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Nephrology

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Inhibition of the TRPC5 ion channel protects the kidney filter
Thomas Schaldecker, … , Astrid Weins, Anna Greka
Thomas Schaldecker, … , Astrid Weins, Anna Greka
Published November 15, 2013
Citation Information: J Clin Invest. 2013. https://doi.org/10.1172/JCI71165.
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Inhibition of the TRPC5 ion channel protects the kidney filter

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Abstract

An intact kidney filter is vital to retention of essential proteins in the blood and removal of waste from the body. Damage to the filtration barrier results in albumin loss in the urine, a hallmark of cardiovascular disease and kidney failure. Here we found that the ion channel TRPC5 mediates filtration barrier injury. Using Trpc5-KO mice, a small-molecule inhibitor of TRPC5, Ca2+ imaging in isolated kidney glomeruli, and live imagining of podocyte actin dynamics, we determined that loss of TRPC5 or its inhibition abrogates podocyte cytoskeletal remodeling. Inhibition or loss of TRPC5 prevented activation of the small GTP-binding protein Rac1 and stabilized synaptopodin. Importantly, genetic deletion or pharmacologic inhibition of TRPC5 protected mice from albuminuria. These data reveal that the Ca2+-permeable channel TRPC5 is an important determinant of albuminuria and identify TRPC5 inhibition as a therapeutic strategy for the prevention or treatment of proteinuric kidney disease.

Authors

Thomas Schaldecker, Sookyung Kim, Constantine Tarabanis, Dequan Tian, Samy Hakroush, Philip Castonguay, Wooin Ahn, Hanna Wallentin, Hans Heid, Corey R. Hopkins, Craig W. Lindsley, Antonio Riccio, Lisa Buvall, Astrid Weins, Anna Greka

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Proximal tubule H-ferritin mediates iron trafficking in acute kidney injury
Abolfazl Zarjou, … , Lukas C. Kuhn, Anupam Agarwal
Abolfazl Zarjou, … , Lukas C. Kuhn, Anupam Agarwal
Published September 9, 2013
Citation Information: J Clin Invest. 2013. https://doi.org/10.1172/JCI67867.
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Proximal tubule H-ferritin mediates iron trafficking in acute kidney injury

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Abstract

Ferritin plays a central role in iron metabolism and is made of 24 subunits of 2 types: heavy chain and light chain. The ferritin heavy chain (FtH) has ferroxidase activity that is required for iron incorporation and limiting toxicity. The purpose of this study was to investigate the role of FtH in acute kidney injury (AKI) and renal iron handling by using proximal tubule–specific FtH-knockout mice (FtHPT–/– mice). FtHPT–/– mice had significant mortality, worse structural and functional renal injury, and increased levels of apoptosis in rhabdomyolysis and cisplatin-induced AKI, despite significantly higher expression of heme oxygenase-1, an antioxidant and cytoprotective enzyme. While expression of divalent metal transporter-1 was unaffected, expression of ferroportin (FPN) was significantly lower under both basal and rhabdomyolysis-induced AKI in FtHPT–/– mice. Apical localization of FPN was disrupted after AKI to a diffuse cytosolic and basolateral pattern. FtH, regardless of iron content and ferroxidase activity, induced FPN. Interestingly, urinary levels of the iron acceptor proteins neutrophil gelatinase–associated lipocalin, hemopexin, and transferrin were increased in FtHPT–/– mice after AKI. These results underscore the protective role of FtH and reveal the critical role of proximal tubule FtH in iron trafficking in AKI.

