糖尿病大鼠肾小管整合素连接激酶的表达及氯沙坦的干预作用

目的：观察糖尿病大鼠肾小管上皮细胞整合素连接激酶（ILK）的表达以及氯沙坦对其的影响。方法：雄性Wistar大鼠腹腔内注射链脲佐菌素（STZ）诱导糖尿病模型,随机分为模型组和氯沙坦组;另设正常组腹腔注射缓冲液。第8周、第16周测24h尿蛋白定量和血肌酐,处死大鼠,取肾组织行HE、Masson染色,观察肾脏病理改变;免疫组化法检测大鼠肾小管上皮细胞ILK、TGF-β1的表达。结果：模型组大鼠肾小管上皮细胞胞浆ILK表达增高,与小管间质病变程度一致;同时TGF-β1表达亦增高,并与ILK表达呈正相关性。氯沙坦组大鼠尿蛋白较模型组明显减少,肾小管间质病变减轻,肾小管上皮细胞ILK、TGF-β1表达明显减弱。结论：糖尿病大鼠肾小管上皮细胞存在有ILK的高表达,ILK的表达强度与肾小管间质损伤程度相一致,并与TGF-β1的表达呈正相关;氯沙坦能下调肾小管上皮细胞ILK的表达。     

血管生成素及其受体Tie2在大龄GK大鼠肾皮质中的表达及意义

目的：研究血管生成素（Angiopoietins）及其受体Tie2在大龄GK大鼠肾皮质中的表达及其意义。方法：自发性糖尿病动物（Goto—Kakizaki，GK）大鼠（GK组），在52周时取肾皮质进行病理切片，光镜检查；电镜观察超微结构改变；Re—alt—time RT—PCR和免疫组化法检测大鼠肾皮质血管生成素Ⅰ（Angiopoietin Ⅰ，Ang Ⅰ）、血管生成素Ⅱ（AngiopoietinⅡ，AngⅡ）、血管生成素受体Tie2和血管内皮生长因子（vascular endothelial growth factor，VEGF）mRNA和蛋白质的表达。并与链脲佐菌素（streptozocin，STZ）诱导的糖尿病大鼠（DM组）及正常SD大鼠（SD组）肾皮质进行比较。将Ang Ⅰ、AngⅡ、Tie2和VEGF与肾小球体积和肾小球细胞外基质（ECM）做相关性分析。结果：与SD组比较，GK组大鼠光镜下无病理改变；而DM组大鼠出现肾小球肥大和系膜基质增生；电镜下观察到GK组大鼠肾小球基底膜增厚。Real—time RT—PCR结果显示GK组肾皮质AngI、AngⅡ、Tie2、VEGFmRNA表达与SD对照组比较无统计学差异（P〉0．05）；而其AngⅡ和VEGF mRNA表达较DM组显著性减少（P〈0.05）。免疫组化半定量分析结果显示，GK组大鼠与SD组相比其肾皮质Ang Ⅰ表达显著性增高（P〈0．05），而AngⅡ、Tie2和VEGF的表达无统计学差异。AngⅡ、Tie2和VEGF与肾小球体积呈显著正相关，VEGF与肾小球ECM呈显著正相关。结论：大龄GK大鼠仅有轻微早期糖尿病肾脏改变，Ang Ⅰ表达增高可能是GK大鼠不易发生严重糖尿病肾损害的原因之一，AngⅡ和VEGF可能参与了糖尿病肾病的发病，其机制可能是通过促进血管增生和ECM增多。     

