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Ambrogini E, Sato AY, Naves-Diaz M, Díaz-Tocados JM. Editorial: Pathophysiology of bone and mineral metabolism. Front Physiol 2024; 15:1383660. [PMID: 38465262 PMCID: PMC10921224 DOI: 10.3389/fphys.2024.1383660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 03/12/2024] Open
Affiliation(s)
- Elena Ambrogini
- John L. McClellan Memorial Veterans Hospital, Central Arkansas Veterans Healthcare System, Veterans Health Administration, United States Department of Veterans Affairs, Little Rock, AR, United States
- Center for Musculoskeletal Disease Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Amy Y. Sato
- Department of Physiology and Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Manuel Naves-Diaz
- Bone and Vascular Metabolism and Chronic Inflammatory Diseases, Health Research Institute of Asturias (ISPA), Oviedo, Spain
- Bone and Mineral Research Unit, Central University Hospital of Asturias, Oviedo, Spain
| | - Juan M. Díaz-Tocados
- Vascular and Renal Translational Research Group, Biomedical Research Institute of Lleida (IRBLleida), Lleida, Spain
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2
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Vergara N, de Mier MVPR, Rodelo-Haad C, Revilla-González G, Membrives C, Díaz-Tocados JM, Martínez-Moreno JM, Torralbo AI, Herencia C, Rodríguez-Ortiz ME, López-Baltanás R, Richards WG, Felsenfeld A, Almadén Y, Martin-Malo A, Ureña J, Santamaría R, Soriano S, Rodríguez M, Muñoz-Castañeda JR. The direct effect of fibroblast growth factor 23 on vascular smooth muscle cell phenotype and function. Nephrol Dial Transplant 2022; 38:322-343. [PMID: 35867864 PMCID: PMC9923714 DOI: 10.1093/ndt/gfac220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In chronic kidney disease (CKD) patients, increased levels of fibroblast growth factor 23 (FGF23) are associated with cardiovascular mortality. The relationship between FGF23 and heart hypertrophy has been documented, however, it is not known whether FGF23 has an effect on vasculature. Vascular smooth muscle cells VSMCs may exhibit different phenotypes; our hypothesis is that FGF23 favours a switch from a contractile to synthetic phenotype that may cause vascular dysfunction. Our objective was to determine whether FGF23 may directly control a change in VSMC phenotype. METHODS This study includes in vitro, in vivo and ex vivo experiments and evaluation of patients with CKD stages 2-3 studying a relationship between FGF23 and vascular dysfunction. RESULTS In vitro studies show that high levels of FGF23, by acting on its specific receptor FGFR1 and Erk1/2, causes a change in the phenotype of VSMCs from contractile to synthetic. This change is mediated by a downregulation of miR-221/222, which augments the expression of MAP3K2 and PAK1. miR-221/222 transfections recovered the contractile phenotype of VSMCs. Infusion of recombinant FGF23 to rats increased vascular wall thickness, with VSMCs showing a synthetic phenotype with a reduction of miR-221 expression. Ex-vivo studies on aortic rings demonstrate also that high FGF23 increases arterial stiffening. In CKD 2-3 patients, elevation of FGF23 was associated with increased pulse wave velocity and reduced plasma levels of miR-221/222. CONCLUSION In VSMCs, high levels of FGF23, through the downregulation of miR-221/222, causes a change to a synthetic phenotype. This change in VSMCs increases arterial stiffening and impairs vascular function, which might ultimately worsen cardiovascular disease.
