Pathological alterations of renal function in insulindependent diabetes have been attributed to numerous factors, including adenosine. This study examined the expression levels of adenosine receptors (ARs) in the kidney of the streptozotocin-induced diabetic rat. In the diabetic kidney A1-AR mRNA levels increased 1.7-and 2.8-fold in cortex and medulla, respectively. This was accompanied by increased A1-AR protein levels in membranes of kidney cortex (1.5-fold) and medulla (threefold). A1-AR immunoreactivity increased strongly along medullar tubules especially in the collecting duct. The levels of A2a-AR mRNA increased twofold in diabetic kidney cortex but remained unchanged in medulla; however, A2a-AR protein levels increased more than threefold in cortex. Immunohistochemistry showed increased A2a-AR immunoreactivity in luminal membranes of cortical collecting ducts and in epithelial cells of preglomerular vessels. There were no significant changes in A2b-AR expression in diabetic kidney except in medullar membranes, where the receptor protein content decreased by 60%. A3-AR mRNA levels in diabetic kidney remained unchanged, but membrane-associated A3-AR protein levels increased by 70% in diabetic kidney cortex and decreased by 80% in medulla. These changes in ARs genes expression, receptor protein content, and cellular and tissue distribution, correspond to abnormalities characteristic of the diabetic kidney, suggesting involvement in pathogenesis of diabetic nephropathy. Kidney disease is one of the leading hallmarks of human diabetes. It is characterized by persistent proteinuria, hypertension, and progressive loss of renal function.
1These changes are preceded by glomerular hyperfiltration, which is an early symptom in the development of diabetic nephropathy.2,3 Pathological changes of renal function in insulin-dependent diabetes have been attributed to numerous factors, including impaired action of angiotensin II, NO, prostaglandins, and adenosine. 4 -7 Adenosine in the kidney plays a broad regulatory role including modulation of renal blood flow, glomerular filtration rate, hormone and neurotransmitter release, transport function, and urine flow.8 Therefore, any changes in its action may significantly affect function of this organ.Adenosine is formed both in the extra-and intracellular space and exerts its physiological effect by coupling to cell-surface receptors, namely A1, A2a, A2b, and A3. The affinity for adenosine varies between receptors; thus its activation depends on adenosine concentration. The level of adenosine depends on its metabolism and transport across plasma membranes. Our previous studies showed that, except for ENT2, the expression level of nucleoside transporters in kidney of diabetic rats was not altered. 10 Moreover, the expression level of adenosine kinase in the diabetic kidney was greatly reduced, suggesting that the turnover of the adenosine-AMP metabolic cycle might be impaired under diabetic conditions. 11