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American journal of physiology. Renal physiology最新文献

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An efficient inducible model for the control of gene expression in renin cells. 控制肾素细胞基因表达的高效诱导模型。
Pub Date : 2024-09-01 Epub Date: 2024-07-11 DOI: 10.1152/ajprenal.00129.2024
Silvia Medrano, Manako Yamaguchi, Lucas Ferreira de Almeida, Jason P Smith, Hiroki Yamaguchi, Curt D Sigmund, Maria Luisa S Sequeira-Lopez, R Ariel Gomez

Fate mapping and genetic manipulation of renin cells have relied on either noninducible Cre lines that can introduce the developmental effects of gene deletion or bacterial artificial chromosome transgene-based inducible models that may be prone to spurious and/or ectopic gene expression. To circumvent these problems, we generated an inducible mouse model in which CreERT2 is under the control of the endogenous Akr1b7 gene, an independent marker of renin cells that is expressed in a few extrarenal tissues. We confirmed the proper expression of Cre using Akr1b7CreERT2/+;R26RmTmG/+ mice in which Akr1b7+/renin+ cells become green fluorescent protein (GFP)+ upon tamoxifen administration. In embryos and neonates, GFP was found in juxtaglomerular cells, along the arterioles, and in the mesangium, and in adults, GFP was present mainly in juxtaglomerular cells. In mice treated with captopril and a low-salt diet to induce recruitment of renin cells, GFP extended along the afferent arterioles and in the mesangium. We generated Akr1b7CreERT2/+;Ren1cFl/-;R26RmTmG/+ mice to conditionally delete renin in adult mice and found a marked reduction in kidney renin mRNA and protein and mean arterial pressure in mutant animals. When subjected to a homeostatic threat, mutant mice were unable to recruit renin+ cells. Most importantly, these mice developed concentric vascular hypertrophy ruling out potential developmental effects on the vasculature due to the lack of renin. We conclude that Akr1b7CreERT2 mice constitute an excellent model for the fate mapping of renin cells and for the spatial and temporal control of gene expression in renin cells.NEW & NOTEWORTHY Fate mapping and genetic manipulation are important tools to study the identity of renin cells. Here, we report on a novel Cre mouse model, Akr1b7CreERT2, for the spatial and temporal regulation of gene expression in renin cells. Cre is properly expressed in renin cells during development and in the adult under basal conditions and under physiological stress. Moreover, renin can be efficiently deleted in the adult, leading to the development of concentric vascular hypertrophy.

肾素细胞的命运图谱绘制和遗传操作一直依赖于非诱导性Cre品系,这种品系可能会带来基因缺失的发育效应,或者依赖于基于BAC转基因的诱导模型,这种模型可能容易出现虚假和/或异位基因表达。为了规避这些问题,我们生成了一种可诱导的小鼠模型,在该模型中,CreERT2 受内源性 Akr1b7 基因控制,Akr1b7 是肾素细胞的独立标记物,在少数肾外组织中表达。我们利用 Akr1b7CreERT2/+;R26RmTmG/+小鼠证实了 Cre 的正确表达,这些小鼠中的 Akr1b7+/肾素+细胞在服用他莫昔芬后会变成 GFP+。在胚胎和新生儿中,GFP 存在于下肾小球细胞、动脉血管和系膜中,而在成年小鼠中,GFP 主要存在于下肾小球细胞中。在使用卡托普利和低盐饮食诱导肾素细胞募集的小鼠中,GFP 沿着传入动脉和系膜延伸。我们培育了 Akr1b7CreERT2/+;Ren1cFl/-;R26RmTmG/+小鼠,在成年小鼠体内有条件地删除肾素,结果发现肾素 mRNA 和蛋白明显减少,突变动物的平均动脉压也明显降低。当受到平衡威胁时,突变小鼠无法招募肾素+细胞。最重要的是,这些小鼠出现了同心性血管肥大,排除了因缺乏肾素而对血管造成的潜在发育影响。我们的结论是,Akr1b7CreERT2小鼠是肾素细胞命运图谱以及肾素细胞基因表达的时空控制的极佳模型。
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引用次数: 0
Paradoxes in magnesium transport in type 1 Bartter's syndrome and Gitelman's syndrome: a modeling analysis. 1 型巴特综合征和吉特曼综合征的镁转运悖论:模型分析。
Pub Date : 2024-09-01 Epub Date: 2024-07-11 DOI: 10.1152/ajprenal.00117.2024
Pritha Dutta, Anita T Layton

