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ResearchIn-Press PreviewInflammationMetabolismNephrology Open Access | 10.1172/JCI200755

Fumarate-induced succination of A-kinase anchor protein 12 exacerbates renal inflammation and fibrosis

Shuai Sun,1 Xu-yang Yan,2 Yu-hang Dong,3 Jian-min You,2 Zhen-yu Guo,2 Dong-xue Lv,3 Shuai-shuai Xie,3 Rui Hou,3 Xiang-yu Li,3 Ju-tao Yu,3 Xiao-yu Shen,3 Jie Wei,3 Zhen-yu Song,2 Zi-qi Chen,2 Yun-long Zhu,2 Xing-xin Xu,4 Juan Jin,3 Jia-gen Wen,3 Hao Wang,5 Xiao-ming Meng,3 and Wei Wang2

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Sun, S. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Yan, X. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Dong, Y. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by You, J. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Guo, Z. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Lv, D. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Xie, S. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Hou, R. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Li, X. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Yu, J. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Shen, X. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Wei, J. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Song, Z. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Chen, Z. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Zhu, Y. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Xu, X. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Jin, J. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Wen, J. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Wang, H. in: PubMed | Google Scholar

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

Find articles by Meng, X. in: PubMed | Google Scholar |

1Department of Urology, The Fifth Affiliated Hospital of Anhui Medical University, Fuyang, China

2Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

3Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, the, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China

4Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, China

5Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China

6Department of Urology, The First Affiliated Hospital of Anhui Medical University, Heifei, China

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Published June 30, 2026 - More info

J Clin Invest. https://doi.org/10.1172/JCI200755.
Copyright © 2026, Sun et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published June 30, 2026 - Version history
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Abstract

The inflammatory response resulting from the abnormal accumulation of metabolites has been implicated in the pathogenesis of organ fibrosis; however, its role and underlying mechanisms in renal fibrosis remain unclear. In this study, we observed a negative correlation between fumarate hydratase (FH) expression and the degree of renal fibrosis. Loss of FH function was associated with heightened inflammation and exacerbated tubulointerstitial damage in the kidney. Moreover, FH deficiency aggravated fibrosis in both the liver and lungs. Mechanistically, the depletion of FH in renal tubular cells led to fumarate accumulation. Fumarate directly succinated A-kinase anchoring protein 12 at cysteine 670, thereby diminishing its capacity to inhibit the activity of protein kinase Cζ (PKCζ). This process exacerbated renal inflammation and fibrosis by activating the downstream PKCζ/NF-κB and PKCζ/β-catenin pathways. Additionally, the upregulation of FH through adeno-associated virus 2/9-mediated FH overexpression markedly mitigated renal inflammation and fibrosis. These findings highlighted the important role of fumarate accumulation in the advancement of renal fibrosis, supporting FH as a potential therapeutic target in renal fibrosis.

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