HIF Stabilization Weakens Primary Cilia

Primary Cilia, Hypoxia, and Liver Dysfunction: A New Perspective on Biliary Atresia

Ciliopathies are disorders that affect primary or secondary cellular cilia or structures associated with ciliary function. Primary cilia (PC) are essential for metabolic regulation and embryonic development, and pathogenic variants in cilia-related genes are linked to several pediatric conditions, including renal-hepatic diseases and congenital defects. Biliary atresia (BA) is a progressive infantile cholangiopathy and the leading cause of pediatric liver transplantation. Although the exact etiology of BA remains unclear, evidence suggests a multifactorial pathogenesis influenced by both genetic and environmental factors. Patients with BA and laterality defects exhibit genetic variants associated with ciliopathies. Interestingly, even isolated BA without extrahepatic anomalies presents morphological and functional ciliary abnormalities, suggesting that environmental triggers may disrupt the ciliary function. Among these factors, hypoxia has emerged as a potential modulator of this dysfunction. Hypoxia-inducible factor 1-alpha (HIF-1α) plays a central role in hepatic responses to oxygen deprivation, influencing bile duct remodeling and fibrosis, which are key processes in BA progression. This review explores the crosstalk between hypoxia and hepatic ciliopathies, with a focus on BA. It discusses the molecular mechanisms through which hypoxia may drive disease progression and examines the therapeutic potential of targeting hypoxia-related pathways. Understanding how oxygen deprivation influences ciliary function may open new avenues for treating biliary ciliopathies and improving patient outcomes.

Structural Disruption of Cilia and Increased Cytoplasmic Tubulin in Biliary Atresia-An Exploratory Study Focusing on Early Postoperative Prognosis Following Portoenterostomy

Introduction: Biliary atresia (BA) is a progressive hepatobiliary disease in infants, leading to liver failure and the need for transplantation. While its etiopathogenesis remains unclear, recent studies suggest primary cilia (PC) disruption plays a role. This study investigates correlations between PC and cytoplasmic tubulin (TUBA4A) alterations with hypoxia in patients with the isolated form of BA, focusing on native liver survival. Methods: Using qualitative and quantitative digital image analysis of immunofluorescence-stained liver samples, we assessed PC and TUBA4A features correlating these findings with HIF-1α nuclear positivity, clinical-laboratory data, and early native liver survival. Liver samples from fourteen BA patients and six controls with another liver disease were analyzed by digital image analysis, with data evaluated using Spearman's correlation and independent t-tests. Results: HIF-1α positivity in cholangiocytes was observed in 42.8% of BA patients. While the PC ratio per biliary structure (cilia ratio status, CRs) was similar between BA patients and controls, PC length was decreased in BA patients. Cytoplasmic TUBA4A levels were elevated in BA patients. CRs positively correlated with lower cytoplasmic TUBA4A expression and was higher in patients without HIF-1α nuclear positivity. Reduced cilia length correlated with higher bilirubin levels at portoenterostomy. Predictors of early poor prognosis (death or need for transplantation until 1 year of life) included HIF-1α positivity, elevated direct bilirubin levels, decreased cilia length, PC bending, and increased TUBA4A expression. Conclusions: Reduced PC length, PC bending, and increased intensity of cytoplasmic TUBA4A expression occur in the isolated BA clinical type and negatively impact the early prognosis after post-portoenterostomy. These findings suggest the existence of a disruption in the tubulin transport between cytoplasm and PC. The detrimental effect of HIF-1alpha pathway activation over early native liver survival was confirmed, although independently from PC or cytoplasmic tubulin features.

Influence of Hypoxia on the Airway Epithelium

The necessity of oxygen for metabolic processes means that hypoxia can lead to serious cell and tissue damage. On the other hand, in some situations, hypoxia occurs under physiological conditions and serves as an important regulation factor. The airway epithelium is specific in that it gains oxygen not only from the blood supply but also directly from the luminal air. Many respiratory diseases are associated with airway obstruction or excessive mucus production thus leading to luminal hypoxia. The main goal of this review is to point out how the airway epithelium reacts to hypoxic conditions. Cells detect low oxygen levels using molecular mechanisms involving hypoxia-inducible factors (HIFs). In addition, the cells of the airway epithelium appear to overexpress HIFs in hypoxic conditions. HIFs then regulate many aspects of epithelial cell functions. The effects of hypoxia include secretory cell stimulation and hyperplasia, epithelial barrier changes, and ciliogenesis impairment. All the changes can impair mucociliary clearance, exacerbate infection, and promote inflammation leading to damage of airway epithelium and subsequent airway wall remodeling. The modulation of hypoxia regulatory mechanisms may be one of the strategies for the treatment of obstructive respiratory diseases or diseases with mucus hyperproduction. Keywords: Secretory cells, Motile cilia, Epithelial barrier, Oxygenation, Obstructive respiratory diseases.