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Affiliation(s)
| | | | | | - Gonzalo Revilla-González
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Departemento de Fisiología Médica y Biofísica, Sevilla, Spain
| | - Cristina Membrives
- Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain,University of Cordoba, Spain
| | - Juan M Díaz-Tocados
- Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain,University of Cordoba, Spain
| | - Julio M Martínez-Moreno
- Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain,University of Cordoba, Spain
| | - Ana I Torralbo
- Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain,University of Cordoba, Spain
| | - Carmen Herencia
- Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain,University of Cordoba, Spain
| | | | - Rodrigo López-Baltanás
- Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain,University of Cordoba, Spain
| | | | - Arnold Felsenfeld
- Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System and the David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Yolanda Almadén
- Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain,Internal Medicine Service, Reina Sofia University Hospital, Cordoba, Spain,Spanish Biomedical Research Networking Centre consortium for the area of Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Alejandro Martin-Malo
- Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain,University of Cordoba, Spain,Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain,Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain, and the European Uremic Toxins group
| | - Juan Ureña
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Departemento de Fisiología Médica y Biofísica, Sevilla, Spain
| | | | - Sagrario Soriano
- Maimonides Institute for Biomedical Research of Cordoba, Cordoba, Spain,University of Cordoba, Spain,Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain,Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain, and the European Uremic Toxins group
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3
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López-Baltanás R, Encarnación Rodríguez-Ortiz M, Canalejo A, Díaz-Tocados JM, Herencia C, Leiva-Cepas F, Torres-Peña JD, Ortíz-Morales A, Muñoz-Castañeda JR, Rodríguez M, Almadén Y. Magnesium supplementation reduces inflammation in rats with induced chronic kidney disease. Eur J Clin Invest 2021; 51:e13561. [PMID: 33870500 DOI: 10.1111/eci.13561] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/13/2021] [Accepted: 03/29/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Inflammation is a common feature in chronic kidney disease (CKD) that appears specifically associated with cardiovascular derangements in CKD patients. Observational studies have revealed a link between low Mg levels and inflammation. In this study, we hypothesize that Mg might have a modulatory effect on the inflammation induced under the uraemic milieu. METHODS In vivo studies were performed in a 5/6 nephrectomized rat model of CKD. Furthermore, a possible direct effect of Mg was addressed through in vitro studies with vascular smooth muscle cells (VSMCs). RESULTS Uraemic rats fed a normal (0.1%) Mg diet showed a systemic inflammatory response evidenced by the elevation in plasma of the pro-inflammatory cytokines TNF-α, IL-1β and IL-6, and GPx activity, a marker of oxidative stress. Importantly, an increased expression of these cytokines in the aortic tissue was also observed. In contrast, a dietary Mg supplementation (0.6%) greatly prevented the oxidative stress and the pro-inflammatory response. In vitro, in VSMCs cultured in a pro-inflammatory high phosphate medium, incubation with Mg 1.6 mM inhibited the increase in the production of ROS, the rise in the expression of TNF-α, IL-1β, IL-6 and IL-8 and the activation of NF-κB signalling that was observed in cells incubated with a normal (0.8 mM) Mg. CONCLUSION Mg supplementation reduced inflammation associated with CKD, exerting a direct effect on vascular cells. These findings support a possible beneficial effect of Mg supplementation along the clinical management of CKD patients.
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Affiliation(s)
- Rodrigo López-Baltanás
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain
| | - Maria Encarnación Rodríguez-Ortiz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain.,Red Nacional de Investigación en Nefrología (REDinREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Canalejo
- Department of Integrated Sciences/Research Center RENSMA, University of Huelva, Huelva, Spain
| | - Juan M Díaz-Tocados
- Biomedical Research Institute of Lleida (IRBLleida), Vascular and Renal Translational Research Group, Arnau de Vilanova University Hospital, Lleida, Spain.,Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Carmen Herencia
- Renal, Vascular and Diabetes Research Laboratory, Fundación Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz,, Universidad Autónoma de Madrid, Madrid, Spain
| | - Fernando Leiva-Cepas
- UGC de Anatomía Patología del Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain.,Departamento de Ciencias Morfológicas y Ciencias Sociosanitarias, Facultad de Medicina y Enfermería, Universidad de Córdoba, Córdoba, Spain
| | - José D Torres-Peña
- Lipid and Atherosclerosis Unit, Department of Internal Medicine, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain.,CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Ortíz-Morales
- Lipid and Atherosclerosis Unit, Department of Internal Medicine, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain.,CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Rafael Muñoz-Castañeda
- Red Nacional de Investigación en Nefrología (REDinREN), Instituto de Salud Carlos III, Madrid, Spain.,Instituto Maimonides de Investigacion Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Unidad de Gestión Clinica Nefrología, Córdoba, Spain
| | - Mariano Rodríguez
- Red Nacional de Investigación en Nefrología (REDinREN), Instituto de Salud Carlos III, Madrid, Spain.,Instituto Maimonides de Investigacion Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Unidad de Gestión Clinica Nefrología, Córdoba, Spain
| | - Yolanda Almadén
- CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Unidad de Gestión Clinica Medicina Interna, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain
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4
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Pendón-Ruiz de Mier MV, Rodelo-Haad C, Díaz-Tocados JM, Muñoz-Castañeda JR, Rodríguez M. Magnesium: An old player revisited in the context of CKD-MBD. Clin Chim Acta 2019; 501:53-59. [PMID: 31836501 DOI: 10.1016/j.cca.2019.11.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 12/18/2022]
Abstract
Chronic kidney disease (CKD) is associated with a wide number of abnormalities in mineral metabolism. Often, these alterations are the leading players in the development of comorbidities associated with CKD, which are risk factors of mortality. In this context, mineral and bone disorder associated with CKD (CKD-MBD) are highlighted, connecting bone, renal, and cardiovascular disorders. Many studies have been led to propose strategies to avoid, reduce, or slow down CKD-MBD progression using different compositions of metallic elements-based P binders such as aluminum, magnesium, or calcium. Magnesium, the aim of this review, has been used by nephrologists to treat CKD-MBD with a variable acceptation due mainly to different results on bone homeostasis. Nowadays, we have new evidence about the efficacy of magnesium supplementation on vascular calcification, renal function, and bone disorders, suggesting potential beneficial effects of Magnesium in the management of CKD-MBD.
