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Bell RMB, Conway BR. Macrophages in the kidney in health, injury and repair. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2022; 367:101-147. [PMID: 35461656 DOI: 10.1016/bs.ircmb.2022.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Macrophages are a key component of the renal mononuclear phagocyte system, playing a major role in defense against infection, renal injury and repair. Yolk sac macrophage precursors seed the early embryonic kidney and are important for renal development. Later, renal macrophages are derived from hematopoietic stem cells and in adult life, there is a significant contribution from circulating monocytes, which is enhanced in response to infection or injury. Macrophages are highly plastic and can alter their phenotype in response to cues from parenchymal renal cells. Danger-associated molecules released from injured kidney cells may activate macrophages toward a pro-inflammatory phenotype, mediating further recruitment of inflammatory cells, exacerbating renal injury and activating renal fibroblasts to promote scarring. In acute kidney injury, once the injury stimulus has abated, macrophages may adopt a more reparative phenotype, dampening the immune response and promoting repair of renal tissue. However, in chronic kidney disease ongoing activation of pro-inflammatory monocytes and persistence of reparative macrophages leads to glomerulosclerosis and tubulointerstitial fibrosis, the hallmarks of end-stage kidney disease. Several strategies to inhibit the recruitment, activation and secretory products of pro-inflammatory macrophages have proven beneficial in pre-clinical models and are now undergoing clinical trials in patients with kidney disease. In addition, macrophages may be utilized in cell therapy as a "Trojan Horse" to deliver targeted therapies to the kidney. Single-cell RNA sequencing has identified a previously unappreciated spectrum of macrophage phenotypes, which may be selectively present in injury or repair, and ongoing functional analyses of these subsets may identify more specific targets for therapeutic intervention.
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Affiliation(s)
- Rachel M B Bell
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Bryan R Conway
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
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Inhibition of Spleen Tyrosine Kinase Reduces Renal Allograft Injury in a Rat Model of Acute Antibody-Mediated Rejection in Sensitized Recipients. Transplantation 2017; 101:e240-e248. [DOI: 10.1097/tp.0000000000001826] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Dholakia S, Fildes JE, Friend PJ. The use of kinase inhibitors in solid organ transplantation. Transplant Rev (Orlando) 2017; 31:166-171. [PMID: 28396194 DOI: 10.1016/j.trre.2017.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/15/2017] [Accepted: 02/27/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Despite the efficacy of current immunosuppression regimes used in solid organ transplantation, graft dysfunction, graft lost and antibody-mediated rejection continue to be problematic. As a result, clear attraction in exploiting key potential targets controlled by kinase phosphorylation has led to a number of studies exploring the use of these drugs in transplantation. Aim In this review, we consider the role of tyrosine kinase as a target in transplantation and summarize the relevant studies on kinase inhibitors that have been reported to date. METHODS Narrative review of literature from inception to December 2016, using OVID interface searching EMBASE and MEDLINE databases. All studies related to kinase based immunosuppression were examined for clinical relevance with no exclusion criteria. Key ideas were extracted and referenced. CONCLUSION The higher incidence of infections when using kinase inhibitors is an important consideration, however the number and range inhibitors and their clinical indications are likely to expand, but their exact role in transplantation is yet to be determined.
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Affiliation(s)
- S Dholakia
- Nuffield Department of Surgical Science, Oxford Transplant Centre, Churchill Hospital, Oxford, OX3 7LE, UK; The Manchester Collaborative Centre for Inflammation Research (MCCIR), Institute of Inflammation and Repair, Core Technology Facility, University of Manchester, Manchester, M13 9NT, UK.
