Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Am J Pathol. 2013 Jul;183(1):160-72. doi: 10.1016/j.ajpath.2013.04.005. Epub 2013 May 15.
Severe acute kidney injury (AKI) is frequently accompanied by maladaptive repair and renal fibrogenesis; however, the molecular mechanisms that mediate these acute and chronic consequences of AKI remain poorly understood. In this study, we examined the role of epidermal growth factor receptor (EGFR) in these processes using waved-2 (Wa-2) mice, which have reduced EGFR activity, and their wild-type (WT) littermates after renal ischemia. Renal EGFR phosphorylation was induced within 2 days after ischemia, increased over time, and remained elevated at 28 days in WT mice, but this was diminished in Wa-2 mice. At the early stage of postischemia (2 days), Wa-2 mice developed more severe acute renal tubular damage with less reparative responses as indicated by enhanced tubular cell apoptosis, and reduced dedifferentiation and proliferation as compared to WT animals. At the late stage of postischemia (28 days), Wa-2 mice exhibited a less severe renal interstitial fibrosis as shown by reduced activation/proliferation of renal myofibroblasts and decreased deposition of extracellular matrix proteins. EGFR activation also contributed to cell cycle arrest at the G2/M phase, a cellular event associated with production of profibrogenetic factors, in the injured kidney. Collectively, these results indicate that severe AKI results in sustained activation of EGFR, which is required for reparative response of renal tubular cells initially, but eventually leads to fibrogenesis.
严重急性肾损伤 (AKI) 常伴有适应性修复和肾纤维化;然而,介导 AKI 这些急性和慢性后果的分子机制仍知之甚少。在这项研究中,我们使用波状-2 (Wa-2) 小鼠及其野生型 (WT) 同窝仔鼠,研究了表皮生长因子受体 (EGFR) 在这些过程中的作用,这些小鼠的 EGFR 活性降低。肾 EGFR 磷酸化在缺血后 2 天内被诱导,随着时间的推移而增加,并在 WT 小鼠中持续升高至 28 天,但在 Wa-2 小鼠中减少。在缺血后早期(2 天),Wa-2 小鼠发生更严重的急性肾小管损伤,修复反应减少,表现为肾小管细胞凋亡增加,而向未分化细胞和增殖细胞的分化减少。在缺血后晚期(28 天),Wa-2 小鼠的肾间质纤维化程度较轻,表现为肾肌成纤维细胞的激活/增殖减少,细胞外基质蛋白沉积减少。EGFR 激活也导致损伤肾脏中细胞周期停滞在 G2/M 期,这是一个与产生促纤维化因子相关的细胞事件。综上所述,这些结果表明严重的 AKI 导致 EGFR 的持续激活,这最初是肾小管细胞修复反应所必需的,但最终导致纤维化。