 show similar results as BGP, increasing expressions of all cytokines, TNF-α, IL-1β, IL-6 and MCP-1.ET-1 response was earlier than BGP, around at 2 hours with ET-1 instead of at 8 hours with BGP. In order to elucidate a possible mechanism, ROS production was assessed after BGP treatment. BGP induced ROS production at 15 min in lung fibroblasts.

Conclusion

BGP induces the synthesis of pro-inflammatory cytokines as well as the system of synthesis of ET-1, besides to rise ROS production.ET-1 itself also increases pro-inflammatory cytokines expression. ET-1 could contribute to the inflammation observed in lung fibroblast after BGP treatment. We propose oxidative stress as a potential mechanism implied, as it is well known that ROS can mediate in inflammation and in the ET system. However, more studies are necessary to confirm this role. All in all, these results relate hyperphosphatemia with a higher inflammation in lung fibroblasts which could decline lung function in chronic diseases associated to aging as CKD.

Uraemic toxins impair skeletal muscle regeneration by inhibiting myoblast proliferation, reducing myogenic differentiation, and promoting muscular fibrosis

Uraemic toxins increase in serum parallel to a decline in the glomerular filtration rate and the development of sarcopenia in patients with chronic kidney disease (CKD). This study analyses the role of uraemic toxins in sarcopenia at different stages of CKD, evaluating changes in the muscular regeneration process. Cultured C₂C₁₂ cells were incubated with a combination of indoxyl sulphate and p-cresol at high doses (100 µg/mL) or low doses (25 µg/mL and 10 µg/mL) resembling late or early CKD stages, respectively. Cell proliferation (analysed by scratch assays and flow cytometry) was inhibited only by high doses of uraemic toxins, which inactivated the cdc2-cyclin B complex, inhibiting mitosis and inducing apoptosis (analysed by annexin V staining). By contrast, low doses of uraemic toxins did not affect proliferation, but reduced myogenic differentiation, primed with 2% horse serum, by inhibiting myogenin expression and promoting fibro-adipogenic differentiation. Finally, to assess the in vivo relevance of these results, studies were performed in gastrocnemii from uraemic rats, which showed higher collagen expression and lower myosin heavy chain expression than those from healthy rats. In conclusion, uraemic toxins impair the skeletal muscular regeneration process, even at low concentrations, suggesting that sarcopenia can progress from the early stages of CKD.

Endothelin-1 induces cellular senescence and fibrosis in cultured myoblasts. A potential mechanism of aging-related sarcopenia

Endothelial dysfunction, with increased endothelin-1 (ET-1) synthesis, and sarcopenia, characterized by the loss of muscular mass and strength, are two aging–related conditions. However, a relationship between them has not been already established. The aim of this study was to determine whether ET-1 induces senescence and fibrosis in cultured murine myoblasts, which could be involved in the development of sarcopenia related to aging. For this purpose, myoblasts were incubated with ET-1 to assess cellular senescence, analyzed by senescence associated β-galactosidase activity and p16 expression; and fibrosis, assessed by fibronectin expression. ET-1 induced myoblast senescence and fibrosis through ET_A receptor. The use of antioxidants and several antagonists revealed that ET-1 effect on senescence and fibrosis depended on ROS production and activation of PI₃K-AKT-GSK pathway. To stress the in vivo relevance of these results, circulating ET-1, muscular strength, muscular fibrosis and p16 expression were measured in male C57Bl6 mice from 5-18-24-months-old. Old mice shown high levels of ET-1 correlated with muscular fibrosis, muscular p16 expression and loss of muscle strength. In conclusion, ET-1 promotes fibrosis and senescence in cultured myoblasts, similar results were found in old mice, suggesting a potential role for ET-1 in the development of sarcopenia related to aging.

