肾毒宁冲剂对慢性肾衰竭大鼠肾组织TGF-β1和CTGF的影响

目的：观察肾毒宁冲剂对5/6肾切除慢性肾衰竭（CRF）大鼠肾组织转化生长因子-β1（TGF-β1）、结缔组织生长因子（CTGF）的影响。方法：取雄性SD大鼠,通过Platt法5/6肾切除制作CRF模型,术后2周行大鼠断尾采血,测定血清肌酐（Scr）、尿素氮（BUN）值,根据Scr随机分为模型组、尿毒清组及肾毒宁组,并设正常组和假手术组。饲养或治疗8周后处死大鼠,测定血Scr、BUN、Hb、RBC,用Real-time PCR法测定肾组织内TGF-β1及CTGF的表达。结果：肾毒宁组血Scr、BUN、Hb、RBC与模型组相比有统计学差异（P〈0.01）。肾毒宁冲剂对肾组织内TGF-β1、CTGF表达有较强的抑制作用（P〈0.05和P〈0.01）,尿毒清冲剂作用次之,肾毒宁组与尿毒清组间无统计学差异。结论：肾毒宁冲剂通过抑制肾组织TGF-β1、CTGF的表达,降低血清Scr、BUN含量,从而起到延缓CRF肾功能的恶化,改善肾脏纤维化的作用。     

螺内酯对糖尿病大鼠肾小球保护作用的机制探讨

目的 观察螺内酯对糖尿病大鼠肾小球的保护作用并探讨其机制。 方法 将SD大鼠随机分为健康对照组、病理组、螺内酯治疗组。治疗30 d后处死，观察肾小球病理形态变化；RT-PCR法观察肾脏皮质纤溶酶原激活剂抑制物1(PAI-1) 和转化生长因子β1(TGF-β1)mRNA的变化； Western印迹法观察肾脏皮质PAI-1的表达；免疫组化方法观察肾脏皮质TGF-β1、纤连蛋白(FN)变化及检测肾皮质丙二醛(MDA) 含量、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px) 、总抗氧化能力(T-AOC)活性。 结果 与病理组比，螺内酯治疗后可下调肾皮质TGF-β1、PAI-1 mRNA与蛋白表达（P均< 0.05）；降低肾皮质MDA水平[（0.95±0.20）比（1.23±0.31） nmol/mg，P < 0.05]；增强SOD、GSH-Px、T-AOC活性[分别为（550.19±20.06）比（509.53±33.25） U/mg，（21.67±2.70）比（18.91±2.30） U/mg，（1.15±0.21）比（0.86±0.26） U/mg，P均< 0.05]；减少FN在肾小球的沉积(P < 0.01)；改善肾小球的病理状况。 结论 螺内酯可能通过下调糖尿病大鼠肾皮质TGF-β1、PAI-1表达，降低肾皮质氧化应激水平，起到保护糖尿病大鼠肾脏，延缓肾小球硬化的作用。     

依那普利和丹芪合剂对糖尿病大鼠肾组织结缔组织生长因子表达的影响

目的:探讨依那普利和丹芪合剂对糖尿病大鼠肾组织结缔组织生长因子(CTGF)及蛋白激酶Cα(PKCα)表达的影响.方法:SD大鼠随机分为正常组(A组)、糖尿病组(B组)、糖尿病丹芪合剂组(C组)和依那普利组(D组).尾静脉注射链脲佐菌素复制糖尿病模型.用免疫组化检测肾组织CTGF、PKCα、纤维连接蛋白(FN);Western印迹法检测肾组织CTGF蛋白水平;光镜观察肾组织的形态结构变化;生化方法检测尿蛋白、血糖、血脂和血肌酐.结果:12周后,药物处理的糖尿病大鼠肾组织CTGF、PKCα、FN表达高于正常组,但低于未处理的糖尿病组,血肌酐和尿蛋白水平较低,肾脏病理改变较轻,同时CTGF与PKCα和FN及肾脏指数和肾功能呈显著正相关.丹芪合剂组动物与未处理组相比,血脂水平较低.结论:依那普利和丹芪合剂可能通过PKC信号通路而抑制CTGF的表达,使FN的生成减少,从而对糖尿病大鼠肾脏起保护作用.     