洛沙坦对糖尿病大鼠肾脏炎症反应及足细胞损伤的影响

目的 探讨洛沙坦对糖尿病大鼠模型肾组织炎症反应及足细胞损伤的影响。方法 Wistar大鼠随机分为3组：对照组（NC）、糖尿病组（DM）、洛沙坦治疗组（DL）。链脲菌素（STZ）注射建立糖尿病动物模型，洛沙坦治疗组在大鼠建立糖尿病同时即开始以洛沙坦（20mg·kg·d^-1）灌胃治疗。分别于2周和12周杀鼠，观察体重、肾重、肾重／体重指数、尿蛋白量（24h）、Scr、Ccr以及肾组织病理改变；免疫组化染色观察肾小球细胞间黏附分子（ICAM-1）、白细胞共同抗原（CD45）、nephrin、血管内皮生长因子（VEGF）表达的改变；免疫印迹观察肾组织nephrin、VEGF表达的改变。结果 （1）DL组大鼠肾重／体重指数、尿蛋白量（24h）、Ccr则均低于DM组，差异均有统计学意义（P均〈0．05），其病理改变程度也比DM组轻。（2）免疫组化及免疫印迹显示，DM组和DL组肾小球ICAM-1、CD45、VEGF表达均高于对照组，而DL组ICAM-1、CD45、VEGF表达均低于DM组；DM组和DL组大鼠肾小球nephrin表达低于对照组；DL组肾小球nephrin表达高于DM组，差异均有统计学意义（P均〈0．01）。结论 洛沙坦可能通过抑制肾组织白细胞浸润、炎症反应及减轻足细胞损伤，达到肾脏保护作用。     

厄贝沙坦联合雷公藤甲素对2型糖尿病大鼠肾脏ANGPTL2、VEGF表达影响

目的：观察厄贝沙坦联合雷公藤甲素（TP）对ANGPTL2、VEGF在2型糖尿病（T2DM）大鼠肾脏表达的影响并探讨其机制.方法：50只SD雄性大鼠随机分为正常对照组（NC,10只）和实验组（40只）,实验组给予高糖高脂喂养联合小剂量链脲佐菌素（STZ 30 mg/kg）建立T2DM大鼠模型,再随机分为4组：糖尿病对照组（DM）、厄贝沙坦组（DI）、雷公藤甲素组（DT）及厄贝沙坦联合雷公藤甲素组（DIT）.药物干预8周后,测体重、血压、肾重、血糖、血肌酐（Scr）、尿素氮（BUN）,24 h尿蛋白（UAL）的排泄量;镜下观察肾组织病理改变;免疫组化显色技术及实时定量PCR检测血管生成素样蛋白2（ANGPTL2）、血管内皮生长因子（VEGF）表达的变化.结果：DM组与NC组相比血糖、肌酐、BUN及UAL明显升高（P〈0.01）,实时定量PCR示ANGPTL2、VEGF mRNA 明显上调（P〈0.01 ）;与DM组相比较,DT、DI及DIT组血糖、肌酐、BUN及UAL明显降低（P＜0.01）,DT、DI组中ANGPTL2、VEGF mRNA表达下调,DIT组更为明显（P〈0.05）.结论：ANGPTL2、VEGF在T2DM大鼠肾脏中的表达上调,厄贝沙坦及雷公藤甲素可降低ANGPTL2及VEGF在T2DM大鼠肾脏中的表达,并有协同作用.     

血管内皮生长因子及其受体对糖尿病肾病大鼠微血管病变的作用

目的：探讨血管内皮生长因子（VEGF）及其受体（VEGFR2）在糖尿病肾病（DN）大鼠肾微血管病变发病中的作用。方法：将正常Wistar大鼠12只随机分为正常对照组、糖尿病肾病组。糖尿病肾病组用STZ诱导建立DN模型,大鼠自由进食、饮水。于第4周和第8周各组分别处死大鼠6只。测定血生化及24h尿蛋白定量,以正常肾小球为对照,采用特异性抗体和免疫组织化学方法,观察大鼠肾小球VEGF、VEGFR2、TM-1的分布及其强度变化,并结合肾脏病理进行分析。应用RT-PCR技术测定VEGF和VEGFR2mRNA的表达。结果：（1）糖尿病肾病组第4周,8周时,尿白蛋白排泄率,血糖,血脂升高,均高于正常对照组（P〈0.01）,肾组织光镜,出现早期糖尿病肾病典型的病理改变过程。（2）免疫组化显示糖尿病组4周、8周时肾脏VEGF、VEGFR2及TM-1表达均较正常对照组上调（P〈0.01）,VEGF与TM-1呈正相关（4周时r=0.947,P〈0.001;8周时r=0.923,P〈0.001）;RT-PCR检测结果显示糖尿病肾病组第8周时VEGF-mRNA和VEGFR2-mRNA表达均较正常对照组升高（P〈0.05）,第8周时VEGF-mRNA和VEGFR2-mRNA表达较第4周时增高（P〈0.05）。结论：糖尿病肾病大鼠肾小球VEGF、VEGFR2、TM-1表达增强,与糖尿病肾脏新生血管生成有关。     

