Department of Nephrology, Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Nephrology, Radboud Institute of Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
J Am Soc Nephrol. 2018 Aug;29(8):2099-2109. doi: 10.1681/ASN.2016111248. Epub 2018 Jun 28.
The hallmark of podocytopathies, such as FSGS, is podocyte injury resulting in proteinuria. Transient receptor potential channel C6 (TRPC6) is a calcium-conducting ion channel expressed at the slit diaphragm. TRPC6 gain-of-function mutations and glomerular TRPC6 overexpression are associated with proteinuria. However, the pathways linking TRPC6 to podocyte injury, which is characterized by loss of the slit diaphragm protein nephrin, activation of several intracellular pathways (including calcineurin-NFAT signaling), and cytoskeletal rearrangement, remain elusive.
We tested whether the calcium-dependent protease calpain-1 mediates TRPC6-dependent podocyte injury in human and experimental FSGS and cultured podocytes.
Compared with kidneys of healthy controls, kidneys of patients with FSGS had increased TRPC6 expression, increased calpain and calcineurin activity, and reduced expression of the calpain target Talin-1, which links the actin cytoskeleton to integrins and is critical for podocyte cytoskeletal stability. In a rat model of human FSGS, increased glomerular and urinary calpain activity associated with reduced Talin-1 abundance, enhanced calcineurin activity, and increased proteinuria. Treatment with the calpain inhibitor calpeptin prevented these effects. In cultured podocytes, pharmacologic stimulation of TRPC6-dependent calcium influx increased calpain-1 and calcineurin activity and reduced Talin-1 expression, and knockdown of TRPC6 or calpain-1 prevented these effects.
We elucidated a novel mechanism that links TRPC6 activity to calpain-1 activation and through Talin-1 loss and possibly, calcineurin activation, the podocyte injury characterizing FSGS. Therefore, calpain-1 and/or TRPC6 inhibition could be future therapeutic options to treat patients with FSGS or other podocytopathies.
足细胞病变,如 FSGS 的特征是足细胞损伤导致蛋白尿。瞬时受体电位通道 C6(TRPC6)是一种在裂孔隔膜表达的钙导离子通道。TRPC6 功能获得性突变和肾小球 TRPC6 过表达与蛋白尿有关。然而,将 TRPC6 与足细胞损伤联系起来的途径仍然难以捉摸,足细胞损伤的特征是裂孔隔膜蛋白nephrin 的丢失、几个细胞内途径(包括钙调神经磷酸酶-NFAT 信号通路)的激活和细胞骨架重排。
我们测试了钙依赖性蛋白酶钙蛋白酶-1 是否介导了人类和实验性 FSGS 及培养的足细胞中 TRPC6 依赖性足细胞损伤。
与健康对照组肾脏相比,FSGS 患者肾脏的 TRPC6 表达增加,钙蛋白酶和钙调神经磷酸酶活性增加,钙蛋白酶靶标Talin-1 的表达减少,Talin-1 将肌动球蛋白细胞骨架与整合素连接,对足细胞细胞骨架的稳定性至关重要。在人类 FSGS 的大鼠模型中,肾小球和尿钙蛋白酶活性增加与 Talin-1 丰度降低、钙调神经磷酸酶活性增强和蛋白尿增加相关。用钙蛋白酶抑制剂 calpeptin 治疗可预防这些作用。在培养的足细胞中,TRPC6 依赖性钙内流的药理学刺激增加了钙蛋白酶-1 和钙调神经磷酸酶的活性,并减少了 Talin-1 的表达,而 TRPC6 或钙蛋白酶-1 的敲低可预防这些作用。
我们阐明了一种将 TRPC6 活性与钙蛋白酶-1 激活联系起来的新机制,通过 Talin-1 的缺失和可能的钙调神经磷酸酶激活,导致 FSGS 特征性的足细胞损伤。因此,钙蛋白酶-1 和/或 TRPC6 抑制可能是治疗 FSGS 或其他足细胞病变患者的未来治疗选择。