Effects of endometrial embryokines on the preimplantation bovine embryo to create a gene expression signature consistent with a high competence phenotype†

Optimal embryonic development depends upon cell-signaling molecules released by the maternal reproductive tract called embryokines. The identity of specific embryokines that enhance the competence of the embryo for sustained survival is largely lacking. The current objective was to evaluate the effects of three putative embryokines in cattle on embryonic development to the blastocyst stage. The molecules tested were vascular endothelial growth factor A (VEGFA), C-X-C motif chemokine ligand 12 (CXCL12), and interleukin-6 (IL6). Molecules were added from day 4 to 7.5 of culture at 50 ng/mL (VEGFA and CXCL12) or 100 ng/mL (IL6). Endpoints were development to the blastocyst stage and transcript abundance for 94 specific genes involved in lineage commitment, epigenetic regulation, and other functions. Among the genes examined were eight whose transcript abundance has been related to embryo competence for survival after embryo transfer. None of the molecules increased the proportion of putative zygotes or cleaved embryos becoming blastocysts at day 7.5 of development. An embryo competence index based on a Bayesian multiple regression formula to weigh transcript abundance of the eight biomarker genes was not affected by treatment with VEGFA but was increased by both CXCL12 and IL6. The transcript abundance of 5 genes was modified by VEGFA, 19 by CXCL12, and 19 by IL6. A total of 11 genes were modified in a similar manner by CXCL12 and IL6. Most differentially expressed genes for CXCL12 and IL6 were downregulated, suggesting that the embryokines may promote a less energetically demanding metabolic state than would be the case in their absence.

Acute kidney injury is associated with liver-related events in patients with metabolic dysfunction-associated fatty liver disease

BACKGROUND

Evidence regarding the role of acute kidney injury (AKI) in long-term development of metabolic dysfunction-associated fatty liver disease (MAFLD) is limited. We aimed to investigate the associations between AKI and liver-related events in patients with MAFLD.

METHODS

This study involved 50,499 Chinese adults with MAFLD from the China Renal Data System (CRDS) database. We identified AKI using patient-level serum creatinine data according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The primary outcome was a composite of liver-related mortality and major adverse liver outcomes. The secondary outcome was an escalation of fibrosis-4 (FIB-4) risk scores. Cox proportional hazard models were performed to assess the association between AKI and the study outcomes.

RESULTS

The median age of the patients was 59.17 years, with 54.7% being male. There were 3,711 (7.3%) patients who experienced AKI during hospitalization. A total of 1,660 (3.3%) patients experienced composite liver outcome. Patients with AKI during hospitalization had higher risk of composite liver outcomes (adjusted hazard ratio (aHR) 1.83 [95% confidence interval 1.38;2.41] P < 0.001), especially among those with severe AKI (stage 2/3) (aHR 2.36 [1.57;3.54] P < 0.001). Regarding the secondary outcome, AKI was also associated with an increased risk of escalation of FIB-4 risk scores (aHR 1.28 [1.14;1.44] P < 0.001). These associations remained consistent across various subgroups and sensitivity analyses.

CONCLUSIONS

AKI was significantly associated with an increased risk of liver-related events among patients with MAFLD. These findings suggest that enhanced vigilance toward AKI may be justifiable in MAFLD patients.

Maternal exposure to polystyrene nanoplastics induces sex-specific kidney injury in offspring

Maternal exposure to polystyrene nanoplastics (PS-NPs) during pregnancy and lactation has been linked to adverse effects on offspring kidney development, with sex-specific outcomes. This study investigated the impact of maternal PS-NPs exposure on kidney weight, histology, transcriptomics, and functional pathways in offspring mice. Offspring exposed to PS-NPs exhibited significantly lower body weight (P < 0.05) and an increased kidney-to-body weight ratio (P < 0.05), particularly in males. Histological analysis revealed a reduction in glomerular number in PS-NP-treated groups. Transcriptome profiling identified 758 differentially expressed genes (DEGs) in male and 101 DEGs in female offspring, with males showing a more pronounced alteration in gene expression. KEGG pathway enrichment highlighted disruptions in immune response, cell cycle regulation, and metabolism, with males exhibiting more extensive pathway changes than females. Additionally, PS-NPs exposure increased renal fibrosis (P < 0.05), with molecular analyses confirming sex-specific gene expression patterns linked to fibrosis and apoptosis. Immunohistochemical analysis revealed enhanced macrophage infiltration and cleaved caspase-3 expression, indicating heightened immune and apoptotic responses in males. Further investigation identified small molecules BI-D1870 and Resatorvid as potential therapeutic agents, reducing fibrosis, inflammation, and apoptosis in male and female offspring, respectively. These findings demonstrate that maternal PS-NPs exposure induces sex-specific kidney injury in offspring, disrupting key biological processes and pathways. The study underscores the need for targeted therapeutic interventions to mitigate these effects and highlights potential compounds for future treatment.

Extractable organic matter from PM2.5 inhibits cardiomyocyte differentiation via AHR-mediated m6A RNA methylation

An ever-increasing body of research has established a link between maternal PM2.5 exposure and congenital heart diseases in the offspring, but the underlying mechanisms remain elusive. We recently reported that activation of the aryl hydrocarbon receptor (AHR) by PM2.5 causes aberrant m6A RNA methylation, leading to cardiac malformations in zebrafish embryos. We hypothesized that PM2.5 can disrupt heart development by inducing m6A methylation changes through AHR in mammals. In this study, we observed that extractable organic matters (EOM) from PM2.5 significantly impaired cardiomyocyte differentiation in embryonic rat cardiomyoblasts H9c2. Importantly, EOM exposure reduced global m6A methylation levels, which was reversed by AHR inhibition. Moreover, AHR, activated by EOM directly promoted the transcription of the demethylase, FTO, leading to global m6A hypomethylation. Specifically, AHR-induced FTO overexpression decreased the m6A methylation levels of Nox4 mRNA, resulting in NOX4 overexpression and subsequent oxidative stress in EOM samples. We then demonstrated that oxidative stress contributes to the inhibition of cardiomyocyte differentiation by EOM through suppression of Wnt/β-catenin signaling. In summary, our findings indicate that AHR activation by PM2.5 directly enhances the expression of the demethylase, FTO, which increases NOX4 expression by reducing its m6A methylation. The oxidative stress caused by NOX4 overexpression inhibits Wnt/β-catenin signaling, thereby compromising cardiomyocyte differentiation.

Estimated glucose processing rates and the association of chronic kidney disease and proteinuria in non-diabetic adults

The study, which was based on NHANES data (1999-2018), included 21,234 nondiabetic individuals aged 20 years and older to investigate the associations between the estimated glucose disposal rate (eGDR) and the risk of chronic kidney disease (CKD) and proteinuria. CKD was defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2, and proteinuria was defined as a urinary albumin-to-creatinine ratio (UACR) exceeding 30 mg/g. The results demonstrated a significant inverse association between eGDR levels and the risks of CKD and proteinuria. After adjusting for potential confounders, the association between eGDR and CKD showed that, compared with those for Q1, the adjusted odds ratios (ORs) for Q2, Q3, and Q4 were 0.82 (95% CI: 0.61-1.11), 0.62 (95% CI: 0.39-0.98), and 0.55 (95% CI: 0.28-1.05), respectively. For the relationship between eGDR and proteinuria, the adjusted ORs for Q2, Q3, and Q4 were 0.54 (95% CI: 0.42-0.69), 0.41 (95% CI: 0.27-0.62), and 0.65 (95% CI: 0.43-0.98), respectively. Moreover, each standard deviation increase in eGDR was associated with a 9% reduction in CKD risk (OR: 0.91, 95% CI: 0.85-0.98) and a 13% reduction in proteinuria risk (OR: 0.87, 95% CI: 0.82-0.93). Further adjustments via restricted cubic spline (RCS) regression analysis revealed a significant nonlinear relationship between eGDR and CKD and a U-shaped relationship between eGDR and proteinuria. A lower risk of proteinuria was observed when eGDR levels were between 8.70 and 9.91. These findings, combined with those of previous studies, suggest that eGDR may serve as a potential alternative metric for insulin resistance (IR). In nondiabetic individuals, the eGDR was significantly associated with the risk of CKD and proteinuria, with a notable nonlinear pattern in these relationships.

Therapeutic inhibition of PHF21B attenuates pathological cardiac hypertrophy by inhibiting the BMP4/GSK3β/β-catenin axis

BACKGROUND

Pathological cardiac hypertrophy is a hallmark of various cardiovascular diseases, unfortunately, effective targeted therapies are still lacking. This study aims to verify the role of plant-homeodomain finger protein21b (PHF21B) in pathological cardiac hypertrophy.

METHODS

Angiotensin-II (Ang II) induced cardiomyocyte hypertrophy in vitro, and short hairpin (sh) RNA-mediated PHF21B silencing was used to assess its role in hypertrophic growth. Transverse aortic constriction (TAC) was performed to induce cardiac hypertrophy in mice. To assess the effect of PHF21B on pathological cardiac hypertrophy in vivo, the myocardium was transduced with adeno-associated virus 9 (AAV9) encoding a PHF21B-targeting shRNA for gene ablation. Chromatin immunoprecipitation-polymerase chain reaction (PCR), western blotting, and quantitative reverse transcription-PCR were performed to elucidate the mechanisms through which PHF21B regulates pathological cardiac hypertrophy.

RESULTS

This investigation revealed that PHF21B levels were elevated in patients with pathological cardiac hypertrophy. PHF21B inhibition alleviated pressure overload-induced cardiac dysfunction and hypertrophy in vivo, and Ang-II-induced cardiomyocyte hypertrophy in vitro. Genome-wide transcriptome analysis and biological experiments revealed that PHF21B silencing inhibited the Wnt signalling pathway, include the protein expression of β-catenin, and the phosphorylation of glycogen synthase kinase (GSK)-3β. Mechanistically, PHF21B influenced the translation of bone morphogenetic protein (BMP)-4 and facilitated the activation of the GSK3β/β-catenin pathway. The anti-hypertrophic effects of PHF21B knockdown were blocked by BMP4 supplementation.

