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Curtis LM. Sex and Gender Differences in AKI. KIDNEY360 2024; 5:160-167. [PMID: 37990360 PMCID: PMC10833607 DOI: 10.34067/kid.0000000000000321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
Sex differences in AKI continue to be identified. Generally, women are protected from AKI when compared to men. Much of the protection exhibited in women is diminished after menopause. These sex and age effects have also been noted in animal models of AKI. Gonadal hormones, as modifiers of incidence, severity, and progression of AKI, have been offered as likely contributors to this sex and age effect. In animal models of AKI, estrogen and testosterone seem to modulate susceptibility. Questions remain however regarding cellular and molecular changes that are initiated by modulation of these hormones because both estrogen and testosterone have effects across cell types that play a role in AKI. Although findings have largely been informed by studies in males, molecular pathways that are involved in the initiation and progression of AKI may be modulated by gonadal hormones. Compounding the hormone-receptor effects are developmental effects of sex chromosomal complement and epigenetic influences that may confer sex-based baseline differences in gene and protein expression, and gene dosage effects of X inactivation and escape on molecular pathways. Elucidation of sex-based protection may afford a more complete view of AKI and potential therapeutic interventions. Furthermore, the effect on susceptibility to AKI in transgender patients, who receive life-altering and essential gender-affirming hormone therapy, requires greater attention. In this review, several potential contributors to the sex differences observed in humans and animal models are discussed.
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Affiliation(s)
- Lisa M Curtis
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama
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2
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Zhang L, Miao M, Xu X, Bai M, Wu M, Zhang A. From Physiology to Pathology: The Role of Mitochondria in Acute Kidney Injuries and Chronic Kidney Diseases. KIDNEY DISEASES (BASEL, SWITZERLAND) 2023; 9:342-357. [PMID: 37901706 PMCID: PMC10601966 DOI: 10.1159/000530485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/18/2023] [Indexed: 10/31/2023]
Abstract
Background Renal diseases remain an increasing public health issue affecting millions of people. The kidney is a highly energetic organ that is rich in mitochondria. Numerous studies have demonstrated the important role of mitochondria in maintaining normal kidney function and in the pathogenesis of various renal diseases, including acute kidney injuries (AKIs) and chronic kidney diseases (CKDs). Summary Under physiological conditions, fine-tuning mitochondrial energy balance, mitochondrial dynamics (fission and fusion processes), mitophagy, and biogenesis maintain mitochondrial fitness. While under AKI and CKD conditions, disruption of mitochondrial energy metabolism leads to increased oxidative stress. In addition, mitochondrial dynamics shift to excessive mitochondrial fission, mitochondrial autophagy is impaired, and mitochondrial biogenesis is also compromised. These mitochondrial injuries regulate renal cellular functions either directly or indirectly. Mitochondria-targeted approaches, containing genetic (microRNAs) and pharmaceutical methods (mitochondria-targeting antioxidants, mitochondrial permeability pore inhibitors, mitochondrial fission inhibitors, and biogenesis activators), are emerging as important therapeutic strategies for AKIs and CKDs. Key Messages Mitochondria play a critical role in the pathogenesis of AKIs and CKDs. This review provides an updated overview of mitochondrial homeostasis under physiological conditions and the involvement of mitochondrial dysfunction in renal diseases. Finally, we summarize the current status of mitochondria-targeted strategies in attenuating renal diseases.
