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TNIK depletion induces inflammation and apoptosis in injured renal proximal tubule epithelial cells. Tnik消耗可诱导损伤的肾近曲小管上皮细胞发生炎症和凋亡。
Pub Date : 2024-05-01 Epub Date: 2024-03-14 DOI: 10.1152/ajprenal.00262.2023
Shayna T J Bradford, Haojia Wu, Yuhei Kirita, Changfeng Chen, Nicole P Malvin, Yasuhiro Yoshimura, Yoshiharu Muto, Benjamin D Humphreys

In the aftermath of acute kidney injury (AKI), surviving proximal tubule epithelia repopulate injured tubules to promote repair. However, a portion of cells fail to repair [termed failed-repair proximal tubule cells (FR-PTCs)] and exert ongoing proinflammatory and profibrotic effects. To better understand the molecular drivers of the FR-PTC state, we reanalyzed a mouse ischemia-reperfusion injury single-nucleus RNA-sequencing (snRNA-seq) atlas to identify Traf2 and Nck interacting kinase (Tnik) to be exclusively expressed in FR-PTCs but not in healthy or acutely injured proximal tubules after AKI (2 and 6 wk) in mice. We confirmed expression of Tnik protein in injured mouse and human tissues by immunofluorescence. Then, to determine the functional role of Tnik in FR-PTCs, we depleted TNIK with siRNA in two human renal proximal tubule epithelial cell lines (primary and immortalized hRPTECs) and analyzed each by bulk RNA-sequencing. Pathway analysis revealed significant upregulation of inflammatory signaling pathways, whereas pathways associated with differentiated proximal tubules such as organic acid transport were significantly downregulated. TNIK gene knockdown drove reduced cell viability and increased apoptosis, including differentially expressed poly(ADP-ribose) polymerase (PARP) family members, cleaved PARP-1 fragments, and increased annexin V binding to phosphatidylserine. Together, these results indicate that Tnik upregulation in FR-PTCs acts in a compensatory fashion to suppress inflammation and promote proximal tubule epithelial cell survival after injury. Modulating TNIK activity may represent a prorepair therapeutic strategy after AKI.NEW & NOTEWORTHY The molecular drivers of successful and failed repair in the proximal tubule after acute kidney injury (AKI) are incompletely understood. We identified Traf2 and Nck interacting kinase (Tnik) to be exclusively expressed in failed-repair proximal tubule cells after AKI. We tested the effect of siTNIK depletion in two proximal tubule cell lines followed by bulk RNA-sequencing analysis. Our results indicate that TNIK acts to suppress inflammatory signaling and apoptosis in injured renal proximal tubule epithelial cells to promote cell survival.

急性肾损伤(AKI)后,存活的近端肾小管上皮细胞会重新填充受伤的肾小管,以促进修复。然而,一部分细胞未能修复(称为修复失败的近端肾小管细胞,FR-PTCs),并持续发挥促炎和促组织坏死作用。为了更好地了解FR-PTC状态的分子驱动因素,我们重新分析了小鼠缺血再灌注损伤单核RNA测序(snRNA-seq)图谱,发现Traf2和Nck相互作用激酶Tnik只在FR-PTC中表达,而不在小鼠AKI后(2周和6周)的健康或急性损伤近端小管中表达。我们通过免疫荧光证实了 Tnik 蛋白在小鼠和人类损伤组织中的表达。然后,为了确定 Tnik 在 FR-PTCs 中的功能作用,我们使用 siRNA 在两个人肾近曲小管上皮细胞系(原代和永生化 hRPTECs)中删除了 Tnik,并通过大量 RNA 序列分析了每个细胞系。通路分析显示炎症信号通路明显上调,而与分化的近端肾小管相关的通路(如有机酸转运)则明显下调。TNIK 基因敲除导致细胞活力降低、凋亡增加,包括 PARP 家族成员表达不同、PARP-1 片段裂解和 Annexin V 与磷脂酰丝氨酸结合增加。总之,这些结果表明,Tnik 在 FR-PTC 中的上调以代偿的方式抑制炎症并促进损伤后近曲小管上皮细胞的存活。调节 Tnik 的活性可能是一种促进 AKI 后修复的治疗策略。
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引用次数: 0
Cognate antigen-independent differentiation of resident memory T cells in chronic kidney disease. 慢性肾脏病常驻记忆 T 细胞的认知抗原独立分化。
Pub Date : 2024-05-01 Epub Date: 2024-03-07 DOI: 10.1152/ajprenal.00373.2023
Kyle H Moore, Elise N Erman, Amie M Traylor, Stephanie K Esman, Yanlin Jiang, Jennifer R LaFontaine, Anna Zmijewska, Yan Lu, Reham H Soliman, Anupam Agarwal, James F George