CONCLUSIONS

Collectively, our results demonstrated that PHF21B is contributes to pathological cardiac hypertrophy by regulating BMP4 expression and the GSK3β/β-catenin pathway. The inhibition of PHF21B is a potential new therapeutic strategy to mitigate pathological cardiiac hypertrophy.

The PPAR-α agonist oleoyethanolamide (OEA) ameliorates valproic acid-induced steatohepatitis in rats via suppressing Wnt3a/β-catenin and activating PGC-1α: Involvement of network pharmacology and molecular docking

Liver damage is one of the most severe side effects of valproic acid (VPA) therapy. Research indicates that PPAR-α prevents Wnt3a/β-catenin-induced PGC-1α dysregulation, which is linked to liver injury. Although PPAR-α activation has hepatoprotective effects, its role in preventing VPA-induced liver injury remains unclear. Our research used network analysis, molecular docking, and in-vivo validation to predict and assess targets and pathways associated with the hepatoprotective effects of oleoylethanolamide (OEA), a PPAR-α agonist, on VPA-induced steatohepatitis. For in-vivo experiments, 24 rats were assigned to V, OEA, VPA, and OEA + VPA. Liver functions, TGs, cholesterol, and LDL were tested. Hepatic levels of PPAR-α, ACO, TNF-α, IL-1β, HO-1, MDA, and TAC, along with Wnt3a/β-catenin, PGC-1α, and Nrf2 expression were assessed. Further, NF-κB, Bax, Bcl-2, and caspase-3 expression were detected immunohistochemically. Network pharmacology identified 258 targets for OEA-steatohepatitis connection, including NFKB1, PPARA, and NFE2L2, in addition to TNF, non-alcoholic fatty liver, NF-κB, PPAR, and WNT signaling, as contributing to steatohepatitis pathogenesis. The docking revealed a strong affinity between OEA and Wnt3a, β-catenin, and PGC-1α. Therefore, we postulated that the hepatoprotective effect of OEA may be due to Wnt3a/β-catenin-mediated inactivation of PGC1-α pathway. In vivo, OEA inhibited Wnt3a/β-catenin and increased PGC1-α by activating PPAR-α. Hence, PGC1-α reduced fat cell β-oxidation and NF-κB-mediated inflammation. OEA lessened MDA and raised TAC to mitigate oxidative damage. OEA additionally reduced apoptosis by lowering Bax/Bcl-2 ratio and caspase-3. In summary, PPAR-α involvement in the protective effects of OEA against VPA-induced steatohepatitis can be confirmed by suppressing Wnt3a/β-catenin and activating PGC-1α signaling.

Molecular and Cellular Mediators of Renal Fibrosis in Lupus Nephritis

Lupus nephritis (LN), a significant complication of systemic lupus erythematosus (SLE), represents a challenging manifestation of the disease. One of the prominent pathophysiologic mechanisms targeting the renal parenchyma is fibrosis, a terminal process resulting in irreversible tissue damage that eventually leads to a decline in renal function and/or end-stage kidney disease (ESKD). Both glomerulosclerosis and interstitial fibrosis emerge as reliable prognostic indicators of renal outcomes. This article reviews the hallmarks of renal fibrosis in lupus nephritis, including the known and putative drivers of fibrogenesis. A better understanding of the cellular and molecular processes driving fibrosis in LN may help inform the development of therapeutic strategies for this disease, as well as the identification of individuals at higher risk of developing ESKD.

Seabirds in crisis: Plastic ingestion induces proteomic signatures of multiorgan failure and neurodegeneration

Understanding plastics' harmful impacts on wildlife would benefit from the application of hypothesis agnostic testing commonly used in medical research to detect declines in population health. Adopting a data-driven, proteomic approach, we assessed changes in 745 proteins in a free-living nonmodel organism with differing levels of plastic exposure. Seabird chicks heavily affected by plastic ingestion demonstrated a range of negative health consequences: Intracellular components that should not be found in the blood were frequently detected, indicative of cell lysis. Secreted proteins were less abundant, indicating that the stomach, liver, and kidneys are not functioning as normal. Alarmingly, these signatures included evidence of neurodegeneration in <90-day-old seabird chicks with high levels of ingested plastic. The proteomic signatures reflect the effects of plastic distal to the site of exposure (i.e., the stomach). Notably, metrics commonly used to assess condition in wildlife (such as body mass) do not provide an accurate description of health or the impacts of plastic ingestion.

Inonotus obliquus (chaga) ameliorates folic acid-induced renal fibrosis in mice: the crosstalk analysis among PT cells, macrophages and T cells based on single-cell sequencing

Background

Renal fibrosis, characterized by the abnormal accumulation of extracellular matrix in renal tissue and progressive loss of kidney function, is posing a significant challenge in clinical treatment. While several therapeutic options exist, effective treatments remain limited. Inonotus obliquus (Chaga), a traditional medicinal mushroom, has shown promising effects in chronic kidney disease (CKD), yet its cellular and molecular mechanisms remain largely unexplored.

Methods

We analysed the chemical composition of Chaga using UPLC-MS and predicted its biological targets using PubChem and Swiss Target Prediction. We used single-cell RNA sequencing to study cellular responses in a mouse model of folic acid-induced renal fibrosis, complemented by spatial transcriptomics to map cellular location patterns. Histological assessment was performed using H&E and Masson trichrome staining.

Results

For the first time, we employed single-cell RNA sequencing technology to investigate Chaga treatment in renal fibrosis. Histological analysis revealed that Chaga treatment significantly reduced renal tubular damage scores [from 5.00 (5.00, 5.00) to 2.00 (2.00, 2.00), p < 0.05] and decreased collagen deposition area (from 11.40% ± 3.01% to 4.06% ± 0.45%, p < 0.05) at day 14. Through analysis of 82,496 kidney cells, we identified 30 distinct cell clusters classified into eight cell types. Key findings include the downregulation of pro-inflammatory M1 macrophages and upregulation of anti-inflammatory M2 macrophages, alongside decreased T cell responses. Single-cell sequencing revealed differential gene expression in proximal tubular subpopulations associated with reduced fibrosis. Pathway and network pharmacology analyses of 60 identified compounds in Chaga and their 675 predicted targets suggested potential effects on immune and fibrotic pathways, particularly affecting Tregs and NKT cells. Cell-to-cell communication analyses revealed potential interactions between proximal tubular cells, macrophages, and T Cells, providing insights into possible mechanisms by which Chaga may ameliorate renal fibrosis.

Conclusion

Our study provided new insights into the potential therapeutic effects of Chaga in renal fibrosis through single-cell sequencing analysis. Our findings suggest that Chaga may represent a promising candidate for renal fibrosis treatment, though further experimental validation is needed to establish its clinical application.

TaoHeChengQi Decotion alleviate chronic renal failure via regulation of PHD2/UCP1 and RIPK3/AKT/TGF-β pathway

ETHNOPHARMACOLOGICAL RELEVANCE

Chronic renal failure (CRF) is a late stage in the development of chronic kidney disease (CKD). Currently, there are no specific clinical drugs available. Traditional Chinese medicine (TCM), as a holistic therapeutic approach, may provide new strategies to improve the clinical management of CRF.

AIM OF THE STUDY

This study aimed to investigate the ameliorative effect of TaoHeChengQi Decoction (THCQD) on CRF and to elucidate its potential mechanism.

MATERIALS AND METHODS

Animal experiments were performed using 5/6 nephrectomy to establish a model of renal failure in rats, and serum, urine, and kidney samples were collected for study after low, medium, and high doses of (2, 4, and 8 g/kg) of THCQD were given by gavage for 8 consecutive weeks. Cellular experiments were performed using Ang II or TGF-β to stimulate HK-2 cells to produce symptoms similar to those of renal failure in vivo to evaluate the ameliorative effect and mechanism of THCQD. After clarifying the chemical composition of THCQD Tang, this study explored the pathogenesis of the disease by mass spectrometry-based proteomics technology, and used affinity ultrafiltration mass spectrometry, surface plasmon resonance, DARTS, and CETSA to investigate the pharmacological material basis of the compound, which was verified by immunoblotting and and immunofluorescence staining experiments.

RESULTS

THCQD attenuated renal injury, renal fibrosis and oxidative stress indices in serum (urine or kidney tissue) of CRF rats. Cellular experiments confirmed that THCQD also protected HK-2 cells from Ang II or TGF-β-induced injury. The mechanism of action was found to be related to the PHD2/UCP1 and RIPK3/AKT/TGF-β pathways by proteomic studies and verified by immunoblotting experiments. In addition, the pharmacodynamic material bases of PHD2/UCP1 and RIPK3/AKT/TGF-β pathways were confirmed to be amygdalin (Amy) and rhein (Rhe), respectively, by AUF-MS, SPR, CETSA and DARTS.

CONCLUSION

THCQD synergistically ameliorates 5/6 nephrectomy-induced CRF by activating PHD2/UCP2-mediated autophagy and targeting RIPK3 and its downstream TGF-β pathway. The basis of the synergistic effects of the above signaling pathways are Amy and Rhe, respectively.