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Affiliation(s)
- Lingge Zhang
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Nanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Mengqiu Miao
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Nanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyue Xu
- School of Medicine, Southeast University, Nanjing, China
| | - Mi Bai
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Nanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Mengqiu Wu
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Nanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Aihua Zhang
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Nanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical University, Nanjing, China
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3
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Srivastava A, Tomar B, Sharma D, Rath SK. Mitochondrial dysfunction and oxidative stress: Role in chronic kidney disease. Life Sci 2023; 319:121432. [PMID: 36706833 DOI: 10.1016/j.lfs.2023.121432] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
Chronic kidney disease (CKD) is associated with a variety of distinct disease processes that permanently change the function and structure of the kidney across months or years. CKD is characterized as a glomerular filtration defect or proteinuria that lasts longer than three months. In most instances, CKD leads to end-stage kidney disease (ESKD), necessitating kidney transplantation. Mitochondrial dysfunction is a typical response to damage in CKD patients. Despite the abundance of mitochondria in the kidneys, variations in mitochondrial morphological and functional characteristics have been associated with kidney inflammatory responses and injury during CKD. Despite these variations, CKD is frequently used to define some classic signs of mitochondrial dysfunction, including altered mitochondrial shape and remodeling, increased mitochondrial oxidative stress, and a marked decline in mitochondrial biogenesis and ATP generation. With a focus on the most significant developments and novel understandings of the involvement of mitochondrial remodeling in the course of CKD, this article offers a summary of the most recent advances in the sources of procured mitochondrial dysfunction in the advancement of CKD. Understanding mitochondrial biology and function is crucial for developing viable treatment options for CKD.
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Affiliation(s)
- Anjali Srivastava
- Division of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Bhawna Tomar
- Division of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Divyansh Sharma
- Division of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Srikanta Kumar Rath
- Division of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
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4
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Coca A, Arias-Cabrales C, Pérez-Sáez MJ, Fidalgo V, González P, Acosta-Ochoa I, Lorenzo A, Rollán MJ, Mendiluce A, Crespo M, Pascual J, Bustamante-Munguira J. Impact of intra-abdominal pressure on early kidney transplant outcomes. Sci Rep 2022; 12:2257. [PMID: 35145181 PMCID: PMC8831606 DOI: 10.1038/s41598-022-06268-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 01/06/2022] [Indexed: 12/13/2022] Open
Abstract
Increased intra-abdominal pressure (IAP) is common among post-surgical patients and may cause organ dysfunction. However, its impact after kidney transplantation on early postoperative complications and graft recovery remains unclear. We designed a prospective, observational cohort study to describe the prevalence and determinants of IAP, as well as its effect on delayed graft function, postoperative complications, and graft recovery. IAP was measured in 205 kidney transplant recipients every 8 h during the first 72 h after surgery using the urinary bladder technique. Intra-abdominal hypertension was defined as IAP ≥ 12 mmHg. Patients were followed for 6 months or until graft failure/death. Mean IAP was 12 ± 3.3 mmHg within the first 24 h. 78% of subjects presented with intra-abdominal hypertension during the first 72 h. Increased IAP was associated with higher renal resistive index [r = 0.213; P = 0.003] and lower urine output [r = - 0.237; P < 0.001]. 72 h mean IAP was an independent risk factor for delayed graft function [OR: 1.31; 95% CI: 1.13-1.51], postoperative complications [OR: 1.17; 95% CI: 1.03-1.33], and absence of graft function recovery [HR for graft function recovery: 0.94; 95% CI: 0.88-0.99]. Increased IAP was highly prevalent after transplantation and was independently associated with delayed graft function, postoperative complications, and absence of graft function recovery. Routine IAP monitoring should be considered post-transplantation to facilitate early recognition of relevant complications.
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Affiliation(s)
- Armando Coca
- Department of Nephrology, Hospital Clínico Universitario, Avda. Ramón y Cajal 3, 47003, Valladolid, Spain.
