Inhibition of chymase protects against diabetes-induced oxidative stress and renal dysfunction in hamsters. Am J Physiol Renal Physiol 299: F1328 -F1338, 2010. First published September 29, 2010 doi:10.1152/ajprenal.00337.2010.-Accumulating evidence suggests that the intrarenal renin-angiotensin system may be involved in the progression of diabetic nephropathy. Chymase is a potent local angiotensin II-forming enzyme in several species, including humans and hamsters. However, the pathophysiological role of chymase is not fully understood. Here, we report a causal role of chymase in diabetic nephropathy and the therapeutic effectiveness of chymase inhibition. In the present study, renal chymase expression was markedly upregulated in streptozotocin-induced diabetic hamsters. Oral administration of a specific chymase inhibitor, TEI-F00806, completely ameliorated proteinuria, the overexpression of transforming growth factor-†and fibronectin in glomeruli, and renal mesangial expansion, by normalizing the increase in intrarenal angiotensin II levels in diabetic hamsters independently of blood pressure levels. In contrast, ramipril did not show such sufficient effects. These effects occurred in parallel with improvements in superoxide production and expression of NAD(P)H oxidase components [NAD(P)H oxidase 4 and p22 phox ] in glomeruli. This study showed for the first time that chymase inhibition may protect against elevated intrarenal angiotensin II levels, oxidative stress, and renal dysfunction in diabetes. These findings suggest that chymase offers a new therapeutic target for diabetic nephropathy.angiotensin II; NAD(P)H oxidase DIABETIC NEPHROPATHY IS A leading cause of renal failure worldwide and is associated with an increased risk of cardiovascular events. Experimental and clinical trials have indicated that blockade of the renin-angiotensin system (RAS) with angiotensin I-converting enzyme (ACE) inhibitors or angiotensin II (ANG II) antagonists has some protective effects on diabetic nephropathy and on cardiovascular events (3, 4, 32), which appear to be independent of its antihypertensive effect. These findings suggest that the intrarenal RAS may be involved in the progression of diabetic nephropathy. It is well recognized that the ACE-dependent ANG II-generating system is a source of intrarenal ANG II production. However, the use of ACE inhibitors was reported to only partly reduce the intrarenal ANG II production (10), suggesting the existence of alternative pathways. Indeed, human chymase specifically hydrolyzes the Phe 8 -His 9 bond in ANG I and forms ANG II (26). Tissue chymase of other several species including the hamster also have more efficient ANG II-forming activities than ACE, while rat chymase degrades ANG II inversely (1, 26). Of note, several reports have shown that chymase expression may be upregulated in diabetic renal tissues (14,19,29). However, it is still unclear whether chymase substantially contributes to the activation of intrarenal RAS in diabetic renal tissues. More importantly, th...