Dissertation (Ph.D.)--University of South Florida, 2008. / Includes vita. Also available online. Includes bibliographical references (leaves 121-140).

Airway remodeling in asthma includes alterations in extracellular matrix and airway smooth muscle (ASM) mass. For this study, ASM cells were obtained from rats that were challenged with ovalbumin (OVA) or saline (SAL) as control. OVA and SAL cells were seeded on plastic control (PC) or on plates coated with decorin or biglycan. OVA cell number was significantly increased versus SAL cells, for cells seeded on PC (48 h). A significant decrease in cell number was observed for both OVA and SAL cells seeded on decorin compared to PC cells (48 h). OVA cells, however, showed a more modest reduction in cell number. Furthermore, biglycan decreased SAL cell number only. Compared to no strain (NS), mechanical strain (S) reduced cell number for OVA and SAL cells on all matrices. In addition, S up-regulated expression of beta 1-integrin relative to NS controls. Results suggest an ability of ASM cells to be modulated by matrix and mechanical stimulation.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

The increase in ASMC mass is a major structural change described in airway remodeling in asthma. This increase has been attributed to ASMC hyperplasia and hypertrophy. The distance between ASMC and the epithelium is reduced suggesting expansion of the muscle bundle towards the epithelium. Recent studies have suggested a role of epithelial derived chemokines in ASMC migration toward the epithelium. We hypothesized that chemokines (Eotaxin, RANTES, MIP-1alpha and IL-8) can directly influence ASMC mass by increasing the rate of proliferation or enhancing survival. ASMCs were exposed to different concentrations of eotaxin, RANTES, IL-8 or MIP-1alpha. To test for proliferation, stimulated ASMC were pulsed with 3H-thymidine or stained with BrdU and then analyzed with flow cytometry. Apoptosis was measured using Annexin V and flow cytometry. Expression of phosphorylated p42/p44 and MAPKinases was assessed by Western analysis. In a concentration-dependent manner, chemokines such as Eotaxin, RANTES, IL-8 and MIP-lalpha increased ASMCs 3H-thymidine incorporation and DNA synthesis. Eotaxin, RANTES and IL-8 decreased the number of apoptotic ASMCs compared to the matched controls. A significant increase in phosphorylated p42/p44 MAPKs was seen after treating ASMCs with RANTES and eotaxin. We conclude that chemokines might contribute to airway remodeling by increasing the number of ASMCs.

Thesis (Ph. D.)--University of Nevada, Reno, 2002. / Includes bibliographical references. Online version available on the World Wide Web.

Mutações no gene Hfe causam a forma mais comum da hemocromatose hereditária, doença caracterizada por acúmulo progressivo de ferro nos tecidos parenquimatosos. Um estudo prévio conduzido em nosso laboratório (Am J Cardiol 88(4):388-91, 2001) encontrou associação entre mutação do gene Hfe e cardiomiopatia isquêmica, sugerindo que o acúmulo de ferro no tecido cardíaco pode ser um fator que potencializa as agressões ao sistema cardiovascular. O objetivo do presente trabalho foi testar a hipótese de que o ferro aumenta a susceptibilidade ao risco cardiovascular. A análise de dados de 318 pacientes seguidos durante 10 anos indicou que variantes genéticas do Hfe estão associadas com maior mortalidade em pacientes com insuficiência cardíaca de diferentes etiologias. Em seguida, verificou-se o acúmulo de ferro no coração, aorta e fígado ao longo de 1, 3, 6 e 12 meses em camundongos FVB. Para mimetizar os efeitos deletérios do ferro no ser humano, validamos proteínas envolvidas no metabolismo do ferro em camundongos e tratamos os animais com 10 mg diárias de ferro dextrano durante 4 semanas. Os resultados sem a sobrecarga de ferro já apontaram acúmulo de ferro significativo no coração e no fígado ao longo de 12 meses de vida, consistente com a ideia de aumento progressivo de risco cardiovascular associado ao envelhecimento. A sobrecarga de ferro foi associada com maior mortalidade e deterioração da função cardíaca. Os camundongos tratados com ferro apresentaram diminuição da fração de ejeção, redução da espessura do septo, maior remodelamento cardíaco e aumento do volume nuclear dos cardiomiócitos. Para entender as modulações gênicas causadas pelo ferro no coração, foi medida a expressão dos transcritos