| | - Carlos Arias-Cabrales
- Department of Nephrology, Hospital del Mar, Paseo Marítimo de la Barceloneta 25-29, 08003, Barcelona, Spain
| | - María José Pérez-Sáez
- Department of Nephrology, Hospital del Mar, Paseo Marítimo de la Barceloneta 25-29, 08003, Barcelona, Spain
| | - Verónica Fidalgo
- Department of Nephrology, Hospital General, C/ Luis Erik Clavería Neurólogo s/n, 40002, Segovia, Spain
| | - Pablo González
- Department of Nephrology, Hospital Clínico Universitario, Avda. Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Isabel Acosta-Ochoa
- Department of Nephrology, Hospital Clínico Universitario, Avda. Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Arturo Lorenzo
- Department of Nephrology, Hospital Clínico Universitario, Avda. Ramón y Cajal 3, 47003, Valladolid, Spain
| | - María Jesús Rollán
- Department of Nephrology, Hospital Clínico Universitario, Avda. Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Alicia Mendiluce
- Department of Nephrology, Hospital Clínico Universitario, Avda. Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Marta Crespo
- Department of Nephrology, Hospital del Mar, Paseo Marítimo de la Barceloneta 25-29, 08003, Barcelona, Spain
| | - Julio Pascual
- Department of Nephrology, Hospital del Mar, Paseo Marítimo de la Barceloneta 25-29, 08003, Barcelona, Spain
| | - Juan Bustamante-Munguira
- Department of Cardiac Surgery, Hospital Clínico Universitario, Avda. Ramón y Cajal 3, 47003, Valladolid, Spain
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Curtis LM, Balkawade R. Thermoneutral Regulation and Acute Injury: Implications for Acute Kidney Injury. Nephron Clin Pract 2022; 146:229-233. [PMID: 34823244 PMCID: PMC9090934 DOI: 10.1159/000520143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 10/01/2021] [Indexed: 01/03/2023] Open
Abstract
Acute kidney injury (AKI) has demonstrated sex differences as illustrated in clinical and preclinical studies. In most cases, females show a significant resistance to AKI as manifested by renal indicators of injury, and thus much of the literature is derived from studies exclusively in males. Thermoneutral housing alters sex differences in acute injury of the liver, but has not been studied in the kidney. Thermoneutrality, the ambient temperature at which additional energy is not needed to maintain core body temperature, is regulated by mechanisms residing in mitochondria. Importantly, mitochondrial function plays an important role in induction and recovery of AKI. Mechanisms that regulate thermoneutrality include uncoupling proteins (UCPs) and one of its upstream regulators peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α). PGC-1α has been extensively studied in AKI in males. UCP-2, a UCP expressed in the kidney, has been minimally studied in AKI in males. Expression of other UCPs in the kidney has not been well defined. No studies of either PGC-1α or UCPs have interrogated for a sex difference nor have they been investigated at thermoneutrality in the kidney. In this brief review, pathways of importance in thermoneutrality are described and related to pathways of importance in modulating susceptibility to AKI. Clarity in the understanding of the impact of thermoneutrality on AKI in altering susceptibility in females may expand our understanding of the critical role of mitochondrial function in this setting. Unique utilization of mitochondrial-based molecular pathways in females may then inform potential therapies.
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Affiliation(s)
- Lisa M Curtis
- Division of Nephrology, Department of Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Rohan Balkawade
- Division of Nephrology, Department of Medicine, University of Alabama, Birmingham, Alabama, USA
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Li Y, Hepokoski M, Gu W, Simonson T, Singh P. Targeting Mitochondria and Metabolism in Acute Kidney Injury. J Clin Med 2021; 10:3991. [PMID: 34501442 PMCID: PMC8432487 DOI: 10.3390/jcm10173991] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 12/21/2022] Open
Abstract
Acute kidney injury (AKI) significantly contributes to morbidity and mortality in critically ill patients. AKI is also an independent risk factor for the development and progression of chronic kidney disease. Effective therapeutic strategies for AKI are limited, but emerging evidence indicates a prominent role of mitochondrial dysfunction and altered tubular metabolism in the pathogenesis of AKI. Therefore, a comprehensive, mechanistic understanding of mitochondrial function and renal metabolism in AKI may lead to the development of novel therapies in AKI. In this review, we provide an overview of current state of research on the role of mitochondria and tubular metabolism in AKI from both pre-clinical and clinical studies. We also highlight current therapeutic strategies which target mitochondrial function and metabolic pathways for the treatment of AKI.