Type 1 Bartter's syndrome and Gitelman's syndrome are characterized by mutations in two key renal Na+ transporters, Na-K-2Cl cotransporter (NKCC2) and Na-Cl cotransporter (NCC). Since these two transporters play an important role in regulating magnesium (Mg2+) and calcium (Ca2+) transport in the kidney, significant alterations in the transport of these two electrolytes are observed in type 1 Bartter's syndrome and Gitelman's syndrome. In this study, we used our sex-specific computational models of renal electrolyte transport in rats to understand the complex compensatory mechanisms, in terms of alterations in tubular dimensions and ion transporter activities, that lead to Mg2+ and Ca2+ preservation or wasting in these two genetic disorders. Given the sexual dimorphism in renal transporter patterns, we also assessed how the magnitude of these alterations may differ between males and females. Model simulations showed that in type 1 Bartter's syndrome, nephron adaptations prevent salt wasting and favor Mg2+ preservation but not Ca2+, whereas in Gitelman's syndrome, those adaptations favor Ca2+ preservation over Mg2+. In addition, our models predicted that the compensatory alterations in tubular dimensions and ion transporter activities are stronger in females than in males.NEW & NOTEWORTHY Although changes in Ca2+ excretion in type 1 Bartter's syndrome and Gitelman's syndrome are well understood, Mg2+ excretion displays an interesting paradox. This computational modeling study provides insights into how renal adaptations in these two disorders impact Ca2+ and Mg2+ transport along different nephron segments. Model simulations showed that nephron adaptations favor Mg2+ preservation over Ca2+ in Bartter's syndrome and Ca2+ preservation over Mg2+ in Gitelman's syndrome and are stronger in females than in males.

1 型巴特综合征和吉特曼综合征的特征是两个关键的肾脏 Na+ 转运体(Na-K-2Cl 共转运体 (NKCC2) 和 Na-Cl 共转运体 (NCC))发生突变。由于这两个转运体在调节肾脏中镁(Mg2+)和钙(Ca2+)的转运方面发挥着重要作用,因此在 1 型巴特氏综合征和吉特曼氏综合征中观察到这两种电解质的转运发生了显著变化。在本研究中,我们利用大鼠肾电解质转运的性别特异性计算模型来了解这两种遗传疾病中导致 Mg2+ 和 Ca2+ 保存或消耗的复杂代偿机制,即肾小管尺寸和离子转运体活性的改变。考虑到肾脏转运体模式的性别双态性,我们还评估了这些改变的程度在男性和女性之间可能存在的差异。模型模拟显示,在 1 型巴特氏综合征中,肾小球适应性可防止盐耗竭,并有利于保存 Mg2+,但不利于保存 Ca2+;而在 Gitelman 综合征中,这些适应性有利于保存 Ca2+,不利于保存 Mg2+。此外,我们的模型预测,女性肾小管尺寸和离子转运活性的代偿性改变比男性更强。
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引用次数: 0
Empagliflozin attenuates epithelial-to-mesenchymal transition through senescence in peritoneal dialysis. Empagliflozin 可通过腹膜透析中的衰老减轻上皮向间充质的转变。
Pub Date : 2024-09-01 Epub Date: 2024-07-04 DOI: 10.1152/ajprenal.00028.2024
Yunmee Lho, Yeong Park, Jun Young Do, A-Young Kim, Yong-Eun Park, Seok Hui Kang

Epithelial-to-mesenchymal transition (EMT) is considered as one of the senescence processes; reportedly, antisenescence therapies effectively reduce EMT. Some models have shown antisenescence effects with the use of sodium-glucose cotransporter 2 (SGLT2) inhibitor. Therefore, our study investigated the antisenescence effects of empagliflozin as an SGLT2 inhibitor in a peritoneal fibrosis model and their impact on EMT inhibition. For in vitro study, human peritoneal mesothelial cells (HPMCs) were isolated and grown in a 96-well plate. The cell media were exchanged with serum-free M199 medium with d-glucose, with or without empagliflozin. All animal experiments were carried out in male mice. Mice were randomly classified into three treatment groups based on peritoneal dialysis (PD) or empagliflozin. We evaluated changes in senescence and EMT markers in HPMCs and PD model. HPMCs treated with glucose transformed from cobblestone to spindle shape, resulting in EMT. Empagliflozin attenuated these morphological changes. Reactive oxygen species production, DNA damage, senescence, and EMT markers were increased by glucose treatment; however, cotreatment with glucose and empagliflozin attenuated these changes. For the mice with PD, an increase in thickness, collagen deposition, staining for senescence, or EMT markers of the parietal peritoneum was observed, which, however, was attenuated by cotreatment with empagliflozin. p53, p21, and p16 increased in mice with PD compared with those in the control group; however, these changes were decreased by empagliflozin. In conclusion, empagliflozin effectively attenuated glucose-induced EMT in HPMCs through a decrease in senescence. Cotreatment with empagliflozin improved peritoneal thickness and fibrosis in PD.NEW & NOTEWORTHY Epithelial-to-mesenchymal transition (EMT) is considered one of the senescence processes. Antisenescence therapies may effectively reduce EMT in peritoneal dialysis models. Human peritoneal mesothelial cells treated with glucose show an increase in senescence and EMT markers; however, empagliflozin attenuates these changes. Mice undergoing peritoneal dialysis exhibit increased senescence and EMT markers, which are decreased by empagliflozin. These findings suggest that empagliflozin may emerge as a novel strategy for prevention or treatment of peritoneal fibrosis.

