Velez Juan Carlos Q, Arif Ehtesham, Rodgers Jessalyn, Hicks Megan P, Arthur John M, Nihalani Deepak, Bruner Evelyn T, Budisavljevic Milos N, Atkinson Carl, Fitzgibbon Wayne R, Janech Michael G
Department of Nephrology, Ochsner Clinic Foundation, New Orleans, Louisiana;
Division of Nephrology, Department of Medicine and.
J Am Soc Nephrol. 2017 Jul;28(7):2119-2132. doi: 10.1681/ASN.2016111166. Epub 2017 Feb 15.
Aminopeptidase A (APA) is expressed in glomerular podocytes and tubular epithelia and metabolizes angiotensin II (AngII), a peptide known to promote glomerulosclerosis. In this study, we tested whether APA expression changes in response to progressive nephron loss or whether APA exerts a protective role against glomerular damage and during AngII-mediated hypertensive kidney injury. At advanced stages of FSGS, fawn-hooded hypertensive rat kidneys exhibited distinctly increased APA staining in areas of intact glomerular capillary loops. Moreover, BALB/c APA-knockout (KO) mice injected with a nephrotoxic serum showed persistent glomerular hyalinosis and albuminuria 96 hours after injection, whereas wild-type controls achieved virtually full recovery. We then tested the effect of 4-week infusion of AngII (400 ng/kg per minute) in APA-KO and wild-type mice. Although we observed no significant difference in achieved systolic BP, AngII-treated APA-KO mice developed a significant rise in albuminuria not observed in AngII-treated wild-type mice along with increased segmental and global sclerosis and/or collapse of juxtamedullary glomeruli, microcystic tubular dilation, and tubulointerstitial fibrosis. In parallel, AngII treatment significantly increased the kidney AngII content and attenuated the expression of podocyte nephrin in APA-KO mice but not in wild-type controls. These data show that deficiency of APA increases susceptibility to glomerular injury in BALB/c mice. The augmented AngII-mediated kidney injury observed in association with increased intrarenal AngII accumulation in the absence of APA suggests a protective metabolizing role of APA in AngII-mediated glomerular diseases.
氨肽酶A(APA)在肾小球足细胞和肾小管上皮细胞中表达,并代谢血管紧张素II(AngII),这是一种已知可促进肾小球硬化的肽。在本研究中,我们测试了APA表达是否会因进行性肾单位丢失而发生变化,或者APA是否在肾小球损伤以及AngII介导的高血压肾损伤过程中发挥保护作用。在局灶节段性肾小球硬化(FSGS)的晚期,淡色带帽高血压大鼠的肾脏在完整的肾小球毛细血管袢区域显示出明显增加的APA染色。此外,注射肾毒性血清的BALB/c APA基因敲除(KO)小鼠在注射后96小时出现持续性肾小球玻璃样变性和蛋白尿,而野生型对照组几乎完全恢复。然后,我们测试了在APA-KO小鼠和野生型小鼠中连续4周输注AngII(每分钟400 ng/kg)的效果。尽管我们观察到收缩压没有显著差异,但AngII处理的APA-KO小鼠出现了AngII处理的野生型小鼠未观察到的蛋白尿显著增加,同时伴有节段性和全球性硬化增加和/或近髓肾小球塌陷、微囊性肾小管扩张和肾小管间质纤维化。同时,AngII处理显著增加了APA-KO小鼠的肾脏AngII含量,并减弱了足细胞nephrin的表达,但在野生型对照组中没有。这些数据表明,APA缺乏会增加BALB/c小鼠对肾小球损伤的易感性。在没有APA的情况下,观察到与肾内AngII积累增加相关的AngII介导的肾脏损伤增强,这表明APA在AngII介导的肾小球疾病中具有保护性代谢作用。