Papel do receptor B1 para cininas e o efeito da inibição da enzima conversora de angiotensina em ataques agudos de gota em roedores

Abstract

Gout, or gouty arthritis, has been associated of a range of comorbidities as hypertension and kidney diseases. Some studies have indicated that certain antihypertensive drugs, such as angiotensin I-converting enzyme inhibitors (ACEi), increase the risk of gout. Notably, ACEi block the metabolism of several peptides, in particular bradykinin hydrolysis. Bradykinin is also a substrate for kininase I, which forms des-Arg-kinin B1R agonists. Therefore, ACE inhibition can activate the B1R pathway. Moreover, ACEi are allosteric enhancers of kinin receptors and B1R are linked to inflammatory cardiovascular diseases. However, despite the body of evidence demonstrating a clear contribution of the kinin system to the pathogenesis of some arthritic conditions, the role of the kinin B1 receptor in monosodium urate (MSU) crystals crystal-induced gout is currently unknown, especially in respect to ACEi. Thus, the aim of the present study was to verify the role of the bradykinin B1 receptors and the effect of ACEi on acute gout induced by MSU crystals in rodents. Painful (overt pain and allodynia) and inflammatory parameters (joint edema, leukocyte trafficking, interleukin-1β levels) of acute gout attacks were assessed several hours after intra-articular (IA) injection of MSU (1.25 or 0.5 mg/articulation) in the ankle of rats or mice, respectively. The role of B1R was investigated by pharmacological antagonism or gene deletion. In addition, B1R immunoreactivity on ankle tissue and sensory neurons, kininase I activity and des-Arg9-bradykinin synovial levels were also measured. Similar tools were used to investigate the effects of ACEi on low dose of MSU (0.0125 mg/articulation)-induced inflammation. Bouth, bradykinin B1R antagonism or gene deletion largely reduced all painful and inflammatory signs of gout. Furthermore, MSU increased not only the B1R expression in articular tissues, but also the content of the B1 agonist des-Arg9-bradykinin and the activity of the B1 agonist-forming enzyme kininase I. Finally, low dose of MSU crystals (which did not induced inflammation in control animals) was capable of causing signs of acute gout attacks in ACEi-treated animals, which was B1R-dependent. Concluding, bradykinin B1R activation contributes to acute gouty attacks, including the ones facilitated by ACEi. Thus, B1R is a potential therapeutic target for treatment and prophylaxis of gout, especially in patients taking ACEi.