法舒地尔对糖尿病大鼠肾小管上皮细胞转分化的影响

目的 观察法舒地尔对糖尿病大鼠肾小管上皮细胞转分化的影响并探讨其机制。 方法 将实验性Wistar大鼠随机分为正常对照组、糖尿病组、法舒地尔治疗组。3个月后处死动物,PAS染色法观察肾小球病理变化,Masson染色法观察肾间质病理变化;免疫组化观察肾脏皮质ROCKⅠ、α平滑肌肌动蛋白（α-SMA）、E钙黏蛋白（E-cadherin）的变化和β连环蛋白（β-catenin)的细胞定位改变;Western印迹法观察肾脏皮质p-MYPT1、α-SMA、E-cadherin、胞膜β-catenin蛋白的变化;实时定量PCR法观察ROCKⅠ、E-cadherin和总β-catenin的mRNA变化。 结果 法舒地尔治疗可改善肾间质纤维化状况。与正常对照组相比,糖尿病组大鼠肾皮质内p-MYPT1、α-SMA蛋白表达增强（均P < 0.01）;E-cadherin、胞膜β-catenin的蛋白表达减弱（均P < 0.01）;ROCK1、总β-catenin mRNA表达增强（均P < 0.01）;E-cadherin mRNA表达减弱（P < 0.01）。与糖尿病组相比,治疗组p-MYPT1、α-SMA蛋白表达减弱 （均P < 0.01）;E-cadherin、胞膜β-catenin的蛋白表达增强（均P < 0.05）;ROCK1、β-catenin mRNA表达减弱（均P < 0.01）;E-cadherin mRNA表达增强（P < 0.01）。 结论 法舒地尔可能通过抑制Rho激酶活性减轻糖尿病大鼠肾小管上皮细胞转分化和肾间质纤维化,该作用可能与法舒地尔恢复肾小管上皮细胞的黏附特性与紧密连接复合体有关。     

氟伐他汀对糖尿病大鼠肾脏CTGF表达的影响

目的：研究氟伐他汀对糖尿病大鼠肾组织CTGF表达的影响,探讨氟伐他汀肾脏保护作用的机制。方法：SD雄性大鼠54只,随机分为：正常对照组（N组）、糖尿病对照组（D组）、糖尿病氟伐他汀治疗组（4 mg.kg-1.d-1）（F组）。由大鼠尾静脉单次注射链脲佐菌素（60 mg/kg）,造成糖尿病大鼠模型。经氟伐他汀治疗糖尿病大鼠2、4、8周后,分别观察其对大鼠血糖、血胆固醇、血肌酐、24 h尿蛋白定量和肾皮质CTGF表达的影响。结果：与正常对照组相比,糖尿病大鼠24 h尿蛋白定量、血胆固醇及肾组织CTGF表达显著增加;经氟伐他汀治疗后,糖尿病大鼠的24 h尿蛋白定量、胆固醇和CTGF表达下降。结论：糖尿病大鼠肾组织CTGF表达增加,氟伐他汀可能通过下调糖尿病大鼠肾脏CTGF表达而达到部分肾脏保护作用。     

NF-κB在醛固酮所致大鼠肾损伤中的作用及相关机制

目的 探讨NF-κB在醛固酮-1%NaCl诱导的单侧肾切除肾损伤模型中的作用及可能机制。 方法 32只雄性SD大鼠单侧肾脏切除后随机分为4组：对照组（n=8）;1%NaCl组（1%NaCl饲料喂养,n=8）;醛固酮组（1%NaCl饲料喂养+0.75 μg/h醛固酮泵入,n=8）;吡咯烷二硫氨基甲酸（PDTC）组（1%NaCl饲料喂养+0.75 μg/h醛固酮泵入+PDTC 100 mg/kg灌胃,n=8）。共治疗4周。观察各组大鼠收缩压、蛋白尿、肾功能、肾组织形态学改变。.Western印迹和实时定量PCR法观察肾皮质胞间黏附分子1（ICAM-1）及结缔组织生长因子（CTGF）的蛋白表达及mRNA表达;EMSA法检测肾皮质NF-κB活性;免疫组化法观察NF-κB的表达情况。 结果 醛固酮组大鼠表现明显的高血压、蛋白尿、肾小球硬化,ICAM-1及CTGF蛋白和mRNA表达水平较1%NaCl组显著升高（均P < 0.05）,NF-κB活性明显增强,NF-κB在肾组织表达也明显增加。PDTC干预后在抑制NF-κB活性和表达的同时,ICAM-1及CTGF表达明显减少（均P < 0.05）,同时大鼠血压和肾小球硬化也得到了明显缓解。 结论 NF-κB抑制剂PDTC可通过减少ICAM-1及CTGF的表达缓解单侧肾切除-1%NaCl-醛固酮所致肾损伤。     