Resident memory T cells (TRMs), which are memory T cells that are retained locally within tissues, have recently been described as antigen-specific frontline defenders against pathogens in barrier and nonbarrier epithelial tissues. They have also been noted for perpetuating chronic inflammation. The conditions responsible for TRM differentiation are still poorly understood, and their contributions, if any, to sterile models of chronic kidney disease (CKD) remain a mystery. In this study, we subjected male C57BL/6J mice and OT-1 transgenic mice to five consecutive days of 2 mg/kg aristolochic acid (AA) injections intraperitoneally to induce CKD or saline injections as a control. We evaluated their kidney immune profiles at 2 wk, 6 wk, and 6 mo after treatment. We identified a substantial population of TRMs in the kidneys of mice with AA-induced CKD. Flow cytometry of injured kidneys showed T cells bearing TRM surface markers and single-cell (sc) RNA sequencing revealed these cells as expressing well-known TRM transcription factors and receptors responsible for TRM differentiation and maintenance. Although kidney TRMs expressed Cd44, a marker of antigen experience and T cell activation, their derivation was independent of cognate antigen-T cell receptor interactions, as the kidneys of transgenic OT-1 mice still harbored considerable proportions of TRMs after injury. Our results suggest a nonantigen-specific or antigen-independent mechanism capable of generating TRMs in the kidney and highlight the need to better understand TRMs and their involvement in CKD.NEW & NOTEWORTHY Resident memory T cells (TRMs) differentiate and are retained within the kidneys of mice with aristolochic acid (AA)-induced chronic kidney disease (CKD). Here, we characterized this kidney TRM population and demonstrated TRM derivation in the kidneys of OT-1 transgenic mice with AA-induced CKD. A better understanding of TRMs and the processes by which they can differentiate independent of antigen may help our understanding of the interactions between the immune system and kidneys.

常驻记忆 T 细胞(TRMs)是保留在组织局部的记忆 T 细胞,最近被描述为屏障和非屏障上皮组织中抗原特异性的前线卫士。人们还注意到,它们会使慢性炎症长期存在。人们对导致 TRM 分化的条件仍然知之甚少,它们对慢性肾病(CKD)不育模型的贡献(如果有的话)仍然是个谜。在这项研究中,我们对雄性 C57BL/6J 小鼠和 OT-1 转基因小鼠连续五天注射 2 毫克/千克马兜铃酸(AA)以诱导 CKD,或注射生理盐水作为对照。我们分别在治疗后两周、六周和六个月对它们的肾脏免疫概况进行了评估。我们在 AA 诱导的 CKD 小鼠肾脏中发现了大量的 TRMs。损伤肾脏的流式细胞术显示T细胞带有TRM表面标记,单细胞RNA测序显示这些细胞表达众所周知的TRM转录因子和受体,负责TRM的分化和维持。虽然肾脏 TRMs 表达抗原经历和 T 细胞活化的标记物 Cd44,但它们的产生与同源抗原-T 细胞受体的相互作用无关,因为转基因 OT-1 小鼠的肾脏在损伤后仍含有相当比例的 TRMs。我们的研究结果表明,一种非抗原特异性或抗原依赖性机制能够在肾脏中产生 TRMs,并强调了更好地了解 TRMs 及其在慢性肾脏病中的参与的必要性。
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引用次数: 0
Renal vascular control during normothermia and passive heat stress does not differ between healthy younger men and women. 健康年轻男性和女性在正常体温和被动热应激状态下的肾血管控制。
Pub Date : 2024-05-01 Epub Date: 2024-03-28 DOI: 10.1152/ajprenal.00034.2024
Jessica A Freemas, Morgan L Worley, Mikaela C Gabler, Hayden W Hess, Curtis S Goss, Tyler B Baker, Blair D Johnson, Christopher L Chapman, Zachary J Schlader

Men are likely at greater risk for heat-induced acute kidney injury compared with women, possibly due to differences in vascular control. We tested the hypothesis that the renal vasoconstrictor and vasodilator responses will be greater in younger women compared with men during passive heat stress. Twenty-five healthy adults [12 women (early follicular phase) and 13 men] completed two experimental visits, heat stress or normothermic time-control, assigned in a block-randomized crossover design. During heat stress, participants wore a water-perfused suit perfused with 50°C water. Core temperature was increased by ∼0.8°C in the first hour before commencing a 2-min cold pressor test (CPT). Core temperature remained clamped and at 1-h post-CPT, subjects ingested a whey protein shake (1.2 g of protein/kg body wt), and measurements were taken pre-, 75 min, and 150 min post-protein. Beat-to-beat blood pressure (Penaz method) was measured and segmental artery vascular resistance (VR, Doppler ultrasound) was calculated as segmental artery blood velocity ÷ mean arterial pressure. CPT-induced increases in segmental artery VR did not differ between trials (trial effect: P = 0.142) nor between men (heat stress: 1.5 ± 1.0 mmHg/cm/s, normothermia: 1.4 ± 1.0 mmHg/cm/s) and women (heat stress: 1.4 ± 1.2 mmHg/cm/s, normothermia: 2.1 ± 1.1 mmHg/cm/s) (group effect: P = 0.429). Reductions in segmental artery VR following oral protein loading did not differ between trials (trial effect: P = 0.080) nor between men (heat stress: -0.6 ± 0.8 mmHg/cm/s, normothermia: -0.6 ± 0.6 mmHg/cm/s) and women (heat stress: -0.5 ± 0.5 mmHg/cm/s, normothermia: -1.1 ± 0.6 mmHg/cm/s) (group effect: P = 0.204). Renal vasoconstrictor responses to the cold pressor test and vasodilator responses following an oral protein load during heat stress or normothermia do not differ between younger men and younger women in the early follicular phase of the menstrual cycle.NEW & NOTEWORTHY The mechanisms underlying greater heat-induced acute kidney injury risk in men versus women remain unknown. This study examined renal vascular control, including both vasodilatory (oral protein load) and vasoconstrictor (cold presser test) responses, during normothermia and heat stress and compared these responses between men and women. The results indicated that in both conditions neither renal vasodilatory nor vasoconstrictor responses differ between younger men and younger women.

