Phyllanthus niruri as a promising alternative treatment for nephrolithiasis

In spite of considerable efforts to identify effective treatments for urolithiasis, this is a goal yet to be achieved. This review summarizes experimental and clinical data evaluating the effect of the plant Phyllanthus niruri, a plant with worldwide distribution, as a potential agent to prevent and/or to treat urolithiasis The review is based on data from the literature and on the results obtained by our group from either in vivo/in vitro experiments or clinical studies. Phyllanthus niruri has been shown to interfere with many stages of stone formation, reducing crystals aggregation, modifying their structure and composition as well as altering the interaction of the crystals with tubular cells leading to reduced subsequent endocytosis. The clinical beneficial effects of Phyllanthus niruri may be related to ureteral relaxation, helping to eliminate calculi or to clear fragments following lithotripsy, or also to a putative reduction of the excretion of urinary crystallization promoters such as calcium. No adverse renal, cardiovascular, neurological or toxic effects have been detected in either of these studies. Altogether, these studies suggest a preventive effect of Phyllanthus niruri in stone formation or elimination, but still longer-term randomized clinical trials are necessary to confirm its therapeutic properties.Federal University of São Paulo Renal DivisionUNIFESP, Renal DivisionSciEL

Heterogeneity of glomerular perfusion and filtration induced by epinephrine and norepinephrine

The role of catecholamines in the distribution of intrarenal blood flow and in single-nephron glomerular filtration rate (SNGFR) was evaluated in anesthetized Wistar rats by the Hanssen technique. Epinephrine (EPI) and norepinephrine (NOR) were infused to produce elevations of 20-30 mmHg in mean arterial pressure. Superficial and juxtamedullary nephron perfusion and filtration were determined by the presence of Prussian blue dye. In the control group, 100% of the nephrons presented a homogeneous pattern of perfusion and filtration. In contrast, a heterogeneous distribution of the dye was found even in the larger arteries (arciform and radial), indicating variable perfusion and filtration in both superficial and juxtamedullary nephrons. The effects of EPI and NOR were also evaluated in the superficial cortex by the micropuncture technique in two additional groups of Munich-Wistar rats. Mean SNGFR was 27% and 54% lower in the EPI- and NOR-treated groups, respectively. No change in mean intraglomerular hydraulic pressure was observed after EPI or NOR infusion in spite of a highly scattered pattern, indicating an important variability in perfusion along the superficial cortex, and/or different sensitivity of the pre- and post-glomerular arterioles. The present data suggest that EPI and NOR may affect intrarenal hemodynamics by modifying perfusion and filtration in both superficial and juxtamedullary glomeruli and not by shifting blood flow from superficial to juxtamedullary nephrons. The heterogeneous pattern of perfusion was a consequence of differential vasoconstriction along the intrarenal arteries, probably due to different density and/or sensitivity of the adrenergic receptor subtypes present in the intrarenal vascular tree.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Mesangial Cells Cultured from Pregnant Rats Display Reduced Reactivity to Angiotensin II: the Role of Relaxin, Nitric Oxide and AT2 Receptor

Background/Aims: Pregnancy is characterized by vasodilatation and increased glomerular filtration rate (GFR), despite overstimulation of the renin angiotensin system (RAS). the mesangial cells (MCs) influences GFR and when cultured from pregnant rats displays refractoriness to Ang II. We evaluated the role of relaxin (RLX) and its receptor (RXFP1), nitric oxide (NO) and the AT2 receptor in this response. Methods: MCs cultured from kidneys of virgin (V) and pregnant (P) Wistar rats were treated with RLX or AT2 receptor blocker PD123319 or NO synthase inhibitor L-NAME. After 24 hr, intracellular calcium concentration ([Ca]i) was recorded before and after the addition of Ang II. Results: MCs from V group expressed AT2, RLX and RXFP1, whose levels were increased in P cells. Ang II induced a 150% increase in [Ca]i in the V cells and 85% (p<0.05) in the P cells. V cells treated with RLX displayed a similar response to that observed in P cells, suggesting that RLX can modulate the reactivity of the MCs to Ang II. L-NAME and PD123319 did not interfere in this response. Conclusion: Results suggest that RLX is a mediator of the refractoriness of the MCs to Ang II during pregnancy. Copyright (c) 2012 S. Karger AG, BaselFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundacao Oswaldo Ramos (FOR)Universidade Federal de São Paulo, Dept Med, Div Renal, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Div Renal, São Paulo, BrazilWeb of Scienc

