Abstract-The hemodynamic and nonhemodynamic effects of angiotensin II on diabetic complications are considered to be primarily mediated by the angiotensin II type 1 receptor subtype. However, its biological and functional effect mediated through the angiotensin II type 2 receptor subtype is still unclear. Activation of the angiotensin II type 2 receptors has been postulated to oppose angiotensin II type 1 receptor-mediated actions and thus attenuate fibrosis. This study aimed to elucidate the reno-protective role of the novel selective angiotensin II type 2 receptor agonist, Compound 21, in an experimental model of type 1 diabetic nephropathy. Compound 21 treatment significantly attenuated diabetes mellitus-induced elevated levels of cystatin C, albuminuria, mesangial expansion, and glomerulosclerosis in diabetic mice. Moreover, Compound 21 markedly inhibited the expression of various proteins implicated in oxidative stress, inflammation, and fibrosis, in association with decreased extracellular matrix production. These findings demonstrate that monotherapy of Compound 21 is protective against the progression of experimental diabetic nephropathy by inhibiting renal oxidative stress, inflammation, and fibrosis.
Materials and MethodsRefer to Materials and Methods in the online-only Data Supplement for greater details.
In Vivo Experimental ProcedureSix-week-old ApoE −/− mice were rendered diabetic via 5-daily intraperitoneal injection of streptozotocin at 55 mg/kg/d (Sigma-Aldrich, St Louise, MO). Diabetic animals were subjected to either a vehicle (0.1 mol/L citrate buffer) or C21 (1 mg/kg/d; Vicore Pharma AB, Göteborg, Sweden) treatment via daily gavaging, over a 20-week period. Additional subgroups of nondiabetic mice subjected to similar treatments were also studied concurrently.
In Vitro Experimental ProcedureMouse mesangial cells cultured in normal (5 mmol/L) and high (25 mmol/L) glucose conditions were treated with C21 (0.1-1 μmol/L) in the absence or presence of Ang II (3 μmol/L; Sigma-Aldrich) for 72 hours. RNA and proteins were then extracted from cell layers using Trizol reagent (Life Technologies, Rockville, MD) according to the manufacturer's instructions.
Metabolic and Renal Functional MeasurementsAssessment of body weight, metabolic parameters, and blood pressure were performed as described. 19 Collected serum and urine samples were assayed for cystatin C and albuminuria level, respectively, by a kit-based enzyme-linked immunosorbent assay (ELISA).
Glomerulosclerotic Injury AssessmentParaffin-embedded kidney sections were subjected to periodic acid-schiff staining for glomerulosclerotic injury assessment, as described. 20 Nuclei free area of periodic acid-schiff-positively stained glomeruli were expressed as a percentage of total glomerular area for quantification of mesangial area.
21Quantitative Real-time PCR Gene expression was analyzed by quantitative real-time PCR (qRT-PCR) using the Taqman System on an ABI Prism 7500 Sequence Detector (Applied Biosystems, Foster City, CA) as described.
22Prim...