我们测试了这样一个假设:在被动热应激时,年轻女性的肾脏血管收缩和血管扩张反应比男性更大。25 名健康成年人(12 名女性(卵泡早期),13 名男性)完成了两次实验访问,分别是热应激或常温时间控制,采用分块随机交叉设计。在热应激期间,在开始 2 分钟冷加压试验(CPT)之前的第一个小时内,核心温度升高约 0.8°C。受试者在冷压试验后一小时摄入乳清蛋白奶昔(1.2 克蛋白质/公斤体重),并在蛋白奶昔摄入前、摄入后 75 分钟和摄入后 150 分钟进行测量。节段动脉血管阻力(VR,多普勒超声)按节段动脉血速÷平均动脉压计算。CPT 引起的节段动脉血管阻力增加在不同试验之间没有差异(试验效应:P=0.142),在男性(热应激:1.5 ± 1.0 mmHg/cm/s,常温:1.4 ± 1.0 mmHg/cm/s)和女性(热应激:1.4 ± 1.2 mmHg/cm/s,常温:2.1 ± 1.1 mmHg/cm/s)之间也没有差异(组效应:P=0.429)。口服蛋白负荷后节段动脉 VR 的降低在不同试验之间没有差异(试验效应:p=0.080),在男性(热应激:-0.6 ± 0.8 mmHg/cm/s,常温:-0.6 ± 0.6 mmHg/cm/s)和女性(热应激:-0.5 ± 0.5 mmHg/cm/s,常温:-1.1 ± 0.6 mmHg/cm/s)之间也没有差异(组效应:p=0.204)。处于月经周期早期卵泡期的年轻男性和年轻女性对冷压试验的肾血管收缩反应以及在热应激或常温状态下口服蛋白质负荷后的血管扩张反应没有差异。
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引用次数: 0
The calcium-sensing receptor has only a parathyroid hormone-dependent role in the acute response of renal phosphate transporters to phosphate intake. 钙感应受体(CaSR)在肾脏磷酸盐转运体对磷酸盐摄入的急性反应中只起着依赖 PTH 的作用。
Pub Date : 2024-05-01 Epub Date: 2024-03-28 DOI: 10.1152/ajprenal.00009.2024
Arezoo Daryadel, Catharina J Küng, Betül Haykir, Sibylle Sabrautzki, Martin Hrabĕ de Angelis, Nati Hernando, Isabel Rubio-Aliaga, Carsten A Wagner

The kidney controls systemic inorganic phosphate (Pi) levels by adapting reabsorption to Pi intake. Renal Pi reabsorption is mostly mediated by sodium-phosphate cotransporters NaPi-IIa (SLC34A1) and NaPi-IIc (SLC34A3) that are tightly controlled by various hormones including parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23). PTH and FGF23 rise in response to Pi intake and decrease NaPi-IIa and NaPi-IIc brush border membrane abundance enhancing phosphaturia. Phosphaturia and transporter regulation occurs even in the absence of PTH and FGF23 signaling. The calcium-sensing receptor (CaSR) regulates PTH and FGF23 secretion, and may also directly affect renal Pi handling. Here, we combined pharmacological and genetic approaches to examine the role of the CaSR in the acute phosphaturic response to Pi loading. Animals pretreated with the calcimimetic cinacalcet were hyperphosphatemic, had blunted PTH levels upon Pi administration, a reduced Pi-induced phosphaturia, and no Pi-induced NaPi-IIa downregulation. The calcilytic NPS-2143 exaggerated the PTH response to Pi loading but did not abolish Pi-induced downregulation of NaPi-IIa. In mice with a dominant inactivating mutation in the Casr (CasrBCH002), baseline NaPi-IIa expression was higher, whereas downregulation of transporter expression was blunted in double CasrBCH002/PTH knockout (KO) transgenic animals. Thus, in response to an acute Pi load, acute modulation of the CaSR affects the endocrine and renal response, whereas chronic genetic inactivation, displays only subtle differences in the downregulation of NaPi-IIa and NaPi-IIc renal expression. We did not find evidence that the CaSR impacts on the acute renal response to oral Pi loading beyond its role in regulating PTH secretion.NEW & NOTEWORTHY Consumption of phosphate-rich diets causes an adaptive response of the body leading to the urinary excretion of phosphate. The underlying mechanisms are still poorly understood. Here, we examined the role of the calcium-sensing receptor (CaSR) that senses both calcium and phosphate. We confirmed that the receptor increases the secretion of parathyroid hormone involved in stimulating urinary phosphate excretion. However, we did not find any evidence for a role of the receptor beyond this function.

