The presence of proximal tubulelike cells in the kidney parietal epithelium in response to unilateral nephrectomy

The Heterogeneity of Renal Stem Cells and Their Interaction with Bio- and Nano-materials

For a long time, the kidney has been considered incapable of regeneration. Instead, in recent years, studies have supported the existence of heterogeneity of renal stem/progenitor cells with the ability to regenerate both glomerular and tubular epithelial cells. Indeed, several studies evidence that renal progenitor cells, releasing chemokines, growth factors, microvesicles, and transcription factors through paracrine mechanisms, can induce tissue regeneration and block pathological processes of the kidney. In this chapter the potentiality of the kidney regenerative processes is considered and reviewed, and the main classes of stem/progenitor cells that might contribute to the renal tissue renewal is analyzed. Moreover, we evaluate the role of biomaterials in the regulation of cellular functions, specifically addressing renal stem/progenitor cells. Materials can be synthesized and tailored in order to recreate a finely structured microenvironment (by nanostructures, nanofibers, bioactive compounds, etc.) with which the cells can interact actively. For instance, by patterning substrates in regions that alternately promote or prevent protein adsorption, cell adhesion and spreading processes can be controlled in space. We illustrate the potentiality of nanotechnologies and engineered biomaterials in affecting and enhancing the behavior of renal stem/progenitor cells. Although there are still many challenges for the translation of novel therapeutics, advances in biomaterials and nanomedicine have the potential to drastically change the clinical and therapeutic landscape, even in combination with stem cell biology.

Characterization of renal progenitors committed toward tubular lineage and their regenerative potential in renal tubular injury

Recent studies implicated the existence in adult human kidney of a population of renal progenitors with the potential to regenerate glomerular as well as tubular epithelial cells and characterized by coexpression of surface markers CD133 and CD24. Here, we demonstrate that CD133+CD24+ renal progenitors can be distinguished in distinct subpopulations from normal human kidneys based on the surface expression of vascular cell adhesion molecule 1, also known as CD106. CD133+CD24+CD106+ cells were localized at the urinary pole of Bowman's capsule, while a distinct population of scattered CD133+CD24+CD106- cells was localized in the proximal tubule as well as in the distal convoluted tubule. CD133+CD24+CD106+ cells exhibited a high proliferative rate and could differentiate toward the podocyte as well as the tubular lineage. By contrast, CD133+CD24+CD106- cells showed a lower proliferative capacity and displayed a committed phenotype toward the tubular lineage. Both CD133+CD24+CD106+ and CD133+CD24+CD106- cells showed higher resistance to injurious agents in comparison to all other differentiated cells of the kidney. Once injected in SCID mice affected by acute tubular injury, both of these populations displayed the capacity to engraft within the kidney, generate novel tubular cells, and improve renal function. These properties were not shared by other tubular cells of the adult kidney. Finally, CD133+CD24+CD106- cells proliferated upon tubular injury, becoming the predominating part of the regenerating epithelium in patients with acute or chronic tubular damage. These data suggest that CD133+CD24+CD106- cells represent tubular-committed progenitors that display resistance to apoptotic stimuli and exert regenerative potential for injured tubular tissue.

Renal progenitors in non-diabetic and diabetic nephropathies

Chronic kidney disease represents a major health problem worldwide. Although the kidney has the ability to repopulate structures that have sustained some degree of injury, the mechanisms underlying its regenerative capacity have been unclear. Recent evidence now supports the existence of a renal progenitor system able to replace podocytes and tubular cells, localized within the urinary pole of Bowman's capsule and along the tubule. Altered growth or differentiation of renal progenitors has been reported in several renal disorders including diabetic nephropathy. Pharmacological modulation of renal progenitor growth or differentiation can enhance kidney regeneration, suggesting that treatments aimed at reversing kidney injury are possible. Renal progenitors may represent a novel target in diabetic nephropathy and other kidney disorders.

Regeneration and the kidney

PURPOSE OF REVIEW

Following any injury, various intracellular and intercellular pathways must be activated and coordinated if tissue integrity and homeostasis need to be restored. In most injuries, repair results in once-functional tissue becoming a patch of cells and disorganized extracellular matrix that is referred to as a scar. However, most adult organs of the body, including the kidney, have the potential to regenerate functional tissues if appropriate conditions are restored. In this review, we highlight the burst of recent knowledge leading to discovery of regenerative mechanisms also in adult kidneys.

RECENT FINDINGS

A large body of evidence has recently shown that the parietal epithelium of the Bowman's capsule represents a reservoir of renal progenitors in adult kidney.

SUMMARY

The discovery of a hierarchical population of renal progenitors within the Bowman's capsule which can generate novel podocytes and also proximal tubular cells provides a new point of view for the understanding of renal physiology. In addition, the observation that renal progenitors can also generate hyperplastic glomerular lesions opens up a novel view of the pathogenesis of different types of glomerular disorders, which may at least in part result from abnormal regenerative responses to podocyte injury.

Toward the identification of a "renopoietic system"?