氟伐他汀对糖尿病大鼠肾皮质胞外调节蛋白激酶活性水平的影响

目的:探讨HMG-CoA还原酶抑制剂氟伐他汀对实验性糖尿病大鼠肾皮质胞外调节蛋白激酶(ERK1/2)活性水平的影响.方法:将实验动物随机分为正常对照组(NC组)、糖尿病对照组(DC组)和氟伐他汀治疗组(DF组),于第2、6周末常规检测各组大鼠血清总胆固醇(TC)、甘油三酯(TC)、低密度脂蛋白胆固醇(LDL)、血糖(BG)、尿白蛋白排泄率(UAER)及肾脏肥大指数;Western Blot测定肾皮质磷酸化ERK1/2(pERK1/2)、TCF-β1表达,免疫组化方法测定肾皮质Ⅳ型胶原;光镜PAS染色及透射电镜观察第6周各组大鼠肾皮质组织学改变.结果:第2、6周末DF组TC、TG、LDL、肾脏肥大指数、UAER、肾皮质Ⅳ型胶原、pERK1/2及TGF-β1表达水平均低于DC组(P＜0.05),但高于NC组(P＜0.01);第6周末光镜、电镜观察DF组较DC组肾组织病变明显减轻.结论:氟伐他汀能下调糖尿病大鼠肾皮质ERK1/2活性、抑制TCF-β1过多生成,降低肾皮质Ⅳ型胶原表达,减轻肾脏病理学改变,抑制和延缓肾小球硬化.     

缬沙坦对早期糖尿病肾病大鼠肾组织TGF-β1/Smad2的影响

目的:探讨血管紧张素Ⅱ受体拮抗剂缬沙坦(代文)对早期糖尿病肾病大鼠肾小管上皮细胞丝/苏氨酸激酶受体(Smad2) 的影响.方法:用代文灌服DN模型大鼠,生化检测实验大鼠24 h尿蛋白、血肌酐(Scr)、尿素氮(BUN)、血浆白蛋白(Alb);PAS染色观察大鼠肾脏病理变化;免疫组化(IHC) 检测肾组织TGF-β1/Smad2表达.结果:缬沙坦能够降低实验大鼠肾小管上皮细胞Smad2的表达,减少24 h尿蛋白、Scr、BUN,升高Alb,缩小肾小球直径,改善肾脏病理,缬沙坦组与模型组相比,P<0.05或P<0.01.结论:缬沙坦可能通过影响DN大鼠肾组织TGF-β1/Smad2的表达改善上述生化指标,从而减轻肾脏病理损害.     

缬沙坦与螺内酯联合应用对单侧输尿管梗阻大鼠肾间质纤维化的影响

目的:探讨缬沙坦与螺内酯联合应用对单侧输尿管梗阻大鼠肾间质纤维化的影响。方法:取6周龄SD大鼠50只,随机分为正常组、模型组、缬沙坦组、螺内酯组及缬沙坦+螺内酯联合治疗组,每组10只。采用单侧输尿管梗阻(UUO)大鼠模型。正常组及模型组给予生理盐水10 ml·kg~(-1)·d~(-1)灌胃,治疗组均给予缬沙坦10 mg·kg~(-1)·d~(-1)、螺内酯100 mg·kg~(-1)·d~(-1)灌胃、缬沙坦10 mg·kg~(-1)·d~(-1)+螺内酯100 mg·kg~(-1)·d~(-1)灌胃,各组大鼠均于术后2周后处死。肾组织行HE染色及逆转录聚合酶链反应(RT-PCR)法观察梗阻肾组织TGF-β1mRNA、BMP-7 mRNA的表达。结果:与假手术组相比,模型组的TGF-β1mRNA表达增多(P0.05),BMP-7 mRNA表达则显著降低,三组治疗组TGF-β1mRNA表达显著低于模型组(P值均0.05),而BMP-7mRNA表达则显著增加。联合治疗组与缬沙坦、螺内酯组的差异均有统计学意义(P值均0.05)。结论:与单用缬沙坦、螺内酯相比,联合治疗能减轻UUO大鼠肾间质纤维化。     

