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Antifibrotic, nephroprotective potential of ACE inhibitor vs AT1 antagonist in a murine model of renal fibrosis

Gross, Oliver, Schulze-Lohoff, Eckhard, Koepke, Marie-Louise, Beirowski, Bogdan, Addicks, Klaus, Bloch, Wilhelm, Smyth, Neil and Weber, Manfred (2004) Antifibrotic, nephroprotective potential of ACE inhibitor vs AT1 antagonist in a murine model of renal fibrosis Nephrology, Dialysis, Transplantation, 19, (7), pp. 1716-1723. (doi:10.1093/ndt/gfh219).

Record type: Article


BACKGROUND: Several studies have shown antifibrotic effects of angiotensin converting enzyme (ACE) inhibitors as well as of angiotensin receptor 1 (AT1) antagonists, however, prospective trials with clinical end points comparing these effects do not exist. COL4A3-/- mice develop a non-hypertensive progressive renal fibrosis. We used this animal model to compare the potential of ACE inhibitor vs AT1 antagonist to prevent renal fibrosis irrespective of blood pressure-dependent involvement by the renin system. METHODS: COL4A3-/- mice were treated with placebo, ramipril or candesartan. Blood pressure, proteinuria, serum urea and lifespan were monitored. Renal matrix was characterized by immuno-histochemistry, light and electron microscopy. Further biochemical analysis was provided using cDNA microarray and western blot techniques. RESULTS: Untreated mice died of renal failure after 71+/-6 days. Ramipril and candesartan both delayed onset and reduced the extent of proteinuria. Both had minor effects on blood pressure and postponed onset of uraemia. Ramipril increased lifespan by 111% to 150+/-21 days (P<0.01), whereas candesartan resulted in only a 38% prolongation to 98+/-16 days (P<0.01). Ramipril reduced glomerular and tubulo-interstitial fibrosis and numbers of activated fibroblasts to a greater extent than candesartan. Microarray and western blot analysis revealed a higher antifibrotic potential of ramipril in terms of downregulation of TGFbeta, connective tissue growth factor, metalloproteinases and extracellular matrix proteins. CONCLUSIONS: The results indicate an antifibrotic, nephroprotective effect of ACE inhibitors and AT1 antagonists in an animal model of progressive renal fibrosis. The greater antifibrotic effect of ramipril at the maximal therapeutic doses employed may not be explained by different antiproteinuric or blood pressure lowering properties, but by-in contrast to candesartan-its ability to hinder the proinflammatory, profibrotic activation of the angiotensin receptor 2.

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Published date: 1 July 2004
Keywords: angiotensin, collagen, fibrinogen, renal hypertension


Local EPrints ID: 55880
ISSN: 0931-0509
PURE UUID: f3d7f34f-c1cb-44c9-8c9f-96cc0ae1ae14

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Date deposited: 06 Aug 2008
Last modified: 17 Jul 2017 14:31

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Author: Oliver Gross
Author: Eckhard Schulze-Lohoff
Author: Marie-Louise Koepke
Author: Bogdan Beirowski
Author: Klaus Addicks
Author: Wilhelm Bloch
Author: Neil Smyth
Author: Manfred Weber

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