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Artunc F, Bohnert BN, Schneider JC, Staudner T, Sure F, Ilyaskin AV, Wörn M, Essigke D, Janessa A, Nielsen NV, Birkenfeld AL, Etscheid M, Haerteis S, Korbmacher C, Kanse SM. Proteolytic activation of the epithelial sodium channel (ENaC) by factor VII activating protease (FSAP) and its relevance for sodium retention in nephrotic mice. Pflugers Arch 2021; 474:217-229. [PMID: 34870751 PMCID: PMC8766372 DOI: 10.1007/s00424-021-02639-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 12/18/2022]
Abstract
Proteolytic activation of the epithelial sodium channel (ENaC) by aberrantly filtered serine proteases is thought to contribute to renal sodium retention in nephrotic syndrome. However, the identity of the responsible proteases remains elusive. This study evaluated factor VII activating protease (FSAP) as a candidate in this context. We analyzed FSAP in the urine of patients with nephrotic syndrome and nephrotic mice and investigated its ability to activate human ENaC expressed in Xenopus laevis oocytes. Moreover, we studied sodium retention in FSAP-deficient mice (Habp2−/−) with experimental nephrotic syndrome induced by doxorubicin. In urine samples from nephrotic humans, high concentrations of FSAP were detected both as zymogen and in its active state. Recombinant serine protease domain of FSAP stimulated ENaC-mediated whole-cell currents in a time- and concentration-dependent manner. Mutating the putative prostasin cleavage site in γ-ENaC (γRKRK178AAAA) prevented channel stimulation by the serine protease domain of FSAP. In a mouse model for nephrotic syndrome, active FSAP was present in nephrotic urine of Habp2+/+ but not of Habp2−/− mice. However, Habp2−/− mice were not protected from sodium retention compared to nephrotic Habp2+/+ mice. Western blot analysis revealed that in nephrotic Habp2−/− mice, proteolytic cleavage of α- and γ-ENaC was similar to that in nephrotic Habp2+/+ animals. In conclusion, active FSAP is excreted in the urine of nephrotic patients and mice and activates ENaC in vitro involving the putative prostasin cleavage site of γ-ENaC. However, endogenous FSAP is not essential for sodium retention in nephrotic mice.
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Affiliation(s)
- Ferruh Artunc
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tubingen, Germany. .,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University Tübingen, Tubingen, Germany. .,German Center for Diabetes Research (DZD) at the University Tübingen, Tubingen, Germany.
| | - Bernhard N Bohnert
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tubingen, Germany.,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University Tübingen, Tubingen, Germany.,German Center for Diabetes Research (DZD) at the University Tübingen, Tubingen, Germany
| | - Jonas C Schneider
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tubingen, Germany
| | - Tobias Staudner
- Institute of Cellular and Molecular Physiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Florian Sure
- Institute of Cellular and Molecular Physiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Alexandr V Ilyaskin
- Institute of Cellular and Molecular Physiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Wörn
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tubingen, Germany
| | - Daniel Essigke
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tubingen, Germany.,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University Tübingen, Tubingen, Germany.,German Center for Diabetes Research (DZD) at the University Tübingen, Tubingen, Germany
| | - Andrea Janessa
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tubingen, Germany
| | - Nis V Nielsen
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Andreas L Birkenfeld
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tubingen, Germany.,Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University Tübingen, Tubingen, Germany.,German Center for Diabetes Research (DZD) at the University Tübingen, Tubingen, Germany
| | | | - Silke Haerteis
- Institute of Cellular and Molecular Physiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Institute of Anatomy, University of Regensburg, Regensburg, Germany
