Excessive cellular growth is a major contributor to pathological changes associated with diabetic nephropathy. In particular, high glucose-induced growth of glomerular mesangial cells is a characteristic feature of diabetes-induced renal complications. Glomerular mesangial cells respond to traditional growth factors, although in diabetes this occurs in the context of an environment enriched in both circulating vasoactive mediators and high glucose. For example, the vasoactive peptide ANG II has been implicated in the pathogenesis of diabetic renal disease, and recent findings suggest that high glucose and ANG II activate intracellular signaling processes, including the polyol pathway and generation of reactive oxygen species. These pathways activate the Janus kinase (JAK)/signal transducers and activators of transcription (STAT) signaling cascades in glomerular mesangial cells. Activation of the JAK/STAT signaling cascade can stimulate excessive proliferation and growth of glomerular mesangial cells, contributing to diabetic nephropathy. This review focuses on some of the key elements in the diabetic microenvironment, especially high glucose and the accumulation of advanced glycoxidation end products and considers their impact on ANG II and other vasoactive peptidemediated signaling events in vitro and in vivo. ANG II; high glucose; glomerular mesangial cells; advanced glycoxidation end products GLOMERULAR MESANGIAL CELLS possess both contractile and mitogenic properties and contribute to the physiological regulation of glomerular dynamics (30,73). Growth factors have a maladaptive role in the glomerular damage accompanying experimental and human glomerulonephritis. This is especially evident in diabetic nephropathy through enlargement of the glomerular remnant and mesangial matrix expansion associated with the accumulation of extracellular matrix proteins synthesized by glomerular mesangial cells (12,30,73). The vasoactive peptide ANG II, not usually considered in the context of traditional growth factors, has been implicated in both normal and diabetic cellular growth (3, 64). Our group has found that activation of the Janus kinase (JAK)/signal transducers and activation of transcription (STAT) pathway is essential for ANG II-induced growth of glomerular mesangial cells (4,70). In addition, we have recently shown that high glucose augments ANG II-induced activation of the JAK/STAT pathway in rat kidney glomeruli (7) and that this pathway contributes importantly to production of the cytokine TGF-␤ as well as the extracellular matrix proteins collagen IV and fibronectin (70). Furthermore, recent studies also demonstrate that high glucose induces intracellular production of reactive oxygen species (ROS) (24), which have been shown to augment ANG II-induced signaling cascades and to activate JAK and STAT proteins (63,68).Renal disease is one of the leading causes of morbidity and mortality in patients with diabetes mellitus, and ANG II has been implicated in the pathogenesis of maladaptive growth in renal tissues...

Chronic angiotensin II (AngII) infusion stimulates IL-6 release, and we and others have shown that preventing the increase in IL-6 significantly attenuates AngII hypertension. This study measured renal blood flow (RBF) chronically, using Transonic flow probes in wildtype (WT) and IL-6 knockout (KO) mice, to determine the role of renal blood flow regulation in that response. AngII infusion at 200, 800, and 3600 ng/kg/min caused a dose-dependent decrease in renal blood flow in WT mice, and the response at 800 ng/kg/min was compared between WT and IL-6 KO mice. AngII infusion increased plasma IL-6 concentration in WT mice and increased MAP (19 hrs/day; DSI telemetry) from 113±4 to 149±4 mmHg (Δ 36 mmHg) over the 7-day infusion period, and that effect was blocked in IL-6 KO mice (119±7 to 126±7 mmHg). RBF decreased to an average of 61±8% of control over the 7-day period (control = 0.86±0.02 ml/min) in the WT mice; however, the average decrease to 72±6% of control (control = 0.88±0.02 ml/min) in the KO mice was not significantly different. There also was no difference in afferent arteriolar constriction by AngII in blood-perfused juxtamedullary nephrons in WT vs. KO mice. Phosphorylation of JAK2 and STAT3 in renal cortex homogenates increased significantly in AngII-infused WT mice, and that effect was prevented completely in AngII-infused IL-6 KO mice. These data suggest that IL-6-dependent activation of the renal JAK2/STAT3 pathway plays a role in AngII hypertension, but not by mediating the effect of AngII to decrease total renal blood flow.

