Pathogenic role of angiotensin II and the NF-κB system in a model of malignant hypertensive nephrosclerosis

• Published in: Hypertension research 2019-06, Vol.42 (6), p.779-789
• Main Authors: Ávila, Victor F, Foresto-Neto, Orestes, Arias, Simone C A, Faustino, Viviane D, Malheiros, Denise M A C, Camara, Niels O S, Zatz, Roberto, Fujihara, Clarice K
• Format: Article
• Language: English
• Subjects: Breastfeeding & lactation; Diet; Hypertension; Kidney diseases; Rodents; Salt
• ISSN: 0916-9636; 1348-4214
• DOI: 10.1038/s41440-019-0226-6

We previously reported that rats treated with an NF-κB inhibitor, pyrrolidine dithiocarbamate (PDTC), during lactation developed hypertension in adult life, without apparent functional or structural damage to kidneys, providing a new model of essential hypertension. Here, we investigated whether uninephrectomy associated with salt overload would unveil a latent renal dysfunction in this model, aggravating arterial hypertension and promoting renal injury. Male Munich-Wistar rat pups received PDTC from maternal milk (PDTC ) from 0 to 20 days after birth. Another group received no treatment during lactation. All offspring underwent uninephrectomy (UNx) at 10 weeks of age and then were subdivided into NS, receiving a normal salt (0.5% Na ) diet, PDTC  + NS, HS, receiving a high-salt diet (2% Na chow + 0.5% saline to drink), and PDTC +HS. Twelve weeks later, HS rats were moderately hypertensive with mild albuminuria and renal injury. In contrast, severe hypertension, glomerulosclerosis, and cortical collagen deposition were prominent in PDTC  + HS animals, along with "onion-skin" arteriolar lesions, evidence of oxidative stress and intense renal infiltration by macrophages, and lymphocytes and angiotensin II-positive cells, contrasting with low circulating renin. The NF-κB pathway was also activated. In a separate set of PDTC +HS rats, Losartan treatment prevented NF-κB activation and strongly attenuated glomerular injury, cortical fibrosis, and renal inflammation. NF-κB activity during late nephrogenesis is essential for the kidneys to properly maintain sodium homeostasis in adult life. Paradoxically, this same system contributed to renal injury resembling that caused by malignant hypertension when renal dysfunction caused by its inhibition during lactation was unmasked by uninephrectomy associated with HS.