Authors

Abolfazl Zarjou, Subhashini Bolisetty, Reny Joseph, Amie Traylor, Eugene O. Apostolov, Paolo Arosio, Jozsef Balla, Jill Verlander, Deepak Darshan, Lukas C. Kuhn, Anupam Agarwal

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Exclusive CX3CR1 dependence of kidney DCs impacts glomerulonephritis progression
Katharina Hochheiser, … , Pierre-Louis Tharaux, Christian Kurts
Katharina Hochheiser, … , Pierre-Louis Tharaux, Christian Kurts
Published September 3, 2013
Citation Information: J Clin Invest. 2013. https://doi.org/10.1172/JCI70143.
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Exclusive CX3CR1 dependence of kidney DCs impacts glomerulonephritis progression

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Abstract

DCs and macrophages both express the chemokine receptor CX3CR1. Here we demonstrate that its ligand, CX3CL1, is highly expressed in the murine kidney and intestine. CX3CR1 deficiency markedly reduced DC numbers in the healthy and inflamed kidney cortex, and to a lesser degree in the kidney medulla and intestine, but not in other organs. CX3CR1 also promoted influx of DC precursors in crescentic glomerulonephritis, a DC-dependent aggressive type of nephritis. Disease severity was strongly attenuated in CX3CR1-deficient mice. Primarily CX3CR1-dependent DCs in the kidney cortex processed antigen for the intrarenal stimulation of T helper cells, a function important for glomerulonephritis progression. In contrast, medullary DCs played a specialized role in inducing innate immunity against bacterial pyelonephritis by recruiting neutrophils through rapid chemokine production. CX3CR1 deficiency had little effect on the immune defense against pyelonephritis, as medullary DCs were less CX3CR1 dependent than cortical DCs and because recruited neutrophils produced chemokines to compensate for the DC paucity. These findings demonstrate that cortical and medullary DCs play specialized roles in their respective kidney compartments. We identify CX3CR1 as a potential therapeutic target in glomerulonephritis that may involve fewer adverse side effects, such as impaired anti-infectious defense or compromised DC functions in other organs.

Authors

Katharina Hochheiser, Christoph Heuser, Torsten A. Krause, Simon Teteris, Anissa Ilias, Christina Weisheit, Florian Hoss, André P. Tittel, Percy A. Knolle, Ulf Panzer, Daniel R. Engel, Pierre-Louis Tharaux, Christian Kurts

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Chronic epithelial kidney injury molecule-1 expression causes murine kidney fibrosis
Benjamin D. Humphreys, … , Vijay K. Kuchroo, Joseph V. Bonventre
Benjamin D. Humphreys, … , Vijay K. Kuchroo, Joseph V. Bonventre
Published August 27, 2013
Citation Information: J Clin Invest. 2013. https://doi.org/10.1172/JCI45361.
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Chronic epithelial kidney injury molecule-1 expression causes murine kidney fibrosis

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Abstract

Acute kidney injury predisposes patients to the development of both chronic kidney disease and end-stage renal failure, but the molecular details underlying this important clinical association remain obscure. We report that kidney injury molecule-1 (KIM-1), an epithelial phosphatidylserine receptor expressed transiently after acute injury and chronically in fibrotic renal disease, promotes kidney fibrosis. Conditional expression of KIM-1 in renal epithelial cells (Kim1RECtg) in the absence of an injury stimulus resulted in focal epithelial vacuolization at birth, but otherwise normal tubule histology and kidney function. By 4 weeks of age, Kim1RECtg mice developed spontaneous and progressive interstitial kidney inflammation with fibrosis, leading to renal failure with anemia, proteinuria, hyperphosphatemia, hypertension, cardiac hypertrophy, and death, analogous to progressive kidney disease in humans. Kim1RECtg kidneys had elevated expression of proinflammatory monocyte chemotactic protein-1 (MCP-1) at early time points. Heterologous expression of KIM-1 in an immortalized proximal tubule cell line triggered MCP-1 secretion and increased MCP-1–dependent macrophage chemotaxis. In mice expressing a mutant, truncated KIM-1 polypeptide, experimental kidney fibrosis was ameliorated with reduced levels of MCP-1, consistent with a profibrotic role for native KIM-1. Thus, sustained KIM-1 expression promotes kidney fibrosis and provides a link between acute and recurrent injury with progressive chronic kidney disease.