Efeito da hipóxia e reoxigenação na resposta à angiotensina II em células mesangiais in vitro

INTRODUCTION: Mesangial cells (MC) may be involved in the glomerular alterations induced by ischemia/reperfusion injury. OBJECTIVE: To evaluate the response of immortalized MC (IMC) to 30 minutes of hypoxia followed by reoxygenation periods of 30 minutes (H/R30) or 24 hours (H/R24). METHODS: The intracellular calcium concentration ([Ca+2]i) was measured before (baseline) and after adding angiotensin II (AII, 10-5 M) in the presence and absence of glybenclamide (K ATP channel blocker). We estimated the level of intracellular ATP, nitric oxide (NO) and PGE2. RESULTS: ATP concentration decreased after hypoxia and increased after reoxygenation. Hypoxia and H/R induced increases in basal [Ca+2]i. AII induced increases in [Ca+2]i in normoxia (97 ± 9%), hypoxia (72 ± 10%) or HR30 (85 ± 17%) groups, but there was a decrease in the response to AII in group H/R24 since the elevation in [Ca+2]i was significantly lower than in control (61 ± 10%, p < 0.05). Glybenclamide did not modify this response. It was observed a significant increase in NO generation after 24 hours of reoxygenation, but no difference in PGE2 production was observed. Data suggest that H/R injury is characterized by increased basal [Ca+2]i and by an impairment in the response of cells to AII. Results suggest that the relative insensibility to AII may be at least in part mediated by NO but not by prostaglandins or vasodilator K ATP channels. CONCLUSION: H/R caused dysfunction in IMC characterized by increases in basal [Ca+2]i during hypoxia and reduction in the functional response to AII during reoxygenation.INTRODUÇÃO: Células mesangiais (CM) podem estar envolvidas na lesão glomerular induzida por hipoxia/reperfusão (H/R). OBJETIVO: Avaliar a resposta de CM imortalizadas (CMI) à hipoxia por 30 minutos seguida de reoxigenação por 30 minutos (H/R30) ou 24 horas (H/R24). MÉTODOS: Concentração de cálcio intracelular ([Ca+2]i) foi avaliada antes (basal) e após a adição de angiotensina II (AII, 10-5 M), na presença e na ausência de glibenclamida (bloqueador de canais K ATP). Foram estimados o nível de ATP intracelular, de óxido nítrico (NO) e de PGE2. RESULTADOS: Nível de ATP diminuiu após hipóxia e aumentou após a reoxigenação. H/R induziu aumento na [Ca+2]i basal. A AII elevou a [Ca+2]i nas condições de normoxia (97 ± 9%), hipoxia (72 ± 10%) ou HR30 (85 ± 17%), porém no grupo H/R24, houve diminuição significativa na resposta à AII, uma vez que a elevação da [Ca+2]i foi mais baixa do que no controle (61 ± 10%, p < 0,05). Glibenclamida não alterou esta resposta. Houve um aumento significativo na geração de NO após 24 horas de reoxigenação, mas não foi observada nenhuma diferença na produção de PGE2. Os dados indicam que a injuria celular causada pela hipoxia/reoxigenação é caracterizada pelo aumento na [Ca+2]i basal e por uma diminuição na reatividade celular à AII. Resultados sugerem que a insensibilidade ao agonista constritor pode ser pelo menos em parte, mediada pelo NO, mas não pelas prostaglandinas ou por canais K ATP. CONCLUSÃO: H/R resultou em disfunção das CMI, caracterizada pelo aumento na [Ca+2]i basal durante a hipóxia e redução da resposta funcional a AII durante a reoxigenação.Federal University of São PauloUNIFESPSciEL

