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Am J Physiol Renal Physiol 297: F1381-F1390, 2009. First published August 26, 2009; doi:10.1152/ajprenal.00101.2009
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Activation of local aldosterone system within podocytes is involved in apoptosis under diabetic conditions

Sun Ha Lee,1,* Tae-Hyun Yoo,1,* Bo-Young Nam,1,* Dong Ki Kim,1 Jin Ji Li,1,2 Dong-Sub Jung,1 Seung-Jae Kwak,1 Dong-Ryeol Ryu,3 Seung Hyeok Han,1 Jung Eun Lee,1 Sung Jin Moon,1 Dae Suk Han,1 and Shin-Wook Kang1

1Department of Internal Medicine, College of Medicine, Brain Korea 21 for Medical Science, Yonsei University, and ; 3Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea; and ; 2Nephrology and Dialysis Unit, Department of Internal Medicine, The Affiliated Hospital, YanBian University Medical College, JiLin, China

Submitted February 21, 2009 ; accepted in final form August 19, 2009

Previous studies have shown that mineralocorticoid receptor (MCR) blocker reduces proteinuria in diabetic nephropathy (DN), but the role of aldosterone in podocyte injury has never been explored in DN. This study was undertaken to elucidate whether a local aldosterone system existed in podocytes and to examine its role in podocyte apoptosis under diabetic conditions. In vitro, immortalized podocytes were exposed to 5.6 mM glucose (NG), NG + 24.4 mM mannitol, and 30 mM glucose (HG) with or without 10–7 M spironolactone (SPR). In vivo, 32 Sprague-Dawley rats were injected with diluent (C, n = 16) or streptozotocin intraperitoneally [diabetes mellitus (DM), n = 16], and 8 rats from each group were treated with SPR for 3 mo. Aldosterone synthase (CYP11B2) and MCR mRNA and protein expression were determined by real-time PCR and Western blot, respectively, and aldosterone levels by radioimmunoassay. Western blot for apoptosis-related molecules, Hoechst 33342 staining, and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay were performed to determine apoptosis. CYP11B2 and MCR expression were significantly higher in HG-stimulated podocytes and DM glomeruli compared with NG cells and C glomeruli, respectively, along with increased aldosterone levels. Western blot analysis revealed that cleaved caspase-3 and Bax expression was significantly increased, whereas Bcl-2 expression was significantly decreased in HG-stimulated podocytes and in DM glomeruli. Apoptosis determined by Hoechst 33342 staining and TUNEL assay were also significantly increased in podocytes under diabetic conditions. These changes in the expression of apoptosis-related proteins and the increase in apoptotic cells were inhibited by SPR treatment. These findings suggest that a local aldosterone system is activated and is involved in podocyte apoptosis under diabetic conditions.

diabetic nephropathy; podocytes; aldosterone; apoptosis; high glucose



Address for reprint requests and other correspondence: S.-W. Kang, Dept. of Internal Medicine, Yonsei Univ. College of Medicine, 134 Shinchon-Dong, Seodaemoon-Gu, Seoul, Korea, 120-752 (e-mail: kswkidney{at}yumc.yonsei.ac.kr).







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