Article
Reversal of renal tubule transporter downregulation during severe leptospirosis with antimicrobial therapy.
Registro en:
SPICHLER, A. et al. Reversal of renal tubule transporter downregulation during severe leptospirosis with antimicrobial therapy. American Journal of Tropical Medicine and Hygiene, v. 77, n. 6, p. 1111-1119, 2007.
0002-9637
Autor
Spichler, Anne
Ko, Albert Icksang
Silva, Everton Fagonde
Brito, Thales de
Silva, Ana Maria Gonçalves da
Athanazio, Daniel Abensur
Silva, Cleiton Santos
Seguro, Antonio Carlos
Resumen
Tubular dysfunction is a hallmark of severe leptospirosis. Antimicrobial therapy is thought to interfere on renal involvement. We evaluated the expression of a proximal tubule type-3 Na+/H+ exchanger (NHE3) and a thick ascending limb Na+-K+-2Cl(-) cotransporter (NKCC2) in controls and treated hamsters. Animals infected by a serovar Copenhageni isolate, were treated or not with ampicillin (AMP) and/or N-acetylcysteine (NAC). Leptospiral antigen(s) and expression of renal transporters were evaluated by immunohistochemistry, and serum thiobarbituric acid (TBARS) was quantified. Infected hamsters had high amounts of detectable leptospiral antigen(s) in target tissues while renal expression of NHE3 and NKCC2 decreased. Ampicillin treatment was associated with minimal or no detection of leptospiral antigens, normal expression of NHE3 and NKCC2 transporters, and reduced levels of TBARS. NAC effect was restricted to lowering TBARS. Early and late AMP treatment rescued tubular defects in severe leptospirosis disease, and there was no evidence of benefit from antioxidant therapy.