背景:上皮细胞向间充质转化(EMT)被认为是衰老过程之一;据报道,抗衰老疗法可有效减少 EMT。一些模型显示,钠-葡萄糖共转运体-2(SGLT2)抑制剂具有抗衰老作用。因此,我们的研究调查了作为SGLT2抑制剂的empagliflozin在腹膜纤维化模型中的抗衰老作用及其对EMT抑制的影响:在体外研究中,分离人腹膜间皮细胞(HPMCs)并将其培养在96孔板中。将细胞培养基与含D-葡萄糖的无血清M199培养基(含或不含empagliflozin)进行交换。所有动物实验均在雄性小鼠中进行。根据腹膜透析(PD)或empagliflozin将小鼠随机分为三个治疗组。我们评估了HPMCs和腹膜透析模型中衰老和EMT标记物的变化:结果:经葡萄糖处理的HPMC由鹅卵石形转变为纺锤形,导致EMT。结果:经葡萄糖处理的HPMC由鹅卵石形转变为纺锤形,导致EMT。葡萄糖处理会增加活性氧生成、DNA损伤、衰老和EMT标记物;然而,葡萄糖和恩格列净联合处理可减轻这些变化。与对照组相比,腹膜透析小鼠腹膜厚度、胶原沉积、衰老或EMT标记物染色均有所增加,但联合使用恩格列净可减轻这些变化:结论:Empagliflozin通过减少衰老有效地减轻了葡萄糖诱导的HPMCs的EMT。结论:Empagliflozin通过减少衰老有效地减轻了葡萄糖诱导的HPMCs的EMT,与empagliflozin联合治疗可改善腹膜厚度和腹膜纤维化。
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引用次数: 0
Altered kidney distribution and loss of ACE2 into the urine in acute kidney injury. 急性肾损伤时 ACE2 在尿液中的分布和流失发生改变。
Pub Date : 2024-09-01 Epub Date: 2024-07-04 DOI: 10.1152/ajprenal.00237.2023
Mina Shirazi, Cosimo Cianfarini, Ahmed Ismail, Jan Wysocki, Jiao-Jing Wang, Minghao Ye, Zheng Jenny Zhang, Daniel Batlle

There are diverse pathophysiological mechanisms involved in acute kidney injury (AKI). Among them, overactivity of the renin-angiotensin system (RAS) has been described. Angiotensin-converting enzyme 2 (ACE2) is a tissue RAS enzyme expressed in the apical border of proximal tubules. Given the important role of ACE2 in the metabolism of angiotensin II, this study aimed to characterize kidney and urinary ACE2 in a mouse model of AKI. Ischemia-reperfusion injury (IRI) was induced in C57BL/6 mice by clamping of the left renal artery followed by removal of the right kidney. In kidneys harvested 48 h after IRI, immunostaining revealed a striking maldistribution of ACE2 including spillage into the tubular lumen and the presence of ACE2-positive luminal casts in the medulla. In cortical membranes, ACE2 protein and enzymatic activity were both markedly reduced (37 ± 4 vs. 100 ± 6 ACE2/β-actin, P = 0.0004, and 96 ± 14 vs. 152 ± 6 RFU/μg protein/h, P = 0.006). In urine, full-length membrane-bound ACE2 protein (100 kDa) was markedly increased (1,120 ± 405 vs. 100 ± 46 ACE2/µg creatinine, P = 0.04), and casts stained for ACE2 were recovered in the urine sediment. In conclusion, in AKI caused by IRI, there is a marked loss of ACE2 from the apical tubular border with deposition of ACE2-positive material in the medulla and increased urinary excretion of full-length membrane-bound ACE2 protein. The deficiency of tubular ACE2 in AKI suggests that provision of this enzyme could have therapeutic applications and that its excretion in the urine may also serve as a diagnostic marker of severe proximal tubular injury.NEW & NOTEWORTHY This study provides novel insights into the distribution of kidney ACE2 in a model of AKI by IRI showing a striking detachment of apical ACE2 from proximal tubules and its loss in urine and urine sediment. The observed deficiency of kidney ACE2 protein and enzymatic activity in severe AKI suggests that administration of forms of this enzyme may mitigate AKI and that urinary ACE2 may serve as a potential biomarker for tubular injury.