| | - Christoph Korbmacher
- Institute of Cellular and Molecular Physiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Sandip M Kanse
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Haerteis S, Schork A, Dörffel T, Bohnert BN, Nacken R, Wörn M, Xiao M, Essigke D, Janessa A, Schmaier AH, Feener EP, Häring HU, Bertog M, Korbmacher C, Artunc F. Plasma kallikrein activates the epithelial sodium channel in vitro but is not essential for volume retention in nephrotic mice. Acta Physiol (Oxf) 2018; 224:e13060. [PMID: 29489063 DOI: 10.1111/apha.13060] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 01/04/2023]
Abstract
AIM Recent work has demonstrated that activation of the epithelial sodium channel (ENaC) by aberrantly filtered serine proteases causes sodium retention in nephrotic syndrome. The aim of this study was to elucidate a potential role of plasma kallikrein (PKLK) as a candidate serine protease in this context. METHODS We analysed PKLK in the urine of patients with chronic kidney disease (CKD, n = 171) and investigated its ability to activate human ENaC expressed in Xenopus laevis oocytes. Moreover, we studied sodium retention in PKLK-deficient mice (klkb1-/- ) with experimental nephrotic syndrome induced by doxorubicin injection. RESULTS In patients with CKD, we found that PKLK is excreted in the urine up to a concentration of 2 μg mL-1 which was correlated with albuminuria (r = .71) and overhydration as assessed by bioimpedance spectroscopy (r = .44). PKLK increased ENaC-mediated whole-cell currents, which was associated with the appearance of a 67 kDa γ-ENaC cleavage product at the cell surface consistent with proteolytic activation. Mutating a putative prostasin cleavage site in γ-ENaC prevented channel stimulation by PKLK. In a mouse model for nephrotic syndrome, active PKLK was present in nephrotic urine of klkb1+/+ but not of klkb1-/- mice. However, klkb1-/- mice were not protected from ENaC activation and sodium retention compared to nephrotic klkb1+/+ mice. CONCLUSION Plasma kallikrein is detected in the urine of proteinuric patients and mice and activates ENaC in vitro involving the putative prostasin cleavage site. However, PKLK is not essential for volume retention in nephrotic mice.
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Affiliation(s)
- S. Haerteis
- Institute of Cellular and Molecular Physiology; Friedrich-Alexander University Erlangen-Nürnberg; Erlangen Germany
| | - A. Schork
- Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry; Department of Internal Medicine; University Hospital Tübingen; Tübingen Germany
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich; University of Tübingen; Tübingen Germany
- German Center for Diabetes Research (DZD); University of Tübingen; Tübingen Germany
| | - T. Dörffel
- Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry; Department of Internal Medicine; University Hospital Tübingen; Tübingen Germany
| | - B. N. Bohnert
- Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry; Department of Internal Medicine; University Hospital Tübingen; Tübingen Germany
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich; University of Tübingen; Tübingen Germany
- German Center for Diabetes Research (DZD); University of Tübingen; Tübingen Germany
| | - R. Nacken
- Institute of Cellular and Molecular Physiology; Friedrich-Alexander University Erlangen-Nürnberg; Erlangen Germany
| | - M. Wörn
- Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry; Department of Internal Medicine; University Hospital Tübingen; Tübingen Germany
| | - M. Xiao
- Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry; Department of Internal Medicine; University Hospital Tübingen; Tübingen Germany
| | - D. Essigke
- Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry; Department of Internal Medicine; University Hospital Tübingen; Tübingen Germany
| | - A. Janessa
- Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry; Department of Internal Medicine; University Hospital Tübingen; Tübingen Germany
| | - A. H. Schmaier
- Division of Hematology and Oncology; University Hospitals Cleveland Medical Center; Cleveland OH USA
- Case Western Reserve University; Cleveland OH USA
