Abstract
Objective:
Uremia accelerates atherosclerosis in apolipoprotein E-deficient (apoE-/-) mice. We examined whether this effect may be preventable by pharmacological blockade of the renin-angiotensin system (RAS).
Methods and results:
Uremia was induced in apoE-/- mice by 5/6 nephrectomy (NX). Treatment with the angiotensin converting enzyme inhibitor enalapril (2 or 12 mg/kg/d) from week 4 to 36 after NX reduced the aortic plaque area fraction from 0.23+/-0.02 (n=20) in untreated mice to 0.11+/-0.01 (n=21) and 0.08+/-0.01 (n=23), respectively (P<0.0001); the aortic plaque area fraction was 0.09+/-0.01 (n=22) in sham-operated controls. Enalapril from week 20 to 44 after NX also retarded the progression of atherosclerosis. Plasma levels of soluble intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) and concentrations of IgM antibodies against oxidized low density lipoprotein (OxLDL) increased after NX (P<0.01). Enalapril (12 mg/kg/d) attenuated these increases (P<0.05) and reduced aortic expression of vascular cell adhesion molecule (VCAM)-1 mRNA (P<0.05). Atherosclerosis in NX mice was also reduced by losartan (an angiotensin II receptor-blocker), but not when blood pressure was lowered with hydralazine (a non-RAS-dependent vasodilator).
Conclusion:
The results suggest that inhibition of RAS abolishes the proatherogenic effect of uremia independent of its blood pressure-lowering effect, possibly because of antiinflammatory and antioxidative mechanisms.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Angiotensin II Type 1 Receptor Blockers / pharmacology*
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Angiotensin-Converting Enzyme Inhibitors / pharmacology*
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Animals
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Antibodies, Anti-Idiotypic / blood
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Antibodies, Anti-Idiotypic / immunology
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Aorta, Thoracic / metabolism
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Aorta, Thoracic / pathology
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Aortic Diseases / blood
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Aortic Diseases / etiology
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Aortic Diseases / prevention & control*
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Apolipoproteins E / deficiency*
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Atherosclerosis / blood
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Atherosclerosis / etiology
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Atherosclerosis / prevention & control*
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Blood Pressure / drug effects
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Disease Models, Animal
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Disease Progression
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Drosophila Proteins
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Enalapril / pharmacology
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Follow-Up Studies
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Gene Expression / drug effects
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Immunoglobulin G / immunology
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Immunoglobulin M / immunology
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Intercellular Adhesion Molecule-1 / genetics
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Intercellular Adhesion Molecule-1 / metabolism
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Lipoproteins, LDL / immunology
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Losartan / pharmacology
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Mice
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Nephrectomy / adverse effects
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Oxidation-Reduction
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Peptidyl-Dipeptidase A / blood
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Peptidyl-Dipeptidase A / drug effects
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Prognosis
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RNA, Messenger / genetics
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Receptors, Cell Surface
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Renin-Angiotensin System / drug effects*
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Uremia / blood
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Uremia / complications*
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Uremia / immunology
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Vascular Cell Adhesion Molecule-1 / genetics
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Vascular Cell Adhesion Molecule-1 / metabolism
Substances
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Angiotensin II Type 1 Receptor Blockers
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Angiotensin-Converting Enzyme Inhibitors
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Antibodies, Anti-Idiotypic
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Apolipoproteins E
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Drosophila Proteins
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Immunoglobulin G
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Immunoglobulin M
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Lipoproteins, LDL
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RNA, Messenger
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Receptors, Cell Surface
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Vascular Cell Adhesion Molecule-1
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gustatory receptor, Drosophila
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oxidized low density lipoprotein
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Intercellular Adhesion Molecule-1
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Enalapril
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Peptidyl-Dipeptidase A
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Losartan