Division of Nephrology.
Departments of Medicine and.
J Am Soc Nephrol. 2019 Oct;30(10):1925-1938. doi: 10.1681/ASN.2019020111. Epub 2019 Jul 23.
Polarized macrophage populations can orchestrate both inflammation of the kidney and tissue repair during CKD. Proinflammatory M1 macrophages initiate kidney injury, but mechanisms through which persistent M1-dependent kidney damage culminates in fibrosis require elucidation. Krüppel-like factor 4 (KLF4), a zinc-finger transcription factor that suppresses inflammatory signals, is an essential regulator of macrophage polarization in adipose tissues, but the effect of myeloid KLF4 on CKD progression is unknown.
We used conditional mutant mice lacking KLF4 or TNF (KLF4's downstream effector) selectively in myeloid cells to investigate macrophage KLF4's role in modulating CKD progression in two models of CKD that feature robust macrophage accumulation, nephrotoxic serum nephritis, and unilateral ureteral obstruction.
In these murine CKD models, KLF4 deficiency in macrophages infiltrating the kidney augmented their M1 polarization and exacerbated glomerular matrix deposition and tubular epithelial damage. During the induced injury in these models, macrophage-specific KLF4 deletion also exacerbated kidney fibrosis, with increased levels of collagen 1 and -smooth muscle actin in the injured kidney. CD11bLy6C myeloid cells isolated from injured kidneys expressed higher levels of TNF mRNA versus wild-type controls. In turn, mice bearing macrophage-specific deletion of TNF exhibited decreased glomerular and tubular damage and attenuated kidney fibrosis in the models. Moreover, treatment with the TNF receptor-1 inhibitor R-7050 during nephrotoxic serum nephritis reduced damage, fibrosis, and necroptosis in wild-type mice and mice with KLF4-deficient macrophages, and abrogated the differences between the two groups in these parameters.
These data indicate that macrophage KLF4 ameliorates CKD by mitigating TNF-dependent injury and fibrosis.
极化的巨噬细胞群体可以协调 CKD 期间肾脏的炎症和组织修复。促炎 M1 巨噬细胞引发肾脏损伤,但持续的 M1 依赖性肾脏损伤导致纤维化的机制仍需阐明。Krüppel 样因子 4(KLF4)是一种锌指转录因子,可抑制炎症信号,是脂肪组织中巨噬细胞极化的重要调节因子,但髓系 KLF4 对 CKD 进展的影响尚不清楚。
我们使用条件性突变小鼠,选择性地在髓系细胞中缺乏 KLF4 或 TNF(KLF4 的下游效应物),以研究巨噬细胞 KLF4 在两种具有丰富巨噬细胞积累的 CKD 模型中调节 CKD 进展中的作用,这两种模型是肾病综合征和单侧输尿管梗阻。
在这些小鼠 CKD 模型中,肾脏浸润的巨噬细胞中 KLF4 的缺失增强了它们的 M1 极化,并加剧了肾小球基质沉积和肾小管上皮损伤。在这些模型的诱导损伤期间,巨噬细胞特异性 KLF4 缺失也加剧了肾脏纤维化,损伤肾脏中胶原 1 和 -平滑肌肌动蛋白的水平增加。与野生型对照相比,从损伤肾脏中分离出的 CD11bLy6C 髓样细胞表达更高水平的 TNF mRNA。反过来,巨噬细胞特异性缺失 TNF 的小鼠在这些模型中表现出较低的肾小球和肾小管损伤以及减弱的肾脏纤维化。此外,在肾病综合征中使用 TNF 受体-1 抑制剂 R-7050 治疗可降低野生型小鼠和 KLF4 缺陷巨噬细胞小鼠的损伤、纤维化和坏死性凋亡,并消除两组在这些参数上的差异。
这些数据表明,巨噬细胞 KLF4 通过减轻 TNF 依赖性损伤和纤维化来改善 CKD。