Chronic kidney disease is a leading cause of mortality and morbidity in Western countries and is estimated to affect 11% of the adult population. The possibility of treatment of chronic kidney disease has been severely impaired by our poor knowledge of the regenerative properties of the kidney. Recent results obtained in humans, together with genetic tagging experiments performed in rodents, demonstrated that the epithelial components of the cortical nephron share a unique progenitor, which can generate podocytes as well as tubular cells. Accordingly, lineage tracing experiments demonstrated that bone marrow-derived interstitial or papillary cells are not involved in the repair of injured adult renal epithelium. In addition, assessment of the markers CD24 and CD133 in adult human kidney as well as genetic tagging in rodents allowed us to identify a hierarchical population of renal progenitors arranged in a precise sequence within Bowman's capsule. The results of all of these studies suggest that the kidney contains a “renopoietic system,” with a progenitor localized at the urinary pole of Bowman's capsule, from where it can initiate the replacement and regeneration of glomerular, as well as tubular, epithelial cells. Knowledge of renal progenitor cell biology may enable a better comprehension of the mechanisms of renal repair as well as more effective targeted therapies for acute and chronic kidney diseases.

Possible mechanisms of kidney repair

In most adult epithelia the process of replacing damaged or dead cells is maintained through the presence of stem/progenitor cells, which allow epithelial tissues to be repaired following injury. Existing evidence strongly supports the presence of stem cells in the adult kidney. Indeed, recent findings provide evidence in favour of a role for intrinsic renal cells and against a physiological role for bone marrow-derived stem cells in the regeneration of renal epithelial cells. In addition, recent studies have identified a subset of CD24⁺CD133⁺ renal progenitors within the Bowman's capsule of adult human kidney, which provides regenerative potential for injured renal epithelial cells. Intriguingly, CD24⁺CD133⁺ renal progenitors also represent common progenitors of tubular cells and podocytes during renal development. Chronic injury causes dysfunction of the tubular epithelial cells, which triggers the release of fibrogenic cytokines and recruitment of inflammatory cells to injured kidneys. The rapid interposition of scar tissue probably confers a survival advantage by preventing infectious microorganisms from invading the wound, but prevents subsequent tissue regeneration. However, the existence of renal epithelial progenitors in the kidney suggests a possible explanation for the regression of renal lesions which has been observed in experimental animals and even in humans. Thus, manipulation of the wound repair process in order to shift it towards regeneration will probably require the ability to slow the rapid fibrotic response so that renal progenitor cells can allow tissue regeneration rather than scar formation.

Strain differences in morphometrical characteristics of rat kidneys

To clarify the strain differences in the morphology of the rat kidneys, we investigated the morphometrical characteristics of the kidneys of Slc:Wistar, Slc:SD, and F344/NSlc rats. The diameter of the renal corpuscles in female F344/N rats is smaller than that in female Wistar rats. Although sex differences (males>females) were shown in SD and F344/N rats, no effects of castration were detected in any of the groups. Strain-dependent differences in the percentage of renal corpuscles with a cuboidal parietal layer were found in both male and female groups. The highest percentage of them was noted in male Wistar rats. Effects of castration were observed in female Wistar and male F344/N rats, and the values after castration were significantly higher than those in the intact animals. As for the number of proximal convoluted tubular nuclei, no strain differences were detected in either the male or female groups. Although a sex difference was found in SD rats (female>male), no effects of castration were detected in any of the groups. In female F344/N rats, numerous numbers of PAS-positive granules, which were observed in the proximal convoluted and straight tubular epithelia, were noted. Orchiectomy induced an increase of these granules in male SD and F344/N rats, but ovariectomy showed no effects on them in any strains. This is the first study to clarify the strain differences in the morphological characteristics of the kidneys in ordinary rat strains.

Extent of Glomerular Tubularization Is an Indicator of the Severity of Experimental Acute Kidney Injury in Mice

BACKGROUND

Acute kidney injury (AKI) secondary to ischemia continues to be a major clinical problem due to its high morbidity and mortality, and limited treatment options. Animal models are critical to both the study of the pathophysiology of AKI and the development of new interventions. Although histological changes at the glomerulotubular junction have been described in AKI, we examined here whether the extent of glomerular tubularization correlates with the degree of renal insufficiency in this condition.

METHODS

Groups of mice with ischemia/reperfusion AKI were utilized in which the severity of renal insufficiency was defined. The resulting level of glomerular tubularization was analyzed, and the involved cell type was identified by immunohistochemistry and electron microscopy.

RESULTS

The extent of glomerular tubularization increased significantly with the degree of renal insufficiency. Low level glomerular tubularization was present in normal mouse kidneys, while it was more common and increasingly circumferential in mice with more severe loss of kidney function. The parietal monolayer of cuboidal cells in glomeruli was contiguous with proximal tubular cells, showing a well-developed luminal brush border and positive staining for proliferating cell nuclear antigen and Lotus tetragonolobus, a proximal tubular cell-specific lectin.

CONCLUSION

Increased levels of glomerular tubularization represent a poorly understood response to ischemic AKI in mice. As such, this glomerular 'tubularization score' may be useful to complement standard injury scores in experimental and, if detected, in clinical AKI.

