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2016 ; 36
(5
): ä Nephropedia Template TP
gab.com Text
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Differential renal effects of candesartan at high and ultra-high doses in
diabetic mice-potential role of the ACE2/AT2R/Mas axis
#MMPMID27612496
Callera GE
; Antunes TT
; Correa JW
; Moorman D
; Gutsol A
; He Y
; Cat AN
; Briones AM
; Montezano AC
; Burns KD
; Touyz RM
Biosci Rep
2016[Oct]; 36
(5
): ä PMID27612496
show ga
High doses of Ang II receptor (AT1R) blockers (ARBs) are renoprotective in
diabetes. Underlying mechanisms remain unclear. We evaluated whether
high/ultra-high doses of candesartan (ARB) up-regulate angiotensin-converting
enzyme 2 (ACE2)/Ang II type 2 receptor (AT2R)/Mas receptor [protective axis of
the of the renin-angiotensin system (RAS)] in diabetic mice. Systolic blood
pressure (SBP), albuminuria and expression/activity of RAS components were
assessed in diabetic db/db and control db/+ mice treated with increasing
candesartan doses (intermediate, 1 mg/kg/d; high, 5 mg/kg/d; ultra-high, 25 and
75 mg/kg/d; 4 weeks). Lower doses candesartan did not influence SBP, but
ultra-high doses reduced SBP in both groups. Plasma glucose and albuminuria were
increased in db/db compared with db/+ mice. In diabetic mice treated with
intermediate dose candesartan, renal tubular damage and albuminuria were
ameliorated and expression of ACE2, AT2R and Mas and activity of ACE2 were
increased, effects associated with reduced ERK1/2 phosphorylation, decreased
fibrosis and renal protection. Ultra-high doses did not influence the
ACE2/AT2R/Mas axis and promoted renal injury with increased renal ERK1/2
activation and exaggerated fibronectin expression in db/db mice. Our study
demonstrates dose-related effects of candesartan in diabetic nephropathy:
intermediate-high dose candesartan is renoprotective, whereas ultra-high dose
candesartan induces renal damage. Molecular processes associated with these
effects involve differential modulation of the ACE2/AT2R/Mas axis:
intermediate-high dose candesartan up-regulating RAS protective components and
attenuating pro-fibrotic processes, and ultra-high doses having opposite effects.
These findings suggest novel mechanisms through the protective RAS axis, whereby
candesartan may ameliorate diabetic nephropathy. Our findings also highlight
potential injurious renal effects of ultra-high dose candesartan in diabetes.
|Angiotensin II Type 2 Receptor Blockers/administration & dosage
[MESH]