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Affiliation(s)
- M V Pendón-Ruiz de Mier
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; University of Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
| | - C Rodelo-Haad
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; University of Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
| | - J M Díaz-Tocados
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; University of Cordoba, Spain
| | - J R Muñoz-Castañeda
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; University of Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain.
| | - M Rodríguez
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; University of Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
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5
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Díaz-Tocados JM, Rodríguez-Ortiz ME, Almadén Y, Pineda C, Martínez-Moreno JM, Herencia C, Vergara N, Pendón-Ruiz de Mier MV, Santamaría R, Rodelo-Haad C, Casado-Díaz A, Lorenzo V, Carvalho C, Frazão JM, Felsenfeld AJ, Richards WG, Aguilera-Tejero E, Rodríguez M, López I, Muñoz-Castañeda JR. Calcimimetics maintain bone turnover in uremic rats despite the concomitant decrease in parathyroid hormone concentration. Kidney Int 2019; 95:1064-1078. [PMID: 30878213 DOI: 10.1016/j.kint.2018.12.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/01/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022]
Abstract
Calcimimetics decrease parathyroid hormone (PTH) secretion in patients with secondary hyperparathyroidism. The decrease in PTH should cause a reduction in bone turnover; however, the direct effect of calcimimetics on bone cells, which express the calcium-sensing receptor (CaSR), has not been defined. In this study, we evaluated the direct bone effects of CaSR activation by a calcimimetic (AMG 641) in vitro and in vivo. To create a PTH "clamp," total parathyroidectomy was performed in rats with and without uremia induced by 5/6 nephrectomy, followed by a continuous subcutaneous infusion of PTH. Animals were then treated with either the calcimimetic or vehicle. Calcimimetic administration increased osteoblast number and osteoid volume in normal rats under a PTH clamp. In uremic rats, the elevated PTH concentration led to reduced bone volume and increased bone turnover, and calcimimetic administration decreased plasma PTH. In uremic rats exposed to PTH at 6-fold the usual replacement dose, calcimimetic administration increased osteoblast number, osteoid surface, and bone formation. A 9-fold higher dose of PTH caused an increase in bone turnover that was not altered by the administration of calcimimetic. In an osteosarcoma cell line, the calcimimetic induced Erk1/2 phosphorylation and the expression of osteoblast genes. The addition of a calcilytic resulted in the opposite effect. Moreover, the calcimimetic promoted the osteogenic differentiation and mineralization of human bone marrow mesenchymal stem cells in vitro. Thus, calcimimetic administration has a direct anabolic effect on bone that counteracts the decrease in PTH levels.