| | - J E Fildes
- Nuffield Department of Surgical Science, Oxford Transplant Centre, Churchill Hospital, Oxford, OX3 7LE, UK; The Manchester Collaborative Centre for Inflammation Research (MCCIR), Institute of Inflammation and Repair, Core Technology Facility, University of Manchester, Manchester, M13 9NT, UK
| | - P J Friend
- Nuffield Department of Surgical Science, Oxford Transplant Centre, Churchill Hospital, Oxford, OX3 7LE, UK; The Manchester Collaborative Centre for Inflammation Research (MCCIR), Institute of Inflammation and Repair, Core Technology Facility, University of Manchester, Manchester, M13 9NT, UK
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Ryan J, Kanellis J, Blease K, Ma FY, Nikolic-Paterson DJ. Spleen Tyrosine Kinase Signaling Promotes Myeloid Cell Recruitment and Kidney Damage after Renal Ischemia/Reperfusion Injury. THE AMERICAN JOURNAL OF PATHOLOGY 2016; 186:2032-2042. [DOI: 10.1016/j.ajpath.2016.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/24/2016] [Accepted: 04/06/2016] [Indexed: 12/13/2022]
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Ma TKW, McAdoo SP, Tam FWK. Spleen Tyrosine Kinase: A Crucial Player and Potential Therapeutic Target in Renal Disease. Nephron Clin Pract 2016; 133:261-9. [PMID: 27476075 DOI: 10.1159/000446879] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 04/24/2016] [Indexed: 02/06/2023] Open
Abstract
Spleen tyrosine kinase (Syk), a 72 kDa cytoplasmic non-receptor protein-tyrosine kinase, plays an important role in signal transduction in a variety of cell types. Ever since its discovery in the early 1990s, there has been accumulating evidence to suggest a pathogenic role of Syk in various allergic disorders, autoimmune diseases and malignancies. Additionally, there is emerging data from both pre-clinical and clinical studies that Syk is implicated in the pathogenesis of proliferative glomerulonephritis (GN), including anti-glomerular basement membrane disease, anti-neutrophil cytoplasmic antibody-associated GN, lupus nephritis and immunoglobulin A nephropathy (IgAN). Moreover, recent animal studies have shed light on the importance of Syk in mediating acute renal allograft rejection, Epstein Barr virus-associated post-transplant lymphoproliferative disease and kidney fibrosis. Fostamatinib, an oral Syk inhibitor, has undergone clinical testing in rheumatoid arthritis, refractory immune thrombocytopenic purpura, leukemia and lymphoma. The recent STOP-IgAN trial showed that the addition of non-selective immunosuppressive therapy to intensive supportive care did not improve clinical outcomes in high-risk IgAN patients. A Syk-targeted approach may be beneficial and is currently being evaluated in a phase II randomized controlled trial. In this review, we will discuss the pathogenic role of Syk and potential use of Syk inhibitor in a variety of renal diseases.
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Affiliation(s)
- Terry King-Wing Ma
- Renal and Vascular Inflammation Section, Department of Medicine, Imperial College London, Hammersmith Hospital, London, UK
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Ma FY, Blease K, Nikolic-Paterson DJ. A role for spleen tyrosine kinase in renal fibrosis in the mouse obstructed kidney. Life Sci 2016; 146:192-200. [PMID: 26779657 DOI: 10.1016/j.lfs.2016.01.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/28/2015] [Accepted: 01/13/2016] [Indexed: 02/08/2023]
Abstract
AIMS Spleen tyrosine kinase (Syk) is a non-receptor tyrosine kinase involved in the signalling pathways of the B cell receptor, Fcγ-receptor and some leukocyte integrins. However, Syk can also be expressed by some non-haematopoietic cell types, although whether Syk signalling in these cells contributes to the pathogenesis of kidney disease is unknown. To address this question, we examined the function of Syk in antibody-independent renal interstitial fibrosis in the unilateral ureteric obstruction (UUO) model. MAIN METHODS Groups of C57BL/6J mice were treated with a selective Syk inhibitor (CC0417, 30 mg/kg/bid), vehicle, or no treatment, from the time of surgery until being killed 7 days later. KEY FINDINGS A substantial accumulation of interstitial Syk(+) cells was seen in the UUO kidney. Double staining identified Syk expression by infiltrating macrophages and by a subset of α-SMA(+) myofibroblasts. CC0417 treatment substantially reduced the Syk(+) cell population in conjunction with a reduction in both myofibroblast and macrophage accumulation. This was associated with a substantial reduction in collagen IV deposition and mRNA levels of pro-fibrotic (collagen I, collagen IV, fibronectin, α-SMA, TGF-β1 and PAI-1) and pro-inflammatory molecules (MCP-1, TNF-α and NOS2). CC0417 treatment reduced both PDGF-B mRNA levels and Ki67(+) proliferating interstitial cells in the UUO kidney. Furthermore, CC0417 inhibited PDGF-AB induced ERK activation and cell proliferation of cultured primary kidney fibroblasts. SIGNIFICANCE This study has identified a pathologic role for Syk in renal interstitial fibrosis. Syk inhibitors may have therapeutic potential in chronic fibrotic kidney disease.