Acrolein exposure associated with kidney damage: a cross‑sectional study

Acrolein (Acr) is a common volatile toxic substance excreted by the kidneys. There are no studies that specifically look at the effects of Acr on kidney function. This study was designed to investigate the relationship between Acr and kidney damage. A cross-sectional study of data (n = 4951) from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) was conducted. Participants' urinary Acr concentration, estimated glomerular filtration rate (eGFR), and urinary albumin to creatinine ratio (UACR) were recorded based on laboratory tests. The number of participants with chronic kidney disease (CKD) was counted. Urinary Acr concentration was divided into quartiles. The association of urinary Acr with CKD and eGFR was investigated using multivariate linear regression, multivariate logistic regression, and smooth curve fitting. Subgroup analyses, interaction tests and sensitivity analyses were used to examine the independence of the Acr-CKD and Acr-eGFR associations in the population. In 4951 participants, urinary Acr concentration was positively associated with CKD risk and negatively associated with eGFR. In the fully adjusted model, each log2Acr increase of one unit was associated with a 6% increased risk of CKD (OR = 1.06, 95% CI 1.01, 1.13) and a 0.54 mL/min/1.73 m2 decrease in eGFR (β = - 0.54, 95% CI - 0.95, - 0.13). For categorical log2Acr, for each log2Acr increase of one unit, the risk of CKD was 29% higher in the Q4 group than in the Q1 group (OR = 1.29, 95% CI 1.01, 1.64), while eGFR was 1.9 mL/min/1.73 m2 lower in the Q4 group than in the Q1 group (β = - 1.90, 95% CI - 3.65, - 0.14). Smooth curve fitting confirmed urinary Acr's nonlinear positive and negative correlations with CKD and eGFR. According to subgroup analyses, sensitivity analyses and interaction tests, the confounding variables did not affect the independent correlations of urinary Acr with CKD and eGFR. Our study found that Acr exposure was significantly associated with kidney damage. Our study provides a new piece of research evidence to support a link between the volatile toxic substance Acr and a decline in kidney function.

Signaling pathway dysregulation in breast cancer

This article provides a comprehensive analysis of the signaling pathways implicated in breast cancer (BC), the most prevalent malignancy among women and a leading cause of cancer-related mortality globally. Special emphasis is placed on the structural dynamics of protein complexes that are integral to the regulation of these signaling cascades. Dysregulation of cellular signaling is a fundamental aspect of BC pathophysiology, with both upstream and downstream signaling cascade activation contributing to cellular process aberrations that not only drive tumor growth, but also contribute to resistance against current treatments. The review explores alterations within these pathways across different BC subtypes and highlights potential therapeutic strategies targeting these pathways. Additionally, the influence of specific mutations on therapeutic decision-making is examined, underscoring their relevance to particular BC subtypes. The article also discusses both approved therapeutic modalities and ongoing clinical trials targeting disrupted signaling pathways. However, further investigation is necessary to fully elucidate the underlying mechanisms and optimize personalized treatment approaches.

Network pharmacology, molecular docking, and experimental verification reveal the mechanism of Yi-Shen-Hua-Shi granules treating acute kidney injury

ETHNOPHARMACOLOGICAL RELEVANCE

Yi-Shen-Hua-Shi granules (YSHSG) have been shown to improve kidney function in various renal disorders, which are characterized by the sudden decline and impairment of kidney function.

AIM OF THE STUDY

To investigate the precise mechanisms and targets of YSHSG in combating sepsis-induced AKI.

MATERIALS AND METHODS

Through network pharmacology, the active ingredients, main target proteins, and related signaling pathways of YSHSG in the treatment of sepsis-induced AKI were predicted. The AKI model was induced by sepsis using the cecal ligation and puncture (CLP) technique. Prior to the operation, YSHSG was administered intragastrically once daily for 1 week. Blood and kidney tissues were collected 48 h post-CLP to verify the network pharmacology analysis.

RESULTS

The core target proteins of YSHSG in the treatment of sepsis-induced AKI include AKT1, JUN, IL6, PTGS2, NFKBIA, MAPK3, Caspase-3 and MMP9, which were further confirmed by molecular docking. Pathway analyses such as Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) show that YSHSG plays a role in protecting the kidneys from sepsis-induced AKI through the PI3K/AKT, TNF, and IL17 signaling pathways. These findings were validated using qPCR and western blotting. In vivo experiments demonstrated that YSHSG inhibits the activation of TNF and IL17 signaling pathways while protecting against deactivation of the PI3K/AKT signaling pathway in sepsis-induced AKI. YSHSG also exhibits an effect on attenuating inflammation response and pyroptosis processes associated with the PI3K/AKT, TNF, and IL17 signaling pathways.

CONCLUSION

YSHSG mitigated sepsis-induced AKI by influencing the PI3K/AKT, TNF, and IL17 signaling pathways associated with inflammation and pyroptosis.

Keap1-independent Nrf2 regulation: A novel therapeutic target for treating kidney disease

The transcription factor NF-E2-related factor 2 (Nrf2) is a master regulator of antioxidant responses in mammals, where it plays a critical role in detoxification, maintaining cellular homeostasis, combating inflammation and fibrosis, and slowing disease progression. Kelch-like ECH-associated protein 1 (Keap1), an adaptor subunit of Cullin 3-based E3 ubiquitin ligase, serves as a critical sensor of oxidative and electrophilic stress, regulating Nrf2 activity by sequestering it in the cytoplasm, leading to its proteasomal degradation and transcriptional repression. However, the clinical potential of targeting the Keap1-dependent Nrf2 regulatory pathway has been limited. This is evidenced by early postnatal lethality in Keap1 knockout mice, as well as significant adverse events after pharmacological blockade of Keap1 in human patients with Alport syndrome as well as in those with type 2 diabetes mellitus and chronic kidney disease. The exact underlying mechanisms remain elusive, but may involve non-specific and systemic activation of the Nrf2 antioxidant response in both injured and normal tissues. Beyond Keap1-dependent regulation, Nrf2 activity is modulated by Keap1-independent mechanisms, including transcriptional, epigenetic, and post-translational modifications. In particular, GSK3β has emerged as a critical convergence point for these diverse signaling pathways. Unlike Keap1-dependent regulation, GSK3β-mediated Keap1-independent Nrf2 regulation does not affect basal Nrf2 activity but modulates its response at a delayed/late phase of cellular stress. This allows fine-tuning of the inducibility, magnitude, and duration of the Nrf2 response specifically in stressed or injured tissues. As one of the most metabolically active organs, the kidney is a major source of production of reactive oxygen and nitrogen species and also a vulnerable organ to oxidative damage. Targeting the GSK3β-mediated Nrf2 regulatory pathway represents a promising new approach for the treatment of kidney disease.

Pathological and Inflammatory Consequences of Aging

Aging is a complex, progressive, and irreversible biological process that entails numerous structural and functional changes in the organism. These changes affect all bodily systems, reducing their ability to respond and adapt to the environment. Chronic inflammation is one of the key factors driving the development of age-related diseases, ultimately causing a substantial decline in the functional abilities of older individuals. This persistent inflammatory state (commonly known as "inflammaging") is characterized by elevated levels of pro-inflammatory cytokines, an increase in oxidative stress, and a perturbation of immune homeostasis. Several factors, including cellular senescence, contribute to this inflammatory milieu, thereby amplifying conditions such as cardiovascular disease, neurodegeneration, and metabolic disorders. Exploring the mechanisms of chronic inflammation in aging is essential for developing targeted interventions aimed at promoting healthy aging. This review explains the strong connection between aging and chronic inflammation, highlighting potential therapeutic approaches like pharmacological treatments, dietary strategies, and lifestyle changes.

Renal nerve afferents drive preferential renal sympathoexcitation in response to acute renal ischemia/reperfusion in rats

Renal nerve activity is composed of afferent (sensory) and efferent (sympathetic) nerve activity. Ischemia/reperfusion (IR) of the kidney increases renal sympathetic nerve activity (rSNA) and depresses renal function. As the role of renal afferent fibers in acute renal IR is unclear, we tested the hypothesis that renal IR increases rSNA triggered by renal afferent nerves responding to acute ischemia. Two experimental series were performed in adult male Wistar rats. IR was induced by total obstruction of blood flow to the left kidney by clamping the renal artery for 60 min and reperfusion for 120 min. We recorded MAP, HR, rSNA, and splanchnic sympathetic vasomotor activity (sSNA) in 8 normal IR rats and 6 left kidney deafferented IR rats (IR ARD). Renal deafferentation was performed using capsaicin administration to the left renal nerve 2 weeks before the experiments. Blood samples were collected before ischemia and at the end of reperfusion for total and differential leukocyte counts. Renal ischemia significantly increased rSNA 23 % (20 min: 0,07 ± 0,04mVs P < 0.05) but not sSNA. The increase in rSNA was triggered by activation of renal afferent fibers, since IR significantly reduced rSNA in the IR ARD group maximal decrease in frequency 22 % (180 min: -62 ± 29Δspikes/s) and in amplitude 41 % (-0,29 ± 0, 12mVs, P < 0.05) and induced hypotension and bradycardia. However, no significant difference was observed between groups in blood leukocyte profile, but a significant reduction in renal IL-6 was found in IR ARD, suggesting a reduction in renal inflammation in deafferented IR rats. The results show that renal afferent nerves trigger a preferential increase in rSNA and inflammation in the kidney during acute IR.

Mesenchymal cell-derived exosomes and miR-29a-3p mitigate renal fibrosis and vascular rarefaction after renal ischemia reperfusion injury

BACKGROUND

Renal fibrosis and vascular rarefaction are significant complications of ischemia/reperfusion (I/R) injury. Human umbilical cord mesenchymal cell-derived exosomes (hucMSC-exos) have shown potential in mitigating these conditions. This study investigates the role of miR-29a-3p in exosomes and its therapeutic effects on I/R-induced renal damage.

METHODS

Male C57BL/6 mice were subjected to unilateral renal ischemia for 28 min followed by reperfusion. Exosomes and miR-29a-3p mimics/inhibitors were injected into the mice. Renal function, histological analysis, and molecular assays were performed to evaluate fibrosis and vascular integrity.

RESULTS

Exosome treatment significantly improved renal function and reduced fibrosis and vascular rarefaction post-I/R. MiR-29a-3p was highly expressed in hucMSC-exos but reduced in renal fibrosis models. MiR-29a-3p mimic reduced, while its inhibitor exacerbated I/R-induced renal fibrosis and vascular rarefaction. Collagen I and TNFR1 were identified as direct targets of miR-29a-3p in fibroblasts and endothelial cells, respectively. Exosomes overexpressing miR-29a-3p provided superior protection compared to unmodified hucMSC-exos.

