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 METHODS:Review of relevant recent publications in the field, and in addition of in part unpublished data obtained in our laboratories.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

journal_name

Kidney Blood Press Res

authors

Krämer BK,Kammerl MC,Kömhoff M

doi

10.1159/000075811

keywords:

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

43-62

issue

1

eissn

1420-4096

issn

1423-0143

pii

75811

journal_volume

27

pub_type

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