Patients treated with the immunosuppressive drug tacrolimus (FK506), which binds FK506 Binding Protein 12 (FKBP12) then inhibits the calcium-dependent phosphatase calcineurin, exhibit decreased regulatory T cells, endothelial dysfunction, and hypertension; however the mechanisms and whether altered T cell polarization play a role are unknown. Tacrolimus treatment of mice for 1 week dose-dependently decreased CD4+/FoxP3+ (regulatory T cells) and increased CD4+/IL-17+ (T helper 17) cells in the spleen, and caused endothelial dysfunction and hypertension. To determine the mechanisms, we crossed floxed FKBP12 mice with Tie2-Cre mice to generate offspring lacking FKBP12 in endothelial and hematopoietic cells only (FKBP12EC KO). Given FKBP12’s role in inhibiting TGF-β receptor activation, Tie2-Cre-mediated deletion of FKBP12 increased TGF-β receptor activation and SMAD2/3 signaling. FKBP12EC KO mice exhibited increased vascular expression of genes and proteins related to endothelial cell activation and inflammation. Serum levels of the pro-inflammatory cytokines IL-2, IL-6, IFNγ, IL-17a, IL-21, and IL-23 were increased significantly suggesting a Th17 cell-mediated inflammatory state. Flow cytometry studies confirmed this as splenocyte levels of CD4+/IL-17+ cells were increased significantly while CD4+/FoxP3+ cells were decreased in FKBP12EC KO mice. Furthermore, spleens from FKBP12EC KO mice showed increased STAT3 activation, involved in Th17 cell induction, and decreased STAT5 activation, involved in regulatory T cell induction. FKBP12EC KO mice also exhibited endothelial dysfunction and hypertension. These data suggest that tacrolimus, through its activation of TGF-β receptors in endothelial and hematopoietic cells, may cause endothelial dysfunction and hypertension by activating endothelial cells, reducing Tregs, and increasing Th17 cell polarization and inflammation.

Banes-Berceli AK, Ketsawatsomkron P, Ogbi S, Patel B, Pollock DM, Marrero MB. Angiotensin II and endothelin-1 augment the vascular complications of diabetes via JAK2 activation. Am J Physiol Heart Circ Physiol 293: H1291-H1299, 2007. First published May 25, 2007; doi:10.1152/ajpheart.00181.2007.-The JAK/STAT pathway is activated in vitro by angiotensin II (ANG II) and endothelin-1 (ET-1), which are implicated in the development of diabetic complications. We hypothesized that ANG II and ET-1 activate the JAK/ STAT pathway in vivo to participate in the development of diabetic vascular complications. Using male Sprague-Dawley rats, we performed a time course study [days 7, 14, and 28 after streptozotocin (STZ) injection] to determine changes in phosphorylation of JAK2, STAT1, and STAT3 in thoracic aorta using standard Western blot techniques. On day 7 there was no change in phosphorylation of JAK2, STAT1, and STAT3. Phosphorylation of JAK2, STAT1, and STAT3 was significantly increased on days 14 and 28 and was inhibited by treatment with candesartan (AT 1 receptor antagonist, 10 mg ⅐ kg Ϫ1 ⅐ day Ϫ1 orally in drinking water), atrasentan (ETA receptor antagonist, 10 mg ⅐ kg Ϫ1 ⅐ day Ϫ1 orally in drinking water), and AG-490 (JAK2 inhibitor, 5 mg ⅐ kg Ϫ1 ⅐ day Ϫ1 intraperitoneally). On day 28, treatment with all inhibitors prevented the significant increase in systolic blood pressure (SBP; tail cuff) of STZ-induced diabetic rats (SBP: 157 Ϯ 9.0, 130 Ϯ 3.3, 128 Ϯ 6.8, and 131 Ϯ 10.4 mmHg in STZ, STZ-candesartan, STZ-atrasentan, and STZ-AG-490 rats, respectively). In isolated tissue bath studies, diabetic rats displayed impaired endothelium-dependent relaxation in aorta (maximal relaxation: 95.3 Ϯ 3.0, 92.6 Ϯ 7.4, 76.9 Ϯ 12.1, and 38.3 Ϯ 13.1% in sham, sham ϩ AG-490, STZ ϩ AG-490, and STZ rats, respectively). Treatment of rats with AG-490 restored endothelium-dependent relaxation in aorta from diabetic rats at 14 and 28 days of treatment. These results demonstrate that JAK2 activation in vivo participates in the development of vascular complications associated with STZinduced diabetes. vascular smooth muscle cells; type 1 diabetes; angiotensin II; Janusactivated kinase 2; signal transducer and activator of transcription COMPLICATIONS ASSOCIATED WITH type 1 and type 2 diabetes include both renal and vascular aspects. Vascular complications include an accelerated development of atherosclerosis and endothelial dysfunction (15). The loss of endothelial function has important implications for both the regulation of vascular tone and the unregulated growth of smooth muscle cells involved in the development of atherosclerosis.One activator of the tyrosine kinase Janus kinase 2 (JAK2) pathway is angiotensin II (ANG II). ANG II is involved in the vascular dysfunction and renal complications associated with many diseases, including hypertension and diabetes (27,18). In addition, our group (1, 26) has previously shown that JAK2 plays a critical role in the ANG II-and high glucose-induced growth in rat mesangial cells and ANG II-in...