CONCLUSION

HucMSC-exos, particularly those overexpressing miR-29a-3p, have potent therapeutic effects against renal fibrosis and vascular rarefaction post-I/R. MiR-29a-3p targets TNFR1 and collagen I, highlighting its potential in renal fibrosis therapy.

Association between the aggregate index of systemic inflammation and CKD: evidence from NHANES 1999-2018

Purpose

We aimed to investigate the potential association between the aggregate index of systemic inflammation (AISI) and chronic kidney disease (CKD).

Patients and methods

This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018. CKD was defined as either an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m2 or the presence of albuminuria, defined as a urine albumin-to-creatinine ratio (ACR) of 30 mg/g or higher. Low eGFR is an eGFR of less than 60 mL/min/1.73 m2. Multivariate regression analysis, smoothed curve fitting, and subgroup analyses were conducted to investigate the relationship between the Inflammatory status index (AISI) and CKD. The receiver operating characteristic (ROC) curve analysis was used to evaluate its ability to identify CKD and low eGFR. The AISI was transformed using the natural logarithm (Ln) for statistical analysis.

Results

Of the 50,768 recruits, 49.86% were male. The prevalence of CKD and low eGFR was 20.31% and 8.57%, respectively. Ln-AISI was positively associated with CKD (OR = 1.24; 95% CI: 1.19, 1.28) and low eGFR (OR = 1.17; 95% CI:1.11, 1.24). Smooth curve fitting revealed a positive association between AISI and CKD and low eGFR. Subgroup analysis and interaction tests indicated that stratifications did not significantly alter the association between AISI and CKD and low eGFR. Threshold effect analysis indicated that this relationship became more pronounced when Ln-AISI exceeded 5.2 (AISI > 181.27). The ROC analysis showed that AISI had better discrimination and accuracy for identifying CKD and low eGFR compared to other inflammatory indicators [lymphocyte count (LYM), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and the product of platelet count and neutrophil count (PPN)].

Conclusion

AISI was significantly and positively correlated with the prevalence of CKD, and this relationship was more potent when AISI was greater than 181.27. Compared with other inflammatory indicators, AISI was more effective in identifying CKD.

Cornuside as a promising therapeutic agent for diabetic kidney disease: Targeting regulation of Ca2+ disorder-mediated renal tubular epithelial cells apoptosis

Renal tubular epithelial cells (RTECs) apoptosis is the key factor in the development of diabetic kidney disease (DKD). Endoplasmic reticulum stress (ERS) leading to mitochondrial Ca2+ overload is one of the causes of apoptosis in RTECs. Corni Fructus (CF) is an herbal medicine, developed and applied as a functional food, and it is commonly used to treat DKD. Cornuside (Cor) is one of the main chemical components in CF. This research seeks to investigate the function of Cor in DKD and delve into its possible mechanisms. Cor significantly improved renal function and ameliorated renal pathological changes of db/db mice. Bioinformatics analyses suggested that the modulation of endoplasmic reticulum-induced intrinsic apoptosis pathway was a primary mechanism by which Cor ameliorated DKD. TUNEL assays and flow cytometry assays indicated that Cor effectively inhibited RTECs apoptosis in db/db mice and AGE-induced HK-2 cells. Further experimental studies showed that Cor mitigated ERS by inhibiting the activation of PERK/ATF4/CHOP signal pathway and down-regulation of VDAC1 protein expression, thus alleviating mitochondrial Ca2+ overload. More importantly, Cor directly targeted NEDD4 to facilitate VDAC1 degradation. Notably, the silencing of NEDD4 nearly abolished Cor's inhibitory effects on mitochondrial Ca2+ overload and apoptosis. In conclusion, Cor modulated Ca2+ homeostasis by alleviating ERS and targeting NEDD4, thus mitigating apoptosis of RTECs in DKD. These findings indicate that Cor has the potential for the treatment and drug development of DKD.

Recent advances in understanding the mechanisms by which sodium-glucose co-transporter type 2 inhibitors protect podocytes in diabetic nephropathy

BACKGROUND

Diabetes mellitus is associated with systemic damage across multiple organ systems, and an increasing number of patients are presenting with diabetic kidney disease as its initial manifestation. The onset and progression of diabetic nephropathy is closely associated with podocyte injury.

MAIN BODY

Sodium-glucose cotransporter type 2 (SGLT2) inhibitors, which can significantly reduce glucose levels as well as protecting against kidney damage, are therefore widely used for the clinical treatment of patients with diabetic kidney disease. An increasing body of research has revealed that the renal protective effect of SGLT2 inhibitors is primarily derived from their enhancement of podocyte autophagy and their inhibition of inflammation and podocyte apoptosis. Multiple signaling pathways are involved in these processes.

CONCLUSION

A deeper exploration of the renal protective effects of SGLT2 inhibitors and the underlying mechanisms will provide more solid theoretical support for their application in the prevention and treatment of diabetic kidney disease.

Focal adhesion in the tumour metastasis: from molecular mechanisms to therapeutic targets

The tumour microenvironment is the "hotbed" of tumour cells, providing abundant extracellular support for growth and metastasis. However, the tumour microenvironment is not static and is constantly remodelled by a variety of cellular components, including tumour cells, through mechanical, biological and chemical means to promote metastasis. Focal adhesion plays an important role in cell-extracellular matrix adhesion. An in-depth exploration of the role of focal adhesion in tumour metastasis, especially their contribution at the biomechanical level, is an important direction of current research. In this review, we first summarize the assembly of focal adhesions and explore their kinetics in tumour cells. Then, we describe in detail the role of focal adhesion in various stages of tumour metastasis, especially its key functions in cell migration, invasion, and matrix remodelling. Finally, we describe the anti-tumour strategies targeting focal adhesion and the current progress in the development of some inhibitors against focal adhesion proteins. In this paper, we summarize for the first time that focal adhesion play a positive feedback role in pro-tumour metastatic matrix remodelling by summarizing the five processes of focal adhesion assembly in a multidimensional way. It is beneficial for researchers to have a deeper understanding of the role of focal adhesion in the biological behaviour of tumour metastasis and the potential of focal adhesion as a therapeutic target, providing new ideas for the prevention and treatment of metastases.

Targeting endothelial cells: A novel strategy for pulmonary fibrosis treatment

Endothelial cells (ECs) are a monolayer of flat cells lining the inner surfaces of blood and lymphatic vessels. They play a key role in many physiological and pathological processes. Specifically, they maintain vascular permeability and structural stability and participate in immune responses, inflammation, coagulation, and other vital functions. ECs play a decisive role in various age-related diseases; however, their involvement in pulmonary fibrosis (PF) remains poorly understood. PF refers to a group of chronic interstitial lung diseases characterised by progressive scarring of the pulmonary parenchyma, primarily caused by aberrant tissue repair mechanisms. These changes lead to irreversible loss of lung function. Although the exact pathophysiological mechanism underlying PF has not yet been elucidated, recent studies have indicated that ECs may play a pivotal role in PF. This review outlines the involvement of pulmonary vascular ECs in PF, focusing on the regulation of vascular remodelling and endothelial barrier integrity and on the maintenance of angiogenesis through EC-specific markers, such as vascular endothelial growth factor. This review also explores processes such as endothelial-to-mesenchymal transition, immune cell interactions, anti-EC antibody reactions, metabolic dysregulation, and cellular senescence. By elucidating recent advancements in understanding the role of ECs in PF and examining drugs targeting ECs for the treatment of PF, this study provides novel insights into the pathological mechanisms of PF and the development of endothelium-based therapeutic agents.

Advances in the diagnosis of early biomarkers for acute kidney injury: a literature review

Acute kidney injury (AKI) is a critical condition with diverse manifestations and variable outcomes. Its diagnosis traditionally relies on delayed indicators such as serum creatinine and urine output, making early detection challenging. Early identification is essential to improving patient outcomes, driving the need for novel biomarkers. Recent advancements have identified promising biomarkers across various biological processes. Tubular injury markers, including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP), offer insights into early tubular damage. Inflammatory and repair-associated biomarkers, such as interleukin-18 (IL-18), monocyte chemotactic protein-1 (MCP-1), osteopontin (OPN), and C-C motif chemokine ligand 14 (CCL14), reflect ongoing injury and recovery processes. Additionally, stress and repair markers like tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein-7 (IGFBP-7), alongside filtration markers such as cystatin C (CysC) and proenkephalin (PenKid®) e.tal, further enhance diagnostic precision. Oxidative stress-related markers, including Superoxide Dismutase 1 (SOD1), also contribute valuable information. Emerging candidates, such as microRNAs, soluble urokinase plasminogen activator receptor (SuPAR), and chitinase-3-like protein 1 (CHI3L1), hold substantial promise for AKI detection and prognosis. This review summarizes the progress in AKI biomarker research, highlighting their clinical utility and exploring their potential to refine early diagnosis and management strategies. These findings offer a new perspective for integrating novel biomarkers into routine clinical practice, ultimately improving AKI care.

Network pharmacology and molecular docking technology-based predictive study and potential targets analysis of icariin for the treatment of diabetic nephropathy

OBJECTIVE

Epimedium glycoside is a flavonoid compound in Epimedium, which has been found to alleviate various chronic diseases. The effect and mechanism of icariin on the treatment of diabetes nephropathy still need to be clarified. In this study, we conducted network pharmacology and molecular docking analysis to reveal the mechanism of icariin treating DKD, and then validated its efficacy using a cell model.