Authors

Benjamin D. Humphreys, Fengfeng Xu, Venkata Sabbisetti, Ivica Grgic, Said Movahedi Naini, Ningning Wang, Guochun Chen, Sheng Xiao, Dhruti Patel, Joel M. Henderson, Takaharu Ichimura, Shan Mou, Savuth Soeung, Andrew P. McMahon, Vijay K. Kuchroo, Joseph V. Bonventre

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Calcium oxalate crystals induce renal inflammation by NLRP3-mediated IL-1β secretion
Shrikant R. Mulay, … , Helen Liapis, Hans-Joachim Anders
Shrikant R. Mulay, … , Helen Liapis, Hans-Joachim Anders
Published December 10, 2012
Citation Information: J Clin Invest. 2012. https://doi.org/10.1172/JCI63679.
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Calcium oxalate crystals induce renal inflammation by NLRP3-mediated IL-1β secretion

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Abstract

Nephrocalcinosis, acute calcium oxalate (CaOx) nephropathy, and renal stone disease can lead to inflammation and subsequent renal failure, but the underlying pathological mechanisms remain elusive. Other crystallopathies, such as gout, atherosclerosis, and asbestosis, trigger inflammation and tissue remodeling by inducing IL-1β secretion, leading us to hypothesize that CaOx crystals may induce inflammation in a similar manner. In mice, intrarenal CaOx deposition induced tubular damage, cytokine expression, neutrophil recruitment, and renal failure. We found that CaOx crystals activated murine renal DCs to secrete IL-1β through a pathway that included NLRP3, ASC, and caspase-1. Despite a similar amount of crystal deposits, intrarenal inflammation, tubular damage, and renal dysfunction were abrogated in mice deficient in MyD88; NLRP3, ASC, and caspase-1; IL-1R; or IL-18. Nephropathy was attenuated by DC depletion, ATP depletion, or therapeutic IL-1 antagonism. These data demonstrated that CaOx crystals trigger IL-1β–dependent innate immunity via the NLRP3/ASC/caspase-1 axis in intrarenal mononuclear phagocytes and directly damage tubular cells, leading to the release of the NLRP3 agonist ATP. Furthermore, these results suggest that IL-1β blockade may prevent renal damage in nephrocalcinosis.

Authors

Shrikant R. Mulay, Onkar P. Kulkarni, Khader V. Rupanagudi, Adriana Migliorini, Murthy N. Darisipudi, Akosua Vilaysane, Daniel Muruve, Yan Shi, Fay Munro, Helen Liapis, Hans-Joachim Anders

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CSF-1 signaling mediates recovery from acute kidney injury
Ming-Zhi Zhang, … , Amar Singh, Raymond C. Harris
Ming-Zhi Zhang, … , Amar Singh, Raymond C. Harris
Published November 12, 2012
Citation Information: J Clin Invest. 2012. https://doi.org/10.1172/JCI60363.
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CSF-1 signaling mediates recovery from acute kidney injury

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Abstract

Renal tubule epithelia represent the primary site of damage in acute kidney injury (AKI), a process initiated and propagated by the infiltration of macrophages. Here we investigated the role of resident renal macrophages and dendritic cells in recovery from AKI after ischemia/reperfusion (I/R) injury or a novel diphtheria toxin–induced (DT-induced) model of selective proximal tubule injury in mice. DT-induced AKI was characterized by marked renal proximal tubular cell apoptosis. In both models, macrophage/dendritic cell depletion during the recovery phase increased functional and histologic injury and delayed regeneration. After I/R-induced AKI, there was an early increase in renal macrophages derived from circulating inflammatory (M1) monocytes, followed by accumulation of renal macrophages/dendritic cells with a wound-healing (M2) phenotype. In contrast, DT-induced AKI only generated an increase in M2 cells. In both models, increases in M2 cells resulted largely from in situ proliferation in the kidney. Genetic or pharmacologic inhibition of macrophage colony-stimulating factor (CSF-1) signaling blocked macrophage/dendritic cell proliferation, decreased M2 polarization, and inhibited recovery. These findings demonstrated that CSF-1–mediated expansion and polarization of resident renal macrophages/dendritic cells is an important mechanism mediating renal tubule epithelial regeneration after AKI.

