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2014 ; 2014
(ä): 576929
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Conversion to sirolimus ameliorates cyclosporine-induced nephropathy in the rat:
focus on serum, urine, gene, and protein renal expression biomarkers
#MMPMID24971338
Sereno J
; Nunes S
; Rodrigues-Santos P
; Vala H
; Rocha-Pereira P
; Fernandes J
; Santos-Silva A
; Teixeira F
; Reis F
Biomed Res Int
2014[]; 2014
(ä): 576929
PMID24971338
show ga
Protocols of conversion from cyclosporin A (CsA) to sirolimus (SRL) have been
widely used in immunotherapy after transplantation to prevent CsA-induced
nephropathy, but the molecular mechanisms underlying these protocols remain
nuclear. This study aimed to identify the molecular pathways and putative
biomarkers of CsA-to-SRL conversion in a rat model. Four animal groups (n = 6)
were tested during 9 weeks: control, CsA, SRL, and conversion (CsA for 3 weeks
followed by SRL for 6 weeks). Classical and emergent serum, urinary, and kidney
tissue (gene and protein expression) markers were assessed. Renal lesions were
analyzed in hematoxylin and eosin, periodic acid-Schiff, and Masson's trichrome
stains. SRL-treated rats presented proteinuria and NGAL (serum and urinary) as
the best markers of renal impairment. Short CsA treatment presented slight or
even absent kidney lesions and TGF-?, NF- ??, mTOR, PCNA, TP53, KIM-1, and CTGF
as relevant gene and protein changes. Prolonged CsA exposure aggravated renal
damage, without clear changes on the traditional markers, but with changes in
serums TGF- ? and IL-7, TBARs clearance, and kidney TGF-? and mTOR. Conversion to
SRL prevented CsA-induced renal damage evolution (absent/mild grade lesions),
while NGAL (serum versus urine) seems to be a feasible biomarker of CsA
replacement to SRL.