L-651,392, A POTENT LEUKOTRIENE INHIBITOR, CONTROLS INFLAMMATORY PROCESS IN ESCHERICHIA-COLI PYELONEPHRITIS

In this study, the relationship between leukotrienes, peritubular cell infiltration,vith polymorphonuclear cells (PMNs) and renal tubular da mage was investigated in a rat model of acute ascending pyelonephritis . Infection was induced by the injection of 10(5) CFU of Escherichia c oli into the bladder and occlusion of the left ureter for 24 h. Treatm ent of infected animals was started 24 h after the induction of pyelon ephritis with either hydrocortisone (25 mg/kg of body weight per day), the leukotriene inhibitor L-651,392 (10 mg/kg/day), or the vehicle of L-651,392 and was maintained for 5 days. At the end of treatment, the animals were killed, serum was collected, and both kidneys were remov ed for colony counts and histopathology. Renal function was evaluated by the measurement of blood urea nitrogen levels and creatinine cleara nce. The numbers of PMNs and mononuclear cells (MNs) in the cortex and medulla were recorded for all groups on plastic sections done from th e left kidney. Infection alone (vehicle of L-651,392) resulted in inte nsive interstitial infiltration and a severe tubular destruction in th e cortex. Treatment with hydrocortisone did not prevent PMN migration and tissue damage. By contrast, treatment with L-651,392 resulted in a significant reduction in PMNs (P < 0.001 in comparisons with all othe r groups) and greater preservation of the tubular structure despite id entical bacterial counts than in the group receiving hydrocortisone. W e conclude that L-651,392 prevents inflammatory cells from reaching th e site of infection and protects the kidney from tubular damage associ ated with inflammation during pyelonephritis. Inhibitors of leukotrien es should be further investigated for their potential benefit as adjuv ants to antibiotherapy in the treatment of pyelonephritis.