Abstract

The progression of renal fibrosis is characterized by loss of kidney function and deposition of extracellular matrix components. The mechanism implicated in the development of renal fibrosis involves cytokines and growth factors originating from endothelial, tubular epithelial and interstitial cells. Activated myofibloblasts derive from differentiated tubular epithelial cells trough a process called epithelial to mesenchymal transition. Various kidney injury mediators like cyclosporine-A (CsA) are entering the luminal space of the tubules causing activation of profibrotic factors such as nitric oxide (NO) and endothelin-1 (ET-1). A cross talk exists between endothelin and NO systems in the regulation of vascular tone and inflammatory process. Aim of this study was to investigate the effect of cyclosporine-A on the expression of Nitric Oxide and endothelin-1 on cultured renal tubular cells. Human tubular epithelial cells (HK-2) were cultured in the presence of CsA at various concentrations (0 -1,000 ng/ml). RT-PCR was used to determine NO synthases (eNOS, iNOS) and endothelin receptors (ETR-A, ETR-B) and Western Blot analysis for the subsequent proteins. Similar experiments were also carried out using specific NO (L-NAME) and endothelin receptor (BQ123, BQ 788) inhibitors. At therapeutic concentrations, CsA exerts a significant cytotoxic effect on tubular epithelial cells. A dose dependent activation of NO synthases eNOS and iNOS and endothelin receptors ET-A and ETR-B was observed, even at therapeutic concentrations of CsA. An interaction between NO and ET-1 systems under the influence of CsA was also observed, since blockage of NO production was followed by down-regulation of ET-B while blocking of endothelin pathway with ET receptor antagonists, was followed by down-regulation of eNOS expression.

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