METHOD

The structure and targets of icariin were screened using Traditional Chinese Medicine Systems Pharmacology (TCMSP), and their targets were annotated. Retrieve DKD targets from OMIM, GeneCards, and TTD databases. We constructed a protein-protein interaction (PPI) network using the STRING platform and visualized the results using Cytoscape 3.9.1 software. We also conducted GO and KEGG enrichment analysis on icariin and then performed molecular docking between icariin and key targets. Finally, we established a cell model of DKD to evaluate the efficacy of icariin in treating DKD.

RESULT

A total of 77 icariin targets were associated with DKD. The GO and KEGG enrichment results showed that the therapeutic effect of icariin on DKD was significantly correlated with inflammatory response, cell apoptosis, epithelial-mesenchymal transition, and PI3K/AKT signaling pathway. The molecular docking results indicate that icariin has a high affinity for key targets EGER, AKT1, and IGF1. Cell experiments showed that icariin inhibited high glucose-induced EMT, fibrosis-related proteins, levels of inflammatory factors TGF-β1, IL-6, and TNF-α, as well as phosphorylation of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (AKT) in renal tubular epithelial cells. In addition, icariin inhibited the increase in EGER and AKT1 mRNA levels caused by high glucose and alleviated the decrease in IGF1 mRNA levels.

CONCLUSION

Epimedium glycoside may protect DKD by targeting EGER, AKT1, and IGF1 to inhibit PI3K/AKT signaling, but the specific mechanism needs further exploration.

Podocyte A20/TNFAIP3 Controls Glomerulonephritis Severity via the Regulation of Inflammatory Responses and Effects on the Cytoskeleton

A20/Tnfaip3, an early NF-κB response gene and key negative regulator of NF-κB signaling, suppresses proinflammatory responses. Its ubiquitinase and deubiquitinase activities mediate proteasomal degradation within the NF-κB pathway. This study investigated the involvement of A20 signaling alterations in podocytes in the development of kidney injury. The phenotypes of A20Δpodocyte (podocyte-specific knockout of A20) mice were compared with those of control mice at 6 months of age to identify spontaneous changes in kidney function. A20Δpodocyte mice presented elevated serum urea nitrogen and creatinine levels, along with increased accumulation of inflammatory cells-neutrophils and macrophages-within the glomeruli. Additionally, A20Δpodocyte mice displayed significant podocyte loss. Ultrastructural analysis of A20 podocyte-knockout mouse glomeruli revealed hypocellularity of the glomerular tuft, expansion of the extracellular matrix, podocytopenia associated with foot process effacement, karyopyknosis, micronuclei, and podocyte detachment. In addition to podocyte death, we also observed damage to intracapillary endothelial cells with vacuolation of the cytoplasm and condensation of nuclear chromatin. A20 expression downregulation and CRISPR-Cas9 genome editing targeting A20 in a podocyte cell line confirmed these findings in vitro, highlighting the significant contribution of A20 activity in podocytes to glomerular injury pathogenesis. Finally, we analyzed TNFAIP3 transcription levels alongside genes involved in apoptosis, anoikis, NF-κB regulation, and cell attachment in glomerular and tubular compartments of kidney biopsies of patients with various renal diseases.

MMP12-dependent myofibroblast formation contributes to nucleus pulposus fibrosis

Intervertebral disc degeneration (IDD) is associated with low back pain, a leading cause of disability worldwide. Fibrosis of nucleus pulposus (NP) is a principal component of IDD, featuring an accumulation of myofibroblast-like cells. Previous study indicates that matrix metalloproteinase 12 (MMP12) expression is upregulated in IDD, but its role remains largely unexplored. We here showed that TGF-β1 could promote myofibroblast-like differentiation of human NP cells along with an induction of MMP12 expression. Intriguingly, MMP12 knockdown not only ameliorated the myofibroblastic phenotype but also increased chondrogenic marker expression. Transcriptome analysis revealed that the MMP12-mediated acquisition of myofibroblast phenotype was coupled to processes related to fibroblast activation and osteogenesis and to pathways mediated by MAPK and Wnt signaling. Injury induced mouse IDD showed NP fibrosis with marked increase of collagen deposition and αSMA-expressing cells. In contrast, MMP12-KO mice exhibited largely reduced collagen I and III but increased collagen II and aggrecan deposition, indicating an inhibition of NP fibrosis along with an enhanced cartilaginous matrix remodeling. Consistently, an increase of SOX9+ and CNMD+ but decrease of αSMA+ NP cells was found in the KO. Altogether, our findings suggest a pivotal role of MMP12 in myofibroblast generation, thereby regulating NP fibrosis in IDD.

Diabetic kidney disease: m6A modification as a marker of disease progression and subtype classification

This paper aims to investigate m6A modification during DKD progression. We evaluated m6A regulators expression in peripheral blood mononuclear cells, whole kidney tissue, glomerular, and tubulointerstitial samples. CIBERSORT and single-sample gene set enrichment analysis analyzed glomerular immune characteristics. Logistic-LASSO regression were used to develop the m6A regulators model that can identify early DKD. Consensus clustering algorithms were used to classify DKD in glomerular samples into m6A modified subtypes based on the expression of m6A regulators. Gene set variation analysis algorithm was used to evaluate the functional pathway enrichment of m6A modified subtypes. Weighted gene co-expression network analysis and protein-protein interaction networks identified m6A modified subtype marker genes. The Nephroseq V5 tool was used to evaluate the correlation between m6A modified subtypes marker genes and renal function. DKD patients' m6A regulators expression differed from the control group in various tissue types. DKD stages have various immune characteristics. The m6A regulators model with YTHDC1, METTL3, and ALKBH5 better identified early DKD. DKD was divided into two subtypes based on the expression of 26 m6A regulators. Subtype 1 was enriched in myogenesis, collagen components, and cytokine receptor interaction, while subtype 2 was enriched in protein secretion, proliferation, apoptosis, and various signaling pathways (e.g., TGFβ signaling pathway, PI3K/AKT/mTOR pathway, and etc.). Finally, AXIN1 and GOLGA4 were identified as possible biomarkers associated with glomerular filtration rate. From the viewpoint of m6A modification, the immune characteristics and molecular mechanisms of DKD at various stages are different, and targeted treatment would improve efficacy.

Multi-omics analysis of the dynamic role of STAR+ cells in regulating platinum-based chemotherapy responses and tumor microenvironment in serous ovarian carcinoma

Background

Serous ovarian carcinoma (SOC) is the most lethal subtype of ovarian cancer, with chemoresistance to platinum-based chemotherapy remaining a major challenge in improving clinical outcomes. The role of the tumor microenvironment (TME), particularly cancer-associated fibroblasts (CAFs), in modulating chemotherapy responses is not yet fully understood.

Methods

To explore the relationship between CAF subtypes and chemotherapy sensitivity, we employed single-cell RNA sequencing (scRNA-seq), bulk RNA-seq, spatial transcriptomics, immunohistochemistry (IHC), and immunofluorescence (IF). This multi-omics approach enabled the identification, characterization, and functional analysis of CAF subtypes in both chemotherapy-sensitive and chemotherapy-resistant SOC patients.

Results

We identified steroidogenic acute regulatory protein-positive (STAR+) cells as a novel CAF subtype enriched in chemotherapy-sensitive SOC patients. STAR + cells exhibited unique transcriptional profiles and were functionally enriched in pathways related to P450 drug metabolism, lipid metabolism, and amino acid metabolism, with enhanced pathway activity observed in chemotherapy-sensitive groups. Spatial transcriptomics and IF revealed that STAR + cells were closely localized to tumor cells, suggesting potential cell-cell interactions. Further communication analysis indicated that STAR + cells may suppress WNT signaling in tumor cells, contributing to improved chemotherapy responses. Importantly, STAR expression levels, validated by IHC, were positively correlated with chemotherapy sensitivity and improved patient prognosis. Platinum-based chemotherapy was shown to increase the proportion of STAR + cells, underscoring their dynamic response to treatment.

Conclusion

Our study identifies STAR + cells as a novel CAF subtype that enhances chemotherapy sensitivity in SOC. By modulating key metabolic pathways and potentially suppressing WNT signaling, STAR + cells could contribute to improved treatment responses. These findings position STAR + cells as a promising biomarker for predicting chemotherapy efficacy in SOC, which warrants further investigation.

The compound XueShuanTong promotes podocyte mitochondrial autophagy via the AMPK/mTOR pathway to alleviate diabetic nephropathy injury

The study aimed to elucidate the molecular mechanisms underlying the protective effects of Compound Xueshuantong (CXst) in the context of diabetic nephropathy (DN), a major cause of kidney failure driven by podocyte injury and metabolic dysfunction. Given the critical role of the AMPK/mTOR signaling pathway in regulating cellular energy balance, autophagy, and mitochondrial health, we focused on its involvement in podocyte function and how it might be influenced by CXst. Through a series of experiments, we found that CXst treatment led to the upregulation of key proteins involved in autophagy, such as LC3 and p62, as well as proteins critical for mitochondrial function, like PGC-1α. These molecular changes helped to counteract the damaging effects of high glucose levels on podocytes, which are central to maintaining the filtration function of the kidneys. Additionally, CXst's ability to modulate the AMPK/mTOR pathway was shown to be a pivotal factor in its protective effects, as inhibition of AMPK significantly reduced these benefits. This comprehensive study provides strong evidence that CXst exerts its protective effects against DN by modulating the AMPK/mTOR pathway, thus preserving podocyte integrity and function. These findings suggest that CXst could be a promising candidate for the development of new therapeutic strategies for the treatment of DN, offering hope for better management of this challenging condition.