Authors

Ming-Zhi Zhang, Bing Yao, Shilin Yang, Li Jiang, Suwan Wang, Xiaofeng Fan, Huiyong Yin, Karlton Wong, Tomoki Miyazawa, Jianchun Chen, Ingrid Chang, Amar Singh, Raymond C. Harris

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Gain of glycosylation in integrin α3 causes lung disease and nephrotic syndrome
Nayia Nicolaou, … , Kirsten Y. Renkema, Arnoud Sonnenberg
Nayia Nicolaou, … , Kirsten Y. Renkema, Arnoud Sonnenberg
Published November 1, 2012
Citation Information: J Clin Invest. 2012. https://doi.org/10.1172/JCI64100.
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Gain of glycosylation in integrin α3 causes lung disease and nephrotic syndrome

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Abstract

Integrins are transmembrane αβ glycoproteins that connect the extracellular matrix to the cytoskeleton. The laminin-binding integrin α3β1 is expressed at high levels in lung epithelium and in kidney podocytes. In podocytes, α3β1 associates with the tetraspanin CD151 to maintain a functional filtration barrier. Here, we report on a patient homozygous for a novel missense mutation in the human ITGA3 gene, causing fatal interstitial lung disease and congenital nephrotic syndrome. The mutation caused an alanine-to-serine substitution in the integrin α3 subunit, thereby introducing an N-glycosylation motif at amino acid position 349. We expressed this mutant form of ITGA3 in murine podocytes and found that hyperglycosylation of the α3 precursor prevented its heterodimerization with β1, whereas CD151 association with the α3 subunit occurred normally. Consequently, the β1 precursor accumulated in the ER, and the mutant α3 precursor was degraded by the ubiquitin-proteasome system. Thus, these findings uncover a gain-of-glycosylation mutation in ITGA3 that prevents the biosynthesis of functional α3β1, causing a fatal multiorgan disorder.

Authors

Nayia Nicolaou, Coert Margadant, Sietske H. Kevelam, Marc R. Lilien, Michiel J.S. Oosterveld, Maaike Kreft, Albertien M. van Eerde, Rolph Pfundt, Paulien A. Terhal, Bert van der Zwaag, Peter G.J. Nikkels, Norman Sachs, Roel Goldschmeding, Nine V.A.M. Knoers, Kirsten Y. Renkema, Arnoud Sonnenberg

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PTH-independent regulation of blood calcium concentration by the calcium-sensing receptor
Alexandre Loupy, … , Martial Ruat, Pascal Houillier
Alexandre Loupy, … , Martial Ruat, Pascal Houillier
Published August 13, 2012
Citation Information: J Clin Invest. 2012. https://doi.org/10.1172/JCI57407.
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PTH-independent regulation of blood calcium concentration by the calcium-sensing receptor

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Abstract

Tight regulation of calcium levels is required for many critical biological functions. The Ca2+-sensing receptor (CaSR) expressed by parathyroid cells controls blood calcium concentration by regulating parathyroid hormone (PTH) secretion. However, CaSR is also expressed in other organs, such as the kidney, but the importance of extraparathyroid CaSR in calcium metabolism remains unknown. Here, we investigated the role of extraparathyroid CaSR using thyroparathyroidectomized, PTH-supplemented rats. Chronic inhibition of CaSR selectively increased renal tubular calcium absorption and blood calcium concentration independent of PTH secretion change and without altering intestinal calcium absorption. CaSR inhibition increased blood calcium concentration in animals pretreated with a bisphosphonate, indicating that the increase did not result from release of bone calcium. Kidney CaSR was expressed primarily in the thick ascending limb of the loop of Henle (TAL). As measured by in vitro microperfusion of cortical TAL, CaSR inhibitors increased calcium reabsorption and paracellular pathway permeability but did not change NaCl reabsorption. We conclude that CaSR is a direct determinant of blood calcium concentration, independent of PTH, and modulates renal tubular calcium transport in the TAL via the permeability of the paracellular pathway. These findings suggest that CaSR inhibitors may provide a new specific treatment for disorders related to impaired PTH secretion, such as primary hypoparathyroidism.

