Isthmin-1 (Ism1) modulates renal branching morphogenesis and mesenchyme condensation during early kidney development

Crystal structure of Isthmin-1 and reassessment of its functional role in pre-adipocyte signaling

Isthmin-1 (ISM1) is a recently described adipokine with insulin-like properties that can control hyperglycemia and liver steatosis. Additionally, ISM1 is proposed to play critical roles in patterning, angiogenesis, vascular permeability, and apoptosis. A key feature of ISM1 is its AMOP (adhesion-associated domain in MUC4 (Mucin-4) and other proteins) domain which is essential for many of its functions. However, the molecular details of AMOP domains remain elusive as there are no descriptions of their structure. Here we determined the crystal structure of ISM1 including its thrombospondin type I repeat (TSR) and AMOP domain. Interestingly, ISM1's AMOP domain exhibits a distinct fold with similarities to bacterial streptavidin. When comparing our structure to predicted structures of other AMOP domains, we observed that while the core streptavidin-like barrel is conserved, the surface helices and loops vary greatly. Thus, the AMOP domain fold allows for structural plasticity that may underpin its diverse functions. Furthermore, and contrary to prior studies, we show that highly purified ISM1 does not stimulate AKT phosphorylation on 3T3-F442A pre-adipocytes. Rather, we find that co-purifying growth factors are responsible for this activity. Together, our data reveal the structure and clarify functional studies of this enigmatic protein.

Isthmin-1: A critical regulator of branching morphogenesis and metanephric mesenchyme condensation during early kidney development

Isthmin-1 (Ism1) was first described to be syn-expressed with Fgf8 in Xenopus. However, its biological role has not been elucidated until recent years. Despite of accumulated evidence that Ism1 participates in angiogenesis, tumor invasion, macrophage apoptosis, and glucose metabolism, the cognate receptors for Ism1 remain largely unknown. Ism1 deficiency in mice results in renal agenesis (RA) with a transient loss of Gdnf transcription and impaired mesenchyme condensation at E11.5. Ism1 binds to and activates Integrin α8β1 to positively regulate Gdnf/Ret signaling, thus promoting mesenchyme condensation and ureteric epithelium branching morphogenesis. Here, we propose the hypothesis underlying the mechanism by which Ism1 regulates branching morphogenesis during early kidney development.

Glomerular filtration rate in patients with type 2 diabetes mellitus: is serum isthmin-1 level a possible link?

INTRODUCTION

Isthmin-1 (Ism-1) is a novel adipokine. However, little is known regarding the association between Ism-1 and type 2 diabetes mellitus (T2DM). This study aimed to investigate the relationship between serum Ism-1 levels and glomerular filtration rate (GFR) in patients with T2DM.

RESEARCH DESIGN AND METHODS

A total of 209 patients with T2DM were recruited into this retrospective study. Clinical data were collected. Fasting blood samples were collected for serum Ism-1 testing using ELISA kits. Based on the estimated glomerular filtration rate (eGFR), participants were divided into the normal eGFR group (n=167) and the decreased eGFR group (n=42). The relationship between Ism-1 and eGFR was assessed using linear and binary logistic regression analyses. Receiver operating characteristic (ROC) curve analysis was employed to examine the predictive efficacy of Ism-1 for distinguishing patients with eGFR <60 mL/min/1.73 m2.

RESULTS

Compared with patients with normal eGFR, serum Ism-1 levels were increased in patients with decreased eGFR (p<0.001). Serum Ism-1 levels were negatively correlated with eGFR in patients with T2DM even after multiple adjustments (p<0.001). For each 0.1 ng/mL increment of Ism-1, the odds of having an eGFR <60 mL/min/1.73 m2 increased by 54.5% (OR=1.545; p<0.001) in patients with T2DM. ROC analysis showed that higher serum Ism-1 levels (>1.297 ng/mL) had predictive efficacy in patients with eGFR <60 mL/min/1.73 m2, with an area under the curve of 0.908.

CONCLUSIONS

Serum Ism-1 levels were inversely associated with eGFR, and high Ism-1 levels may be used as a potential biomarker for predicting kidney function impairment in patients with T2DM.