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A more recent version of this article appeared on December 10, 2004
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Papers In Press, published online ahead of print September 8, 2004
J. Biol. Chem, 10.1074/jbc.M407629200
Submitted on July 7, 2004
Revised on September 3, 2004
Accepted on September 8, 2004

Testosterone is responsible for enhanced susceptibility of males to ischemic renal injury

Kwon Moo Park, Jee In Kim, Youngkeun Ahn, Andrew J. Bonventre, and Joseph V. Bonventre

Department of Anatomy, Kyungpook National University, Daegu, Daegu 700-422

Corresponding Author: kmpark{at}knu.ac.kr

Female mice are much more resistant to ischemia/reperfusion (I/R)-induced kidney injury when compared with males. Although estrogen administration can partially reduce kidney injury associated with I/R, we demonstrate that the presence of testosterone, more than the absence of estrogen, plays a critical role in gender differences in susceptibility of the kidney to ischemic injury. Testosterone administration to females increases kidney susceptibility to ischemia. Dihydrotestosterone, which can not be aromatized to estrogen, has effects equal to those of testosterone. Castration reduces the I/R-induced kidney injury. In contrast, ovariectomy does not affect kidney injury induced by ischemia in females. Testosterone reduces ischemia-induced activation of nitric oxide synthases (NOSs) and Akt and the ratio of extracellular signal related kinase (ERK) to c-jun N-terminal kinase (JNK) phosphorylation. Pharmacological (Nw-nitro-L-arginine) or genetic (endothelial NOS or inducible NOS) inhibition of NOSs in females enhances kidney susceptibility to ischemia. Nitric oxide increases Akt phosphorylation and protects MDCK kidney epithelial cells from oxidant stress. Antagonists of androgen or estrogen receptors do not affect the gender differences. In conclusion, testosterone inhibits post-ischemic activation of NOSs and Akt and the ratio of ERK to JNK phosphorylation through non-androgen receptor medicated mechanisms, leading to increased inflammation and increased functional injury to the kidney. These findings provide a new paradigm for design of therapies for ischemia/reperfusion injury and may be important to our understanding of the pathophysiology of acute renal failure in pregnancy where plasma androgen levels are elevated.


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