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Published ahead of print on September 21, 2005
Journal of the American Society of Nephrology
© 2005 American Society of Nephrology
doi: 10.1681/ASN.2004111011
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BASIC SCIENCE: Pathophysiology of Renal Disease and Progression

Methotrexate Prevents Renal Injury in Experimental Diabetic Rats via Anti-Inflammatory Actions

Kosuke Yozai 1, Kenichi Shikata 1*, Motofumi Sasaki 1, Atsuhiro Tone 1, Sakiko Ohga 1, Hitomi Usui 1, Shinichi Okada 1, Jun Wada 1, Ryo Nagase 1, Daisuke Ogawa 1, Yasushi Shikata 1*, Hirofumi Makino 1

1

Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan


* To whom correspondence should be addressed. E-mail: shikata{at}md.okayama-u.ac.jp.


   Abstract

Recent studies suggested the involvement of inflammatory processes in the pathogenesis of diabetic nephropathy. Methotrexate (MTX), a folic acid antagonist, is widely used for the treatment of inflammatory diseases. Recently, it has been shown that treatment with low-dose MTX reduces the cardiovascular mortality in patients with rheumatoid arthritis, suggesting that MTX has anti-atherosclerotic effects via its anti-inflammatory actions. This study was designed to determine the anti-inflammatory effects of this agent on diabetic nephropathy. Diabetes was induced in Sprague-Dawley rats with streptozotocin, and MTX (0.5 or 1.0 mg/kg) was administered once a week for 8 wk. Treatment with MTX reduced urinary albumin excretion, mesangial matrix expansion, macrophage infiltration, expression of TGF-{beta} and type IV collagen, and intercellular adhesion molecule-1 in glomeruli. MTX also reduced the high glucose-induced NF-{kappa}B activation in vitro and in vivo. The results indicate that intermittent administration of MTX prevented renal injuries without changes in blood glucose level and BP in experimental diabetic rats. The protective effects of MTX are suggested to be mediated by its anti-inflammatory actions through inhibition of NF-{kappa}B activation and consequent reduction of intercellular adhesion molecule-1 expression and macrophage infiltration. The results suggest that anti-inflammatory agents might be beneficial for the treatment of diabetic nephropathy.




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