CYP450, COX-2 and Obesity Related Renal Damage.

Abstract The number of obese people in the world is growing rapidly worldwide and has reached epidemic status. Obesity is often associated with the clustering of metabolic and cardiovascular risk factors that contribute to metabolic syndrome or syndrome X. Likewise, metabolic syndrome and its associated traits are major contributing factors to the increase in nephropathy and end stage renal disease. The specific factors that link the metabolic syndrome traits to the progression of nephropathy remain largely unexplored. Recent studies have demonstrated that an imbalance between cyclooxygenase-2 (COX-2) and cytochrome P450 (CYP450) arachidonic acid metabolizing enzymes in the kidney may contribute to the renal damage associated with obesity. Along these lines, COX-2 inhibition decreases renal cytokine levels and glomerular injury in obese rats. Peroxisome proliferators-activated receptors (PPARs) are transcription factors that also contribute to chronic kidney disease in obesity and metabolic syndrome. Intriguingly, interactions between PPARs and arachidonic acid metabolites could be key determinants of renal damage in metabolic syndrome patients. Therefore, there is a promising future for pharmacological agents that manipulate COX-2 and CYP450 metabolites and PPARs to treat obesity related nephropathy.