肾脏通过使重吸收适应 Pi 摄入量来控制全身无机磷酸盐 (Pi) 水平。肾脏对 Pi 的重吸收主要由钠磷酸共转运体 NaPi-IIa (SLC34A1) 和 NaPi-IIc (SLC34A3)介导,而这两种转运体受各种激素的严格控制,包括甲状旁腺激素(PTH)和成纤维细胞生长因子 23(FGF23)。PTH 和 FGF23 会随着 Pi 摄入量的增加而升高,并降低 NaPi-IIa 和 NaPi-IIc 刷状缘膜的丰度,从而加剧磷酸盐尿。即使在没有 PTH 和 FGF23 信号的情况下,也会出现磷酸盐尿和转运体调节。钙感受体(CaSR)调节 PTH 和 FGF23 的分泌,也可能直接影响肾脏对 Pi 的处理。在此,我们结合药理学和遗传学方法,研究了钙感受受体在π负荷的急性磷酸盐反应中的作用。用钙化剂西那卡西特预处理的动物会出现高磷酸盐血症,服用 Pi 后 PTH 水平降低,Pi 诱导的磷酸盐血症减轻,并且没有 Pi 诱导的 NaPi-IIa 下调。钙化剂 NPS-2143 会加剧 PTH 对 Pi 负荷的反应,但不会消除 Pi- 诱导的 NaPi-IIa 下调。在Casr(CasrBCH002)显性失活突变的小鼠中,基线NaPi-IIa表达较高,而在双CasrBCH002/PTH KO转基因动物中,转运体表达的下调被削弱。因此,针对急性π负荷,CaSR的急性调节会影响内分泌和肾脏反应,而慢性基因失活仅在下调NaPi-IIa和NaPi-IIc肾脏表达方面显示出微妙的差异。除了调节 PTH 分泌的作用外,我们没有发现 CaSR 对口服 Pi- 负荷的急性肾脏反应有影响的证据。
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引用次数: 0
Regulation of the water channel aquaporin-2 by cullin E3 ubiquitin ligases. Cullin E3 泛素连接酶对水通道 Aquaporin-2 的调控。
Pub Date : 2024-05-01 Epub Date: 2024-03-28 DOI: 10.1152/ajprenal.00049.2024
Sathish K Murali, James A McCormick, Robert A Fenton

Aquaporin 2 (AQP2) is a vasopressin (VP)-regulated water channel in the renal collecting duct. Phosphorylation and ubiquitylation of AQP2 play an essential role in controlling the cellular abundance of AQP2 and its accumulation on the plasma membrane in response to VP. Cullin-RING ubiquitin ligases (CRLs) are multisubunit E3 ligases involved in ubiquitylation and degradation of their target proteins, eight of which are expressed in the collecting duct. Here, we used an established cell model of the collecting duct (mpkCCD14 cells) to study the role of cullins in modulating AQP2. Western blotting identified Cul-1 to Cul-5 in mpkCCD14 cells. Treatment of cells for 4 h with a pan-cullin inhibitor (MLN4924) decreased AQP2 abundance, prevented a VP-induced reduction in AQP2 Ser261 phosphorylation, and attenuated VP-induced plasma membrane accumulation of AQP2 relative to the vehicle. AQP2 ubiquitylation levels were significantly higher after MLN4924 treatment compared with controls, and they remained higher despite VP treatment. Cullin inhibition increased ERK1/2 activity, a kinase that regulates AQP2 Ser261 phosphorylation, and VP-induced reductions in ERK1/2 phosphorylation were absent during MLN4924 treatment. Furthermore, the greater Ser261 phosphorylation and reduction in AQP2 abundance during MLN4924 treatment were attenuated during ERK1/2 inhibition. MLN4924 increased intracellular calcium levels via calcium release-activated calcium channels, inhibition of which abolished MLN4924 effects on Ser261 phosphorylation and AQP2 abundance. In conclusion, CRLs play a vital role in mediating some of the effects of VP to increase AQP2 plasma membrane accumulation and AQP2 abundance. Whether modulation of cullin activity can contribute to body water homeostasis requires further studies.NEW & NOTEWORTHY Aquaporin 2 (AQP2) is essential for body water homeostasis and is regulated by the antidiuretic hormone vasopressin. The posttranslational modification ubiquitylation is a key regulator of AQP2 abundance and plasma membrane localization. Here we demonstrate that cullin-RING E3 ligases play a vital role in mediating some of the effects of vasopressin to increase AQP2 abundance and plasma membrane accumulation. The results suggest that manipulating cullin activity could be a novel strategy to alter kidney water handling.

