Abstract

Angiotensin-converting enzyme (ACE) is the primary enzyme that converts angiotensin I (Ang I) to angiotensin II (Ang II) in the renin-angiotensin system (RAS). However, chymase hydrates Ang I to Ang II independently of ACE in some kidney diseases, and it may play an important role. The present study investigated whether chymase played a crucial role in aristolochic acid I (AAI)-induced nephropathy. C57BL/6 mice were treated with AAI via intraperitoneal injection for an accumulated AAI dosage of 45 mg/kg body weight (BW) (15 mg/kg BW per day for 3 days). The animals were sacrificed after acute kidney injury development, and blood, urine and kidneys were harvested for biochemical and molecular assays. Mice exhibited increased serum creatinine, BUN and urinary protein after the AAI challenge. Significant infiltrating inflammatory cells and tubular atrophy were observed in the kidneys, and high immunocytokine levels were detected. Renal RAS-related enzyme activities were measured, and a significantly increased chymase activity and slightly decreased ACE activity were observed in the AAI-treated mice. The renal Ang II level reflected the altered profile of RAS enzymes and was significantly increased in AAI-treated mice. Treatment of AAI-induced nephropathic mice with an ACE inhibitor (ACEI) or chymase inhibitor (CI; chymostatin) reduced renal Ang II levels. The combination of ACEI and CI (ACEI+CI) treatment significantly reversed the AAI-induced changes of Ang II levels and kidney inflammation and injuries. AAI treatment significantly increased renal p-MEK without increasing p-STAT3 and p-Smad3 levels, and p-MEK/p-ERK1/2 signalling pathway was significantly activated. CI and ACEI+CI treatments reduced this AAI-activated signaling pathway. AAI-induced nephropathy progression was significantly mitigated with CI and ACEI+CI treatment. This study elucidates the role of RAS in the pathogenesis of AAI-induced nephropathy.

Highlights

  • Aristolochic acid nephropathy (AAN) is a rapidly progressive interstitial nephritis that leads to urothelial malignancy, end-stage renal disease and irreversible kidney failure

  • Increased serum BUN and creatinine and proteinuria are related to kidney dysfunction, and our results indicated that aristolochic acid I (AAI) caused severe renal impairment in the experimental animals

  • renin-angiotensin system (RAS) dysregulation was associated with AAI-induced nephropathic progression and abnormally increased renal angiotensin II (Ang II)

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Summary

Introduction

Aristolochic acid nephropathy (AAN) is a rapidly progressive interstitial nephritis that leads to urothelial malignancy, end-stage renal disease and irreversible kidney failure. Renal histology in the chronic pathology of AAN reveals the formation of tubulointerstitial fibrosis (TIF) and tubular atrophy [7]. Renal microvasculature injury and an imbalance of endothelial vasoactive agents may lead to fibrosis in AAN [3]. Animal models of AAN are widely used in investigations of renal toxicity of Aristolochia and Asarum genus herbs [9,10], and exhibit similar pathological characteristics as human chronic kidney diseases. AAI-induced rodent models of acute or chronic kidney injury/disease models are well-established [9]; information on the disease mechanisms of AAI-induced acute kidney injuries related to the dysregulation or imbalance of the renin-angiotensin system (RAS) are not known

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