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Crowley SD, Navar LG, Prieto MC, Gurley SB, Coffman TM. Kidney Renin-Angiotensin System: Lost in a RAS Cascade. Hypertension 2024; 81:682-686. [PMID: 38507510 PMCID: PMC10957093 DOI: 10.1161/hypertensionaha.123.21367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Renin was discovered more than a century ago. Since then, the functions of the renin-angiotensin system in the kidney have been the focus of intensive research revealing its importance in regulation of renal physiology and in the pathogenesis of heart, vascular, and kidney diseases. Inhibitors of renin-angiotensin system components are now foundational therapies for a range of kidney and cardiovascular diseases from hypertension to heart failure to diabetic nephropathy. Despite years of voluminous research, emerging studies continue to reveal new complexities of the regulation of the renin-angiotensin system within the kidney and identification of nonclassical components of the system like the prorenin receptor (PRR) and ACE2 (angiotensin-converting enzyme 2), with powerful renal effects that ultimately impact the broader cardiovascular system. With the emergence of a range of novel therapies for cardiovascular and kidney diseases, the importance of a detailed understanding of the renin-angiotensin system in the kidney will allow for the development of informed complementary approaches for combinations of treatments that will optimally promote health and longevity over the century ahead.
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Affiliation(s)
- Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC (S.D.C.)
| | - L Gabriel Navar
- Department of Physiology and Renal and Hypertension Center, Tulane University School of Medicine, New Orleans, LA (L.G.N., M.C.P.)
| | - Minolfa C Prieto
- Department of Physiology and Renal and Hypertension Center, Tulane University School of Medicine, New Orleans, LA (L.G.N., M.C.P.)
| | - Susan B Gurley
- Division of Nephrology and Hypertension, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA (S.B.G.)
| | - Thomas M Coffman
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore (T.M.C.)
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Yang B, Crowley SD. Interleukin-37: a new therapeutic target in autosomal dominant polycystic kidney disease. Kidney Int 2024; 105:661-663. [PMID: 38519230 DOI: 10.1016/j.kint.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 03/24/2024]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) has long been considered a genetic renal disorder, but emerging evidence suggests that the immune microenvironment within the kidney plays a pivotal role in disease progression and severity. In recent years, the previously obscure cytokine interleukin-37 has proved a strong inhibitor of innate immunity in multiple disease models. However, its role in ADPKD has not received scrutiny. In a provocative study published in the current issue, Zylberberg et al. show that interleukin-37 activates interferon signaling in renal macrophages, which inhibits ADPKD initiation. This finding identifies interleukin-37 as a potential viable immunomodulatory therapy for ADPKD.
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Affiliation(s)
- Bo Yang
- Division of Nephrology and Endocrinology, Naval Medical Center of PLA, Naval Medical University, Shanghai, People's Republic of China
| | - Steven D Crowley
- Division of Nephrology, Departments of Medicine, Durham VA and Duke University Medical Center, Durham, North Carolina, USA.
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Bowling CB, Berkowitz TSZ, Burrows BT, Ma JE, Whitson HE, Smith B, Crowley SD, Wang V, Maciejewski ML, Olsen MK. Trajectories of Physical Resilience Among Older Veterans With Stage 4 CKD. Am J Kidney Dis 2024:S0272-6386(24)00678-4. [PMID: 38484869 DOI: 10.1053/j.ajkd.2024.01.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/15/2024] [Accepted: 01/28/2024] [Indexed: 04/26/2024]
Abstract
RATIONALE & OBJECTIVE Although functional impairment is common among older adults with chronic kidney disease (CKD), functional reserve before an acute health event and physical resilience after the event have not been characterized in this population. The purpose of this study was to identify distinct patterns of physical function before and after an acute health event among older veterans with stage 4 CKD. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS National sample of veterans≥70 years of age with an estimated glomerular filtration rate (eGFR) of<30mL/min/1.73m2 who had an acute care encounter (emergency department visit or hospitalization) during the follow-up period (n = 272). PREDICTORS Demographic characteristics, eGFR, basic and instrumental activities of daily living (ADL/IADL) difficulty, symptom burden, cognition, depressive symptoms, social support. OUTCOME Function measured using the life-space mobility assessment obtained by telephone survey before and after an acute care encounter. ANALYTICAL APPROACH General growth mixture models to identify classes of functional trajectories. Calculation of percentages for demographic characteristics and means for eGFR, ADL/IADL difficulty, symptom burden, cognition, depressive symptoms, and social support by trajectory class. RESULTS Four trajectory classes were identified and characterized by different levels of life-space mobility before (reserve) and change in life-space mobility after (resilience) an acute care encounter: (1) low reserve, low resilience (n=91), (2) high reserve, high resilience (n=23), (3) moderate reserve, moderate resilience (n=89), and (4) high reserve, low resilience (n=69). Mean levels of ADL/IADL difficulty, symptom burden, cognition, and depressive symptoms, but not demographic characteristics, eGFR, or social support, differed by trajectory class. LIMITATIONS Veteran cohort was primarily male. CONCLUSIONS Among older adults with stage 4 CKD, physical function trajectories before and after an acute health event vary. Integrating reserve and resilience into care for this population may be useful for anticipating changes in function and developing tailored treatment plans.
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Affiliation(s)
- C Barrett Bowling
- Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham, North Carolina; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina; Center for the Study of Aging and Human Development (the Aging Center), Duke University, Durham, North Carolina; Department of Medicine, Duke University, Durham, North Carolina.
| | - Theodore S Z Berkowitz
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina
| | - Brett T Burrows
- Center for the Study of Aging and Human Development (the Aging Center), Duke University, Durham, North Carolina
| | - Jessica E Ma
- Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham, North Carolina; Department of Medicine, Duke University, Durham, North Carolina
| | - Heather E Whitson
- Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham, North Carolina; Center for the Study of Aging and Human Development (the Aging Center), Duke University, Durham, North Carolina; Department of Medicine, Duke University, Durham, North Carolina
| | - Battista Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina
| | - Steven D Crowley
- Durham Veterans Affairs Health Care System, Durham, North Carolina; Department of Medicine, Duke University, Durham, North Carolina
| | - Virginia Wang
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina; Durham Veterans Affairs Health Care System, Durham, North Carolina; Department of Medicine, Duke University, Durham, North Carolina; Department of Population Health Sciences, Duke University, Durham, North Carolina
| | - Matthew L Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina; Durham Veterans Affairs Health Care System, Durham, North Carolina; Department of Medicine, Duke University, Durham, North Carolina; Department of Population Health Sciences, Duke University, Durham, North Carolina
| | - Maren K Olsen
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
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Wen Y, Lu X, Privratsky JR, Ren J, Ali S, Yang B, Rudemiller NP, Zhang J, Nedospasov SA, Crowley SD. TNF- α from the Proximal Nephron Exacerbates Aristolochic Acid Nephropathy. Kidney360 2024; 5:44-56. [PMID: 37986166 PMCID: PMC10833606 DOI: 10.34067/kid.0000000000000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
Key Points Proximal tubular TNF aggravates kidney injury and fibrogenesis in aristolochic acid nephropathy. Tubular TNF disrupts the cell cycle in injured tubular epithelial cells. TNF-mediated toxic renal injury is independent of systemic immune responses. Background Aristolochic acid nephropathy (AAN) presents with tubular epithelial cell (TEC) damage and tubulointerstitial inflammation. Although TNF-α regulates cell apoptosis and inflammatory responses, the effects of tubular TNF in the progression of AAN require elucidation. Methods Floxed TNF mice on the 129/SvEv background were crossed with PEPCK-Cre mice to generate PEPCK-Cre + TNF flox/flox (TNF PTKO) mice or bred with Ksp-Cre mice to generate KSP-Cre + TNF flox/flox (TNF DNKO) mice. TNF PTKO, TNF DNKO, and wild-type controls (Cre negative littermates) were subjected to acute and chronic AAN. Results Deletion of TNF in the proximal but not distal nephron attenuated kidney injury, renal inflammation, and tubulointerstitial fibrosis after acute or chronic aristolochic acid (AA) exposure. The TNF PTKO mice did not have altered numbers of infiltrating myeloid cells in AAN kidneys. Nevertheless, kidneys from AA-treated TNF PTKO mice had reduced levels of proteins involved in regulated cell death, higher proportions of TECs in the G0/G1 phase, and reduced TEC proportions in the G2/M phase. Pifithrin-α , which restores the cell cycle, abrogated differences between the wild-type and PTKO cohorts in G2/M phase arrest of TECs and kidney fibrosis after AA exposure. Conclusions TNF from the proximal but not the distal nephron propagates kidney injury and fibrogenesis in AAN in part by inducing G2/M cell cycle arrest of TECs.
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Affiliation(s)
- Yi Wen
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina
- Department of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China
| | - Xiaohan Lu
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina
| | - Jamie R. Privratsky
- Department of Anesthesiology, Durham VA and Duke University Medical Center, Durham, North Carolina
| | - Jiafa Ren
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina
| | - Saba Ali
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina
| | - Bo Yang
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina
| | - Nathan P. Rudemiller
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina
| | - Jiandong Zhang
- Division of Cardiology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sergei A. Nedospasov
- Engelhardt Institute of Molecular Biology, Moscow, Russia
- Institute of Cell Biology and Neurobiology, Universitatsmedizin, Berlin, Germany
| | - Steven D. Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina
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Ren J, Liu K, Wu B, Lu X, Sun L, Privratsky JR, Xing C, Robson MJ, Mao H, Blakely RD, Abe K, Souma T, Crowley SD. Divergent Actions of Renal Tubular and Endothelial Type 1 IL-1 Receptor Signaling in Toxin-Induced AKI. J Am Soc Nephrol 2023; 34:1629-1646. [PMID: 37545036 PMCID: PMC10561822 DOI: 10.1681/asn.0000000000000191] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/02/2023] [Indexed: 08/08/2023] Open
Abstract
SIGNIFICANCE STATEMENT Activation of the type 1 IL-1 receptor (IL-1R1) triggers a critical innate immune signaling cascade that contributes to the pathogenesis of AKI. However, blockade of IL-1 signaling in AKI has not consistently demonstrated kidney protection. The current murine experiments show that IL-1R1 activation in the proximal tubule exacerbates toxin-induced AKI and cell death through local suppression of apolipoprotein M. By contrast, IL-1R1 activation in endothelial cells ameliorates AKI by restoring VEGFA-dependent endothelial cell viability. Using this information, future delivery strategies can maximize the protective effects of blocking IL-1R1 while mitigating unwanted actions of IL-1R1 manipulation. BACKGROUND Activation of the type 1 IL-1 receptor (IL-1R1) triggers a critical innate immune signaling cascade that contributes to the pathogenesis of AKI. IL-1R1 is expressed on some myeloid cell populations and on multiple kidney cell lineages, including tubular and endothelial cells. Pharmacological inhibition of the IL-1R1 does not consistently protect the kidney from injury, suggesting there may be complex, cell-specific effects of IL-1R1 stimulation in AKI. METHODS To examine expression of IL-1 and IL-1R1 in intrinsic renal versus infiltrating immune cell populations during AKI, we analyzed single-cell RNA sequencing (scRNA-seq) data from kidney tissues of humans with AKI and mice with acute aristolochic acid exposure. We then investigated cell-specific contributions of renal IL-1R1 signaling to AKI using scRNA-seq, RNA microarray, and pharmacological interventions in mice with IL-1R1 deletion restricted to the proximal tubule or endothelium. RESULTS scRNA-seq analyses demonstrated robust IL-1 expression in myeloid cell populations and low-level IL-1R1 expression in kidney parenchymal cells during toxin-induced AKI. Our genetic studies showed that IL-1R1 activation in the proximal tubule exacerbated toxin-induced AKI and cell death through local suppression of apolipoprotein M. By contrast, IL-1R1 activation in endothelial cells ameliorated aristolochic acid-induced AKI by restoring VEGFA-dependent endothelial cell viability and density. CONCLUSIONS These data highlight opposing cell-specific effects of IL-1 receptor signaling on AKI after toxin exposure. Disrupting pathways activated by IL-1R1 in the tubule, while preserving those triggered by IL-1R1 activation on endothelial cells, may afford renoprotection exceeding that of global IL-1R1 inhibition while mitigating unwanted actions of IL-1R1 blockade.
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Affiliation(s)
- Jiafa Ren
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Kang Liu
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Buyun Wu
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Xiaohan Lu
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Lianqin Sun
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Jamie R. Privratsky
- Division of Critical Care Medicine, Center for Perioperative Organ Protection, Durham, North Caorlina
- Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - Changying Xing
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Matthew J. Robson
- Division of Pharmaceutical Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio
| | - Huijuan Mao
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Randy D. Blakely
- Division of Biomedical Science, Charles E. Schmidt College of Medicine and Stiles-Nicholson FAU Brain Institute, Jupiter, Florida
| | - Koki Abe
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Tomokazu Souma
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Steven D. Crowley
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
- Durham VA Medical Center, Durham, North Carolina
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Privratsky JR, Ide S, Chen Y, Kitai H, Ren J, Fradin H, Lu X, Souma T, Crowley SD. A macrophage-endothelial immunoregulatory axis ameliorates septic acute kidney injury. Kidney Int 2023; 103:514-528. [PMID: 36334787 PMCID: PMC9974788 DOI: 10.1016/j.kint.2022.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 10/12/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022]
Abstract
The most common cause of acute kidney injury (AKI) in critically ill patients is sepsis. Kidney macrophages consist of both F4/80hi and CD11bhi cells. The role of macrophage subpopulations in septic AKI pathogenesis remains unclear. As F4/80hi macrophages are reported to contribute to immunomodulation following injury, we hypothesized that selective depletion of F4/80hi macrophages would worsen septic AKI. F4/80hi macrophages were depleted via diphtheria toxin injection in CD11cCre(+)/CX3CR1dtr/wt (F4/80 MKO mice) compared to CD11cCre(-)/CX3CR1dtr/wt (F4/80 MWT) mice. F4/80 MWT and F4/80 MKO mice were subjected to sham or cecal ligation and puncture to induce sepsis. Compared to F4/80 MWT mice, F4/80 MKO mice displayed worsened septic AKI at 24 hours as measured by serum creatinine and histologic injury scoring. Kidneys from F4/80 MKO mice elaborated higher kidney interleukin-6 levels. Mechanistically, single cell RNA sequencing identified a macrophage-endothelial cell immunoregulatory axis that underlies interleukin-6 expression. F4/80hi macrophages expressed interleukin-1 receptor antagonist and limited interleukin-6 expression in endothelial cells. In turn, anti-interleukin-6 therapy ameliorated septic AKI in F4/80 MKO mice. Thus, F4/80hi macrophages express interleukin-1 receptor antagonist and constrain interleukin-6 generation from endothelial cells to limit septic AKI, representing a targetable cellular crosstalk in septic AKI. These findings are particularly relevant owing to the efficacy of anti-interleukin-6 therapies during COVID-19 infection, a disease associated with high rates of AKI and endothelial dysfunction.
