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Publication : Inhibition of 5-lipoxygenase decreases renal fibrosis and progression of chronic kidney disease.

First Author  Montford JR Year  2019
Journal  Am J Physiol Renal Physiol Volume  316
Issue  4 Pages  F732-F742
PubMed ID  30649890 Mgi Jnum  J:280621
Mgi Id  MGI:6368931 Doi  10.1152/ajprenal.00262.2018
Citation  Montford JR, et al. (2019) Inhibition of 5-lipoxygenase decreases renal fibrosis and progression of chronic kidney disease. Am J Physiol Renal Physiol 316(4):F732-F742
abstractText  In inflammatory diseases, the 5-lipoxygenase (5-LO) pathway contributes to epithelial damage and fibrosis by catalyzing the production of leukotrienes (LTs). Antagonists of the 5-LO pathway are currently approved for use in patients and are well tolerated. We found that expression of 5-LO is strongly induced in three models of chronic kidney disease: unilateral ureteral obstruction (UUO), folate nephropathy, and an orthologous mouse model of polycystic kidney disease. Immunohistochemistry showed that macrophages are the dominant source of 5-LO. Zileuton, a US Food and Drug Administration-approved antagonist of 5-LO, significantly reduced fibrosis at 7 and 14 days after UUO; these findings were confirmed using a genetically modified [5-LO-associated protein-knockout ( Alox5ap(-/-))] mouse strain. Inhibition of 5-LO did not appear to change infiltration of leukocytes after UUO as measured by flow cytometry. However, fluorescence-lifetime imaging microscopy showed that 5-LO inhibitors reversed the glycolytic switch in renal tubular epithelial cells after UUO. Two downstream enzymes of 5-LO, LTA4 hydrolase (LTA4H) and LTC4 synthase (LTC4S), are responsible for the synthesis of LTB4 and cysteinyl LTs, respectively. Fibrosis was reduced after UUO in Ltc4s(-/-), but not Lta4h(-/-), mice. In contrast, using the folate nephropathy model, we found reduced fibrosis and improved renal function in both Ltc4s(-/-) and Lta4h(-/-) mice. In summary, our studies suggest that manipulation of the 5-LO pathway may represent a novel treatment approach for chronic kidney disease.
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