蝉花菌丝对糖尿病肾病大鼠的肾脏保护作用机制研究

目的：观察蝉花菌丝对糖尿病肾病（DN）大鼠肾小管沉默信息调节因子2相关酶1（SIRT1）表达及肾小管损伤的影响,探讨蝉花菌丝延缓 DN 进展的作用机制。方法：链脲佐菌素（STZ）诱导大鼠高血糖,糖尿病所致肾损伤的大鼠模型（DN）与正常大鼠一起随机分为4组：对照组、蝉花组、DN 组、DN ＋蝉花组,饲养24周。观察 DN 大鼠肾间质α- SMA、SIRT1表达及纤维化程度,检测血肌酐（Scr）、尿素氮（BUN）、尿白蛋白、24 h 尿蛋白、尿白蛋白肌酐比（UACR）、肌酐清除率（Ccr）、肾脏指数。结果：DN 大鼠肾小管 SIRT1表达显著下降,α- SMA 表达明显上调,肾小管纤维化加速,BUN、尿白蛋白、尿白蛋白排泄率、24 h 尿蛋白等均显著增加;蝉花菌丝治疗能显著提高 DN 大鼠肾小管 SIRT1表达,延缓肾小管纤维化进程,降低 BUN、尿白蛋白、尿蛋白及尿白蛋白肌酐比;蝉花菌丝对非糖尿病大鼠上述指标无显著影响。结论：蝉花菌丝可改善DN 肾小管病理损伤、延缓 DN 进展,从而发挥肾脏保护作用,其机制可能与上调肾小管 SIRT1表达有关。     

NF-κB抑制剂对糖尿病大鼠肾组织ICAM-1和VEGF表达的影响

目的观察核因子-κB（NF-κB）抑制剂吡咯烷二硫基甲酸酯（PDTC）对糖尿病大鼠肾组织细胞间黏附分子-1（ICAM-1）和血管内皮生长因子（VEGF）表达的影响。方法将30只雄性Wistar大鼠随机分成正常对照组（NC组）、糖尿病模型组（DM组）和PDTC干预组（DP组）,每组10只。用链脲佐菌素腹腔注射诱导糖尿病大鼠模型。第8周末,收集24h尿液,检测各组大鼠尿微量白蛋白,处死大鼠后收集肾组织,使用免疫组织化学方法测定肾组织NF-κB、ICAM-1和VEGF的蛋白表达。结果①与NC组相比,DM组尿微量白蛋白升高,差异有统计学意义（P〈0．05）;与DM组相比,DP组尿微量白蛋白降低,差异有统计学意义（P〈0．05）。②与NC组相比,DM组肾组织NF-κB、ICAM1和VEGF蛋白表达升高,差异均有统计学意义（P〈0．05）;与DM组相比,DP组肾组织NF-κB、ICAM-1和VEGF蛋白表达降低,差异均有统计学意义（P〈0．05）。结论肾组织局部表达的ICAM-1和VEGF可能通过NF-κB途径参与糖尿病肾脏病的发生发展。     