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Affiliation(s)
- Jamie R Privratsky
- Center for Perioperative Organ Protection, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA; Division of Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Shintaro Ide
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Yanting Chen
- Center for Perioperative Organ Protection, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Hiroki Kitai
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Jiafa Ren
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Helene Fradin
- Duke Center for Genomic and Computational Biology, Duke University Medical Center, Durham, North Carolina, USA
| | - Xiaohan Lu
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Tomokazu Souma
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Durham VA Medical Center, Durham, North Carolina, USA.
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Tang TT, Lv LL, Wang B, Cao JY, Feng Y, Li ZL, Wu M, Wang FM, Wen Y, Zhou LT, Ni HF, Chen PS, Gu N, Crowley SD, Liu BC. Erratum: Employing Macrophage-Derived Microvesicle for Kidney-Targeted Delivery of Dexamethasone: An Efficient Therapeutic Strategy against Renal Inflammation and Fibrosis: Erratum. Theranostics 2023; 13:870. [PMID: 36632212 PMCID: PMC9830448 DOI: 10.7150/thno.78981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
[This corrects the article DOI: 10.7150/thno.33520.].
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Affiliation(s)
- Tao-Tao Tang
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Lin-Li Lv
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China,✉ Corresponding authors: Bi-Cheng Liu () or Lin-Li Lv ()
| | - Bin Wang
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jing-Yuan Cao
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ye Feng
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zuo-Lin Li
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Min Wu
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Feng-Mei Wang
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yi Wen
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Le-Ting Zhou
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hai-Feng Ni
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ping-Sheng Chen
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ning Gu
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Steven D. Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina, United States
| | - Bi-Cheng Liu
- ✉ Corresponding authors: Bi-Cheng Liu () or Lin-Li Lv ()
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Bowling CB, Olsen MK, Berkowitz TSZ, Smith B, Floyd B, Majette N, Miles AL, Crowley SD, Wang V, Maciejewski ML, Whitson HE. Reserve and resilience in CKD: concept introduction and baseline results from the Physical REsilience Prediction in Advanced REnal Disease (PREPARED) study. BMC Nephrol 2022; 23:418. [PMID: 36585609 PMCID: PMC9803898 DOI: 10.1186/s12882-022-03033-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/06/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The purpose of this manuscript is to introduce reserve and resilience as novel concepts in chronic kidney disease (CKD) research and present baseline data from a unique prospective cohort study designed to characterize recovery from functional decline after a health event. METHODS The Physical REsilience Prediction in Advanced REnal Disease (PREPARED) study recruited a national, prospective cohort of Veterans ≥70 years old with an estimated glomerular filtration rate (eGFR) < 30 ml/min/1.73 m2, prior nephrology care, and at high risk for hospitalization. Electronic health record data were paired with telephone surveys. Self-reported measures of reserve included physical, psychological, and cognitive capacity and environmental resources. We calculated counts (frequencies) and medians (25th, 75th percentiles) for baseline measures of reserve. The study's longitudinal follow-up of physical function every 8 weeks or following an acute care encounter, which will be used to define resilience, is ongoing. RESULTS Participants had a median (25th, 75th percentile) age of 76.3 (72.8, 81.4) years and eGFR of 23.4 (18.2, 28.8) ml/min/1.73 m2; 23.3% were Black, and 97.4% were male, 91.6% had hypertension, 67.4% had diabetes mellitus, 46.0% had coronary heart disease, and 39.8% had heart failure. Baseline measures of physical, psychological, and cognitive domains showed low reserve on average, but with wide ranges. CONCLUSIONS Despite similar levels of kidney function, older adults participating in PREPARED had a wide range of measures of reserve in other health domains. Non-renal measures of reserve may be important indicators of capacity of CKD patients to recover after acute care encounters.
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Affiliation(s)
- C. Barrett Bowling
- Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Health Care System (VAHCS), Durham, NC USA ,Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Center for the Study of Aging and Human Development (the Aging Center), Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University, Durham, NC USA
| | - Maren K. Olsen
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Biostatistics and Bioinformatics, Duke University, Durham, USA
| | - Theodore S. Z. Berkowitz
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC USA
| | - Battista Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC USA
| | - Breana Floyd
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC USA
| | - Nadya Majette
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC USA
| | - Amy L. Miles
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC USA
| | - Steven D. Crowley
- grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University, Durham, NC USA
| | - Virginia Wang
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University, Durham, NC USA
| | - Matthew L. Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, Duke University, Durham, NC USA
| | - Heather E. Whitson
- Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Health Care System (VAHCS), Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Center for the Study of Aging and Human Development (the Aging Center), Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Medicine, Duke University, Durham, NC USA
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Lu X, Chen Y, Yang T, Rianto F, Hammer G, Crowley SD. Abstract 061: Renal A20 Protects Against The Cisplatin-induced Kidney Injury. Hypertension 2022. [DOI: 10.1161/hyp.79.suppl_1.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We recently reported that the ubiquitin-editing protein A20 in myeloid cells can limit the severity of hypertension. However, whether A20 in the kidney regulates renal injury without impacting systemic immune responses remains unclear. To address this question, we bred
A20
flox/flox
mice with the Pax8-rtTA and Tet-On lines, generating inducible renal epithelial cell A20 knockout mice (A20 iKKO). Mice with all 3 transgenes were used as the A20 iKKO group, whereas mice lacking the Pax8-rtTA or Tet-On transgene were wild-type (WT) controls. Before the experiments, mice were given 2mg/ml of doxycycline in water containing 5% (5 of 100) sucrose for 2 weeks so that A20 in renal tubular cells was ablated. 3 days after a single dose of cisplatin (20mg/kg), A20 iKKO mice exhibited more severe kidney injury compared to WTs (blinded injury score, 3.2±0.41 vs. 2.1±0.35 au, p=0.039). A20 iKKOs also had upregulated renal mRNA levels for NGAL (6.0±1.91 vs. 1.0±0.18 au, p=0.018) and KIM-1(3.3±1.2 vs. 1.0±0.29 au, p=0.07). Injured kidneys from the A20 iKKOs contained greater absolute numbers of T cells (123.6±8.5 vs. 53.8±4.7, x10
4
cells per gram kidney, p<0.001), macrophages (159.7±22.5 vs. 52.7±9.9, x10
4
cells per gram kidney, p<0.001), and dendritic cells (66.7±10.6 vs. 32.6±6.1, x10
4
cells per gram kidney, p=0.015) than WTs by flow cytometric analysis. In turn, mRNA levels for TNF-α (9.1±2.62 vs. 1.0±0.18 au; p=0.006) and IL-1β (4.1±1.06 vs. 1.0±0.13 au; p=0.009) were increased in the injured A20 iKKO injured kidneys vs WTs. Thus, A20 in the kidney epithelium protects against cisplatin-induced kidney injury by constraining renal immune cell accumulation and inflammatory cytokine release.
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10
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Leisman DE, Privratsky JR, Lehman JR, Abraham MN, Yaipan OY, Brewer MR, Nedeljkovic-Kurepa A, Capone CC, Fernandes TD, Griffiths R, Stein WJ, Goldberg MB, Crowley SD, Bellomo R, Deutschman CS, Taylor MD. Angiotensin II enhances bacterial clearance via myeloid signaling in a murine sepsis model. Proc Natl Acad Sci U S A 2022; 119:e2211370119. [PMID: 35969740 PMCID: PMC9407661 DOI: 10.1073/pnas.2211370119] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022] Open
Abstract
Sepsis, defined as organ dysfunction caused by a dysregulated host-response to infection, is characterized by immunosuppression. The vasopressor norepinephrine is widely used to treat low blood pressure in sepsis but exacerbates immunosuppression. An alternative vasopressor is angiotensin-II, a peptide hormone of the renin-angiotensin system (RAS), which displays complex immunomodulatory properties that remain unexplored in severe infection. In a murine cecal ligation and puncture (CLP) model of sepsis, we found alterations in the surface levels of RAS proteins on innate leukocytes in peritoneum and spleen. Angiotensin-II treatment induced biphasic, angiotensin-II type 1 receptor (AT1R)-dependent modulation of the systemic inflammatory response and decreased bacterial counts in both the blood and peritoneal compartments, which did not occur with norepinephrine treatment. The effect of angiotensin-II was preserved when treatment was delivered remote from the primary site of infection. At an independent laboratory, angiotensin-II treatment was compared in LysM-Cre AT1aR-/- (Myeloid-AT1a-) mice, which selectively do not express AT1R on myeloid-derived leukocytes, and littermate controls (Myeloid-AT1a+). Angiotensin-II treatment significantly reduced post-CLP bacteremia in Myeloid-AT1a+ mice but not in Myeloid-AT1a- mice, indicating that the AT1R-dependent effect of angiotensin-II on bacterial clearance was mediated through myeloid-lineage cells. Ex vivo, angiotensin-II increased post-CLP monocyte phagocytosis and ROS production after lipopolysaccharide stimulation. These data identify a mechanism by which angiotensin-II enhances the myeloid innate immune response during severe systemic infection and highlight a potential role for angiotensin-II to augment immune responses in sepsis.
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Affiliation(s)
- Daniel E. Leisman
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114
- Department of Medicine, Massachusetts General Hospital, Boston, MA 02114
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
| | - Jamie R. Privratsky
- Division of Critical Care Medicine, Department of Anesthesiology, Duke University, Durham, NC 27708
| | - Jake R. Lehman
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | - Mabel N. Abraham
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | - Omar Y. Yaipan
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | - Mariana R. Brewer
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | - Ana Nedeljkovic-Kurepa
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | - Christine C. Capone
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | - Tiago D. Fernandes
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | - Robert Griffiths
- Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27705
| | - William J. Stein
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | - Marcia B. Goldberg
- Center for Bacterial Pathogenesis, Division of Infectious Disease, Massachusetts General Hospital, Boston, MA 02114
- Department of Medicine, Harvard Medical School, Boston, MA 02115
- Department of Microbiology, Harvard Medical School, Boston, MA 02115
- Broad Institute of MIT and Harvard, Cambridge, MA 02142
| | - Steven D. Crowley
- Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27705
| | - Rinaldo Bellomo
- Broad Institute of MIT and Harvard, Cambridge, MA 02142
- Department of Critical Care, University of Melbourne, Melbourne, VIC 3010, Australia
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Department of Intensive Care, Austin Health, Heidelberg, VIC 3084, Australia
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Clifford S. Deutschman
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
| | - Matthew D. Taylor
- Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Hofstra-Northwell School of Medicine, Manhasset, NY 11030
- Department of Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY 11040
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11
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Lu X, Crowley SD. Actions of Dendritic Cells in the Kidney during Hypertension. Compr Physiol 2022; 12:4087-4101. [PMID: 35950656 DOI: 10.1002/cphy.c210050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The immune response plays a critical role in the pathogenesis of hypertension, and immune cell populations can promote blood pressure elevation via actions in the kidney. Among these cell lineages, dendritic cells (DCs), the most potent antigen-presenting cells, play a central role in regulating immune response during hypertension and kidney disease. DCs have different subtypes, and renal DCs are comprised of the CD103+ CD11b- and CD103- CD11b+ subsets. DCs become mature and express costimulatory molecules on their surface once they encounter antigen. Isolevuglandin-modified proteins function as antigens to activate DCs and trigger them to stimulate T cells. Activated T cells accumulate in the hypertensive kidney, release effector cytokines, promote renal oxidative stress, and promote renal salt and water retention. Individual subsets of activated T cells can secrete tumor necrosis factor-alpha, interleukin-17A, and interferon-gamma, each of which has augmented the elevation of blood pressure in hypertensive models by enhancing renal sodium transport. Fms-like tyrosine kinase 3 ligand-dependent classical DCs are required to sustain the full hypertensive response, but C-X3 -C chemokine receptor 1 positive DCs do not regulate blood pressure. Excess sodium enters the DC through transporters to activate DCs, whereas the ubiquitin editor A20 in dendritic cells constrains blood pressure elevation by limiting T cell activation. By contrast, activation of the salt sensing kinase, serum/glucocorticoid kinase 1 in DCs exacerbates salt-sensitive hypertension. This article discusses recent studies illustrating mechanisms through which DC-T cell interactions modulate levels of pro-hypertensive mediators to regulate blood pressure via actions in the kidney. © 2022 American Physiological Society. Compr Physiol 12:1-15, 2022.
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Affiliation(s)
- Xiaohan Lu
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina, USA
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina, USA
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12
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Abstract
The seminal observations of Dr Lewis Dahl regarding renal mechanisms of hypertension remain highly relevant in light of more recent experiments showing that immune system dysfunction contributes to hypertension pathogenesis. Dr Dahl established that inappropriate salt retention in the kidney plays a central role via Ohm's Law in permitting blood pressure elevation. Nevertheless, inflammatory cytokines whose expression is induced in the early stages of hypertension can alter renal blood flow and sodium transporter expression and activity to foster renal sodium retention. By elaborating these cytokines and reactive oxygen species, myeloid cells and T lymphocytes can connect systemic inflammatory signals to aberrant kidney functions that allow sustained hypertension. By activating T lymphocytes, antigen-presenting cells such as dendritic cells represent an afferent sensing mechanism triggering T cell activation, cytokine generation, and renal salt and water reabsorption. Manipulating these inflammatory signals to attenuate hypertension without causing prohibitive systemic immunosuppression will pose a challenge, but disrupting actions of inflammatory mediators locally within the kidney may offer a path through which to target immune-mediated mechanisms of hypertension while capitalizing on Dr Dahl's key recognition of the kidney's importance in blood pressure regulation.
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Affiliation(s)
- Xiaohan Lu
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC
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13
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Lu X, Zhang J, Wen Y, Ren J, Griffiths R, Rudemiller NP, Ide S, Souma T, Crowley SD. Type 1 Angiotensin Receptors on CD11c-Expressing Cells Protect Against Hypertension by Regulating Dendritic Cell-Mediated T Cell Activation. Hypertension 2022; 79:1227-1236. [PMID: 35430875 DOI: 10.1161/hypertensionaha.121.18734] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Type 1 angiotensin (AT1) receptors are expressed on immune cells, and we previously found that bone marrow-derived AT1 receptors protect against Ang (angiotensin) II-induced hypertension. CD11c is expressed on myeloid cells derived from the bone marrow, including dendritic cells (DCs) that activate T lymphocytes. Here, we examined the role of AT1 receptors on CD11c+ cells in hypertension pathogenesis. METHODS Mice lacking the dominant murine AT1 receptor isoform, AT1a, on CD11c+ cells (dendritic cell [DC] AT1aR knockout [KO]) and wild-type (WT) littermates were subjected to Ang II-induced hypertension. Blood pressures were measured by radiotelemetry. RESULTS DC AT1aR KO mice had exaggerated hypertensive responses to chronic Ang II infusion with enhanced renal accumulation of effector memory T cells and CD40+ DCs. CCL5 (C-C motif chemokine ligand 5) recruits T cells into injured tissues, and CCR7 (C-C motif chemokine receptor 7) facilitates DC and T cell interactions in the kidney lymph node to allow T cell activation. DCs from the hypertensive DC AT1aR KO kidneys expressed higher levels of CCL5 and CCR7. mRNA expressions for CCR7 and tumor necrosis factor-α were increased in CD4+ T cells from the renal lymph nodes of DC AT1aR KO mice. During the second week of Ang II infusion when blood pressures between groups diverged, DC AT1aR KO mice excreted less sodium than WTs. Expressions for epithelial sodium channel subunits were increased in DC AT1aR KO kidneys. CONCLUSIONS Following activation of the renin angiotensin system, AT1aR stimulation on DCs suppresses renal DC maturation and T cell activation with consequent protection from sodium retention and blood pressure elevation.