primários de mRNA relativo para os genes Hfe e para a hepcidina, encontrando-se ambos os genes significativamente menos expressos nos animais tratados com ferro em comparação ao grupo que só recebeu salina. Por fim, com o intuito de estudar em condições mais controladas o comportamento cardíaco frente à sobrecarga de ferro, foram comparados dois protocolos de extração primária de cardiomiócitos ventriculares de ratos neonatos para testes farmacológicos com ferro in vitro. O enriquecimento de cardiomiócitos in vitro se estabeleceu por dois métodos: separação por gradiente de percoll (Per) e por uma pré-seleção nomeada pre plating (PP). As células cardíacas foram mantidas por 8 dias em cultura e avaliações do metabolismo, produção de espécies reativas de oxigênio e contratilidade foram medidas. Ambos os métodos foram eficientes para a obtenção de células cardíacas, entretanto, as células extraídas por protocolo PP apresentaram metabolismo aumentado, com maior consumo de glicose e produção de lactato. Por diferentes parâmetros testados o protocolo PP apresentou maior estresse oxidativo, porém sem modular a quantidade de glutationas reduzidas e oxidadas. Notadamente, o protocolo PP apresentou maior atividade contrátil com aumento dos batimentos e maior influxo intracelular de cálcio. Células cardíacas extraídas pelo método PP foram tratadas com citrato de amônia férrico com doses de 50 ?g/mL e 100 ?g/mL e, após 24 horas, foi possível observar aumento significativo de apoptose. Desta forma, os modelos celulares em questão apresentam-se como importantes ferramentas para a identificação de mecanismos moleculares e celulares associados aos efeitos deletérios causados pelo ferro. Em conjunto, os resultados do presente trabalho apoiam a hipótese de que o acúmulo de ferro no tecido cardíaco aumenta a susceptibilidade cardiovascular. Trabalhos futuros permitirão melhor compreensão dos mecanismos envolvidos no acúmulo de ferro no coração ao longo do envelhecimento em pacientes com insuficiência cardíaca / Mutations in Hfe gene lead to the most common form of hereditary hemochromatosis, an autosomal recessive disease associated with iron accumulation in parenchymal tissues. In a previous study conducted in our laboratory (Am J Cardiol 88(4):388-91, 2001), genetic variation in the Hfe gene was associated with ischemic cardiomyopathy, suggesting that higher cardiac concentrations of iron aggravates injuries on the cardiovascular system. The aim of the present study was to test the hypothesis that iron increases susceptibility to cardiovascular risk. Analysis of data from 318 patients with 10-year follow-up showed that genetic variation in the Hfe gene was associated with higher mortality among patients with heart failure due to cardiomyopathy of different etiologies. Next, we demonstrated iron accumulation in heart, aorta, and liver in mice (FVB background) aged 1, 3, 6, and 12 months. To mimic the deleterious effect of iron observed in humans, we validated proteins playing a major role in iron metabolism and treated mice with 10 mg of iron-dextran daily for 4 weeks. Results showed that even without iron overload there is significant iron accumulation in the heart and liver with time, at 12 months of age, consistent with the idea that there is a progressive age-related increase in cardiovascular risk. Iron overload was associated with higher mortality in mice and impairment of cardiac function; in response to iron treatment ejection fraction and septum thickness were reduced, while cardiac remodeling and myocyte nuclear volume were increased. To understand the underlying mechanisms associated with iron-mediated modulation of genes in the heart, we assessed Hfe and hepcidin mRNA expression and found that these genes were significantly less expressed in iron-treated animals compared with the saline solution group. Lastly, to study cardiac behavior in the face of iron overload under well-controlled conditions we compared two protocols for primary extraction of neonatal rat cardiomyocytes for in vitro pharmacological tests: Percoll (Per) and pre plating (PP) extraction methods. Cardiac cells were used after 8 days and we measured metabolism, ROS production, and contractility. Both methods were effective in obtaining a high yield of cardiomyocytes. Nevertheless, cells extracted using PP protocol presented higher metabolic rate, as suggested by increased lactate