急性肾损伤(AKI)的病理生理机制多种多样。其中,肾素血管紧张素系统(RAS)的过度活动已被描述。血管紧张素转换酶 2(ACE2)是一种在近端肾小管顶端边界表达的组织 RAS 酶。鉴于 ACE2 在血管紧张素 II 代谢中的重要作用,本研究旨在描述 AKI 小鼠模型中肾脏和尿液 ACE2 的特征。通过夹闭左肾动脉并切除右肾,诱导 C57BL/6 小鼠缺血再灌注损伤(IRI)。在IRI 48小时后摘取的肾脏中,免疫染色显示ACE2明显分布不良,包括溢入肾小管管腔和在髓质中出现ACE2阳性管腔铸型。皮质膜中的 ACE2 蛋白和酶活性都明显降低(37±4 对 100±6 ACE2/ß-Actin,P=0.0004;96±14 对 152±6 RFU/μg 蛋白/h,P=0.006)。在尿液中,全长膜结合 ACE2 蛋白(100kD)明显增加(1120±405 vs. 100±46 ACE2/µg Crea,P=0.04),尿沉渣中发现了 ACE2 染色的铸型。在由 IRI 引起的 AKI 中,ACE2 从肾小管顶端边界明显丢失,ACE2 阳性物质沉积在髓质中,全长膜结合 ACE2 蛋白的尿排泄增加。肾小管 ACE2 在 AKI 中的缺乏表明,提供这种酶可能有治疗用途,它在尿液中的排泄也可作为近端肾小管严重损伤的诊断标志。
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引用次数: 0
Role of the CDKL1-SOX11 signaling axis in acute kidney injury. CDKL1-SOX11 信号轴在急性肾损伤中的作用
Pub Date : 2024-09-01 Epub Date: 2024-07-11 DOI: 10.1152/ajprenal.00147.2024
Josie A Silvaroli, Gabriela V Martinez, Thitinee Vanichapol, Alan J Davidson, Diana Zepeda-Orozco, Navjot S Pabla, Ji Young Kim

The biology of the cyclin-dependent kinase-like (CDKL) kinase family remains enigmatic. Contrary to their nomenclature, CDKLs do not rely on cyclins for activation and are not involved in cell cycle regulation. Instead, they share structural similarities with mitogen-activated protein kinases and glycogen synthase kinase-3, although their specific functions and associated signaling pathways are still unknown. Previous studies have shown that the activation of CDKL5 kinase contributes to the development of acute kidney injury (AKI) by suppressing the protective SOX9-dependent transcriptional program in tubular epithelial cells. In the current study, we measured the functional activity of all five CDKL kinases and discovered that, in addition to CDKL5, CDKL1 is also activated in tubular epithelial cells during AKI. To explore the role of CDKL1, we generated a germline knockout mouse that exhibited no abnormalities under normal conditions. Notably, when these mice were challenged with bilateral ischemia-reperfusion and rhabdomyolysis, they were found to be protected from AKI. Further mechanistic investigations revealed that CDKL1 phosphorylates and destabilizes SOX11, contributing to tubular dysfunction. In summary, this study has unveiled a previously unknown CDKL1-SOX11 axis that drives tubular dysfunction during AKI.NEW & NOTEWORTHY Identifying and targeting pathogenic protein kinases holds potential for drug discovery in treating acute kidney injury. Our study, using novel germline knockout mice, revealed that Cdkl1 kinase deficiency does not affect mouse viability but provides protection against acute kidney injury. This underscores the importance of Cdkl1 kinase in kidney injury and supports the development of targeted small-molecule inhibitors as potential therapeutics.

CDKL(类似细胞周期蛋白依赖性激酶)激酶家族的生物学特性仍是一个谜。与它们的命名相反,CDKL 并不依赖于细胞周期蛋白进行激活,也不参与细胞周期调控。相反,它们在结构上与 MAPKs(丝裂原活化蛋白激酶)和 GSK3(糖原合酶激酶 3)相似,但其具体功能和相关信号通路仍然未知。先前的研究表明,CDKL5 激酶的激活会抑制肾小管上皮细胞中依赖于 SOX9 的保护性转录程序,从而导致急性肾损伤(AKI)的发生。在本研究中,我们测量了所有五种 CDKL 激酶的功能活性,发现除了 CDKL5 外,CDKL1 也会在 AKI 期间激活肾小管上皮细胞。为了探索 CDKL1 的作用,我们产生了一种种系基因敲除小鼠,这种小鼠在正常情况下没有任何异常。值得注意的是,当这些小鼠受到双侧缺血再灌注和横纹肌溶解的挑战时,发现它们对 AKI 具有保护作用。进一步的机理研究发现,CDKL1 磷酸化并破坏 SOX11 的稳定性,导致肾小管功能障碍。总之,这些研究揭示了之前未知的 CDKL1-SOX11 轴,它在 AKI 期间驱动肾小管功能障碍。
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引用次数: 0
Renin-angiotensin system-mediated nitric oxide signaling in podocytes. 荚膜细胞中 RAS 介导的一氧化氮信号转导。
Pub Date : 2024-09-01 Epub Date: 2024-07-18 DOI: 10.1152/ajprenal.00316.2023
Marharyta Semenikhina, Ruslan Bohovyk, Mykhailo Fedoriuk, Mariia Stefanenko, Christine A Klemens, Jim C Oates, Alexander Staruschenko, Oleg Palygin