Resistance Training in Spontaneously Hypertensive Rats with Severe Hypertension

Background: Resistance training (RT) has been recommended as a non-pharmacological treatment for moderate hypertension. In spite of the important role of exercise intensity on training prescription, there is still no data regarding the effects of RT intensity on severe hypertension (SH). Objective: This study examined the effects of two RT protocols (vertical ladder climbing), performed at different overloads of maximal weight carried (MWC), on blood pressure (BP) and muscle strength of spontaneously hypertensive rats (SHR) with SH. Methods: Fifteen male SHR [206 +/- 10 mmHg of systolic BP (SBP)] and five Wistar Kyoto rats (WKY; 119 +/- 10 mmHg of SBP) were divided into 4 groups: sedentary (SED-WKY) and SHR (SED-SHR); RT1-SHR training relative to body weight (similar to 40% of MWC); and RT2-SHR training relative to MWC test (similar to 70% of MWC). Systolic BP and heart rate (HR) were measured weekly using the tail-cuff method. The progression of muscle strength was determined once every fifteen days. The RT consisted of 3 weekly sessions on non-consecutive days for 12-weeks. Results: Both RT protocols prevented the increase in SBP (delta -5 and -7 mmHg, respectively; p > 0.05), whereas SBP of the SED-SHR group increased by 19 mmHg (p 0.05). Conclusions: Our data indicated that both RT protocols were effective in preventing chronic elevation of SBP in SH. Additionally, a higher RT overload induced a greater increase in muscle strength.Fundamentos: O treinamento de força (TF) tem sido recomendado como tratamento não farmacológico para hipertensão arterial moderada. Apesar do papel importante que a intensidade do exercício desempenha sobre a prescrição do treinamento, ainda não há nenhum dado avaliando os efeitos da intensidade do TF sobre a hipertensão arterial grave (HAG). Objetivo: Este estudo analisou os efeitos de dois protocolos do TF(subida em escada vertical), realizados com diferentes sobrecargas do peso máximo carregado (PMC), sobre a pressão arterial (PA) e a força muscular de ratos espontaneamente hipertensos (SHR) com HAG. Métodos: Quinze SHR machos (206 ± 10 mmHg de PA sistólica (PAS)) e cinco ratos Wistar Kyoto (WKY; 119 ± 10 mmHg de PAS) foram divididos em 4grupos:sedentários: (SED-WKY) e SHR (SED-SHR); treinados: TF1-SHR conforme o peso corporal (~40% do PMC); e TF2-SHR conforme o teste de PMC (~70% do PMC). Foram coletadas medidas de PAS e a frequência cardíaca (FC) semanalmente usando o método de pressão arterial caudal. A progressão da força muscular foi determinada a cada 15 dias. O TF consistiu de 3 sessões semanais em dias não consecutivos durante 12 semanas. Resultados: Os dois protocolos de TF preveniram o aumento da PAS(respectivamente, delta - 5 e -7 mmHg; p > 0, 05), enquanto que a PAS do grupo SED-SHR aumentou em 19 mmHg (p 0, 05). Conclusões: Nossos dados indicam que ambos os protocolos de TF foram efetivos na prevenção da elevação crônica da PAS na HAG. Além disso, sobrecargas maiores de TF induziram a um maior aumento de força muscular.CapesCNPqUniv Catolica Brasilia, Programa Posgrad Educ Fis, Brasilia, DF, BrazilUniv Fed Sao Paulo, Programa Posgrad Med Translac, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Div Nefrol, Lab Imunol Clin & Expt, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Med, Div Nefrol, Sao Paulo, SP, BrazilUniv Sao Paulo, Escola Artes Ciencias & Humanidades, Sao Paulo, SP, BrazilUniv Sao Paulo, Inst Ciencias Biomed, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Fisiol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Programa Posgrad Med Translac, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Div Nefrol, Lab Imunol Clin & Expt, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Med, Div Nefrol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Fisiol, Sao Paulo, SP, BrazilWeb of Scienc

Célula mesangial em cultura como modelo para o estudo do sistema renina-angiotensina intracelular e seu envolvimento na nefrologia diabética

BV UNIFESP: Teses e dissertaçõe

RENAL SODIUM CONSERVATION DURING STARVATION IN RATS

The natriuresis of fasting has been well characterized in man and rabbits but not in rats. The daily effects of fasting on glomerular filtration rate (GFR) and urinary sodium and potassium excretion were evaluated in Munich-Wistar rats (260-310 g) submitted to prolonged starvation (2-8 days). Rats do not present the natriuresis of fasting. Sodium excretion was reduced since the first few hours (0-4 h) of starvation. Antinatriuresis was abrupt during the early periods (1st and 2nd days) and stabilized at very low levels. During the early phase (4 days), sodium retention occurred due to both reduced glomerular filtration and increased tubular reabsorption. However, during the late phase (after the 4th day), antinatriuresis was mainly induced by the elevation in tubular reabsorption, since a normalization of GFR was observed. Thus, these homeostatic mechanisms permit adequate renal sodium conservation during starvation in rats.ESCOLA PAULISTA MED SCH,DISCIPLINA NEFROL,RUA BOTUCATU 740,BR-04023-062 SAO PAULO,BRAZILESCOLA PAULISTA MED SCH,DISCIPLINA NEFROL,RUA BOTUCATU 740,BR-04023-062 SAO PAULO,BRAZILWeb of Scienc