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Kessel F, Steglich A, Hickmann L, Lira-Martinez R, Gerlach M, Sequeira-Lopez ML, Gomez RA, Hugo C, Todorov VT. Patterns of differentiation of renin lineage cells during nephrogenesis. Am J Physiol Renal Physiol 2021; 321:F378-F388. [PMID: 34338032 DOI: 10.1152/ajprenal.00151.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Developmentally heterogeneous renin expressing cells serve as progenitors for mural, glomerular and tubular cells during nephrogenesis and are collectively termed renin lineage cells (RLCs). In this study, we quantified different renal vascular and tubular cell types based on specific markers, assessed proliferation, and de-novo differentiation in the RLC population. We used kidney sections of mRenCre-mT/mG mice throughout nephrogenesis. Marker positivity was evaluated in whole digitalized sections. At embryonic day 16, RLCs appeared in the developing kidney, and expression of all stained markers in RLCs was observed. The proliferation rate of RLCs did not differ from the proliferation rate of non-RLCs. The RLCs expanded mainly by de-novo differentiation (neogenesis). The fractions of RLCs originating from the stromal progenitors of the metanephric mesenchyme (renin producing cells, vascular smooth muscle cells, mesangial cells) decreased during nephrogenesis. In contrast, aquaporin 2 positive RLCs in the collecting duct system that embryonically emerges almost exclusively from the ureteric bud, expanded postpartum. The cubilin positive RLC fraction in the proximal tubule, deriving from the cap mesenchyme, remained constant. During nephrogenesis, RLCs were continuously detectable in the vascular and tubular compartments of the kidney. Therein, various patterns of RLC differentiation that depend on the embryonic origin of the cells were identified.
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Affiliation(s)
- Friederike Kessel
- Department of Internal Medicine III, Division of Nephrology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Anne Steglich
- Department of Internal Medicine III, Division of Nephrology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Linda Hickmann
- Department of Internal Medicine III, Division of Nephrology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.,Institute of Physiology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ricardo Lira-Martinez
- Department of Internal Medicine III, Division of Nephrology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Michael Gerlach
- Department of Internal Medicine III, Division of Nephrology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.,Core Facility Cellular Imaging (CFCI), University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - Maria Luisa Sequeira-Lopez
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - R Ariel Gomez
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Christian Hugo
- Department of Internal Medicine III, Division of Nephrology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Vladimir T Todorov
- Department of Internal Medicine III, Division of Nephrology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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Viering DHHM, Bech AP, de Baaij JHF, Steenbergen EJ, Danser AHJ, Wetzels JFM, Bindels RJM, Deinum J. Functional tests to guide management in an adult with loss of function of type-1 angiotensin II receptor. Pediatr Nephrol 2021; 36:2731-2737. [PMID: 33768328 PMCID: PMC8370907 DOI: 10.1007/s00467-021-05018-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/04/2021] [Accepted: 02/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Genetic loss of function of AGT (angiotensinogen), REN (renin), ACE (angiotensin-converting enzyme), or AGTR1 (type-1 angiotensin II receptor) leads to renal tubular dysgenesis (RTD). This syndrome is almost invariably lethal. Most surviving patients reach stage 5 chronic kidney disease at a young age. METHODS Here, we report a 28-year-old male with a homozygous truncating mutation in AGTR1 (p.Arg216*), who survived the perinatal period with a mildly impaired kidney function. In contrast to classic RTD, kidney biopsy showed proximal tubules that were mostly normal. During the subsequent three decades, we observed evidence of both tubular dysfunction (hyperkalemia, metabolic acidosis, salt-wasting and a urinary concentrating defect) and glomerular dysfunction (reduced glomerular filtration rate, currently ~30 mL/min/1.73 m2, accompanied by proteinuria). To investigate the recurrent and severe hyperkalemia, we performed a patient-tailored functional test and showed that high doses of fludrocortisone induced renal potassium excretion by 155%. Furthermore, fludrocortisone lowered renal sodium excretion by 39%, which would have a mitigating effect on salt-wasting. In addition, urinary pH decreased in response to fludrocortisone. Opposite effects on urinary potassium and pH occurred with administration of amiloride, further supporting the notion that a collecting duct is present and able to react to fludrocortisone. CONCLUSIONS This report provides living proof that even truncating loss-of-function mutations in AGTR1 are compatible with life and relatively good GFR and provides evidence for the prescription of fludrocortisone to treat hyperkalemia and salt-wasting in such patients.
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Affiliation(s)
- Daan H. H. M. Viering
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Nijmegen, the Netherlands
| | - Anneke P. Bech
- grid.415930.aDepartment of Nephrology, Rijnstate, Arnhem, the Netherlands
| | - Jeroen H. F. de Baaij
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Nijmegen, the Netherlands
| | - Eric J. Steenbergen
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - A. H. Jan Danser
- grid.5645.2000000040459992XDepartment of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Jack F. M. Wetzels
- grid.10417.330000 0004 0444 9382Department of Nephrology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - René J. M. Bindels
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Nijmegen, the Netherlands
| | - Jaap Deinum
- Department of Internal Medicine, Radboud University Medical Centre, Huispost 463, Geert Grooteplein 8, 6525, GA, Nijmegen, the Netherlands.
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