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(American Journal of Pathology. 2007;170:1267-1276.)
© 2007 American Society for Investigative Pathology
DOI: 10.2353/ajpath.2007.060937

The Role of Interstitial Macrophages in Nephropathy of Type 2 Diabetic db/db Mice

Volha Ninichuk*, Alexander G. Khandoga{dagger}, Stephan Segerer*, Pius Loetscher{ddagger}, Achim Schlapbach{ddagger}, Laszlo Revesz{ddagger}, Roland Feifel{ddagger}, Andrej Khandoga{dagger}§, Fritz Krombach{dagger}, Peter J. Nelson*, Detlef Schlöndorff* and Hans-Joachim Anders*

From the Medical Policlinic,* the Department of Surgery,§ Klinikum Grosshadern, and the Institute for Surgical Research,{dagger} University of Munich, Munich, Germany; and Novartis Institutes for BioMedical Research,{ddagger} Basel, Switzerland

Diabetic nephropathy is associated with interstitial macrophage infiltrates, but their contribution to disease progression is unclear. We addressed this question by blockade of chemokine receptor (CCR)1 because CCR1 mediates the macrophage recruitment to the renal interstitium. In fact, when CCR1 was blocked with BL5923, a novel orally available CCR1 antagonist, the interstitial recruitment of ex vivo labeled macrophages was markedly decreased in uninephrectomized male db/db mice with advanced diabetic nephropathy. Likewise, BL5923 (60 mg/kg, twice a day) orally administered from months 5 to 6 of life reduced the numbers of interstitial macrophages in uninephrectomized db/db mice. This was associated with reduced numbers of Ki-67 proliferating tubular epithelial and interstitial cells, tubular atrophy, and interstitial fibrosis in uninephrectomized db/db mice. Glomerular pathology and proteinuria were not affected by the CCR1 antagonist. BL5923 reduced renal mRNA expression of Ccl2, Ccr1, Ccr2, Ccr5, transforming growth factor-ß1, and collagen I-{alpha}1 when compared with untreated uninephrectomized male db/db mice of the same age. Thus, we identified a previously unrecognized role for interstitial macrophages for tubulointerstitial injury, loss of peritubular microvasculature, interstitial inflammation, and fibrosis in type 2 diabetic db/db mice. These data identify oral treatment with the CCR1 antagonist BL5923 as a potential therapy for late-stage diabetic nephropathy.




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