黄芪对糖尿病肾病大鼠肾间质Wnt/β-catenin及TGF-β_1信号通路表达的影响

目的：观察黄芪（AM）对糖尿病肾病（DN）大鼠肾间质中Wnt/β-catenin信号通路及转化生长因子-β1（TGF-β1）表达情况的影响,探讨其抗糖尿病肾病肾间质纤维化的作用机制。方法：采用单次空腹腹腔注射60mg/kg链脲佐菌素（STZ）制备糖尿病大鼠模型。4周后测定24h尿蛋白排泄量,以24h尿蛋白定量≥30mg确定DN大鼠模型成功（n=48）。48只DN大鼠随机分为4组：DN模型组（DN组）、黄芪治疗组（DA组）、DN模型组＋氯沙坦治疗组（DL组）、DN模型组＋黄芪联合氯沙坦治疗组（AL组）,每组12只。选取12只健康雄性wistar大鼠作为正常对照组（N组）。连续给药12周后,记录大鼠体重,并检测血清尿素氮（BUN）、肌酐（Scr）及24h尿蛋白定量;处死大鼠,留取肾组织行HE及Masson染色观察肾间质病理改变,采用免疫组织化学技术及实时荧光定量PCR（FQ-PCR）检测肾间质中Wnt4、β-catenin及TGF-β1蛋白及mRNA的表达。结果：与N组比较,12周末DN组大鼠24h尿蛋白定量、血清BUN、Scr水平明显增高,差异有统计学意义（P〉0.05）。与N组比较,12周末DN组、DA组、DL组和AL组肾间质Wnt4、β-catenin及TGF-β1蛋白表达量明显增加（P〈0.05）。DA组、DL组和AL组作两两比较,AL组24h尿蛋白定量、血清BUN、Scr、Wnt4、β-catenin及TGF-β1下降更为明显,差异有统计学意义（P〈0.05）。DA组与DL组相比各指标差异无统计学意义（P〉0.05）。FQ-PCR结果显示wnt4、β-catenin和TGF-β1mRNA在各组大鼠肾组织中的表达与Wnt4、β-catenin及TGF-β1蛋白表达趋势一致。结论：黄芪可以降低24h尿蛋白定量,减轻肾间质病理损伤,下调wnt4、β-catenin及TGF-β1在肾间质中的表达,提示黄芪可能通过下调Wnt4、β-catenin及TGF-β1在肾间质中的表达,延缓DN大鼠肾间质纤维化的进程,而发挥肾脏保护作用。     

替米沙坦对糖尿病大鼠肾小管间质的保护作用

目的观察替米沙坦对1型糖尿病大鼠肾小管间质损伤的影响，并探讨其可能的机制。方法将雄性SD大鼠随机分为正常对照组和糖尿病组，后者经链脲佐菌素（STZ）诱导制作糖尿病模型成功后再将其随机分为糖尿病模型组和替米沙坦干预组。8周后检测各组大鼠24h尿蛋白、血肌酐、血糖、内生肌酐清除率；留取肾组织行HE和Masson染色，对肾小管间质损伤行半定量评分；免疫组化检测肾小管间质MMP-2及α-SMA表达。结果①与对照组相比，糖尿病模型组大鼠24h尿蛋白、肾小管间质损伤指数明显增加，肾小管间质MMP-2及α-SMA表达均显著增加，差异有统计学意义（P〈0．01）；②与糖尿病模型组相比，替米沙坦组大鼠24h尿蛋白、肾小管间质损伤程度减轻，肾小管间质MMP-2及α-SMA表达显著下降，差异有统计学意义（P〈0．01）。结论替米沙坦对糖尿病肾小管间质病变有保护作用，机制可能与其下调肾小管间质MMP-2表达、抑制肾小管上皮-肌成纤维细胞的转分化有关。     

福辛普利对糖尿病大鼠肾脏NADPH氧化酶p22phox亚基mRNA表达的影响

目的 观察福辛普利对链脲佐菌素(STZ)诱导的糖尿病大鼠肾脏还原型辅酶Ⅱ(NADPH)氧化酶p22phox 亚基mRNA表达及细胞外基质（ECM）聚积的影响，并探讨其可能机制。 方法 STZ诱导的糖尿病大鼠模型，随机分为糖尿病非治疗组（DM组）和福辛普利治疗组（DM+Fosin组，福辛普利10 mg·kg-1·d-1），疗程12周。RT-PCR法检测肾脏NADPH氧化酶p22phox mRNA的表达；免疫组织化学方法检测肾脏纤连蛋白（FN）表达；白明胶酶谱法检测肾脏基质金属蛋白酶9（MMP-9）的活性；并检测Scr、尿蛋白排泄量和肾质量指数等指标。 结果 实验第4 周，DM+Fosin组大鼠肾脏NADPH氧化酶p22phox mRNA表达较DM组减少45％（P ＜ 0.05）。第8周时，DM+Fosin组的肾小球和肾小管间质FN表达较DM组分别降低52.5％和42.9％（均P ＜ 0.05）；肾脏MMP-9的活性升高29.6％（P ＜ 0.05）。实验第12周时，DM+Fosin组大鼠Scr水平、尿蛋白量（24 h）和肾质量指数较DM组分别降低35.9％、50.2％和17.2％（均P ＜ 0.05）。DM+Fosin组和DM组血糖的差异无统计学意义（P ＞ 0.05）。 结论 福辛普利可延缓糖尿病肾病的发生和发展，其机制可能与通过抑制NADPH氧化酶p22phox亚基mRNA的表达有关。     

