Synergic Renoprotective Effects of Combined ASC Therapy with RAAS Blockade in Experimental Advanced CKD
Open Access
- 25 March 2022
- journal article
- research article
- Published by Hindawi Limited in Stem Cells International
- Vol. 2022, 1-20
- https://doi.org/10.1155/2022/5111782
Abstract
Global prevalence of chronic kidney disease (CKD) has increased considerably in the recent decades. Overactivity of the renin-angiotensin-aldosterone system (RAAS), associated to renal inflammation and fibrosis, contributes to its evolution. The treatments currently employed to control CKD progression are limited and mainly based on the pharmacological inhibition of RAAS, associated with diuretics and immunosuppressive drugs. However, this conservative management promotes only partial deceleration of CKD evolution and does not completely avoid the progression of the disease and the loss of renal function, which motivates the medical and scientific community to investigate new therapeutic approaches to detain renal inflammation/fibrosis and CKD progression. Recent studies have shown the application of mesenchymal stem cells (mSC) to exert beneficial effects on the renal tissue of animals submitted to experimental models of CKD. In this context, the aim of the present study was to evaluate the effects of subcapsular application of adipose tissue-derived mSC (ASC) in rats submitted to the 5/6 renal ablation model, 15 days after the establishment of CKD, when the nephropathy was already severe. We also verify whether ASC associated to Losartan would promote greater renoprotection when compared to the respective monotherapies. Animals were followed until 30 days of CKD, when body weight, systolic blood pressure, biochemical, histological, immunohistochemical, and gene expression analysis were performed. The combination of ASC and Losartan was more effective than Losartan monotherapy in reducing systolic blood pressure and glomerulosclerosis and also promoted the complete normalization of proteinuria and albuminuria, a significant reduction in renal interstitial macrophage infiltration and downregulation of renal IL-6 gene expression. The beneficial effects of ACS are possibly due to the immunomodulatory and anti-inflammatory role of factors secreted by these cells, modulating the local immune response. Although studies are still required, our results demonstrated that a subcapsular inoculation of ASC, associated with the administration of Losartan, exerted additional renoprotective effect in rats submitted to a severe model of established CKD, when compared to Losartan monotherapy, thus suggesting ASC may be a potential adjuvant to RAAS-blockade therapy currently employed in the conservative management of CKD.Funding Information
- Fundação de Amparo à Pesquisa do Estado de São Paulo (2017/26216-0)
This publication has 39 references indexed in Scilit:
- Regression of Albuminuria and Hypertension and Arrest of Severe Renal Injury by a Losartan-Hydrochlorothiazide Association in a Model of Very Advanced NephropathyPLOS ONE, 2013
- The potential use of stem cells derived from human amniotic fluid in renal diseasesKidney International Supplements, 2011
- High Vascular Density and Oxygenation of Pancreatic Islets Transplanted in Clusters into Striated MuscleCell Transplantation, 2011
- Immune regulatory properties of multipotent mesenchymal stromal cells: Where do we stand?World Journal of Stem Cells, 2011
- Urinary proteome analysis enables assessment of renoprotective treatment in type 2 diabetic patients with microalbuminuriaBMC Nephrology, 2010
- Angiotensin II mediates epithelial-to-mesenchymal transformation in tubular cells by ANG 1–7/MAS-1-dependent pathwaysAmerican Journal of Physiology-Renal Physiology, 2010
- Models of chronic kidney diseaseDrug Discovery Today: Disease Models, 2010
- The Role of Tubulointerstitial Inflammation in the Progression of Chronic Renal FailureNephron Clinical Practice, 2010
- Renin-Angiotensin-Aldosterone System and Progression of Renal DiseaseJournal of the American Society of Nephrology, 2006
- Immunochemical quantitation of antigens by single radial immunodiffusionImmunochemistry, 1965