Abstract

Vasopressin increases urine concentration through activation of aquaporin-2 (AQP2) in the collecting duct. Nonsteroidal anti-inflammatory drugs (NSAIDs) block prostaglandin E2 synthesis, and may suppress AQP2 producing a urine concentrating defect. There are four serines in AQP2 that are phosphorylated by vasopressin. To determine if chronic use of NSAIDs changes AQP2’s phosphorylation at any of these residues, the effects of a non-selective NSAID, ibuprofen, and a COX-2-selective NSAID, meloxicam, were investigated. Daily ibuprofen or meloxicam increased the urine output and decreased the urine osmolality significantly by days 7 through 14. Concomitantly, meloxicam significantly reduced total AQP2 protein abundance in inner medulla (IM) tip to 64% of control and base to 63%, respectively. Ibuprofen significantly decreased total AQP2 in IM tip to 70% of control, with no change in base. Meloxicam significantly increased the ratios of p256-AQP2 and p261-AQP2 to total AQP2 in IM tip (to 44% and 40%, respectively). Ibuprofen increased the ratio of p256-AQP2 to total AQP2 in IM tip but did not affect p261-AQP2/total AQP2 in tip or base. Both ibuprofen and meloxicam increased p264-AQP2 and p269-AQP2 ratios in both tip and base. Ibuprofen increased UT-A1 levels in IM tip, but not in base. We conclude that NSAIDs reduce AQP2 abundance, contributing to decreased urine concentrating ability. They also increase some phosphorylated forms of AQP2. These changes may partially compensate for the decrease in AQP2 abundance, thereby lessening the decrease in urine osmolality.

Highlights

  • Cyclooxygenase (COX) enzymes can be blocked by nonsteroidal anti-inflammatory drugs (NSAIDs) and this leads to inhibition of prostaglandin (PG) synthesis and their analgesic and antipyretic responses

  • Similar results were revealed in ibuprofen-treated rats (Fig 1C and 1D), ie., urine output was significantly increased and urine osmolality was significant decreased compared with the controls after 7 days and 14 days of treatment, indicating that both meloxicam and ibuprofen produce a urine concentration defect in rats

  • NSAID medications are often associated with some adverse effects in renal function

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Summary

Introduction

Cyclooxygenase (COX) enzymes can be blocked by nonsteroidal anti-inflammatory drugs (NSAIDs) and this leads to inhibition of prostaglandin (PG) synthesis and their analgesic and antipyretic responses. Treatment with high doses on a regular basis can have a marked antiinflammatory effect. COX-1 is expressed constitutively and offers rapid responses to physiological challenges [1]. COX-2 is always induced by biological factors, such as TNFalpha, IL-1, and IL-4 [2,3]. The renal side effects of NSAIDs are considered one of the major issues with the use of these important drugs. The other two most common sites of serious side

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