Aquaporin 2(AQP2)是肾集合管中受血管加压素(VP)调控的水通道。AQP2 的磷酸化和泛素化在控制 AQP2 的细胞丰度及其响应 VP 时在质膜上的积累方面起着至关重要的作用。Cullin-RING 泛素连接酶(CRLs)是一种多亚基 E3 连接酶,参与其目标蛋白的泛素化和降解,其中有 8 种蛋白在集合管中表达。在这里,我们利用已建立的集合管细胞模型(mpkCCD14 细胞)来研究 Cullins 在调节 AQP2 中的作用。Western 印迹鉴定了 mpkCCD14 细胞中的 Cul-1 至 -5。用泛库林抑制剂(MLN4924)处理细胞 4 小时可降低 AQP2 丰度,防止 VP 诱导的 AQP2 Ser261 磷酸化减少,并相对于车辆减轻 VP 诱导的 AQP2 质膜积累。与对照组相比,MLN4924 处理后的 AQP2 泛素化水平明显升高,而且尽管 VP 处理,泛素化水平仍然较高。Cullin抑制增加了ERK1/2(一种调节AQP2 Ser261磷酸化的激酶)的活性,而在MLN4924处理期间,VP诱导的ERK1/2磷酸化降低并没有出现。此外,在 MLN4924 处理期间,AQP2 Ser261 磷酸化程度升高,AQP2 丰度降低,而在 ERK1/2 抑制期间,AQP2 磷酸化程度升高,AQP2 丰度降低。MLN4924 通过钙释放激活的钙通道增加细胞内钙水平,抑制钙释放激活的钙通道可消除 MLN4924 对 Ser261 磷酸化和 AQP2 丰度的影响。总之,CRLs 在介导 VP 增加 AQP2 质膜积累和 AQP2 丰度的某些作用中发挥着重要作用。对cullin活性的调节是否有助于体内水分平衡还需要进一步研究。
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引用次数: 0
Predicting sex differences in the effects of diuretics in renal epithelial transport during angiotensin II-induced hypertension. 预测血管紧张素 II 诱导高血压期间利尿剂对肾上皮细胞转运影响的性别差异
Pub Date : 2024-05-01 Epub Date: 2024-03-14 DOI: 10.1152/ajprenal.00398.2023
Kaixin Zheng, Anita T Layton

Chronic angiotensin II (ANG II) infusion is an experimental model that induces hypertension in rodents. The natriuresis, diuresis, and blood pressure responses differ between males and females. This is perhaps not unexpected, given the rodent kidney, which plays a key role in blood pressure regulation, exhibits marked sex differences. Under normotensive conditions, compared with males, the female rat nephron exhibits lower Na+/H+ exchanger 3 (NHE3) activity along the proximal tubule but higher Na+ transporter activities along the distal segments. ANG II infusion-induced hypertension induces a pressure natriuretic response that reduces NHE3 activity and shifts Na+ transport capacity downstream. The goals of this study were to apply a computational model of epithelial transport along a rat nephron 1) to understand how a 14-day ANG II infusion impacts segmental electrolyte transport in male and female rat nephrons and 2) to identify and explain any sex differences in the effects of loop diuretics, thiazide diuretics, and K+-sparing diuretics. Model simulations suggest that the NHE3 downregulation in the proximal tubule is a major contributor to natriuresis and diuresis in hypertension, with the effects stronger in males. All three diuretics are predicted to induce stronger natriuretic and diuretic effects under hypertension compared with normotension, with relative increases in sodium excretion higher in hypertensive females than in males. The stronger natriuretic responses can be explained by the downstream shift of Na+ transport load in hypertension and by the larger distal transport load in females, both of which limit the ability of the distal segments to further elevate their Na+ transport.NEW & NOTEWORTHY Sex differences in the prevalence of hypertension are found in human and animal models. The kidney, which regulates blood pressure, exhibits sex differences in morphology, hemodynamics, and membrane transporter distributions. This computational modeling study provides insights into how the sexually dimorphic responses to a 14-day angiotensin II infusion differentially impact segmental electrolyte transport in rats. Simulations of diuretic administration explain how the natriuretic and diuretic effects differ between normotension and hypertension and between the sexes.

慢性血管紧张素 II(AngII)输注是一种诱导啮齿类动物高血压的实验模型。雌雄动物的利尿、利尿和血压反应均有所不同。这也许并不出人意料,因为在血压调节中起关键作用的啮齿动物肾脏表现出明显的性别差异。在正常血压条件下,与雄性相比,雌性大鼠肾小管近端表现出较低的 Na+/H+ 交换器 3(NHE3)活性,但远端 Na+ 转运体活性较高。AngII 输注诱导的高血压会诱发压力利钠反应,从而降低 NHE3 活性并使 Na+ 转运能力向下游转移。本研究的目的是应用大鼠肾小球上皮细胞转运的计算模型(i)了解 14 天的 AngII 输注如何影响雄性和雌性大鼠肾小球的节段性电解质转运,以及(ii)识别和解释襻利尿剂、噻嗪类利尿剂和 K+稀释利尿剂作用的性别差异。模型模拟表明,近端肾小管中 NHE3 的下调是导致高血压患者利尿和利尿的主要因素,男性的影响更大。据预测,与正常血压相比,所有三种利尿剂在高血压情况下都会诱发更强的利钠和利尿作用,女性高血压患者钠排泄量的相对增加高于男性。高血压时 Na+ 转运负荷的下游转移和女性较大的远端转运负荷可以解释较强的利钠反应,这两者都限制了远端节段进一步提高其 Na+ 转运的能力。
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引用次数: 0
Cardioprotective effect of intradialytic exercise on left atrial mechanics. 肾内运动对左心房力学的心脏保护作用
Pub Date : 2024-05-01 Epub Date: 2024-03-21 DOI: 10.1152/ajprenal.00380.2023
Claire Maufrais, Matthieu Josse, Laure Patrier, Antoine Grandperrin, Myriam Isnard, Cécile Turc-Baron, Stéphane Nottin, Stéphane Mandigout, Jean-Paul Cristol, Philippe Obert

