Prevention of chronic renal allograft rejection in rats with an oral endothelin A receptor antagonist

BACKGROUND: Chronic rejection is the most common cause of graft loss in renal transplantation. The pathomechanisms underlying chronic rejection are poorly understood, and no treatment has yet successfully been established. We hypothesized that, in analogy to models of reduced renal mass, the adminis...

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Main Authors: Braun, Claude (Author) , Conzelmann, Tobias (Author) , Vetter, Stephan (Author) , Schaub, Meike (Author) , Back, Walter (Author) , Yard, Benito A. (Author) , Kirchengast, Michael (Author) , Tullius, Stefan Günther (Author) , Schnülle, Peter (Author) , Woude, Fokko J. van der (Author) , Rohmeiss, Peter (Author)
Format: Article (Journal)
Language:English
Published: 1999
In: Transplantation
Year: 1999, Volume: 68, Issue: 6, Pages: 739-746
ISSN:1534-6080
DOI:10.1097/00007890-199909270-00005
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/00007890-199909270-00005
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Author Notes:C. Braun, T. Conzelmann, S. Vetter, M. Schaub, W.E. Back, B. Yard, M. Kirchengast, S.G. Tullius, P. Schnülle, F.J. van der Woude, P. Rohmeiss

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245 1 0 |a Prevention of chronic renal allograft rejection in rats with an oral endothelin A receptor antagonist  |c C. Braun, T. Conzelmann, S. Vetter, M. Schaub, W.E. Back, B. Yard, M. Kirchengast, S.G. Tullius, P. Schnülle, F.J. van der Woude, P. Rohmeiss 
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520 |a BACKGROUND: Chronic rejection is the most common cause of graft loss in renal transplantation. The pathomechanisms underlying chronic rejection are poorly understood, and no treatment has yet successfully been established. We hypothesized that, in analogy to models of reduced renal mass, the administration of a selective endothelin (ET) A receptor antagonist could improve the course of chronic rejection in renal allografts. METHODS: Experiments were performed in the Fisher-to-Lewis rat model of chronic rejection. Lewis-->Lewis isografts served as controls. Animals were treated with either the oral selective ET-A receptor antagonist LU135252 (50 mg/kg/day) or vehicle. Animal survival, blood pressure, creatinine clearance, proteinuria, and urinary ET excretion were investigated for 24 weeks. Kidneys were removed for light microscopical evaluation, determination of ET mRNA expression and tissue protein concentration, and immunohistochemical assessment of cell surface markers. RESULTS: Rats with chronic rejection showed an increase in renal ET mRNA synthesis and ET protein content. Treatment with LU135252 resulted in a significant improvement in survival after 24 weeks (0.92 vs. 0.38, P<0.01 by log-rank test). Creatinine clearance was higher in animals treated with the selective ET-A receptor antagonist (P<0.05). LU135252 had no influence on blood pressure and proteinuria. Selective ET-A blockade was associated with significantly less morphological changes and a significant reduction of expression of cell surface markers for macrophages (ED1), T cells (R73), and MHC II (F17-23-2). CONCLUSION: The renal ET-A system plays an important role in the pathomechanisms underlying chronic renal allograft rejection, because the treatment with a selective ET-A receptor antagonist dramatically improves the course of chronic renal failure after allograft transplantation. These results offer a novel therapeutical option for treatment of chronic renal allograft rejection, for which so far no therapy is known. 
650 4 |a Administration, Oral 
650 4 |a Animals 
650 4 |a Endothelin Receptor Antagonists 
650 4 |a Endothelin-1 
650 4 |a Endothelins 
650 4 |a Graft Rejection 
650 4 |a Graft Survival 
650 4 |a Kidney Diseases 
650 4 |a Kidney Glomerulus 
650 4 |a Kidney Transplantation 
650 4 |a Male 
650 4 |a Phenylpropionates 
650 4 |a Pyrimidines 
650 4 |a Rats 
650 4 |a Rats, Inbred F344 
650 4 |a Rats, Inbred Lew 
650 4 |a Receptor, Endothelin A 
650 4 |a Receptors, Endothelin 
650 4 |a RNA, Messenger 
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