Vascular endothelial growth factor expression in human chronic renal allograft rejection

BACKGROUND: Chronic renal allograft rejection is characterized by interstitial fibrosis and vasculopathy. Vascular endothelial growth factor (VEGF) is an endothelial mitogen with increased expression in inflammation and vasculopathy. METHODS: Renal tissue from 17 patients with chronic rejection was examined for VEGF protein and the presence of CD 68-positive macrophages, and compared to biopsies from patients with temporary allograft dysfunction, acute rejection, and native kidneys with thin membrane disease. RESULTS: In the chronic rejection group, there was markedly increased expression of VEGF protein in the interstitium (P<0.0001). In serial sections, VEGF colocalized with the expression of CD 68-positive macrophages. Significantly more macrophages were in the tubulointerstitium in tissue with chronic rejection than in those with temporary allograft dysfunction (P<0.005). Additionally, VEGF protein expression in the glomeruli and the vascular compartment of patients with chronic rejection was increased. CONCLUSION: The up-regulation of VEGF in chronic renal allograft rejection may be important in inflammation and development of fibrosis.     

Fluorofenidone reduces renal fibrosis in diabetic kidney disease mice

Objective To investigate the effects of fluorofenidone (AKF-PD) on diabetic kidney disease in db/db mice and its possible mechanisms. Methods (1) Fifty-six mice aged 8 weeks (half male and half female), including 42 db/db mice and 14 wild-type mice were studied. Forty-two db/db mice randomly were divided into model group (mock-treated diabetic db/db mice), AKF-PD (250 mg?kg-1?d-1) treatment group and losartan (20 mg?kg-1?d-1) treatment group. Wild-type mice and model mice were treated with vehicle (0.5% sodium carboxymethylcellulose), while the treatment groups received either AKF-PD or losartan. After 18 weeks, the blood glucose and urinary albumin were measured, the pathological changes of kidney were observed by PAS staining. The protein expressions of type Ⅳ collagen and fibronectin (FN) in kidney tissue were detected by immunohistochemistry. (2) Mouse glomerular mesangial cells (MES-13 cells) were divided into six groups: normal glucose group (5.5 mmol/L glucose), hypertonic group (5.5 mmol/L glucose+19.5 mmol/L mannitol), high glucose group (25.0 mmol/L glucose), AKF-PD group (25.0 mmol/L glucose+400 mg/L AKF-PD) and losartan group (25.0 mmol/L glucose+2 μmol/L losartan). After 72 h treatment, the expressions of type Ⅰ collagen, type Ⅳ collagen and transforming growth factor-β1 (TGF-β1) mRNA were detected by real-time PCR, and the content of TGF-β1 protein in the culture supernatant was detected by ELISA. Results (1) Compared with the wild type mice, model mice had increased weight, blood glucose and glomerulosclerosis index (all P＜0.01), accompanied with heavy albuminuria, glomerular hypertrophy, mesangial area expansion and deposition of collagen type Ⅳ and FN (all P＜0.01). Compared with model mice, in AKF-PD and losartan groups 24 h urinary albumin and glomerulosclerosis index decreased (all P＜0.01), glomerular hypertrophy and mesangial area expansion alleviated, and the protein expressions of collagen type Ⅳ and FN were inhibited (all P＜0.01). (2) Compared with the normal glucose group, the mRNA expressions of type Ⅰ collagen and type Ⅳ collagen increased in high glucose group, meanwhile the mRNA and protein expressions of TGF-β1 increased (all P＜0.01). In AKF-PD and losartan groups the expressions of type Ⅰ collagen, type Ⅳ collagen and TGF-β1 were inhibited as compared with high glucose group (all P＜0.05). Conclusion Fluorofenidone may play an anti-fibrotic effect in db/db mice by reducing the expression of TGF-β1 and inhibiting collagen synthesis in glomerular mesangial cells.     