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Affiliation(s)
- Juan M Díaz-Tocados
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; University of Cordoba, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
| | - María E Rodríguez-Ortiz
- Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain; Laboratory of Nephrology, Health Research Institute-Jiménez Diaz Foundation, Madrid, Spain
| | - Yolanda Almadén
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Internal Medicine Service, Reina Sofia University Hospital, Cordoba, Spain; Spanish Biomedical Research Networking Centre Consortium for the Area of Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Carmen Pineda
- University of Cordoba, Cordoba, Spain; Department of Medicine and Animal Surgery, Cordoba, Spain
| | - Julio M Martínez-Moreno
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; University of Cordoba, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
| | - Carmen Herencia
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; University of Cordoba, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
| | - Noemi Vergara
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; University of Cordoba, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
| | - M Victoria Pendón-Ruiz de Mier
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; University of Cordoba, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
| | - Rafael Santamaría
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; University of Cordoba, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
| | - Cristian Rodelo-Haad
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; University of Cordoba, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
| | - Antonio Casado-Díaz
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; University of Cordoba, Cordoba, Spain; Clinical Management Unit for Endocrinology and Nutrition, Reina Sofia University Hospital, Cordoba, Spain; Network for Cooperative Research on Aging and Fragility (RETICEF) & Spanish Biomedical Research Networking Centre Consortium for the Area of Frailty and Healthy Aging (CIBERFES), Institute of Health Carlos III, Madrid, Spain
| | - Víctor Lorenzo
- University Hospital of Tenerife, Nephrology Service, Canary Islands, Spain
| | - Catarina Carvalho
- Braga Hospital, Department of Nephrology, Braga, Portugal; Institute of Investigation and Innovation in Health (I3S), University of Porto, Porto, Portugal; National Institute of Biomedical Engineering (INEB), University of Porto, Porto, Portugal
| | - João M Frazão
- Institute of Investigation and Innovation in Health (I3S), University of Porto, Porto, Portugal; National Institute of Biomedical Engineering (INEB), University of Porto, Porto, Portugal; Department of Nephrology, São João Hospital Center, Porto, Portugal
| | - Arnold J Felsenfeld
- Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System and the David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | | | | | - Mariano Rodríguez
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; University of Cordoba, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain.
| | - Ignacio López
- University of Cordoba, Cordoba, Spain; Department of Medicine and Animal Surgery, Cordoba, Spain
| | - Juan R Muñoz-Castañeda
- Maimonides Institute for Biomedical Research (IMIBIC), Cordoba, Spain; Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain; University of Cordoba, Cordoba, Spain; Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain
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6
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Santamaría R, Díaz-Tocados JM, Pendón-Ruiz de Mier MV, Robles A, Salmerón-Rodríguez MD, Ruiz E, Vergara N, Aguilera-Tejero E, Raya A, Ortega R, Felsenfeld A, Muñoz-Castañeda JR, Martín-Malo A, Aljama P, Rodríguez M. Increased Phosphaturia Accelerates The Decline in Renal Function: A Search for Mechanisms. Sci Rep 2018; 8:13701. [PMID: 30209259 PMCID: PMC6135842 DOI: 10.1038/s41598-018-32065-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 08/20/2018] [Indexed: 12/28/2022] Open
Abstract
In chronic kidney disease (CKD), high serum phosphate concentration is associated with cardiovascular disease and deterioration in renal function. In early CKD, the serum phosphate concentration is normal due to increased fractional excretion of phosphate. Our premise was that high phosphate intake even in patients with early CKD would result in an excessive load of phosphate causing tubular injury and accelerating renal function deterioration. In CKD 2–3 patients, we evaluated whether increased phosphaturia accelerates CKD progression. To have a uniform group of patients with early CKD, 95 patients with metabolic syndrome without overt proteinuria were followed for 2.7 ± 1.6 years. The median decline in eGFR was 0.50 ml/min/1.73 m2/year. Patients with a more rapid decrease in eGFR had greater phosphaturia. Moreover, the rate of decrease in eGFR inversely correlated with the degree of phosphaturia. Additionally, phosphaturia independently predicted renal function deterioration. In heminephrectomized rats, a high phosphate diet increased phosphaturia resulting in renal tubular damage associated with inflammation, oxidative stress and low klotho expression. Moreover, in rats with hyperphosphatemia and metabolic syndrome antioxidant treatment resulted in attenuation of renal lesions. In HEK-293 cells, high phosphate promoted oxidative stress while melatonin administration reduced ROS generation. Our findings suggest that phosphate loading in early CKD, results in renal damage and a more rapid decrease in renal function due to renal tubular injury.
