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2016 ; 6
(ä): 27589
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MC1R is dispensable for the proteinuria reducing and glomerular protective effect
of melanocortin therapy
#MMPMID27270328
Qiao Y
; Berg AL
; Wang P
; Ge Y
; Quan S
; Zhou S
; Wang H
; Liu Z
; Gong R
Sci Rep
2016[Jun]; 6
(ä): 27589
PMID27270328
show ga
Melanocortin therapy by using adrenocorticotropic hormone (ACTH) or
non-steroidogenic melanocortin peptides attenuates proteinuria and glomerular
injury in experimental glomerular diseases and induces remission of nephrotic
syndrome in patients with diverse glomerulopathies, even those resistant to
steroids. The underlying mechanism remains elusive, but the role of melanocortin
1 receptor (MC1R) has been implicated and was examined here. Four patients with
congenital red hair color and nephrotic syndrome caused by idiopathic membranous
nephropathy or focal segmental glomerulosclerosis were confirmed by gene
sequencing to bear dominant-negative MC1R mutations. Despite prior corticosteroid
resistance, all patients responded to ACTH monotherapy and ultimately achieved
clinical remission, inferring a steroidogenic-independent and MC1R-dispensable
anti-proteinuric effect of melanocortin signaling. In confirmatory animal
studies, the protective effect of [Nle(4), D-Phe(7)]-?-melanocyte stimulating
hormone (NDP-MSH), a potent non-steroidogenic pan-melanocortin receptor agonist,
on the lipopolysaccharide elicited podocytopathy was completely preserved in
MC1R-null mice, marked by reduced albuminuria and diminished histologic signs of
podocyte injury. Moreover, in complementary in vitro studies, NDP-MSH attenuated
the lipopolysaccharide elicited apoptosis, hypermotility and impairment of
filtration barrier function equally in primary podocytes derived from MC1R-null
and wild-type mice. Collectively, our findings suggest that melanocortin therapy
confers a proteinuria reducing and podoprotective effect in proteinuric
glomerulopathies via MC1R-independent mechanisms.