Renal tubular S100A7a impairs fatty acid oxidation and exacerbates renal fibrosis via both intracellular and extracellular pathway

A couple of S100 family proteins (S100s) have been reported to exert pro-inflammatory functions in the progression of renal fibrosis. Unlike some S100s which are expressed by both epithelial and stromal inflammatory cells, S100A7 is restricted expressed in epithelium. Persistent S100A7 expression occurs in some invasive carcinomas and is associated with poor prognostic factors. Whereas, whether it is implicated in renal tubular epithelial cell injury and kidney disease remains unexplored. In this study, we demonstrate that S100A7 is highly upregulated in tubular cells of both mouse renal fibrotic lesions and kidney biopsies from patients with chronic kidney disease (CKD). The level of renal S100A7 was associated with both the decline of renal function and the progression of renal fibrosis in CKD patients. Overexpressing S100A7a impaired fatty acid oxidation (FAO) and promoted lipid peroxidation in proximal tubular cells (PTCs). Mechanistically, S100A7a interacts with β-catenin, thereby preventing its ubiquitination and degradation by the β-TrCP-SCF complex, and in turn activated β-catenin signaling, downregulated the expression of PGC-1α. Additionally, S100A7a exacerbated lipid peroxidation via RAGE-p-ERK-NOX2 pathway. Specific deletion of S100a7a in tubular cells enhanced FAO and reduced lipid peroxidation, resulting in improved renal function and alleviation of renal fibrosis induced by unilateral ureteral obstruction and unilateral ischemia-reperfusion injury. Collectively, we delineate a previously unrecognized function of S100A7a in the progression of renal fibrosis.

Recombinant Klotho administration after myocardial infarction reduces ischaemic injury and arrhythmias by blocking intracellular calcium mishandling and CaMKII activation

Ischaemic heart disease (IHD) remains a major cause of death and morbidity. Klotho is a well-known anti-ageing factor with relevant cardioprotective actions, at least when renal dysfunction is present, but its actions are much less known when renal function is preserved. This study investigated Klotho as a biomarker and potential novel treatment of IHD-associated complications after myocardial infarction (MI) under preserved renal function. Association between circulating Klotho levels and cardiac injury was investigated in patients after ST-elevation MI (STEMI). Biochemical, in vivo and in vitro cardiac function and histological and molecular studies were performed to determine the effect of recombinant Klotho in the failing hearts of mice after MI. We demonstrated that STEMI patients showed lower systemic Klotho levels, with the lowest Klotho tertile in those patients with higher N-terminal pro B-type natriuretic peptide (NT-proBNP) levels. Mice also showed a decrease in systemic Klotho levels after MI induction. Furthermore, recombinant Klotho administration in mice reduced infarct area and attenuated cardiac hypertrophy and fibrosis. We also demonstrated that Klotho treatment prevented reduction in ejection fraction and MI-related ECG changes, including prolonged QRS, JT, QTc, and TpeakTend intervals and premature ventricular contractions. In adult mouse cardiomyocytes, Klotho treatment restricted systolic calcium (Ca2+) release and cell shortening disturbances after MI. Klotho prevented increased diastolic Ca2+ leak and pro-arrhythmogenic events in PMI mice by blocking activation of the Ca2+/calmodulin-dependent kinase type II (CaMKII) pathway, preventing ryanodine receptor type 2 (RyR2) hyperphosphorylation. In conclusion, Klotho supplementation protected against functional and structural cardiac remodelling and ameliorated ventricular arrhythmic events by preventing intracardiomyocyte Ca2+ mishandling in mice following MI. These data uncover a new cardioprotective role of Klotho, emerging as a biomarker of ventricular injury and potential treatment for patients after MI. © 2025 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

The challenges for developing prognostic prediction models for acute kidney injury in hospitalized children: A systematic review

Importance

Acute kidney injury (AKI) is common in hospitalized children which could rapidly progress into chronic kidney disease if not timely diagnosed. Prognostic prediction models for AKI were established to identify AKI early and improve children's prognosis.

Objective

To appraise prognostic prediction models for pediatric AKI.

Methods

Four English and four Chinese databases were systematically searched from January 1, 2010, to June 6, 2022. Articles describing prognostic prediction models for pediatric AKI were included. The data extraction was based on the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies checklist. The risk of bias (ROB) was assessed according to the Prediction model Risk of Bias Assessment Tool guideline. The quantitative synthesis of the models was not performed due to the lack of methods regarding the meta-analysis of prediction models.

Results

Eight studies with 16 models were included. There were significant deficiencies in reporting and all models were considered at high ROB. The area under the receiver operating characteristic curve to predict AKI ranged from 0.69 to 0.95. However, only about one-third of models have completed internal or external validation. The calibration was provided only in four models. Three models allowed easy bedside calculation or electronic automation, and two models were evaluated for their impacts on clinical practice.

Interpretation

Besides the modeling algorithm, the challenges for developing prediction models for pediatric AKI reflected by the reporting deficiencies included ways of handling baseline serum creatinine and age-dependent blood biochemical indexes. Moreover, few prediction models for pediatric AKI were performed for external validation, let alone the transformation in clinical practice. Further investigation should focus on the combination of prediction models and electronic automatic alerts.

The fundamentals of WNT10A

Human wingless-type MMTV integration site family member 10A (WNT10A) is a secreted glycoprotein that is involved in signaling pathways essential to ectodermal organogenesis and tissue regeneration. WNT10A was first linked to human disorders in 2006, demonstrating a WNT10a variant to be associated with cleft lip with/without cleft palate. Numerous publications have since then identified the importance of WNT10A in the development of ectodermal appendages and beyond. In this review, we provide information on the structure of the WNT10A gene and protein, summarize its expression patterns in different animal models and in human, and describe the identified roles in tissue and organ development and repair in the different animal model organisms. We then correlate such identified functions and working mechanisms to the pathophysiology of a spectrum of human diseases and disorders that result from germline loss-of-function mutations in WNT10A, including ectodermal dysplasia (ED) syndromes Odonto-oncho-dermal dysplasia (OODD), Schöpf-Schulz-Passarge syndrome (SSPS), and selective tooth agenesis, as well as pathological conditions like fibrosis and carcinogenesis that can be correlated with increased WNT10A activity (Section 5).

Stay connected: The myoendothelial junction proteins in vascular function and dysfunction

The appropriate regulation of peripheral vascular tone is crucial for maintaining tissue perfusion. Myoendothelial junctions (MEJs), specialized connections between endothelial cells and vascular smooth muscle cells, are primarily located in peripheral resistance vessels. Therefore, these junctions, with their key membrane proteins, play a pivotal role in the physiological control of relaxation-contraction coupling in resistance arterioles, mainly mediated through endothelium-derived hyperpolarization (EDH). This review aims to illustrate the mechanisms involved in the initiation and propagation of EDH, emphasizing the role of membrane proteins involved in its generation (TRPV4, Piezo1, ASIC1a) and propagation (connexins, Notch). Finally, we discuss relevant studies on pathological events linked to EDH dysfunction and discuss novel approaches, including the effects of natural and dietary bioactive molecules, in modulating EDH-mediated vascular tone.

Iron-Quercetin complex enhances mesenchymal stem cell-mediated HGF secretion and c-Met activation to ameliorate acute kidney injury through the prevention of tubular cell apoptosis

Background

Acute kidney injury (AKI) is a life-threatening clinical syndrome with no effective treatment currently available. This study aims to investigate whether Iron-Quercetin complex (IronQ) pretreatment can enhance the therapeutic efficacy of Mesenchymal stem cells (MSCs) in AKI and explore the underlying mechanisms.

Methods

A cisplatin-induced AKI model was established in male C57BL/6 mice, followed by the intravenous administration of 1x10ˆ6 MSCs or IronQ-pretreated MSCs (MSCIronQ). Renal function, histology, and tubular cell apoptosis were analyzed three days post-treatment. In vitro, apoptosis was induced in mouse tubular epithelial cells (mTECs) using cisplatin, followed by treatment with MSCs or MSCIronQ conditioned medium (CM). Apoptosis was evaluated using TUNEL assay, RT-PCR, and western blotting. Furthermore, RNA sequencing (RNA-seq) was performed on MSCIronQ to explore the underlying mechanisms.

Results

Compared to MSC-treated AKI mice, those treated with MSCIronQ showed significantly improved renal function and histological outcomes, with reduced tubular cell apoptosis. A similar effect was observed in cisplatin-treated mTECs exposed to MSCIronQ-CM. Mechanistically, RNA-seq and subsequent validation revealed that IronQ treatment markedly upregulated the expression and secretion of hepatocyte growth factor (HGF) in MSCs. Furthermore, RNA interference or antibody-mediated neutralization of HGF effectively abolished the anti-apoptotic effects of MSCIronQ on mTECs. This mechanistic insight was reinforced by pharmacological inhibition of c-Met, the specific receptor of HGF, in both in vitro and in vivo models.

Conclusions

IronQ pretreatment enhances MSCs efficacy in AKI by promoting HGF expression and secretion, activating the HGF/c-Met pathway to suppress tubular cell apoptosis. These findings indicate that IronQ improves MSC-based therapies and offers insights into molecular mechanisms, supporting the development of better AKI treatments.

Glial cell line-derived neurotrophic factor and its role in attenuating renal fibrosis: a review

Chronic kidney disease is estimated to affect approximately 10 to 15% of the Chinese population. Renal fibrosis is characterized by progressive extracellular matrix deposition in the kidney parenchyma with eventual tissue scarring and inevitable deterioration of renal function. Vascular rarefaction, glomerulosclerosis, interstitial inflammation, and fibrogenesis are associated with or contribute to renal fibrosis. Recent studies have revealed that glial cell-derived neurotrophic factor (GDNF) is involved in kidney morphogenesis and amelioration of renal injury. Ideal therapies targeting the pathogenesis of renal fibrosis should have the potential to inhibit glomerular and tubulointerstitial fibrosis by targeting multiple pathological events. GDNF plays a unique role in both renal development and improvement of renal fibrosis, and GDNF kidney receptors and signaling pathways can ameliorate renal apoptosis and inflammation. Our work contributes to the establishment of GDNF as an emerging therapy that can increase the effectiveness of currently used interventions to improve renal fibrosis. This literature review focuses on the important role of GDNF in renal development and its relationship with renal fibrosis.

