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Reiss AB, Jacob B, Zubair A, Srivastava A, Johnson M, De Leon J. Fibrosis in Chronic Kidney Disease: Pathophysiology and Therapeutic Targets. J Clin Med 2024; 13:1881. [PMID: 38610646 PMCID: PMC11012936 DOI: 10.3390/jcm13071881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Chronic kidney disease (CKD) is a slowly progressive condition characterized by decreased kidney function, tubular injury, oxidative stress, and inflammation. CKD is a leading global health burden that is asymptomatic in early stages but can ultimately cause kidney failure. Its etiology is complex and involves dysregulated signaling pathways that lead to fibrosis. Transforming growth factor (TGF)-β is a central mediator in promoting transdifferentiation of polarized renal tubular epithelial cells into mesenchymal cells, resulting in irreversible kidney injury. While current therapies are limited, the search for more effective diagnostic and treatment modalities is intensive. Although biopsy with histology is the most accurate method of diagnosis and staging, imaging techniques such as diffusion-weighted magnetic resonance imaging and shear wave elastography ultrasound are less invasive ways to stage fibrosis. Current therapies such as renin-angiotensin blockers, mineralocorticoid receptor antagonists, and sodium/glucose cotransporter 2 inhibitors aim to delay progression. Newer antifibrotic agents that suppress the downstream inflammatory mediators involved in the fibrotic process are in clinical trials, and potential therapeutic targets that interfere with TGF-β signaling are being explored. Small interfering RNAs and stem cell-based therapeutics are also being evaluated. Further research and clinical studies are necessary in order to avoid dialysis and kidney transplantation.
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Affiliation(s)
- Allison B. Reiss
- Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA; (B.J.); (A.Z.); (A.S.); (M.J.); (J.D.L.)
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Petzuch B, Benardeau A, Hofmeister L, Meyer J, Hartmann E, Pavkovic M, Mathar I, Sandner P, Ellinger-Ziegelbauer H. Urinary miRNA profiles in chronic kidney injury - Benefits of extracellular vesicle enrichment and miRNAs as potential biomarkers for renal fibrosis, glomerular injury and endothelial dysfunction. Toxicol Sci 2022; 187:35-50. [PMID: 35244176 DOI: 10.1093/toxsci/kfac028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Micro-RNAs (miRNAs) are regulators of gene expression and play an important role in physiological homeostasis and disease. In biofluids miRNAs can be found in protein complexes or in extracellular vesicles (EVs). Altered urinary miRNAs are reported as potential biomarkers for chronic kidney disease (CKD). In this context we compared established urinary protein biomarkers for kidney injury with urinary miRNA profiles in obese ZSF1 and hypertensive renin transgenic rats. Additionally, the benefit of urinary EV enrichment was investigated in vivo and the potential association of urinary miRNAs with renal fibrosis in vitro. Kidney damage in both rat models was confirmed by histopathology, proteinuria, and increased levels of urinary protein biomarkers. In total 290 miRNAs were elevated in obese ZSF1 rats compared to lean controls, while 38 miRNAs were altered in obese ZSF1 rats during 14 to 26 weeks of age. These 38 miRNAs correlated better with disease progression than established urinary protein biomarkers. MiRNAs increased in obese ZSF1 rats were associated with renal inflammation, fibrosis, and glomerular injury. Eight miRNAs were also changed in urinary EVs of renin transgenic rats, including one which might play a role in endothelial dysfunction. EV enrichment increased the number and detection level of several miRNAs implicated in renal fibrosis in vitro and in vivo. Our results show the benefit of EV enrichment for miRNA detection and the potential of total urine and urinary EV-associated miRNAs as biomarkers of altered kidney physiology, renal fibrosis and glomerular injury, and disease progression in hypertension and obesity induced CKD.