production and glycolysis rate. In the PP protocol there was an increased oxidative stress, notwithstanding without modulating the amount of oxidized and reduced glutathione peroxidase. Notably, we found an increased contractile activity for pre-platting-prepared cells, with increased beating rate and higher calcium influx. Cardiac cells extracted by PP exposed to ferric ammonium citrate with doses of 50?g/mL and 100?g/mL, after 24 hours, displayed significant increased apoptosis. The cell models examined can be considered important tools for the identification of cell and molecular mechanisms associated with the harmful effects caused by iron. Taken together, the results of the present study support the hypothesis that cardiac tissue iron accumulation increases cardiovascular susceptibility. Further studies will help to unravel the mechanisms involved in cardiac iron accumulation throughout the aging process in patients with heart failure

O aumento da pressão arterial não é a única consequência da sobrecarga de sal na dieta. Independente dos efeitos hemodinâmicos, o excesso de sal pode induzir alterações estruturais no miocárdio. A avaliação dos mecanismos destas alterações foi o objetivo do presente estudo. Para tanto, ratos Wistar machos foram alimentados com dieta: normossódica (NR: 1,3% de NaCl), hipersódica 1 (HR1: 4%) e hipersódica 2 (HR2: 8%) desde o desmame até a 18a semana de idade. O grupo HR2 foi dividido em HR2, HR2+Hidralazina (HZ: 15mg/ kg/ dia) e HR2+Losartan (LOS: 20mg/ kg/ dia). As drogas foram administradas a partir da 7a semana de idade. Foram avaliados pressão arterial caudal (PAc), atividade de renina plasmática (ARP), aldosterona sérica, ecocardiograma, massa ventricular esquerda (MVE) e direita (MVD), medida do diâmetro transverso do miócito (DTM), fibrose intersticial (FI), expressão protéica do receptor de angiotensina II do tipo I (AT1) e tipo 2 (AT2), dosagem de angiotensina II (AII) e ligação do anticorpo que reconhece a conformação ativada dos receptores AT1 e AT2 no ventrículo esquerdo (VE) e direito (VD). A PAc foi maior no grupo HR1 e HR2 comparado com o grupo NR. A PAc do grupo HR2+HZ e HR2+LOS não diferiu do grupo NR. ARP e ALDO foram menores nos grupos HR1, HR2, HR2+HZ e HR2+LOS. A espessura do septo interventricular na diástole e da parede posterior do ventrículo esquerdo na diástole foram maiores nos grupos HR1, HR2, HR2+HZ e HR2+LOS comparado com o grupo NR. A MVE e MVD foram maiores nos grupos HR2, HR2+HZ e HR2+LOS comparado com o grupo NR. O DTM do VE foi maior nos grupos HR1, HR2, HR2+HZ comparado com o grupo NR e HR2+LOS. DTM do VD foi maior no grupo HR2 e HR2+HZ comparado com o grupo NR, HR1 e HR2+LOS. A FI no VE e VD foi maior nos grupos HR1, HR2 e HR2+LOS comparado com o grupo NR e HR2+HZ. A expressão da proteína do receptor AT1 no VE e VD foi maior nos animais do grupo HR2 e HR2+HZ quando comparado com o grupo NR, HR1 e HR2+LOS. A expressão da proteina do receptor AT2 não foi alterada pelo alto consumo de sal, mas foi menor no grupo HR2+LOS. A ligação do anticorpo que reconhece a conformação ativada do receptor AT1 no VE e VD foi menor nos grupos HR1, HR2, HR2+HZ e HR2+LOS comparado com o grupo NR. A ligação do anticorpo que reconhece a conformação ativada do receptor AT2 não foi alterada no VE e VD dos grupos HR1, HR2 e HR2+LOS. No entanto, a ligação do anticorpo no receptor AT2 foi menor no VE e VD no grupo HR2+LOS. O conteúdo de AII foi maior em ambos os ventrículos nos grupos HR1, HR2, HR2+HZ e HR2+LOS. O elevado consumo de sal induz hipertrofia e fibrose miocárdica independente do efeito sobre a pressão arterial. A hipertrofia do cardiomiócito e a FI induzida pelo sal ocorre por mecanismos diferentes. Algumas evidências deste estudo sugerem a internalização do receptor AT1 induzido pelo sal provavelmente devido à ligação da AII. / Increased blood pressure is not the only consequence of salt overload. Independently from the hemodynamic effect, salt excess may induce structural alterations in the myocardium. The aim of the present study was to evaluate the mechanisms of the myocardium structural alteration in response to high salt intake. Male Wistar rats were fed normal (NR: 1.3% NaCl), high 1 (HR1 4%) or high 2 (HR2 8%) salt diet since weaning until 18th week of age. HR2 group was divided in HR2, HR2+hydralazine (HZ: 15mg/ kg/ dia) and HR2+losartan (LOS: 20mg/ kg/ dia). Drugs were