Primary cilia: Structure, dynamics, and roles in cancer cells and tumor microenvironment

Despite the initiation of tumor arises from tumorigenic transformation signaling in cancer cells, cancer cell survival, invasion, and metastasis also require a dynamic and reciprocal association with extracellular signaling from tumor microenvironment (TME). Primary cilia are the antenna-like structure that mediate signaling sensation and transduction in different tissues and cells. Recent studies have started to uncover that the heterogeneous ciliation in cancer cells and cells from the TME in tumor growth impels asymmetric paracellular signaling in the TME, indicating the essential functions of primary cilia in homeostasis maintenance of both cancer cells and the TME. In this review, we discussed recent advances in the structure and assembly of primary cilia, and the role of primary cilia in tumor and TME formation, as well as the therapeutic potentials that target ciliary dynamics and signaling from the cells in different tumors and the TME.

Mechanical Properties of Isolated Primary Cilia Measured by Micro-tensile Test and Atomic Force Microscopy

Mechanotransduction is a well-known mechanism by which cells sense their surrounding mechanical environment, convert mechanical stimuli into biochemical signals, and eventually change their morphology and functions. Primary cilia are believed to be mechanosensors existing on the surface of the cell membrane and support cells to sense surrounding mechanical signals. Knowing the mechanical properties of primary cilia is essential to understand their responses, such as sensitivity to mechanical stimuli. Previous studies have so far conducted flow experiments or optical trap techniques to measure the flexural rigidity EI (E: Young’s modulus, I: second moment of inertia) of primary cilia; however, the flexural rigidity is not a material property of materials and depends on mathematical models used in the determination, leading to a discrepancy between studies. For better characterization of primary cilia mechanics, Young’s modulus should be directly and precisely measured. In this study, the tensile Young’s modulus of isolated primary cilia is, for the first time, measured by using an in-house micro-tensile tester. The different strain rates of 0.01–0.3 s⁻¹ were applied to isolated primary cilia, which showed a strain rate–dependent Young’s modulus in the range of 69.5–240.0 kPa on average. Atomic force microscopy was also performed to measure the local Young’s modulus of primary cilia, showing the Young’s modulus within the order of tens to hundreds of kPa. This study could directly provide the global and local Young’s moduli, which will benefit better understanding of primary cilia mechanics.

Primary cilium: a paradigm for integrating mathematical modeling with experiments and numerical simulations in mechanobiology

Primary cilia are non-motile, solitary (one per cell) microtubule-based organelles that emerge from the mother centriole after cells have exited the mitotic cycle. Identified as a mechanosensing organelle that responds to both mechanical and chemical stimuli, the primary cilium provides a fertile ground for integrative investigations of mathematical modeling, numerical simulations, and experiments. Recent experimental findings revealed considerable complexity to the underlying mechanosensory mechanisms that transmit extracellular stimuli to intracellular signaling many of which include primary cilia. In this invited review, we provide a brief survey of experimental findings on primary cilia and how these results lead to various mathematical models of the mechanics of the primary cilium bent under an external forcing such as a fluid flow or a trap. Mathematical modeling of the primary cilium as a fluid-structure interaction problem highlights the importance of basal anchorage and the anisotropic moduli of the microtubules. As theoretical modeling and numerical simulations progress, along with improved state-of-the-art experiments on primary cilia, we hope that details of ciliary regulated mechano-chemical signaling dynamics in cellular physiology will be understood in the near future.

Primary cilia have a length-dependent persistence length

The fluctuating position of an optically trapped cilium tip under untreated and Taxol-treated conditions was used to characterize mechanical properties of the cilium axoneme and its basal body by combining experimental, analytical, and computational tools. We provide, for the first time, evidence that the persistence length of a ciliary axoneme is length-dependent; longer cilia are stiffer than shorter cilia. We demonstrate that this apparent length dependence can be understood by a combination of modeling axonemal microtubules as anisotropic elastic shells and including actomyosin-driven stochastic basal body motion. Our results also demonstrate the possibility of using observable ciliary dynamics to probe interior cytoskeletal dynamics. It is hoped that our improved characterization of cilia will result in deeper understanding of the biological function of cellular flow sensing by this organelle.