Vascular endothelial growth factor gene therapy with intramuscular injections of plasmid DNA enhances the survival of random pattern flaps in a rat model.

The objective of this study was to determine the effects of the naked plasmid DNA encoding vascular endothelial growth factor (VEGF) on the survival of random flaps on rats. Thirty Sprague-Dawley rats whose random flaps were elevated on the back were randomised into three groups of 10 animals each. In the experimental group, the naked plasmid DNA encoding VEGF was injected directly into the panniculus carnosus of the flap. In the two control groups, either control plasmid DNA or physiologic saline was injected. After 7 days, the flaps were evaluated with the following devices: RT-PCR for the expression of VEGF gene, immunohistochemistry for the expression of VEGF protein, histology for vascular density, single photon emission computerised tomography for RBC in the flap, and image analysis for flap survival area. Notably increased expressions of VEGF mRNA and VEGF protein were found in the treatment group. Vascular density was markedly more increased in the treatment group than those in the two control groups (P < 0.01). Compared with the two control groups, the flap treated with VEGF plasmid DNA showed a more significantly enhanced tissue viability: 87 +/- 5 versus 47 +/- 6% for the control plasmid DNA group and 46 +/- 5% for the saline group (P < 0.01). Our results indicated that the VEGF gene therapy was able to enhance the survival of random pattern flaps by inducing angiogenesis.     

Aminoguanidine ameliorates overexpression of prosclerotic growth factors and collagen deposition in experimental diabetic nephropathy

Profibrotic cytokines and the formation of advanced-glycation end products (AGE) have both been implicated in the pathogenesis of glomerulosclerosis in diabetic kidney disease. However, tubulointerstitial pathology is also an important determinant of progressive renal dysfunction in diabetic nephropathy. This study sought to investigate the expression of profibrotic growth factors and matrix deposition in the glomerulus and the tubulointerstitium and to examine the effect of blocking AGE formation in experimental diabetic nephropathy. Thirty-six male Sprague-Dawley rats were randomized into control and diabetic groups. Diabetes was induced in 24 rats by streptozotocin. Twelve diabetic rats were further randomized to receive the inhibitor of AGE formation, aminoguanidine (1 g/l drinking water). At 6 mo, experimental diabetes was associated with a three-fold increase in expression of transforming growth factor (TGF)-beta1 (P < 0.01 versus control) and five-fold increase in platelet-derived growth factor (PDGF)-B gene expression (P < 0.01 versus control) in the tubulointerstitium. In situ hybridization demonstrated a diffuse increase in both TGF-beta1 and PDGF-B mRNA in renal tubules. Aminoguanidine attenuated not only the overexpression of TGF-beta1 and PDGF-B but also reduced type IV collagen deposition in diabetic rats (P < 0.05). TGF-beta1 and PDGF mRNA within glomeruli were also similarly increased with diabetes and attenuated with aminoguanidine. The observed beneficial effects of aminoguanidine on the tubulointerstitium in experimental diabetes suggest that AGE-mediated expression of profibrotic cytokines may contribute to tubulointerstitial injury and the pathogenesis of diabetic nephropathy.     

糖尿病肾病大鼠肾组织α-actinin-4表达及通络泄浊方的干预作用

目的：探讨α-actinin-4在糖尿病肾病大鼠肾组织中表达的变化,并观察通络泄浊方对其表达的影响。方法：采用链脲佐菌素（STZ）法制作大鼠模型,随机分为正常对照组、模型组、通络泄浊方组、科素亚组和通络泄浊方＋科素亚组。采用Realtime-PCR及Westernblot方法检测肾组织α-actinin-4mRNA和蛋白的表达。结果：与正常对照组相比,模型组mRNA表达和蛋白明显降低（P〈0.01）,给药组与模型组相比,mRNA和蛋白表达明显增高（P〈0.01）。结论：α-acti-nin-4的表达降低参与了糖尿病肾病大鼠蛋白尿的发生;通络泄浊方可以通过上调DN大鼠肾组织α-actinin-4mRNA和蛋白的表达而改善大鼠的肾功能及蛋白尿水平。     