扶肾颗粒对腹膜透析相关性腹膜纤维化的影响及其作用机制的实验研究

目的:通过对腹膜透析大鼠进行干预,观察扶肾颗粒对腹膜纤维化相关细胞因子的影响及其作用机制探讨。方法:SPF级健康雄性SD大鼠75只,体重180～200g,适应性饲养1周后,依大鼠体重分层,随机分为:正常对照组(A组,n=15),无任何处理,腹腔注射生理盐水,100ml.kg-1.d-1,连续4周;肾衰5/6切除+1.5%PD组(B组,n=15);肾衰5/6切除+1.5%PD+扶肾颗粒组(C组,n=15);肾衰5/6切除+4.25%PD组(D组,n=15);肾衰5/6切除+4.25%PD+扶肾颗粒组(E组,n=15),除A组外,各组均制成肾衰模型,其中B、C组予腹腔注射1.5%LPDS,100ml.kg-1.d-1,连续4周;D、E组予腹腔注射4.25%LPDS,100ml.kg-1.d-1,连续4周,自透析开始,对C组和E组予灌服扶肾颗粒,以200gSD大鼠计算,灌胃剂量1.8ml/d。其余各组予灌服2ml生理盐水,共灌服4周。观察各组实验动物的大体状态、体重变化、腹膜滤过功能及血清纤维化调控因子表达变化。结果:在治疗4周后,除正常对照组(A组)外,其余各组均体现为负超滤,但是,同浓度透析治疗组中,应用扶肾颗粒干预组其超滤情况明显优于未应用扶肾颗粒组(P<0.05),其作用显著,同时,葡萄糖转运量方面亦体现为相似结果。与正常对照组比较(A组),其余各模型组相关促纤维化因子表达水平均明显升高(P<0.01)。TGF-β1方面,D组的表达水平明显较其他各组升高(P<0.05)。CTGF及IL-6方面,结果与TGF-β1相似。VEGF方面,E组较D组明显降低(P<0.05)。随着透析治疗的进行,HGF与BMP-7表达水平均反应性升高,各模型组二者水平均较正常对照组明显升高(P<0.01)。HGF方面,C组较B组明显升高(P<0.01)。BMP-7方面,E组较D组明显升高(P<0.05)。结论:扶肾颗粒可减轻腹透大鼠的肾功能损伤,保护残余肾功能,改善腹透大鼠的超滤量及葡萄糖转运量,抑制促纤维化因子TGF-β1、CTGF、IL-6、CTGF等表达,调高抗纤维化因子HGF、BMP-7的表达,进而起到抑制腹膜透析相关腹膜纤维化的发生,改善腹膜透析效能。     

Spironolactone ameliorates renal injury and connective tissue growth factor expression in type II diabetic rats

Administration of spironolactone provides a beneficial effect in various animal models of renal injury. In this study, we investigated whether spironolactone prevents the progression of diabetic nephropathy through reduction of connective tissue growth factor (CTGF) synthesis in type II diabetic rats. In addition, we evaluated the effect of aldosterone and spironolactone on CTGF and collagen production in cultured cells. Renal functional and morphologic changes were examined in Otsuka Long-Evans Tokushima Fatty rats with or without spironolactone treatment (20 mg/kg/day) for 8 months, as well as in non-diabetic age-matched Long-Evans Tokushima Otsuka rats. Spironolactone treatment did not induce any significant differences in body weight, kidney/body weight ratio, serum creatinine concentration, blood glucose levels, or systolic blood pressure. However, urinary protein and albumin excretion were significantly decreased in the spironolactone treatment group, which was associated with amelioration of glomerulosclerosis. In addition, renal CTGF, collagen synthesis demonstrated marked decreases in the spironolactone treatment group. In cultured MC and PTC, aldosterone induced significant increases in CTGF gene expression and protein synthesis associated with increased collagen synthesis, which was abolished by prior treatment with spironolactone. However, aldosterone treatment did not induce transforming growth factor (TGF)-beta1 overproduction, and inhibition of TGF-beta1 by neutralization of TGF-beta1 protein did not significantly prevent aldosterone-induced CTGF production. These results suggest that the antifibrotic effects of spironolactone may be mediated by CTGF through a TGF-beta1-independent pathway in this animal model of diabetic nephropathy.     