In the current study, we investigated the effect of simvastatin on the ability of high glucose (HG) and ANG II to activate the JAK2-STAT signaling cascade and induce glomerular mesangial cell (GMC) growth. We found that pretreatment with simvastatin significantly inhibited HG- and ANG II-induced collagen IV production, JAK2 activation, and phosphorylation of STAT1 and STAT3 in GMC. We also found that the activation of JAK2 by HG and ANG II was dependent on the Rho family of GTPases. Consistent with these in vitro results, both albumin protein excretion and phosphorylation of JAK2, STAT1, and STAT3 were attenuated in renal glomeruli by administration of simvastatin in a streptozotocin-induced rat model of HG diabetes. This study demonstrates that simvastatin blocks ANG II-induced activation of the JAK/STAT pathway in the diabetic environment, in vitro and in vivo, and, thereby, provides new insights into the molecular mechanisms underlying early diabetic nephropathy.

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Janus kinase (JAK) 2 is activated by ANG II in vitro and in vivo, and chronic blockade of JAK2 by the JAK2 inhibitor AG-490 has been shown recently to attenuate ANG II hypertension in mice. In this study, AG-490 was infused intravenously in chronically instrumented rats to determine if the blunted hypertension was linked to attenuation of the renal actions of ANG II. In male Sprague-Dawley rats, after a control period, ANG II at 10 ng·kg(-1)·min(-1) was infused intravenously with or without AG-490 at 10 ng·kg(-1)·min(-1) iv for 11 days. ANG II infusion (18 h/day) increased mean arterial pressure from 91 ± 3 to 168 ± 7 mmHg by day 11. That response was attenuated significantly in the ANG II + AG-490 group, with mean arterial pressure increasing only from 92 ± 5 to 127 ± 3 mmHg. ANG II infusion markedly decreased urinary sodium excretion, caused a rapid and sustained decrease in glomerular filtration rate to ∼60% of control, and increased renal JAK2 phosphorylation; all these responses were blocked by AG-490. However, chronic AG-490 treatment had no effect on the ability of a separate group of normal rats to maintain normal blood pressure when they were switched rapidly to a low-sodium diet, whereas blood pressure fell dramatically in losartan-treated rats on a low-sodium diet. These data suggest that activation of the JAK/STAT pathway is critical for the development of ANG II-induced hypertension by mediating its effects on renal sodium excretory capability, but the physiological control of blood pressure by ANG II with a low-salt diet does not require JAK2 activation.

Hypertension, commonly recognized as high blood pressure, is a serious disease that affects millions of people worldwide. Similar to many physiological disorders, hypertension consists of several different cellular signaling pathways that involve various molecular messengers. Recent studies have shown that reactive oxygen species (ROS) play a substantial role in the development of both systemic and pulmonary hypertension, contributing to the pathology of this disease. However, the exact molecular mechanism of ROS in hypertension is not completely understood. In this review, we extensively examine and discuss the most recent experimental findings regarding the role of ROS in both pulmonary and systemic hypertension. Current studies show that excessive ROS not only promote JAK/STAT (janus kinase/signal transducers and activators of transcription)-mediated vascular remodeling in an angiotensin (ANG) II-induced hypertension model but also decrease the nitric oxide bioavailability. Furthermore, it has been shown that ROS generation can be mitigated through the inhibition of upstream ANG II or by blocking key ROS generators, such as nicotinamide adenine dinucleotide phosphate oxidase. Thus, various treatment options have been explored. Yet, as discussed in the current review, the regulation of ROS via novel antioxidant therapies may provide an alternative treatment for hypertension in the future.