administered since the 7th week of age. Tail-cuff blood pressure (Tc-BP), plasma renin activity (PRA), serum aldosterone (ALDO), echocardiography, left (LV) and right (RV) ventricular mass, cardiomyocyte transverse diameter (CTD), interstitial fibrosis (IF), protein expression of AT1 and AT2 receptors, angiotensin II content (AII), binding of the conformational specific anti-AT1 and anti-AT2 antibody in both ventricles were determined in the LV and RV. Tc-BP was higher in the HR1 and HR2 groups when compared to NR. Tc-BP on HR2+HZ and HR2+LOS did not differ from NR. PRA and ALDO were lower in the HR1, HR2, HR2+HZ and HR2+LOS when compared to NR. Interventricular septal and left ventricular posterior wall thicknesses were higher on HR1, HR2, HR2+HZ and HR2+LOS compared to NR. LV and RV mass was higher in the HR2, HR2+HZ and HR2+LOS when compared to NR. CTD in the LV was higher on HR1, HR2 and HR2+HZ groups than on NR and HR2+LOS groups. CTD in the RV was higher in the HR2 and HR2+HZ when compared to NR, HR1 and HR2+LOS groups. IF was higher in the LV and RV in HR1, HR2 and HR2+LOS groups than in NR and HR2+HZ groups. AT1 protein expression was higher in the HR2 and HR2+HZ compared to NR, HR1 and HR2+LOS groups. High salt intake did not increase AT2 protein expression in the HR1, HR2 and HR2+HZ groups. However, losartan induced a decrease in AT2 protein expression. In response to high salt intake, the binding of an AT1 conformational specific antibody was lower in both ventricles. Binding of the conformational specific anti-AT2 antibody in both ventricles did not change in response to HR1 and HR2. However, binding of the conformational specific anti-AT2 antibody was lower in both ventricles in the HR2+LOS group. AII was higher in both ventricles in the HR1, HR2, HR2+HZ and HR2+LOS groups. Myocardial structural alterations in response to high salt intake are independent of the effect on blood pressure. Salt induced cardiomyocyte hypertrophy and interstitial fibrosis are due to different mechanisms. Some evidences from the present study are in favor of salt induced AT1 receptor internalization probably due to AII binding.

Orientador: Kleber Gomes Franchini / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T03:46:54Z (GMT). No. of bitstreams: 1 Pereira_AnaHelenaMacedo_D.pdf: 4791935 bytes, checksum: 1afe275f0fa4f53003b18816bc5c27cb (MD5) Previous issue date: 2013 / Resumo: Os fatores MEF2 (Myocyte Enhancer Factor 2) pertencem à família MADS Box (MCM1-Agamous-Deficiens-Serum response factor) e foram descritos pela primeira vez como fatores de transcrição que se ligam a sequencias de DNA ricas em A/T nos promotores de vários genes músculo específicos. Existem 4 genes da família MEF2 que foram identificados em vertebrados: MEF2A, B, C e D que são expressos de forma distinta durante a embriogênese e nos tecidos adultos. Estudos anteriores do nosso laboratório demonstraram que o fator de transcrição MEF2 é ativado por estiramento mecânico e influencia a expressão de genes relacionados à hipertrofia cardíaca. Utilizando a tecnologia de siRNA para MEF2C (siRNAMEF2C) demonstramos a atenuação da hipertrofia cardíaca induzida por coarctação da aorta nos animais que receberam o siRNAMEF2C. Por outro lado trabalhos demonstraram que animais transgênicos com a superexpressão de MEF2A ou de MEF2C e submetidos à sobrecarga de pressão por coarctação da aorta, não apresentam hipertrofia cardíaca compensatória. Nesses animais a superexpressão de MEF2A ou de MEF2C no coração está associada à deterioração cardíaca funcional e estrutural e o desenvolvimento de cardiomiopatia dilatada. Contudo, a caracterização fenotípica e os mecanismos moleculares envolvidos na superexpressão de MEF2C em miócitos cardíacos ainda são desconhecidos. Da mesma forma não é conhecido o papel do fator de transcrição MEF2C na resposta hipertrófica do miócito cardíaco após coarctação da aorta. No presente trabalho foi demonstrado que a superexpressão de MEF2C em miócitos cardíacos de ratos neonatos (NRMV), com o uso de partículas adenovirais, induziu a desdiferenciação celular e a ativação de mecanismos envolvidos na progressão do ciclo celular. Esses resultados foram obtidos por meio de experimentos de microarranjo de DNA, proteoma, PCR em tempo real e western blotting. A análise do fenótipo celular por microscopias de luz, confocal e eletrônica de transmissão demonstra que NRMV possuem