Glomerular CD68+ macrophages infiltration at initial biopsy predicts response to standard immunosuppression in proliferative lupus nephritis: CD68+ Mø predicts LN treatment response

OBJECTIVE

Predictive models of kidney response to standard immunosuppression are needed in proliferative lupus nephritis (LN). We tested the kidney macrophage infiltration at initial biopsy.

METHODS

The prospective study was performed in 247 patients with newly diagnosed proliferative LN in 2 independent cohorts. Infiltrates of macrophages and lymphocytes in initial biopsies were identified using single-cell RNA sequencing and immunostaining analysis. The outcome was kidney response to standard immunosuppression at 1 year, defined clinically and histologically. Kidney infiltrates were investigated for association with kidney response. Models that combined kidney infiltrates and clinical parameters for predicting kidney response were developed and validated using machine learning algorithms.

RESULTS

In Derivation cohort, glomerular infiltration of CD68+ macrophages at initial biopsy was associated with 1-year clinical response. Subjects in the highest tertile of glomerular CD68+ macrophage infiltrate (versus the lowest) had a 7.92-fold increase in probability of clinical response. An intelligent model incorporating infiltration score of glomerular CD68+ macrophage into clinical measures (area under the curve [AUC] 0.82) outperformed traditional clinical measure-based model (AUC 0.76) in predicting clinical response (P = 0.01). This intelligent model performed well in an independent Validation cohort. Furthermore, in 10 patients undergoing repeat kidney biopsy after 1 year of standard immunosuppression, our intelligent model effectively predicted histological response.

CONCLUSION

Intensity of glomerular CD68+ macrophage infiltration at initial biopsy predicted 1-year kidney response to standard therapy in proliferative LN. The intelligent model, which combines glomerular CD68+ macrophage infiltrates with clinical data at biopsy, could help discriminate responders from non-responders, enabling personalized therapy.

The road to renal denervation for hypertension and beyond (HF): two decades of failed, succeeded, and to be determined

Activation of the sympathetic nervous system has been attributed to the development of hypertension. Two established approaches for treating hypertension are pharmacotherapy and lifestyle changes. With an improved understanding of renal nerve anatomy and physiology, renal denervation has been proposed as an alternative treatment for hypertension. Specifically, it has been shown that the interruption of sympathetic nerves connecting the kidney and the sympathetic nervous system can reduce blood pressure. Here, we present a review on how renal denervation can help hypertension patients, specifically focusing on our novel understanding of renal nerve anatomy, denervation technique, and subsequent clinical trials, and how it may be used to treat other cardiovascular diseases like heart failure.

Activation of HIF-1α C-terminal transactivation domain promotes tubulointerstitial fibrosis through hexokinase 2-mediated metabolic reprogramming

BACKGROUND

The hypoxia-inducible factor-1α (HIF-1α), a master transcription factor for adaptive responses to hypoxia, possesses two transcriptional activation domains [TAD, N-terminal (NTAD) and C-terminal (CTAD)]. However, the exact effects of HIF-1α CTAD in chronic kidney disease (CKD) are poorly understood.

METHODS

Here, two independent mouse models of hypoxia-induced CKD, including ischemia/reperfusion-induced kidney injury and unilateral ureteral obstruction-induced nephropathy, were established using HIF-1α CTAD knockout (HIF-1α CTAD-/-) mice. Further, hexokinase 2 (HK2) and glycolysis pathway were modulated using genetic and pharmacological interventions, respectively.

RESULTS

We found that HIF-1α CTAD knockout significantly ameliorated tubulointerstitial fibrosis in two models of hypoxia-induced CKD. Further, we found that tubular HIF-1α CTAD transcriptionally regulated HK2 and subsequently induced proinflammatory and profibrotic tubule phenotype. Mechanistically, HK2 deficiency, which resulted from HIF-1α CTAD knockout, ameliorated tubulointerstitial fibrosis through inhibiting glycolysis. HK2 overexpression markedly promoted tubulointerstitial fibrosis by inducing proinflammatory and profibrotic tubule phenotype in HIF-1α CTAD-/- mice. Finally, glycolysis inhibition with a specific inhibitor significantly ameliorated tubulointerstitial fibrosis and reduced proinflammatory and profibrotic tubule phenotype in CKD mice.

CONCLUSIONS

Activation of HIF-1α CTAD promotes hypoxia-induced tubulointerstitial fibrosis through hexokinase 2-mediated glycolysis. Our findings suggested that the HIF-1α CTAD-HK2 pathway represents a novel mechanism of the kidney responses to hypoxia in CKD, providing a promising therapeutic strategy for hypoxia-induced CKD.

Low-density lipoprotein receptor-related protein 6 ameliorates cardiac hypertrophy by regulating CTSD/HSP90α signaling during pressure overload

Pressure overload induces pathological cardiac remodeling, including cardiac hypertrophy and fibrosis, resulting in cardiac dysfunction or heart failure. Recently, we observed that the low-density lipoprotein receptor-related protein 6 (LRP6), has shown potential in enhancing cardiac function by mitigating cardiac fibrosis in a mouse model subjected to pressure overload. In this study, we investigated the role of LRP6 as a potential modulator of pressure overload-induced cardiac hypertrophy and elucidated the underlying molecular mechanisms. We performed transverse aortic constriction (TAC) to induce pressure overload in cardiomyocyte-specific LRP6 overexpression mice (LRP6-over mice) and in control mice (α-myosin heavy chain (α-MHC) Mer-Cre-Mer Tg mice or named MCM mice). Cardiac function and hypertrophy were assessed using echocardiography. LRP6-over mice showed improved cardiac function and reduced hypertrophy after TAC, compared with MCM mice. We also applied mechanical stretch to cultured neonatal rat cardiomyocytes to model pressure overload in vitro. Mass spectrometry analysis showed that LRP6 interacts with HSP90α and cathepsin D (CTSD) in cardiomyocytes under mechanical stress. Further analysis demonstrated that LRP6 facilitates CTSD-mediated degradation of HSP90α, consequently inhibiting β-catenin activation and reducing cardiac hypertrophy post-TAC. Treatment with recombinant HSP90α protein or the CTSD inhibitor, pepstatin A, partly abolished the protective effect of LRP6 overexpression on myocardial hypertrophy and cardiac function after TAC in mice. Collectively, our data suggest that LRP6 protects against pressure overload-induced myocardial remodeling and that the CTSD/HSP90α/β-catenin axis may be a potential therapeutic target.

Metastasis and chemoresistance in breast cancer: Crucial function of ZEB1/2 proteins

Breast cancer remains one of the leading causes of mortality worldwide. While advancements in chemotherapy, immunotherapy, radiotherapy, and targeted therapies have significantly improved breast cancer treatment, many patients are diagnosed at advanced stages, where tumor cells exhibit aggressive behavior and therapy resistance. Understanding the mechanisms driving breast cancer progression is therefore critical. Metastasis is a major factor that drastically reduces patient prognosis and survival, accounting for most breast cancer-related deaths. ZEB proteins have emerged as key regulators of cancer metastasis. Beyond their role in metastasis, ZEB proteins also influence drug resistance. This review focuses on the role of ZEB1 and ZEB2 in regulating breast cancer metastasis. These proteins interact with components of the tumor microenvironment (TME) to drive cancer progression and metastasis. Additionally, ZEB proteins regulate angiogenesis through interactions with VEGF. Targeting ZEB proteins offers potential therapeutic benefits, particularly for aggressive breast cancer subtypes such as triple-negative breast cancer (TNBC), which often show poor therapeutic response. ZEB proteins also influence the sensitivity of breast cancer cells to chemotherapy, making them promising targets for enhancing treatment efficacy. Given their upregulation in breast cancer, ZEB proteins can serve as valuable diagnostic and prognostic markers.

Non-coding RNAs as mediators of epithelial to mesenchymal transition in metastatic colorectal cancers

Colorectal cancer (CRC) remains a leading cause of cancer-related mortality globally, necessitating the development of innovative treatment strategies. Recent research has underscored the significant role of non-coding RNAs (ncRNAs) in CRC pathogenesis, offering new avenues for diagnosis and therapy. In this review, we delve into the intricate roles of various ncRNAs, including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), in CRC progression, epithelial-mesenchymal transition (EMT), metastasis, and drug resistance. We highlight the interaction of these ncRNAs with and regulation of key signaling pathways, such as Wnt/β-catenin, Notch, JAK-STAT, EGFR, and TGF-β, and the functional relevance of these interactions in CRC progression. Additionally, the review highlights the emerging applications of nanotechnology in enhancing the delivery and efficacy of ncRNA-based therapeutics, which could address existing challenges related to specificity and side effects. Future research directions, including advanced diagnostic tools, targeted therapeutics, strategies to overcome drug resistance, and the integration of personalized medicine approaches are discussed. Integrating nanotechnology with a deeper understanding of CRC biology offers the potential for more effective, targeted, and personalized strategies, though further research is essential to validate these approaches.

Risk factors for lenvatinib-induced hypertension in patients with hepatocellular carcinoma: A retrospective study

AIMS

Lenvatinib mesylate (LEN) is an orally administered tyrosine kinase inhibitor used to treat various cancers, including hepatocellular carcinoma (HCC). LEN therapy for HCC is associated with a high incidence of adverse events, including hypertension (HTN). However, the risk factors associated with LEN therapy remain unclear. This study investigated the incidence of LEN-induced HTN (LENiHTN), and the relationship between HTN incidence and patient demographics in patients with HCC receiving LEN therapy.

METHODS

This was a single-centre, retrospective study of patients with HCC who received LEN therapy between 19 April 2018 and 30 September 2020. The observation period was from 1 week before the start to 1 month after the end of LEN administration.

