title: Mineralocorticoid Receptor Blocker Protects against Podocyte-Dependent Glomerulosclerosis.
abstract: BACKGROUND
  We previously showed that angiotensin type 1 receptor (AT1) blocker (ARB) attenuates glomerular injury in Nphs1-hCD25 (NEP25) transgenic mice, a model of selective podocyte injury. However, subsequent studies in NEP25 mice with podocyte-specific deficiency of AT1 revealed that the protective effects of ARB are not through the podocyte AT1, thereby raising the possibility that the protective effects of ARB involve mineralocorticoids.
  
  
  METHODS
  NEP25 mice were treated with the mineralocorticoid receptor blocker (MRB) spironolactone (25 mg/kg/day, n = 10), the ARB losartan (250 mg/kg/day, n = 11), both (ARB+MRB, n = 8) or vehicle (Vehicle, n = 9) from day -7 to day 9 of induction of podocyte injury.
  
  
  RESULTS
  ALTHOUGH MRB DID NOT REDUCE SYSTOLIC BLOOD PRESSURE OR PROTEINURIA, ADDITION OF MRB TO ARB SIGNIFICANTLY ATTENUATED GLOMERULOSCLEROSIS (GLOMERULOSCLEROSIS INDEX: ARB+MRB 1.67 ± 0.19 vs. MRB 2.01 ± 0.29, ARB 2.35 ± 0.19, and Vehicle 2.25 ± 0.26, p < 0.05) and preserved the number of WT1-positive podocytes (ARB+MRB 152.5 ± 9.7 vs. MRB 117.2 ± 9.0 or ARB 113.6 ± 7.4, and ARB+MRB vs. Vehicle 97.5 ± 4.0 per glomerulus; p < 0.05).
  
  
  CONCLUSIONS
  These data suggest that, while MRB does not attenuate proteinuria caused by podocyte-specific injury, it provides protective effects against glomerulosclerosis that is independent of systemic blood pressure.
authors.affiliation: Division of Nephrology, Department of Pediatrics, Vanderbilt University, Nashville, Tenn., USA.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Takagi
authors.forename: Takakuni
authors.initials: T
authors.lastname: Tanizawa
authors.forename: Valentina
authors.initials: V
authors.lastname: Kon
authors.forename: Agnes B
authors.initials: AB
authors.lastname: Fogo
authors.forename: Iekuni
authors.initials: I
authors.lastname: Ichikawa
authors.forename: Ji
authors.initials: J
authors.lastname: Ma