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Affiliation(s)
- Rafael Santamaría
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain.,Red de Investigación Renal (RedInRen), Instituto de Salud Carlos III (ISCIII) and EUTOX, Madrid, Spain
| | - Juan M Díaz-Tocados
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain
| | - M Victoria Pendón-Ruiz de Mier
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain
| | - Ana Robles
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain
| | - M Dolores Salmerón-Rodríguez
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain
| | - Erena Ruiz
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain
| | - Noemi Vergara
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain
| | - Escolástico Aguilera-Tejero
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain
| | - Ana Raya
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain
| | - Rosa Ortega
- Pathology Department, Reina Sofia University Hospital, Cordoba, Spain
| | - Arnold Felsenfeld
- Nephrology Service, West Los Angeles VA, UCLA Los Angeles, Los Angeles, USA
| | - Juan R Muñoz-Castañeda
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain. .,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain. .,University of Cordoba, Cordoba, Spain.
| | - Alejandro Martín-Malo
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain.,Red de Investigación Renal (RedInRen), Instituto de Salud Carlos III (ISCIII) and EUTOX, Madrid, Spain
| | - Pedro Aljama
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain.,Red de Investigación Renal (RedInRen), Instituto de Salud Carlos III (ISCIII) and EUTOX, Madrid, Spain
| | - Mariano Rodríguez
- Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Research Unit, Cordoba, Spain.,University of Cordoba, Cordoba, Spain.,Red de Investigación Renal (RedInRen), Instituto de Salud Carlos III (ISCIII) and EUTOX, Madrid, Spain
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7
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Herencia C, Rodríguez-Ortiz ME, Muñoz-Castañeda JR, Martinez-Moreno JM, Canalejo R, Montes de Oca A, Díaz-Tocados JM, Peralbo-Santaella E, Marín C, Canalejo A, Rodriguez M, Almaden Y. Angiotensin II prevents calcification in vascular smooth muscle cells by enhancing magnesium influx. Eur J Clin Invest 2015; 45:1129-44. [PMID: 26268950 DOI: 10.1111/eci.12517] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 08/08/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Vascular calcification (VC) is highly prevalent in patients with chronic kidney disease (CKD). Low magnesium levels are associated with VC, and recent in vitro studies confirm a protective role of magnesium, which is mediated by its entry into the VSMCs through the Transient Receptor Potential Melastatin 7 (TRPM7) channel. The role of Angiotensin II (Ang II) on VC is still unclear. As Ang II is able to stimulate TRPM7 activity, we hypothesize that it might prevent VC. Thus, the aim of this study was to dissect the direct effect of Ang II on VC. MATERIALS AND METHODS We worked with a model of high phosphate (HP)-induced calcification in human aortic smooth muscle cells, which resembles the CKD-related VC. RESULTS Addition of Ang II to cells growing in HP decreased calcification, which was associated with the upregulation of the osteogenic factors BMP2, Runx2/Cbfa1, Osterix and ALP. A reduction of magnesium entry into the HP-calcifying cells was found. The treatment with Ang II avoided this reduction, which was reversed by the cotreatment with the TRPM7-inhibitor 2-APB. The protective effect of Ang II was related to AT1R-induced ERK1/2 MAPKinase activation. HP-induced calcification was also associated with the upregulation of the canonical Wnt/beta-catenin pathway, while its downregulation was related to attenuation of calcification by Ang II. CONCLUSION As hypothesized, Ang II prevented phosphate-induced calcification in VSMCs, which appears mediated by the increase of magnesium influx and by the activation of the ERK1/2 and the inhibition of the canonical Wnt/beta-catenin signalling pathways.
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Affiliation(s)
- Carmen Herencia
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain
| | | | - Juan R Muñoz-Castañeda
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain
| | - Julio Manuel Martinez-Moreno
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain
| | - Rocío Canalejo
- Department of Environmental Biology and Public Health, University of Huelva, Huelva, Spain
| | - Addy Montes de Oca
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain
| | - Juan M Díaz-Tocados
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain
| | - Esther Peralbo-Santaella
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain
| | - Carmen Marín
- Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain
- CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Cordoba, Spain
| | - Antonio Canalejo
- Department of Environmental Biology and Public Health, University of Huelva, Huelva, Spain
| | - Mariano Rodriguez
- REDinREN, Madrid, Spain
- Nefrology Service, Instituto Maimonides de Investigacion Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain
| | - Yolanda Almaden
- Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain
- CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Cordoba, Spain
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