Kim Chang Seong, Kim In Jin, Choi Joon Seok, Bae Eun Hui, Ma Seong Kwon, Kim Soo Wan
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Biol Cell. 2019 Jan;111(1):18-27. doi: 10.1111/boc.201800040. Epub 2018 Oct 21.
Tubulointerstitial fibrosis is the end-point of chronic kidney diseases. Tamoxifen, a selective oestrogen receptor (ER) modulator, attenuates renal fibrosis, by regulating the transforming growth factor (TGF)-β/Smad signalling. Src and phosphoinositide 3-kinase (PI3K)/Akt pathways play critical roles in the pathogenesis of renal fibrosis. However, the activation of the non-canonical TGF-β signalling in renal fibrosis after treatment with tamoxifen remains unclear. Renal fibrosis was induced by unilateral ureteral obstruction (UUO) in rats. Tamoxifen was orally administered after UUO. Additionally, HK-2 cells were treated with tamoxifen in the presence or absence of TGF-β1. The selective ER down-regulator ICI and ER-α silencing were used to confirm the involvement of ER-α on the effect of tamoxifen on TGF-β1-stimulated fibrosis in HK-2 cells.
Tamoxifen treatment ameliorated UUO-induced renal fibrosis as shown by decreased expression of α-smooth muscle actin (SMA), fibronectin and connective tissue growth factor (CTGF). The phosphorylation of Src, PI3K, Akt, mammalian target of rapamycin (mTOR) and p70S6K significantly decreased in UUO kidneys from tamoxifen-treated animals. Tamoxifen dose-dependently suppressed the TGF-β1-induced expression of α-SMA and CTGF, and phosphorylation of Src, PI3K, Akt, mTOR and p70S6K in HK-2 cells. These anti-fibrotic effects were reversed by treatment with ICI and silencing of ER-α. Moreover, inhibition of the PI3K/Akt and mTOR/p70S6K pathways was observed in HK-2 cells co-treated with PP1 (a Src kinase inhibitor) and tamoxifen.
The anti-fibrotic effects of tamoxifen are associated with the suppression of Src kinase function via ER-α, followed by inhibition of the PI3K/Akt and mTOR/p70S6K signalling pathways.
Our findings suggest that tamoxifen is a novel therapeutic option for the prevention and treatment of renal fibrosis.
肾小管间质纤维化是慢性肾脏病的终点。他莫昔芬是一种选择性雌激素受体(ER)调节剂,通过调节转化生长因子(TGF)-β/Smad信号通路减轻肾纤维化。Src和磷酸肌醇3激酶(PI3K)/Akt信号通路在肾纤维化的发病机制中起关键作用。然而,他莫昔芬治疗后肾纤维化中非经典TGF-β信号通路的激活仍不清楚。通过单侧输尿管梗阻(UUO)诱导大鼠肾纤维化。UUO后口服他莫昔芬。此外,在有或无TGF-β1的情况下,用他莫昔芬处理人近端肾小管上皮细胞系(HK-2)细胞。使用选择性ER下调剂ICI和ER-α沉默来证实ER-α参与他莫昔芬对HK-2细胞中TGF-β1刺激的纤维化的作用。
他莫昔芬治疗改善了UUO诱导的肾纤维化,表现为α-平滑肌肌动蛋白(SMA)、纤连蛋白和结缔组织生长因子(CTGF)表达降低。在他莫昔芬治疗动物的UUO肾脏中,Src、PI3K、Akt、雷帕霉素靶蛋白(mTOR)和p70核糖体蛋白S6激酶(p70S6K)的磷酸化显著降低。他莫昔芬剂量依赖性地抑制TGF-β1诱导的HK-2细胞中α-SMA和CTGF的表达以及Src、PI3K、Akt、mTOR和p70S6K的磷酸化。ICI处理和ER-α沉默逆转了这些抗纤维化作用。此外,在与PP1(一种Src激酶抑制剂)和他莫昔芬共同处理的HK-2细胞中观察到PI3K/Akt和mTOR/p70S6K信号通路的抑制。
他莫昔芬的抗纤维化作用与通过ER-α抑制Src激酶功能有关,随后抑制PI3K/Akt和mTOR/p70S6K信号通路。
我们的研究结果表明,他莫昔芬是预防和治疗肾纤维化的一种新的治疗选择。