Nitric oxide (NO) is widely recognized for its role in regulating renal function and blood pressure. However, the precise mechanisms by which NO affects renal epithelial cells remain understudied. Our previous research has shown that NO signaling in glomerular podocytes can be initiated by Angiotensin II (ANG II) but not by ATP. This study aims to elucidate the crucial interplay between the renin-angiotensin system (RAS) and NO production in podocytes. To conduct our research, we used cultured human podocytes and freshly isolated rat glomeruli. A variety of RAS peptides were used, alongside confocal microscopy, to detect NO production and NO/Ca2+ cross talk. Dynamic changes in the podocyte cytoskeleton, mediated by RAS-NO intracellular signaling, were observed using fluorescent labeling for F-actin and scanning probe microscopy. The experiments demonstrated that ANG II and ANG III generated high levels of NO by activating the angiotensin II type 2 receptor (AT2R). We did not detect functional MAS receptor presence in podocytes, and the moderate NO response to ANG 1-7 was also mediated through AT2R. Furthermore, NO production impacted intracellular Ca2+ signaling and correlated with an increase in podocyte volume and growth. Scanning probe experiments revealed that AT2R activation and the corresponding NO generation are responsible for the protrusion of podocyte lamellipodia. Taken together, our data indicate that AT2R activation enhances NO production in podocytes and subsequently mediates changes in Ca2+ signaling and podocyte volume dynamics. These mechanisms may play a significant role in both physiological and pathophysiological interactions between the RAS and podocytes.NEW & NOTEWORTHY The renin-angiotensin system plays a crucial role in the production of intracellular nitric oxide within podocytes. This mechanism operates through the activation of the angiotensin II type 2 receptor, leading to dynamic modifications in intracellular calcium levels and the actin filament network. This intricate process is vital for linking the activity of angiotensin receptors to podocyte function.

一氧化氮(NO)在调节肾功能和血压方面的作用已得到广泛认可。然而,NO 影响肾上皮细胞的确切机制仍未得到充分研究。我们之前的研究表明,肾小球荚膜细胞中的 NO 信号传导可由血管紧张素 II(Ang II)启动,但不能由 ATP 启动。本研究旨在阐明肾素-血管紧张素系统(RAS)与荚膜细胞中 NO 生成之间的重要相互作用。为了进行研究,我们利用了培养的人类荚膜细胞和新鲜分离的大鼠肾小球。我们使用了多种 RAS 肽和共聚焦显微镜来检测 NO 的产生和 NO/Ca2+ 的串扰。利用荧光标记 F-肌动蛋白和扫描探针显微镜观察了 RAS-NO 细胞内信号介导的荚膜细胞细胞骨架的动态变化。实验证明,血管紧张素 II 和血管紧张素 III 通过激活血管紧张素 II 2 型受体(AT2R)产生大量 NO。我们没有在荚膜细胞中检测到功能性 MAS 受体的存在,而对 Ang 1-7 的中度 NO 反应也是通过 AT2R 介导的。此外,NO 的产生影响了细胞内 Ca2+ 信号的传递,并与荚膜细胞体积和生长的增加相关。扫描探针实验显示,AT2R 激活和相应的 NO 生成是荚膜细胞片层突起的原因。总之,我们的数据表明,AT2R 激活会增强荚膜细胞中的 NO 生成,进而介导 Ca2+ 信号转导和荚膜细胞体积动态变化。这些机制可能在 RAS 和荚膜细胞之间的生理和病理相互作用中发挥重要作用。
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引用次数: 0
NAD deficiency contributes to progressive kidney disease in HIV-nephropathy mice. 缺乏 NAD 会导致 HIV 肾病小鼠出现进行性肾病。
Pub Date : 2024-09-01 Epub Date: 2024-07-04 DOI: 10.1152/ajprenal.00061.2024
Teruhiko Yoshida, Komuraiah Myakala, Bryce A Jones, Xiaoxin X Wang, Shashi Shrivastav, Briana A Santo, Tatsat R Patel, Yongmei Zhao, Vincent M Tutino, Pinaki Sarder, Avi Z Rosenberg, Cheryl A Winkler, Moshe Levi, Jeffrey B Kopp

