Amelioration of crescentic glomerulonephritis by RhoA kinase inhibitor, Fasudil, through podocyte protection and prevention of leukocyte migration

Am J Pathol. 2008 Mar;172(3):603-14. doi: 10.2353/ajpath.2008.070196. Epub 2008 Feb 2.

Abstract

The small GTPase RhoA is activated by the angiotensin II (AngII) type 1 receptor (AT1R), which is part of the local renin-angiotensin system that is involved in podocyte injury preceding glomerular crescent formation. We demonstrated previously that inhibition of AT1R protects against crescentic glomerular injury in Fc receptor-deficient mice (gamma -/-) with anti-glomerular basement membrane antibody-induced glomerulonephritis (anti-GBM GN). Here, we hypothesized that the RhoA kinase inhibitor, fasudil, attenuates AT1R-dependent crescentic GN. We examined anti-GBM GN in gamma -/- mice with or without fasudil treatment, and further investigated the underlying mechanisms in cultured differentiated podocytes and leukocytes. Fasudil markedly attenuated crescentic GN with a significant decrease in proteinuria and hematuria, infiltration of T cells and monocytes/macrophages as well as their local proliferation, and preservation of podocyte-specific proteins, including WT-1 and nephrin, in glomeruli. In vitro studies showed that AngII induced the down-regulation of both nephrin and WT-1 expression in podocytes, which was reversed by fasudil in a dose-dependent manner. Additionally, fasudil blocked the AngII-induced migration of both macrophages and T cells. Furthermore, we also examined lipopolysaccharide-induced nephrotic syndrome in severe combined immunodeficiency disease mice and found that fasudil failed to block the development of proteinuria because of a B7-1-dependent podocyte injury. In conclusion, fasudil treatment prevents crescent formation and disease progression in anti-GBM GN by preventing AngII-induced podocyte injury and leukocyte migration.

MeSH terms

  • 1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine / analogs & derivatives*
  • 1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine / pharmacology
  • Animals
  • Blood Pressure / physiology
  • Blood Urea Nitrogen
  • Cells, Cultured
  • Chemotaxis, Leukocyte / drug effects*
  • Cytoprotection / drug effects
  • Female
  • Glomerulonephritis / prevention & control*
  • Mice
  • Mice, Knockout
  • Mice, SCID
  • Podocytes / drug effects*
  • Protein Kinase Inhibitors / pharmacology*
  • Receptors, IgG / genetics
  • rhoA GTP-Binding Protein / antagonists & inhibitors

Substances

  • Protein Kinase Inhibitors
  • Receptors, IgG
  • 1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine
  • rhoA GTP-Binding Protein
  • fasudil