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Affiliation(s)
- Ying Li
- Division of Nephrology and Hypertension, University of California San Diego, San Diego, CA 92093, USA;
- VA San Diego Healthcare System, San Diego, CA 92161, USA;
| | - Mark Hepokoski
- VA San Diego Healthcare System, San Diego, CA 92161, USA;
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA 92093, USA; (W.G.); (T.S.)
| | - Wanjun Gu
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA 92093, USA; (W.G.); (T.S.)
| | - Tatum Simonson
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA 92093, USA; (W.G.); (T.S.)
| | - Prabhleen Singh
- Division of Nephrology and Hypertension, University of California San Diego, San Diego, CA 92093, USA;
- VA San Diego Healthcare System, San Diego, CA 92161, USA;
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7
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McEvoy CM, Clotet-Freixas S, Tokar T, Pastrello C, Reid S, Batruch I, RaoPeters AAE, Kaths JM, Urbanellis P, Farkona S, Van JAD, Urquhart BL, John R, Jurisica I, Robinson LA, Selzner M, Konvalinka A. Normothermic Ex-vivo Kidney Perfusion in a Porcine Auto-Transplantation Model Preserves the Expression of Key Mitochondrial Proteins: An Unbiased Proteomics Analysis. Mol Cell Proteomics 2021; 20:100101. [PMID: 34033948 PMCID: PMC8253910 DOI: 10.1016/j.mcpro.2021.100101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/19/2021] [Indexed: 12/17/2022] Open
Abstract
Normothermic ex-vivo kidney perfusion (NEVKP) results in significantly improved graft function in porcine auto-transplant models of donation after circulatory death injury compared with static cold storage (SCS); however, the molecular mechanisms underlying these beneficial effects remain unclear. We performed an unbiased proteomics analysis of 28 kidney biopsies obtained at three time points from pig kidneys subjected to 30 min of warm ischemia, followed by 8 h of NEVKP or SCS, and auto-transplantation. 70/6593 proteins quantified were differentially expressed between NEVKP and SCS groups (false discovery rate < 0.05). Proteins increased in NEVKP mediated key metabolic processes including fatty acid ß-oxidation, the tricarboxylic acid cycle, and oxidative phosphorylation. Comparison of our findings with external datasets of ischemia-reperfusion and other models of kidney injury confirmed that 47 of our proteins represent a common signature of kidney injury reversed or attenuated by NEVKP. We validated key metabolic proteins (electron transfer flavoprotein subunit beta and carnitine O-palmitoyltransferase 2, mitochondrial) by immunoblotting. Transcription factor databases identified members of the peroxisome proliferator-activated receptors (PPAR) family of transcription factors as the upstream regulators of our dataset, and we confirmed increased expression of PPARA, PPARD, and RXRA in NEVKP with reverse transcription polymerase chain reaction. The proteome-level changes observed in NEVKP mediate critical metabolic pathways. These effects may be coordinated by PPAR-family transcription factors and may represent novel therapeutic targets in ischemia-reperfusion injury.
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Affiliation(s)
- Caitriona M McEvoy
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Division of Nephrology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada; Soham and Shaila Ajmera Family Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
| | - Sergi Clotet-Freixas
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Tomas Tokar
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Chiara Pastrello
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Shelby Reid
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Ihor Batruch
- Department of Laboratory Medicine and Pathobiology, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Adrien A E RaoPeters
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - J Moritz Kaths
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, University Essen-Duisburg, Essen, Germany
| | - Peter Urbanellis
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Sofia Farkona
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Julie A D Van
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Bradley L Urquhart
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Rohan John
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Igor Jurisica
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Departments of Medical Biophysics and Computer Science, University of Toronto, Toronto, Ontario, Canada; Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Lisa A Robinson
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada; Program in Cell Biology, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Markus Selzner
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Soham and Shaila Ajmera Family Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Ana Konvalinka
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Division of Nephrology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada; Soham and Shaila Ajmera Family Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
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8
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Abstract
The kidney is a highly metabolic organ that requires substantial adenosine triphosphate for the active transport required to maintain water and solute reabsorption. Aberrations in energy availability and energy utilization can lead to cellular dysfunction and death. Mitochondria are essential for efficient energy production. The pathogenesis of acute kidney injury is complex and varies with different types of injury. However, multiple distinct acute kidney injury syndromes share a common dysregulation of energy metabolism. Pathways of energy metabolism and mitochondrial dysfunction are emerging as critical drivers of acute kidney injury and represent new potential targets for treatment. This review shows the basic metabolic pathways that all cells depend on for life; describes how the kidney optimizes those pathways to meet its anatomic, physiologic, and metabolic needs; summarizes the importance of metabolic and mitochondrial dysfunction in acute kidney injury; and analyzes the mitochondrial processes that become dysregulated in acute kidney injury including mitochondrial dynamics, mitophagy, mitochondrial biogenesis, and changes in mitochondrial energy metabolism.