HIV disease remains prevalent in the United States and is particularly prevalent in sub-Saharan Africa. Recent investigations revealed that mitochondrial dysfunction in kidney contributes to HIV-associated nephropathy (HIVAN) in Tg26 transgenic mice. We hypothesized that nicotinamide adenine dinucleotide (NAD) deficiency contributes to energetic dysfunction and progressive tubular injury. We investigated metabolomic mechanisms of HIVAN tubulopathy. Tg26 and wild-type (WT) mice were treated with the farnesoid X receptor (FXR) agonist INT-747 or nicotinamide riboside (NR) from 6 to 12 wk of age. Multiomic approaches were used to characterize kidney tissue transcriptomes and metabolomes. Treatment with INT-747 or NR ameliorated kidney tubular injury, as shown by serum creatinine, the tubular injury marker urinary neutrophil-associated lipocalin, and tubular morphometry. Integrated analysis of metabolomic and transcriptomic measurements showed that NAD levels and production were globally downregulated in Tg26 mouse kidneys, especially nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme in the NAD salvage pathway. Furthermore, NAD-dependent deacetylase sirtuin3 activity and mitochondrial oxidative phosphorylation activity were lower in ex vivo proximal tubules from Tg26 mouse kidneys compared with those of WT mice. Restoration of NAD levels in the kidney improved these abnormalities. These data suggest that NAD deficiency might be a treatable target for HIVAN.NEW & NOTEWORTHY The study describes a novel investigation that identified nicotinamide adenine dinucleotide (NAD) deficiency in a widely used HIV-associated nephropathy (HIVAN) transgenic mouse model. We show that INT-747, a farnesoid X receptor agonist, and nicotinamide riboside (NR), a precursor of nicotinamide, each ameliorated HIVAN tubulopathy. Multiomic analysis of mouse kidneys revealed that NAD deficiency was an upstream metabolomic mechanism contributing to HIVAN tubulopathy.

艾滋病毒疾病在美国仍然很普遍,在撒哈拉以南非洲地区尤为流行。最近的研究发现,在 Tg26 转基因小鼠中,肾脏线粒体功能障碍导致了艾滋病毒相关性肾病(HIVAN)。我们推测烟酰胺腺嘌呤二核苷酸(NAD)缺乏会导致能量功能障碍和渐进性肾小管损伤。我们研究了 HIVAN 肾小管病变的代谢组学机制。Tg26和野生型(WT)小鼠在6至12周龄期间接受法尼类固醇-X受体(FXR)激动剂INT-747或烟酰胺核糖苷(NR)治疗。多组学方法用于描述肾组织转录组和代谢组的特征。血清肌酐、肾小管损伤标志物尿中性粒细胞相关脂褐素和肾小管形态测量显示,INT-747或NR能改善肾小管损伤。对代谢组学和转录组学测量结果的综合分析表明,Tg26 小鼠肾脏中的 NAD 水平和产生量全面下调,尤其是烟酰胺磷酸核糖转移酶(NAMPT),它是 NAD 修复途径中的限速酶。此外,与 WT 小鼠相比,Tg26 小鼠肾脏近端肾小管的 NAD 依赖性去乙酰化酶 sirtuin3 活性和线粒体氧化磷酸化活性均较低。恢复肾脏中的 NAD 水平可改善这些异常。这些数据表明,NAD缺乏可能是HIVAN的一个可治疗靶点。
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引用次数: 0
Leveraging quantitative systems pharmacology and artificial intelligence to advance treatment of chronic kidney disease mineral bone disorder. 利用定量系统药理学和人工智能推进慢性肾病矿物质骨病的治疗。
Pub Date : 2024-09-01 Epub Date: 2024-07-04 DOI: 10.1152/ajprenal.00050.2024
Adam Gaweda, Michael Brier, Eleanor Lederer

Chronic kidney disease mineral bone disorder (CKD-MBD) is a complex clinical syndrome responsible for the accelerated cardiovascular mortality seen in individuals afflicted with CKD. Current approaches to therapy have failed to improve clinical outcomes adequately, likely due to targeting surrogate biochemical parameters as articulated by the guideline developer, Kidney Disease: Improving Global Outcomes (KDIGO). We hypothesized that using a Systems Biology Approach combining machine learning with mathematical modeling, we could test a novel approach to therapy targeting the abnormal movement of mineral out of bone and into soft tissue that is characteristic of CKD-MBD. The mathematical model describes the movement of calcium and phosphate between body compartments in response to standard therapeutic agents. The machine-learning technique we applied is reinforcement learning (RL). We compared calcium, phosphate, parathyroid hormone (PTH), and mineral movement out of bone and into soft tissue under four scenarios: standard approach (KDIGO), achievement of KDIGO guidelines using RL (RLKDIGO), targeting abnormal mineral flux (RLFLUX), and combining achievement of KDIGO guidelines with minimization of abnormal mineral flux (RLKDIGOFLUX). We demonstrate through simulations that explicitly targeting abnormal mineral flux significantly decreases abnormal mineral movement compared with standard approach while achieving acceptable biochemical outcomes. These investigations highlight the limitations of current therapeutic targets, primarily secondary hyperparathyroidism, and emphasize the central role of deranged phosphate homeostasis in the genesis of the CKD-MBD syndrome.NEW & NOTEWORTHY Artificial intelligence is a powerful tool for exploration of complex processes but application to clinical syndromes is challenging. Using a mathematical model describing the movement of calcium and phosphate between body compartments combined with machine learning, we show the feasibility of testing alternative goals of therapy for Chronic Kidney Disease Mineral Bone Disorder while maintaining acceptable biochemical outcomes. These simulations demonstrate the potential for using this platform to generate and test hypotheses in silico rapidly, inexpensively, and safely.

