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Int. J. Mol. Sci. 2014, 15(5), 8979-8997; doi:10.3390/ijms15058979
Article

Transition from Cyclosporine-Induced Renal Dysfunction to Nephrotoxicity in an in Vivo Rat Model

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1 Laboratory of Pharmacology & Experimental Therapeutics, Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra 3000-548, Portugal 2 Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra 3000-548, Portugal 3 Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra 3004-504, Portugal 4 Immunology and Oncology Laboratory, Center for Neurosciences and Cell Biology, Coimbra 3004-504, Portugal 5 Agrarian School of Viseu (ESAV), Polytechnic Institute of Viseu, Viseu 3500-606, Portugal 6 Educational, Technologies and Health Study Center, Polytechnic Institute of Viseu, Viseu 3500-606, Portugal 7 Research Center for Health Sciences, Beira Interior University, Covilhã 6201-506, Portugal 8 University Nephrology Unit, Faculty of Medicine, University of Coimbra, Coimbra 3004-504, Portugal 9 Biochemistry Department, Pharmacy Faculty, Porto University, Porto 4050-313, Portugal 10 Institute for Molecular and Cellular Biology, Porto University, Porto 4150-180, Portugal 11 Insulin Resistance & Adipocyte Group, Center for Neuroscience and Cell Biology, Coimbra 3004-504, Portugal 12 The Portuguese Diabetes Association (APDP), Lisbon 1250-203, Portugal
* Author to whom correspondence should be addressed.
Received: 7 April 2014 / Revised: 5 May 2014 / Accepted: 13 May 2014 / Published: 20 May 2014
(This article belongs to the Special Issue Renal Toxicology—Epidemiology and Mechanisms)
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Abstract

Cyclosporin A (CsA), a calcineurin inhibitor, remain the cornerstone of immunosuppressive regimens, regardless of nephrotoxicity, which depends on the duration of drug exposure. The mechanisms and biomarkers underlying the transition from CsA-induced renal dysfunction to nephrotoxicity deserve better elucidation, and would help clinical decisions. This study aimed to clarify these issues, using a rat model of short- and long-term CsA (5 mg/kg bw/day) treatments (3 and 9 weeks, respectively). Renal function was assessed on serum and urine; kidney tissue was used for histopathological characterization and gene and/or protein expression of markers of proliferation, fibrosis and inflammation. In the short-term, creatinine and blood urea nitrogen (BUN) levels increased and clearances decreased, accompanied by glomerular filtration rate (GFR) reduction, but without kidney lesions; at that stage, CsA exposure induced proliferating cell nuclear antigen (PCNA), transforming growth factor beta 1 (TGF-β1), factor nuclear kappa B (NF-κβ) and Tumor Protein P53 (TP53) kidney mRNA up-regulation. In the long-term treatment, renal dysfunction data was accompanied by glomerular and tubulointerstitial lesions, with remarkable kidney mRNA up-regulation of the mammalian target of rapamycin (mTOR) and the antigen identified by monoclonal antibody Ki-67 (Mki67), accompanied by mTOR protein overexpression. Transition from CsA-induced renal dysfunction to nephrotoxicity is accompanied by modification of molecular mechanisms and biomarkers, being mTOR one of the key players for kidney lesion evolution, thus suggesting, by mean of molecular evidences, that early CsA replacement by mTOR inhibitors is indeed the better therapeutic choice to prevent chronic allograft nephropathy.
Keywords: Cyclosporin A; transition from dysfunction to nephrotoxicity; biomarkers; fibrosis; proliferation; animal model Cyclosporin A; transition from dysfunction to nephrotoxicity; biomarkers; fibrosis; proliferation; animal model
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Sereno, J.; Rodrigues-Santos, P.; Vala, H.; Rocha-Pereira, P.; Alves, R.; Fernandes, J.; Santos-Silva, A.; Carvalho, E.; Teixeira, F.; Reis, F. Transition from Cyclosporine-Induced Renal Dysfunction to Nephrotoxicity in an in Vivo Rat Model. Int. J. Mol. Sci. 2014, 15, 8979-8997.

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