肾脏局部醛固酮对糖尿病肾病大鼠肾小管间质转分化的作用

目的 探讨醛固酮对糖尿病肾病（DN）大鼠肾小管间质转分化的影响。 方法 采用Wistar大鼠腹腔注射链脲菌素（STZ,60 mg/kg）制备糖尿病模型,4周后尿蛋白>30 mg/d为DN模型成功（n=16）,随机分为DN组（n=8）和螺内酯组（SP组,n=8）,以另8只正常大鼠作为对照组（N组）。SP组给予螺内酯40 mg&#8226;kg-1&#8226;d-1,N组、DN组每日以等量清水灌胃。8周后处死大鼠,收集尿、血浆、肾组织检测24 h尿蛋白定量、血肌酐和肾脏病理变化;用放射免疫法检测血浆、肾组织醛固酮浓度;用免疫组化、Western印迹方法检测E钙黏蛋白（E-cadherin）、α平滑肌肌动蛋白（α-SMA）蛋白的表达;用RT-PCR的方法检测E-cadherin、α-SMA mRNA的表达。 结果 与对照组比较,DN组尿蛋白排泄量、血肌酐均显著增加（均 P < 0.01）,肾组织E-cadherin蛋白和mRNA表达显著下调（均P < 0.01）,α-SMA蛋白和mRNA表达均显著上调（均P < 0.01）。DN组大鼠肾组织醛固酮显著升高[（24.71±5.30） ng/g比（16.38±2.85） ng/g,P < 0.01],与尿蛋白排泄量、血肌酐、α-SMA蛋白表达呈正相关（r = 0.737、0.574、0.688,均P < 0.05）,与E-cadherin蛋白表达呈负相关（r = －0.659,P < 0.01）。各组间血清醛固酮含量差异无统计学意义。与DN组比较,SP组大鼠尿蛋白排泄和血肌酐显著下降（均P < 0.01）,E-cadherin蛋白和mRNA表达上调（均P < 0.05）,而α-SMA蛋白和mRNA表达显著下调(均P < 0.01)。 结论 DN大鼠肾组织局部醛固酮参与了糖尿病肾病肾间质转分化,螺内酯可以阻断醛固酮与其受体结合,抑制肾小管间质转分化,从而起到肾脏保护作用。     

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。     

大剂量螺内酯对自发性高血压大鼠肾脏纤维化的影响

目的 观察大剂量螺内酯对自发性高血压大鼠（SHR）肾脏纤维化的影响。 方法 8周龄的雄性SHR 24只随机分为低剂量和大剂量螺内酯干预组[分别为20和100 mg&#8226;kg-1&#8226;d-1螺内酯灌胃]和高血压对照组，同时设同源正常对照组京都大鼠（WKY）8只。干预8周，检测收缩压、尿蛋白、血白蛋白、钾、钠、Scr和肾组织及血浆醛固酮水平。肾组织切片分别行HE和Masson染色，以评价肾小球损伤及肾小球内胶原沉积情况。免疫组化SABC法检测肾组织TGF-β1和醛固酮受体蛋白表达。RT-PCR检测肾组织TGF-β1和醛固酮受体mRNA水平。 结果 与高血压组大鼠相比，低剂量螺内酯干预后，尿蛋白减少（P < 0.05），血白蛋白升高（P < 0.05），血浆和肾组织醛固酮水平降低，但差异无统计学意义；大剂量螺内酯干预后，血压没有显著改变，尿蛋白显著升高[（27.3±4.5）比（24.5±3.2） mg/d， P < 0.05]，血白蛋白显著减少[（20.2±4.2）比（22.7±3.5） g/L, P < 0.05]，血浆和肾组织醛固酮水平显著升高[肾组织（28.3±1.5）比（22.2±0.6） ng/g， P < 0.05]。与高血压组比较，低剂量螺内酯干预后，蛋白管型增多、管周炎性细胞浸润均减少（P < 0.05）；大剂量螺内酯干预后，蛋白管型、小管扩张加重，管周炎性细胞浸润明显增多（P < 0.05），肾小球内胶原形成亦明显增多（P < 0.05）。与高血压组大鼠比较，低剂量螺内酯干预后，肾组织醛固酮受体mRNA和蛋白表达均无显著改变，TGF-β1 mRNA和蛋白的表达显著减少（P < 0.05）；大剂量螺内酯干预后，肾组织醛固酮受体及TGF-β1 mRNA和蛋白的表达均显著升高(P < 0.05)。 结论 大剂量螺内酯可以加重高血压肾脏纤维化，可能是通过上调醛固酮及其受体表达实现的。     