慢性肾脏病矿物质骨病(CKD-MBD)是一种复杂的临床综合征,是导致慢性肾脏病患者心血管死亡率加快的原因。目前的治疗方法未能充分改善临床疗效,这很可能是由于以指南制定者 KDIGO(《肾脏病:改善全球疗效》)阐明的替代生化指标为目标所致。我们假设,利用机器学习与数学建模相结合的系统生物学方法,我们可以测试一种针对矿物质从骨骼向软组织异常移动(这是 CKD-MBD 的特征)的新型治疗方法。该数学模型描述了钙和磷酸盐在标准治疗药物作用下在体内各区间的移动。我们采用的机器学习技术是强化学习(RL)。我们比较了以下四种情况下钙、磷酸盐、PTH 和矿物质从骨骼流出并进入软组织的情况:标准方法 (KDIGO)、使用 RL 实现 KDIGO 指南 (RLKDIGO)、针对异常矿物质通量 (RLFLUX) 以及将实现 KDIGO 指南与最小化异常矿物质通量相结合 (RLKDIGOFLUX)。我们通过模拟证明,与标准方法相比,明确针对异常矿物质通量可显著减少异常矿物质移动,同时获得可接受的生化结果。这些研究凸显了当前治疗目标(主要是继发性甲状旁腺功能亢进)的局限性,并强调了磷酸盐平衡失调在 CKD-MBD 综合征发病过程中的核心作用。
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引用次数: 0
Deletion of KS-WNK1 promotes NCC activation by increasing WNK1/4 abundance. KS-WNK1的缺失会通过增加WNK1/4的丰度来促进NCC的激活。
Pub Date : 2024-09-01 Epub Date: 2024-07-04 DOI: 10.1152/ajprenal.00101.2024
Mohammed Z Ferdaus, Andrew S Terker, Rainelli B Koumangoye, Lama Al-Qusairi, Paul A Welling, Eric Delpire

Dietary potassium deficiency causes stimulation of sodium reabsorption leading to an increased risk in blood pressure elevation. The distal convoluted tubule (DCT) is the main rheostat linking plasma K+ levels to the activity of the Na-Cl cotransporter (NCC). This occurs through basolateral membrane potential sensing by inwardly rectifying K+ channels (Kir4.1/5.1); decrease in intracellular Cl-; activation of WNK4 and interaction and phosphorylation of STE20/SPS1-related proline/alanine-rich kinase (SPAK); binding of calcium-binding protein 39 (cab39) adaptor protein to SPAK, leading to its trafficking to the apical membrane; and SPAK binding, phosphorylation, and activation of NCC. As kidney-specific with-no-lysine kinase 1 (WNK1) isoform (KS-WNK1) is another participant in this pathway, we examined its function in NCC regulation. We eliminated KS-WNK1 specifically in the DCT and demonstrated increased expression of WNK4 and long WNK1 (L-WNK1) and increased phosphorylation of NCC. As in other KS-WNK1 models, the mice were not hyperkalemic. Although wild-type mice under low-dietary K+ conditions demonstrated increased NCC phosphorylation, the phosphorylation levels of the transporter, already high in KS-WNK1, did not change under the low-K+ diet. Thus, in the absence of KS-WNK1, the transporter lost its sensitivity to low plasma K+. We also show that under low K+ conditions, in the absence of KS-WNK1, there was no formation of WNK bodies. These bodies were observed in adjacent segments, not affected by the targeting of KS-WNK1. As our data are overall consistent with those of the global KS-WNK1 knockout, they indicate that the DCT is the predominant segment affecting the salt transport regulated by KS-WNK1.NEW & NOTEWORTHY In this paper, we show that KS-WNK1 is a critical component of the distal convoluted tubule (DCT) K+ switch pathway. Its deletion results in an inability of the DCT to sense changes in plasma potassium. Absence of KS-WNK1 leads to abnormally high levels of WNK4 and L-WNK1 in the DCT, resulting in increased Na-Cl phosphorylation and function. Our data are consistent with KS-WNK1 targeting WNK4 and L-WNK1 to degradation.