RESULTS

Seventy-five patients with HCC were enrolled. Any grade LENiHTN was found in 74.7% of patients. Among patients with LENiHTN, the use of 2 or more antihypertensive agents before starting LEN was less common (P = .007); serum potassium (K) and albumin-bilirubin score (ALBI) were lower (P = .013 and 0.038, respectively); and albumin (Alb) was higher (P = .025). The cut-off values of K, Alb and ALBI for HTN were estimated at 4.1 mEq L-1, 3.1 g dL-1 and -1.736, respectively. In the multivariable analysis, low K (adjusted HR: 2.078) and low ALBI (adjusted HR: 2.845) were independent risk factors for LENiHTN.

CONCLUSION

Low K, high Alb and low ALBI were independent risk factors for LENiHTN. Systematic evaluation of HTN risk and early intervention for HTN prevention among high-risk patients can markedly enhance LEN therapy efficacy and use.

Targeting the NF-κB p65-MMP28 axis: Wogonoside as a novel therapeutic agent for attenuating podocyte injury in diabetic nephropathy

BACKGROUND

Although recent progress provides mechanistic insights into diabetic nephropathy (DN), effective treatments remain scarce. DN, characterized by proteinuria and a progressive decline in renal function, primarily arises from podocyte injury, which impairs the glomerular filtration barrier. Wogonoside, a bioactive compound from the traditional Chinese herb Scutellaria baicalensis, has not been explored for its role in DN.

PURPOSE

This study aimed to investigate the therapeutic effects of wogonoside on podocyte injury in DN and its molecular mechanisms.

METHODS

The effects of wogonoside were examined using HFD/STZ-induced DN mouse models and high glucose (HG)-induced MPC-5 cells. Oxidative stress and inflammation markers were analyzed via Western blot and RT-qPCR. Wogonoside targets were identified through DARTS-MS and validated by SPR, molecular docking, alanine scanning, and CETSA. RNA-Seq analysis was employed to identify downstream targets, and the p65-MMP28 axis was explored through p65 knockdown and overexpression studies. The regulatory effect of p65 on Mmp28 was confirmed through dual-luciferase reporter assays and ChIP-qPCR.

RESULTS

Wogonoside treatment significantly reduced oxidative stress and inflammation in vivo and in vitro. Mechanistic studies identified p65 as a direct target of wogonoside, with SPR confirming a strong binding affinity (KD = 25.05 μM). Molecular docking and alanine scanning identified LYS221 as a critical binding site, which was further supported by CETSA using the p65 K221A mutant. RNA-Seq analysis revealed Mmp28 as a downstream effector of p65 involved in HG-induced podocyte injury. Functional studies demonstrated that wogonoside's protective effects on antioxidant and inflammatory pathways are mediated via the p65-MMP28 axis. Dual-luciferase reporter assays revealed that p65 regulates Mmp28 transcription, and ChIP-qPCR confirmed its direct promoter binding.

CONCLUSIONS

This study highlights wogonoside as a promising candidate for the treatment of podocyte injury in DN by targeting the NF-κB p65-MMP28 signaling axis. These findings provide novel insights into wogonoside's therapeutic potential and its molecular mechanisms, paving the way for its further development as a DN intervention.

Integrated analysis of ATAC-seq and RNA-seq reveals the chromatin accessibility and transcriptional landscape of immunoglobulin a nephropathy

BACKGROUNDS

The association between chromatin accessibility in CD4+ T cells and Immunoglobulin A nephropathy (IgAN) remains unclear.

METHODS

We performed the assay for transposase accessible chromatin with sequencing (ATAC-seq) and RNA sequencing (RNA-seq) on CD4+ T cells. ATAC-seq and RNA-seq were conducted to identify differentially accessible regions and differentially expressed genes (DEGs), respectively (P < 0.05, |log2 Fold Change| >1). QRT-PCR was utilized to validate target gene expression.

RESULTS

We identified 100,865 differentially accessible regions, of which 7225 exhibited higher accessibility in IgAN. Functional analysis revealed that these regions are enriched in T lymphocyte activation and immune pathways. ELF3, MEIS1, and NFYC were identified as key TFs associated with IgAN. QRT-PCR indicated a significant upregulation of hub genes including MEIS1 in IgAN.

CONCLUSION

We identified key TFs and genes by integrating ATAC-seq and RNA-seq, which provide novel therapeutic targets for IgAN and insights into its pathogenesis from an epigenetic perspective.

Crosstalk between glomeruli and tubules

Models of kidney injury have classically concentrated on glomeruli as the primary site of injury leading to glomerulosclerosis or on tubules as the primary site of injury leading to tubulointerstitial fibrosis. However, current evidence on the mechanisms of progression of chronic kidney disease indicates that a complex interplay between glomeruli and tubules underlies progressive kidney injury. Primary glomerular injury can clearly lead to subsequent tubule injury. For example, damage to the glomerular filtration barrier can expose tubular cells to serum proteins, including complement and cytokines, that would not be present in physiological conditions and can promote the development of tubulointerstitial fibrosis and progressive decline in kidney function. In addition, although less well-studied, increasing evidence suggests that tubule injury, whether primary or secondary, can also promote glomerular damage. This feedback from the tubule to the glomerulus might be mediated by changes in the reabsorptive capacity of the tubule, which can affect the glomerular filtration rate, or by mediators released by injured proximal tubular cells that can induce damage in both podocytes and parietal epithelial cells. Examining the crosstalk between the various compartments of the kidney is important for understanding the mechanisms underlying kidney pathology and identifying potential therapeutic interventions.

Autophagy in erectile dysfunction: focusing on apoptosis and fibrosis

ABSTRACT

In most types of erectile dysfunction, particularly in advanced stages, typical pathological features observed are reduced parenchymal cells coupled with increased tissue fibrosis. However, the current treatment methods have shown limited success in reversing these pathologic changes. Recent research has revealed that changes in autophagy levels, along with alterations in apoptosis and fibrosis-related proteins, are linked to the progression of erectile dysfunction, suggesting a significant association. Autophagy, known to significantly affect cell fate and tissue fibrosis, is currently being explored as a potential treatment modality for erectile dysfunction. However, these present studies are still in their nascent stage, and there are limited experimental data available. This review analyzes erectile dysfunction from a pathological perspective. It provides an in-depth overview of how autophagy is involved in the apoptotic processes of smooth muscle and endothelial cells and its role in the fibrotic processes occurring in the cavernosum. This study aimed to develop a theoretical framework for the potential effectiveness of autophagy in preventing and treating erectile dysfunction, thus encouraging further investigation among researchers in this area.

Effect of β-catenin on hypoxia induced epithelial mesenchymal transition in HK-2 cells by regulating Brachyury

Background

Chronic kidney disease (CKD) has become a worldwide health problem and the incidence rate and mortality of CKD have been rising. Renal fibrosis (RF) is the final common pathological feature of almost all kinds of CKD and Epithelial-mesenchymal transition (EMT) is the predominant stage of RF. β-catenin is a key component of the Wnt signaling pathway, which has been fully proven to promote EMT. However, the underlying mechanism of β-catenin in EMT during the pathogenesis of RF is yet to be determined.

Objective

This study was designed to investigate the effects of β-catenin on RF-related EMT and further investigate its underlying mechanism.

Methods

Human proximal tubular epithelial cell (HK-2) was treated with hypoxia to construct RF injury cell model. The viability of cells was determined by CCK-8 assay. Immunofluorescence was used to detect α-SMA content. Expressions of β-catenin, Brachyury and RF-related proteins were measured by Western blot. The correlation between β-catenin and Brachyury was detected by ChIP-qPCR and dual luciferase reporter assay.

Results

We found β-catenin was overexpressed in hypoxia-induced HK-2 cells. In the RF cell model, silencing of β-catenin weakened the EMT and fibrogenesis activity of HK-2 cells. Mechanistically, we found β-catenin binds to T-cell factor (TCF) to activate Brachyury, which is a positive player in EMT. Further studies clarified that Brachyury was responsible for β-catenin-promoted the EMT and HK-2 cell injury under hypoxia condition.

Conclusions

Herein, we demonstrated that β-catenin is overexpressed in hypoxia-induced HK-2 cells and promotes EMT and cell injury via activating Brachyury. These findings suggest that targeting β-catenin/Brachyury may be an effective new approach for treating RF.

Vacuole membrane protein 1 and acute response to renal ischemia and ischemia/reperfusion

Ischemia-reperfusion (I/R) injury is an important initiating cause of chronic kidney disease and renal failure. Changes in proximal tubule (PT) morphology, including brush border loss, occur rapidly in response to ischemic stress and I/R injury. Vacuole membrane protein 1 (VMP1) is a compelling target for ischemia-associated renal damage because it is a necessary regulator of autophagy, and the genomic location of hypoxia-responsive microRNA miR-21 lies within an intronic region of the Vmp1 gene. Autophagy is reported to have protective and pathological effects on I/R injury. In this study, we find that VMP1 is rapidly upregulated in renal cortex tissue in response to 15 and 30 min of ischemia. Intravenous delivery of Vmp1-targeting GameR or a scrambled GapmeR was performed on adult male Sprague-Dawley rats for 2 days before either 30 min of renal ischemia, 30 min of ischemia followed by 24 h of reperfusion (I/R), or corresponding control procedures. Autophagy markers and PT morphology were assessed in the renal cortex. Suppression of ischemia-induced upregulation of VMP1 attenuated PT brush border loss following 30 min of ischemia and 24 h post-I/R. Our study reveals a novel and mechanistically important dissociation between VMP1 expression, miR-21-5p expression, autophagy markers, and I/R tubular injury in the renal cortex.NEW & NOTEWORTHY The impact of autophagy on renal ischemia/reperfusion injury (IRI) remains unclear. VMP1 promotes autophagy through interaction with beclin-1 and subsequent localization to the endoplasmic reticulum. In this study, GapmeR-mediated suppression of VMP1 in rats and attenuated proximal tubule damage following 30 min of ischemia or following 24 h of reperfusion, without altering autophagy markers following reperfusion. This new insight suggests that increased VMP1 did not afford autophagy-mediated protection from IRI in proximal tubules.