Numerical study on the dynamics of primary cilium in pulsatile flows by the immersed boundary-lattice Boltzmann method

An explicit immersed boundary-lattice Boltzmann method is applied to numerically investigate the dynamics of primary cilium in pulsatile blood flows with two-way fluid-structure interaction considered. To well characterize the effect of cilium basal body on cilium dynamics, the cilium base is modeled as a nonlinear rotational spring attached to the cilium's basal end as proposed by Resnick (Biophys J 109:18-25, 2015. https://doi.org/10.1016/j.bpj.2015.05.031). After several careful validations, the fluid-cilium interaction system is investigated in detail at various pulsatile flow conditions that are characterized by peak Reynolds numbers ([Formula: see text]) and Womersley numbers ([Formula: see text]). The periodic flapping of primary cilium observed in our simulations is very similar to the in vivo ciliary oscillation captured by O'Connor et al. (Cilia 2:8, 2013. https://doi.org/10.1186/2046-2530-2-8). The cilium's dynamics is found to be closely related to the [Formula: see text] and [Formula: see text]. Increase the [Formula: see text] or decrease the [Formula: see text] bring to an increase in the cilium's flapping amplitude, tip angular speed, basal rotation, and maximum tensile stress. It is also demonstrated that by reducing the [Formula: see text] or enhancing the [Formula: see text] to a certain level, one can shift the flapping pattern of cilium from its original two-side one to a one-side one, making the stretch only happen on one particular side. During the flapping process, the location of the maximum tensile stress is not always found at the basal region; instead, it is able to propagate from time to time within a certain distance to the base. Due to the obstruction of the primary cilium, the distribution of wall shear stress no longer remains uniform as in the absence of cilia. It oscillates in space with the minimum magnitude which is always found near where the cilium is located. The presence of cilium also reduces the overall level of wall shear stress, especially at the region near the cilium's anchor point.

Chronic Hypobaric Hypoxia Modulates Primary Cilia Differently in Adult and Fetal Ovine Kidneys

Hypoxic environments at high altitude have significant effects on kidney injury. Following injury, renal primary cilia display length alterations. Primary cilia are mechanosensory organelles that regulate tubular architecture. The effect of hypoxia on cilia length is still controversial in cultured cells, and no corresponding in vivo study exists. Using fetal and adult sheep, we here study the effect of chronic hypobaric hypoxia on the renal injury, intracellular calcium signaling and the relationship between cilia length and cilia function. Our results show that although long-term hypoxia induces renal fibrosis in both fetal and adult kidneys, fetal kidneys are more susceptible to hypoxia-induced renal injury. Unlike hypoxic adult kidneys, hypoxic fetal kidneys are characterized by interstitial edema, tubular disparition and atrophy. We also noted that there is an increase in the cilia length as well as an increase in the cilia function in the hypoxic fetal proximal and distal collecting epithelia. Hypoxia, however, has no significant effect on primary cilia in the adult kidneys. Increased cilia length is also associated with greater flow-induced intracellular calcium signaling in renal epithelial cells from hypoxic fetuses. Our studies suggest that while hypoxia causes renal fibrosis in both adult and fetal kidneys, hypoxia-induced alteration in cilia length and function are specific to more severe renal injuries in fetal hypoxic kidneys.

Biophysics and biofluid dynamics of primary cilia: evidence for and against the flow-sensing function

Primary cilia have been called “the forgotten organelle” for over 20 yr. As cilia now have their own journal and several books devoted to their study, perhaps it is time to reconsider the moniker “forgotten organelle.” In fact, during the drafting of this review, 12 relevant publications have been issued; we therefore apologize in advance for any relevant work we inadvertently omitted. What purpose is yet another ciliary review? The primary goal of this review is to specifically examine the evidence for and against the hypothesized flow-sensing function of primary cilia expressed by differentiated epithelia within a kidney tubule, bringing together differing disciplines and their respective conceptual and experimental approaches. We will show that understanding the biophysics/biomechanics of primary cilia provides essential information for understanding any potential role of ciliary function in disease. We will summarize experimental and mathematical models used to characterize renal fluid flow and incident force on primary cilia and to characterize the mechanical response of cilia to an externally applied force and discuss possible ciliary-mediated cell signaling pathways triggered by flow. Throughout, we stress the importance of separating the effects of fluid shear and stretch from the action of hydrodynamic drag.