饮食中缺钾会刺激钠的重吸收,从而增加血压升高的风险。远端曲小管是连接血浆 K+ 水平与 Na-Cl 共转运体(NCC)活性的主要调节器。这是通过 Kir4.1/5.1 的基底侧膜电位感应、细胞内 Cl- 的减少、WNK4 的激活、Ste20/SPS1 相关富脯氨酸/丙氨酸激酶(SPAK)的相互作用和磷酸化、钙结合蛋白 39(cab39)适配蛋白与 SPAK 的结合导致其迁移到顶端膜,以及 SPAK 与 NCC 的结合、磷酸化和激活而实现的。肾脏特异性赖氨酸(K)激酶1(WNK1)同工酶(KS-WNK1)是该通路的另一个参与者,因此我们研究了它在NCC调控中的功能。我们特异性地消除了 DCT 中的 KS-WNK1,结果表明 WNK4 和 L-WNK1 的表达增加,NCC 的磷酸化增加。与其他 KS-WNK1 模型一样,这些小鼠没有高血钾症。虽然野生型小鼠在低 K+饮食条件下表现出 NCC 磷酸化增加,但 KS-WNK1 中已经很高的转运体磷酸化水平在低 K+饮食条件下没有变化。因此,在 KS-WNK1 缺失的情况下,转运体失去了对低血浆 K+ 的敏感性。我们还发现,在低 K+条件下,如果没有 KS-WNK1,就不会形成 WNK 体。在不受 KS-WNK1 靶向影响的相邻区段也能观察到 WNK 体。由于我们的数据与 KS-WNK1 整体敲除的数据总体上一致,它们表明 DCT 是影响 KS-WNK1 盐转运的主要区段。
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引用次数: 0
Inhibition of mTORC2 promotes natriuresis in Dahl salt-sensitive rats via the decrease of NCC and ENaC activity. 抑制 mTORC2 可通过降低 NCC 和 ENaC 的活性促进达尔盐敏感大鼠的利尿作用。
Pub Date : 2024-09-01 Epub Date: 2024-05-23 DOI: 10.1152/ajprenal.00403.2023
Chun Yang, Elena Isaeva, Satoshi Shimada, Theresa Kurth, Megan Stumpf, Nadezhda N Zheleznova, Alexander Staruschenko, Ranjan K Dash, Allen W Cowley

We have previously observed that prolonged administration of rapamycin, an inhibitor targeting the mammalian target of rapamycin complex (mTORC)1, partially reduced hypertension and alleviated kidney inflammation in Dahl salt-sensitive (SS) rats. In contrast, treatment with PP242, an inhibitor affecting both mTORC1/mTORC2, not only completely prevented hypertension but also provided substantial protection against kidney injury. Notably, PP242 exhibited potent natriuretic effects that were not evident with rapamycin. The primary objective of this study was to pinpoint the specific tubular sites responsible for the natriuretic effect of PP242 in SS rats subjected to either 0.4% NaCl (normal salt) or 4.0% NaCl (high salt) diet. Acute effects of PP242 on natriuretic, diuretic, and kaliuretic responses were determined in unanesthetized SS rats utilizing benzamil, furosemide, or hydrochlorothiazide [inhibitors of epithelial Na+ channel (ENaC), Na-K-2Cl cotransporter (NKCC2), or Na-Cl cotransporter (NCC), respectively] either administered alone or in combination. The findings indicate that the natriuretic effects of PP242 in SS rats stem predominantly from the inhibition of NCC and a reduction of ENaC open probability. Molecular analysis revealed that mTORC2 regulates NCC activity through protein phosphorylation and ENaC activity through proteolytic cleavage in vivo. Evidence also indicated that PP242 also prevents the loss of K+ associated with the inhibition of NCC. These findings suggest that PP242 may represent an improved therapeutic approach for antihypertensive intervention, potentially controlling blood pressure and mitigating kidney injury in salt-sensitive human subjects.NEW & NOTEWORTHY This study explored mechanisms underlying the natriuretic effects of mammalian target of rapamycin protein complex 2 inhibition using PP242 and revealed both epithelial Na+ channel and Na-Cl cotransporter in the distal tubular segments were potentially inhibited. These observations, with prior lab evidence, indicate that PP242 prevents hypertension via its potent inhibitory effects on these specific sodium transporters and by reducing renal immune responses. This dual action, coupled with potassium sparing effects, suggests an improved approach for managing hypertension and associated kidney damage.

我们以前曾观察到,长期服用雷帕霉素(一种针对哺乳动物雷帕霉素靶标 1(mTORC1)的抑制剂)可部分缓解达尔盐敏感大鼠(SS)的高血压并减轻肾脏炎症。相比之下,同时影响 mTORC1 和 mTORC2 的抑制剂 PP242 不仅能完全防止高血压,还能有效防止肾脏损伤。值得注意的是,PP242 具有雷帕霉素所不具备的强效利钠作用。本研究的主要目的是确定 PP242 在 0.4% NaCl(NS)或 4.0% NaCl(HS)饮食的 SS 大鼠肾小管中发挥利钠作用的特定部位。利用苯扎米尔、呋塞米或氢氯噻嗪(分别是ENaC、NKCC2或NCC的抑制剂)单独或联合给药,在未麻醉的SS大鼠体内测定了PP242对纳尿、利尿和缩尿反应的急性影响。研究结果表明,PP242 对 SS 大鼠的利尿作用主要源于抑制 NCC 和降低 ENaC 开放概率。分子分析表明,mTORC2 在体内通过蛋白磷酸化调节 NCC 活性,通过蛋白水解裂解调节 ENaC 活性。证据还表明,PP242 还能防止与抑制 NCC 相关的 K+ 损失。这些研究结果表明,PP242 可能是一种更好的降压干预治疗方法,有可能控制血压并减轻盐敏感人群的肾损伤。
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引用次数: 0
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American journal of physiology. Renal physiology
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