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Affiliation(s)
- Xiaohan Lu
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., Y.W., J.R., R.G., N.P.R., S.I., T.S., S,D.C.)
| | - Jiandong Zhang
- Division of Cardiology, Department of Medicine, University of North Carolina at Chapel Hill (J.Z.)
| | - Yi Wen
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., Y.W., J.R., R.G., N.P.R., S.I., T.S., S,D.C.)
| | - Jiafa Ren
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., Y.W., J.R., R.G., N.P.R., S.I., T.S., S,D.C.)
| | - Robert Griffiths
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., Y.W., J.R., R.G., N.P.R., S.I., T.S., S,D.C.)
| | - Nathan P Rudemiller
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., Y.W., J.R., R.G., N.P.R., S.I., T.S., S,D.C.)
| | - Shintaro Ide
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., Y.W., J.R., R.G., N.P.R., S.I., T.S., S,D.C.)
| | - Tomokazu Souma
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., Y.W., J.R., R.G., N.P.R., S.I., T.S., S,D.C.)
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., Y.W., J.R., R.G., N.P.R., S.I., T.S., S,D.C.)
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14
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Ren J, Lu X, Hall G, Privratsky JR, Robson MJ, Blakely RD, Crowley SD. IL-1 receptor signaling in podocytes limits susceptibility to glomerular damage. Am J Physiol Renal Physiol 2022; 322:F164-F174. [PMID: 34894725 PMCID: PMC8782651 DOI: 10.1152/ajprenal.00353.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 02/03/2023] Open
Abstract
Interleukin (IL)-1 receptor type 1 (IL-1R1) activation triggers a proinflammatory signaling cascade that can exacerbate kidney injury. However, the functions of podocyte IL-1R1 in glomerular disease remain unclear. To study the role of IL-1R1 signaling in podocytes, we selectively ablated podocyte IL-1R1 in mice (PKO mice). We then subjected PKO mice and wild-type controls to two glomerular injury models: nephrotoxic serum (NTS)- and adriamycin-induced nephropathy. Surprisingly, we found that IL-1R1 activation in podocytes limited albuminuria and podocyte injury during NTS- and adriamycin-induced nephropathy. Moreover, deletion of IL-1R1 in podocytes drove podocyte apoptosis and glomerular injury through diminishing Akt activation. Activation of Akt signaling abrogated the differences in albuminuria and podocyte injury between wild-type and PKO mice during NTS. Thus, IL-1R1 signaling in podocytes limits susceptibility to glomerular injury via an Akt-dependent signaling pathway. These data identify an unexpected protective role for IL-1R1 signaling in podocytes in the pathogenesis of glomerular disease.NEW & NOTEWORTHY The present study establishes that activation of the receptor for interleukin-1 limits susceptibility to damage to the kidney glomerulus in preclinical mouse models by stimulating Akt signaling cascades inside the podocyte.
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Affiliation(s)
- Jiafa Ren
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Centers, Durham, North Carolina
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, People's Republic of China
| | - Xiaohan Lu
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Centers, Durham, North Carolina
| | - Gentzon Hall
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Centers, Durham, North Carolina
| | - Jamie R Privratsky
- Department of Anesthesiology, Durham Veterans Affairs and Duke University Medical Centers, Durham, North Carolina
| | - Matthew J Robson
- Division of Pharmaceutical Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio
| | - Randy D Blakely
- Department of Biomedical Science, Charles E. Schmidt College of Medicine and FAU Brain Institute, Jupiter, Florida
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Centers, Durham, North Carolina
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15
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Li ZL, Wang B, Lv LL, Tang TT, Wen Y, Cao JY, Zhu XX, Feng ST, Crowley SD, Liu BC. FIH-1-modulated HIF-1α C-TAD promotes acute kidney injury to chronic kidney disease progression via regulating KLF5 signaling. Acta Pharmacol Sin 2021; 42:2106-2119. [PMID: 33658705 PMCID: PMC8633347 DOI: 10.1038/s41401-021-00617-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/17/2021] [Indexed: 02/02/2023] Open
Abstract
Incomplete recovery from episodes of acute kidney injury (AKI) can predispose patients to develop chronic kidney disease (CKD). Although hypoxia-inducible factor-1α (HIF-1α) is a master regulator of the response to hypoxia/ischemia, the role of HIF-1α in CKD progression following incomplete recovery from AKI is poorly understood. Here, we investigated this issue using moderate and severe ischemia/reperfusion injury (I/RI) mouse models. We found that the outcomes of AKI were highly associated with the time course of tubular HIF-1α expression. Sustained activation of HIF-1α, accompanied by the development of renal fibrotic lesions, was found in kidneys with severe AKI. The AKI to CKD progression was markedly ameliorated when PX-478 (a specific HIF-1α inhibitor, 5 mg· kg-1·d-1, i.p.) was administered starting on day 5 after severe I/RI for 10 consecutive days. Furthermore, we demonstrated that HIF-1α C-terminal transcriptional activation domain (C-TAD) transcriptionally stimulated KLF5, which promoted progression of CKD following severe AKI. The effect of HIF-1α C-TAD activation on promoting AKI to CKD progression was also confirmed in in vivo and in vitro studies. Moreover, we revealed that activation of HIF-1α C-TAD resulted in the loss of FIH-1, which was the key factor governing HIF-1α-driven AKI to CKD progression. Overexpression of FIH-1 inhibited HIF-1α C-TAD and prevented AKI to CKD progression. Thus, FIH-1-modulated HIF-1α C-TAD activation was the key mechanism of AKI to CKD progression by transcriptionally regulating KLF5 pathway. Our results provide new insights into the role of HIF-1α in AKI to CKD progression and also the potential therapeutic strategy for the prevention of renal diseases progression.
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Affiliation(s)
- Zuo-Lin Li
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China
| | - Bin Wang
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China.
| | - Lin-Li Lv
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China
| | - Tao-Tao Tang
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China
| | - Yi Wen
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China
| | - Jing-Yuan Cao
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China
| | - Xiao-Xiao Zhu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China
| | - Song-Tao Feng
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University, Durham VA Medical Centers, Durham, NC, USA
| | - Bi-Cheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China.
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16
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Yang B, Crowley SD. Polycystic kidney disease strikes a nerve. Physiol Rep 2021; 9:e15078. [PMID: 34665519 PMCID: PMC8525322 DOI: 10.14814/phy2.15078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Bo Yang
- Division of Nephrology & EndocrinologyDepartment of Internal MedicineNaval Medical Center of PLASecond Military Medical UniversityShanghaiPeople's Republic of China
| | - Steven D. Crowley
- Division of NephrologyDepartments of MedicineDurham VA and Duke University Medical CenterDurhamNorth CarolinaUSA
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17
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Ren J, Xu Y, Lu X, Wang L, Ide S, Hall G, Souma T, Privratsky JR, Spurney RF, Crowley SD. Twist1 in podocytes ameliorates podocyte injury and proteinuria by limiting CCL2-dependent macrophage infiltration. JCI Insight 2021; 6:e148109. [PMID: 34369383 PMCID: PMC8410065 DOI: 10.1172/jci.insight.148109] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/06/2021] [Indexed: 11/28/2022] Open
Abstract
The transcription factor Twist1 regulates several processes that could impact kidney disease progression, including epithelial cell differentiation and inflammatory cytokine induction. Podocytes are specialized epithelia that exhibit features of immune cells and could therefore mediate unique effects of Twist1 on glomerular disease. To study Twist1 functions in podocytes during proteinuric kidney disease, we employed a conditional mutant mouse in which Twist1 was selectively ablated in podocytes (Twist1-PKO). Deletion of Twist1 in podocytes augmented proteinuria, podocyte injury, and foot process effacement in glomerular injury models. Twist1 in podocytes constrained renal accumulation of monocytes/macrophages and glomerular expression of CCL2 and the macrophage cytokine TNF-α after injury. Deletion of TNF-α selectively from podocytes had no impact on the progression of proteinuric nephropathy. By contrast, the inhibition of CCL2 abrogated the exaggeration in proteinuria and podocyte injury accruing from podocyte Twist1 deletion. Collectively, Twist1 in podocytes mitigated urine albumin excretion and podocyte injury in proteinuric kidney diseases by limiting CCL2 induction that drove monocyte/macrophage infiltration into injured glomeruli. Myeloid cells, rather than podocytes, further promoted podocyte injury and glomerular disease by secreting TNF-α. These data highlight the capacity of Twist1 in the podocyte to mitigate glomerular injury by curtailing the local myeloid immune response.
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Affiliation(s)
- Jiafa Ren
- Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Centers, Durham, North Carolina, USA.,Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Yuemei Xu
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiaohan Lu
- Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Centers, Durham, North Carolina, USA
| | - Liming Wang
- Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Centers, Durham, North Carolina, USA
| | - Shintaro Ide
- Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Centers, Durham, North Carolina, USA
| | - Gentzon Hall
- Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Centers, Durham, North Carolina, USA
| | - Tomokazu Souma
- Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Centers, Durham, North Carolina, USA
| | - Jamie R Privratsky
- Department of Anesthesiology, Durham VA and Duke University Medical Centers, Durham, North Carolina, USA
| | - Robert F Spurney
- Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Centers, Durham, North Carolina, USA
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Centers, Durham, North Carolina, USA
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18
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Ide S, Kobayashi Y, Ide K, Strausser SA, Abe K, Herbek S, O'Brien LL, Crowley SD, Barisoni L, Tata A, Tata PR, Souma T. Ferroptotic stress promotes the accumulation of pro-inflammatory proximal tubular cells in maladaptive renal repair. eLife 2021; 10:68603. [PMID: 34279220 PMCID: PMC8318592 DOI: 10.7554/elife.68603] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/17/2021] [Indexed: 12/14/2022] Open
Abstract
Overwhelming lipid peroxidation induces ferroptotic stress and ferroptosis, a non-apoptotic form of regulated cell death that has been implicated in maladaptive renal repair in mice and humans. Using single-cell transcriptomic and mouse genetic approaches, we show that proximal tubular (PT) cells develop a molecularly distinct, pro-inflammatory state following injury. While these inflammatory PT cells transiently appear after mild injury and return to their original state without inducing fibrosis, after severe injury they accumulate and contribute to persistent inflammation. This transient inflammatory PT state significantly downregulates glutathione metabolism genes, making the cells vulnerable to ferroptotic stress. Genetic induction of high ferroptotic stress in these cells after mild injury leads to the accumulation of the inflammatory PT cells, enhancing inflammation and fibrosis. Our study broadens the roles of ferroptotic stress from being a trigger of regulated cell death to include the promotion and accumulation of proinflammatory cells that underlie maladaptive repair.
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Affiliation(s)
- Shintaro Ide
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Yoshihiko Kobayashi
- Department of Cell Biology, Duke University School of Medicine, Durham, United States
| | - Kana Ide
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Sarah A Strausser
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Koki Abe
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Savannah Herbek
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Lori L O'Brien
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Laura Barisoni
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States.,Department of Pathology, Duke University School of Medicine, Durham, United States
| | - Aleksandra Tata
- Department of Cell Biology, Duke University School of Medicine, Durham, United States
| | - Purushothama Rao Tata
- Department of Cell Biology, Duke University School of Medicine, Durham, United States.,Regeneration Next, Duke University, Durham, United States.,Duke Cancer Institute, Duke University School of Medicine, Durham, United States
| | - Tomokazu Souma
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States.,Regeneration Next, Duke University, Durham, United States
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19
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Suliman H, Ma Q, Zhang Z, Ren J, Morris BT, Crowley SD, Ulloa L, Privratsky JR. Annexin A1 Tripeptide Mimetic Increases Sirtuin-3 and Augments Mitochondrial Function to Limit Ischemic Kidney Injury. Front Physiol 2021; 12:683098. [PMID: 34276404 PMCID: PMC8281307 DOI: 10.3389/fphys.2021.683098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/28/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Acute kidney injury (AKI) is one of the most common organ failures following surgery. We have developed a tripeptide mimetic (ANXA1sp) of the parent annexin A1 molecule that shows promise as an organ protectant limiting cellular stress; however, its potential as a kidney protective agent remains unexplored, and its mechanism of action is poorly understood. Our hypothesis was that ANXA1sp would limit kidney injury following surgical ischemic kidney injury. Methods: In a blinded fashion, wildtype mice were assigned to receive vehicle control or ANXA1sp one hour prior to and one hour after kidney vascular clamping. Our primary outcomes were markers of kidney injury and function as measured by serum creatinine and histologic injury scoring of kidney tissue sections. Immunofluorescence microscopy, real-time PCR, and Western blot were used to assess cell death, oxidative stress, and mitochondrial biomarkers. An in vitro model of oxygen-glucose deprivation in immortalized kidney tubule cells was used. Results: ANXA1sp given prior to and after ischemic kidney injury abrogated ischemic kidney injury. ANXA1sp limited cell death both in vivo and in vitro and abrogated oxidative stress following ischemia. ANXA1sp significantly increased the expression of markers associated with protective mitophagy and limited the expression of markers associated with detrimental mitochondrial fission. ANXA1sp upregulated the expression of the mitochondrial protectant sirtuin-3 (SIRT3) in the mitochondria of kidney tubular cells. Silencing of SIRT3 reversed ANXA1sp-mediated protection against hypoxic cell death. Conclusions: ANXA1sp limits kidney injury, upregulates SIRT3, and preserves mitochondrial integrity following ischemic kidney injury. ANXA1sp holds considerable promise as a perioperative kidney protectant prior to ischemia inducing surgery and kidney transplantation.