Left atrial (LA) function plays a pivotal role in cardiac performance by modulating left ventricular (LV) function. Impairments in LV function are commonly reported during hemodialysis (HD), but available data describing changes in LA function are limited. There is growing evidence of the cardioprotective effect of intradialytic exercise (IDE) on LV function, but studies analyzing its effect on LA function are scarce. Our aim was to evaluate whether IDE can limit the severity of HD-induced impairment in LA myocardial function. In this prospective, open-label, two-center randomized crossover trial, 56 stable individuals receiving HD participated in 2 HD sessions in random order: standard HD and a session incorporating 30 min of aerobic exercise. LA and LV global longitudinal strains (GLSs) were obtained before and at peak stress of HD (i.e., 30 min before the HD ending). IDE totally eradicated the decline in LA reservoir strain observed during HD (estimated difference: 3.1%, 95% confidence interval: 0.4/5.8, P = 0.02), whereas it did not affect the other components of LA mechanics. A similar result favoring IDE intervention was also demonstrated on GLS changes over the HD procedure (P < 0.001). Between-session differences of changes in GLS and LA reservoir strain were correlated (r = -0.32, P = 0.03). The cardioprotective effect of IDE disappeared in patients with LA enlargement (i.e., LA volume index >34 mL/m2). In conclusion, even a short duration of IDE at moderate intensity is effective in preventing HD-associated decline in LA reservoir function. Further research is needed to explore the long-term benefits of IDE on LA function.NEW & NOTEWORTHY A single bout of intradialytic exercise (IDE) at moderate intensity can prevent the hemodialysis-associated decline in left atrial (LA) function. This was partially explained by the relative preservation of left ventricular systolic function with IDE. Benefits of IDE on LA function were lost in patients with LA dilation. Further studies are needed to explore the mechanisms behind IDE-induced cardioprotection and evaluate the clinical impacts of the repetitive cardioprotective effects of IDE on LA function.

导言:左心房(LA)功能通过调节左心室(LV)功能在心脏性能中起着关键作用。血液透析期间左心室功能受损的报道屡见不鲜,但描述左心房功能变化的现有数据却十分有限。越来越多的证据表明,血液透析内运动(IDE)对左心室功能有保护作用,但分析其对 LA 功能影响的研究却很少。我们的目的是评估 IDE 是否能限制血液透析引起的 LA 心肌功能损害的严重程度:在这项前瞻性、开放标签、双中心随机交叉试验中,56 名稳定的血液透析患者按照随机顺序参加了两次血液透析:标准血液透析(HD)和一次 30 分钟的有氧运动。在血液透析前和血液透析高峰压力时(即血液透析结束前30分钟)采集LA和LV整体纵向(GLS)应变:IDE完全消除了HD期间观察到的LA储层应变的下降(估计差异:3.1%,95% CI 0.4/5.8,P=0.02),而对LA力学的其他组成部分没有影响。在 HD 过程中,GLS 的变化(p34 mL/m²)也显示了类似的有利于 IDE 干预的结果:结论:即使是中等强度的短期 IDE 也能有效防止血液透析引起的 LA 储库功能下降。需要进一步研究 IDE 对 LA 功能的长期益处。
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引用次数: 0
Parental obesity predisposes offspring to kidney dysfunction and increased susceptibility to ischemia-reperfusion injury in a sex-dependent manner. 父母肥胖会导致后代出现肾功能障碍,并以性别依赖的方式增加对缺血/再灌注损伤的易感性。
Pub Date : 2024-05-01 Epub Date: 2024-03-21 DOI: 10.1152/ajprenal.00294.2023
Jussara M do Carmo, John E Hall, Xuemei Dai, Nikaela Aitkens, Kylie Larson, Emilio M Luna-Suarez, Zhen Wang, Ana C M Omoto, Alan Mouton, Xuan Li, Luzia N S Furukawa, Viktoria Woronik, Alexandre A da Silva

