Cyclosporine A attenuates the natriuretic action of loop diuretics by inhibition of renal COX-2 expression Klaus Höcherl, Frieder Kees, Bernhard K. Krämer,

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Cyclosporine A attenuates the natriuretic action of loop diuretics by inhibition of renal COX-2 expression Klaus Höcherl, Frieder Kees, Bernhard K. Krämer, Armin Kurtz Kidney International Volume 65, Issue 6, Pages 2071-2080 (June 2004) DOI: 10.1111/j.1523-1755.2004.00627.x Copyright © 2004 International Society of Nephrology Terms and Conditions

Figure 1 Effect of furosemide, cyclosporine A (CsA), rofecoxib, or their combinations on cyclooxygenase 1 (COX-1) mRNA abundance in the rat renal cortex (A) and outer (B) and inner medulla (C). Furosemide decreased COX-1 mRNA in the outer and inner medulla (mean ± SEM; N = 8). *P < 0.05 compared with vehicle-treated control. Kidney International 2004 65, 2071-2080DOI: (10.1111/j.1523-1755.2004.00627.x) Copyright © 2004 International Society of Nephrology Terms and Conditions

Figure 2 Effect of furosemide, cyclosporine A (CsA), rofecoxib, or their combinations on cyclooxygenase 2 (COX-2) mRNA abundance in the rat renal cortex (A) and outer (B) and inner medulla (C). CsA decreased basal as well as furosemide-stimulated renocortical COX-2 mRNA abundance (A) and decreased COX-2 mRNA in the outer medulla of control or furosemide treated rats (B). CsA further decreased COX-2 mRNA abundance in the rat inner medulla of vehicle and furosemide treated rats (C) (mean ± SEM; N = 8). *P < 0.05 compared with vehicle-treated control. †P < 0.05 compared with furosemide-treated rats. Kidney International 2004 65, 2071-2080DOI: (10.1111/j.1523-1755.2004.00627.x) Copyright © 2004 International Society of Nephrology Terms and Conditions

Figure 3 Renocortical cyclooxygenase 2 (COX-2) (A) and COX-1 (B) protein levels in rats treated with either vehicle or furosemide and in addition with cyclosporine A (CsA), rofecoxib, or the combination of rofecoxib with CsA. The insert shows representative blots for COX-1 and COX-2 protein (-, untreated; +, treated). The furosemide induced increase in COX-2 protein expression was attenuated by CsA given alone or in combination with rofecoxib, whereas rofecoxib had no influence (A). COX-1 protein abundance was not influenced by any treatment maneuver (B) (mean ± SEM; N = 8). *P < 0.05 compared with vehicle-treated control; †P < 0.05 compared with furosemide-treated rats. Kidney International 2004 65, 2071-2080DOI: (10.1111/j.1523-1755.2004.00627.x) Copyright © 2004 International Society of Nephrology Terms and Conditions

Figure 4 Renocortical prostaglandin E2 (PGE2) (A), 6-keto prostaglandin F1α (6-keto PGF1α) (B), and thromboxane B2 (TxB2) (C) levels in rats treated with either cyclosporine A (CsA), rofecoxib, furosemide, or the combination of CsA with rofecoxib. CsA, rofecoxib, and the combination of CsA with rofecoxib decreased basal as well as furosemide stimulated tissue levels of PGE2 (A) and 6-keto PGF1α (B). Tissue levels of TxB2 were not altered by any treatment maneuver (C) (mean ± SEM; N = 8). *P < 0.05 compared with vehicle-treated control; †P < 0.05 compared with furosemide-treated rats. Kidney International 2004 65, 2071-2080DOI: (10.1111/j.1523-1755.2004.00627.x) Copyright © 2004 International Society of Nephrology Terms and Conditions

Figure 5 Urinary prostaglandin E2 (PGE2) (A), 6-keto prostaglandin F1α (6-keto PGF1α) (B), and thromboxane B2 (TxB2) (C) excretion in rats treated with either cyclosporine A (CsA), rofecoxib, furosemide, or the combination of CsA with rofecoxib. CsA and rofecoxib decreased basal as well as furosemide stimulated daily urinary excretion of PGE2 (A) and 6-keto PGF1α (B). CsA increased TxB2 excretion, what was attenuated by additional rofecoxib treatment (C). Rofecoxib decreased basal as well as furosemide-induced TxB2 excretion (mean ± SEM; N = 8). *P < 0.05 compared with vehicle-treated control; †P < 0.05 compared with furosemide-treated rats; ‡P < 0.05 compared with CsA. Kidney International 2004 65, 2071-2080DOI: (10.1111/j.1523-1755.2004.00627.x) Copyright © 2004 International Society of Nephrology Terms and Conditions

Figure 6 Urinary volume (A) and daily urinary sodium (B) and potassium excretion (C) in rats treated with either vehicle and furosemide and in addition with cyclosporine A (CsA), rofecoxib, or the combination of rofecoxib with CsA. Furosemide increased urinary volume (A) and daily urinary sodium excretion (B). These increases were attenuated by co-administration of rofecoxib, CsA, or a combination of rofecoxib with CsA. Urinary potassium excretion was decreased by CsA treatment (C) (mean ± SEM; N = 8). *P < 0.05 compared with vehicle-treated control; †P < 0.05 compared with furosemide-treated rats. Kidney International 2004 65, 2071-2080DOI: (10.1111/j.1523-1755.2004.00627.x) Copyright © 2004 International Society of Nephrology Terms and Conditions

Figure 7 Plasma renin activity (PRA) (A) and renocortical renin mRNA abundance (B) in rats treated with either vehicle or furosemide and in addition with cyclosporine A (CsA), rofecoxib, or the combination of rofecoxib with CsA. The furosemide induced raise in PRA was attenuated by rofecoxib or the combination of rofecoxib with CsA. CsA further increased PRA (A). The furosemide-induced increase in renocortical renin mRNA abundance was attenuated by rofecoxib or the combination of rofecoxib with CsA. CsA further increased renocortical renin mRNA abundance (B) (mean ± SEM; N = 8). *P < 0.05 compared with vehicle-treated control; †P < 0.05 compared with furosemide-treated rats; ‡P < 0.05 compared with CsA. Kidney International 2004 65, 2071-2080DOI: (10.1111/j.1523-1755.2004.00627.x) Copyright © 2004 International Society of Nephrology Terms and Conditions

Figure 8 Plasma concentrations of 6-keto prostaglandin F1α (6-keto PGF1α) in rats treated with either cyclosporine A (CsA), rofecoxib, furosemide, or the combination of CsA with rofecoxib. Furosemide increased plasma levels of 6-keto PGF1α. CsA further increased 6-keto PGF1α levels. Rofecoxib attenuated the furosemide-stimulated rise in plasma 6-keto PGF1α levels and attenuated the CsA-stimulated increase in plasma levels of 6-keto PGF1α (mean ± SEM; N = 8). *P < 0.05 compared with vehicle-treated control; †P < 0.05 compared with furosemide-treated rats; ‡P < 0.05 compared with CsA. Kidney International 2004 65, 2071-2080DOI: (10.1111/j.1523-1755.2004.00627.x) Copyright © 2004 International Society of Nephrology Terms and Conditions