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Affiliation(s)
- Hagir Suliman
- Center for Perioperative Organ Protection, Department of Anesthesiology. Duke University Medical Center, Durham, NC, United States
| | - Qing Ma
- Center for Perioperative Organ Protection, Department of Anesthesiology. Duke University Medical Center, Durham, NC, United States
| | - Zhiquan Zhang
- Center for Perioperative Organ Protection, Department of Anesthesiology. Duke University Medical Center, Durham, NC, United States
| | - Jiafa Ren
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Benjamin T. Morris
- Center for Perioperative Organ Protection, Department of Anesthesiology. Duke University Medical Center, Durham, NC, United States
| | - Steven D. Crowley
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Department of Medicine, Durham VA Medical Center, Durham, NC, United States
| | - Luis Ulloa
- Center for Perioperative Organ Protection, Department of Anesthesiology. Duke University Medical Center, Durham, NC, United States
| | - Jamie R. Privratsky
- Center for Perioperative Organ Protection, Department of Anesthesiology. Duke University Medical Center, Durham, NC, United States
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20
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Huang HI, Jewell ML, Youssef N, Huang MN, Hauser ER, Fee BE, Rudemiller NP, Privratsky JR, Zhang JJ, Reyes EY, Wang D, Taylor GA, Gunn MD, Ko DC, Cook DN, Chandramohan V, Crowley SD, Hammer GE. Th17 Immunity in the Colon Is Controlled by Two Novel Subsets of Colon-Specific Mononuclear Phagocytes. Front Immunol 2021; 12:661290. [PMID: 33995384 PMCID: PMC8113646 DOI: 10.3389/fimmu.2021.661290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/31/2021] [Indexed: 12/23/2022] Open
Abstract
Intestinal immunity is coordinated by specialized mononuclear phagocyte populations, constituted by a diversity of cell subsets. Although the cell subsets constituting the mononuclear phagocyte network are thought to be similar in both small and large intestine, these organs have distinct anatomy, microbial composition, and immunological demands. Whether these distinctions demand organ-specific mononuclear phagocyte populations with dedicated organ-specific roles in immunity are unknown. Here we implement a new strategy to subset murine intestinal mononuclear phagocytes and identify two novel subsets which are colon-specific: a macrophage subset and a Th17-inducing dendritic cell (DC) subset. Colon-specific DCs and macrophages co-expressed CD24 and CD14, and surprisingly, both were dependent on the transcription factor IRF4. Novel IRF4-dependent CD14+CD24+ macrophages were markedly distinct from conventional macrophages and failed to express classical markers including CX3CR1, CD64 and CD88, and surprisingly expressed little IL-10, which was otherwise robustly expressed by all other intestinal macrophages. We further found that colon-specific CD14+CD24+ mononuclear phagocytes were essential for Th17 immunity in the colon, and provide definitive evidence that colon and small intestine have distinct antigen presenting cell requirements for Th17 immunity. Our findings reveal unappreciated organ-specific diversity of intestine-resident mononuclear phagocytes and organ-specific requirements for Th17 immunity.
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Affiliation(s)
- Hsin-I. Huang
- Department of Immunology, Duke University Medical Center, Durham, NC, United States
| | - Mark L. Jewell
- Department of Immunology, Duke University Medical Center, Durham, NC, United States
| | - Nourhan Youssef
- Department of Immunology, Duke University Medical Center, Durham, NC, United States
| | - Min-Nung Huang
- Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, United States
| | - Elizabeth R. Hauser
- Department of Biostatistics and Bioinformatics, and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, United States
- Cooperative Studies Program Epidemiology Center, VA Medical Center, Durham, NC, United States
| | - Brian E. Fee
- Geriatric Research, Education, and Clinical Center, VA Health Care Center, Durham, NC, United States
- Department of Medicine, Division of Geriatrics, and Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, United States
| | - Nathan P. Rudemiller
- Department of Medicine, Division of Nephrology, Duke University and Durham VA Medical Centers, Durham, NC, United States
| | - Jamie R. Privratsky
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
| | - Junyi J. Zhang
- Department of Immunology, Duke University Medical Center, Durham, NC, United States
| | - Estefany Y. Reyes
- Department of Immunology, Duke University Medical Center, Durham, NC, United States
| | - Donghai Wang
- Department of Medicine, Division of Rheumatology and Immunology, Duke University Medical Center, Durham, NC, United States
| | - Gregory A. Taylor
- Department of Immunology, Duke University Medical Center, Durham, NC, United States
- Geriatric Research, Education, and Clinical Center, VA Health Care Center, Durham, NC, United States
- Department of Medicine, Division of Geriatrics, and Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, United States
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, United States
| | - Michael D. Gunn
- Department of Immunology, Duke University Medical Center, Durham, NC, United States
- Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, United States
| | - Dennis C. Ko
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, United States
| | - Donald N. Cook
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, NIH, Durham, NC, United States
| | - Vidyalakshmi Chandramohan
- Department of Neurosurgery and Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Steven D. Crowley
- Department of Medicine, Division of Nephrology, Duke University and Durham VA Medical Centers, Durham, NC, United States
| | - Gianna Elena Hammer
- Department of Immunology, Duke University Medical Center, Durham, NC, United States
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, United States
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21
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Ren J, Lu X, Griffiths R, Privratsky JR, Crowley SD. Twist1 in T Lymphocytes Augments Kidney Fibrosis after Ureteral Obstruction. Kidney360 2021; 2:784-794. [PMID: 35373065 PMCID: PMC8791343 DOI: 10.34067/kid.0007182020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/17/2021] [Indexed: 02/04/2023]
Abstract
Background Twist1 is a basic helix-loop-helix domain-containing transcription factor that participates in diverse cellular functions, including epithelial-mesenchymal transition and the cellular immune response. Although Twist1 plays critical roles in the initiation and progression of kidney diseases, the effects of Twist1 in the T lymphocyte on the progression of renal fibrosis require elucidation. Methods 129/SvEv mice with a floxed allele for the gene encoding Twist1 or TNFα were bred with CD4-Cre mice to yield CD4-Cre+ Twist1flox/flox (Twist1-TKO) or CD4-Cre+ TNFflox/flox (TNF-TKO) mice with robust, but selective, deletion of Twist1 or TNFα mRNA in T cells, respectively. Twist1 TKO, TNF TKO, and WT controls underwent UUO with assessment of kidney fibrosis and T-cell phenotype at 14 days. Results Compared with WT controls, obstructed kidneys from Twist1 TKO mice had attenuated extracellular matrix deposition. Despite this diminished fibrosis, Twist1 TKO obstructed kidneys contained more CD8+ T cells than in WTs. These intrarenal CD8+ T cells exhibited greater activation and higher levels of TNFα expression than those from WT obstructed kidneys. Further, we found that selective deletion of TNFα from T cells exaggerated renal scar formation and injury after UUO, highlighting the capacity of T-cell TNF to constrain fibrosis in the kidney. Conclusions Twist1 in T cells promotes kidney fibrogenesis, in part, by curtailing the renal accumulation of TNF-elaborating T cells.
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Affiliation(s)
- Jiafa Ren
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Xiaohan Lu
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Robert Griffiths
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Jamie R. Privratsky
- Department of Anesthesiology, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Steven D. Crowley
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
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22
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Sparks MA, Rianto F, Diaz E, Revoori R, Hoang T, Bouknight L, Stegbauer J, Vivekanandan-Giri A, Ruiz P, Pennathur S, Abraham DM, Gurley SB, Crowley SD, Coffman TM. Direct Actions of AT 1 (Type 1 Angiotensin) Receptors in Cardiomyocytes Do Not Contribute to Cardiac Hypertrophy. Hypertension 2021; 77:393-404. [PMID: 33390039 PMCID: PMC7803456 DOI: 10.1161/hypertensionaha.119.14079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Supplemental Digital Content is available in the text. Activation of AT1 (type 1 Ang) receptors stimulates cardiomyocyte hypertrophy in vitro. Accordingly, it has been suggested that regression of cardiac hypertrophy associated with renin-Ang system blockade is due to inhibition of cellular actions of Ang II in the heart, above and beyond their effects to reduce pressure overload. We generated 2 distinct mouse lines with cell-specific deletion of AT1A receptors, from cardiomyocytes. In the first line (C-SMKO), elimination of AT1A receptors was achieved using a heterologous Cre recombinase transgene under control of the Sm22 promoter, which expresses in cells of smooth muscle lineage including cardiomyocytes and vascular smooth muscle cells of conduit but not resistance vessels. The second line (R-SMKO) utilized a Cre transgene knocked-in to the Sm22 locus, which drives expression in cardiac myocytes and vascular smooth muscle cells in both conduit and resistance arteries. Thus, although both groups lack AT1 receptors in the cardiomyocytes, they are distinguished by presence (C-SMKO) or absence (R-SMKO) of peripheral vascular responses to Ang II. Similar to wild-types, chronic Ang II infusion caused hypertension and cardiac hypertrophy in C-SMKO mice, whereas both hypertension and cardiac hypertrophy were reduced in R-SMKOs. Thus, despite the absence of AT1A receptors in cardiomyocytes, C-SMKOs develop robust cardiac hypertrophy. By contrast, R-SMKOs developed identical levels of hypertrophy in response to pressure overload–induced by transverse aortic banding. Our findings suggest that direct activation of AT1 receptors in cardiac myocytes has minimal influence on cardiac hypertrophy induced by renin-Ang system activation or pressure overload.
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Affiliation(s)
- Matthew A Sparks
- From the Division of Nephrology, Department of Medicine (M.A.S., F.R., E.D., R.R., T.H., L.B., J.S., S.D.C., T.M.C.), Duke University School of Medicine, Durham, NC.,Renal Section, Durham VA Health System, NC (M.A.S, S.D.C., T.M.C.)
| | - Fitra Rianto
- From the Division of Nephrology, Department of Medicine (M.A.S., F.R., E.D., R.R., T.H., L.B., J.S., S.D.C., T.M.C.), Duke University School of Medicine, Durham, NC
| | - Edward Diaz
- From the Division of Nephrology, Department of Medicine (M.A.S., F.R., E.D., R.R., T.H., L.B., J.S., S.D.C., T.M.C.), Duke University School of Medicine, Durham, NC
| | - Ritika Revoori
- From the Division of Nephrology, Department of Medicine (M.A.S., F.R., E.D., R.R., T.H., L.B., J.S., S.D.C., T.M.C.), Duke University School of Medicine, Durham, NC
| | - Thien Hoang
- From the Division of Nephrology, Department of Medicine (M.A.S., F.R., E.D., R.R., T.H., L.B., J.S., S.D.C., T.M.C.), Duke University School of Medicine, Durham, NC
| | - Lucas Bouknight
- From the Division of Nephrology, Department of Medicine (M.A.S., F.R., E.D., R.R., T.H., L.B., J.S., S.D.C., T.M.C.), Duke University School of Medicine, Durham, NC
| | - Johannes Stegbauer
- From the Division of Nephrology, Department of Medicine (M.A.S., F.R., E.D., R.R., T.H., L.B., J.S., S.D.C., T.M.C.), Duke University School of Medicine, Durham, NC.,Department of Nephrology, Medical Faculty, University Hospital Düsseldorf, Germany (J.S.)
| | - Anuradha Vivekanandan-Giri
- Division of Nephrology, Department of Medicine, Michigan University Medical Center, Ann Arbor (A.V.-G., S.P.)
| | - Phillip Ruiz
- Department of Surgery and Pathology, University of Miami, FL (P.R.)
| | - Subramaniam Pennathur
- Division of Nephrology, Department of Medicine, Michigan University Medical Center, Ann Arbor (A.V.-G., S.P.)
| | - Dennis M Abraham
- Division of Cardiology, Department of Medicine (D.M.A.), Duke University School of Medicine, Durham, NC
| | - Susan B Gurley
- Division of Nephrology and Hypertension, Department of Medicine, Oregon Health and Sciences University, Portland (S.B.G.)
| | - Steven D Crowley
- From the Division of Nephrology, Department of Medicine (M.A.S., F.R., E.D., R.R., T.H., L.B., J.S., S.D.C., T.M.C.), Duke University School of Medicine, Durham, NC.,Renal Section, Durham VA Health System, NC (M.A.S, S.D.C., T.M.C.)
| | - Thomas M Coffman
- From the Division of Nephrology, Department of Medicine (M.A.S., F.R., E.D., R.R., T.H., L.B., J.S., S.D.C., T.M.C.), Duke University School of Medicine, Durham, NC.,Renal Section, Durham VA Health System, NC (M.A.S, S.D.C., T.M.C.).,Cardiovascular and Metabolic Disorders Research Program, Duke-NUS Medical School, Singapore (T.M.C.)
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23
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Sparks MA, South AM, Badley AD, Baker-Smith CM, Batlle D, Bozkurt B, Cattaneo R, Crowley SD, Dell’Italia LJ, Ford AL, Griendling K, Gurley SB, Kasner SE, Murray JA, Nath KA, Pfeffer MA, Rangaswami J, Taylor WR, Garovic VD. Severe Acute Respiratory Syndrome Coronavirus 2, COVID-19, and the Renin-Angiotensin System: Pressing Needs and Best Research Practices. Hypertension 2020; 76:1350-1367. [PMID: 32981369 PMCID: PMC7685174 DOI: 10.1161/hypertensionaha.120.15948] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is associated with significant morbidity and mortality throughout the world, predominantly due to lung and cardiovascular injury. The virus responsible for COVID-19-severe acute respiratory syndrome coronavirus 2-gains entry into host cells via ACE2 (angiotensin-converting enzyme 2). ACE2 is a primary enzyme within the key counter-regulatory pathway of the renin-angiotensin system (RAS), which acts to oppose the actions of Ang (angiotensin) II by generating Ang-(1-7) to reduce inflammation and fibrosis and mitigate end organ damage. As COVID-19 spans multiple organ systems linked to the cardiovascular system, it is imperative to understand clearly how severe acute respiratory syndrome coronavirus 2 may affect the multifaceted RAS. In addition, recognition of the role of ACE2 and the RAS in COVID-19 has renewed interest in its role in the pathophysiology of cardiovascular disease in general. We provide researchers with a framework of best practices in basic and clinical research to interrogate the RAS using appropriate methodology, especially those who are relatively new to the field. This is crucial, as there are many limitations inherent in investigating the RAS in experimental models and in humans. We discuss sound methodological approaches to quantifying enzyme content and activity (ACE, ACE2), peptides (Ang II, Ang-[1-7]), and receptors (types 1 and 2 Ang II receptors, Mas receptor). Our goal is to ensure appropriate research methodology for investigations of the RAS in patients with severe acute respiratory syndrome coronavirus 2 and COVID-19 to ensure optimal rigor and reproducibility and appropriate interpretation of results from these investigations.