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Affiliation(s)
- Amanda J Clark
- Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Samir M Parikh
- Division of Nephrology, Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
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9
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Tammaro A, Kers J, Scantlebery AML, Florquin S. Metabolic Flexibility and Innate Immunity in Renal Ischemia Reperfusion Injury: The Fine Balance Between Adaptive Repair and Tissue Degeneration. Front Immunol 2020; 11:1346. [PMID: 32733450 PMCID: PMC7358591 DOI: 10.3389/fimmu.2020.01346] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 05/27/2020] [Indexed: 01/10/2023] Open
Abstract
Renal ischemia reperfusion injury (IRI), a common event after renal transplantation, causes acute kidney injury (AKI), increases the risk of delayed graft function (DGF), primes the donor kidney for rejection, and contributes to the long-term risk of graft loss. In the last decade, epidemiological studies have linked even mild episodes of AKI to chronic kidney disease (CKD) progression, and innate immunity seems to play a crucial role. The ischemic insult triggers an acute inflammatory reaction that is elicited by Pattern Recognition Receptors (PRRs), expressed on both infiltrating immune cells as well as tubular epithelial cells (TECs). Among the PRRs, Toll-like receptors (TLRs), their synergistic receptors, Nod-like receptors (NLRs), and the inflammasomes, play a pivotal role in shaping inflammation and TEC repair, in response to renal IRI. These receptors represent promising targets to modulate the extent of inflammation, but also function as gatekeepers of tissue repair, protecting against AKI-to-CKD progression. Despite the important considerations on timely use of therapeutics, in the context of IRI, treatment options are limited by a lack of understanding of the intra- and intercellular mechanisms associated with the activation of innate immune receptors and their impact on adaptive tubular repair. Accumulating evidence suggests that TEC-associated innate immunity shapes the tubular response to stress through the regulation of immunometabolism. Engagement of innate immune receptors provides TECs with the metabolic flexibility necessary for their plasticity during injury and repair. This could significantly affect pathogenic processes within TECs, such as cell death, mitochondrial damage, senescence, and pro-fibrotic cytokine secretion, well-known to exacerbate inflammation and fibrosis. This article provides an overview of the past 5 years of research on the role of innate immunity in experimental and human IRI, with a focus on the cascade of events activated by hypoxic damage in TECs: from programmed cell death (PCD) and mitochondrial dysfunction-mediated metabolic rewiring of TECs to maladaptive repair and progression to fibrosis. Finally, we will discuss the important crosstalk between metabolism and innate immunity observed in TECs and their therapeutic potential in both experimental and clinical research.
