Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
J Pathol. 2013 Nov;231(3):342-53. doi: 10.1002/path.4237. Epub 2013 Sep 3.
Renal disease associated with type 2 diabetes and the metabolic syndrome is characterized by a distinct inflammatory phenotype. The purinergic 2X7 receptor (P2X7 R) and the nucleotide-binding and oligomerization domain-like receptor containing a pyrin domain 3 (NLRP3) inflammasome have been separately shown to play a role in two models of non-metabolic chronic kidney disease. Moreover, the NLRP3 inflammasome has been implicated in chronic low-grade sterile inflammation characterizing metabolic disorders, though the mechanism(s) involved in inflammasome activation under these conditions are still unknown. We investigated the role of P2X7 R (through activation of the NLRP3 inflammasome) in renal inflammation and injury induced by a high-fat diet, an established model of the metabolic syndrome. On a high-fat diet, mice lacking P2X7 R developed attenuated renal functional and structural alterations as well as reduced inflammation, fibrosis, and oxidative/carbonyl stress, as compared with wild-type animals, in the absence of significant differences in metabolic parameters. This was associated with blunted up-regulation of the NLRP3 inflammasome components NLRP3, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), pro-caspase 1, pro-interleukin (IL)-1β, and pro-IL-18, as well as reduced inflammasome activation, as evidenced by decreased formation of mature caspase 1, whereas mature IL-1β and IL-18 were not detected. Up-regulated expression of NLRP3 and pro-caspase 1, post-translational processing of pro-caspase-1, and release of IL-18 in response to lipopolysaccharide + 2'(3')-O-(4-benzoylbenzoyl)ATP were attenuated by P2X7 R silencing in cultured mouse podocytes. Protein and mRNA expression of P2X7 R, NLRP3, and ASC were also increased in kidneys from subjects with type 2 diabetes and the metabolic syndrome, showing histologically documented renal disease. These data provide evidence of a major role for the purinergic system, at least in part through activation of the NLRP3 inflammasome, in the process driving 'metabolic' renal inflammation and injury and identify P2X7 R and NLRP3 as novel therapeutic targets.
与 2 型糖尿病和代谢综合征相关的肾脏疾病的特征是具有独特的炎症表型。嘌呤能 2X7 受体 (P2X7R) 和含吡喃结构域的核苷酸结合寡聚化结构域样受体 3 (NLRP3) 炎性小体已分别被证明在两种非代谢性慢性肾脏疾病模型中发挥作用。此外,NLRP3 炎性小体已被牵涉到代谢紊乱所导致的慢性低度无菌性炎症中,尽管在这些条件下激活炎性小体的机制尚不清楚。我们研究了嘌呤能 2X7R(通过激活 NLRP3 炎性小体)在高脂肪饮食诱导的肾脏炎症和损伤中的作用,高脂肪饮食是代谢综合征的一种已建立模型。在高脂肪饮食中,与野生型动物相比,缺乏 P2X7R 的小鼠表现出减弱的肾功能和结构改变,以及减少的炎症、纤维化和氧化/羰基应激,而代谢参数没有显著差异。这与 NLRP3 炎性小体成分 NLRP3、含有半胱氨酸天冬氨酸蛋白酶募集域的凋亡相关斑点样蛋白 (ASC)、前胱天冬酶 1、前白细胞介素 (IL)-1β 和前白细胞介素 (IL)-18 的上调减少有关,以及炎症小体激活减少,证据是成熟的 caspase 1 形成减少,而成熟的 IL-1β 和 IL-18 未检测到。在培养的小鼠足细胞中,沉默嘌呤能 2X7R 可减弱 NLRP3 和前胱天冬酶 1 的上调表达、前胱天冬酶-1 的翻译后加工以及对脂多糖+2'(3')-O-(4-苯甲酰苯甲酰)ATP 的 IL-18 释放。在 2 型糖尿病和代谢综合征患者的肾脏中,P2X7R、NLRP3 和 ASC 的蛋白和 mRNA 表达也增加,表现为组织学证实的肾脏疾病。这些数据提供了证据表明,至少部分通过激活 NLRP3 炎性小体,嘌呤能系统在驱动“代谢性”肾脏炎症和损伤的过程中起主要作用,并确定 P2X7R 和 NLRP3 为新的治疗靶点。
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