Authors

Alexandre Loupy, Suresh Krishna Ramakrishnan, Bharath Wootla, Régine Chambrey, Renaud de la Faille, Soline Bourgeois, Patrick Bruneval, Chantal Mandet, Erik Ilso Christensen, Hélène Faure, Lydie Cheval, Kamel Laghmani, Corinne Collet, Dominique Eladari, Robert H. Dodd, Martial Ruat, Pascal Houillier

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Crk1/2-dependent signaling is necessary for podocyte foot process spreading in mouse models of glomerular disease
Britta George, … , Maria Pia Rastaldi, Lawrence B. Holzman
Britta George, … , Maria Pia Rastaldi, Lawrence B. Holzman
Published January 17, 2012
Citation Information: J Clin Invest. 2012. https://doi.org/10.1172/JCI60070.
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Crk1/2-dependent signaling is necessary for podocyte foot process spreading in mouse models of glomerular disease

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Abstract

The morphology of healthy podocyte foot processes is necessary for maintaining the characteristics of the kidney filtration barrier. In most forms of glomerular disease, abnormal filter barrier function results when podocytes undergo foot process spreading and retraction by remodeling their cytoskeletal architecture and intercellular junctions during a process known as effacement. The cell adhesion protein nephrin is necessary for establishing the morphology of the kidney podocyte in development by transducing from the specialized podocyte intercellular junction phosphorylation-mediated signals that regulate cytoskeletal dynamics. The present studies extend our understanding of nephrin function by showing that nephrin activation in cultured podocytes induced actin dynamics necessary for lamellipodial protrusion. This process required a PI3K-, Cas-, and Crk1/2-dependent signaling mechanism distinct from the previously described nephrin-Nck1/2 pathway necessary for assembly and polymerization of actin filaments. Our present findings also support the hypothesis that mechanisms governing lamellipodial protrusion in culture are similar to those used in vivo during foot process effacement in a subset of glomerular diseases. In mice, podocyte-specific deletion of Crk1/2 prevented foot process effacement in one model of podocyte injury and attenuated foot process effacement and associated proteinuria in a delayed fashion in a second model. In humans, focal adhesion kinase and Cas phosphorylation — markers of focal adhesion complex–mediated Crk-dependent signaling — was induced in minimal change disease and membranous nephropathy, but not focal segmental glomerulosclerosis. Together, these observations suggest that activation of a Cas-Crk1/2–dependent complex is necessary for foot process effacement observed in distinct subsets of human glomerular diseases.

Authors

Britta George, Rakesh Verma, Abdulsalam A. Soofi, Puneet Garg, Jidong Zhang, Tae-Ju Park, Laura Giardino, Larisa Ryzhova, Duncan B. Johnstone, Hetty Wong, Deepak Nihalani, David J. Salant, Steven K. Hanks, Tom Curran, Maria Pia Rastaldi, Lawrence B. Holzman

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The CXCR4/CXCR7/SDF-1 pathway contributes to the pathogenesis of Shiga toxin–associated hemolytic uremic syndrome in humans and mice
Tania N. Petruzziello-Pellegrini, … , James L. Brunton, Philip A. Marsden
Tania N. Petruzziello-Pellegrini, … , James L. Brunton, Philip A. Marsden
Published January 9, 2012
Citation Information: J Clin Invest. 2012. https://doi.org/10.1172/JCI57313.
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The CXCR4/CXCR7/SDF-1 pathway contributes to the pathogenesis of Shiga toxin–associated hemolytic uremic syndrome in humans and mice

