Mechanisms of renal structural alterations in combined hypercholesterolemia and renal artery stenosis

Alejandro R. Chade, Martin G Rodriguez-Porcel, Joseph Peter Grande, Xiangyang Zhu, Vincenzo Sica, Claudio Napoli, Tatsuya Sawamura, Stephen C Textor, Amir Lerman, Lilach O Lerman

Research output: Contribution to journalArticle

127 Citations (Scopus)

Abstract

Objective - Atherosclerotic renovascular disease (ARVD) aggravates renal scarring more than other causes of renal artery stenosis (RAS), but the underlying pathogenic mechanisms of this potential profibrotic effect remain unclear. We tested the hypothesis that coexistence of atherosclerosis and RAS interferes with renal tissue remodeling. Methods and Results - Single-kidney hemodynamics and function were quantified in vivo with electron-beam computed tomography in 3 groups of pigs (n = 7 each): normal pigs, pigs 12 weeks after induction of unilateral RAS (RAS group), and pigs with similar-degree RAS fed a 12-week 2% hypercholesterolemic diet (HC + RAS, simulating early ARVD). Kidneys were studied ex vivo by Western blotting and immunohistochemistry. Renal volume, renal blood flow, and glomerular filtration rate were similarly decreased in RAS and HC+RAS ischemic kidneys, accompanied by similar increased expression of profibrotic factors like transforming growth factor-β, tissue inhibitor of metalloproteinase-1, and plasminogen activator inhibitor-1. Nevertheless, HC + RAS kidneys showed increased intrarenal fibrosis compared with RAS-only kidneys. Furthermore, expression of nuclear factor-κB was increased, expression of extracellular (matrix metalloproteinase-2) and intracellular (ubiquitin) protein degradation systems was decreased, and apoptosis was blunted. Conclusions - Diet-induced HC superimposed on RAS accelerates the development of fibrosis in the stenotic kidney by amplifying profibrotic mechanisms and disrupting tissue remodeling. These alterations might contribute to renal disease progression in ARVD and might account for the increased propensity for end-stage renal disease.

Original languageEnglish (US)
Pages (from-to)1295-1301
Number of pages7
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume23
Issue number7
DOIs
StatePublished - Jul 1 2003

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Renal Artery Obstruction
Hypercholesterolemia
Kidney
Swine
Fibrosis
Diet
Tissue Inhibitor of Metalloproteinase-1
X Ray Computed Tomography
Renal Circulation
Matrix Metalloproteinase 2
Plasminogen Activator Inhibitor 1
Transforming Growth Factors
Ubiquitin
Glomerular Filtration Rate
Proteolysis
Chronic Kidney Failure
Cicatrix
Extracellular Matrix
Disease Progression
Atherosclerosis

Keywords

  • Atherosclerosis
  • Fibrosis
  • Kidney
  • Renal disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Mechanisms of renal structural alterations in combined hypercholesterolemia and renal artery stenosis. / Chade, Alejandro R.; Rodriguez-Porcel, Martin G; Grande, Joseph Peter; Zhu, Xiangyang; Sica, Vincenzo; Napoli, Claudio; Sawamura, Tatsuya; Textor, Stephen C; Lerman, Amir; Lerman, Lilach O.

In: Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 23, No. 7, 01.07.2003, p. 1295-1301.

Research output: Contribution to journalArticle

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AU - Chade, Alejandro R.

AU - Rodriguez-Porcel, Martin G

AU - Grande, Joseph Peter

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AU - Sica, Vincenzo

AU - Napoli, Claudio

AU - Sawamura, Tatsuya

AU - Textor, Stephen C

AU - Lerman, Amir

AU - Lerman, Lilach O

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N2 - Objective - Atherosclerotic renovascular disease (ARVD) aggravates renal scarring more than other causes of renal artery stenosis (RAS), but the underlying pathogenic mechanisms of this potential profibrotic effect remain unclear. We tested the hypothesis that coexistence of atherosclerosis and RAS interferes with renal tissue remodeling. Methods and Results - Single-kidney hemodynamics and function were quantified in vivo with electron-beam computed tomography in 3 groups of pigs (n = 7 each): normal pigs, pigs 12 weeks after induction of unilateral RAS (RAS group), and pigs with similar-degree RAS fed a 12-week 2% hypercholesterolemic diet (HC + RAS, simulating early ARVD). Kidneys were studied ex vivo by Western blotting and immunohistochemistry. Renal volume, renal blood flow, and glomerular filtration rate were similarly decreased in RAS and HC+RAS ischemic kidneys, accompanied by similar increased expression of profibrotic factors like transforming growth factor-β, tissue inhibitor of metalloproteinase-1, and plasminogen activator inhibitor-1. Nevertheless, HC + RAS kidneys showed increased intrarenal fibrosis compared with RAS-only kidneys. Furthermore, expression of nuclear factor-κB was increased, expression of extracellular (matrix metalloproteinase-2) and intracellular (ubiquitin) protein degradation systems was decreased, and apoptosis was blunted. Conclusions - Diet-induced HC superimposed on RAS accelerates the development of fibrosis in the stenotic kidney by amplifying profibrotic mechanisms and disrupting tissue remodeling. These alterations might contribute to renal disease progression in ARVD and might account for the increased propensity for end-stage renal disease.

AB - Objective - Atherosclerotic renovascular disease (ARVD) aggravates renal scarring more than other causes of renal artery stenosis (RAS), but the underlying pathogenic mechanisms of this potential profibrotic effect remain unclear. We tested the hypothesis that coexistence of atherosclerosis and RAS interferes with renal tissue remodeling. Methods and Results - Single-kidney hemodynamics and function were quantified in vivo with electron-beam computed tomography in 3 groups of pigs (n = 7 each): normal pigs, pigs 12 weeks after induction of unilateral RAS (RAS group), and pigs with similar-degree RAS fed a 12-week 2% hypercholesterolemic diet (HC + RAS, simulating early ARVD). Kidneys were studied ex vivo by Western blotting and immunohistochemistry. Renal volume, renal blood flow, and glomerular filtration rate were similarly decreased in RAS and HC+RAS ischemic kidneys, accompanied by similar increased expression of profibrotic factors like transforming growth factor-β, tissue inhibitor of metalloproteinase-1, and plasminogen activator inhibitor-1. Nevertheless, HC + RAS kidneys showed increased intrarenal fibrosis compared with RAS-only kidneys. Furthermore, expression of nuclear factor-κB was increased, expression of extracellular (matrix metalloproteinase-2) and intracellular (ubiquitin) protein degradation systems was decreased, and apoptosis was blunted. Conclusions - Diet-induced HC superimposed on RAS accelerates the development of fibrosis in the stenotic kidney by amplifying profibrotic mechanisms and disrupting tissue remodeling. These alterations might contribute to renal disease progression in ARVD and might account for the increased propensity for end-stage renal disease.

KW - Atherosclerosis

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