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Affiliation(s)
- Alessandra Tammaro
- Department of Pathology, Amsterdam UMC, Amsterdam Infection & Immunity Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Jesper Kers
- Department of Pathology, Amsterdam UMC, Amsterdam Infection & Immunity Institute, University of Amsterdam, Amsterdam, Netherlands.,Department of Pathology, Leiden University Medical Center, Leiden, Netherlands.,Biomolecular Systems Analytics, Van 't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, Amsterdam, Netherlands
| | - Angelique M L Scantlebery
- Department of Pathology, Amsterdam UMC, Amsterdam Infection & Immunity Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Sandrine Florquin
- Department of Pathology, Amsterdam UMC, Amsterdam Infection & Immunity Institute, University of Amsterdam, Amsterdam, Netherlands.,Department of Pathology, Leiden University Medical Center, Leiden, Netherlands
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Liu S, Chang X, Yu J, Xu W. Cerasus humilis Cherry Polyphenol Reduces High-Fat Diet-Induced Obesity in C57BL/6 Mice by Mitigating Fat Deposition, Inflammation, and Oxidation. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2020; 68:4424-4436. [PMID: 32227855 DOI: 10.1021/acs.jafc.0c01617] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to determine the anti-obesity effects and mechanisms of Cerasus humilis polyphenol (CHP) in C57BL/6 obese mice and 3T3-L1 cells. High-performance liquid chromatography-electrospray ionization-tandem mass spectrometry was used for the qualitative and quantitative identification of CHP components. The obese mice, induced by feeding high-fat diet (HFD), were treated with CHP (250 mg/kg/day) by gavage for 12 weeks. Orlistat was gavaged at 15.6 mg/kg bw/day, as a positive control group. The analysis revealed that the main components of CHP were procyanidin B2, cyanidin-3-glucoside, and pelargonidin-3-glucoside. CHP dietary supplementation significantly reduced body weight and improved blood lipid measurements in HFD-fed mice (p < 0.01). Moreover, it inhibited mRNA expression of miR-122, Srebp-1c, and Cpt1a (p < 0.01) and reduced hepatic lipid deposition, as seen by hematoxylin and eosin staining. CHP downregulated the protein expression of PPARγ and C/EBPα in HFD-induced obese mice and inhibited adipocyte differentiation (p < 0.01). Compared with the HFD group, CHP supplementation had an obvious anti-inflammatory effect (decreased protein expression, such as TNF-α, IL-6, and MCP1), reducing leptin levels and TNF-α secretion in serum and cells (p < 0.01). CHP significantly inhibited the expression of miR-27a/b (53.3 and 29.9%, p < 0.01) in mice retroperitoneal white adipocytes, enhancing the expression of the target gene Prdm16 and significantly upregulating Sirt1 (105.5%, p < 0.01) compared with the HFD group. Moreover, CHP supplementation effectively improved oxidative stress (ROS, T-AOC, SOD, CAT, and GSH-Px) induced by HFD in obese mice (p < 0.01). Thus, CHP mitigates adipocyte differentiation, browning of white adipocytes, and reduction of inflammation and antioxidant activity to reduce obesity. Consequently, these results provide novel insights into the anti-obesity roles of CHP in HFD-induced obesity.
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Affiliation(s)
- Suwen Liu
- College of Food Science & Technology, Hebei Normal University of Science and Technology, Qinhuangdao, Hebei 066004, China
| | - Xuedong Chang
- College of Food Science & Technology, Hebei Normal University of Science and Technology, Qinhuangdao, Hebei 066004, China
- Hebei Yanshan Special Industrial Technology Research Institute, Qinhuangdao, Hebei 066004, China
| | - Jincheng Yu
- College of Food Science & Technology, Hebei Normal University of Science and Technology, Qinhuangdao, Hebei 066004, China
| | - Weifeng Xu
- College of Food Science & Technology, Hebei Normal University of Science and Technology, Qinhuangdao, Hebei 066004, China
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Abstract