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Affiliation(s)
- Matthew A. Sparks
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, NC
- Renal Section, Durham VA Health Care System, Durham, NC
- American Heart Association, Council on Kidney in Cardiovascular Disease
| | - Andrew M. South
- American Heart Association, Council on Kidney in Cardiovascular Disease
- American Heart Association, Council on Hypertension
- Section of Nephrology, Department of Pediatrics, Brenner Children’s Hospital, Wake Forest School of Medicine, Winston Salem, NC
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC
- Department of Surgery-Hypertension and Vascular Research, Wake Forest School of Medicine, Winston Salem, NC
- Cardiovascular Sciences Center, Wake Forest School of Medicine, Winston Salem, NC
| | - Andrew D. Badley
- Division of Infectious Diseases, Mayo Clinic College of Medicine, Rochester, MN
| | - Carissa M. Baker-Smith
- Director of Preventive Cardiology, Division of Pediatric Cardiology, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
- American Heart Association, Council on Lifelong Congenital Heart Disease and Heart Health in the Young
| | - Daniel Batlle
- Division of Nephrology and Hypertension, Northwestern University Feinberg Medical School, Chicago, IL
- American Heart Association, Council on Hypertension
| | - Biykem Bozkurt
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, Houston, TX
- Michael E. DeBakey VA Medical Center, Houston, TX
- American Heart Association, Council on Clinical Cardiology
| | - Roberto Cattaneo
- Department of Molecular Medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Steven D. Crowley
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, NC
- Renal Section, Durham VA Health Care System, Durham, NC
- American Heart Association, Council on Kidney in Cardiovascular Disease
| | - Louis J. Dell’Italia
- Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL
- Department of Veterans Affairs Medical Center, Birmingham, AL
- American Heart Association, Council on Basic Cardiovascular Sciences
| | - Andria L. Ford
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO
- American Heart Association, Stroke Council
| | - Kathy Griendling
- American Heart Association, Council on Basic Cardiovascular Sciences
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA
| | - Susan B. Gurley
- American Heart Association, Council on Kidney in Cardiovascular Disease
- Department of Medicine, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, OR
| | - Scott E. Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
- American Heart Association, Stroke Council
| | - Joseph A. Murray
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN
| | - Karl A. Nath
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN
| | - Marc A. Pfeffer
- American Heart Association, Council on Clinical Cardiology
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Janani Rangaswami
- American Heart Association, Council on Kidney in Cardiovascular Disease
- Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, PA
- Sidney Kimmel College of Thomas Jefferson University, Philadelphia, PA
| | - W. Robert Taylor
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA
- American Heart Association, Council on Arteriosclerosis, Thrombosis and Vascular Biology
| | - Vesna D. Garovic
- American Heart Association, Council on Hypertension
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN
- Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN
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24
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Tang TT, Wang B, Wu M, Li ZL, Feng Y, Cao JY, Yin D, Liu H, Tang RN, Crowley SD, Lv LL, Liu BC. Extracellular vesicle-encapsulated IL-10 as novel nanotherapeutics against ischemic AKI. Sci Adv 2020; 6:eaaz0748. [PMID: 32851154 PMCID: PMC7423360 DOI: 10.1126/sciadv.aaz0748] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 06/26/2020] [Indexed: 05/07/2023]
Abstract
Recently, extracellular vesicles (EVs) have been attracting strong research interest for use as natural drug delivery systems. We report an approach to manufacturing interleukin-10 (IL-10)-loaded EVs (IL-10+ EVs) by engineering macrophages for treating ischemic acute kidney injury (AKI). Delivery of IL-10 via EVs enhanced not only the stability of IL-10, but also its targeting to the kidney due to the adhesive components on the EV surface. Treatment with IL-10+ EVs significantly ameliorated renal tubular injury and inflammation caused by ischemia/reperfusion injury, and potently prevented the transition to chronic kidney disease. Mechanistically, IL-10+ EVs targeted tubular epithelial cells, and suppressed mammalian target of rapamycin signaling, thereby promoting mitophagy to maintain mitochondrial fitness. Moreover, IL-10+ EVs efficiently drove M2 macrophage polarization by targeting macrophages in the tubulointerstitium. Our study demonstrates that EVs can serve as a promising delivery platform to manipulate IL-10 for the effective treatment of ischemic AKI.
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Affiliation(s)
- Tao-Tao Tang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Bin Wang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Min Wu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Zuo-Lin Li
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Ye Feng
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Jing-Yuan Cao
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Di Yin
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Hong Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Ri-Ning Tang
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Steven D. Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC, USA
| | - Lin-Li Lv
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
- Corresponding author. (B.-C.L.); (L.-L.L.)
| | - Bi-Cheng Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
- Corresponding author. (B.-C.L.); (L.-L.L.)
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25
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Ide S, Yahara Y, Kobayashi Y, Strausser SA, Ide K, Watwe A, Xu-Vanpala S, Privratsky JR, Crowley SD, Shinohara ML, Alman BA, Souma T. Yolk-sac-derived macrophages progressively expand in the mouse kidney with age. eLife 2020; 9:51756. [PMID: 32301704 PMCID: PMC7205460 DOI: 10.7554/elife.51756] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 04/16/2020] [Indexed: 12/15/2022] Open
Abstract
Renal macrophages represent a highly heterogeneous and specialized population of myeloid cells with mixed developmental origins from the yolk-sac and hematopoietic stem cells (HSC). They promote both injury and repair by regulating inflammation, angiogenesis, and tissue remodeling. Recent reports highlight differential roles for ontogenically distinct renal macrophage populations in disease. However, little is known about how these populations change over time in normal, uninjured kidneys. Prior reports demonstrated a high proportion of HSC-derived macrophages in the young adult kidney. Unexpectedly, using genetic fate-mapping and parabiosis studies, we found that yolk-sac-derived macrophages progressively expand in number with age and become a major contributor to the renal macrophage population in older mice. This chronological shift in macrophage composition involves local cellular proliferation and recruitment from circulating progenitors and may contribute to the distinct immune responses, limited reparative capacity, and increased disease susceptibility of kidneys in the elderly population. Older people are more likely to develop kidney disease, which increases their risk of having other conditions such as a heart attack or stroke and, in some cases, can lead to their death. Older kidneys are less able to repair themselves after an injury, which may help explain why aging contributes to kidney disease. Another possibility is that older kidneys are more susceptible to excessive inflammation. Learning more about the processes that lead to kidney inflammation in older people might lead to better ways to prevent or treat their kidney disease. Immune cells called macrophages help protect the body from injury and disease. They do this by triggering inflammation, which aides healing. Too much inflammation can be harmful though, making macrophages a prime suspect in age-related kidney harm. Studying these immune cells in the kidney and how they change over the lifespan could help scientists to better understand age-related kidney disease. Now, Ide, Yahara et al. show that one type of macrophage is better at multiplying in older kidneys. In the experiments, mice were genetically engineered to make a fluorescent red protein in one kind of macrophage. This allowed Ide, Yahara et al. to track these immune cells as the mice aged. The experiments showed that this subgroup of cells is first produced when the mice are embryos. They stay in the mouse kidneys into adulthood, and are so prolific that, over time, they eventually become the most common macrophage in older kidneys. The fact that one type of embryonically derived macrophage takes over with age may explain the increased inflammation and reduced repair capacity seen in aging kidneys. More studies will help scientists to understand how these particular cells contribute to age-related changes in susceptibility to kidney disease.
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Affiliation(s)
- Shintaro Ide
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States.,Regeneration Next, Duke University, Durham, United States
| | - Yasuhito Yahara
- Regeneration Next, Duke University, Durham, United States.,Department of Orthopedic Surgery, Duke University School of Medicine, Durham, United States.,Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yoshihiko Kobayashi
- Department of Cell Biology, Duke University School of Medicine, Durham, United States
| | - Sarah A Strausser
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Kana Ide
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Anisha Watwe
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Shengjie Xu-Vanpala
- Department of Immunology, Duke University School of Medicine, Durham, United States
| | - Jamie R Privratsky
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States
| | - Mari L Shinohara
- Department of Immunology, Duke University School of Medicine, Durham, United States.,Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, United States
| | - Benjamin A Alman
- Regeneration Next, Duke University, Durham, United States.,Department of Orthopedic Surgery, Duke University School of Medicine, Durham, United States
| | - Tomokazu Souma
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, United States.,Regeneration Next, Duke University, Durham, United States
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26
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Ren J, Crowley SD. A complex role for Bcl10 in kidney injury. Cardiovasc Res 2020; 116:882-884. [PMID: 31808815 PMCID: PMC7098544 DOI: 10.1093/cvr/cvz320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jiafa Ren
- Division of Nephrology, Department of Medicine, Duke University and Durham Veterans Affairs Medical Centers, Box 103015 DUMC, Durham, NC 27710, USA
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham Veterans Affairs Medical Centers, Box 103015 DUMC, Durham, NC 27710, USA
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27
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Wen Y, Crowley SD. Connecting cytokines and cellular signals in the nephron during CKD and hypertension. Kidney Int 2020; 97:651-653. [PMID: 32200858 DOI: 10.1016/j.kint.2020.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 10/24/2022]
Abstract
Chronic kidney disease features chronic inflammation and fibrosis, both of which contribute to and are exacerbated by arterial hypertension. The contribution of immune responses to renal sodium retention has received intense scrutiny. In this regard, the article by Furusho et al. details a mechanism wherein intrarenal TNFα augments salt-sensitive hypertension during CKD via activation of the WNK1-SPAKNCC phosphorylation cascade.
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Affiliation(s)
- Yi Wen
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina, USA; Department of Medicine, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina, USA; Department of Medicine, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.
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28
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Wen Y, Rudemiller NP, Zhang J, Lu X, Ren J, Privratsky JR, Griffiths R, Zhang JJ, Hammer GE, Crowley SD. C-C Motif Chemokine Receptor 7 Exacerbates Hypertension Through Effects on T Lymphocyte Trafficking. Hypertension 2020; 75:869-876. [PMID: 31983306 DOI: 10.1161/hypertensionaha.119.14148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Activated T lymphocytes that infiltrate blood pressure control organs make a critical contribution to the pathogenesis of hypertension. Dendritic cells act as potent antigen-presenting cells to stimulate prohypertensive T cells. However, the mechanisms that facilitate the recruitment of prohypertensive T cells and dendritic cells into the kidney's draining lymph node during hypertension require elucidation. As CCR7 (C-C motif chemokine receptor type 7) directs the homing of lymphocytes and dendritic cells into lymph nodes, we posited that dendritic cell-mediated T lymphocyte stimulation in the renal lymph node is CCR7 dependent and required for a full hypertensive response. We found that CCR7-deficient (CCR7 KO) mice had a blunted hypertensive response in our model of chronic Ang II (angiotensin II) infusion. Ang II-infused CCR7 KO animals had exaggerated accumulation of CD8+ T cells in the kidney but reduced numbers of CD4+ and CD8+ T cells in the kidney's draining lymph node. To understand whether CCR7-dependent homing of T lymphocytes or dendritic cells into the lymph node regulates the hypertensive response, we injected CCR7 KO or wild-type T cells or dendritic cells into CCR7 KO recipients, neither of which restored the full hypertensive response to Ang II infusion. However, adoptive transfer of wild-type but not CCR7 KO T lymphocytes into RAG1 (recombination-activating gene 1)-deficient mice that lack a lymphocyte niche restored full blood pressure elevation during Ang II infusion. Thus, CCR7-dependent interactions between T lymphocytes and dendritic cells are essential for T lymphocyte stimulation and hypertension accruing from inappropriate activation of the renin-angiotensin system.
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Affiliation(s)
- Yi Wen
- From the Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Center, NC (Y.W., N.P.R., J.Z., X.L., J.R., R.G., S.D.C.)
| | - Nathan P Rudemiller
- From the Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Center, NC (Y.W., N.P.R., J.Z., X.L., J.R., R.G., S.D.C.)
| | - Jiandong Zhang
- From the Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Center, NC (Y.W., N.P.R., J.Z., X.L., J.R., R.G., S.D.C.)
| | - Xiaohan Lu
- From the Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Center, NC (Y.W., N.P.R., J.Z., X.L., J.R., R.G., S.D.C.)
| | - Jiafa Ren
- From the Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Center, NC (Y.W., N.P.R., J.Z., X.L., J.R., R.G., S.D.C.)
| | - Jamie R Privratsky
- Departments of Anesthesiology (J.R.P.), Duke University Medical Center, Durham, NC
| | - Robert Griffiths
- From the Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Center, NC (Y.W., N.P.R., J.Z., X.L., J.R., R.G., S.D.C.)
| | - Junyi J Zhang
- Immunology (J.J.Z., G.H.), Duke University Medical Center, Durham, NC
| | - Gianna E Hammer
- Immunology (J.J.Z., G.H.), Duke University Medical Center, Durham, NC.,Molecular Genetics and Microbiology (G.H.), Duke University Medical Center, Durham, NC
| | - Steven D Crowley
- From the Division of Nephrology, Department of Medicine, Durham VA and Duke University Medical Center, NC (Y.W., N.P.R., J.Z., X.L., J.R., R.G., S.D.C.)
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Abstract
Background Twist1 is a basic helix-loop-helix domain containing transcription factor that regulates cell differentiation, migration, proliferation, survival, and inflammatory responses by transcriptionally regulating a wide range of downstream target genes. Its homologous protein, Twist2, shares many structural and functional similarities with Twist1. Summary Accumulating evidence from both preclinical and clinical studies suggests that Twist1 is a pivotal regulator of several forms of renal disease. Twist1 is persistently activated following renal insults, particularly in chronic kidney diseases, and contributes to the renal inflammatory responses, tubular cell transformation programs, and possibly fibroblast activation, all of which are involved in the initiation and progression of kidney diseases. Key Message This review will specifically focus on Twist1 and outline our understanding of its functions in kidney disorders along with the introduction of Twist2 where pertinent. The thorough knowledge of Twist1's actions in the pathogenesis of kidney diseases should facilitate the development of novel therapeutics for kidney injury.
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Affiliation(s)
- Jiafa Ren
- Division of Nephrology, Department of Medicine, Duke University and Durham Veterans Affairs Medical Centers, Durham, North Carolina, USA
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham Veterans Affairs Medical Centers, Durham, North Carolina, USA
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30
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Wen Y, Rudemiller NP, Zhang J, Robinette T, Lu X, Ren J, Privratsky JR, Nedospasov SA, Crowley SD. TNF-α in T lymphocytes attenuates renal injury and fibrosis during nephrotoxic nephritis. Am J Physiol Renal Physiol 2020; 318:F107-F116. [PMID: 31736350 PMCID: PMC6985827 DOI: 10.1152/ajprenal.00347.2019] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/11/2019] [Accepted: 11/14/2019] [Indexed: 02/08/2023] Open
Abstract
Nephrotoxic serum nephritis (NTN) models immune-mediated human glomerulonephritis and culminates in kidney inflammation and fibrosis, a process regulated by T lymphocytes. TNF-α is a key proinflammatory cytokine that contributes to diverse forms of renal injury. Therefore, we posited that TNF-α from T lymphocytes may contribute to NTN pathogenesis. Here, mice with T cell-specific deletion of TNF-α (TNF TKO) and wild-type (WT) control mice were subjected to the NTN model. At 14 days after NTN, kidney injury and fibrosis were increased in kidneys from TNF TKO mice compared with WT mice. PD1+CD4+ T cell numbers and mRNA levels of IL-17A were elevated in NTN kidneys of TNF TKO mice, suggesting that augmented local T helper 17 lymphocyte responses in the TNF TKO kidney may exaggerate renal injury and fibrosis. In turn, we found increased accumulation of neutrophils in TNF TKO kidneys during NTN. We conclude that TNF-α production in T lymphocytes mitigates NTN-induced kidney injury and fibrosis by inhibiting renal T helper 17 lymphocyte responses and infiltration of neutrophils.