Rho kinase inhibition protects kidneys from diabetic nephropathy without reducing blood pressure

Rho-associated kinases (ROCK) are activated in the kidney as well as in cultured cells of diabetic models and have been implicated in renal pathophysiology. To explore whether inhibition of ROCK is protective, we studied its role in a model of accelerated diabetic nephropathy where uninephrectomized rats were made diabetic by streptozotocin. After establishing diabetes, rats were treated with the ROCK inhibitor fasudil continuously or for the final 6 weeks of an 18-week experimental period. The results were compared to similar rats given losartan, an established treatment of clinical and experimental diabetic nephropathy, or a combination of both agents. Vehicle-treated diabetic and non-diabetic uninephrectomized rats served as controls. Diabetes resulted in a rapid development of albuminuria, higher glomerulosclerosis and interstitial fibrosis scores, lower glomerular filtration rates, and increased expression of several molecular markers of diabetic nephropathy. Eighteen weeks of fasudil treatment reduced renal ROCK activity, and ameliorated diabetes-induced structural changes in the kidney and expression of the molecular markers in association with a modest anti-proteinuric effect but no change in blood pressure. Late intervention with fasudil reduced glomerulosclerosis, but did not influence proteinuria. Most effects of fasudil were comparable to those of losartan, although losartan lowered blood pressure and further lowered proteinuria. The combination of both treatments was no different than losartan alone. Thus, ROCK inhibition protected the kidney from diabetic nephropathy even though it did not reduce the blood pressure.     

Effects of 1,25-dihydroxyvitamin D3 on the expression of connective tissue growth factor and heat shock protein 47 in peritoneum fibrosis rats

Objective To investigate the expression of connective tissue growth factor (CTGF) and heat shock protein 47 (HSP47) in peritoneum fibrosis rats, and the mechanism of 1,25-dihydroxyvitamin D3 [1,25-(OH)2-VitD3] in inhibiting the peritoneum fibrosis. Methods Adult male Sprague-Dawley rats were randomly divided into 3 groups: control group (n=8), model group (n=8) and 1,25-dihydroxyvitamin D3 group (VitD3, n=8). The model of peritoneum fibrosis rats were induced by daily intraperitoneally injection of 15% chlorhexidine gluconate (CHX) 0.2 ml/d with 0.1% glucose for 4 weeks. Rats in VitD3 group were also treated with 1,25-(OH)2-VitD3 [i.p. 6 ng?(100 g)-1?d-1]. Peritoneal transport function, renal function, peritoneum thickness and serum level of 25 hydroxyvitamin D3 were detected. In vitro, primary cultured peritoneal mesothelial cells were divided into control group, high glucose group (HG, 2.5%), CTGF siRNA intervention group (CTGF siRNA+HG), VitD3 intervention group (VitD3+HG) and combined intervention group (CTGF siRNA+VitD3+HG). Real-time PCR, Western blotting and immunofluorescence were applied to measure the expression of CTGF and HSP47, also ELISA was used to detect the protein level of FN in peritoneum and peritoneal mesothelial cells. Results Compared with control group, the peritoneal ultrafiltration in peritoneum fibrosis rats were significantly decreased (P＜0.05), the absorbance level of peritoneal fibrosis, peritoneum thickness, the rate of dialysate urea nitrogen and blood urea nitrogen (DUN/BUN) and the expressions of CTGF and HSP47 were increased (all P＜0.05). After application of 1,25-dihydroxyvitamin D3, peritoneal fibrosis lesion was significantly improved, the peritoneum thickness, the expressions of CTGF and HSP47 were decreased (all P＜0.05). In vitro, 2.5% high glucose induced-peritoneal mesothelial cells were respectively treated by CTGF siRNA, 1,25-(OH)2-VitD3 and combined interventions, the expression of FN, CTGF and HSP47 was significantly lower than that in high glucose group (all P＜ 0.05). Conclusions The expression of CTGF and HSP47 is significantly increased in peritoneal fibrosis rats. 1,25-(OH)2-VitD3 may ameliorate the progression of peritoneal fibrosis via reducing the expression of CTGF, decreasing the expression of HSP47 and FN.     