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Affiliation(s)
- B Petzuch
- Bayer AG, Pharmaceuticals, Investigational Toxicology, 42096 Wuppertal, Germany.,Boehringer Ingelheim Pharma GmbH & Co. KG, Investigative Toxicology, Department of Non-Clinical Drug Safety, 88400 Biberach (Riß), Germany
| | - A Benardeau
- Novo Nordisk A/S,Cardio-Renal Biology, Måløv, Denmark
| | - L Hofmeister
- Bayer AG, Pharmaceuticals, Cardiovascular Research, 42096 Wuppertal, Germany
| | - J Meyer
- Bayer AG, Pharmaceuticals, Cardiovascular Research, 42096 Wuppertal, Germany
| | - E Hartmann
- Bayer AG, Pharmaceuticals, Toxicology, Pathology and Clinical Pathology, 42096 Wuppertal, Germany
| | - M Pavkovic
- Bayer AG, Pharmaceuticals, Investigational Toxicology, 42096 Wuppertal, Germany
| | - I Mathar
- Bayer AG, Pharmaceuticals, Cardiovascular Research, 42096 Wuppertal, Germany
| | - P Sandner
- Bayer AG, Pharmaceuticals, Cardiovascular Research, 42096 Wuppertal, Germany.,Hannover Medical School, Institute of Pharmacology, 30625 Hannover, Germany
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Schley G, Grampp S, Goppelt-Struebe M. Inhibition of oxygen-sensing prolyl hydroxylases increases lipid accumulation in human primary tubular epithelial cells without inducing ER stress. Cell Tissue Res 2020; 381:125-140. [PMID: 32189058 PMCID: PMC7306052 DOI: 10.1007/s00441-020-03186-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 02/03/2020] [Indexed: 12/18/2022]
Abstract
The role of the hypoxia-inducible transcription factor (HIF) pathway in renal lipid metabolism is largely unknown. As HIF stabilizing prolyl hydroxylase (PHD) inhibitors are currently investigated in clinical trials for the treatment of renal anemia, we studied the effects of genetic deletion and pharmacological inhibition of PHDs on renal lipid metabolism in transgenic mice and human primary tubular epithelial cells (hPTEC). Tubular cell-specific deletion of HIF prolyl hydroxylase 2 (Phd2) increased the size of Oil Red-stained lipid droplets in mice. In hPTEC, the PHD inhibitors (PHDi) DMOG and ICA augmented lipid accumulation, which was visualized by Oil Red staining and assessed by microscopy and an infrared imaging system. PHDi-induced lipid accumulation required the exogenous availability of fatty acids and was observed in both proximal and distal hPTEC. PHDi treatment was not associated with structural features of cytotoxicity in contrast to treatment with the immunosuppressant cyclosporine A (CsA). PHDi and CsA differentially upregulated the expression of the lipid droplet-associated genes PLIN2, PLIN4 and HILPDA. Both PHDi and CsA activated AMP-activated protein kinase (AMPK) indicating the initiation of a metabolic stress response. However, only CsA triggered endoplasmic reticulum (ER) stress as determined by the increased mRNA expression of multiple ER stress markers but CsA-induced ER stress was not linked to lipid accumulation. Our data raise the possibility that PHD inhibition may protect tubular cells from toxic free fatty acids by trapping them as triacylglycerides in lipid droplets. This mechanism might contribute to the renoprotective effects of PHDi in experimental kidney diseases.
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Affiliation(s)
- Gunnar Schley
- Department of Nephrology and Hypertension, Friedrich-Alexander University Erlangen-Nürnberg and University Hospital Erlangen, Loschgestrasse 8, 91054, Erlangen, Germany.
| | - Steffen Grampp
- Department of Nephrology and Hypertension, Friedrich-Alexander University Erlangen-Nürnberg and University Hospital Erlangen, Loschgestrasse 8, 91054, Erlangen, Germany
| | - Margarete Goppelt-Struebe
- Department of Nephrology and Hypertension, Friedrich-Alexander University Erlangen-Nürnberg and University Hospital Erlangen, Loschgestrasse 8, 91054, Erlangen, Germany
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Chen X, Wu Y, Diao Z, Han X, Li D, Ruan X, Liu W. C1q/tumor necrosis factor‐related protein‐3 improves renal fibrosis via inhibiting notch signaling pathways. J Cell Physiol 2019; 234:22352-22364. [PMID: 31074042 DOI: 10.1002/jcp.28801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/20/2019] [Accepted: 04/24/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Xinpan Chen
- Department of Nephrology, Beijing Friendship Hospital, Faculty of Kidney Diseases Capital Medical University Beijing China
| | - Yiru Wu
- Department of Nephrology, Beijing Friendship Hospital, Faculty of Kidney Diseases Capital Medical University Beijing China
| | - Zongli Diao
- Department of Nephrology, Beijing Friendship Hospital, Faculty of Kidney Diseases Capital Medical University Beijing China
| | - Xue Han
- Department of Nephrology, Beijing Friendship Hospital, Faculty of Kidney Diseases Capital Medical University Beijing China
| | - Dishan Li
- Department of Nephrology, Beijing Friendship Hospital, Faculty of Kidney Diseases Capital Medical University Beijing China
| | - Xiongzhong Ruan
- Department of Nephrology, John Moorhead Research Laboratory, University College London Medical School, Royal Free Campus University College London London United Kingdom
| | - Wenhu Liu
- Department of Nephrology, Beijing Friendship Hospital, Faculty of Kidney Diseases Capital Medical University Beijing China
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Strauss FJ, Di Summa F, Stähli A, Matos L, Vaca F, Schuldt G, Gruber R. TGF-β activity in acid bone lysate adsorbs to titanium surface. Clin Implant Dent Relat Res 2019; 21:336-343. [PMID: 30817088 PMCID: PMC6593995 DOI: 10.1111/cid.12734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/19/2019] [Accepted: 01/22/2019] [Indexed: 11/29/2022]
