Retinoic acid receptor-beta prevents cisplatin-induced proximal tubular cell death

Vitamin A and retinoid signaling in the kidneys

Vitamin A (VA, retinol) and its metabolites (commonly called retinoids) are required for the proper development of the kidney during embryogenesis, but retinoids also play key roles in the function and repair of the kidney in adults. Kidneys filter 180-200 liters of blood per day and each kidney contains approximately 1 million nephrons, which are often referred to as the 'functional units' of the kidney. Each nephron consists of a glomerulus and a series of tubules (proximal tubule, loop of Henle, distal tubule, and collecting duct) surrounded by a network of capillaries. VA is stored in the liver and converted to active metabolites, most notably retinoic acid (RA), which acts as an agonist for the retinoic acid receptors ((RARs α, β, and γ) to regulate gene transcription. In this review we discuss some of the actions of retinoids in the kidney after injury. For example, in an ischemia-reperfusion model in mice, injury-associated loss of proximal tubule (PT) differentiation markers occurs, followed by re-expression of these differentiation markers during PT repair. Notably, healthy proximal tubules express ALDH1a2, the enzyme that metabolizes retinaldehyde to RA, but transiently lose ALDH1a2 expression after injury, while nearby myofibroblasts transiently acquire RA-producing capabilities after injury. These results indicate that RA is important for renal tubular injury repair and that compensatory mechanisms exist for the generation of endogenous RA by other cell types upon proximal tubule injury. ALDH1a2 levels also increase in podocytes, epithelial cells of the glomeruli, after injury, and RA promotes podocyte differentiation. We also review the ability of exogenous, pharmacological doses of RA and receptor selective retinoids to treat numerous kidney diseases, including kidney cancer and diabetic kidney disease, and the emerging genetic evidence for the importance of retinoids and their receptors in maintaining or restoring kidney function after injury. In general, RA has a protective effect on the kidney after various types of injuries (eg. ischemia, cytotoxic actions of chemicals, hyperglycemia related to diabetes). As more research into the actions of each of the three RARs in the kidney is carried out, a greater understanding of the actions of vitamin A is likely to lead to new insights into the pathology of kidney disorders and the development of new therapies for kidney diseases.

Betulin alleviates cisplatin-induced hepatic injury in rats: Targeting apoptosis and Nek7-independent NLRP3 inflammasome pathways

Cisplatin is a chemotherapeutic agent that induces multiorgan toxicity side effect due to induction of inflammation, apoptosis and disruption of intracellular antioxidant pathways. Betulin is a natural triterpenoid that has been shown to counteract cisplatin-induced nephrotoxicity. In this study, we investigated the ameliorative effect of betulin against cisplatin-promoted hepatotoxicity in rats. Moreover, we studied the molecular mechanism underlying betulin's effect. Single intraperitoneal injection (i.p.) of 10 mg/kg of cisplatin, was used to induce acute liver injury in rats. To assess betulin effect, a dose of 8 mg/kg (i.p.) was daily administered for 10 days. Betulin significantly improved serum Aspartate transaminase (AST), Alanine transaminase (ALT), albumin and total bilirubin levels in comparison with cisplatin group. Histopathologically, betulin restored cisplatin-deteriorated liver structural features and hepatic fibrosis. Mechanistically, betulin reduced hepatic oxidative stress as indicated by increased total antioxidant capacity and decreased malondialdehyde levels compared to cisplatin group. In addition, betulin reduced hepatic inflammation via significant inhibition of NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome, caspase-1 and interleukin-1β (IL-1β) levels. Intriguingly, betulin did not affect the expression levels of the mitotic kinase NIMA-related kinase 7 (Nek7), an NLRP3 interacting/activating protein. Last, Betulin induced anti-apoptotic effects as denoted by significant downregulation of P53 and Bax apoptotic proteins, upregulation of the anti-apoptotic protein, BCL2 and reduction of caspases 8, -9 and -3. This study is the first to provide evidence that betulin might be beneficial as a safe therapeutic approach to manage cisplatin-induced hepatotoxicity via targeting inflammatory and apoptotic pathways.

The yin and yang of retinoic acid signaling in kidney diseases

Retinoic acid (RA) signaling is involved in various physiological and pathological conditions, including development, tumorigenesis, inflammation, and tissue damage and repair. In kidneys, the beneficial effect of RA has been reported in multiple disease models, such as glomerulosclerosis, renal fibrosis, and acute kidney injury. In this issue of the JCI, Chen et al. report a pathway activated by RA signaling that is mediated by the retinoic acid receptor responder protein 1 (RARRES1). Specifically, RARRES1, which is proteolytically cleaved to release the extracellular domain, was endocytosed by podocytes to induce apoptosis and glomerular dysfunction kidney disease. These findings unveil the contrasting aspects, a Janus face, of RA signaling that may guide its therapeutic use.