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Abstract

Hemolytic uremic syndrome (HUS) is a potentially life-threatening condition. It often occurs after gastrointestinal infection with E. coli O157:H7, which produces Shiga toxins (Stx) that cause hemolytic anemia, thrombocytopenia, and renal injury. Stx-mediated changes in endothelial phenotype have been linked to the pathogenesis of HUS. Here we report our studies investigating Stx-induced changes in gene expression and their contribution to the pathogenesis of HUS. Stx function by inactivating host ribosomes but can also alter gene expression at concentrations that minimally affect global protein synthesis. Gene expression profiling of human microvascular endothelium treated with Stx implicated a role for activation of CXCR4 and CXCR7 by their shared cognate chemokine ligand (stromal cell–derived factor-1 [SDF-1]) in Stx-mediated pathophysiology. The changes in gene expression required a catalytically active Stx A subunit and were mediated by enhanced transcription and mRNA stability. Stx also enhanced the association of CXCR4, CXCR7, and SDF1 mRNAs with ribosomes. In a mouse model of Stx-mediated pathology, we noted changes in plasma and tissue content of CXCR4, CXCR7, and SDF-1 after Stx exposure. Furthermore, inhibition of the CXCR4/SDF-1 interaction decreased endothelial activation and organ injury and improved animal survival. Finally, in children infected with E. coli O157:H7, plasma SDF-1 levels were elevated in individuals who progressed to HUS. Collectively, these data implicate the CXCR4/CXCR7/SDF-1 pathway in Stx-mediated pathogenesis and suggest novel therapeutic strategies for prevention and/or treatment of complications associated with E. coli O157:H7 infection.

Authors

Tania N. Petruzziello-Pellegrini, Darren A. Yuen, Andrea V. Page, Sajedabanu Patel, Anna M. Soltyk, Charles C. Matouk, Dennis K. Wong, Paul J. Turgeon, Jason E. Fish, J.J. David Ho, Brent M. Steer, Vahid Khajoee, Jayesh Tigdi, Warren L. Lee, David G. Motto, Andrew Advani, Richard E. Gilbert, S. Ananth Karumanchi, Lisa A. Robinson, Phillip I. Tarr, W. Conrad Liles, James L. Brunton, Philip A. Marsden

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Local TNF mediates free cholesterol–dependent podocyte injury
In this episode, Alessia Fornoni reveals that TNF promotes free cholesterol–dependent podocyte apoptosis via an NFATc1/ ABCA1-dependent mechanism.
Published August 2, 2016
Video AbstractsNephrology

Anti-THSD7A is a bona fide culprit in membranous nephropathy
Nicola M. Tomas, Elion Hoxha, and colleagues provide evidence that anti-THSD7A antibodies promote the development of membranous nephropathy...
Published May 23, 2016
Scientific Show StopperNephrology

Identifying sporadic focal segmental glomerulosclerosis-associated genes
Haiyang Yu, Mykyta Artomov, Sebastian Brähler and colleagues demonstrate the genetic contribution to the development of focal segmental glomerulosclerosis...
Published February 22, 2016
Scientific Show StopperNephrology

DNA replication stress linked to ciliopathies
Gisela Slaats and colleagues reveal that ciliopathy syndrome-associated mutations in CEP290 result in replication errors and DNA damage…
Published August 24, 2015
Scientific Show StopperNephrology

Nephrotic syndrome-associated mutations
Heon Yung Gee, Fujian Zhang, and colleagues reveal that mutations in KANK family genes underlie podocyte dysfunction and are associated with nephrotic syndrome…
Published May 11, 2015
Scientific Show StopperNephrology

Podocyte macropinocytosis
Jun-Jae Chung, Tobias B. Huber, Markus Gödel, and colleagues show that albumin-bound free fatty acids increase fluid-phase uptake in podocytes…
Published April 27, 2015
Scientific Show StopperNephrology

A network of diuretic resistance
Richard Grimm and colleagues use a systems biology approach to uncover mechanisms of renal compensation that lead to diuretic resistance…
Published April 20, 2015
Scientific Show StopperNephrology

KIM-1 protects the kidney after injury
Li Yang, Craig Brooks, and colleagues at Harvard Medical School demonstrate that KIM-1-mediated phagocytosis of apoptotic cells dampens inflammatory responses after kidney injury.. .
Published March 9, 2015
Scientific Show StopperNephrology

Protection against acute kidney injury
Marina Morigi and colleagues demonstrate that sirtuin 3 expression improves survival in a murine model of acute kidney injury...
Published January 20, 2015
Scientific Show StopperNephrology

Helping polycysin-1 reach the surface
Vladimir Gainullin and colleagues reveal that polycystin-2 is required for maturation and surface localization of polycystin-1…
Published January 9, 2015
Scientific Show StopperNephrology
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