Abstract
Objectives Osteoblasts lay down new bone on implant surfaces. The underlying cellular mechanism and the spatio‐temporal mode of action, however, remain unclear. It can be proposed that growth factors released upon acidification by osteoclasts adsorb to the implant surface and control the early stages of osseointegration. Methods To simulate bone lysis by osteoclasts, titanium discs were exposed to acid bone lysate (ABL) followed by vigorous washing and seeding of oral fibroblasts. The expression of TGF‐β target genes interleukin 11 (IL11) and NADPH oxidase 4 (NOX4) was evaluated by reverse transcriptase polymerase chain reaction and IL11 ELISA. TGF‐β signaling activation was assessed via Smad2/3 immunofluorescence. The impact of ABL on osteogenic differentiation was determined with murine ST2 mesenchymal stromal cells. Results We report here that ABL‐conditioned titanium discs, independent of turned or rough surface, increased the expression of IL11 and NOX4. This increase was blocked by the TGF‐β receptor 1 antagonist SB431542. Further support for the TGF‐β signaling activation came from the translocation of Smad2/3 into the nucleus of oral fibroblasts. Moreover, titanium discs exposed to ABL decreased alkaline phosphatase and osteopontin in ST2 cells. Conclusions These in vitro findings suggest that titanium can adsorb TGF‐β from ABLs. The data provide a strong impetus for studies on the protein adsorption on implant surfaces in vitro and in vivo, specifically for growth factors including bone‐derived TGF‐β during successful and failed osseointegration.
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Affiliation(s)
- Franz Josef Strauss
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria.,Department of Conservative Dentistry, School of Dentistry, University of Chile, Santiago, Chile
| | - Francesca Di Summa
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
| | - Alexandra Stähli
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria.,Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Luiza Matos
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
| | - Fabiola Vaca
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
| | - Guenther Schuldt
- Department of Periodontics, University of Southern Santa Catarina, Grande Florianopolis, Brazil
| | - Reinhard Gruber
- Department of Oral Biology, Medical University of Vienna, Vienna, Austria
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Zhang Q, Liu H, Yang J. Regulation of TGF-β1 on PI3KC3 and its role in hypertension-induced vascular injuries. Exp Ther Med 2018; 17:1717-1727. [PMID: 30783440 PMCID: PMC6364233 DOI: 10.3892/etm.2018.7128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 07/26/2018] [Indexed: 12/26/2022] Open
Abstract
The aim of the present study was to investigate the expression and role of transforming growth factor (TGF)-β1/phosphatidylinositol 3-kinase catalytic subunit type 3 (PI3KC3) in the peripheral blood in patients with hypertension. A total of 28 patients with primary hypertension and 20 healthy control subjects were included. Peripheral blood samples were collected. The mRNA and protein expression levels were detected by reverse transcription-quantitative polymerase chain reaction and western blot analysis, respectively. Cell counting kit-8 assay, Transwell chamber assay and flow cytometry were performed to detect the cell proliferation, migration ability and cellular apoptosis, respectively. Laser scanning confocal microscopy was used to detect the intracellular autophagosomes. The expression of TGF-β1 was significantly elevated, whereas the expression of PI3KC3 was significantly downregulated in the patients with hypertension compared with controls. There was negative correlation between the TGF-β1 and PI3KC3 expression. Following treatment with TGF-β1, the protein expression of PI3KC3 was significantly decreased in human umbilical vein endothelial cells (HUVECs), and the autophagic activity was significantly decreased. Furthermore, following the treatment of TGF-β1 the proliferation of HUVECs was significantly reduced in the HUVECs, the hypoxia-induced apoptosis rates were significantly elevated and the number of penetrating cells were significantly declined (indicating declined migration ability). However, the overexpression of PI3KC3 significantly ameliorated the proliferation, migration ability and hypoxia tolerance of TGF-β1-treated HUVECs. In conclusion, the present results indicated that TGF-β1 expression was elevated in the peripheral blood in hypertensive patients and negatively correlated with the PI3KC3 expression; and that TGF-β1 regulates the PI3KC3 signaling pathway to inhibit the autophagic activity of vascular endothelial cells, and regulate the cell proliferation, migration and anti-apoptosis ability, thus aggregating the endothelial cell injuries in hypertension. The results of the current study revealed a novel mechanism of TGF-β1 in the regulation of endothelial cell injury in hypertension, which may provide a potential target for disease therapy.
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Affiliation(s)
- Qin Zhang
- Department of Cardiology, Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277101, P.R. China
| | - Hu Liu
- Department of Cardiology, Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277101, P.R. China
| | - Jun Yang
- Department of Cardiology, Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277101, P.R. China
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