Although obesity is recognized as a risk factor for cardiorenal and metabolic diseases, the impact of parental obesity on the susceptibility of their offspring to renal injury at adulthood is unknown. We examined the impact of parental obesity on offspring kidney function, morphology, and markers of kidney damage after acute kidney injury (AKI). Offspring from normal (N) diet-fed C57BL/6J parents were fed either N (NN) or a high-fat (H) diet (NH) from weaning until adulthood. Offspring from obese H diet-fed parents were fed N (HN) or H diet (HH) after weaning. All offspring groups were submitted to bilateral AKI by clamping the left and right renal pedicles for 30 min. Compared with male NH and NN offspring from lean parents, male HH and HN offspring from obese parents exhibited higher kidney injury markers such as urinary, renal osteopontin, plasma creatinine, urinary albumin excretion, and neutrophil gelatinase-associated lipocalin (NGAL) levels, and worse histological injury score at 22 wk of age. Only albumin excretion and NGAL were elevated in female HH offspring from obese parents compared with lean and obese offspring from lean parents. We also found an increased mortality rate and worse kidney injury scores after AKI in male offspring from obese parents, regardless of the diet consumed after weaning. Female offspring were protected from major kidney injury after AKI. These results indicate that parental obesity leads to increased kidney injury in their offspring after ischemia-reperfusion in a sex-dependent manner, even when their offspring remain lean.NEW & NOTEWORTHY Offspring from obese parents are more susceptible to kidney injury and worse outcomes following an acute ischemia-reperfusion insult. Male, but not female, offspring from obese parents exhibit increased blood pressure early in life. Female offspring are partially protected against major kidney injury induced by ischemia-reperfusion.