霉酚酸酯及缬沙坦对糖尿病大鼠足细胞的保护机制研究

目的探讨霉酚酸酯、缬沙坦及2者联合应用对糖尿病。肾病（DN）大鼠足细胞损伤的保护作用。方法雄性Wistar大鼠行右肾切除后，腹腔注射链脲佐菌素（STZ，65mg／kg）建立糖尿病模型。将实验动物随机分为右。肾切除对照组（NC）、糖尿病组（DM）、霉酚酸酯治疗组（M）、缬沙坦治疗组（V）、缬沙坦和霉酚酸酯联合治疗组（V＋M）。治疗组分别给予霉酚酸酯15mg·kg^-1·d^-1，缬沙坦40mg·kg^-1·d^-1；联合治疗组为上述两组之和。检测各组8周末的左肾质量／体质量比值、尿蛋白量（24h）、血糖（Glu）、Scr。光镜及电镜观察肾组织形态学变化。免疫组化检测肾组织中nephrin、结蛋白（desmin）及单核细胞趋化因子1（MCP-1）蛋白表达。实时PCR测定肾组织中nephrin及MCP-1mRNA表达。结果与NC组相比，DM组大鼠血糖、尿蛋白量及左肾质量／体质量比值均显著上升（P〈0．01）；肾小球硬化指数（GSI）及肾间质损害加重（P〈0．01）；肾组织内MCP-1、desmin蛋白表达均显著上调（P〈0．01）。与DM组比较，M组、V组及V＋M组上述指标除Glu、Scr外，均明显改善（P〈0．05或P〈0．01）。与NC组（100％）相比，DM组nephrinmRNA表达下调（78％，P〈0.05）；各治疗组nephrinmRNA表达增加，以M组增加最明显（134％，P〈0．01）。与NC组（100％）相比，DM组MCP-1mRNA表达明显上调（251％，P〈0.05）；各治疗组明显降低，以M组最显著（126％，P〈0．01）。nephrinmRNA与MCP-1mRNA表达呈负相关（r=-0，86。P〈0．01）。尿蛋白量（24h）与MCP-1mRNA呈正相关fr=0．82，P〈0．01）；与nephrinmRNA呈负相关（r=-0．78，P〈0．01）。结论霉酚酸酯及缬沙坦均能下调糖尿病大鼠肾组织中desmin及MCP-1基因及蛋白的表达，上调nephrin基因及蛋白表达，降低尿蛋白量，预防肾损伤。联合治疗不优于单一治疗。霉酚酸酯可能通过抗炎性反应减轻足细胞损伤，减少蛋白尿，对早期DN大鼠具有明显的肾保护作用。     

Spironolactone prevents early renal injury in streptozotocin-induced diabetic rats

BACKGROUND: Glomerular and tubulointerstitial injury leads to chronic impairment of renal function, and thus, reversal of the injury may improve renal function and survival. The present study investigated whether and how mineralocorticoid receptor antagonist spironolactone ameliorates early renal injury in streptozotocin-induced diabetic rats. METHODS: Streptozotocin (65 mg/kg, single intraperitoneal injection)- or vehicle-administered rats were used as diabetic or control rats, respectively. The streptozotocin-administered rats were treated with spironolactone (50 mg/kg/day sc) for 3 weeks. Among the 3 groups of rats, we compared renal fibrosis and renal hypertrophy, using picro-sirius red staining and immunohistochemistry of ED-1 macrophage marker, plasminogen activator inhibitor-1 (PAI-1), and transforming growth factor (TGF)-beta1. RESULTS: Three weeks after administration of streptozotocin, rats exhibited increased collagen deposition in glomerular, tubulointerstitial, and perivascular areas in the kidney, which was completely attenuated by spironolactone treatment. In rats given streptozotocin alone, there were increases in ED-1-positive cell, PAI-1 expression, and TGF-beta1 expression in glomeruli and tubulointerstitiums, which were also suppressed by spironolactone treatment. Maximal glomerular and proximal tubular areas were not significantly different among the 3 groups. Rats given streptozotocin alone revealed an increase in proximal tubule wall-to-lumen ratio that was not influenced by treatment with spironolactone. CONCLUSION: Streptozotocin-induced renal fibrosis, PAI-1 expression, TGF-beta1 expression, and macrophage infiltration occur via mineralocorticoid receptor, and spironolactone ameliorates renal fibrosis presumably via the inhibition of macrophage infiltration, PAI-1 expression, and TGF-beta1 expression in streptozotocin-induced early diabetic injury.