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Affiliation(s)
- Yi Wen
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Nathan P Rudemiller
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Jiandong Zhang
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Taylor Robinette
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Xiaohan Lu
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Jiafa Ren
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Jamie R Privratsky
- Department of Anesthesiology, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
| | - Sergei A Nedospasov
- Laboratory of Molecular Immunology, Engelhardt Institute of Molecular Biology and Lomonosov Moscow State University, Moscow, Russia
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Center, Durham, North Carolina
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31
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Lu X, Rudemiller NP, Privratsky JR, Ren J, Wen Y, Griffiths R, Crowley SD. Classical Dendritic Cells Mediate Hypertension by Promoting Renal Oxidative Stress and Fluid Retention. Hypertension 2019; 75:131-138. [PMID: 31786985 DOI: 10.1161/hypertensionaha.119.13667] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
FLT3L (Fms-like tyrosine kinase 3 ligand) stimulates the development of classical dendritic cells (DCs). Here we tested the hypothesis that classical DCs drive blood pressure elevation by promoting renal fluid retention. FLT3L-deficient (FLT3L-/-) mice that lack classical DCs in the kidney had mean arterial pressures similar to wild-types (WTs) at baseline but had blunted hypertensive responses during 4 weeks of chronic Ang II (angiotensin II) infusion. In FLT3L-/- mice, the proportions of effector memory T cells in the kidney were similar to those in WTs at baseline. However, after Ang II infusion, proportions of effector memory T cells were dramatically lower in the FLT3L-/- kidneys versus WTs, indicating that classical DCs augment the renal accumulation of effector T cells after renin-angiotensin system activation. Consistent with their lower blood pressures, the Ang II-infused FLT3L-/- mice had attenuated cardiac hypertrophy and lower renal mRNA expression for pro-hypertensive cytokines. Moreover, the Ang II-infused FLT3L-/- mice had lower urinary excretion of the oxidative stress marker 8-isoprostane and lower renal mRNA levels of nicotinamide adenine dinucleotide phosphate oxidase 2. In an intraperitoneal saline challenge test at day 7 of Ang II, FLT3L-/- mice excreted higher proportions of the injected volume and sodium than WTs. Consistent with this enhanced diuresis, mRNA expressions for the sodium chloride cotransporter and all 3 subunits of the epithelial sodium channel were diminished by >40% in FLT3L-/- kidneys compared with the WTs. Thus, classical FLT3L-dependent DCs promote renal T-cell activation with consequent oxidative stress, fluid retention, and blood pressure elevation.
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Affiliation(s)
- Xiaohan Lu
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., J.R.P., J.R., Y.W., R.G., S.D.C.)
| | - Nathan P Rudemiller
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., J.R.P., J.R., Y.W., R.G., S.D.C.)
| | - Jamie R Privratsky
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., J.R.P., J.R., Y.W., R.G., S.D.C.)
| | - Jiafa Ren
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., J.R.P., J.R., Y.W., R.G., S.D.C.)
| | - Yi Wen
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., J.R.P., J.R., Y.W., R.G., S.D.C.)
| | - Robert Griffiths
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., J.R.P., J.R., Y.W., R.G., S.D.C.)
| | - Steven D Crowley
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., J.R.P., J.R., Y.W., R.G., S.D.C.).,Department of Immunology, Duke University School of Medicine, Durham, NC (S.D.C.)
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32
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Lerman LO, Kurtz TW, Touyz RM, Ellison DH, Chade AR, Crowley SD, Mattson DL, Mullins JJ, Osborn J, Eirin A, Reckelhoff JF, Iadecola C, Coffman TM. Animal Models of Hypertension: A Scientific Statement From the American Heart Association. Hypertension 2019; 73:e87-e120. [PMID: 30866654 DOI: 10.1161/hyp.0000000000000090] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hypertension is the most common chronic disease in the world, yet the precise cause of elevated blood pressure often cannot be determined. Animal models have been useful for unraveling the pathogenesis of hypertension and for testing novel therapeutic strategies. The utility of animal models for improving the understanding of the pathogenesis, prevention, and treatment of hypertension and its comorbidities depends on their validity for representing human forms of hypertension, including responses to therapy, and on the quality of studies in those models (such as reproducibility and experimental design). Important unmet needs in this field include the development of models that mimic the discrete hypertensive syndromes that now populate the clinic, resolution of ongoing controversies in the pathogenesis of hypertension, and the development of new avenues for preventing and treating hypertension and its complications. Animal models may indeed be useful for addressing these unmet needs.
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33
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Zhang L, Wu JH, Huang TQ, Nepliouev I, Brian L, Zhang Z, Wertman V, Rudemiller NP, McMahon TJ, Shenoy SK, Miller FJ, Crowley SD, Freedman NJ, Stiber JA. Drebrin regulates angiotensin II-induced aortic remodelling. Cardiovasc Res 2019; 114:1806-1815. [PMID: 29931051 DOI: 10.1093/cvr/cvy151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 06/14/2018] [Indexed: 01/07/2023] Open
Abstract
Aims The actin-binding protein Drebrin is up-regulated in response to arterial injury and reduces smooth muscle cell (SMC) migration and proliferation through its interaction with the actin cytoskeleton. We, therefore, tested the hypothesis that SMC Drebrin inhibits angiotensin II-induced remodelling of the proximal aorta. Methods and results Angiotensin II was administered via osmotic minipumps at 1000 ng/kg/min continuously for 28 days in SM22-Cre+/Dbnflox/flox (SMC-Dbn-/-) and control mice. Blood pressure responses to angiotensin II were assessed by telemetry. After angiotensin II infusion, we assessed remodelling in the proximal ascending aorta by echocardiography and planimetry of histological cross sections. Although the degree of hypertension was equivalent in SMC-Dbn-/- and control mice, SMC-Dbn-/- mice nonetheless exhibited 60% more proximal aortic medial thickening and two-fold more outward aortic remodelling than control mice in response to angiotensin II. Proximal aortas demonstrated greater cellular proliferation and matrix deposition in SMC-Dbn-/- mice than in control mice, as evidenced by a higher prevalence of proliferating cell nuclear antigen-positive nuclei and higher levels of collagen I. Compared with control mouse aortas, SMC-Dbn-/- aortas demonstrated greater angiotensin II-induced NADPH oxidase activation and inflammation, evidenced by higher levels of Ser-536-phosphorylated NFκB p65 subunits and higher levels of vascular cell adhesion molecule-1, matrix metalloproteinase-9, and adventitial macrophages. Conclusions We conclude that SMC Drebrin deficiency augments angiotensin II-induced inflammation and adverse aortic remodelling.
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Affiliation(s)
- Lisheng Zhang
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Jiao-Hui Wu
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Tai-Qin Huang
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Igor Nepliouev
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Leigh Brian
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Zhushan Zhang
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Virginia Wertman
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Nathan P Rudemiller
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Timothy J McMahon
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Sudha K Shenoy
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Francis J Miller
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Steven D Crowley
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Neil J Freedman
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
| | - Jonathan A Stiber
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC, USA
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34
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Lu X, Rudemiller NP, Wen Y, Ren J, Hammer GE, Griffiths R, Privratsky JR, Yang B, Sparks MA, Crowley SD. A20 in Myeloid Cells Protects Against Hypertension by Inhibiting Dendritic Cell-Mediated T-Cell Activation. Circ Res 2019; 125:1055-1066. [PMID: 31630621 DOI: 10.1161/circresaha.119.315343] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
RATIONALE The ubiquitin-editing protein A20 in dendritic cells (DCs) suppresses NF-κB (nuclear factor-κB) signaling and constrains DC-mediated T-cell stimulation, but the role of A20 in modulating the hypertensive response requires elucidation. OBJECTIVE Here, we tested the hypothesis that A20 in CD11c-expressing myeloid cells mitigates Ang II (angiotensin II)-induced hypertension by limiting renal T-cell activation. METHODS AND RESULTS Mice with heterozygous deletion of A20 in CD11c-expressing myeloid cells (DC ACT[Cd11c-Cre+ A20flox/wt]) have spontaneous DC activation but have normal baseline blood pressures. In response to low-dose chronic Ang II infusion, DC ACT mice compared with WT (wild type) controls had an exaggerated hypertensive response and augmented proportions of CD62LloCD44hi effector memory T lymphocytes in the kidney lymph node. After 10 days of Ang II, DC ACT kidneys had increased numbers of memory effector CD8+, but not CD4+ T cells, compared with WTs. Moreover, the expressions of TNF-α (tumor necrosis factor-α) and IFN-γ (interferon-γ) were upregulated in the DC ACT renal CD8+ T cells but not CD4+ T cells. Saline challenge testing revealed enhanced renal fluid retention in the DC ACT mice. DC ACT kidneys showed augmented protein expression of γ-epithelial sodium channel and NHE3 (sodium-hydrogen antiporter 3). DC ACT mice also had greater reductions in renal blood flow following acute injections with Ang II and enhanced oxidant stress in the vasculature as evidenced by higher circulating levels of malondialdehyde compared with WT controls. To directly test whether enhanced T-cell activation in the DC ACT cohort was responsible for their exaggerated hypertensive response, we chronically infused Ang II into lymphocyte-deficient DC ACT Rag1 (recombination activating protein 1)-deficient (Rag1-/-) mice and WT (Cd11c-Cre- A20flox/wt) Rag1-/- controls. The difference in blood pressure elevation accruing from DC activation was abrogated on the Rag1-/- strain. CONCLUSIONS Following stimulation of the renin-angiotensin system, A20 suppresses DC activation and thereby mitigates T-cell-dependent blood pressure elevation.
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Affiliation(s)
- Xiaohan Lu
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., Y.W., J.R., R.G., J.R.P., B.Y., M.A.S., S.D.C.)
| | - Nathan P Rudemiller
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., Y.W., J.R., R.G., J.R.P., B.Y., M.A.S., S.D.C.)
| | - Yi Wen
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., Y.W., J.R., R.G., J.R.P., B.Y., M.A.S., S.D.C.)
| | - Jiafa Ren
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., Y.W., J.R., R.G., J.R.P., B.Y., M.A.S., S.D.C.)
| | - Gianna E Hammer
- Department of Immunology, Duke University School of Medicine, Durham, NC (G.E.H.).,Department of Molecular Genetics and Microbiology, Durham, NC (G.E.H.)
| | - Robert Griffiths
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., Y.W., J.R., R.G., J.R.P., B.Y., M.A.S., S.D.C.)
| | - Jamie R Privratsky
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., Y.W., J.R., R.G., J.R.P., B.Y., M.A.S., S.D.C.)
| | - Bo Yang
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., Y.W., J.R., R.G., J.R.P., B.Y., M.A.S., S.D.C.)
| | - Matthew A Sparks
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., Y.W., J.R., R.G., J.R.P., B.Y., M.A.S., S.D.C.)
| | - Steven D Crowley
- From the Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, NC (X.L., N.P.R., Y.W., J.R., R.G., J.R.P., B.Y., M.A.S., S.D.C.)
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35
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Ren J, Zhang J, Rudemiller NP, Griffiths R, Wen Y, Lu X, Privratsky JR, Gunn MD, Crowley SD. Twist1 in Infiltrating Macrophages Attenuates Kidney Fibrosis via Matrix Metallopeptidase 13-Mediated Matrix Degradation. J Am Soc Nephrol 2019; 30:1674-1685. [PMID: 31315922 PMCID: PMC6727252 DOI: 10.1681/asn.2018121253] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/18/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Following an acute insult, macrophages regulate renal fibrogenesis through the release of various factors that either encourage the synthesis of extracellular matrix synthesis or the degradation of matrix via endocytosis, proteolysis, or both. However, the roles of infiltrating versus resident myeloid cells in these opposing processes require elucidation. The transcription factor Twist1 controls diverse essential cellular functions through induction of several downstream targets, including matrix metalloproteinases (MMPs). In macrophages, Twist1 can influence patterns of cytokine generation, but the role of macrophage Twist1 in renal fibrogenesis remains undefined. METHODS To study Twist1 functions in different macrophage subsets during kidney scar formation, we used two conditional mutant mouse models in which Twist1 was selectively ablated either in infiltrating, inflammatory macrophages or in resident tissue macrophages. We assessed fibrosis-related parameters, matrix metallopeptidase 13 (MMP13, or collagen 3, which catalyzes collagen degradation), inflammatory cytokines, and other factors in these Twist1-deficient mice compared with wild-type controls after subjecting the animals to unilateral ureteral obstruction. We also treated wild-type and Twist1-deficient mice with an MMP13 inhibitor after unilateral ureteral obstruction. RESULTS Twist1 in infiltrating inflammatory macrophages but not in resident macrophages limited kidney fibrosis after ureteral obstruction by driving extracellular matrix degradation. Moreover, deletion of Twist1 in infiltrating macrophages attenuated the expression of MMP13 in CD11b+Ly6Clo myeloid cells. Inhibition of MMP13 abrogated the protection from renal fibrosis afforded by macrophage Twist1. CONCLUSIONS Twist1 in infiltrating myeloid cells mitigates interstitial matrix accumulation in the injured kidney by promoting MMP13 production, which drives extracellular matrix degradation. These data highlight the complex cell-specific actions of Twist1 in the pathogenesis of kidney fibrosis.
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Affiliation(s)
- Jiafa Ren
- Divisions of Nephrology and
- Departments of Medicine and
| | | | | | | | - Yi Wen
- Divisions of Nephrology and
- Departments of Medicine and
| | - Xiaohan Lu
- Divisions of Nephrology and
- Departments of Medicine and
| | - Jamie R Privratsky
- Anesthesiology, Durham VA and Duke University Medical Centers, Durham, North Carolina
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36
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Lu X, Rudemiller N, Privratsky J, Ren J, Wen Y, Griffiths R, Gunn MD, Crowley SD. Abstract P110: Classical Dendritic Cells Mediate Hypertension by Promoting Oxidative Stress and Renal Fluid Retention. Hypertension 2019. [DOI: 10.1161/hyp.74.suppl_1.p110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dendritic cells (DCs) promote hypertension via the activation of T cells, but the specific DC subtypes that mediate hypertension require elucidation. We previously found that Fms-like tyrosine kinase 3 ligand-deficient (FLT3L
-/-
) mice that lack classical CD11c
hi
MHCII
hi
DCs have blunted renal accumulation of effector T cells vs wild-type (WT) mice during chronic angiotensin (Ang) II infusion (500ng/kg/min). In the current studies, we tested the hypothesis that classical DCs drive blood pressure elevation by promoting renal fluid and sodium retention. We found that FLT3L
-/-
mice had mean arterial pressures (MAPs) similar to WTs at baseline but had blunted hypertensive responses measured by radiotelemetry during 4 weeks of chronic Ang II infusion (166±2 vs.178±4 mmHg,
p
<0.02). Consistent with their lower blood pressures, the Ang II-infused FLT3L
-/-
mice had attenuated cardiac hypertrophy (6.7±0.1 vs. 7.8±0.4 mg/g body weight,
p
<0.01) and reduced renal mRNA expression for the pro-hypertensive cytokines IL-1β (0.4±0.1 vs. 1.0±0.2; p<0.02) and TNF-α (0.6±0.1 vs. 1.0±0.1; p<0.02). The Ang II-infused FLT3L
-/-
mice had lower urinary excretion of the oxidative stress marker 8-isoprostane (1403±158 vs. 2257±372 pg/24 hours; p<0.04). To examine the effects of classical DCs on renal fluid retention after 7 days of Ang II, we performed an IP saline challenge test. FLT3L
-/-
mice excreted higher proportions of the injected volume (69±7 vs. 49±5%; p<0.04) and sodium (54±7 vs. 38±4%; p=0.07) compared to WTs. Consistent with this enhanced diuresis, mRNA expression for the NCC sodium transporter and all 3 subunits of ENaC were diminished by > 40% (0.4 of 1) in FLT3L
-/-
kidneys compared to the WTs during hypertension. Thus, classical FLT3L
+
DCs promote renal T cell activation with consequent oxidative stress, fluid retention, and blood pressure elevation.