虽然肥胖被认为是心肾疾病和代谢性疾病的危险因素,但父母肥胖对其后代成年后肾损伤易感性的影响尚不清楚。我们研究了父母肥胖对后代肾功能、形态以及急性肾损伤(AKI)后肾损伤标志物的影响。从断奶到成年,喂养正常(N)饮食的 C57BL/6J 亲本的后代要么喂养 N(NN)饮食,要么喂养高脂肪(H)饮食(NH)。肥胖的 H 型饮食喂养亲本的后代断奶后喂养 N 型饮食(HN)或 H 型饮食(HH)。通过夹闭左右肾蒂 30 分钟,对所有子代组进行双侧肾动脉缺血。与来自瘦父母的NH和NN雄性后代相比,来自肥胖父母的HH和HN雄性后代在22周龄时表现出更高的肾损伤指标,如尿、肾骨蛋白、血浆肌酐、尿白蛋白排泄量和NGAL水平,以及更差的组织学损伤评分。与瘦父母和肥父母的肥胖后代相比,肥父母的肥胖后代中只有白蛋白排泄量和NGAL水平升高。我们还发现,无论断奶后的饮食如何,肥胖父母所生的雄性后代的死亡率增加,肾脏损伤评分也更差。而雌性后代在发生 AKI 后则不会出现严重的肾损伤。这些结果表明,父母肥胖会以性别依赖的方式导致其后代在缺血/再灌注后肾脏损伤加重,即使其后代仍然很瘦。
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引用次数: 0
SGLT2-independent effects of canagliflozin on NHE3 and mitochondrial complex I activity inhibit proximal tubule fluid transport and albumin uptake. 卡格列净对 NHE3 和线粒体复合物 I 活性的 SGLT2 依赖性影响抑制了近端肾小管液体转运和白蛋白摄取。
Pub Date : 2024-04-25 DOI: 10.1152/ajprenal.00005.2024
Wafaa N. Albalawy, Elynna B Youm, Katherine E. Shipman, Keelan J. Trull, C. Baty, K. Long, Y. Rbaibi, Xue-Ping Wang, O. G. Fagunloye, Katharine A White, Michael J Jurczak, O. Kashlan, O. Weisz
Beyond glycemic control, SGLT2 inhibitors (SGLT2i) have protective effects on cardiorenal function. Renoprotection has been suggested to involve inhibition of NHE3 leading to reduced ATP-dependent tubular workload and mitochondrial oxygen consumption. NHE3 activity is also important for regulation of endosomal pH, but the effects of SGLT2i on endocytosis are unknown. We used a highly differentiated cell culture model of proximal tubule (PT) cells to determine the direct effects of SGLT2i on Na+-dependent fluid transport and endocytic uptake in this nephron segment. Strikingly, canagliflozin but not empagliflozin reduced fluid transport across cell monolayers, and dramatically inhibited endocytic uptake of albumin. These effects were independent of glucose and occurred at clinically relevant concentrations of drug. Canagliflozin acutely inhibited surface NHE3 activity, consistent with a direct effect, but did not affect endosomal pH or NHE3 phosphorylation. Additionally, canagliflozin rapidly and selectively inhibited mitochondrial complex I activity. Inhibition of mitochondrial complex I by metformin recapitulated the effects of canagliflozin on endocytosis and fluid transport, whereas modulation of downstream effectors AMPK and mTOR did not. Mice given a single dose of canagliflozin excreted twice as much urine over 24 h compared with empagliflozin-treated mice despite similar water intake. We conclude that canagliflozin selectively suppresses Na+-dependent fluid transport and albumin uptake in PT cells via direct inhibition of NHE3 and of mitochondrial function upstream of the AMPK/mTOR axis. These additional targets of canagliflozin contribute significantly to reduced PT Na+-dependent fluid transport in vivo.
除了控制血糖外,SGLT2 抑制剂(SGLT2i)还对心肾功能有保护作用。肾脏保护作用被认为涉及抑制 NHE3,从而降低 ATP 依赖性肾小管工作量和线粒体耗氧量。NHE3 活性对调节内膜 pH 也很重要,但 SGLT2i 对内吞的影响尚不清楚。我们利用近端肾小管(PT)细胞的高度分化细胞培养模型来确定 SGLT2i 对该肾段 Na+ 依赖性液体转运和内吞摄取的直接影响。令人震惊的是,canagliflozin(而非 empagliflozin)降低了跨细胞单层的液体转运,并显著抑制了白蛋白的内吸收。这些效应与葡萄糖无关,并且发生在临床相关的药物浓度下。卡格列净急性抑制表面 NHE3 活性,这与直接效应一致,但不影响内体 pH 值或 NHE3 磷酸化。此外,卡格列净还能快速、选择性地抑制线粒体复合物 I 的活性。二甲双胍对线粒体复合物 I 的抑制再现了 canagliflozin 对内吞和液体转运的影响,而对下游效应物 AMPK 和 mTOR 的调节则没有影响。单剂量服用卡格列净的小鼠在24小时内排出的尿液量是服用empagliflozin的小鼠的两倍,尽管小鼠的饮水量相似。我们的结论是,卡格列净通过直接抑制 NHE3 和 AMPK/mTOR 轴上游的线粒体功能,选择性地抑制 PT 细胞中 Na+ 依赖性液体转运和白蛋白摄取。卡格列净的这些额外靶点在很大程度上降低了 PT 在体内的 Na+ 依赖性体液转运。
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引用次数: 0
Resting state MRI reveals spontaneous physiological fluctuations in the kidney and tracks diabetic nephropathy in rats. 静息状态核磁共振成像显示肾脏的自发生理波动并追踪大鼠的糖尿病肾病。
Pub Date : 2024-04-25 DOI: 10.1152/ajprenal.00423.2023
E. Baldelomar, Darya Morozov, Leslie D Wilson, C. Eldeniz, Hongyu An, Jennifer R Charlton, Adam Bauer, S. Keilholz, M. Hulbert, Kevin M Bennett
The kidneys maintain fluid-electrolyte balance and excrete waste in the presence of constant fluctuations in plasma volume and systemic blood pressure. The kidneys perform these functions to control capillary perfusion and glomerular filtration by modulating the mechanisms of autoregulation. An effect of these modulations are spontaneous, natural fluctuations in nephron perfusion. Numerous other mechanisms can lead to fluctuations in perfusion and flow. The ability to monitor these spontaneous physiological fluctuations in vivo could facilitate the early detection of kidney disease. The goal of this work was to investigate the use of resting- state magnetic resonance imaging (rsMRI) to detect spontaneous physiological fluctuations in the kidney. We performed rsMRI of rat kidneys in vivo over 10 minutes, applying motion correction to resolve time series in each voxel. We observed spatially variable, spontaneous fluctuations in rsMRI signal between 0-0.3 Hz, in frequency bands also associated with autoregulatory mechanisms. We further applied rsMRI to investigate changes in these fluctuations in a rat model of diabetic nephropathy. Spectral analysis was performed on time series of rsMRI signal in kidney cortex and medulla. Power from spectra in specific frequency bands from kidney cortex correlated with severity of glomerular pathology caused by diabetic nephropathy. Finally, we investigated the feasibility of using rsMRI of the human kidney in two participants, observing the presence of similar, spatially variable fluctuations. This approach may enable a range of preclinical and clinical investigations of kidney function, and facilitate the development of new therapies to improve outcomes in patients with kidney disease.
在血浆容量和全身血压不断波动的情况下,肾脏仍能维持体液电解质平衡并排泄废物。肾脏通过调节自身调节机制来控制毛细血管灌注和肾小球滤过,从而实现这些功能。这些调节机制的作用之一是肾小球灌注的自发自然波动。许多其他机制也会导致灌注和流量的波动。在体内监测这些自发生理波动的能力有助于早期发现肾脏疾病。这项工作的目的是研究利用静息状态磁共振成像(rsMRI)检测肾脏的自发生理波动。我们在体内对大鼠肾脏进行了长达 10 分钟的静息磁共振成像(rsMRI),应用运动校正来解析每个体素的时间序列。我们观察到 rsMRI 信号在 0-0.3 Hz 之间的空间可变自发波动,这些频段也与自动调节机制有关。我们进一步应用 rsMRI 研究了糖尿病肾病大鼠模型中这些波动的变化。我们对肾皮质和髓质的 rsMRI 信号时间序列进行了频谱分析。肾皮质特定频段的频谱功率与糖尿病肾病引起的肾小球病变的严重程度相关。最后,我们研究了对两名参与者的人体肾脏使用 rsMRI 的可行性,观察到存在类似的空间可变波动。这种方法可以对肾功能进行一系列临床前和临床研究,促进新疗法的开发,改善肾病患者的预后。
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引用次数: 0
期刊
American journal of physiology. Renal physiology
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