Renal cyclooxygenase-2 (COX-2). Physiological, pathophysiological, and clinical implications.

Abstract

BACKGROUND/AIMS:

The role of COX-2 for renal function during renal development, for physiology and pathophysiology of renal diseases and the side effects of available COX-2 inhibitors, has gained increasing interest. We aimed therefore to review the respective role of renal COX-2.

METHODS:

Review of relevant recent publications in the field, and in addition of in part unpublished data obtained in our laboratories.

RESULTS:

COX-2 is 'constitutively' localized in the kidney i.e. in macula densa, TALH, interstitial cells, and is of utmost importance for normal renal development. Renal COX-2 is regulated by for example sodium and volume intake, angiotensin II, glucocorticoids often involving specific COX-2 promotor response elements. COX-2 derived prostanoids are required for preservation of renal blood flow and glomerular filtration especially in states of fluid deficit, they promote natriuresis, and furthermore may stimulate renin secretion during low-sodium intake/loop diuretic use. Conversely, COX-2 inhibitors decrease glomerular filtration, and renal perfusion, sometimes even causing acute renal failure. In addition, COX-2 inhibitors cause sodium retention, edema formation, cardiac failure and hypertension. The role of COX-2 derived prostanoids in renal inflammation or failure including diabetic nephropathy and renal transplantation remains at present controversial.

CONCLUSION:

COX-2 is one of the major players in renal physiology and pathophysiology. One focus of future work should be placed on COX-2 in primary renal diseases.

• Authors: Bernhard K Krämer, Martin C Kammerl, Martin Kömhoff
• Journal: Kidney & blood pressure research (Kidney Blood Press Res) Vol. 27 Issue 1 Pg. 43-62 ( 2004) ISSN: 1420-4096 [Print] Switzerland
• PMID: 14691350 (Publication Type: Journal Article, Review)
• Copyright: Copyright 2004 S. Karger AG, Basel

Chemical References

• Isoenzymes
• Membrane Proteins
• Cyclooxygenase 2
• PTGS2 protein, human
• Prostaglandin-Endoperoxide Synthases
• Renin

Topics

• Animals
• Cyclooxygenase 2
• Humans
• Isoenzymes (metabolism, physiology)
• Kidney (enzymology, growth & development, physiology)
• Kidney Diseases (physiopathology)
• Membrane Proteins
• Natriuresis (physiology)
• Nephritis (metabolism)
• Prostaglandin-Endoperoxide Synthases (metabolism, physiology)
• Renin (metabolism)