| | | | - H.-U. Häring
- Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry; Department of Internal Medicine; University Hospital Tübingen; Tübingen Germany
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich; University of Tübingen; Tübingen Germany
- German Center for Diabetes Research (DZD); University of Tübingen; Tübingen Germany
| | - M. Bertog
- Institute of Cellular and Molecular Physiology; Friedrich-Alexander University Erlangen-Nürnberg; Erlangen Germany
| | - C. Korbmacher
- Institute of Cellular and Molecular Physiology; Friedrich-Alexander University Erlangen-Nürnberg; Erlangen Germany
| | - F. Artunc
- Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry; Department of Internal Medicine; University Hospital Tübingen; Tübingen Germany
- Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich; University of Tübingen; Tübingen Germany
- German Center for Diabetes Research (DZD); University of Tübingen; Tübingen Germany
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Larsen CK, Jensen IS, Sorensen MV, de Bruijn PI, Bleich M, Praetorius HA, Leipziger J. Hyperaldosteronism after decreased renal K+ excretion in KCNMB2 knockout mice. Am J Physiol Renal Physiol 2016; 310:F1035-46. [PMID: 26962098 DOI: 10.1152/ajprenal.00010.2016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/08/2016] [Indexed: 11/22/2022] Open
Abstract
The kidney is the primary organ ensuring K(+) homeostasis. K(+) is secreted into the urine in the distal tubule by two mechanisms: by the renal outer medullary K(+) channel (Kir1.1) and by the Ca(2+)-activated K(+) channel (KCa1.1). Here, we report a novel knockout mouse of the β2-subunit of the KCa1.1 channel (KCNMB2), which displays hyperaldosteronism after decreased renal K(+) excretion. KCNMB2(-/-) mice displayed hyperaldosteronism, normal plasma K(+) concentration, and produced dilute urine with decreased K(+) concentration. The normokalemia indicated that hyperaldosteronism did not result from primary aldosteronism. Activation of the renin-angiotensin-aldosterone system was also ruled out as renal renin mRNA expression was reduced in KCNMB2(-/-) mice. Renal K(+) excretion rates were similar in the two genotypes; however, KCNMB2(-/-) mice required elevated plasma aldosterone to achieve K(+) balance. Blockade of the mineralocorticoid receptor with eplerenone triggered mild hyperkalemia and unmasked reduced renal K(+) excretion in KCNMB2(-/-) mice. Knockout mice for the α-subunit of the KCa1.1 channel (KCNMA1(-/-) mice) have hyperaldosteronism, are hypertensive, and lack flow-induced K(+) secretion. KCNMB2(-/-) mice share the phenotypic traits of normokalemia and hyperaldosteronism with KCNMA1(-/-) mice but were normotensive and displayed intact flow-induced K(+) secretion. Despite elevated plasma aldosterone, KNCMB2(-/-) mice did not display salt-sensitive hypertension and were able to decrease plasma aldosterone on a high-Na(+) diet, although plasma aldosterone remained elevated in KCNMB2(-/-) mice. In summary, KCNMB2(-/-) mice have a reduced ability to excrete K(+) into the urine but achieve K(+) balance through an aldosterone-mediated, β2-independent mechanism. The phenotype of KCNMB2 mice was similar but milder than the phenotype of KCNMA1(-/-) mice.
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Affiliation(s)
- Casper K Larsen
- Department of Biomedicine, Physiology, and Health, Aarhus University, Aarhus, Denmark
| | - Iben S Jensen
- Department of Biomedicine, Physiology, and Health, Aarhus University, Aarhus, Denmark
| | - Mads V Sorensen
- Department of Biomedicine, Physiology, and Health, Aarhus University, Aarhus, Denmark; Aarhus Institute for Advanced Studies, Aarhus University, Aarhus, Denmark; and
| | - Pauline I de Bruijn
- Department of Biomedicine, Physiology, and Health, Aarhus University, Aarhus, Denmark
| | - Markus Bleich
- Institute of Physiology, Christian-Albrechts-University, Kiel, Germany
| | - Helle A Praetorius
- Department of Biomedicine, Physiology, and Health, Aarhus University, Aarhus, Denmark
| | - Jens Leipziger
- Department of Biomedicine, Physiology, and Health, Aarhus University, Aarhus, Denmark;
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