Battistone MA, Mendelsohn AC, Brown D, Breton S. Urinary UDP-Glucose as a Novel Actionable Biomarker of Dehydration-Induced Acute Kidney Injury.
ANNALS OF NUTRITION AND METABOLISM 2021. [PMID:
35226908 DOI:
10.1159/000520566]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND
People working in "extreme" conditions termed as sugar cane workers, firefighters and military personnel are subjected to significant dehydration. Prolonged episodes of dehydration may result in acute kidney Injury (AKI). AKI is associated with inflammation and is usually diagnosed only after the kidneys have gone through significant and often irreversible damage. We showed that the P2Y14 receptor mediates renal inflammation, leading to AKI following ischemia-reperfusion-injury [<xref ref-type="bibr" rid="ref1">1</xref>]. P2Y14 is activated by the danger molecule UDP-glucose (UDP-Glc). Here we hypothesized that UDP-Glc is released by cells throughout the body after dehydration-induced stress. UDP-Glc is filtered by the kidney and concentrated in collecting ducts where it activates P2Y14 in intercalated cells. This would trigger renal inflammation and contribute to dehydration-associated AKI.
OBJECTIVE
The aim of this study was to characterize the participation of UDP-Glc in pro-inflammatory cell recruitment and renal dysfunction following dehydration.
METHOD
Mice were subjected to water deprivation for 24, 48, and 72 h. Kidney function was assessed via serum creatinine (SCr), blood urea nitrogen (BUN), and urine albumin. To study proximal tubule (PT) damage, aquaporin 1 (AQP1) localization was analyzed by immunofluorescence (IF). Urinary UDP-Glc concentration was measured by LC-MS, and renal recruitment of immune cells by flow cytometry and IF.
RESULTS
Water deprivation induced elevations in SCr and BUN after 48 h and 72 h, relative to control. Dehydration also induced albuminuria and the redistribution of AQP1 from the plasma membrane into the PT cell body indicating PT injury. An increase in urinary UDP-Glc concentration and renal recruitment of macrophages were detected at 48 h and 72 h of dehydration.
CONCLUSION
This study supports the hypothesis that UDP-Glc, released by damaged cells during severe dehydration, induces the renal recruitment of inflammatory macrophages leading to PT injury and kidney dysfunction (Fig. 1). Blocking the UDP-Glc/P2Y14 pathway represents, therefore, a new therapeutic avenue for the attenuation of dehydration-induced renal inflammation and injury. In this context, urinary UDP-Glc is a promising actionable biomarker for dehydration-induced AKI.
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