A scanning electron microscope study of the neck segment of the rabbit nephron

The three-dimensional structure of the neck segment (NS) of the rabbit nephrons was studied by scanning electron microscopy (after fracture, micro-dissection, or after corrosion nephron casts), and by the air-cast method. The NS was observed at the glomerulotubular junction in 68.5% of all nephrons. In every case the NS appeared as a straight tube with its long axis oriented radially in relation to the glomerulus. Although the external diameter of the NS was smaller than that of the proximal tubule, its luminal diameter was greater. No valve-like structures were observed. Three cell types were observed in the NS: parietal-like, tubule-like, and intermediate. Parietal-like cells showed the same morphology as the parietal cells of the Bowman's capsule. Parietal-like cells constituted the only cell type in 25% of the NS. Tubule-like cells showed morphologic characteristics similar to proximal tubule cells; however, their microvilli were less numerous and exhibited an irregular pattern. Intermediate cells presented an intermediate morphology between tubule-like and parietal cells. In 75% of all NS, the three cellular types were present at the same time. The presence of tubule-like and intermediate cells is interpreted as the result of metaplasic transformation of the parietal cells. Our observations suggest that, in rabbits, the presence of the NS can be explained on the basis of phenotypical lability of the cells located at the glomerulo-tubular junction.

Morphological alterations of the glomerular (visceral) epithelium in response to pathological and experimental situations

The glomerular (visceral) layer of Bowman's capsule is comprised of a unique population of cells which have been termed "podocytes." Arising from these cells are large major processes and numerous smaller foot processes which completely surround underlying glomerular capillary loops. Podocyte foot processes interdigitate with each other and are separated by spaces (filtration slits) which are designed to facilitate flow of a large amount of filtrate across the glomerular wall. Podocytes exhibit dramatic morphological changes in response to the nephrotic syndrome and some forms of acute renal failure and may play an important role in the pathophysiology of these conditions. In vitro and in vivo studies have shown that a reduction in the sialic acid component of a thick anionic surface coat plays a major role in the morphological changes that these cells exhibit in the nephrotic syndrome. Also, it has been shown that filamentous actin concentrated mainly within podocyte foot processes are the contractile elements responsible for altering the shapes of these processes. There is evidence to suggest that by altering the shapes of their foot processes, podocytes in the normal kidney are able to alter the number of fully patent filtration slits and thereby actively regulate the rate of solute efflux across the glomerular wall. In vitro and in vivo studies have indicated that cytoplasmic microtubules are probably not involved in alterations of the podocyte foot processes but do appear important in maintaining the morphological integrity of podocyte cell bodies and their major processes. In the present paper, the morphological changes which glomerular podocytes exhibit in response to the nephrotic syndrome, various forms of acute renal failure, and during in vitro incubation are discussed along with studies of the possible roles of cytoplasmic microtubules, microtubules, and the glomerular anionic surface coat in these changes.

The aging male rat: structure and function of the kidney

The progression of anatomic and functional changes that occur with aging in normal male Sprague-Dawley rats was investigated. Renal function studies were followed by vascular perfusion fixation of the kidneys. The kidneys were examined with light microscopy and scanning and transmission electron microscopy. The glomerular filtration rate of 12-month-old rats (0.30 +/- 0.06 ml/min/100 gm body weight) was significantly lower (P less than .05) than the rates of the 3-month-old (0.91 +/- 0.08 ml/min/100 gm body weight) and 5-month-old (0.99 +/- 0.16 ml/min/100 gm body weight) rats. Urine protein levels were moderately elevated in 12-month-old rats. Structural changes mainly involved the renal corpuscle and proximal tubule. The parietal layer of Bowman's capsule was transformed from a squamous to a columnar epithelium resembling that of the proximal tubule in 48% of the capsules surveyed in 12-month-old rats. This value was significantly higher (P less than .05) than that of the 5- (14%) or 3- (6%) month-old rats. Thin sheets of cytoplasm extended from podocytic cell bodies over the layer of pedicels. The proximal tubule displayed focal areas of cell injury and necrosis. Basement membranes associated with the renal corpuscle, glomerulus, and proximal tubule were considerably thickened in the oldest group of rats. Some cellular infiltration occurred in the interstitium. Therefore, kidneys of aging Sprague-Dawley rats exhibited capsular metaplasia, death, and injury of proximal tubular epithelial cells, and other structural changes not seen in younger animals. Some of these changes may underlie the functional deterioration of their kidneys.

Presence of alkaline phosphatase and gamma-glutamyl transpeptidase on the parietal layer of Bowman's capsule

Generally, the parietal layer of Bowman's capsule in the mammal kidney consists of a squamous epithelium resting upon a basement lamina. However, tall cylindrical cells resembling those of the proximal tubules were observed on the outer wall of Bowman's capsule in the mouse and rat kidneys. These cells were provided with an apical brush border and were positive for alkaline phosphatase and gamma-glutamyl transpeptidase suggesting phosphate and amino acid transport at the capsular level.