Le Corre Stéphanie, Viau Amandine, Burtin Martine, El-Karoui Khalil, Cnops Yvette, Terryn Sara, Debaix Huguette, Bérissi Sophie, Gubler Marie-Claire, Devuyst Olivier, Terzi Fabiola
Nephron. 2015;129(1):42-51. doi: 10.1159/000369312. Epub 2014 Dec 19.
Cystic kidney disease is characterized by the progressive development of multiple fluid-filled cysts. Cysts can be acquired, or they may appear during development or in postnatal life due to specific gene defects and lead to renal failure. The most frequent form of this disease is the inherited polycystic kidney disease (PKD). Experimental models of PKD showed that an increase of cellular proliferation and apoptosis as well as defects in apico-basal and planar cell polarity or cilia play a critical role in cyst development. However, little is known about the mechanisms and the mediators involved in acquired cystic kidney diseases (ACKD). In this study, we used the nephron reduction as a model to study the mechanisms underlying cyst development in ACKD. We found that tubular dilations after nephron reduction recapitulated most of the morphological features of ACKD. The development of tubular dilations was associated with a dramatic increase of cell proliferation. In contrast, the apico-basal polarity and cilia did not seem to be affected. Interestingly, polycystin 1 and fibrocystin were markedly increased and polycystin 2 was decreased in cells lining the dilated tubules, whereas the expression of several other cystic genes did not change. More importantly, Pkd1 haploinsufficiency accelerated the development of tubular dilations after nephron reduction, a phenotype that was associated to a further increase of cell proliferation. These data were relevant to humans ACKD, as cystic genes expression and the rate of cell proliferation were also increased. In conclusion, our study suggests that the nephron reduction can be considered a suitable model to study ACKD and that dosage of genes involved in PKD is also important in ACKD.
多囊肾病的特征是多个充满液体的囊肿逐渐发展。囊肿可以是后天获得的,也可能由于特定基因缺陷在发育过程中或出生后出现,并导致肾衰竭。这种疾病最常见的形式是遗传性多囊肾病(PKD)。PKD的实验模型表明,细胞增殖和凋亡增加以及顶-基和平面细胞极性或纤毛缺陷在囊肿形成中起关键作用。然而,关于获得性多囊肾病(ACKD)的发病机制和相关介质知之甚少。在本研究中,我们以肾单位减少为模型来研究ACKD囊肿形成的机制。我们发现肾单位减少后的肾小管扩张重现了ACKD的大多数形态学特征。肾小管扩张的发展与细胞增殖的显著增加有关。相比之下,顶-基极性和纤毛似乎未受影响。有趣的是,扩张肾小管内衬细胞中的多囊蛋白1和纤维囊蛋白明显增加,而多囊蛋白2减少,而其他几个囊性基因的表达没有变化。更重要的是,Pkd1单倍体不足加速了肾单位减少后肾小管扩张的发展,这种表型与细胞增殖的进一步增加有关。这些数据与人类ACKD相关,因为囊性基因表达和细胞增殖率也增加了。总之,我们的研究表明,肾单位减少可被视为研究ACKD的合适模型,并且PKD相关基因的剂量在ACKD中也很重要。