辛伐他汀对糖尿病肾病大鼠肾小管间质CTGF、β-catenin表达的影响

目的:观察辛伐他汀对糖尿病肾病(DN)大鼠肾小管间质结缔组织生长因子(connective tissue growth factor,CTGF)、β-连环蛋白(β-catenin)表达的影响。方法:将30只Wistar雄性大鼠随机分为正常对照组(N)、DN模型组(DN)、DN模型+辛伐他汀治疗组(DS)三组。利用腹腔注射链脲佐菌素建立DN大鼠模型;模型建立后,第4周、8周、12周,记录大鼠体重、检测血糖、测量24 h尿蛋白定量;12周末处死大鼠,检测血肌酐(Scr)、尿素氮(BUN)、胆固醇(TC);取大鼠肾组织行HE染色,进行病理组织学观察;用免疫组化法检测肾小管间质中CTGF及β-catenin的表达;采用实时荧光定量PCR技术检测肾组织中CTGF及β-catenin基因mRNA的表达。结果:实验12周末,与DN模型组比较,DS组大鼠24 h尿蛋白定量、Scr、BUN显著降低(P<0.05);肾组织病理改变减轻,免疫组化和实时荧光定量PCR结果均显示,肾小管间质CTGF、β-catenin的表达明显下调(P<0.05)。结论:辛伐他汀可同时下调糖尿病肾病大鼠肾小管间质CTGF及β-catenin的表达,降低蛋白尿,保护肾脏功能。提示辛伐他汀可能通过调节CTGF和Wnt/β-catenin信号通路的表达,发挥其延缓肾小管间质纤维化的作用。     

Modulation of vascular endothelial growth factor and mitogen‐activated protein kinase‐related pathway involved in extracorporeal shockwave therapy accelerate diabetic wound healing

Extracorporeal shockwave therapy (ESWT) has a significant positive effect to accelerate chronic wound healing. This study investigated whether the vascular endothelial growth factor (VEGF)–related pathway has involved in ESWT enhancement of diabetic wound healing. A dorsal skin defect (area, 6 × 5 cm) in a streptozotocin‐induced diabetes rodent model was used. Thirty‐two male Wistar rats were divided into four groups. Group I consisted of nondiabetic control; group II, diabetic control without treatment; group III, diabetic rats received ESWT; and group IV, rats received Avastin (a VEGF monoclonal antibody) on day 0 (post‐wounding immediately) to day 7 and ESWT on day 3 and day 7. The wound healing was assessed clinically. The VEGF, endothelial nitric oxide synthase (eNOS), and Ki‐67 were analyzed with immunohistochemical staining. The mRNA expression of mitogen‐activated protein kinase–related genes was measured by real‐time quantitative real‐time polymerase chain reaction. The results revealed wound size was significantly reduced in the ESWT‐treated rats as compared to the diabetic control (p < 0.01). The positive effect of ESWT‐increasing wound healing was significantly suppressed in pretreatment of the Avastin group. Histological findings revealed significant increase in neo‐vessels in the ESWT group as compared to the control. In immunohistochemical stain, significant increases in VEGF, eNOS, and Ki‐67 expressions were noted in the ESWT group as compared to that in controls. However, Avastin suppressed the shockwave effect and down‐regulation of VEGF, eNOS, and Ki‐67 expressions in the Avastin‐ESWT group as compared to that in the ESWT alone group. We found that highly mRNA expression of Kras, Raf1, Mek1, Jnkk, Jnk, and Jun at early stage in the ESWT group, as compared to the diabetic control. These evidences indicated treatment with multiple sessions of ESWT significantly enhanced diabetic wound healing associated with increased neovascularization and tissue regeneration. The bio‐mechanism of ESWT‐enhanced wound healing is correlated with VEGF and mitogen‐activated protein kinase–mediated pathway.