aumento na binucleação e desorganização sarcomérica, alterações coerentes com o quadro de desdiferenciação celular e ativação da progressão do ciclo celular. Por meio da técnica de incorporação de iodeto de propídeo e citometria de fluxo confirmamos o aumento de células em ciclo celular. Para confirmar os achados nos cardiomiócitos neonatos passamos a investigar o efeito da superexpressão de MEF2C em cardiomiócitos de ratos adultos. Para isso padronizamos a técnica de isolamento destas células e tratamos com AdMEF2C. Sendo assim o tratamento com AdMEF2C em miócitos cardíacos de ratos adultos resultou em aumento da expressão de MEF2C após 48 horas de tratamento. O efeito observado foi semelhante ao encontrado em cardiomiócitos neonatos, sendo que os adultos apresentaram aumento da expressão de genes relacionados ao ciclo celular e diminuição dos genes estruturais. O nível ultraestrutural observado por microscopia eletrônica de transmissão no tempo de 48 horas de tratamento não observamos diferenças na estrutura sarcomérica das células tratadas com AdMEF2C. Por fim demonstramos que o silenciamento de MEF2C pela injeção de lentivírus no coração demonstrou ser capaz de impedir o desenvolvimento da hipertrofia cardíaca em camundongos coarctados por 15 dias. A hipertrofia do coração foi avaliada por meio da espessura da parede posterior do ventrículo esquerdo e gravimetria do ventrículo esquerdo e dos pulmões. O conjunto de dados demonstra que a superexpressão de MEF2C leva a alterações estruturais no miócito cardíaco compatíveis com quadro de deterioração e insuficiência cardíaca e que o silenciamento de MEF2C no coração impede o desenvolvimento da hipertrofia cardíaca decorrente da coarctação da aorta / Abstract: The factors MEF2 (myocyte enhancer factor 2) belong to the family MADS box (MCM1-Agamous-deficiens-Serum response factor) and were first described as transcription factors that bind DNA sequences rich in A / T in the promoters of multiple muscle-specific genes. There are four MEF2 family genes that were identified in vertebrates MEF2A, B, C and D are expressed differently during embryogenesis and in adult tissues. Previous studies from our laboratory demonstrated that the transcription factor MEF2 is activated by mechanical stretch and influences the expression of genes related to cardiac hypertrophy. Using siRNA technology to MEF2C (siRNAMEF2C) demonstrated attenuation of cardiac hypertrophy induced by aortic coarctation in animals that received siRNAMEF2C. On the other hand studies have demonstrated that transgenic mice with overexpression of MEF2A or MEF2C and subjected to pressure overload by aortic coarctation show no compensatory cardiac hypertrophy. In these animals the overexpression of MEF2A or MEF2C in the heart is associated with structural and functional cardiac deterioration and development of dilated cardiomyopathy. However, the phenotypic and molecular mechanisms involved in the overexpression of MEF2C in cardiac myocytes are still unknown. Likewise, there is known the role of the transcription factor MEF2C in cardiac myocyte hypertrophic response after aortic coarctation. In the present study it was shown that overexpression of MEF2C in neonatal rat cardiac myocytes (NRMV) with the use of adenoviral particles, and cellular dedifferentiation induced activation mechanisms involved in cell cycle progression. These results were obtained by DNA microarray experiments, proteomics, real time PCR and western blotting. The analysis of cell phenotype by light microscopy, confocal and transmission electron shows that NRMV have increased binucleation and sarcomeric disorganization, changes consistent with the framework of cellular dedifferentiation and activation of cell cycle progression. By means of the propidium iodide incorporation technique and flow cytometry, confirmed increasing cells in the cell cycle. To confirm the findings in neonatal cardiomyocytes we investigate the effect of overexpression of MEF2C in cardiomyocytes of adult rats. For this standardized technique and isolation of these cells treated with AdMEF2C. Thus treatment with AdMEF2C in adult rat cardiac myocytes resulted in increased expression of MEF2C after 48 hours of treatment. The observed effect was similar to that found in cardiomyocytes neonates, adults who showed increased expression of genes related to cell cycle and decreased structural genes. The