Division of Pediatric Urology, Department of Surgery, Washington University, St. Louis Children's Hospital, St. Louis, Missouri, USA.
J Urol. 2011 Jun;185(6 Suppl):2523-30. doi: 10.1016/j.juro.2011.01.034. Epub 2011 Apr 27.
Urinary tract obstruction causes hydroureteronephrosis and requires surgical intervention to prevent permanent renal injury. While many studies have focused on the development of renal injury, we examined the molecular mechanisms that promote renal recovery after correcting obstruction.
A reversible murine model of ureteral obstruction was used to examine the bone morphogenic protein-7 and transforming growth factor-β signaling pathways during renal recovery after obstruction induced injury. Analysis was done using standard molecular techniques, including reverse transcriptase-polymerase chain reaction, enzyme-linked immunosorbent assay, immunoblotting and co-immunoprecipitation.
After correcting obstruction the up-regulation of bone morphogenic protein-7 inhibited the transforming growth factor-β dependent profibrotic pathways that are central to renal injury pathogenesis. The inhibitory effects of bone morphogenic protein-7 were mediated in part by the activation of its downstream target proteins, SMA and MAD related proteins 1, 5 and 8, which suppress the activity of transforming growth factor-β dependent Smad proteins and in turn inhibit the expression of transforming growth factor-β dependent genes. Activation of the bone morphogenic protein-7-Smad related protein 1/5/8 pathway during renal recovery promoted renal architecture restoration and fibrosis resolution in the kidney after correcting obstruction.
Together these findings show that the bone morphogenic protein-7-Smad1/5/8 pathway promotes kidney repair after obstruction induced injury. Accordingly the pathway represents an important therapeutic target to stimulate this innate repair mechanisms of the kidney during treatment for obstruction induced renal injury.
尿路梗阻可导致肾积水,并需要手术干预以防止永久性肾损伤。虽然许多研究都集中在肾损伤的发展上,但我们研究了纠正梗阻后促进肾恢复的分子机制。
使用可逆转的小鼠输尿管梗阻模型,在梗阻诱导损伤后肾恢复期间研究骨形态发生蛋白-7 和转化生长因子-β 信号通路。分析采用标准分子技术,包括逆转录-聚合酶链反应、酶联免疫吸附测定、免疫印迹和共免疫沉淀。
在纠正梗阻后,骨形态发生蛋白-7 的上调抑制了转化生长因子-β 依赖的致纤维化途径,该途径是肾损伤发病机制的核心。骨形态发生蛋白-7 的抑制作用部分是通过其下游靶蛋白 SMA 和 MAD 相关蛋白 1、5 和 8 的激活介导的,它们抑制转化生长因子-β 依赖的 Smad 蛋白的活性,进而抑制转化生长因子-β 依赖基因的表达。在纠正梗阻后的肾恢复期间,骨形态发生蛋白-7-Smad 相关蛋白 1/5/8 通路的激活促进了肾结构的恢复和纤维化的解决。
这些发现表明,骨形态发生蛋白-7-Smad1/5/8 通路促进梗阻诱导损伤后的肾脏修复。因此,该通路代表了一种重要的治疗靶点,可在治疗梗阻性肾损伤时刺激肾脏的这种固有修复机制。