The mammalian kidney relies on abundant mitochondria in the renal tubule to generate sufficient ATP to provide the energy required for constant reclamation of solutes from crude blood filtrate. The highly metabolically active cells of the renal tubule also pair their energetic needs to the regulation of diverse cellular processes, including energy generation, antioxidant responses, autophagy and mitochondrial quality control. Nicotinamide adenine dinucleotide (NAD+) is essential not only for the harvesting of energy from substrates but also for an array of regulatory reactions that determine cellular health. In acute kidney injury (AKI), substantial decreases in the levels of NAD+ impair energy generation and, ultimately, the core kidney function of selective solute transport. Conversely, augmentation of NAD+ may protect the kidney tubule against diverse acute stressors. For example, NAD+ augmentation can ameliorate experimental AKI triggered by ischaemia–reperfusion, toxic injury and systemic inflammation. NAD+-dependent maintenance of renal tubular metabolic health may also attenuate long-term profibrotic responses that could lead to chronic kidney disease. Further understanding of the genetic, environmental and nutritional factors that influence NAD+ biosynthesis and renal resilience may lead to novel approaches for the prevention and treatment of kidney disease. Here, the authors discuss evidence for a role of NAD+ imbalance in the pathogenesis of acute kidney injury (AKI) and chronic kidney disease (CKD). They suggest that disruption of NAD+ metabolism may contribute to mechanistic links among AKI, CKD and ageing. NAD+ has critical roles in the generation of ATP from fuel substrates and as a substrate for important enzymes that regulate cellular health and stress responses. The renal tubule is highly metabolically active and requires a constant supply of ATP to provide the energy required to pump solutes across unfavourable gradients. Experimental acute kidney injury (AKI) induced by various insults rapidly leads to a decrease in NAD+ levels that probably results from a combination of reduced NAD+ biosynthesis and increased NAD+ consumption. Renal NAD+ levels can be augmented using vitamin B3 analogues and related nutritional precursors. NAD+ augmentation can prevent and/or treat various aetiologies of experimental AKI and might also attenuate long-term profibrotic responses following AKI, suggesting a potential role in the treatment of chronic kidney disease.
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Melis N, Thuillier R, Steichen C, Giraud S, Sauvageon Y, Kaminski J, Pelé T, Badet L, Richer JP, Barrera-Chimal J, Jaisser F, Tauc M, Hauet T. Emerging therapeutic strategies for transplantation-induced acute kidney injury: protecting the organelles and the vascular bed. Expert Opin Ther Targets 2019; 23:495-509. [PMID: 31022355 DOI: 10.1080/14728222.2019.1609451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Renal ischemia-reperfusion injury (IRI) is a significant clinical challenge faced by clinicians in a broad variety of clinical settings such as perioperative and intensive care. Renal IRI induced acute kidney injury (AKI) is a global public health concern associated with high morbidity, mortality, and health-care costs. Areas covered: This paper focuses on the pathophysiology of transplantation-related AKI and recent findings on cellular stress responses at the intersection of 1. The Unfolded protein response; 2. Mitochondrial dysfunction; 3. The benefits of mineralocorticoid receptor antagonists. Lastly, perspectives are offered to the readers. Expert opinion: Renal IRI is caused by a sudden and temporary impairment of blood flow to the organ. Defining the underlying cellular cascades involved in IRI will assist us in the identification of novel interventional targets to attenuate IRI with the potential to improve transplantation outcomes. Targeting mitochondrial function and cellular bioenergetics upstream of cellular damage may offer several advantages compared to targeting downstream inflammatory and fibrosis processes. An improved understanding of the cellular pathophysiological mechanisms leading to kidney injury will hopefully offer improved targeted therapies to prevent and treat the injury in the future.