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Yang B, Fu L, Privratsky JR, Lu X, Ren J, Mei C, Crowley SD. Interleukin-1 receptor activation aggravates autosomal dominant polycystic kidney disease by modulating regulated necrosis. Am J Physiol Renal Physiol 2019; 317:F221-F228. [PMID: 31141402 PMCID: PMC6732457 DOI: 10.1152/ajprenal.00104.2019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 01/08/2023] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is associated with increased chemokines, cytokines, and growth factors in the diseased kidney. We found that both isoforms of IL-1, IL-1α and IL-1β, were upregulated in ADPKD tissues. Here, we used a unique murine ADPKD model with selective deletion of polycystin-1 (pkd1) in the kidney (KPKD1) to study the role of IL-1 signaling in ADPKD progression. In KPKD mice, genetic deletion of the IL-1 receptor [IL-1 receptor (IL-1R) knockout (KO)] prolongs survival and attenuates cyst volume. Compared with IL-1R wild-type KPKD1 kidneys, IL-1R KO KPKD1 kidneys have upregulated TNF-α gene expression, with consequent elevations in markers for TNF-dependent regulated necrosis. We further observed that regulated necrosis was increased in ADPKD tissues from both humans and mice. To confirm that enhanced necroptosis is protective in ADPKD, we treated KPKD1 mice with an inhibitor of regulated necrosis (Nec-1). Regulated necrosis suppression augments kidney weights, suggesting that regulated necrosis is required to limit kidney growth in ADPKD. Thus, IL-1R activation drives ADPKD progression by paradoxically limiting regulated necrosis.
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Affiliation(s)
- Bo Yang
- Division of Nephrology, Kidney Institution of Chinese People's Liberation Army, Changzheng Hospital , Shanghai , China
- Division of Nephrology, Department of Medicine, Duke University School of Medicine , Durham, North Carolina
| | - Lili Fu
- Division of Nephrology, Kidney Institution of Chinese People's Liberation Army, Changzheng Hospital , Shanghai , China
| | - Jamie R Privratsky
- Department of Anesthesiology, Department of Medicine, Duke University School of Medicine , Durham, North Carolina
| | - Xiaohan Lu
- Division of Nephrology, Department of Medicine, Duke University School of Medicine , Durham, North Carolina
| | - Jiafa Ren
- Division of Nephrology, Department of Medicine, Duke University School of Medicine , Durham, North Carolina
| | - Changlin Mei
- Division of Nephrology, Kidney Institution of Chinese People's Liberation Army, Changzheng Hospital , Shanghai , China
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University School of Medicine , Durham, North Carolina
- Durham Veterans Affairs Medical Center , Durham, North Carolina
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38
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Lu X, Rudemiller NP, Ren J, Wen Y, Yang B, Griffiths R, Privratsky JR, Madan B, Virshup DM, Crowley SD. Opposing actions of renal tubular- and myeloid-derived porcupine in obstruction-induced kidney fibrosis. Kidney Int 2019; 96:1308-1319. [PMID: 31585741 DOI: 10.1016/j.kint.2019.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/03/2019] [Accepted: 06/20/2019] [Indexed: 02/06/2023]
Abstract
Wnt/β-catenin signaling is essential in the pathogenesis of renal fibrosis. We previously reported inhibition of the Wnt O-acyl transferase porcupine, required for Wnt secretion, dramatically attenuates kidney fibrosis in the murine unilateral ureteral obstruction model. Here, we investigated the tissue-specific contributions of porcupine to renal fibrosis and inflammation in ureteral obstruction using mice with porcupine deletion restricted to the kidney tubular epithelium or infiltrating myeloid cells. Obstruction of the ureter induced the renal mRNA expression of porcupine and downstream targets, β-catenin, T-cell factor, and lymphoid enhancer factor in wild type mice. Renal tubular specific deficiency of porcupine reduced the expression of collagen I and other fibrosis markers in the obstructed kidney. Moreover, kidneys from obstructed mice with tubule-specific porcupine deficiency had reduced macrophage accumulation with attenuated expression of myeloid cytokine and chemokine mRNA. In co-culture with activated macrophages, renal tubular cells from tubular-specific porcupine knockout mice had blunted induction of fibrosis mediators compared with wild type renal tubular cells. In contrast, macrophages from macrophage-specific porcupine deficient mice in co-culture with wild type renal tubular cells had markedly enhanced expression of pro-fibrotic cytokines compared to wild type macrophages. Consequently, porcupine deletion specifically within macrophages augmented renal scar formation following ureteral obstruction. Thus, our experiments suggest a benefit of interrupting Wnt secretion specifically within the kidney epithelium while preserving Wnt O-acylation in infiltrating myeloid cells during renal fibrogenesis.
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Affiliation(s)
- Xiaohan Lu
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Nathan P Rudemiller
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Jiafa Ren
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Yi Wen
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Bo Yang
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Robert Griffiths
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Jamie R Privratsky
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Babita Madan
- Program in Cancer and Stem Cell Biology, Duke-National University of Singapore Graduate Medical School, Singapore
| | - David M Virshup
- Program in Cancer and Stem Cell Biology, Duke-National University of Singapore Graduate Medical School, Singapore; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Steven D Crowley
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.
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39
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Wen Y, Lu X, Ren J, Privratsky JR, Yang B, Rudemiller NP, Zhang J, Griffiths R, Jain MK, Nedospasov SA, Liu BC, Crowley SD. KLF4 in Macrophages Attenuates TNF α-Mediated Kidney Injury and Fibrosis. J Am Soc Nephrol 2019; 30:1925-1938. [PMID: 31337692 DOI: 10.1681/asn.2019020111] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/20/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Polarized macrophage populations can orchestrate both inflammation of the kidney and tissue repair during CKD. Proinflammatory M1 macrophages initiate kidney injury, but mechanisms through which persistent M1-dependent kidney damage culminates in fibrosis require elucidation. Krüppel-like factor 4 (KLF4), a zinc-finger transcription factor that suppresses inflammatory signals, is an essential regulator of macrophage polarization in adipose tissues, but the effect of myeloid KLF4 on CKD progression is unknown. METHODS We used conditional mutant mice lacking KLF4 or TNFα (KLF4's downstream effector) selectively in myeloid cells to investigate macrophage KLF4's role in modulating CKD progression in two models of CKD that feature robust macrophage accumulation, nephrotoxic serum nephritis, and unilateral ureteral obstruction. RESULTS In these murine CKD models, KLF4 deficiency in macrophages infiltrating the kidney augmented their M1 polarization and exacerbated glomerular matrix deposition and tubular epithelial damage. During the induced injury in these models, macrophage-specific KLF4 deletion also exacerbated kidney fibrosis, with increased levels of collagen 1 and α-smooth muscle actin in the injured kidney. CD11b+Ly6Chi myeloid cells isolated from injured kidneys expressed higher levels of TNFα mRNA versus wild-type controls. In turn, mice bearing macrophage-specific deletion of TNFα exhibited decreased glomerular and tubular damage and attenuated kidney fibrosis in the models. Moreover, treatment with the TNF receptor-1 inhibitor R-7050 during nephrotoxic serum nephritis reduced damage, fibrosis, and necroptosis in wild-type mice and mice with KLF4-deficient macrophages, and abrogated the differences between the two groups in these parameters. CONCLUSIONS These data indicate that macrophage KLF4 ameliorates CKD by mitigating TNF-dependent injury and fibrosis.
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Affiliation(s)
- Yi Wen
- Division of Nephrology.,Departments of Medicine and
| | - Xiaohan Lu
- Division of Nephrology.,Departments of Medicine and
| | - Jiafa Ren
- Division of Nephrology.,Departments of Medicine and
| | - Jamie R Privratsky
- Anesthesiology, Durham VA and Duke University Medical Center, Durham, North Carolina
| | - Bo Yang
- Division of Nephrology.,Departments of Medicine and
| | | | | | | | - Mukesh K Jain
- Department of Medicine, Case Cardiovascular Research Institute, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Sergei A Nedospasov
- Laboratory of Molecular Immunology, Engelhardt Institute of Molecular Biology, Lomonosov Moscow State University, Moscow, Russia; and
| | - Bi Cheng Liu
- Institute of Nephrology, Zhongda Hospital, Southeast University, Nanjing, China
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40
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Tang TT, Lv LL, Wang B, Cao JY, Feng Y, Li ZL, Wu M, Wang FM, Wen Y, Zhou LT, Ni HF, Chen PS, Gu N, Crowley SD, Liu BC. Employing Macrophage-Derived Microvesicle for Kidney-Targeted Delivery of Dexamethasone: An Efficient Therapeutic Strategy against Renal Inflammation and Fibrosis. Am J Cancer Res 2019; 9:4740-4755. [PMID: 31367254 PMCID: PMC6643445 DOI: 10.7150/thno.33520] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 05/15/2019] [Indexed: 01/13/2023] Open
Abstract
Although glucocorticoids are the mainstays in the treatment of renal diseases for decades, the dose dependent side effects have largely restricted their clinical use. Microvesicles (MVs) are small lipid-based membrane-bound particles generated by virtually all cells. Here we show that RAW 264.7 macrophage cell-derived MVs can be used as vectors to deliver dexamethasone (named as MV-DEX) targeting the inflamed kidney efficiently. Methods: RAW macrophages were incubated with dexamethasone and then MV-DEX was isolated from the supernatants by centrifugation method. Nanoparticle tracking analysis, transmission electron microscopy, western blot and high-performance liquid chromatography were used to analyze the properties of MV-DEX. The LC-MS/MS was applied to investigate the protein compositions of MV-DEX. Based on the murine models of LPS- or Adriamycin (ADR)-induced nephropathy or in-vitro culture of glomerular endothelial cells, the inflammation-targeting characteristics and the therapeutic efficacy of MV-DEX was examined. Finally, we assessed the side effects of chronic glucocorticoid therapy in MV-DEX-treated mice. Results: Proteomic analysis revealed distinct integrin expression patterns on the MV-DEX surface, in which the integrin αLβ2 (LFA-1) and α4β1 (VAL-4) enabled them to adhere to the inflamed kidney. Compared to free DEX treatment, equimolar doses of MV-DEX significantly attenuated renal injury with an enhanced therapeutic efficacy against renal inflammation and fibrosis in murine models of LPS- or ADR-induced nephropathy. In vitro, MV-DEX with about one-fifth of the doses of free DEX achieved significant anti-inflammatory efficacy by inhibiting NF-κB activity. Mechanistically, MV-DEX could package and deliver glucocorticoid receptors to renal cells, thereby, increasing cellular levels of the receptor and improving cell sensitivity to glucocorticoids. Notably, delivering DEX in MVs significantly reduced the side effects of chronic glucocorticoid therapy (e.g., hyperglycemia, suppression of HPA axis). Conclusion: In summary, macrophage-derived MVs efficiently deliver DEX into the inflamed kidney and exhibit a superior capacity to suppress renal inflammation and fibrosis without apparent glucocorticoid adverse effects. Our findings demonstrate the effectiveness and security of a novel drug delivery strategy with promising clinical applications.
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Affiliation(s)
- Tao-Tao Tang
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Lin-Li Lv
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China,✉ Corresponding authors: Bi-Cheng Liu () or Lin-Li Lv ()
| | - Bin Wang
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jing-Yuan Cao
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ye Feng
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zuo-Lin Li
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Min Wu
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Feng-Mei Wang
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yi Wen
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Le-Ting Zhou
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Hai-Feng Ni
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ping-Sheng Chen
- Institute of Nephrology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ning Gu
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Steven D. Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina, United States
| | - Bi-Cheng Liu
- ✉ Corresponding authors: Bi-Cheng Liu () or Lin-Li Lv ()
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41
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Abstract
The contributions of T lymphocytes to the pathogenesis of salt-sensitive hypertension has been well established. Under hypertensive stimuli, naive T cells develop into different subsets, including Th1, Th2, Th17, Treg, and cytotoxic CD8+ T cells, depending on the surrounding microenviroment in organs. Distinct subsets of T cells may play totally different roles in tissue damage and hypertension. The underlying mechanisms by which hypertensive stimuli activate naive T cells involve many events and different organs, such as neoantigen presentation by dendritic cells, high salt concentration, and the milieu of oxidative stress in the kidney and vasculature. Infiltrating and activated T subsets in injured organs, in turn, exert considerable impacts on tissue dysfunction, including sodium retention in the kidney, vascular stiffness, and remodeling in the vasculature. Therefore, a thorough knowledge of T-cell actions in hypertension may provide novel insights into the development of new therapeutic strategies for patients with hypertension.
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Affiliation(s)
- Jiafa Ren
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Centers , Durham, North Carolina
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Centers , Durham, North Carolina
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42
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Wen Y, Rudemiller NP, Zhang J, Jeffs AD, Griffiths R, Lu X, Ren J, Privratsky J, Crowley SD. Stimulating Type 1 Angiotensin Receptors on T Lymphocytes Attenuates Renal Fibrosis. Am J Pathol 2019; 189:981-988. [PMID: 31000207 DOI: 10.1016/j.ajpath.2019.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/27/2019] [Accepted: 02/01/2019] [Indexed: 12/18/2022]
Abstract
Most forms of chronic kidney disease culminate in renal fibrosis that heralds organ failure. In contrast to the protective effects of globally blocking type 1 angiotensin (AT1) receptors throughout the body, activating AT1 receptors directly on immune cells may serve protective functions. However, the effects of stimulating the T-cell AT1 receptor on the progression of renal fibrosis remain unknown. In this study, mice with T-cell-specific deletion of the dominant murine AT1 receptor isoform Lck-Cre Agtraflox/flox [total knockout (TKO)] and wild-type (WT) controls were subjected to the unilateral ureteral obstruction model of kidney fibrosis. Compared with WT controls, obstructed kidneys from TKO mice at day 14 had increased collagen 1 deposition. CD4+ T cells, CD11b+Ly6Chi myeloid cells, and mRNA levels of Th1 inflammatory cytokines are elevated in obstructed TKO kidneys, suggesting that augmented Th1 responses in the TKO mice may exaggerate renal fibrosis by driving proinflammatory macrophage differentiation. In turn, T-bet deficient (T-bet knockout) mice lacking Th1 responses have attenuated collagen deposition after unilateral ureteral obstruction. We conclude that activating the AT1 receptor on T cells mitigates renal fibrogenesis by inhibiting Th1 differentiation and renal accumulation of profibrotic macrophages.
