title: Role of hypomagnesemia in chronic cyclosporine nephropathy.
abstract: BACKGROUND
  Hypomagnesemia is a common finding of cyclosporine (CsA)-treated patients and has been proposed as both a cause and a consequence of CsA-induced nephrotoxicity. This experiment was conducted to elucidate the role of hypomagnesemia in the pathogenesis of chronic CsA nephropathy.
  
  
  METHODS
  CsA (15 mg/kg/day subcutaneously) was administered to rats maintained on a low-sodium diet for 1, 2, and 4 weeks, and the effects of magnesium (Mg) supplementation on renal function, renal histology, and renal gene expression profile of fibrogenic molecules and vasoconstrictors was examined.
  
  
  RESULTS
  CsA elicited hypomagnesemia and induced a progressive decline in glomerular filtration. At 28 day, renal tubular atrophy and cortical striped interstitial fibrosis were evident with CsA treatment. Dietary supplementation of Mg ameliorated CsA-induced hypomagnesemia and almost completely abolished CsA-induced chronic fibrotic lesions. Neither CsA nor Mg supplementation affected blood pressure. Renal cortical mRNA of transforming growth factor beta, plasminogen activator inhibitor (PAI)-1, and extracellular matrix started to increase at 14 days and elevated further at 28 days. In contrast, the increase in mRNA of tissue inhibitor of matrix metalloproteinase-1 and renin was evident early at 7 days and reached peak at 14 days. These mRNA increases, except that of renin, were almost abolished when hypomagnesemia was corrected. Magnesium supplementation also improved glomerular dysfunction, at least in part, through inhibition of up-regulated mRNA of endothelin-1.
  
  
  CONCLUSIONS
  CsA-induced hypomagnesemia contributes to chronic renal fibrotic lesions seen during CsA treatment through up-regulation of fibrogenic molecules, most notably early activation of tissue inhibitor of matrix metalloproteinase-1 expression.
authors.affiliation: Department of Pharmacology, Osaka City University Medical School, Abeno, Osaka, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakatani
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Asai
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamanaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tamada
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tashiro
authors.forename: Shokei
authors.initials: S
authors.lastname: Kim
authors.forename: Mikio
authors.initials: M
authors.lastname: Okamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwao
mesh_terms: D000818:Animals; D015152:Blotting, Northern; D003094:Collagen / Q000235:genetics; D016572:Cyclosporine / Q000097:blood / Q000633:toxicity*; D019332:Endothelin-1 / Q000235:genetics; D005786:Gene Expression Regulation / Q000187:drug effects; D007166:Immunosuppressive Agents / Q000633:toxicity*; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D008274:Magnesium / Q000097:blood*; D008297:Male; D012333:RNA, Messenger / Q000032:analysis; D051381:Rats; D017207:Rats, Sprague-Dawley; D012083:Renin / Q000235:genetics; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000235:genetics; D016212:Transforming Growth Factor beta / Q000235:genetics
chemical_list: D019332:Endothelin-1; D007166:Immunosuppressive Agents; D012333:RNA, Messenger; D019715:Tissue Inhibitor of Metalloproteinase-1; D016212:Transforming Growth Factor beta; D016572:Cyclosporine; D003094:Collagen; D012083:Renin; D008274:Magnesium