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From the Department of Medicine,*
Division of Nephrology
and Hypertension, Henry Ford Hospital, Detroit; and the Department of
Pathology,
the University of Michigan Medical
School, Ann Arbor, Michigan
Intraglomerular hypertension is a primary causal factor in the
progressive glomerulosclerosis that characterizes diabetic nephropathy
or severe renal ablation. However, inflammation of the
glomerular mesangium also participates in at least the early phase of
these diseases. In glomerulonephritis, where inflammation is
thought to be the predominant causal factor, intraglomerular
hypertension is also often present. Mesangial cells (MCs) are critical
in orchestrating key functions of the glomerulus including
extracellular matrix metabolism, cytokine production,
and interaction with leukocytes. Because MCs are subject to increased
stretching when intraglomerular hypertension is present, and in
glomerulonephritis MC/leukocyte interactions seem to be mediated
primarily via the up-regulation of intercellular adhesion molecule-1
(ICAM-1), we examine the possibility that cyclic stretching is
a stimulus for increased MC ICAM-1 activity. We demonstrate that the
normal low levels of MC ICAM-1 mRNA and protein are dramatically
up-regulated by even short intervals of cyclic stretch. This effect is
dose- and time-dependent, and requires little amplitude and a
brief period of elongation for significant induction. Stretch-induced
MC ICAM-1 also leads to a marked elevation in phagocytic leukocyte
adherence. This stimulated adherence is equal or greater than that
induced by the inflammatory cytokine tumor necrosis factor-
,
whereas an additive effect occurs when both are applied in combination.
Our results indicate that stretch-induced ICAM-1 may provide a direct
link between hypertension and inflammation in the progression of injury
and glomerulosclerosis in diabetes, renal ablation, and
other forms of glomerulonephritis.
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