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Affiliation(s)
- Frank Y Ma
- Department of Nephrology, Monash Medical Centre, Monash Health, Clayton, Victoria 3168, Australia; Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria 3168, Australia
| | | | - David J Nikolic-Paterson
- Department of Nephrology, Monash Medical Centre, Monash Health, Clayton, Victoria 3168, Australia; Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria 3168, Australia.
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Matsuda Y, Wang X, Oishi H, Guan Z, Saito M, Liu M, Keshavjee S, Chow CW. Spleen Tyrosine Kinase Modulates Fibrous Airway Obliteration and Associated Lymphoid Neogenesis After Transplantation. Am J Transplant 2016; 16:342-52. [PMID: 26308240 DOI: 10.1111/ajt.13442] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 06/16/2015] [Accepted: 06/21/2015] [Indexed: 01/25/2023]
Abstract
Chronic lung allograft dysfunction, the major cause of death following lung transplantation, usually manifests as irreversible airflow obstruction associated with obliterative bronchiolitis (OB), a lesion characterized by chronic inflammation, lymphoid neogenesis, fibroproliferation and small airway obliteration. Spleen tyrosine kinase (Syk), a tyrosine kinase that regulates B cell function and innate immunity, has been implicated in the pathogenesis of chronic inflammation and tissue repair. This study evaluated the role of Syk in development of OB, using an intrapulmonary tracheal transplant model of OB with the conditional Syk-knockout Syk(flox/flox) //rosa26-CreER(T2) mice and a Syk-selective inhibitor, GSK2230413. BALB/c trachea allografts were transplanted into Syk-knockout (Syk(del/del) ) mice or wild-type C57BL/6 recipients treated with GSK2230413. At day 28, histological analysis revealed that in the Syk(del/del) and GSK2230413-treated C57BL/6 recipients, the graft lumen remained open compared with allografts transplanted into Syk-expressing (Syk(flox/flox) ) and placebo control-treated C57BL/6 recipients. Immunofluorescence showed lymphoid neogenesis with distinct B and T cell zones in control mice. In contrast, lymphoid neogenesis was absent and few B or T cells were found in Syk(del/del) and GSK2230413-treated mice. These observations suggest that inhibition of Syk may be a potential therapeutic strategy for the management of OB following lung transplantation.
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Affiliation(s)
- Y Matsuda
- The Toronto Lung Transplant Program, University of Toronto, Toronto, Canada.,Latner Thoracic Surgery Laboratories, Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - X Wang
- Division of Respirology, Department of Medicine, University Health Network, University of Toronto, Toronto, Canada
| | - H Oishi
- The Toronto Lung Transplant Program, University of Toronto, Toronto, Canada.,Latner Thoracic Surgery Laboratories, Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - Z Guan
- Latner Thoracic Surgery Laboratories, Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - M Saito
- The Toronto Lung Transplant Program, University of Toronto, Toronto, Canada.,Latner Thoracic Surgery Laboratories, Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - M Liu
- Latner Thoracic Surgery Laboratories, Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - S Keshavjee
- The Toronto Lung Transplant Program, University of Toronto, Toronto, Canada.,Latner Thoracic Surgery Laboratories, Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - C-W Chow
- The Toronto Lung Transplant Program, University of Toronto, Toronto, Canada.,Division of Respirology, Department of Medicine, University Health Network, University of Toronto, Toronto, Canada
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