P0913HYPERPHOSPHATEMIA INCREASE INFLAMMATION PROMOTING SENESCENCE AND MUSCLE DYSFUNCTION

Background and Aims

Hyperphosphatemia has been associated with aging and chronic kidney disease (CKD). Sarcopenia, which is a related condition of these pathologies, is defined by loss of force and muscular mass. During aging, chronic systemic inflammation appears, termed inflammaging, due to changes in immune system function. Inflammaging has been associated with many age-related diseases including Sarcopenia and CKD. The work aimed to evaluate the effect of hyperphosphatemia on proinflammatory profile of cultured myoblast cells and to analyze, in old mice, the effect of a dietary restriction in the phosphate intake on the aging-related sarcopenia.

Methods

Culture murine myoblast C2C12 cells were used for in vitro experiments. Cells were treated with 10 mM beta-glycerophosphate (BGP) as phosphate donor for 24, 48 or 72h. Inflammation was assessed through IL6, TNFα and MCP-1 expression by RT-qPCR. Twenty-four months old, C57BL6 mice were used for in vivo studies. Mice were fed with a normal diet containing 0.6% of phosphate until 21 months, after that, one group of mice continued with a normal diet and the other group was fed with a hypophosphatemic diet, containing a 0.2% of phosphate, for the following 3 months. Old mice were compared with 5 months old mice. Muscle force was measured by a grip strength test. Serum phosphate concentration was evaluated with a commercial kit and inflammation was assessed through IL-1β expression levels by RT-qPCR.

Results

Results showed that BGP treatment augmented pro-inflammatory cytokines levels, in myoblast, at 72h. On the other hand, old mice had a 40% increase in serum phosphate concentration regarding young mice, and, in parallel, they showed a reduction in forelimb strength. Old animals feeding with a hypophosphatemic diet showed a decreased level of phosphate serum linked to a better muscle function. Pro-inflammatory cytokines expression was higher in old mice compared to young mice; those values were reduced in 24-month-mice fed with a low phosphate diet. Furthermore, there was a positive correlation between IL-1β expression levels and serum phosphate levels, suggesting that high levels of serum phosphate were increasing inflammation in vivo and a negative correlation between IL-1β and grip strength test, which shows that high levels of inflammation decrease muscular function

Conclusion

In this work, we propose that high levels of phosphate are related to inflammation in vitro and in vivo. This increase of proinflammatory cytokines decreases muscle function whereas dietary restriction of phosphate decreases inflammation and improves muscle function. These results could point to a direct link between elevated serum phosphate levels and inflammaging presented in sarcopenic people such as CKD patients and aged people.

P0707UREMIC TOXINS IMPAIR SKELETAL MUSCLE REGENERATION PROCESS INDUCING CELL CYCLE ARREST AND APOPTOSIS IN CULTURED MYOBLASTS

Background and Aims

The loss of muscle mass and function has been related to chronic kidney disease (CKD). About 37% of dialysis patients show symptoms of sarcopenia and this has been related to an increased risk of mortality. Changes in sarcopenic muscle include the loss of its regenerative capacity due to a reduction in the number and function of satellite cells, the muscle stem cells. The concentration of serum uremic toxins (UT) increases in parallel to a decline in the glomerular filtration rate in patients with CKD and this uremia may be involved in the development of sarcopenia. Previous studies showed as serum concentration of UT found in the early stages of CKD inhibits myogenic differentiation of cultured myoblasts. Nevertheless, the effect of those concentrations found in the advanced stages of CKD has not been described. The study aimed to analyse whether UT affect the muscular regeneration process by modifying the proliferation capacity of myoblasts (activated satellite cells).

Method

Cultured mouse myoblasts C2C12 cells were used for all experiments. Cells were grown with 0% or 10% FBS culture media in the presence or absence of indoxyl sulphate and para-cresol at doses of 100µg/ml each one, which are similar to ones found in the advanced stages of CKD. Proliferation was evaluated by scratch wound healing and cell cycle by flow cytometry with propidium iodide and the fluorescent probe CFSE, an intracellular protein binding dye that is divided equally between daughter cells, allowing the discrimination of successive rounds of cell division. Chromosome condensation was assessed by immunofluorescence staining by confocal microscopy. Apoptosis was analysed by annexin V staining.