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Affiliation(s)
- Yi Wen
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina; Department of Medicine, Durham Veterans Affairs Medical Centers, Durham, North Carolina
| | - Nathan P Rudemiller
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina; Department of Medicine, Durham Veterans Affairs Medical Centers, Durham, North Carolina
| | - Jiandong Zhang
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina; Department of Medicine, Durham Veterans Affairs Medical Centers, Durham, North Carolina
| | - Alexander D Jeffs
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina; Department of Medicine, Durham Veterans Affairs Medical Centers, Durham, North Carolina
| | - Robert Griffiths
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina; Department of Medicine, Durham Veterans Affairs Medical Centers, Durham, North Carolina
| | - Xiaohan Lu
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina; Department of Medicine, Durham Veterans Affairs Medical Centers, Durham, North Carolina
| | - Jiafa Ren
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina; Department of Medicine, Durham Veterans Affairs Medical Centers, Durham, North Carolina
| | - Jamie Privratsky
- Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina; Department of Medicine, Durham Veterans Affairs Medical Centers, Durham, North Carolina.
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43
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Privratsky JR, Wang N, Qi Y, Ren J, Morris BT, Hunting JC, Johnson GA, Crowley SD. Dynamic contrast-enhanced MRI promotes early detection of toxin-induced acute kidney injury. Am J Physiol Renal Physiol 2019; 316:F351-F359. [PMID: 30516426 PMCID: PMC6397378 DOI: 10.1152/ajprenal.00416.2018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/26/2018] [Accepted: 12/02/2018] [Indexed: 12/26/2022] Open
Abstract
Acute kidney injury (AKI) is a common cause of morbidity and mortality in hospitalized patients. Nevertheless, there is limited ability to diagnose AKI in its earliest stages through the collection of structural and functional information. Magnetic resonance imaging (MRI) is increasingly being used to provide structural and functional data that characterize the injured kidney. Dynamic contrast-enhanced (DCE) MRI is an imaging modality with robust spatial and temporal resolution; however, its ability to detect changes in kidney function following AKI has not been determined. We hypothesized that DCE MRI would detect a prolongation in contrast transit time following toxin-induced AKI earlier than commonly used serum and tissue biomarkers. To test our hypothesis, we injected mice with either vehicle or cisplatin (30 mg/kg) and performed DCE MRI at multiple time points. We found that commonly used kidney injury biomarkers, including creatinine, blood urea nitrogen, and neutrophil gelatinase-associated lipocalin, did not rise until day 2 following cisplatin. Tissue levels of the proinflammatory cytokines and chemokines, tumor necrosis factor-α, interleukin (IL)-1β, IL-1α, IL-6, C-C motif chemokine ligand 2, and C-X-C motif chemokine ligand 2 similarly did not upregulate until day 2 following cisplatin. However, the time to peak intensity of contrast in the renal collecting system was already prolonged at day 1 following cisplatin compared with vehicle-treated mice. This intensity change mirrored changes in kidney injury as measured by histological analysis and in transporter expression in the proximal tubule. Taken together, DCE MRI is a promising preclinical imaging modality that is useful for assessing functional capacity of the kidney in the earliest stages following AKI.
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Affiliation(s)
- Jamie R Privratsky
- Department of Anesthesiology, Duke University Medical Center , Durham, North Carolina
| | - Nian Wang
- Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center , Durham, North Carolina
| | - Yi Qi
- Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center , Durham, North Carolina
| | - Jiafa Ren
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Benjamin T Morris
- Department of Anesthesiology, Duke University Medical Center , Durham, North Carolina
| | - John C Hunting
- Department of Biostatistics and Bioinformatics, Duke University Medical Center , Durham, North Carolina
| | - G Allan Johnson
- Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center , Durham, North Carolina
| | - Steven D Crowley
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
- Durham Veterans Affairs Medical Center , Durham, North Carolina
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44
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Abstract
Preclinical studies point to a key role for immune cells in hypertension via augmenting renal injury and/or hypertensive responses. Blood pressure elevation in rheumatologic patients is attenuated by anti-inflammatory therapies. Both the innate and adaptive immune systems contribute to the pathogenesis of hypertension by modulating renal sodium balance, blood flow, and functions of the vasculature and epithelial cells in the kidney. Monocytes/macrophages and T lymphocytes are pivotal mediators of hypertensive responses, while dendritic cells and B lymphocytes can regulate blood pressure indirectly by promoting T lymphocytes activation. Pro-inflammatory cytokines, such as tumor necrosis factor-α (TNF), interleukin-1 (IL-1), interleukin-17 (IL-17), and interferon-γ (IFN), amplify blood pressure elevation and/or renal injury. By contrast, interleukin-10 (IL-10) protects against renal and vascular function when produced by T helper 2 cells (Th2) and regulatory T cells (Treg). Thus, understanding the renal effects of cytokines in hypertension will provide targets for precise immunotherapies to inhibit targeted organ damage while preserving necessary immunity.
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Affiliation(s)
- Yi Wen
- Division of Nephrology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China.,Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC, USA
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC, USA.
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45
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Wyatt CM, Crowley SD. Intersection of salt- and immune-mediated mechanisms of hypertension in the gut microbiome. Kidney Int 2018; 93:532-534. [PMID: 29475542 DOI: 10.1016/j.kint.2018.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 01/11/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Christina M Wyatt
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina, USA.
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46
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Abstract
Renin-expressing cells have been conserved through evolution and maintain blood pressure and fluid homeostasis. Lack of availability of tools to study the specifics of renin regulation has limited advances in this field. In the current issue of the Journal of Clinical Investigation, Martinez and colleagues used the genome-wide assessment of the chromatin status of cells and uncovered a unique set of super-enhancers that determine the identity of renin cells. The renin super-enhancers play a key role in the molecular memory of renin cell function, a mechanism at the core of preserving homeostasis.
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47
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Affiliation(s)
- Steven D Crowley
- Division of Nephrology, Department of Medicine at Duke University and Durham VA Medical Centers, DUMC Durham, NC, USA
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48
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Shen Y, Yan B, Zhao Q, Wang Z, Wu J, Ren J, Wang W, Yu S, Sheng H, Crowley SD, Ding F, Paschen W, Yang W. Aging Is Associated With Impaired Activation of Protein Homeostasis-Related Pathways After Cardiac Arrest in Mice. J Am Heart Assoc 2018; 7:e009634. [PMID: 30371162 PMCID: PMC6201440 DOI: 10.1161/jaha.118.009634] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/02/2018] [Indexed: 01/08/2023]
Abstract
Background The mechanisms underlying worse outcome at advanced age after cardiac arrest ( CA ) and resuscitation are not well understood. Because protein homeostasis (proteostasis) is essential for cellular and organismal health, but is impaired after CA , we investigated the effects of age on proteostasis-related prosurvival pathways activated after CA . Methods and Results Young (2-3 months old) and aged (21-22 months old) male C57Bl/6 mice were subjected to CA and cardiopulmonary resuscitation ( CPR ). Functional outcome and organ damage were evaluated by assessing neurologic deficits, histological features, and creatinine level. CA / CPR -related changes in small ubiquitin-like modifier conjugation, ubiquitination, and the unfolded protein response were analyzed by measuring mRNA and protein levels in the brain, kidney, and spinal cord. Thiamet-G was used to increase O-linked β-N-acetylglucosamine modification. After CA / CPR , aged mice had trended lower survival rates, more severe tissue damage in the brain and kidney, and poorer recovery of neurologic function compared with young mice. Furthermore, small ubiquitin-like modifier conjugation, ubiquitination, unfolded protein response, and O-linked β-N-acetylglucosamine modification were activated after CA / CPR in young mice, but their activation was impaired in aged mice. Finally, pharmacologically increasing O-linked β-N-acetylglucosamine modification after CA improved outcome. Conclusions Results suggest that impaired activation of prosurvival pathways contributes to worse outcome after CA / CPR in aged mice because restoration of proteostasis is critical to the survival of cells stressed by ischemia. Therefore, a pharmacologic intervention that targets aging-related impairment of proteostasis-related pathways after CA / CPR may represent a promising therapeutic strategy.
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Affiliation(s)
- Yuntian Shen
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of EducationCo‐Innovation Center of NeuroregenerationNantong UniversityNantongChina
| | - Baihui Yan
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
- Department of AnesthesiologyThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Qiang Zhao
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
- Department of NeurologyTianjin Neurological InstituteTianjin Medical University General HospitalTianjinChina
| | - Zhuoran Wang
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
| | - Jiangbo Wu
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
| | - Jiafa Ren
- Division of NephrologyDepartment of MedicineDuke University and Durham VA Medical CentersDurhamNC
| | - Wei Wang
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
- Department of AnesthesiologySouthern Medical University Nanfang HospitalGuangzhouChina
| | - Shu Yu
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of EducationCo‐Innovation Center of NeuroregenerationNantong UniversityNantongChina
| | - Huaxin Sheng
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
| | - Steven D. Crowley
- Division of NephrologyDepartment of MedicineDuke University and Durham VA Medical CentersDurhamNC
| | - Fei Ding
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of EducationCo‐Innovation Center of NeuroregenerationNantong UniversityNantongChina
| | - Wulf Paschen
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
| | - Wei Yang
- Center for Perioperative Organ ProtectionDepartment of AnesthesiologyDuke University Medical CenterDurhamNC
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Privratsky JR, Zhang J, Lu X, Rudemiller N, Wei Q, Yu YR, Gunn MD, Crowley SD. Interleukin 1 receptor (IL-1R1) activation exacerbates toxin-induced acute kidney injury. Am J Physiol Renal Physiol 2018; 315:F682-F691. [PMID: 29790392 PMCID: PMC6172579 DOI: 10.1152/ajprenal.00104.2018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 12/30/2022] Open
Abstract
Acute kidney injury (AKI) is a leading cause of morbidity and mortality. Drug-induced/toxic AKI can be caused by a number of therapeutic agents. Cisplatin is an effective chemotherapeutic agent whose administration is limited by significant nephrotoxicity. Therapies to prevent cisplatin-induced AKI are lacking. Although tumor necrosis factor-α (TNF) plays a key role in the pathogenesis of cisplatin nephrotoxicity, the innate immune signaling pathways that trigger TNF generation in this context require elucidation. In this regard, sterile injury triggers the release and activation of both isoforms of interleukin(IL)-1, IL-1α and IL-1β. In turn, stimulation of the interleukin-1 receptor (IL-1R1) by these ligands engages a proinflammatory signaling cascade that induces TNF induction. We therefore hypothesized that IL-1R1 activation exacerbates cisplatin-induced AKI by inducing TNF production, thereby augmenting inflammatory signals between kidney parenchymal cells and infiltrating myeloid cells. IL-1R1+/+ (WT) and IL-1R1-/- (KO) mice were subjected to cisplatin-induced AKI. Compared with WT mice, IL-1R1 KO mice had attenuated AKI as measured by serum creatinine and BUN, renal NGAL mRNA levels, and blinded histological analysis of kidney pathology. In the cisplatin-injured kidney, IL-1R1 KO mice had diminished levels of whole kidney TNF, and fewer Ly6G-expressing neutrophils. In addition, an unbiased machine learning analysis of intrarenal immune cells revealed a diminished number of CD11bint/CD11cint myeloid cells in IL-1R1 KO injured kidneys compared with IL-1R1 WT kidneys. Following cisplatin, IL-1R1 KO kidneys, compared with WTs, had fewer TNF-producing: macrophages, CD11bint/CD11cint cells, and neutrophils, consistent with an effect of IL-1R1 to polarize intrarenal myeloid cells toward a proinflammatory phenotype. Interruption of IL-1-dependent signaling pathways warrants further evaluation to decrease nephrotoxicity during cisplatin therapy.
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Affiliation(s)
- Jamie R Privratsky
- Department of Anesthesiology, Duke University Medical Center , Durham, North Carolina
| | - Jiandong Zhang
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Xiaohan Lu
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Nathan Rudemiller
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Qingqing Wei
- Department of Cellular Biology and Anatomy, Augusta University , Augusta, Georgia
| | - Yen-Rei Yu
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Michael D Gunn
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Steven D Crowley
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
- Durham Veterans Affairs Medical Center , Durham, North Carolina
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50
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Lu X, Rudemiller N, Zhang J, Privratsky J, Hammer G, Zhang J, Wen Y, Ren J, Crowley SD. Abstract 019: A20 in Dendritic Cells Protects Against Hypertension by Inhibiting Dendritic Cell-Mediated T Cell Activation. Hypertension 2018. [DOI: 10.1161/hyp.72.suppl_1.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The ubiquitin-editor protein A20 in dendritic cells (DCs) suppresses NF-κB signaling and inhibits their capacity to activate T cells by limiting DC expression of co-stimulatory molecules. We previously reported that mice with spontaneous DC activation due to heterozygous deletion of A20 in DCs (CD11c-cre+ A20
flox/wt
= DC ACT) have an exaggerated hypertensive response to low dose (300 ng/kg/min) chronic angiotensin (Ang) II infusion (143±2 vs. 131±4 mmHg; p=0.04) and augmented proportions of effector T cells in the kidney lymph node. Here, we explored the mechanism through which A20 in DCs limits blood pressure elevation. After 7 days of chronic Ang II infusion, flow cytometric analysis of kidney homogenates from wild-type (WT = CD11c-cre
-
A20
flox/wt
) and DC ACT mice revealed similar numbers of renal DCs in the 2 groups (2832±342 vs. 2531±435; p=NS). By contrast, numbers of CD11b
+
Ly6C
hi
inflammatory monocytes (9849±1108 vs. 6019±597; p=0.01) and CD8
+
T cells (1757±101 vs. 908±155; p<0.03) were increased in the DC ACT kidneys compared to WT controls. Accordingly, the DC ACT kidneys showed upregulated mRNA expression for the pro-hypertensive cytokines TNF-α (1.6±0.2 vs. 1±0.2; p<0.02) and IL-17A (2.3±0.6 vs. 1±0.3; p=0.09) and the mononuclear cell chemokine CCL5 (1.9±0.27 vs. 1±0.11; p=0.01). Both monocytes and T cells have been implicated in the pathogenesis of hypertension. Therefore, to directly test whether enhanced T cell activation in the DC ACT cohort was responsible for their augmented hypertensive response, we chronically infused Ang II into lymphocyte-deficient DC ACT Rag1
-/-
mice and WT (CD11c-cre- A20
flox/wt
) Rag1
-/-
controls for 4 wks. In WT Rag1
-/-
and DC ACT Rag1
-/-
mice, radiotelemetry blood pressures (128±1 vs. 128±2 mmHg; p=NS) and heart to body weight ratios (6.0±0.1 vs. 6.4±0.2 mg/g body wt) were similar during Ang II, suggesting that T cells are required to mediate the augmented hypertensive response accruing from DC activation due to A20 deficiency. Thus, following stimulation of the renin angiotensin system, A20 suppresses DC activation and thereby mitigates T cell-dependent blood pressure elevation. These studies identify a novel target through which to limit the engagement of adaptive immunity during chronic hypertension.
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