Sun Guangping, Yin Zhongmin, Liu Naiquan, Bian Xiaohui, Yu Rui, Su Xiaoxiao, Zhang Beiru, Wang Yanqiu
Department of Nephrology, Shengjing Hospital, China Medical University, China.
Department of Neurosurgery, 463rd Hospital of PLA, Shenyang, Liaoning, China.
Biochem Biophys Res Commun. 2017 Nov 18;493(2):964-970. doi: 10.1016/j.bbrc.2017.09.108. Epub 2017 Sep 20.
Emerging evidence shows that obesity induces renal injury and is an independent risk factor for the development of chronic kidney disease (CKD), even without diabetes or hyperglycemia. Although multiple metabolic factors have been suggested to account for obesity-associated renal injury, the precious underlying mechanisms are not completely understood. Recent study shows that increased trimethylamine N-Oxide (TMAO), a gut microbiota-generated metabolite, directly contributes to renal interstitial fibrosis and dysfunction. Circulating TMAO is elevated in high-fat diets (HFD)-induced obese animals. Here we tested the hypothesis that elevated TMAO might play a contributory role in the development of renal dysfunction in a mouse model of HFD-induced obesity that mimics human obesity syndrome. Male C57BL/6 mice received either a low-fat diet (LFD) or a HFD, without or with 3,3-Dimethyl-1-butanol (DMB, a trimethylamine formation inhibitor) for 16 weeks. Compared with mice fed a LFD, mice fed a HFD developed obesity and metabolic disorders, and exhibited significantly elevated plasma TMAO levels at the end of the experiment. Molecular and morphological studies revealed that renal interstitial fibrosis, phosphorylation of SMAD3 (a key regulator of renal fibrosis), expression of kidney injury molecule-1 and plasma cystatin C were significantly increased in mice fed a HFD, compared with mice fed a LFD. Additionally, expression of NADPH oxidase-4 and pro-inflammatory cytokines tumor necrosis factor-α and interleukin-1 β was also augmented in mice fed a HFD as compared to mice fed a LFD. These molecular and morphological alterations observed in mice fed a HFD were prevented by concomitant treatment with DMB, which reduced plasma TMAO levels. Furthermore, elevated circulating TMAO levels were positively correlated with increased renal interstitial fibrosis and expression of kidney injury molecule-1. Notable, there was no difference in blood pressure among groups, and DMB treatment had no effects on body weight and metabolic parameters. These data suggest that HFD-induced obesity leads to elevations in gut microbiota-generated metabolite TMAO in the circulation, which contributes to renal interstitial fibrosis and dysfunction by promoting renal oxidative stress and inflammation. These findings may provide new insights into the mechanisms underlying obesity-associated CKD. Targeting TMAO may be a novel strategy for prevention and treatment of CKD in patients with obesity.
新出现的证据表明,肥胖会引发肾损伤,并且是慢性肾脏病(CKD)发生发展的独立危险因素,即便没有糖尿病或高血糖也是如此。尽管已有多种代谢因素被认为与肥胖相关的肾损伤有关,但其确切的潜在机制尚未完全明确。最近的研究表明,三甲胺N-氧化物(TMAO)增加,一种由肠道微生物群产生的代谢产物,直接导致肾间质纤维化和功能障碍。在高脂饮食(HFD)诱导的肥胖动物中,循环中的TMAO升高。在此,我们测试了这样一个假设,即在模拟人类肥胖综合征的HFD诱导肥胖小鼠模型中,升高的TMAO可能在肾功能障碍的发生发展中起促成作用。雄性C57BL/6小鼠接受低脂饮食(LFD)或HFD,分别给予或不给予3,3-二甲基-1-丁醇(DMB,一种三甲胺形成抑制剂),持续16周。与喂食LFD的小鼠相比,喂食HFD的小鼠出现肥胖和代谢紊乱,并且在实验结束时血浆TMAO水平显著升高。分子和形态学研究显示,与喂食LFD的小鼠相比,喂食HFD的小鼠肾间质纤维化、SMAD3(肾纤维化的关键调节因子)磷酸化、肾损伤分子-1的表达以及血浆胱抑素C均显著增加。此外,与喂食LFD的小鼠相比,喂食HFD的小鼠中NADPH氧化酶-4以及促炎细胞因子肿瘤坏死因子-α和白细胞介素-1β的表达也增加。在喂食HFD的小鼠中观察到的这些分子和形态学改变可通过同时给予DMB来预防,DMB可降低血浆TMAO水平。此外,循环中升高的TMAO水平与肾间质纤维化增加以及肾损伤分子-1的表达呈正相关。值得注意的是,各组之间血压无差异,并且DMB处理对体重和代谢参数无影响。这些数据表明,HFD诱导的肥胖导致循环中由肠道微生物群产生的代谢产物TMAO升高,这通过促进肾氧化应激和炎症导致肾间质纤维化和功能障碍。这些发现可能为肥胖相关CKD的潜在机制提供新的见解。靶向TMAO可能是预防和治疗肥胖患者CKD的一种新策略。
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