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Am J Physiol Regul Integr Comp Physiol (December 14, 2006). doi:10.1152/ajpregu.00620.2005
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Submitted on August 25, 2005
Accepted on December 7, 2006

TNF-{alpha} neutralization ameliorates obstruction-induced renal fibrosis and dysfunction

Kirstan K Meldrum1*, Rosalia Misseri1, Peter Metcalfe1, Charles A Dinarello2, Karen L Hile1, and Daniel R. Meldrum3

1 Urology, Indiana University, Indianapolis, Indiana, United States
2 Medicine, University of Colorado Health Sci, Denver, Colorado, United States
3 Surgery, Indiana University, Indianapolis, Indiana, United States

* To whom correspondence should be addressed. E-mail: kmeldrum{at}iupui.edu.

Upper urinary tract obstruction results in tubulointerstitial fibrosis and a progressive decline in renal function. Although several inflammatory mediators have been implicated in the pathophysiology of renal obstruction, the contribution of tumor necrosis factor-{alpha} (TNF-{alpha}) to obstruction-induced fibrosis and renal dysfunction has not been thoroughly evaluated. To study this, male Sprague-Dawley rats were subjected to left unilateral ureteral obstruction (UUO) vs. sham operation. Rats received either vehicle or a pegylated form of soluble TNF receptor type 1 (PEG-sTNFR1) every 84 hours. The kidneys were harvested 1, 3, or 7 days postoperatively, and tissue samples were analyzed for TNF- {alpha} expression (ELISA), macrophage infiltration (ED-1 staining), TGF-{beta} 1 expression (ELISA, RT-PCR), collagen I and IV activity (Western Blot, Immunohistochemistry), {alpha}-smooth muscle actin accumulation ( {alpha}-SMA, Immunohistochemistry, Western blot analysis), and angiotensinogen expression (Western Blot). In a separate arm, the glomerular filtration rate (GFR; inulin clearance) of rats subjected to UUO in the presence of either vehicle or PEG-sTNFR1 was determined. Renal obstruction induced increased tissue TNF- {alpha} and TGF-{beta} 1 levels, collagen I and IV activity, interstitial volume, {alpha}-SMA accumulation, angiotensinogen expression and renal dysfunction, while treatment with PEG-sTNFR1 significantly reduced each of these markers of renal fibrosis. These results demonstrate that TNF- {alpha} mediates obstruction-induced renal fibrosis and identify TNF- {alpha} neutralization as a potential therapeutic option for the amelioration of obstruction-induced renal injury.




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