Results

C2C12 cells treated with UT shown a significant decrease in the proliferation rate. A significant delay in wound closure was observed in cells treated with UT compared to control cells. Myoblasts treated with UT suffered a significant decrease in the proliferation rate since the probe remained higher than in the vehicle-treated cells. Proliferating cells treated with UT suffered a dramatic cell cycle arrest between the phases S and G2/M. Chromosome condensation was also analysed, finding that in the presence of colcemid, vehicle-treated cells condensed their chromosomes, as expected, whereas UT-treated cells did not, suggesting that UT stop the cell cycle at any point before the entry of cells in the mitosis phase. Besides, there was strong phosphorylation of cdc2 in the presence of UT indicating that cdc2 and the complex cdc2-cyclin B were inactive. This result explains why cells did not enter in the mitosis phase under UT exposition. Finally, UT induced the death of proliferating C2C12 cells by apoptosis.

Conclusion

In the advanced stages of CKD, uremic toxins concentration increases, thereby inducing a dramatic arrest in the cell cycle of myoblasts, inactivating the cdc2-cyclin B complex, interrupting their proliferation and leading them towards cell apoptosis. These results point to a role of uremic toxins impairing the skeletal muscle regeneration process, which could be involved in CKD-related sarcopenia and frailty.

P0726ENDOTHELIAL DYSFUNCTION ASSOCIATED TO ATHEROSCLEROSIS OF KNOCKOUT APOE MICE COULD BE MEDIATED BY VASCULAR FIBROSIS

Background and Aims

Patients with chronic kidney disease (CKD) present a high rate of cardiovascular mortality mainly associated with endothelial dysfunction, which causes more cardiovascular events in presence of atherosclerosis. Atherosclerosis is characterized by a significant increase of low density lipoproteins (LDL), reactive oxygen species (ROS) and inflammation. ROS can oxidize LDL generating oxidized-LDL (oxLDL) that promotes the development of cardiovascular pathologies. The aim of this study was to evaluate whether oxLDL induce endothelial dysfunction analysing the involvement of vascular fibrosis.

Method

The model used for in vivo studies was the Knockout apolipoprotein E (KO-apoE) mice, which resemble human atherosclerosis and shown high levels of cholesterol (LDL) that can be oxidized to oxLDL. In mice, blood pressure was registered before sacrificed them. After that, we measured different parameters as serum cholesterol levels, vascular function by vascular reactivity in mesenteric arteries and vascular fibrosis in aorta by Sirius Red staining and by the protein expression of fibronectin and collagen-I by immunohistochemistry. In order to investigate the mechanism of action of oxLDL, in vitro studios were performed on human smooth muscle cells (SMC) incubated with oxLDL at different times. Fibrosis was evaluated by the expression of TGF- β and extracellular matrix proteins such as fibronectin and collagen-I by Western blot and by immunofluorescence. ROS production was also measured by fluorescence confocal microscopy, using the CellROX Deep Red probe.

Results

KO-apoE mice shown higher levels of serum cholesterol and blood pressure than WT animals. Moreover, KO-apoE mice showed endothelial dysfunction since their arteries were less relaxed and more contracted. In addition, these mice presented thickening of vascular wall (SMC layer), more fibrosis showing intense Sirius Red staining and less expression of elastin, all compatible with their vascular dysfunction compared to WT mice. Furthermore, aortas from KO-apoE mice showed a slight increase in fibronectin and collagen-I expression assessed by immunohistochemistry. In vivo studies were confirmed in vitro after treating SMC with oxLDL. oxLDL induced fibrosis in SMC by increasing TGF-β, fibronectin and collagen-I protein expressions evaluated by Western blot and immunofluorescence assays. Treatment with oxLDL also increased ROS production, which seem to be responsible of oxLDL-induced fibrosis in human SMC, as it was blocked in the presence of the antioxidant N-Acetyl-cysteine.

Conclusion

In summary, these results point to endothelial dysfunction associated to atherosclerosis (oxLDL) could be mediated by an increase in the development of vascular fibrosis where ROS could play an important role. Therefore, the endothelial dysfunction typical of CKD patients could impair with more vascular fibrosis when atherosclerosis is also present.