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Am J Physiol Renal Physiol (November 5, 2008). doi:10.1152/ajprenal.90567.2008
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Submitted on September 22, 2008
Revised on October 24, 2008
Accepted on October 28, 2008

Cyclosporine triggers endoplasmic reticulum stress in endothelial cells: a role for endothelial phenotypic changes and death

Nicolas Bouvier1, Jean-Pierre Flinois1, Jérôme Gilleron1, François-Ludovic Sauvage2, Christophe Legendre3, Philippe Beaune1, Eric Thervet1, Dany Anglicheau1, and Nicolas Pallet1*

1 INSERM
2 CHU de Limoges
3 Hopital Necker

* To whom correspondence should be addressed. E-mail: nicolas.pallet{at}univ-paris5.fr.

Calcineurin inhibitors, cyclosporine and tacrolimus are effective immunosuppressants, but both substances have the same intrinsic nephrotoxic potential that adversely affects allograft survival in renal transplant patients and causes end-stage renal disease in other solid organ or bone marrow transplant recipients. Endothelial cells are the first biological interface between drugs and the kidney, and calcineurin inhibitors may influence endothelial function and viability in a number of ways. Notably, endothelial cells have recently been shown to contribute to the accumulation of interstitial fibroblasts in non-renal models, through endothelial-to-mesenchymal transition. Here, we demonstrate that cyclosporine, but not tacrolimus or its metabolites, induces morphological and phenotypic endothelial changes suggestive of a partial endothelial-to-mesenchymal transition in human umbilical arterial endothelial cells. We identify for the first time a contingent of interstitial myofibroblasts that coexpress endothelial markers in rat kidneys treated with cyclosporine, suggesting that endothelial-to-mesenchymal transition could occur in vivo. Finally, our findings suggest that endoplasmic reticulum stress triggered by cyclosporine induce endothelial cells to undergo endothelial phenotypic changes suggestive of a partial endothelial-to-mesenchymal transition, whereas salubrinal partially preserves the endothelial phenotype. Inversely, tacrolimus does not induce endothelial-to-mesenchymal transition or endoplasmic reticulum stress. In conclusion, this study demonstrates for the first time that cyclosporine, and not tacrolimus, induces endoplasmic reticulum stress in endothelial cells. Our findings also suggest that endoplasmic reticulum stress contributes to endothelial cell death and phenotypic changes similar to a partial endothelial-to-mesenchymal transition.




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Induction of the unfolded protein response by calcineurin inhibitors: a double-edged sword in renal transplantation
Nephrol. Dial. Transplant., October 1, 2009; (2009) gfp516v1.
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