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Affiliation(s)
- Nicolas Melis
- a Laboratory of Cellular and Molecular Biology , Center for Cancer Research, National Cancer Institute , Bethesda , MD , USA
| | - Raphael Thuillier
- b IRTOMIT , Inserm U1082 , Poitiers , France.,c Faculté de Médecine et de Pharmacie , Université de Poitiers , Poitiers , France.,d CHU Poitiers , Service de Biochimie , Poitiers , France.,e Fédération Hospitalo-Universitaire SUPORT , Poitiers , France
| | - Clara Steichen
- b IRTOMIT , Inserm U1082 , Poitiers , France.,c Faculté de Médecine et de Pharmacie , Université de Poitiers , Poitiers , France
| | - Sebastien Giraud
- b IRTOMIT , Inserm U1082 , Poitiers , France.,c Faculté de Médecine et de Pharmacie , Université de Poitiers , Poitiers , France.,d CHU Poitiers , Service de Biochimie , Poitiers , France
| | - Yse Sauvageon
- b IRTOMIT , Inserm U1082 , Poitiers , France.,c Faculté de Médecine et de Pharmacie , Université de Poitiers , Poitiers , France
| | - Jacques Kaminski
- b IRTOMIT , Inserm U1082 , Poitiers , France.,c Faculté de Médecine et de Pharmacie , Université de Poitiers , Poitiers , France
| | - Thomas Pelé
- b IRTOMIT , Inserm U1082 , Poitiers , France.,c Faculté de Médecine et de Pharmacie , Université de Poitiers , Poitiers , France
| | - Lionel Badet
- f Faculté de Médecine , Université Claude Bernard Lyon 1 , Villeurbanne , France.,g Hospices Civiles de Lyon , Service d'urologie et de chirurgie de la transplantation , Lyon , France
| | - Jean Pierre Richer
- b IRTOMIT , Inserm U1082 , Poitiers , France.,c Faculté de Médecine et de Pharmacie , Université de Poitiers , Poitiers , France.,h CHU de Poitiers , Service de chirurgie générale et endocrinienne , Poitiers , France.,i Faculté de Médecine et de Pharmacie , ABS Lab (Laboratoire d'Anatomie, Biomécanique et Simulation), Université de Poitiers , Poitiers , France
| | - Jonatan Barrera-Chimal
- j Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Medicina Traslacional , Instituto de Investigaciones Biomédicas, UNAM and Instituto Nacional de Cardiología Ignacio Chávez , Mexico City , Mexico
| | - Frédéric Jaisser
- k INSERM, UMRS 1138, Team 1 , Centre de Recherche des Cordeliers, Pierre et Marie Curie University, Paris, Descartes University , Paris , France
| | - Michel Tauc
- l LP2M CNRS-UMR7370, LabEx ICST , Medical Faculty, Université Côte d'Azur , Nice , France
| | - Thierry Hauet
- b IRTOMIT , Inserm U1082 , Poitiers , France.,c Faculté de Médecine et de Pharmacie , Université de Poitiers , Poitiers , France.,d CHU Poitiers , Service de Biochimie , Poitiers , France.,e Fédération Hospitalo-Universitaire SUPORT , Poitiers , France.,i Faculté de Médecine et de Pharmacie , ABS Lab (Laboratoire d'Anatomie, Biomécanique et Simulation), Université de Poitiers , Poitiers , France.,m IBiSA Plateforme 'plate-forme MOdélisation Préclinique - Innovation Chirurgicale et Technologique (MOPICT)', Domaine Expérimental du Magneraud , Surgères , France
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Parikh SM. Metabolic Stress Resistance in Acute Kidney Injury: Evidence for a PPAR-Gamma-Coactivator-1 Alpha-Nicotinamide Adenine Dinucleotide Pathway. Nephron Clin Pract 2019; 143:184-187. [PMID: 31055583 DOI: 10.1159/000500168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/04/2019] [Indexed: 01/30/2023] Open
Abstract
Acute kidney injury (AKI) is estimated to affect 3-10% of all hospitalized adults in the United States, making it one of the most common inpatient diagnoses. Despite this staggering incidence, most individuals exposed to AKI stressors, such as intravenous radiocontrast or cardiopulmonary bypass, do not develop AKI. In fact, whereas animal models of ischemia, sepsis, or nephrotoxicity suggest near-uniform responses to stressors, the natural history of stressed patients is highly heterogeneous. Recent studies of mitochondrial perturbations underlying experimental and human AKI suggest a conserved metabolic contribution to this variance. The renal tubule is only second to the heart in terms of mitochondrial abundance, reflecting the exquisite need for fuel combustion to generate the energy for active solute transport. The homeostasis of nicotinamide adenine dinucleotide (NAD+), a requisite coenzyme in oxidative metabolism, may be an important determinant of the renal response to AKI stressors. This mini-review highlights recent studies implicating NAD+ dysregulation in experimental and human AKI and summarizes findings from a pilot randomized trial to augment NAD+ among at-risk individuals.
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Affiliation(s)
- Samir M Parikh
- Division of Nephrology and Center for Vascular Biology Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA,
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