ultrastructural level observed by transmission electron microscopy in the time of 48 hours of treatment showed no difference in sarcomeric structure of cells treated with AdMEF2C. Finally we show that MEF2C silencing by lentivirus injection in the heart has been shown to prevent the development of cardiac hypertrophy in mice after 15 days of pressure overload. The heart hypertrophy was evaluated by the thickness of the posterior wall of the left ventricle and the left ventricle gravity and lungs. The data set shows that overexpression of MEF2C leads to structural changes in the cardiac myocyte compatible framework of deterioration and failure, and MEF2C silencing of the heart prevents the development of cardiac hypertrophy due to aortic coarctation / Doutorado / Biologia Estrutural, Celular, Molecular e do Desenvolvimento / Doutora em Ciências

La ciclosporine est un traitement immunosuppresseur très utilisé : elle inhibe l'activation des lymphocytes T via la calcineurine. Sa néphrotoxicité limite son utilisation : la ciclosporine induit une augmentation de la vasoconstriction ainsi qu'une augmentation de la réponse des cellules musculaires lisses vasculaires (CMLV) aux agents vasoactifs. Le récepteur minéralocorticoïde (RM), au-delà de ses effets sur la réabsorption sodée, agit sur le tonus vasculaire en modulant la réponse des cellules (endothéliales et musculaires lisses) vasculaires aux agents vasoactifs. Notre hypothèse était que le RM pouvait participer à l'action vasoconstrictrice de la ciclosporine ; son inactivation pourrait limiter la néphrotoxicité de la ciclosporine. Deux modèles de souris ont été invalidés génétiquement pour le RM : dans les cellules endothéliales et les CMLV (KO-RM CMLV). Seules les souris KO-RM CMLV étaient protégées contre la néphrotoxicité de la ciclosporine. Ces effets impliquent une action sur le tonus vasculaire rénal. L'antagonisme pharmacologique du RM (par le canrénoate) administré per os confère la même protection. En revanche, la néphrotoxicité induite par le tacrolimus (une autre anticalcineurine) n'est pas prévenue par l'antagonisme du RM. Utiliser un antagoniste sélectif du RM (l'éplérénone) pourrait prévenir la néphrotoxicité de la ciclosporine. Nous avons prouvé sa bonne tolérance en association à la ciclosporine chez les patients transplantés et insuffisants rénaux chroniques. Une kaliémie supérieure à 4,35mmol/L à l'initiation indique un sur-risque de développer une hyperkaliémie. L'efficacité reste à démontrer au cours d'un essai prospectif et randomisé. / Cyclosporine A (cyclo) is a widely used drug in kidney transplantation: its anticalcineurin actioninhibits T lymphocytes activation and prevents allograft rejection. Despite a huge benefit on graftsurvival, cyclo exerts a side effect that limits its use: nephrotoxicity. Vasculotoxicity appears to becentral: cyclo enhances renal vasoconstriction by altering vasoactive factors and vascular smoothmuscle cells (VSMC) response to vasoactive factors. Beyond its effects on sodium reabsorption,Mineralocorticoid Receptor (MR) acts on vascular tone by modulating both endothelial and VSMCresponses to vasoactive factors. Our working hypothesis was that MR could participate to cycloinducedvasoconstriction and that MR inactivating (pharmacologically or genetically) could alleviatecyclo-induced nephrotoxicity. Two genetically MR-knock out (MR-KO) were generated: inendothelial or VSMC. Only VSMC MR-KO mice were protected from cyclo-induced nephrotoxicity.We also show that such an effect was mediated by vascular tone modulation. This prevention was alsoconferred by the systemic pharmacological antagonism of MR (by canrenoate) in mice but not duringnephrotoxicity induced by tacrolimus (another anticalcineurine drug used in kidney transplantation).Then, we proposed to use MR pharmacological antagonism in humans (by eplerenone) during kidneytransplantation. We first had to prove its safety in such a population. Among 31 cyclo-treated patients,only 9 developed hyperkalemia (>5mmol/L) and none presented serious side effect. We propose akalemia higher than 4.35mmol/L at baseline to be the marker of a higher risk of developinghyperkalemia under treatment. The efficiency of eplerenone to prevent/alleviate cyclo-inducednephrotoxicity during kidney transplantation should be tested during a randomized controlled trial.

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